Male incontinence

[thabiso]

Hi guys,

Please advise on physiotherapy management for male patients with urinary incontinence secondary to transurethral resection of the prostrate. Or any literature I could have a look at.

Many thanks

Thabiso

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[emad]

Hello Thabiso,

Really mysterious to work with incontinence both male and female. I have NOT worked with that problem. If I were you, I would search for anatomy of the muscles performing that function, then training these functions (motions).

Hope, others here provide input .

Cheers
Emad

[wutti]

hi there, you should start with pelvic floor strenghtening. there are a lot of exercises. also strengthening of the abdominal muscles and all surrounding hip muscles might be indicated. I did a study about whole body vibration and it seems to influence the urodynamics positivley as well. so if you have access to vibration therapy advice use them as an additive treatment.
good luck. cheers

[thabiso]

Hi wutti. I think I need more info on 'whole body vibration' or a summary of the study.

[wutti]

hi basically the vibration therapy is based on the myostatic stretching reflex which means that you have muscle contraction and relaxation all the time during vibration. it works unconcious so you cant influence it. i did my study on animals and we checked the bone mineral density and changes of pressure in the bladder and urinate trackt.
it was all positivley influenced by VT or better known under whole body vibration WBV. Currently we are performing a study in osteoporosis patients and the changes of koordination and stability in daily life with WBV as an additive treatment.
i am using it as well as additive strengthening and stability training and it works out pretty well. so give it a try, its not the only way but a nice additive.
cheers

[shabs5050]

Hi guys,

Please advise on physiotherapy management for male patients with urinary incontinence secondary to transurethral resection of the prostrate. Or any literature I could have a look at.

Many thanks

Thabiso

Teach him Kegel's exs for men.Check youtube videos for the same.
If you are trained in internal examination then you can do an anal check of the pelvic floor muscle strength, and then proceed with elctrical stim if necessary, followed with Kegels.

[Crystal R. Westergard]

i agree, the best practice for the patient is to see a physio trained in internal examiniation. Some essential parts of the continence mechanism is cut during this surgery. Cana da and the USA have specific courses that physios take to be trained to treat post prostate surgery.
Crystal

[Agostino]

i agree, the best practice for the patient is to see a physio trained in internal examiniation. Some essential parts of the continence mechanism is cut during this surgery. Cana da and the USA have specific courses that physios take to be trained to treat post prostate surgery.
Crystal

I agree, it's very important to find a RIGHT physio!! In Italy I have treated these type of problems and I think that the Kegel's exercises are very useful to improve the correct pelvic muscles' neuro-muscular control (it's also important strengthen the abdominal muscle but be careful to the activation, it has been right coordinated with the pelvic floor muscles).

Most likely this patient has also a urge incontinence (due to a bad adaptation of the bladder's muscle) and to treat this problem the best actually approach is the endo-anal electrical stimulation (the magnetic chair or body-vibration could be used such as a "maintenance").

At home the patient could use the "Stoller's technique" but he needs of a electrical stimulator.


Best regards
Agostino

P.S.: sorry for my english