When to start doing Kegel exercises for the best effect after surgery

For many years now, The “New” Prostate Cancer InfoLink has argued (on the basis of no good data at all) that starting to do Kegel exercises prior to having surgery for prostate cancer was likely to be able to accelerate recovery of good continence after one’s surgery. The premise was a pretty simple one. If your muscles get trained to do Kegel exercises (properly known as pelvic floor muscle exercises or PFMEs) before surgery, it should be easier to relearn how to do the exercises again after the surgery. … And we are pleased to see that maybe we have been right all of this time!

In a report by Chang et al. in European Urology, the authors provide consolidated results from a meta-analysis of 11 relevant studies and 739 patients who underwent radical prostatectomy.

Here is a summary of the study’s key findings:

  • 11 relevant published studies met the study selection criteria.
  • 7/11 studies included sufficient quantitative data on postoperative incontinence and were available for meta-analysis.
  • At 1 month of follow-up post-surgery, there was no significant difference in continence rates between patients who started PFMEs before surgery and those who only started after their surgery (odds ratio [OR] = 0.68).
  • At 3 months of follow-up post-surgery, there was a significant, 36 percent improvement in continence rates between the patients who started PFMEs before surgery compared to those who started after their surgery (OR = 0.64).
  • At 6 months of follow-up post surgery there was, again, no difference, there was, again, no significant difference between the two groups groups (OR = 0.60)
  • In 4/7 studies there was a significant improvement in quality of life measures at 3 months of follow-up between the preoperative PFME group and the post-operative PFME group.
  • In 2/7 studies there was still a signifcicant improvement in quality of life measures at 6 months of follow-up.

Chang et al. conclude that:

Preoperative PFME improves postoperative urinary incontinence after radical prostatectomy at 3 mo[nths] but not at 6 mo[nths], suggesting it improves early continence but not long-term continence rates.

The difference documented in this study is not dramatic. However, we are very conscious that continence is a critically important factor for many men immediately after their surgery. Early recovery of continence gives a man confidence in his surgical recovery and an important sense of control over his daily life. IT may also help him to get back to work — or just his daily routine if he is retired — sooner rather than later.

One Response

  1. I have advocated beginning Kegel exercises pre-treatment for several years in my papers on the subject of incontinence:

    Practices Important to Begin Prior to and Continuing Beyond Surgical Removal of the Prostate Gland or Radiation Therapy to the Prostate Gland

    Kegel Exercises

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