Doctor not recommending kegels

[SmasherOfAjumma]

Getting ready for my RALP surgery. My doctor does not recommend doing kegel exercises prior to the surgery. He says it is going to feel very different after the surgery, and does not want me to become accustomed to how it feels now. He says he has consulted with physical therapists on this. He is quite experienced and recommended, but this advice is contrary to what I'm reading online. What do you all think?

[cesces]

If you are talking about a few weeks, doesn't seem like it should have enough time to help anyway.

[Travelinman]

Hello Smasher. I've read a lot of wonderful advice on this website since being diagnosed with prostate cancer in mid-2015. While it's not all correct, it's been mostly on point over the years, especially the advice provided by Tall Allen. I haven't written often because there's quite frankly not a lot for me to add. However, I'm disgusted by the advice that your doctor has provided. And that's why I'm replying now.

Following a high PSA test, but prior to my initial cancer diagnosis, I had already reviewed a huge number of medical articles and case studies on sex and continence following prostate cancer treatment. I then began kegels 6 months "prior to" my first treatment (to get the hang of things) and then, a few months before treatment, began working with the one of the top experts on penile recovery from prostate cancer treatment in the world, Dr. John Mulhall, still "prior" to my treatment. He started me on sildenafil at that time. Since then, and following a biological recurrence, I added a second highly regarded penis specialist. And, I can tell you this: seven years after my prostatectomy and more than a year after salvage radiation, I can still control my continence "and" have rock hard erections with sildenafil. I attribute this to (1) having had the wherewithal and (fortunately) flexible health insurance to find the best doctors for treatment (a top surgeon and radiation oncologist -- Dr. Ash Tewari and Dr. Michael Zelefsky, respectively), (2) having been fortunate that the treatments have gone well "so far, anyway," (3) and having done kegels prior to and all throughout the period beginning in mid-2015 (except for a very, very brief stoppage while I had a catheter following my initial prostatectomy).

There are "many" reasons why kegels may not work for you. But, number one, always get a second and even third opinion regarding your treatment, if you haven't done so already. Number two, visit one or two penis specialists beforehand (ASAP because the wait for appointments and the travel to such a specialist can be very long). And three, regardless of whether the kegels ultimately work, when it comes to these exercises, your doctor is a moron. It's not a matter of being disappointed by whether the kegels work as well as they did before treatment. It's about building up your muscles, confidence and understanding of what you're doing beforehand. Sure, they likely won't work as well (or even nearly as well or even at all) as before. But, you will be stronger going into treatment, have an idea of your baseline, and be ready to continue the fight regardless.

One other thing: when I started kegels, months before my treatment in 2015, I felt that my erections had been declining for awhile -- a particularly bad omen heading into my prostatectomy. Well, they came back to life prior to treatment, and I was ready. And ... I can totally control my continence -- if I don't drink more than a bottle of wine or eat a lot of gassy foods. So, you go all out. You be ready too. And, give it your best shot!

[Tony666]

I think about 95% of docs recommend kegals before prostatectomy. Can it be proven without doubt? Probably not. But there is no harm and it doesn’t take much time so why not? In my case, I did 80 kegals a day for six months before surgery. . I was fully continent 6 weeks after surgery.

other things that can help:

- a pd-5 inhibitor daily a few months before and after surgery (to help on Ed)

- excercises to strengthen core (like planks) before and after surgery

- walking after surgery

- arm swinging to increase circulation (also called ping shui)