Tightening the plumbing
Prostate cancer survivors require more specific and guided cues by health professionals when managing incontinence. The Continence Foundation of Australia and the Prostate Cancer Foundation of Australia recommend men undertake pelvic floor training, preferably before surgery, and always after surgery.
While there has been considerable research confirming the benefits of pelvic floor training for women, there has been little for men, which prompted University of Sydney researcher and men’s continence physiotherapist, Dr Stuart Baptist, to investigate the issue.
Using real time ultrasound, Dr Baptist and co-researchers, Roger Adams and Trudy Rebbeck, studied the progress of 91 men with prostate cancer as they were trained in pelvic floor motor control, some before and some after their prostatectomy.
Their study found that while some were quick to learn the feel of the muscles, others were working just as hard but getting nowhere.
“We gave them different cues for isolating independent muscles, and got them to slow down and feel subtle changes in the feel of the muscles, and work them gently. This can be seen on the ultrasound monitor,” Dr Baptist says.
Before, the participants were focusing on strength, but now they were learning to experience these new sensations, and improving motor control.
Dr Baptist claims there is promising research about the value of ultrasound to assess pelvic floor muscle function in men. His view is that men require more specific, guided cues, principally as a result of their physiology as well as their male psychology.
“In my experience, men are naturally impatient and visually driven, and want to see evidence that what they’re doing is working. Using ultrasound biofeedback is a better way of keying in the cues,” he says.
Dr Baptist’s next step will be to work on developing more effective pelvic floor muscle strength training techniques for the treatment of incontinence in men.
The prescribed regimen of 10 repetitions of 10 second pelvic floor contractions also needed reviewing, he says.
“I feel that you have to get the right ‘feel’ before you continue, and aiming for 10 by 10-second holds makes little sense in terms of muscle hypertrophy (increasing the size of muscle cells).”
He also encourages men to seek specialist training from a continence physiotherapist with a special interest in men’s health.
Call the National Continence Helpline on 1800 33 00 66 to arrange a referral to a continence physiotherapist if needed. Alternatively, Stuart Baptist can be contacted by emailing: stuartbaptist@ssop.com.au
