David Hughes Pelvic Floor Exercise – The Prostate Clinic

my name is David Hughes I'm a nurse and I specialize in working with men after diagnosis of prostate cancer one of the major issues that afflicts men having prostate cancer therapy of many types including removal of the prostate is incontinence incontinence is lack of control of the bladder after an operation so that when you cough or sneeze or go to the pub and have a few beers you can wet yourself or you can have a continuous stream of wetness that would bother men for years leading to either catheterization or wearing pads of some type for a long period of time one of our main goals in fact our main goal is to ensure this doesn't happen with men the way we do this is by teaching pelvic floor muscle exercises as soon as you're aware that you have a prostate issue and up to surgery or radiotherapy and for long periods of time after that you would need to continue these exercises the pelvic floor muscles themselves are located in the pelvis obviously below your bladder and around the prostate they start at about your backbone and run all the way around to a bone in the front of your hip your pelvis called your symphysis pubis there are big sling of muscles that sit in your pelvis they have a number of jobs that they do but one of their major jobs is to support your bladder and to support the sphincter at the base of your bladder to ensure that it is able to close and stay closed to prevent wetness on an ongoing basis these muscles are damaged during the course of surgery and will recover but need to be built up and maintained in order that they will stay in good condition and keep you going for many years of dryness there are a number of ways to do these a number of people discuss different ways the way I'm going to show you the way that the experts have shown me to do this now there are a number of steps and stages to doing pelvic floor muscle exercises so we'll start with the most basic two begin with there are three steps that you would need to learn separately once you can learn that once you have worked these three steps you would need to put them together and do this as one exercise now the exercise begins with the first exercises imagine that you've got a bow full of wind and you're at a party and you just can't pass that when you have to hold on to it so the first exercise is to close your backside sphincter and hold it for five seconds you count to five and then release it now this must be done with as much bigger as possible because muscles only work when they're contracting so you need to contract this muscle hold it as tightly as you can and release it the second exercise is the area that you will see here between the back of your scrotum and your anus this area of skin between your scrotum and your anus at the bottom of your pelvis is called your perineum what you need to do is imagine that there's a red-hot poker or a needle coming up towards that perineum and you're lifting it up you're sucking that perineum up and lifting it off the chair hold it up for five seconds and then relax so the third exercise now is imagine you on the side of the road you're having a wee busload of people come around the corner and you need to stop that way and hold it for some reason so that's the third exercise imagine you're having a wee it's a great stream and you have to stop it and hold it for five seconds so you clamp and hold for five seconds and then relax once you can do those three exercises you would put them together as one exercise so let's go over them again first exercise is close your backside and hold it as tightly as you can wall that back sides closed lifting that perineum up and holding that while your perineum is being lifted in your backsides close clamp off your urine all three together hold for 5 seconds 1000 2000 3000 4000 5000 and relax that swated those exercises now you need to do those exercises 10 times in a row is one exercise so I call it close lifting clamp close your back side lift your perineum clamp your urine hold for 5 seconds relax do that 10 times the row that's one set of exercises these exercises need to be done 10 times a day in the build-up and rehabilitation phases of your pelvic floor muscle exercises so I teach these sitting down that's not necessary to do these sitting down but it's a great way to do it it's a trigger your backside will hit the seat at least 10 to 15 times a day it's a great visual and reminder that to do those exercises so try it every time you sit down to do this exercise close your back side lift that perineum and clamp that is that's the best way to remember to do those exercises every time you sit down ask your wife or partner to remind you because there's one thing that women like more than shopping it's telling men what to do so try to get your wife involved in helping you to do these by reminding you every time you sit down to do these exercises if there's something else you do 10 times they like playing golf or anything that you do ten times say that's a great way to remember I don't know of many things so this is a great way to learn what we're doing so far we built for muscle exercises nothing particularly new or earth-shattering what you're doing is when muscles contract they exercise when they relax they're they're not exercising you can tract and hold and you relax what that's what you're doing at the moment imagine these are your bicep you're contracting and holding these muscles and relaxing them contracting and holding and relax which is a great way to start the pelvic floor muscle exercises what we want to do now is build up on that to ensure that you get good strength in these product for muscle exercises this is where you show fantastic results to achieve and maintain dryness over long periods of time and stress what we have to do is add resistance just as just as I wanted to build up my arm I would need to pick up some weights and lift and hold and release to get great extra muscle exercises out of that if you can't put weights on your pelvic floor muscles so the best way to do that is to put resistance imagine that instead of using weights I'm lifting and holding and contracting and relaxing pushing down with my left heart I hand into my right hand I'm adding resistance and the amount of exercise that I'm getting in this muscle is far superior to just relaxing Contracting so we're going to try that now is our second step of our pelvic floor muscle exercises what we're going to need to do this is to get down on the floor and we're going to do some little crunches where your hands go behind your head and you lift up and you hold and that way you're putting the extra stress and strain on those muscles those muscles pelvic floor muscles as we were saying we need to add resistance to these muscles in order that we get real strength a great way to do that is to lay on the floor and do some little crunches which like many sit-ups that will that will put the strain in that you need to add the strength to these muscles so this is this is a simple easiest way to do it find yourself a nice comfortable spot get your feet nice and comfortable sitting flat on the floor and and get ready and then lay down you're now on the floor what we need is your feet flat on the floor knees up in the air hands cupped behind your head with your elbows facing straight out get nice and comfortable actually may need a mat or something like that next to your bed to do these so as I said before all muscles are only working when they're contracted so the first thing we're going to do is could track those pelvic floor muscle exercises and then we're going to do little sit-ups little crunches where we slowly come up and we bend over from side to side now because our muscles wrap around our body in three ways we're going to do these much exercises in three ways first of all we'll come up and across to the left then we'll come straight up and then we'll come up and across to the right so the idea would be that out as we come up here right elbow comes across towards our left knee then both elbows would come up towards both knees or our left that our left elbow up towards our right knee it's not about speed it's about stamina with these muscles so take your time take it easy and only come up as far as you can if you have a bad back or any other problems take it nice and easy what we're going to look at doing is five each three times that's three repetitions of five of these exercises in each direction and this is how it goes close your backside lift that perineum up clamp off your urine so you've got a good strong contraction ready to go and then imagine someone's going to punch you in the stomach and you need to brace the fourth exercise is to brace your tummy and hold it you're now ready with those muscles contracted you're ready to go so close your back side lift that perineum clap off your brace your tummy and slowly come up and across you would need to do five of these in that direction and then relax when you're ready to go again have a deep breath close your back side lift up your perineum clamp off your of urine brace now comes wall air being he'll come up five times straight away easy nice and straightforward if you have probable troubles doing five relax and just hold for five seconds so you could do the same exercise and instead of going up and down five times hold this is the way you would do that close your back side lift your perineum clamp off your urine and up you come hold 1,000 2,000 3,000 4,000 5,000 and relax let it all go now you need to do three repetitions so you would do five close your back side lift clamp brace five from right elbow to left knee then you do five straight up and five from left elbow across the right knee you would do three repetitions of them and you need to do them at least twice a day to three times a day that then gives you that extra sustenance and strength that you're looking for that enables those pelvic floor muscles to get super strong and support your bladder and your bladders Fichter in a way that will ensure that you get continence very very quickly and very very permanently a number of men that I see out they've had prostate cancer therapy complain about being dry most of the time it's it's it's normal for men to get dry at nighttime fairly quickly and but during the day a lot of men complain to me especially down the track six to twelve months after therapy that they're okay they're wearing a pad still just for comfort or fur security but if they coughed or sneeze or get tired then they often just have a small accident wait a bit there is a great way to sort that problem out using pelvic floor muscles as well the way we do this is against resistance as we've already discussed every time you were to sit down stand up open a door lift up lift a box with a pumpkin in it or a bag of groceries sneeze or cough is the time that you're most likely going to wet a bit so what we would do is the same pelvic floor muscle contraction that we've discussed just before you do any form of exercise that increases the stress on the top of your bladder the way we do this is as I've discussed that close lift and clamp prior to coughing or sneezing it's that simple so what you would do is close your backside lift that perineum up clamp off your urethra to stop your wing and then cough or sneeze or or stand up and sit down or open that door what you're doing is twofold here the first thing you are doing by closing your back side lifting that perineum and clamping off that's Viktor is you're supporting the sphincter and the bladder to help hold them close while you're coughing or sneezing or putting strain on that bladder so you will stay dry as a result of that second that what you're doing is what you call an activity of daily living exercise when we stand up or when we sit down we put a lot of strain on the top of our bladder and these public floor muscles which is why we wet when we cough or sneeze we put a lot of strain on the top of that bladder which is again why we wet by closing lifting and clamping off that pelvic floor muscle and then coughing sneezing or lifting where we're maintaining the integrity of our bladder and those muscles by closing the sphincter off at the same time we're exercising that muscle against the stress of coughing sneezing or lifting so you have a two-fold win on this one that you stay drier and you exercise that muscle that's a very important aspect of your pelvic floor muscle rehabilitation and ongoing maintenance is it whenever you do anything that would strain that pelvic floor muscle you would do this little close lift and clamp exercise and you'll find in no time at all that you build that muscle back up and get complete continence back again thank you for your time you


  1. Thanks for that. I am here as i have overactive bladder which is making my life a nightmare at times esp travel. I gave an expert what amounted to a week of my wages , to no result, and she didn't give me the exercises you have given us free here. Every blessing from Ireland!

  2. Great quality

  3. Thanks Dave will give it a go prior to the old laser and hope for the best .

  4. Post Holep operation I have watched your exercise video and put it into practice – not very successfully so far.  Previously I used to have acute discomfort of needing to pee and frequency.  Since doing the exercises yesterday the acute discomfort sensation has disappeared but I now have partial incontinence. Do I continue?

  5. Thanks David
    You are my last hope
    You convinced me that this will work


  7. Biggest take away… do Close, lift, clamp exercise 10 times a day… high frequency was an eye opener….. Thx

  8. Good advice, I’m sure, but I found it extremely disconcerting that at no stage did Shan Morrison look at the camera.  Talking to two inflated rubber bladders is so unnatural; surely those two balls have no problem with their valve. David Hughes, in the second video is excellent.

  9. Thanks for the upload David. It's been of great value.

  10. Does this also work for frequent night time urination due to BPH? Thanks.

  11. Thank you David.

  12. I'm a cancer patient. Recently diagnosed with prostate cancer. Soon they will remove my prostate. I think this is a good exercise. Seem to me it's not only works for your bladder it also work's for your to get rid of the body fats as well

  13. Thank you for explaining in details. Doctors talk about kegel exercise which only reduces liking

  14. When i’m trying to hold my pelvic muscles .. my lower abdomen is paining.. is it ok ?? I mean is it right way ??? Please tell me

  15. Hello. Can you do these exercises when you have a catheter in your bladder through penis (before HoLEP O.P.)?

  16. 5:06 LMAO!

  17. Hi , One question. I had my prostate removed only 6 weeks ago . I Now do leak whenever I am not sat down .Would you consider it safe to do the " crunches" so soon after ?
    Could I damage / tear the rejoining of the Urethra to my bladder ?
    Many thanks for such a concise video.

  18. do you do all three of these exercises the first group close lift clamp, then sit ups,then and cough and chair or do you alternate them?

  19. Dear David, I am very impressed with the quality of your communication skills and completing this video which has the clarity and focus to transmit information. You take a serious and sometimes complicated issue and transmit this knowledge with out frivolity, verbosity or trivialization. Bravo!

  20. Best explanation I've heard yet. Thanks.

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