BackTable / Urology / Podcast / Episode #60

Pelvic Floor Physical Therapy for Early Incontinence Recovery After Prostatectomy

with Vanita Gaglani

In this episode, Dr. Aditya Bagrodia interviews pelvic floor therapist Vanita Gaglani from Vanita’s Rehab about the role of pelvic floor physical therapy for early continence recovery after prostatectomy.

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Pelvic Floor Physical Therapy for Early Incontinence Recovery After Prostatectomy with Vanita Gaglani on the BackTable Urology Podcast)
Ep 60 Pelvic Floor Physical Therapy for Early Incontinence Recovery After Prostatectomy with Vanita Gaglani
00:00 / 01:04

BackTable, LLC (Producer). (2022, October 19). Ep. 60 – Pelvic Floor Physical Therapy for Early Incontinence Recovery After Prostatectomy [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Vanita Gaglani, RPT discusses Pelvic Floor Physical Therapy for Early Incontinence Recovery After Prostatectomy on the BackTable 60 Podcast

Vanita Gaglani, RPT

Vanita Gaglani is a physical therapist and the founder of Vanita's Rehab, a clinic specializing in physical therapy for urinary incontinence and other urological conditions in Melbourne, Florida.

Dr. Aditya Bagrodia discusses Pelvic Floor Physical Therapy for Early Incontinence Recovery After Prostatectomy on the BackTable 60 Podcast

Dr. Aditya Bagrodia

Dr. Aditya Bagrodia is an associate professor of urology and genitourinary oncology team leader at UC San Diego Health in California and adjunct professor of urology at UT Southwestern.

Show Notes

She starts the discussion by explaining her schedule for seeing prostatectomy patients. She usually has the patient come in for a preoperative visit to counsel him on proper nutrition, hydration, and shows him how to do Kegel exercises correctly. She advises her patients against drinking tea, coffee, or soda because these liquids can irritate the surgical sites. She recommends doing complete Kegels involving the pelvic floor muscles around the rectum first because she believes these muscles are stronger. When the patient is ready to progress, she then advises them to practice Kegels with the pelvic floor muscles around the urethra. Her regimen consists of 6-8 sets of 10 quick repetitions, each held for 1-2 seconds. She also mentions that “hold” is often a vague term; male patients usually squeeze too hard and cause muscle fatigue, which causes the prostatic sphincter to lose control and leak more urine. Therefore, she emphasizes that Kegels must be done gently at first. Additionally, she encourages her patients to start Kegels at least 3 weeks before surgery.

Then, she schedules the first postoperative visit 4-5 days after the catheter removal. During the first postoperative visit, she often hears the complaint that patients are continent while sitting but incontinent when standing up and walking. To teach her patients how to get up without leaking, she shows them how to sustain pelvic floor contraction while standing. She notes that this skill is more a result of endurance, not strength; overfatigue of the pelvic floor during the daytime is very common. She also evaluates lumbar and hip muscle strength too, as they both contribute to pelvic floor strength. Additionally, she discourages patients from getting up to use the bathroom frequently because this behavior may cause bladder capacity to decrease. To prevent this behavior, engaging in breathing exercises while in butterfly position and using thinner pads can help. By 10 weeks, 98% of patients should be completely dry. For the 2% of patients who are incontinent for more than 10 weeks, another factor (such as scar tissue, bladder spasms, and constipation) may be at play.

Finally, Vanita discusses resources for patients seeking more information about pelvic floor physical therapy. She has her own website with information and journals as well as her own book, “Life after Prostatectomy and Other Urological Surgeries: 10 Weeks from Incontinence to Continence."

Resources

Vanita’s Rehab
http://vanitasrehab.com/resources/

“Life after Prostatectomy and Other Urological Surgeries: 10 Weeks from Incontinence to Continence” (Vanita’s book available on Amazon)

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Articles

Topics

Post-Prostatectomy Incontinence Condition Overview
Prostatectomy Procedure Prep
Urinary Incontinence Condition Overview

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