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Surgery to treat men with prostate cancer is often followed by months of difficulty controlling urine flow, a condition known as urinary incontinence. But new research suggests that this problem may go away more quickly if the men perform certain exercises to strengthen their pelvic floor muscles.
Researchers from the Kaiser Permanente Medical Center in Los Angeles, California, found that men who were taught how to perform pelvic floor exercises before and after surgery were more likely to have regained continence three months later.

Men Doing Pelvic Exercises Recover Earlier

In the current study, the researchers randomly assigned 38 men scheduled for radical prostatectomy to either a treatment group or a control group. The men in the treatment group were referred to a physical therapist. They were instructed how to do Pelvic Floor Exercises both before and after surgery, using biofeedback to ensure they were using the proper muscles. The control group did not receive any formal instruction. All of the men completed questionnaires regarding bladder function at regular intervals over the next year.
Overall, 82% of the patients had regained continence (defined as not needing to use any absorbent pads) by the end of the year, including about equal numbers in both groups. But on average the men who had been educated about Pelvic exercises regained continence about one month earlier than those in the control group (at 12 weeks vs. 16 weeks).
Most of the men who did not regain continence within a year were still using at least three absorbent pads a day, indicating continued severe incontinence. The study authors explained that these men probably had extensive damage to the bladder sphincter or severe dysfunction of the bladder after surgery, and the exercises alone were unable to compensate for this.
But the exercises seemed to be effective. Pelvic floor exercise and education initiated prior to surgery is an effective noninvasive intervention useful for improving early return of urinary continence, the authors concluded. It would certainly have a positive impact on our patients undergoing radical prostatectomy in an effort to improve quality of life after major urological surgery.

The results of the study were published in the Journal of Urology (Vol. 170, No. 1: 130-133)

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Dr. Neel Joshi, Clinical Chief, Department of Surgery at Cedars Sinai, describes his technique for trocar removal at the end of laparoscopic cholecystectomy.

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Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael's Hospital.

Written and Narrated by Dr. Mike Evans
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©2014 Michael Evans and Reframe Health Films Inc.

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A new well designed randomized study has suggested that long term baby aspirin usage may aid in fight against cancer. The suggested mechanism is that cancers induce inflammatory responses so the anti-inflammatory mechanism of prostaglandins inhibitors may cease the progress of many cancers. There are some concerns about the study because despite the well-designed randomized study; the study didn't include a satisfying number of female participants. The study was also conducted on esophageal, colorectal and lung cancers.

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A decade ago we thought that Chikungunya was a tropical disease restricted to the rain forests. However, after the 2007 epidemic in Italy and later in the Reunion islands, this dreaded condition has now spread to the Carribean and the Americas. Its an arthropod borne alpha virus which causes fever, polyarthralgia and arthritis. There could be serious complications in the adult such as meningoencephalitis or GBS as well as in neonates. This presentation discusses in detail the clinical features, diagnosis and management of Chikungunya fever. A detailed discussion of its complications is also included. Check out our other videos

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