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Pelvic Floor Exercises & INNOVO

User
Posted 12 May 2020 at 17:20

Hi, 

It is 2 months since I had a radical prostatectomy. Since then I have been doing pelvic floor exercises around six times a day. I realise it is still early days, but iMEDicare.co.uk has a product called INNOVO which looks like a pair of cycling shorts with gel electrodes inside which create a current that stimulates the pelvic floor muscle contractions. Could anyone who has experience of this product let me know what they think of it. 

Thanks Jonnywhite

User
Posted 13 May 2020 at 00:25
At only 2 months post-op, it isn't your pelvic floor that is the issue - you would be wasting your money, I think.

You have had the main sphincter or valve that controls the bladder removed, and the second sphincter may have been re-positioned or at least bashed about a lot. the main cause of incontinence after RP is that the brain has to re-learn how to interpret messages from the bladder and to control the sphincter that is still there. It is like when you were a toddler being potty trained - at first, the child's brain has no interest in the messages about a full bladder so the parent is constantly reminding the child "do you want the potty?" After a while, the brain starts to recognise the feeling but may not get to the potty quickly enough and doesn't know how to hold the urine in. Then comes the stage where the child can recognise the urge, can go to the potty and use it but there are still accidents (especially when the child is tired or playing a game, for example). Eventually, it becomes a sub-conscious and then unconscious behaviour.

It seems you are still at the early stages - electro-stimulation of yur pelvic floor isn't going to help your brain to learn what it has forgotten. If you mostly recover your bladder control except when coughing, lifting, etc that is stress incontinence which is when the pelvic floor becomes a concern.

Are you dry at night yet?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 May 2020 at 13:57

Thanks Lyn.

I am dry at night. I'm also in pretty good control during the day, except for stress incontinence brought on by coughing, sneezing, bending or lifting. 

I realise it is early days for me, and it may be that I should leave this for a while, but I wondered if the INNOVO electo-stimulation system would get my pelvic floor muscle working faster and stronger?

Thanks, Jonnywhite

User
Posted 13 May 2020 at 17:49
As I said, it is unlikely to be a problem with your pelvic floor at this stage - it is the external sphincter that needs a bit more time to heal and / or that your brain needs to practice controlling.

Even so, there is no harm in doing PFEs but rather than getting a machine (which is hardly going to help your brain to learn better control) I would invest some time in making sure you are doing the exercises correctly. Have you downloaded one of the apps onto your phone? Have you seen a physiotherapist to check your technique?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 May 2020 at 18:31

Thanks again Lyn, all noted.

Jonnywhite

User
Posted 13 May 2020 at 19:38

Jonny 

There were some impressive recovery figures quoted on their site but did you notice, the study was based on female users.

As already said keep the money in your pocket and persevere. 

Thanks Chris

 

User
Posted 13 May 2020 at 19:41

Thanks Chris.

Jonnywhite

User
Posted 24 May 2020 at 19:40

I had my prostate removed in early 2018 and pretty well had no bladder control at all during the day for the first couple of months - although was always dry at night. I used full incontinence pants at that stage. I used the NHS Squeezy APP and still do - would never have managed without it. I have been doing 10 repetitions of 10 seconds each with 6 seconds between repetitions and 10 quick squeezes for over 3 years. Over the first 6 months there was gradual improvement and was only using light pads by that autumn (c. 9 months). Deteriorated over the winter - I tend to leak more when it is cold, if I am tired or if I have faeces in the rectum. Never really got back the next summer to where I was the first summer and deteriorated again in the autumn and was back to needing quite a large pad every day. Nothing ventured, nothing gained I bought a pair of Innovo pants on eBay and started using them at the start of 2020. I also had a cystoscopy in February which showed some mild bladder inflammation. I had a course of antibiotics for cystitis. I am now using a very light pad. I still leak every day but have probably gone from leaking more than 100ml some days to probably leaking less than 10 ml most days. There are 3 possible reasons for this - the Innovo pants (I do 30 minutes most days with as high a level of electrical stimulation as I can bear); resolving the low grade cystitis and the psychological effect of seeing my bladder sphincter was contracting well during cystoscopy. I still leak mostly as tire in evenings or when I have faeces in the rectum, but it is manageable.

I have had a problem with the Innovo pants - they have stretched or I have lost weight. The pants need to fit snugly or they won't work - no connection leads to an error message. It started with having to use clothes pegs on the legs to tighten them up. Now I have problems with the top pads and that is more difficult to solve - if they don't fit snugly it can be painful. I have lost up to 2 inch off my waist so perhaps that has contributed but the legs of the shorts have definitely overstretched after less than 100 uses. You are basically giving yourself electric shocks and I have used quite a high level (80) to get the progress I have seen. The regular auctions of Innovo systems on eBAy that are not used or used only a couple of times suggests not everyone enjoys using them.

I would have paid £250 to get the progress I have achieved over the last 4 months (and I did not use them for 3 weeks during that time). I expect the shorts would also have been replaced under warranty but replacing them at £165 after 6 months would have been painful. I got size 6 but probably need size 5 now but even then expect they will not last much more than 6 months - but I could be wrong.

I think the Innovo pants have helped me but if I was in your position with your level of leakage I would stick with PFEs  for at least 6-9 months - nerves take a minimum of 6 months to repair and I am still seeing evidence of nerve repair after more than 2 years. If leakage starts to increase I would now get checked for cystitis even if there are no other signs of infection. You could consider Innovo if you are having difficulty sticking to the number of PFEs but you then have to find 30 minutes a day to stand around - you can watch something or use a computer but only if you can put it on something a the right height which allows you to stand up straight while doing so. 

The only predictor of long-term outcomes for leakage for which I could find even weak evidence was the level of leakage in the first month after the op. As mine was very high I anticipated it would take a long time for me to get dry and I now think complete dryness will remain just out of reach - but then I had occasional leakage even before the op. My physiotherapist suggested there was potentially value in advising all men to go pad-free after 3 months. I think the philosophy was that it helped the 'brain training'. "Brain, I have no pad here, don't let me leak". If there is leakage the automatic reaction is disappointment that this was not wanted gets straight back to the brain. If using a pad, it's a disappointment, but ah just as well I had a pad. My consultant said 10% of men are dry within one month; 50% within 6 months and 90% within a year. I guess I am in the 10% that take more than a year, but I can live with that.

Just my story and everybody's story is different. Good luck. I am sure you will get to total dryness by 6 months after the op.

User
Posted 25 May 2020 at 15:58

Hi Anach,

Thank you very much for taking the time to post up such a detailed and helpful note. I will stick with the pelvic  floor exercises for now and review the position when I am 6 months post operation.

Jonnywhite

 
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