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The 4-3-2 Method for Kegel Exercises

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Abstract

Performing Kegel exercises following prostatectomy is helpful in restoring continence, but requires concentration to accomplish the required contractions consistently. Confusion and effort with executing the procedure can reduce compliance. A new method subdivides the exercises into segments that can be executed without counting. The patient performs four sets of contractions daily, each set consisting of three contractions lasting two natural breaths, separated by two natural breaths. Because each number is below the limit that can be apprehended by subitizing without counting, cognitive effort is minimized.

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... The second session: Diagnosis of BPH, explanation of TURP as a treatment modality of BPH, probable complications of TURP including pain, infection, bleeding, urinary incontinence, and sexual dysfunction [1,16]. The third session: Effect of fatigue on sexual function, the importance of managing urinary incontinence for improving sexual satisfaction, role of physical activity and exercise in the recovery of sexual performance, role of pelvic floor muscle exercises in the improvement of sexual function and activity through controlling urinary incontinence [8,17,18]. ...
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... Kegel exercises are the most commonly practiced techniques for conservative management of post-prostatectomy incontinence [14], and various pelvic floor muscle exercise programs have been developed and spread widely for incontinence studies [15][16][17]. Those previous studies have not, however, investigated the mechanism of recovery from post-prostatectomy incontinence and have failed to make plausible assumptions [15][16][17]. ...
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We evaluated the efficacy of progressive resistance training of the pelvic floor muscle for post-prostatectomy incontinence. In this prospective study, 59 patients who underwent radical prostatectomy were evaluated preoperatively. Continence was sequentially assessed within 2 weeks postoperatively, and an exercise regimen was initiated at 6- and 12-weeks. The primary outcome was continent status and the secondary outcome was changes in muscle strength and endurance after the exercise intervention. Continence was defined as no urine loss in a 1h pad test. A total of 59 patients participated in this study. Six patients dropped out of the study because of non-compliance and orthopedic problems. Of the remaining 53 patients, 31 (58.5%) achieved pad-free continence at 12 weeks postoperatively. The patients were divided into two groups based on their continence status, and no statistically significant difference was observed in age, body mass index, prostate volume, prostate-specific antigen, pathological Gleason score sum, and pathological T stage. Meanwhile, preoperative maximal urethral closure pressure and change in hip extensor muscle strength and endurance during the 12-week exercise program were significantly higher in the continent group. In multivariate analysis, change in hip extensor muscle strength was the only significant parameter predicting achievement of continence status (Odds ratio, 1.039; p = 0.045). The changes in hip extensor muscle strength in the current exercise program was an independent predictor of continence status after radical prostatectomy. A large-scale prospective study on the relationship between extensor muscle strength and urinary incontinence should be explored in future.
... Anything and everything was his source of inspiration. After a clinic visit, he would come up with an improved pelvic floor exercise plan that is easier to follow and keep track of (Bridgeman & Roberts, 2010). And after a dinner with his friend from the Literature and Film department, he and his friends came up with an experiment whereby one could test whether apparent phi-motion was deliberately induced in a 1927 movie scene (Pannasch, Selden, Velichkovsky, & Bridgeman, 2011; speaking of movies, "Bruce Almighty" was reportedly one of Bruce's favorites, while another fascinating story for students of perception recounts how a 3D movie reversed Bruce's stereoblind vision (see Bridgeman, 2014;Peck, 2012)). ...
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