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Perineal Physiotherapy for incontinence

User
Posted 22 Jan 2024 at 19:09

Let me start by saying that I live in France and benefit from their awesome health system (at least in my region).


My post RARP PSA is on the rise and I may need salvage RT in the near future and so I had a consult with my urologist. During this consult she asked me how I was getting on with incontinence and I explained that RARP+9 months I was doing OK but coughing would catch me out with dribbles. Anyway, she gave me a prescription to get "Perineal Physiotherapy" - I had no idea what it was and after a bit of digging around, I found a local physio who could help me.


I had my first appointment today and wow, what an amazing procedure.


She explained that I would have about 12 appointments weekly for about 45 minutes. I had to go to the pharmacy to get my own Anal Sonar Probe which I take with me to each appointment.
I lay back on the bed and raise my knees and she hands me the lubed probe which I insert myself into my rectum. It has a flange that sets it to the correct depth. She then connects to a TENS electro stimulation device and it starts tingling - she only used the low settings for the first appointment. This stimulates the pelvic floor muscles.

After about 15 minutes, she disconnects the electro-stimulation and connects it to a bio-feedback input on what looks like a ipad tablet. This displays a series of graphs with orange lines and I have to get the pointer to follow the lines by tensing the pelvic floor muscles.


I was able to get the pointer to move up and down but trying to follow the areas where you need to hold a constant tension is very difficult but I can see with practice that it will get much easier.


So far I think that this a game changer for me - I can feel exactly what muscles to exercise and the electro stimulation is making them work.


I'll let you know how I get on over the next few weeks :)

Edited by member 23 Jan 2024 at 11:15  | Reason: Better heading

User
Posted 22 Jan 2024 at 19:09

Let me start by saying that I live in France and benefit from their awesome health system (at least in my region).


My post RARP PSA is on the rise and I may need salvage RT in the near future and so I had a consult with my urologist. During this consult she asked me how I was getting on with incontinence and I explained that RARP+9 months I was doing OK but coughing would catch me out with dribbles. Anyway, she gave me a prescription to get "Perineal Physiotherapy" - I had no idea what it was and after a bit of digging around, I found a local physio who could help me.


I had my first appointment today and wow, what an amazing procedure.


She explained that I would have about 12 appointments weekly for about 45 minutes. I had to go to the pharmacy to get my own Anal Sonar Probe which I take with me to each appointment.
I lay back on the bed and raise my knees and she hands me the lubed probe which I insert myself into my rectum. It has a flange that sets it to the correct depth. She then connects to a TENS electro stimulation device and it starts tingling - she only used the low settings for the first appointment. This stimulates the pelvic floor muscles.

After about 15 minutes, she disconnects the electro-stimulation and connects it to a bio-feedback input on what looks like a ipad tablet. This displays a series of graphs with orange lines and I have to get the pointer to follow the lines by tensing the pelvic floor muscles.


I was able to get the pointer to move up and down but trying to follow the areas where you need to hold a constant tension is very difficult but I can see with practice that it will get much easier.


So far I think that this a game changer for me - I can feel exactly what muscles to exercise and the electro stimulation is making them work.


I'll let you know how I get on over the next few weeks :)

Edited by member 23 Jan 2024 at 11:15  | Reason: Better heading

User
Posted 31 Jan 2024 at 13:36
So second appointment completed and the physio commented on how much better the muscle control was - I managed to keep the bio feedback line inside of the orange area for about 30% of the time. She is going to increase the electro stimulation on the next visit as she thinks I am ready for it.
The good news is that I have found out that the electro stimulation equipment is available on the French health care system after I have completed the physio appointments so I should be able to do this at home in the near future.

If anyone is having trouble with mild incontinence after their RP then I can highly recommend giving this a try if it's available to you. I even managed a sneeze today with no dribble even though it's still early days.
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User
Posted 27 Jan 2024 at 12:29

Bumping this post as it seemed to get lost. This sounds interesting and we'll be interested to see how you get on.

Dave

User
Posted 27 Jan 2024 at 13:13
I'm off for my second appointment on Monday pm - I think it's definitely helping but that may just be psychological at this stage. I'll see if she will let me take a video of the bio feedback screen as that is really interesting. In fact it could become a new video game with a new type of controller - using a bio feedback sensor up your bum to control the screen character LOL
User
Posted 27 Jan 2024 at 21:18

These are called pelvic floor physiotherapists in the UK.


They are rather few and far between in the NHS but they are available privately and not as expensive as a private consultant. Obviously, you need one which specialises in men with prostate treatments. (Most specialise in treating women.)

User
Posted 31 Jan 2024 at 13:36
So second appointment completed and the physio commented on how much better the muscle control was - I managed to keep the bio feedback line inside of the orange area for about 30% of the time. She is going to increase the electro stimulation on the next visit as she thinks I am ready for it.
The good news is that I have found out that the electro stimulation equipment is available on the French health care system after I have completed the physio appointments so I should be able to do this at home in the near future.

If anyone is having trouble with mild incontinence after their RP then I can highly recommend giving this a try if it's available to you. I even managed a sneeze today with no dribble even though it's still early days.
 
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