Tim,
I treat men for incontinence post prostatectomy.
Pelvic floor muscles need to be able to tighten quickly as well as
slowly - just as we have fast and slow muscle fibres in other muscle
groups. The site John Perry referred you to is a good one, it does
emphasise biofeedback. There is evidence to support elec stim to
reinforce the reflexes associated with the bladder; Mahonie (?can't
remember the reference). As per Fall and Lindstrom, I use 10 Hz to get
the bladder to become more stable as is required when the bladder is
unstable. 35 - 40 Hz is used when the sphincter is insufficient
resulting in stress incontinence.
Also, caffeine, concentrated urine and alcohol all irritate the bladder
making incontinence more likely. decaffeinated drinks or alternatives
are OK. If your friend fills in a frequency volume chart he will see how
often he passes urine and how much urine his bladder holds. Some
averages;
3 - 7 voids per 24 hours
214 - 500 ml per void
1500ml urine passed in 24 hours
Let me know if I can help any more.
Nicky Mackenzie
Senior I Physiotherapist
Birmingham
England
[log in to unmask]
> I was asked by a friend whom his prostate removed secondary to cancer
> about incontinence. He was instructed in the proper Kegal Exercises
> and does them regularly. He is 80% continent but wears a pad because
> of stress incontinence occassionaly. He is bothered by this. Is
> there anything else that one can do with e-stim or any other modality
> to help. He does take the prescribed medication from his urologist
> which helps also. References to articles on the why and how would
> also be helpful. Thank you in advance. Tim Schwartz MS PT
> [log in to unmask]
>
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