Pelvic Floor Exercises Specifically For Men

Pelvic Floor Exercises Specifically For Men

Pelvic Floor Exercises Specifically For Men

A guest blog written by Michelle Herbst, PT

As a physical therapist specializing in pelvic floor rehabilitation we are referred to as women’s health physical therapists. But, this a little of a misnomer as men have pelvic floors and can have concerns too. In my experience, men participating in pelvic floor rehabilitation make the best patients. They are engaged, compliant and determined to positively affect their condition.  

Kegels for Men:

Kegels for men can help with erectile dysfunction and urinary and fecal incontinence. They are most effective when performed in a consistent, specific manner and progressed slowly over time. Here are a few ideas and tips for men to consider when performing kegels.

A kegel is a contraction of the pelvic floor muscles. It feels like a gentle pulling up and in of the pelvic floor followed by a relaxation of the entire muscle group. The kegel contraction begins with a slight lift of the tail bone moving forward as a gentle tightening of the muscles between and tail bone and pubic bone. Lastly, the lower abdominals contract slightly. Then the muscles gently release or relax. There may be a feeling of a reversal of the contraction sequence.

There is no need for weights as our body weight and gravity provide resistance. The contraction is a sub-maximal in effort. If kegels are performed too hard and too fast the result may be muscle soreness and aggravation of symptoms. Performing a submaximal contraction is key and mild muscle soreness may be expected.

Avoid breath holding when kegeling. Repetitive contraction of the pelvic floor while holding the breath could aggravate prior back injuries or make pelvic floor symptoms worse. Normal breathing is the standard when kegeling. Your face should not be turning red. After normal breathing while kegeling is mastered you can further enhance the kegel during exhalation. A long exhalation during a kegel - such as you would blowing out a candle - can allow you to improve muscle performance. Here, give it a try: gently tighten the pelvic floor – take a deep breath in and slowing exhale like you are blowing out a candle while holding the kegel muscle contraction. Then release.

Kegels should be progressed gradually and can be progressed by increasing the hold time and number of repetitions. For example, when you first begin kegeling, you will want to measure how long you can hold the muscle contraction before the muscles ‘give away’ and release the kegel. If you can hold one kegel for 3 seconds, without breath holding, use that as your benchmark for holding time.  Next, work your way up to 10 contractions of 3-second holds. Repeat another set of 10 later in the day. Eventually you may work up to completing multiple sets of 10, 3 to 5 times per day while advancing the kegel-hold time to 10 seconds. And, please remember to relax between each consecutive kegel to avoid moderate muscle soreness.

Try kegeling in different positions. Use the above suggestions of progressing the kegel hold time and repetition and apply to your place in space. The combined effect of body weight and gravity can increase the resistance and difficulty of the kegel. For example, if you have been performing your kegels while lying down, try to perform them in a seated position, followed by standing and during your daily activities.

Lastly, consistency and patience are key. If you don’t take your medicine you will not get well. Continue to perform your kegels daily while your symptoms are improving and to maintain your gains. Be creative and patient with progressing kegels. Depending on your starting point it may take weeks or months to progress to performing multiple repetitions in functional positions. Do not give up too soon. Kegels - they are not just for women and can greatly improve a man’s overall health and quality of life. Give them a try.

 
Michelle Herbst, PT

Michelle Herbst, PT

 

With Incontinence Treatment, Educating Yourself Is Half The Battle

Millions of Americans experience some form of incontinence.  And, while this condition affects both genders, if you are a woman, you are more likely to suffer from incontinence than men due to things like pregnancy, childbirth, and menopause. 

There are several different types of incontinence you may experience:

  • Stress Urinary Incontinence: SUI occurs when any extra pressure placed on your bladder or abdomen causes you to leak urine. Things like sneezing, laughing, or certain exercise all may trigger SUI.

  • Urge Incontinence: Also known as Overactive Bladder, Urge Incontinence is the sudden, frequent feeling that you need to use the restroom.

  • Mixed Incontinence: Many people suffer from both Stress Urinary Incontinence and Urge Incontinence combined.

  • Urinary Retention: This type of incontinence occurs when you are unable to completely empty your bladder, leading to leaks.

The good news is that all of these conditions are treatable.  And now, more than ever, there are countless options for treatment, so if you haven’t yet found something that works for you, try again!  Here are some popular treatment options:

  • Absorbent products: Probably one of the most widely used treatment options, absorbent products are a good first line treatment for those who experience leaks. There are many different types and fit is very important, so expect to try out a few and see what works best for you. And whatever you do, don’t use sanitary pads in place of absorbent products specifically designed for leaks – the two are made of different materials and sanitary pads are not designed to hold urine, so leaks are likely to occur if you use them for that purpose.

  • Behavioral Therapy: Before trying out medication or other procedures, you may want to tweak some of your behaviors to see if they have any effect. Things like altering your diet to eliminate bladder-irritating foods, starting a physical therapy routine, or practicing bladder retraining can all have an effect on managing your symptoms.

  • Medications: There are a number of medications that may help you with bladder control. Most medications work by calming the bladder and reducing the spasms that sometimes happen and cause leakage. Talk with your doctor about the different types and learn what may work best for you.

  • Non-invasive procedures: If you’ve tried medications and have not seen results, or experienced unwanted side effects, you may want to give a non-invasive procedure a try. InterStim, Botox, and PTNS are all simple procedures that can be administered in a urologist’s office and can have a significant effect on symptoms and quality of life. Talk with your doctor to learn more about these procedures and what you can expect if you choose to go this route.

  • Surgery: Several surgical options exist for those experiencing urinary incontinence. Surgery is often a more permanent solution, and is a common approach for many who have failed on other treatment plans. But, it’s not for everyone, and may not always eliminate all your symptoms. Be sure to talk to your doctor (usually a urological surgeon) about what may work for you and what you can expect after surgery.

Finding the best treatment plan for you requires you to play an active role.  Know your options and educate yourself about the different treatments available so you are better able to discuss them with your physician and make an informed decision together. 

To find a specialist in your area, visit the NAFC Specialist Locator and make an appointment today!


SUI TReatment Tracker

SUI TReatment Tracker

SIGN UP TO RECEIVE THE SUI TREATMENT TRACKER!

Have you started treatment for SUI? Sign up to receive our SUI Treatment Tracker and keep track of your progress! This 6 week program will help keep you on track and will help determine how your treatment is working.


When The “Going Problem” Becomes A Growing Problem

urinary incontinence in men

Concluding his 3-part series on urinary incontinence in men suffering with benign prostatic hyperplasia, Dr. Richard Roach, of Advanced Urology in Oxford, FL, shares the story of a patient who found an alternative to chronic urinary catheter use.  

In my first two posts on the BHEALTH blog, I outlined the link between urinary retention and incontinence in men with benign prostatic hyperplasia (BPH) while highlighting some of the challenges of using indwelling catheters to treat BPH-related symptoms. For many individuals, there are significant drawbacks to long-term catheterization, among them a significantly heightened risk of infection and a variety of lifestyle restrictions. In this, my final post on BPH-related incontinence symptoms, I would like to share a story of one of my patients, and detail how an innovative treatment option transformed his life and ended his reliance on urinary catheters.  

Ray is a 65-year-old man who lives in The Villages, Florida. He was diagnosed with an enlarged prostate when he began experiencing severe BPH symptoms in October 2014. Like many men, he was placed on a Foley catheter, which drained his bladder but also led to discomfort, pain and self-consciousness. For more than six months, continuous use of the Foley catheter severely impacted even the most basic of Ray’s daily activities, and soon a series of urinary tract infections (UTI) led to frequent hospital stays. It was during one of his hospital visits that I was called to treat a UTI.

Ray had a very different future in mind before catheterization interrupted his life. He never envisioned himself spending the rest his days using a catheter; just six months earlier he was an avid golfer with a thriving social life and in relatively good health. Now he was weak, self-conscious about his leg bag and battling one infection after the other. 

During our first meeting he explained that much of his day revolved around catheter care. Ray explained that he was looking for a solution that worked with his lifestyle, not against it. Ray believed he was out of options, but he shared that he wanted just three things:

1.    Restore his continence and ability to naturally urinate

2.    End the recurring urinary tract infections

3.    Resume the daily activities he cherished most

And in Ray’s case, there was a solution. Several weeks after I first examined Ray, we inserted a temporary prostate stent to keep his urethra open and maintain urine flow. Prostatic stents are not yet widely adopted, but I have used them in my practice with great success. Like many patients using a temporary prostate stent with similar physical conditions, Ray immediately saw the benefits: he was able to fill and empty his bladder naturally, he had no more concerns about catheter maintenance, and he resumed nearly all of the daily activities that he couldn’t perform during his period of chronic catheterization. 

“Using the catheter was just not a nice way to live,” Ray told me. “With the stent in place, I felt normal again. Quite simply, I was able to resume my life. I felt healthier physically and mentally, just extremely fortunate to have found an option like the stent to replace the catheter and lead to a more permanent solution to my health problem. The stent saved me from using the Foley for the rest of my life.”

Ray’s case isn’t unique. Men all over the world struggle with incontinence due to BPH and other BPH symptoms. While some patients are not candidates for removal of the catheter, urologists have a wide variety of prostate treatment options. Every chronically catheterized patient should have a discussion with his urologist to understand if a catheter-free lifestyle is possible. 

As we close this series, I encourage all men suffering from symptoms of BPH (incontinence or otherwise) to bear in mind the importance of open dialogue and awareness of alternatives. Find out what treatment options are available to you; ask the right questions and be an informed healthcare consumer. It could make all the difference in the world. 

Best of health, and thanks for reading!

 
 

The Hidden (And Not-So-Hidden) Dangers Of Treating Incontinence With Urinary Catheters

Treating incontinence with catheters

Treating incontinence with catheters

This is the second in a 3-part series on urinary incontinence in men suffering with benign prostatic hyperplasia. Dr. Richard Roach, of Advanced Urology in Oxford, FL, discusses the challenges of using urinary catheters to treat men with BPH-related incontinence, and the drawbacks of long-term catheterization.  

In my last BHEALTH blog post, we touched on the peculiar, yet common link between BPH and incontinence. Among other topics, we reviewed the progression of BPH disease state, to the point that symptoms begin to manifest themselves through urge and stress incontinence. Likewise, we also discussed the role that urinary catheters play in men who are not good candidates for BPH therapies.

So let’s now take a closer look at this population of men who must rely on urinary catheters to manage BPH-related incontinence symptoms, and examine the shortcomings of long-term catheter use:

Losing the ability to void naturally 

The first (and most obvious) drawback of chronic catheter use is losing the ability to urinate at-will. Of course, managing supplies and components can be a hassle, but there are also health concerns associated with preventing your bladder to fill and empty on its own. Chronic catheterization, particularly with an indwelling catheter, can increase the risk for deterioration in overall bladder health, which can lead to a permanent inability to store and drain urine naturally, or even cancer.

Heightened infection risk 

Perhaps the most immediate health concern with chronic catheter use is the heightened risk of infection. According to the Centers for Disease Control, more than 500,000 patients each year in the U.S. develop urinary tract infections (UTIs) while in the hospital, and indwelling urinary catheters (commonly known as Foley catheters, which reside inside the bladder for either a short or long period of time) are the leading cause. And the CDC numbers only count UTIs acquired while in the hospital; many others develop infections from long-term indwelling catheter use at home.

Compromises to quality of life 

The last, but no less important, drawback of chronic catheter use is the impact on quality of life. Many men are simply unable to perform day-to-day activities inside and outside the home. The embarrassment or inconvenience of a drainage bag is a commonly lamented life-limiter, and some types of catheterization restrict a man’s ability to be sexually active, which can strain relationships.

These challenges represent the key reasons that healthcare professionals around the world are seeking alternatives to long-term catheter use. And though it’s not always feasible to have a catheter removed, it’s important to point out that there are alternatives to long-term catheterization.

The final post in this series will highlight the story of one such patient who stopped using a catheter after several challenge-fraught years, and gained back his ability to urinate when he wanted to – without components or supplies, without infections and (most importantly for him) without any significant compromises to his everyday life.

Read part 3 of this series here.

 
Dr. Richard Roach attended the University of Wisconsin-Madison Medical School and completed his residency at the University of Wisconsin-Madison Hospital and Clinics. After graduation, Dr. Roach moved to Minocqua, Wisconsin and joined the Marshfield Clinic, where he practiced for the next 26 years. In 2013, he moved to Florida and is currently a partner in Advanced Urology Institute. He is certified by the American Board of Urology. His specialties include plasma vaporization for BPH, treatment of female stress incontinence and penile prosthesis for ED. He is also an expert in laser & laparoscopic surgery.
Dr. Richard Roach attended the University of Wisconsin-Madison Medical School and completed his residency at the University of Wisconsin-Madison Hospital and Clinics. After graduation, Dr. Roach moved to Minocqua, Wisconsin and joined the Marshfield Clinic, where he practiced for the next 26 years. In 2013, he moved to Florida and is currently a partner in Advanced Urology Institute. He is certified by the American Board of Urology. His specialties include plasma vaporization for BPH, treatment of female stress incontinence and penile prosthesis for ED. He is also an expert in laser & laparoscopic surgery.
 

When Going Gets Tough, The Tough Become Incontinent

Incontinence in Men Due To Benign Prostatic Hyperplasia (BPH)

This is the first in a 3-part series on urinary incontinence in men suffering with benign prostatic hyperplasia (BPH). Dr. Richard Roach, of Advanced Urology in Oxford, FL, discusses disease state, symptoms and treatments.

Bearing in mind the fantastic wealth of resources available on the National Association for Continence BHEALTH blog, I thought I would take the opportunity to focus on a somewhat lesser known facet of continence: the unique link between urinary retention and incontinence in men with benign prostatic hyperplasia (BPH).

The classic male patient with BPH often experiences both filling and emptying symptoms. These could manifest themselves in the form of frequency, urgency or weak stream, among others. Patients with BPH will often tell me they feel like they have to go all the time, but can’t seem to go when they stand at the urinal. It’s a perplexing (and frustrating) feeling.

So why am I contributing to a continence blog writing about a population of men who can’t pee? In short, these men often experience stress and overflow incontinence.

It’s counterintuitive, but when you give it some thought, it makes sense.

BPH causes the prostate to enlarge. This growth can cause narrowing of the prostatic urethra, which makes the process of urination more difficult. All the while, the bladder must work harder to overcome the resistance from the obstruction in the urethra. If left untreated, the bladder’s muscular lining will thicken, causing it to weaken and become less efficient at draining – in some cases irrevocably. 

It’s usually at this juncture that symptoms become severe. Men suffer from incomplete emptying, even after using the restroom, and always have the feeling of being “full.” Their frequent trips to the restroom at night cause sleep cycle interruptions. With the bladder stretched, sneezing, laughing or coughing can cause leakage, or in more extreme cases the bladder may leak because it’s simply too full.

If they haven’t found a urologist by this point, usually we find them … recovering in the hospital from acute urinary retention. In this setting, the most immediate relief comes in the form of catheterization, either from an indwelling or intermittent catheter. Usually, the patient’s bladder health and overall physiology dictate whether a de-obstructive procedure to remove prostate tissue will provide more permanent relief.

For a smaller percentage of men, particularly those who have aversions to the risk of surgery, or more commonly, health complications that prevent a surgical de-obstructive procedure, catheterization is the only solution. Yet chronic catheterization comes with several important drawbacks, including:

  1.    Losing the ability to void naturally
  2.    Heightened infection risk
  3.    Compromises to quality of life

In the next post on this topic, we’ll delve into these three issues in more detail, as we take a closer look at urinary catheters. Part 3 of this series will also cover the amazing story of a patient who was brought back from the brink after years of struggling with chronic catheterization for BPH symptoms. But first, let me add a few closing thoughts on the theme of BPH-induced incontinence.

I can’t stress enough how important it is to get regular screenings for bladder and prostate health. Checkups like these should be likened to that of mammograms or stress tests. Furthermore, males experiencing the symptoms above should seek medical guidance from a urologist as early as possible, preferably well before incontinence becomes a focal point of symptoms.

Read Part 2 of this series here.

 
Dr. Richard Roach attended the University of Wisconsin-Madison Medical School and completed his residency at the University of Wisconsin-Madison Hospital and Clinics. After graduation, Dr. Roach moved to Minocqua, Wisconsin and joined the Marshfield Clinic, where he practiced for the next 26 years. In 2013, he moved to Florida and is currently a partner in Advanced Urology Institute. He is certified by the American Board of Urology. His specialties include plasma vaporization for BPH, treatment of female stress incontinence and penile prosthesis for ED. He is also an expert in laser & laparoscopic surgery.
Dr. Richard Roach attended the University of Wisconsin-Madison Medical School and completed his residency at the University of Wisconsin-Madison Hospital and Clinics. After graduation, Dr. Roach moved to Minocqua, Wisconsin and joined the Marshfield Clinic, where he practiced for the next 26 years. In 2013, he moved to Florida and is currently a partner in Advanced Urology Institute. He is certified by the American Board of Urology. His specialties include plasma vaporization for BPH, treatment of female stress incontinence and penile prosthesis for ED. He is also an expert in laser & laparoscopic surgery.
 

The Basics of Benign Prostate Hyperplasia

BPH

The prostate is a walnut shaped gland responsible for producing semen in a man’s reproductive system. Enlargement of this gland is pretty typical, as most men experience some enlargement of the prostate as they age. Statistically, about 50% of men experience symptoms of an enlarged prostate by age 60, and 90% of men report symptoms by age 85.

You might be wondering, "If it’s so common, what’s the big deal about having benign prostatic hyperplasia (BPH)?"

To begin with, a healthy prostate is important in supporting sperm nourishment and transport. When a man ejaculates, the prostate produces the semen that propels the sperm. In a post-pubescent male, the prostate is about the size of a walnut and stays that way until age 40. For a still unknown reason, the prostate experiences a second growth spurt and can grow to the size of an apricot or even a lemon.

When you take into account that the prostate gland is located just below the bladder at the site where the urethra connects, you can start to see how this can become a serious issue. The enlarged prostate begins to interfere with the urethra, the tube inside the penis that carries urine and semen out of the body. The pressure can block the natural flow of urine (and semen) causing irritation. If left untreated, this condition can lead to more serious problems.

There is not a consensus among physicians on exactly why the prostate begins to grow again, though it is widely speculated that an excess of certain hormones may be the catalyst. One study has shown a high correlation between DHT levels (dihydrotestosterone) in the blood and enlarged prostates. Conversely, men with low DHT levels do not experience enlarged prostates.

The best way to combat this growth is to talk to your doctor. Click here to read about some of the potential exams, treatments, and solutions. 

Our 3 Best Tips For Supporting Your Husband’s Bladder Health Treatment

Help Your Husband With Incontinence By Being A Supportive Partner In His Treatment

At NAFC, we are advocates for rallying behind men and encouraging greater awareness of bladder, bowel, and prostate issues men often face. Men have the capacity to struggle with many of the same bladder and bowel health concerns as women but often struggle to be open, honest, and transparent about those difficulties.

Being a wife of a man with a bladder or bowel concern puts you in a unique position to be a listener and supporter throughout their treatment.

Our three tips for helping your husband resolve his bladder concern are as follows:  

  1. Be open and available to talk about his treatment when he is ready. So often, men take a silent sufferer approach to health because they think they have to do everything with courage and bravery. It might be helpful to your spouse if you can make it clear that your willingness to talk about their experience doesn’t negate their ability to face their health situation ‘like a man.’
  2. Offer to help refill his prescriptions or pick up absorbent products for him during your normal errands. It’s good for him to know how and where to get the medication and supplies he needs, but helping your husband by picking things up for him can be a real boost in the midst of this change.
  3. Check in and make sure he is following up with his Doctor as he was advised to. Details can be lost on a person when they’re given a diagnosis less than desirable. It’s not just your husband who forgot the advice and follow up procedures his doctor gave him-- it’s most people. Use this checklist to determine what follow up your husband needs to complete. 

Lastly, check our section on the website entirely devoted to male incontinence. You’ll be able to learn more about stress incontinence, enlarged prostates, and fecal incontinence, and about the various options that are available to men for treating this condition.

Over 10 Million Men Struggle With Bowel Leakage

Bowel Leakage Is Common In Men, Too.

While women make up the majority of individuals struggling with bladder concerns, there are millions of men dealing with accidental bowel leakage (ABL). The National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) defines bowel control problems as "the inability to hold a bowel movement until reaching a bathroom.”

Bowel leakage can include symptoms like: trouble holding a bowel movement, having solid or liquid stool leak when least expected or finding streaks of stool in underwear.

While age is a contributing factor, ABL has been reported to affect both men and women as early as 40. As a growing concern among the Baby Boomer generation, more studies and research are being conducted to see what can be done to better manage and reduce or treat ABL.

The causes of bowel leakage can vary. Some folks experience ABL as a result of diarrhea, constipation, or damage to muscles or nerves. No matter the reason, many individuals are encouraged to normalize stool consistency with increased fiber intake and strengthen the sphincter muscles with pelvic floor exercises.

With practice and patience in finding the right solution, ABL can be managed effectively so individuals can move on.

Read our bowel retraining guide to learn more about a transitional treatment options. how to regulate your system.

Incontinence: Myths VS. Truths

Incontinence Myths Vs. Truths

Incontinence affects millions of people every day— both men and women. Talking about issues like stress urinary incontinence, an enlarged prostate, or adult bedwetting isn’t something people do regularly, so there are a lot of rumors swirling around about how to manage your bladder and bowel health.

We’d like to combat the rumors and get an honest dialogue going. Let us put the myths side by side for you to review.

Myths Vs. Truths of Incontinence

Myth:  If you drink less water, you won’t have to go as often.

Truth:  Drinking enough water every day is crucial to avoiding infections and keeping your body hydrated. Drinking fewer diuretics, like coffee or tea, will help lessen the urge to go.

Myth Always buy one size larger in absorbency products.

Truth It is very important to buy the appropriate size absorbency product to avoid skin rashes, leakage, or bunching under clothes. Learn more about how to find the right type of absorbent product here.

Myth:  Incontinence just happens with old age. It’s normal!

Truth:  Incontinence isn’t necessarily indicative of old age. It’s really indicative of weak pelvic floor muscles.

Myth Going to the bathroom at night isn’t an issue until you have to go more than 3 times.

Truth:  If you go the bathroom two times or more a night regularly, you may have Nocturia. Nocturia is an overproduction of urine at night or an overproduction of urine during the daytime and nighttime.

Myth Accidentally wetting the bed is just a kid’s problem.

Truth While once thought of as something only little kids experienced, studies show that at least 2% of adults lose control of urination during the night. This is bedwetting or Nocturnal Enuresis (NE).

Myth Only women deal with incontinence. What I have is just temporary. Men don’t have problems like this.

Truth Men and women are both privy to bladder and bowel struggles. In fact, as many as 50% of men experience symptoms of an enlarged prostate by the age of 60. An enlarged prostate can interfere with the urethra, the tube inside the penis that carries urine and semen out of the body and create pressure that blocks the natural flow of urine (and semen) causing irritation. If left untreated, this condition can lead to more serious problems. 

Myth:  You don’t need to talk to your doctor about your incontinence. It will go away on its own.

Truth With more than 25 million Americans affected by either bladder control or bowel control issues, the medical community has taken note. And because incontinence is a symptom rather than a disease, the method of treatment depends on diagnostic results. Talk to you doctor to learn more about other areas of your health that may be affecting your bladder or bowel control. Click here to find the right doctor for you.

Did you learn anything new in the comparison above? Share your thoughts in the comment section or share this post to start the conversation on Facebook!

Best Practices For Preparedness (laying out clothes, prepping coffee/lunch, pick-up)

Best Practices For Preparedness

We believe that preparedness is the key to building a solid treatment plan for your incontinence. It’s also a great way to build stability in your life in general.

Read our top ten ways you can be better prepared to handle accidents, maintain your treatment plan, and stay accountable to your health goals.

1. Lay out your outfit for the next day.

Include shoes, accessories, briefcase or purse, and an extra set of absorbency products for your car or bag. Use the downtime at night to avoid the risk of forgetting something in the morning.

2. Set out your breakfast and lunch so you can grab and go.

There’s nothing worse that forgetting your breakfast or lunch and drinking coffee to sustain you. Not only will your stomach be growling, but you’ll likely irritate your bladder without the proper balance of food and hydration.

3. Schedule your pelvic floor workout with your regular workout.

By penciling in time to exercise, you’re keeping yourself accountable to the goals you set for your body. Your pelvic floor should be no different.

4. Put a reminder in your calendar to review your bladder diary.

Pick a time of the week or day where you’ll have no distractions and can focus on reviewing your notes. Maybe you stop at the library before you go home from work, or you leave early to get your morning coffee on the way to work and review it then.

5. Check in with a friend or mentor once a month at the same time and place every month.

Finding a person to glean guidance and support from can be key to living your life as fully as possible. Maybe this person is a friend who has dealt with incontinence before, or it is a mentor who helps you manage your life holistically? Make time with that accountability partner count by adhering to the schedule you agreed on.

6. Review your day the night before.

There are a lot of things that can be challenging with incontinence. Finding the restroom in a location is at the top of our list. Review your day the night before to avoid running in circles when you really need to go.

7. Refill your prescriptions on time.

For some, medicine is a crucial part to their incontinence treatment plan. Don’t ruin the progress you’ve made in your treatment by forgetting to renew your prescription. When the pharmacy calls or emails you to renew—do it right away to avoid a lapse in your intake.

8. Take time to breathe.

One of the best ways you can prepare yourself for the unexpected is stress management. And one of the best, cheapest, and most accessible ways to manage your stress is breathing. According to an article by NPR, deep breathing is not only relaxing, it's been scientifically proven to affect the heart, the brain, digestion, the immune system — and maybe even the expression of genes. Take time to breathe and focus on slowing your body down so you can be prepared and strong enough to face the chaos when it comes.

9. Have a ‘worst-case’ solution.

When everything fails and all of your steps to prepare yourself for the day or for treatment fall through, have a last resort trick up your sleeve. For some, this might be taking ten minutes to go on a walk and debrief, or a change of clothes in the car. For others, a worst-case solution is taking a lunch break or coffee break early away from their desk. Designate your worst-case solution and use it when necessary. You need a place to be redeemed from the unexpected pitfalls of treatment and day-to-day life.  

10.  Imagine your perfect day.

There’s a benefit to letting your mind idealize your plan because it can give you something to look forward to. Take time to imagine your perfect treatment plan and your ideal day when you’re setting goals with your doctor. Think about that ideal situation when things get stressful and chaotic so you can bring your focus back to what you can control. 

Integrate Kegels Into Your Daily Workout Warmup

Integrate kegels into your workout warmup

Going from zero to 60mph is great for your new two-seater racing car, but not for your muscles. It’s important to slowly gain speed in your workout routine, making your warm up routine a prime time to work your pelvic floor.

Strengthening your pelvic floor will help restore muscle function and lessen the symptoms of incontinence. Kegels are the primary pelvic floor exercise.

Whether you’re jogging, running, hiking, biking, or playing a contact sport, warming up is crucial to your exercise plan, so why not incorporate kegel training into your daily routine to help strengthen your pelvic floor muscles?

Here are a few suggestions for including kegels in your warm up routine:

  • Walk for 3-5 minutes at a steady pace. Take a break at a corner on your block or a turn on a trail and do 10 pelvic floor holds.

  • Do 10 lunges and 10 wall-sits for three reps. Between rotations, practice 5 kegels.

  • Practice a forward fold to stretch your hamstrings and back. Hold the fold 10-15 seconds, then stand and hold a kegel for 5-10 seconds. Repeat for 2-3 times.

  • Do jumping jacks or jump rope for 30-second intervals. Between each interval, practice 10 kegels.

Both men and women have pelvic floor muscles and both men and women experience a lack in pelvic floor strength as they age. Learn more about the importance of working your pelvic floor here. And find instructions on how to properly kegel, or lift your pelvic floor, here.  It is important to remember to let your muscles relax between contractions and to work all the muscles of your core to ensure optimal pelvic floor strength.  If you are unsure of the exercises that would work best for you, finding a physical therapist specialized in pelvic floor strengthening can be very helpful in creating a routine.

If you are looking for more ways to warm up before your work outs, we suggest heading over to workoutlabs.com. You can make your own printable full-body warm up graphic so you always have examples at hand. Print your own sheet out and add kegels wherever you feel most comfortable.

See our favorite full body warm up rotation below. Click here to make your own

Overactive Bladder in Men

Overactive Bladder In Men

You've all probably seen ads on television showing women rushing to the bathroom because of a severe or sudden urge to urinate. That's overactive bladder (OAB). You've also seen ads of men rushing to the bathroom at football games. Those ads say it's a prostate or "growing problem" - the prostate is getting too big or causing a blockage resulting in the bladder becoming overactive. Whether you are a man or a woman, if you have to rush to get to the bathroom to urinate, you might have overactive bladder.

Most of the time, there are other symptoms that accompany OAB - including frequency of urination, loss of urine control on the way to the bathroom, or waking from sleep to urinate. Sometimes OAB presents with other related symptoms such as difficulty starting urination, having to push or strain, and having a weak stream. Occasionally it can get so bad that you cannot urinate at all and a tube (catheter) needs to be inserted temporarily into the bladder to let the urine out.

The causes of overactive bladder are different in men and women. In men, about two-thirds of the time, a blockage to the flow of urine by the prostate is the culprit, but there are other causes as well. These include weakness of the muscles of the bladder, infection of the bladder or prostate (prostatitis), bladder stones, and even bladder cancer. Neurologic conditions such as Parkinson's disease, nerve damage from a stroke, multiple sclerosis, and diabetes can also cause symptoms of OAB.

So, if you're a man and you have OAB, what should you do? The first step is to see your doctor. The doctor should take a brief history focusing on the urinary tract and previous medical conditions and procedures. The doctor then should examine you.

Typical examinations include a digital rectal examination, focus neurological examination, and anal sphincter tone. The doctor should also check a urine specimen for infection or microscopic blood. He/she should also check how well you are emptying your bladder. That can be done by a simple examination or by an ultrasound - a simple, non-invasive, painless test done in the office. If there are signs of infection, you will be started on antibiotics and you should be better within a matter of days.

Once you are better the doctor might suggest that you have more tests to determine why you got the infection in the first place. The usual reason is that there is a blockage by the prostate and he/she might recommend treatment for that.

If you are not emptying your bladder completely and/or if there are other signs of a blockage by the prostate, your doctor will probably recommend either a medication called an alpha-blocker or want you to see a urologist right away.

An alpha-blocker is a medication that helps to relax the muscles in the wall of the prostate and that helps to relieve the blockage. It is also effective in relieving the OAB symptoms. If the medication alone or a combination with other medications does not alleviate your symptoms, then you should see a urologist.

The urologist will likely recommend more tests to determine the cause of your symptoms. He/she may want you to complete a diary for 24 hours in which you record the time and amount of each urination, perform an uroflow test (urinating into a special toilet in the bathroom that measures how fast the urine comes out) and check for residual urine with an ultrasound.

On the basis of these tests, he can determine whether there might be a blockage by the prostate. If there is, he will likely prescribe an alpha-blocker, if you are not already taking one, or possibly add another type of medication called a 5 alpha reductase inhibitor, if the prostate is enlarged. If there are no signs of a blockage he/she may recommend a behavior modification approach or prescribe an anticholinergic medication that relaxes the muscles in the walls of the bladder and diminishes the strong urge to urinate.

These treatments are effective in the majority of men and often have long lasting results. When they are not effective or if the effect wears off, surgical treatment of the blockage by the prostate is effective in the vast majority of men and those results are long lasting too.

The two best operations are transurethral resection of the prostate (TURP) and laser ablation of the prostate. Both operations are done by passing a surgical instrument through the penis and cutting out (TURP) or vaporizing (laser) the prostate. The operations are very safe, require no incisions, and no or very short hospital stay. There are very few serious complications and the success rate is very high.

In conclusion, most men with OAB also have prostatic obstruction. Treatment of the obstruction is effective in majority of patients. For those without obstruction, there are a variety of effective treatments.