Pelvic floor muscle exercises

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1 Lifestyle Helpline prostatecanceruk.org 31 Pelvic floor muscle exercises In this fact sheet: How do pelvic floor muscle exercises help with urinary problems? How do I do the exercises? More information About us What else can help? This fact sheet is for men who would like information about pelvic floor muscle exercises. Pelvic floor muscle exercises may help many men deal with urinary problems such as incontinence. There are many different reasons for urinary problems, including some treatments for prostate cancer, treatments for an enlarged prostate, obesity, smoking and constipation. This fact sheet explains how pelvic floor muscle exercises can help, and how to do them. You can read more about urinary problems as a side effect of prostate cancer treatment in our Tool Kit fact sheet, Urinary problems after prostate cancer treatment. How do pelvic floor muscle exercises help with urinary problems? The pelvic floor muscles stretch below the bladder and bowel. They support the bladder, and help to control when you pass urine. The muscles can become weak, for example following surgery to the prostate. This can lead to problems controlling when you pass urine. Pelvic floor muscle exercises strengthen these muscles and give you more control over passing urine. They may be particularly helpful if you leak urine when you stand, cough or sneeze. This is known as stress incontinence. They can also help you to hold on for longer if you need to pass urine frequently, or have a sudden urgent need to pass urine. If you are going to have treatment for prostate cancer in the near future, doing pelvic floor muscle exercises before treatment may help reduce or prevent urinary problems. If you have had surgery to treat prostate cancer (a radical prostatectomy) or for an enlarged prostate (a transurethral resection of the prostate or TURP), doing pelvic floor muscle exercises soon after the surgery may help you to regain control of your bladder more quickly. If you have a temporary catheter after surgery, you should check with your doctor or nurse whether you need to wait until the catheter is removed before starting pelvic floor muscle exercises. You can read more about radical prostatectomy in our Tool Kit fact sheet, Surgery: radical prostatectomy. You can read more about TURP in our fact sheet, Transurethral resection of the prostate (TURP).

2 Lifestyle Helpline prostatecanceruk.org 42 Within three months of the radical prostatectomy I was able to stay dry for a day at a time. I always do my exercises first thing in the morning. A personal experience 5. You can also check if you are using the correct muscles by placing your finger tips on the skin behind the scrotum. You will feel the muscles lift up away from your fingers when you are tightening the pelvic floor muscles correctly. Pelvic floor muscles bladder spine rectum How do I do the exercises? If you would like more advice about doing pelvic floor muscle exercises, or are finding them difficult to do, you can ask your doctor, nurse or GP to refer you to a continence advisor or specialist physiotherapist. They can help you learn to do the exercises and strengthen your pelvic floor muscles. pubic bone urethra prostate gland pelvic floor muscles Finding the right muscles 1. Your pelvic floor muscles stretch underneath your bladder and bowel. To find the right muscles you need to sit, stand or lie comfortably with the muscles of your thighs, buttocks and tummy relaxed. 2. Tighten the ring of muscle around your back passage (anus) as if you are trying to control wind. Relax it. Try not to squeeze your buttocks together or tighten your thighs or tummy muscles. Don t hold your breath. 3. Now imagine you are passing urine. Try to stop mid-flow and then start again. Don t do this when you are actually passing urine as this can cause problems emptying your bladder if you do it too often just imagine doing it. 4. If you are tightening the right muscles, you should be able to feel a dip at the base of your penis and feel your scrotum (pouch of skin containing the testicles) move up slightly. You may find it helpful to do the exercises in front of a mirror so that you can see the base of your penis and your scrotum move. The exercises Once you have found the correct muscles, and you know what it feels like when you tense them, you can do the following exercises. There are two sets of exercises. Do the slow exercises first. You can do them while lying down, sitting or standing. Slow pelvic floor muscle exercises 1. Slowly tense the muscles as hard as you can so you feel a lifting sensation. 2. Try to hold this lift for ten seconds. Keep breathing normally. 3. Slowly relax the muscles and rest for ten seconds. 4. Repeat the lift. You should aim to lift then relax up to ten times. You may find that you cannot hold the lift for ten seconds. Just hold for as long as you can and try to build up to ten seconds.

3 Lifestyle Helpline prostatecanceruk.org 53 Fast pelvic floor muscle exercises 1. Repeat the same action, but, this time, try tightening the muscles as quickly as possible. 2. Hold the lift for one second and then let go. 3. Try to do up to ten short fast lifts. You will need to concentrate when you are doing the exercises. It is important to do them properly otherwise you may not benefit from them. Try to maintain a healthy weight and level of fitness. Being overweight can put pressure on your pelvic floor muscles. Avoid constipation, as straining to go to the toilet may put pressure on your pelvic floor muscles. Eating a healthy diet that is high in fibre will help to avoid constipation. Get medical advice for hayfever, asthma or bronchitis to reduce sneezing and coughing. If you smoke, try to stop as this can cause coughing. I find that it helps to make my exercises part of my everyday routine. I do them whenever I am washing my hands. A personal experience How often should I do the exercises? You should do a set of slow exercises followed by a set of fast exercises about three to six times each day. Try to make them part of your daily routine. You might find it helpful to do them at regular times each day, for example, before you get up in the morning, after lunch, and in the evening. You should also practise doing the exercises when doing activities that may cause you to leak urine, such as getting up from a chair, lifting, or when you cough or sneeze. This may help prevent urine leaking. It may take three to six months before you begin to notice an improvement so it is important that you keep doing them. You will need to continue doing them regularly to keep your pelvic floor muscles strong. What else can help? You can also try to reduce the amount of pressure on the pelvic floor muscles. The following tips may help: Avoid heavy lifting. There is more information about a healthy diet in our Tool Kit fact sheet, Diet, exercise and prostate cancer. Pelvic floor exercises still work for me ten years after a radical prostatectomy. A personal experience Biofeedback To help you practise pelvic floor muscle exercises, your continence advisor or specialist physiotherapist may suggest biofeedback. This is a way of monitoring your pelvic floor muscle contractions while you do the exercises. It can be particularly helpful if you are struggling to find your pelvic floor muscles or do the exercises. A small probe is inserted into your back passage. You squeeze your pelvic floor muscles, which puts pressure on the probe. This pressure is displayed on a computer screen and tells you whether you are doing the exercises correctly. Your continence advisor or specialist physiotherapist will show you how to use biofeedback during a clinic session and give you advice about doing the exercises. They may also lend you a portable biofeedback unit to take home.

4 Lifestyle Helpline prostatecanceruk.org 64 Notes

5 Lifestyle Helpline prostatecanceruk.org 51 More information The Bladder and Bowel Foundation Helpline: Provides information and support for all types of bladder and bowel related problems, to patients, their families, carers and healthcare professionals. Chartered Physiotherapists Promoting Continence (CPPC) Allows you to search for details of specialist continence physiotherapists in your area.. Macmillan Cancer Support Freephone: (9am-8pm, Mon-Fri) Practical, emotional and financial support for people with cancer, family and friends. Information about cancer, its treatment and living with cancer. PromoCon (Promoting Continence and Product Awareness) Helpline: (9am-4pm, Mon-Fri) Part of the Disabled Living Foundation. Provides impartial information and advice about bladder and bowel problems. About us Prostate Cancer UK fights to help more men survive prostate cancer and enjoy a better life. At Prostate Cancer UK, we take great care to provide up-to-date, unbiased and accurate facts about prostate cancer. We hope these will add to the medical advice you have had and help you to make decisions. Our services are not intended to replace advice from your doctor. References to sources of information used in the production of this fact sheet are available at prostatecanceruk.org This publication was written and edited by: Prostate Cancer UK s Information Team It was reviewed by: Hilary Baker, Macmillan Uro-oncology Clinical Nurse Specialist, Wycombe Hospital, Buckinghamshire Valerie Clarke, Team Lead Physiotherapist, Royal Alexandra Hospital, Paisley Evelyn Pearson, Urology Nurse Specialist, Stepping Hill Hospital, Stockport Christine Williams, Clinical Nurse Specialist Urology / Continence Advisor, Royal Derby Hospitals, Derby Prostate Cancer UK Specialist Nurses Prostate Cancer Voices Tell us what you think If you have any comments about our publications, you can literature@prostatecanceruk.org or write to the Information Team at: Prostate Cancer UK 100 Cambridge Grove London W6 0LE This fact sheet is part of the Tool Kit. You can order more Tool Kit fact sheets, including an A-Z of medical words, which explains some of the words and phrases used in this fact sheet. All of our publications are available to download and order from the website. You can also order printed copies by calling or ing literature@prostatecanceruk.org

6 Speak to our Specialist Nurses * prostatecanceruk.org Donate today help others like you Did you find this information useful? Would you like to help others in your situation access the facts they need? Every year, 40,000 men face a prostate cancer diagnosis. To help us continue providing free information, you could make a donation of any amount. Please call us on , visit prostatecanceruk.org/donations or text PROSTATE to 70004** There are many other ways to support us. For more details please visit: prostatecanceruk.org/get-involved **You can donate up to 10 via SMS and we will receive 100% of your donation. Texts are charged at your standard rate. For full terms and conditions and more information, please visit prostatecanceruk.org/terms Prostate Cancer UK London Cambridge House 100 Cambridge Grove London W6 0LE info@prostatecanceruk.org Glasgow Unit F22-24 Festival Business Centre 150 Brand Street Glasgow G51 1DH scotland@prostatecanceruk.org Prostate Cancer UK February 2012 To be reviewed February 2014 The helpline is open Mon - Fri 10am - 4pm, Wed 7pm - 9pm * Calls are recorded for training purposes only. Confidentiality is maintained between callers and Prostate Cancer UK. Prostate Cancer UK is a registered charity in England and Wales ( ) and in Scotland (SC039332). Registered company number PEL/AUG12