KEGEL EXERCISES
Pelvic muscle exercises, also called Kegel (kay-gull) exercises after Dr. Arnold Kegel, who developed them, strengthen the pelvic floor muscles. The actual name of the exact muscles are the 'pubococcygeus' muscles. These muscles contract and relax under your command to control the opening and closing of your urethral sphincters, or the muscles that give you urinary control. When they are weak, urine leakage results. However, through regular exercise, you may be able to build up their strength and endurance and, in many cases, regain bladder control.
 

Post Radical Prostatectomy Anatomy

Begin by locating the muscles to be exercised:
1. As you begin urinating, try to stop or slow the urine without tensing the muscles of your legs, buttocks, or abdomen. It is very important not to use these other muscles, because only the pelvic floor muscles help with bladder control.
2. When you are able to slow or stop the stream of urine, you have located the correct muscles. Feel the sensation of the muscles pulling inward and upward.

Helpful hint: Squeeze in the rectal area to tighten the anus as if trying not to pass gas. You will be using the correct muscles.
Now you are ready to exercise regularly:

1. When you have located the correct muscles, set aside two times each day for exercising: morning and evening .

Set # 1 Quick Contractions (QC) Tighten and relax the sphincter muscles as rapidly as you can.

Set # 2 Slow Contractions (SC) Contract the sphincter muscle and hold to a count of 3, (gradually increasing to 10 seconds per exercise daily) then RELAX completely before the next contraction.
In the beginning, check yourself frequently by looking in the mirror or by placing a hand on your abdomen and buttocks to ensure that you do not feel your belly, thigh, or buttock muscles move. If there is movement, continue to experiment until you have isolated just the muscles of the pelvic floor.
Your bladder control should begin to improve in 3 to 6 weeks. If you keep a record of urine leakage each day, you should begin to notice fewer marks in the bladder leakage column.

The notation
5 QC, 10 3 sec SC, 5 QC means 5 quick contractions, then 10 3 sec slow contractions, then 5 quick contractions. The 3 sec slow contraction means holding the contraction for 3 seconds.)
20 QC, 25 10 sec SC, 20 QC means 20 quick contractions, then 25 10 sec slow contractions, then 20 quick contractions.
KEGEL EXERCISES CONTINUED........

Make pelvic muscle exercises a part of your daily routine: Whether you are doing pelvic muscle exercises to improve or maintain bladder control, you must do them regularly on a lifetime basis. Use daily routines such as watching TV, reading, stopping at traffic lights, and waiting in the grocery checkout line as cues to perform a few exercises.

These 10 healthy habits will help improve your bladder control:

1. Use the toilet regularly and make toilet facilities convenient, which may mean a bedside commode, bedpan or urinal placed near the bed.
2. Wear clothes that are easy to remove when it is time to use the toilet.
3. Train your bladder. Use a clock to schedule times to toilet. Every hour, then every 1 1/2 hours, etc. until you achieve a satisfactory schedule. Avoid frequent trips to the toilet "just in case."
4. Remain at the toilet until you feel your bladder is empty. Don't rush. If you feel there is still some urine in the bladder, move around or stand up if you were sitting, sit back down, and lean forward slightly over the knees.
5. Empty your bladder before you start on a trip of an hour or more. Don't try to wait until you get home or until it's more convenient.
6. Learn to squeeze before you sneeze --and before you cough, laugh, get out of a chair, or pick up something heavy.
7. Establish regular bowel habits. Constipation affects bladder control.
8. Consider avoiding foods that are known to affect the bladder, such as tomatoes, chocolate, spicy foods, and beverages, including alcohol and those containing caffeine. These make the bladder more irritable and therefore increase incontinence.
9. Watch your weight. Obesity makes bladder control more difficult. Ask your regular doctor about a sensible diet if you are overweight.
10. Stop smoking. Smoking is irritating to the bladder, and a smoker's cough may cause bladder leakage.

When you have the urge to urinate try the following:
Stop what you doing and sit down or stand still and remain quiet. Relax you body by taking a few deep breaths.
Do some quick Kegel squeezes (pelvic floor excercises) quickly 3 or 4 times without relaxing.
Concentrate hard on suppressing the urge to urinate and wait until the urge passes or subsides.
Once the urge has subsided, walk at a regular pace to the bathroom. Don't run. Continue to do the Kegel squeezes as you walk.

You can also get more information from the National Association for Continence at 1-800-BLADDER or www.nafc.org. Address: PO Box 8310 Spartanburg, SC 29305-8310
Request their Male Pelvic Muscle Training Kit

KEGEL EXCERCISE CHART

FOR EXAMPLE: DURING WEEK 1, DO 5 QUICK CONTRACTIONS, 10 SLOW CONTRACTIONS TO A COUNT OF 3, AND 5 QUICK CONTRACTIONS

Week 1 Week 5
5 QC, 10 3 sec SC, 5 QC 20 QC, 25 10 sec SC, 20 QC
Date DAY AM PM Date Day AM PM
____ MON ___ ___ ____ MON ___ ___
____ TUES ___ ___ ____ TUES ___ ___
____ WED ___ ___ ____ WED ___ ___
____ THURS ___ ___ ____ THUR ___ ___
____ FRI ___ ___ ____ FRI ___ ___
____ SAT ___ ___ ____ SAT ___ ___
____ SUN ___ ___ ____ SUN ___ ___


WEEK 2 WEEK 6
10 QC, 15 4 sec SC, 10 QC 30 QC, 30 10 sec SC, 30 QC
Date Day AM PM Date Day AM PM
____ MON ___ ___ ____ MON ___ ___
____ TUES ___ ___ ____ TUES ___ ___
____ WED ___ ___ ____ WED ___ ___
____ THUR ___ ___ ____ THUR ___ ___
____ FRI ___ ___ ____ FRI ___ ___
____ SAT ___ ___ ____ SAT ___ ___
____ SUN ___ ___ ____ SUN ___ ___

WEEK 3 WEEK 7
15 QC, 20 5 sec SC, 15 QC 40 QC, 40 10 sec SC, 40 QC
Date Day AM PM Date Day AM PM
____ MON ___ ___ ____ MON ___ ___
____ TUES ___ ___ ____ TUES ___ ___
____ WED ___ __ ____ WED ___ ___
____ THUR ___ ___ ____ THUR ___ ___
____ FRI ___ ___ ____ FRI ___ ___
____ SAT ___ ___ ____ SAT ___ ___
____ SUN ___ ___ ____ SUN ___ ___

WEEK 4 Week 8
15 QC, 20 10sec SC, 15 QC 50 QC, 50 10 sec SC, 50QC
Date Day AM PM Date Day AM PM
____ MON ___ ___ ____ MON ___ ___
____ TUES ___ ___ ____ TUES ___ ___
____ WED ___ ___ ____ WED ___ ___
____ THUR ___ ___ ____ THUR ___ ___
____ FRI ___ ___ ____ FRI ___ ___
____ SAT ___ ___ ____ SAT ___ ___
____ SUN ___ ___ ____ SUN ___ ___

CONTINUE AT RATE OF 50, MAY INCREASE MORE IF DESIRED. THE TOTAL NUMBER CAN BE DIVIDED UP OVER THE COURSE OF THE ENTIRE DAY.