Category Archives: Men’s Health

App of The Week

The Prostate Cancer app is your complete guide to understanding prostate cancer!

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This app is designed to provide patients with prostate cancer and their families and caregivers with the information and resources they need to better understand and manage all stages of prostate cancer.
The app includes tips and answers to common questions about prostate cancer, an illustrated guide to prostate cancer, a personalized journal section, and news, resources, and expert answers about prostate cancer. Keep track of symptoms, medications, improvements in urinary continence, and stay up to date on the latest news on Twitter about prostate cancer.

App of The Week

Up until now, all of our “App of The Weeks” have been free, however, this incredible Prostate Health App is $0.99… but worth every penny.

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If you are 45 years or older, you will be interested to know that prostate evaluations are recommended for your age group. A team of expert urologists have developed this application, which provides answers to the following questions:

What is the prostate?
Do I have prostate symptoms?
When should I have an evaluation, and what does the evaluation consist of?
How can my physician treat my symptoms?
What is PSA?
What is a prostate biopsy?
What options do I have if I am diagnosed with prostate cancer?
What is prostatitis?

What can a pelvic floor therapist do for you after a prostatectomy?

My first priority in seeing males pre-operatively to educate them on proper performance of Kegels (or drops) and what to expect after the catheter is removed. The research is so mixed on the prescription of Kegel exercises. I have seen 10 second holds, 10 times every hour for 10 hours PER DAY to 3 sets of 10 with 5-10 second holds. Most studies lack reliability because there is so much variability within the subject population (surgeon, technique, co-morbidities, etc) and the prescription of home exercise programs (HEP). What we tend to find, is that these muscles (prior to the prostatectomy) have been working beautifully without the implementation of a formal HEP. Therefore, treatment emphasis should be on proper technique and initiation of an exercise routine to facilitate carry over after surgery. Following surgery, most males cannot hold an isolated 10 seconds, without breath holding or compensation and we usually modify the HEP so the patient performs quality PF contractions with coordination of breathing.

On the other hand, there are a number of factors that can limit a patients’ return to continence. Immediate post-operative interventions emphasize:

– Isolated pelvic floor contractions & training with EMG biofeedback

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– Education in functional pelvic floor contractions prior to increases in intra-abdominal pressure

– Training in Diaphragmatic Breathing techniques

– Behavioral management techniques for:

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o Constipation care & Toilet positioning

o Bladder Health Training

o Urgency Suppression Management

o Body mechanics training & Bed mobility

– Management of postoperative pain (as needed)

– Management of incisions (scar tissue)

– Management of diastasis (as needed)

Not all post-prostatectomy patients require this education following surgery, however if you know someone, or are struggling with regaining urinary control following a prostatectomy, find a local Pelvic Floor therapist and get started on returning to a more healthy YOU!

Written by: Jenna Sires PT, DPT

For You Men!

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The truth is, men are suffering from urinary incontinence. However, there is something that can be done about it (i.e. Pelvic PT) and utilizing proper protection, if necessary. Check out http://www.depend.com/guard-your-manhood/samples and try a free Depend® Sample Pack.

Prostate Cancer Resources

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Fellas, The Prostate Cancer Foundation of Australia has some amazing resources for you after a prostatectomy (or if you’re just trying to educate yourself on what to do following the diagnosis of prostate cancer). Check out their website for amazing access to personal organizers and other useful tools to reduce the impact of living with cancer.

Jenna Sires PT, DPT

The Prostate: What Does it do? And What Happens When it is Removed?

A large majority of our patients include men who have, or are about to undergo a prostatectomy. I thought it would be fitting to educate not only these patients, but the rest of us on the function, and repercussions of removing this vital structure.

First of all… what in the world is the prostate? And what does it do? Well, the prostate is a gland in the male reproductive system found below the bladder and in front of the rectum. The prostate surrounds the urethra, the tube through which urine flows.

Prostate Anatomy

This walnut sized gland contributes to the production of seminal fluid. During orgasm, this seminal fluid helps carry sperm out of the man’s body as part of semen. (NCI.org)

Why do men have this gland removed you might ask?…. Primarily due to cancer of the prostate. Cancer begins in cells, the building blocks that make up all tissues and organs of the body, including the prostate. Normal cells in the prostate and other parts of the body grow and divide to form new cells as they are needed. When normal cells grow old or get damaged, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when the body doesn’t need them, and old or damaged cells don’t die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor. (NCI.org)

According to the National Cancer Institute, there will be 238,590 new cases of prostate cancer in 2013 and ~ 29, 720 deaths in the United States. That is a lot of cancer, and if treated via a prostatectomy, that is a TON of males who may need the help of a skilled pelvic floor physical therapist.
During a prostatectomy a surgeon removes the prostate gland from the surrounding tissue. The seminal vesicles, two small fluid-filled sacs next to the prostate, are sometimes also removed. The surgeon tries carefully not to damage nerves and blood vessels. Once the prostate is removed, the surgeon reattaches the urethra to a part of the bladder called the bladder neck. Following the surgery, a urinary catheter is left in the bladder to drain urine.

Some risks of this procedure include:
– Difficulty controlling bowel movements (bowel incontinence)
– Difficulty controlling urine (urinary incontinence); Incidence after radical prostatectomy varies from 2.5-87%. At 6 months 5-72% (Cooperberg J Urology 2003; 170: 512-515)
– Erection problems (impotence)
– Injury to the rectum
– Urethral stricture (tightening of the urinary opening due to scar tissue)

Now, as the urethra and bladder neck are healing the control of urinary continence is left to the pelvic floor muscles.

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These muscles wrap around the urethra and rectum, maintaining continence, and must fully relax to allow complete urine and bowel emptying (Check out this amazing video to learn more about this muscle group). Many men benefit from pelvic floor muscle retraining prior to surgery to increase their awareness, strength, and endurance of the pelvic floor. Research has also shown that men who participate in skilled PT pre-operatively are less likely to struggle with chronic urinary incontinence (Burgio J Urology 2006; 175: 196-201).

The sad part is, post-operatively, many men are not even informed that PT is an option to improve continence. They may struggle with the embarrassment of leaking urine, difficulty returning to work, depression, and the list goes on and on.

Do you know someone with prostate cancer or who has had their prostate removed? If so, guide them to the National Institute of Cancer, show them this blog, and remember that education is key to improving our quality of life and general health.

Written by: Jenna Sires PT, DPT

References
http://drexel.adam.com
www.cancer.gov/cancertopics/types/prostate
Pictures: http://www.uchospitals.edu , http://www.continence.org.au

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