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Thread: Mayo Kegel Instructions

  1. #1
    Moderator Top User HighlanderCFH's Avatar
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    Mayo Kegel Instructions

    Quote Originally Posted by HighlanderCFH View Post
    Yup, several guys have mentioned that their incontinence is greatly improved after reducing the number of Kegels.

    At Mayo, they told me to do just one set (of 7) per day, best done at bedtime, also sitting on a toilet. I told them I do my set in bed before turning out the light and they said this is fine.

    They also advised me to continue doing the Kegels for the rest of my life because the sphincter muscle tends to grow weaker as we age -- and the single set a day will hopefully help prevent that from happening.
    I'm currently starting my packing for Saturday morning when my Mother & I make our annual drive to Mayo for our general physicals, and for my 3rd annual post-op PSA check.

    In the meantime, I happened to come across the single sheet Kegel instructions that Mayo gave to me after my surgery.

    So I scanned it and am attaching it to this post. I had to scan it in color because the doctor had used a highlighter on the specific instructions to perform the actual exercise.

    I hope this is of great benefit to anyone having problems after surgery -- and those anticipating surgery in the future.

    Good luck!
    Chuck
    Attached Images Attached Images
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  2. #2
    Chuck, obviously these work well for you. I find it surprising as when you eliminate the rest periods, you are doing slightly more than 1 minute of exercise/day (7x10 sec). However in your case, if it isn't broke, don't fix it.
    I am sure I need to reduce my schedule so I am giving my new ones (standing) 30 more days to show results, if not I will switch to yours.
    Allen

  3. #3
    Moderator Top User HighlanderCFH's Avatar
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    Good luck, Allen. Here's hoping that one of these two methods will work for you.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  4. #4
    Does anyone know what the recommendation for Kegels is, pre-surgey? I've been doing 2-3 sets of 10, holding for 10 seconds, each day.
    Diagnosed at age 64 (in November, 2014), PSA 4.3
    Nov 2014 BX 3 of 12 cores positive original pathology G8. Johns Hopkins second opinion, G6
    Surgery with Dr Ash Tewari Jan 6, 2015
    Post surgical pathology, stage T2c, bilateral disease, upstaged to G7(3+4)
    5% of Prostate involved in Tumor. Organ confined, Margins, SV, lymph nodes (9) all negative, PNI positive
    PSA <.02 until (uh-oh), 2/17 .02. Then 5/17-.033, 8/17-.033, 11/17-.046, 4/18-.060, 6/18-.068, 7/18- .082, 8/18-. 078.
    Decipher score low risk, .37
    ADT/Firmagon started August 2018. SRT to start SEPT 2018. Finished SRT November 2018, Finished ADT Feb 2019
    T=7, PSA <.05

  5. #5
    Moderator Top User HighlanderCFH's Avatar
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    Howdy,

    I know that some guys do lots of them to build up, etc. But I asked my surgeon at Mayo about this before I scheduled the surgery and he told me it would make no difference. So I did not start doing them until sometime after the catheter was removed after surgery.

    However, it does not hurt at all to do general conditioning exercises to be in better overall condition before the surgery. But any kegels, pre-op, apparently do not matter at all.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  6. #6
    Thanks Chuck. I've been doing about 3-3 1/2 miles a day 5 days a week, of walking, and also doing planks to strengthen my abs, hoping it helps to a quicker recovery.

    My surgeon said I should do the Kegels, so I guess I will continue, since it can't hurt. I suppose pre surgery Kegels are like everything else PC related - lots of different opinions, even among the top doctors.
    Diagnosed at age 64 (in November, 2014), PSA 4.3
    Nov 2014 BX 3 of 12 cores positive original pathology G8. Johns Hopkins second opinion, G6
    Surgery with Dr Ash Tewari Jan 6, 2015
    Post surgical pathology, stage T2c, bilateral disease, upstaged to G7(3+4)
    5% of Prostate involved in Tumor. Organ confined, Margins, SV, lymph nodes (9) all negative, PNI positive
    PSA <.02 until (uh-oh), 2/17 .02. Then 5/17-.033, 8/17-.033, 11/17-.046, 4/18-.060, 6/18-.068, 7/18- .082, 8/18-. 078.
    Decipher score low risk, .37
    ADT/Firmagon started August 2018. SRT to start SEPT 2018. Finished SRT November 2018, Finished ADT Feb 2019
    T=7, PSA <.05

  7. #7
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
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    That is true. Even though I let everyone know about Mayo's instructions, I also caution them to not violate whatever personal instructions they have received from their own doctor. So I think you are correct in continuing to do the pre-op kegels.

    I personally jog about 8 miles a day (1 full hour) and did this right up to my surgery. It does help in post-op recovery because the better shape you are in pre-op leaves you in a better situation afterward.

    Keep up the good work!
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  8. #8
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
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    Hi all,

    I've come to realize that not everyone is able to download the link to the copy of the Kegel instruction sheet I received from Mayo Clinic. So I have typed them out word for word, down below, so everyone has a chance to read them. I don't recommend violating your own doctors' instructions. But, if you are still having problems after doing tons of Kegels, consider trying the Mayo way as pasted down below.

    Good luck -- and may all your future leaks be restricted to your garden hoses!
    Chuck

    MAYO CLINIC PATIENT EDUCATION

    EXERCISE FOR MEN WITH URINARY LEAKAGE

    The following exercise may help you regain bladder control if you are leaking urine. Urinary leakage is often due to weak muscles. This sometimes occurs following prostate surgery. Exercise can improve muscle condition and tone, allowing you greater control over your bladder.

    You will exercise two groups of muscles:
    1. THE MUSCLES THAT STOP A BOWEL MOVEMENT -- This is the group of muscles you tighten when you suddenly want to stop a bowel movement or hold back gas in the rectum.
    2. THE MUSCLES AT THE BASE OF THE PENIS -- This is the group of muscles you use to expel the final drops of urine at the end of urination or to ejaculate semen.

    Perform the exercise according to the following directions:
    1. Tighten the muscles you use to stop a bowel movement.
    2. Then, while tightening these muscles, tighten muscles at the base of the penis (you may feel your penis pull in slightly toward your body).
    3. Hold both sets of muscles as tight as possible for a count of "10."
    4. Relax muscles and rest for one minute.
    5. Repeat exercise six times.

    General Information
    * Perform this exercise before going to bed. This allows your muscles to rest while you sleep.
    * Perform this exercise once each day. If you overexercise, your muscles may become tired, and you may experience more leakage.
    * It is recommended that you do this exercise while sitting on a toilet seat.
    * Holding these muscles tight while rising from a sitting position or while lifting can help prevent urinary leakage.

    ONCE YOU ACHIEVE URINARY CONTROL, CONTINUE TO PERFORM THIS EXERCISE TO KEEP YOUR MUSCLES IN GOOD CONDITION.

    The urethra may narrow after prostate surgery. Contact your physician if you notice that your urine stream has decreased in size and force when urinating with a full bladder during the day.
    Last edited by HighlanderCFH; 03-17-2015 at 06:37 AM.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  9. #9
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
    Posts
    7,214
    Here is a link, suggested by Ray61, that provides great info about incontinence. Since this sticky basically deals with incontinence, I thought I'd paste the link here with admin approval.

    http://www.continence.nz/pages/Conti...d-Prostate/37/
    Last edited by HighlanderCFH; 05-17-2015 at 10:15 PM.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  10. #10
    Newbie New User
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    "...it does not hurt at all to do general conditioning exercises to be in better overall condition before the surgery. But any kegels, pre-op, apparently do not matter at all. "

    Hey Chuck,

    It seems counterintuitive to me that it would make no difference doing kegels before surgery. Isn't this essentially just strengthening urinary muscles? Wouldn't having stronger urinary muscles prior surgery equal the same post surgery?

    Do you recall the reasoning your surgeon had that kegels are not of value pre-surgery?

    I ask this because I don't even have my surgery scheduled but I've been religiously doing these to prepare.
    DOB 1958

    PSA

    03/09 3.39
    09/10 3.82
    12/11 4.12
    09/13 4.10
    08/14 4.48
    08/15 5.06

    DRE not detectable

    10/15 MRI anomalies observed

    11/15 Bioposy
    3 of 16
    1) Right 3+3=6 <5%
    2) Lesion 3+3=6 <5%
    3) Lesion 3+4=7 10%

 

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