Pelvic Floor Physical Therapy After Prostatectomy w/ Vanita Gaglani | BackTable Urology Ep. 60

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.
---
CHECK OUT OUR SPONSOR
Laurel Road for Doctors
www.laurelroad...
---
EARN CME
Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: earnc.me/23I7tu
---
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
vanitasrehab.co...
“Life after Prostatectomy and Other Urological Surgeries: 10 Weeks from Incontinence to Continence” (Vanita’s book available on Amazon)
---
The BackTable Urology Podcast is a resource for practicing urologists to learn tips, techniques, and practical advice from their peers in the field. Listen on BackTable.com/Urology or on the streaming platform of your choice.
Get notified when new episodes drop! Subscribe to the BackTable Urology Podcast on your go-to podcast platform, and follow us on your social media platform of choice for regular updates.
Apple ► podcasts.apple...
Spotify ► open.spotify.c...
UA-cam ► / @_backtableuro
LinkedIn ► / backtable-urology
Twitter ► / _backtableuro
Instagram ► / _backtableuro
Newsletter ► www.backtable....

[@gabrielsticks2829]

Thank you, learned a lot as resident

[@_backtableURO]

Glad it was helpful!