Kegel exercises are special exercises designed to help you control urine flow after your surgery. Sometimes after surgery, men have trouble controlling their urine flow and often leak or drip urine. It is normally recommended that men start Kegel exercises as soon as the catheter is removed. They should not be carried out while the catheter is in. Many men find that doing these exercises allows them to reduce urine leakage more quickly after removal of their catheter

Why do Kegel exercises work?

During surgery, the internal sphincter muscle at the neck of the bladder is often damaged and in some cases destroyed. In the normal male, it is this sphincter muscle which plays the most important role in controlling urine flow. If this sphincter muscle is damaged, urine leakage will often occur. However, men also have a second sphincter close to the bottom of the prostate. In time, this sphincter can take over some of the control that is lost when the other sphincter is damaged, but this second sphincter is usually not strong enough at first., Kegel exercises can be used to strengthen the muscle group (the pelvic floor muscles) that controls this second sphincter. Improving the muscle tone of the pelvic floor muscles can be of great help in regaining urinary control. Not only do the pelvic floor muscles control the second sphincter, they also support the bladder and keep it from sagging. By strengthening the pelvic floor muscles through Kegel exercises, many men are able to slow or stop urine leakage.

Are Kegel exercises difficult?

Kegel exercises are fast. They take just 5 to 8 minutes maximum, once or twice a day. Kegel exercises are convenient. You can do Kegels while lying down sitting, standing, watching TV or reading the newspaper. In fact, you can do them at almost any time except when you're engaged in moderate to vigorous physical activity. Kegel exercises are completely invisible to others. Nobody, not even someone sitting squashed next to you on a narrow bench, can tell if you are doing Kegel exercises at that moment. If they are done correctly, your pulse rate and breathing remain perfectly normal and your body remains relaxed.

How do I do Kegel exercises?

Step I - identify the pelvic floor muscles The pelvic floor muscles are the muscles you would squeeze shut to stop urinating in mid- stream, to hold back a bowel movement, or to stop your urologist from doing a rectal exam.

Step 2 - perform Kegel exercises There are actually two kinds of Kegel exercises: long and short. Each kind is described below. When you practice Kegel exercises, you will first do the long exercise, followed by the short exercise.

To do the long Kegel exercise:

1. Squeeze your pelvic floor muscles shut as tightly as you can and hold them shut for as long as you can up to a maximum of 10 seconds. Don't hold for more than 10 seconds - longer is not better.
2. Relax your pelvic floor muscles completely for 10 seconds. Make sure you relax them for at least 10 seconds, never less than 10 seconds.
3. Squeezing once then relaxing once is called a cycle. You should try to do as many cycles as you can, up to 15. After doing 15 cycles, relax for a full 30 seconds. You have just done the long exercise.

After doing the long exercise, you should then perform the short Kegel exercise.

To do the short Kegel exercises:

1. Squeeze and hold for 1 second, then relax completely for 1second.
2. Repeat squeezing then relaxing a total of 5 times.
3. Relax completely for 10 seconds.
4. Repeat the above (i.e., 5 squeezes and relaxes followed by 10 seconds of rest) another 3 or 4 times. You have just done the short exercises.

Once you have practiced a few times, it should take you about 8 minutes to do the long and the short Kegel exercises.

When you first begin to do Kegels you may find that you can't squeeze for more than a second or two, or you can't keep it tight because the muscles just don't have enough strength. Don't be discouraged and don't worry. This is typical. If you find that your muscles have become fatigued, and you just can't squeeze them tight, then stop. You've done enough exercises for that session. It is better to do fewer cycles, each with good form and tight control, than it is to do more cycles with poor form and weak control. As you practice daily, your muscles will gradually develop more and more strength. Eventually, after a few weeks or months of careful practice, you will be able to squeeze the pelvic floor muscles tightly for a full 10 seconds during the long exercises.

How often should I do the exercises?

You should try to do a complete exercise session (one long and one short exercise) twice a day: once first thing in the morning and then again later in the day or in the early evening, If you wait until too late in the evening to do the second exercise session, you may find that your pelvic floor muscles are too tired from the days other activities. If this happens, you will need to skip the second session that day. Try to have regular exercise sessions, but don't worry if you miss a session from time to time.

How will I know if I am doing the exercises correctly?

If you are holding your breath or squeezing any other muscles, then you are not doing the exercises correctly. Try talking to yourself out loud while you exercise. If you can talk normally and comfortably, then you are probably doing the exercises correctly. Remember, the pelvic floor muscles are the only muscles that should be squeezed during the Kegel exercises. If you find yourself squeezing or stretching any other muscles - in the stomach, lower abdomen, hips, thighs, or elsewhere - you will not benefit from the exercises.

When can I stop the exercises?

Once you have eliminated urine leakage or appear to have reached a permanent level of control, you can ease back on the frequency of exercise. However, you should not stop completely, you should gradually decrease the frequency of exercise from twice a day to once a day. If no control is lost, reduce to twice or once a week. By continuing the Kegel exercises once a week, you help to ensure good muscle tone of the pelvic floor muscles.

This information was conducted in affiliation with the Walther Cancer Institute, Indianapolis, IN