Posts Tagged ‘radical prostatectomy’

Penile “Prehab” (Pre-habilitation)

January 2, 2021

Andrew Siegel MD   1/2/2021 HAPPY NEW YEAR!

NEW YEAR’S PROMOTIONAL FREE BOOK SPECIAL: Starting today and continuing for 5 days my book: MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health will be available for free on Amazon Kindle. This book will help you achieve a strong, powerful and fit pelvic floor, instrumental to the pre-hab process of preparing for prostate surgery. Additionally, this book will teach you everything you need to know about your favorite organ and the mysterious muscles that govern its function. Exercising and training these muscles is useful not only for prostate surgery pre-hab purposes, but also for helping men to deal with or prevent erectile dysfunction, ejaculation issues, urinary control problems (stress incontinence, overactive bladder, post-void dribbling) and bowel issues.

NY Times article that references the Male Pelvic Fitness book.

PREHAB

Prehab is a preemptive strategy that helps one prepare for possible side effects of prostatectomy during the time interval between the establishment of the cancer diagnosis and the performance of the prostatectomy. This “proactive” as opposed to “reactive” approach can help prevent or minimize the occurrence of erectile and urinary control issues.

After the diagnosis of prostate cancer is made, there are usually several weeks prior to the scheduled surgery. While this is obviously an emotionally fraught time, it can be put to good use by preparing for the surgery so as to help prevent side effects. Aside from the physical benefits of pre-hab, it can also have a meaningful psychological and emotional impact, enabling and empowering one to take an active role in readying for surgery as well as facilitating recovery in the post-operative period.

Prehab includes pelvic floor muscle training (Man Kegels) and healthy lifestyle measures including a nutritious diet, weight management, regular general exercise and the cessation of tobacco usage. Pelvic floor muscle training increases the strength, power and endurance of the pelvic floor muscles that contribute to urinary control and erectile rigidity. Numerous clinical studies have demonstrated the benefits of pelvic floor muscle training after prostate surgery in decreasing the duration and severity of urinary control and sexual issues.  Mastering pelvic floor muscle exercises prior to surgery confers the advantage of going into surgery with a fit and optimized pelvic floor, as well as learning the exercises under ideal circumstances that will result in the effortless resumption of the exercises in the post-operative period.

Excellent 2-minute 3-D animation of the male pelvic floor muscles from the Continence Foundation of Australia.

As the most expedient means of achieving pelvic strengthening, I highly recommend the following exercise programs (disclaimer: I am co-creator of this program that I felt was strongly needed, as no adequate source for pre- and post-surgery male pelvic floor training exercises existed): PelvicRx. Well-designed and easy to use, it is a follow-along and interactive pelvic training DVD that offers strengthening and endurance pelvic floor exercises. It provides education, guidance, training and feedback to confirm the engagement of the proper muscles and is structured so that repetitions, contraction intensity and contraction duration are gradually increased over the course of the program. This progression is the key to optimizing pelvic strength and endurance. If you would prefer the streaming version with digital access, it can be obtained at Private Gym.

Bottom Line: In the words of Benjamin Franklin: “Failure to prepare is preparing to fail.”   Being proactive instead of reactive and pursuing pre-hab is smart, prudent and a beneficial means of preparing for surgery.  

Man Kegels Part 1 blog

Man Kegels Part 2 blog

Wishing you the best of health,

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.  His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families. 

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Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

PROSTATE CANCER 20/20 is now available at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

Video on THE KEGEL FIX