Good exercises to fix urinary retention from enlarged prostate, surgery?

[Query]

I know this isn't a medical advice board. But other skaters (or at least hockey players) often have somewhat similar problems. Maybe someone here has received some advice. My urologist (a surgeon) is hard to reach and isn't very helpful.

I am over 65 & have an enlarged prostate, had a prostate biopsy, surgical entry in the perineal area. After a week, due to frequent urination and eventually back pain, I saw a urology team. Said I had an overfull bladder. They installed an indwelling (semi-permanent) catheter and urine bag, which fixed overfull bladder & back pain, but interferes with almost everything I enjoy.

Over the next two months I had a voiding trial, a cystoscopy & UDS (urodynamics). My prostate now blocks urination. The urology surgeon wants to perform TURP surgery, gives a 50-70% chance of success. If it fails, I will always need a catheter.

I want to try using exercise to fix the problem. What might help?

Before biopsy I skated and did other active sports, often hours/day, using techniques that focused on core muscles, especially abdominals, and did some stretches. But from the biopsy until a couple days ago I was told to refrain from exercise. Even now I am warned I may bleed a little from exercise, and did yesterday after skating 2 hours and hiking a little over an hour to and from the rink. (BTW, I had a lot of trouble skating, even at my low level. My muscles are very weak due to the enforced rest.)

Should I return to using abdominal and other core muscles? Some websites say extreme abdominal muscle training (e.g., weight lifting) can complicate urinary retention.

Some websites say to stretch, not strengthen, the pelvic floor. https://cathywatsonphysio.ca/the-tight-male-pelvic-floor says male hockey players often develop similar problems due to turned out hips, which shortens pelvic floor muscles. Figure skating seems similar. Should I stop skating and similar sports?

I sometimes used to use gym machines to strengthen other muscles. Good or bad idea for this purpose?

Other exercises and stretches that might help?

The urology surgeon and hospital have average online ratings by patients. Is a better rated surgeon and hospital likely to do better?

[Bill_S]

I don't know the answers to your questions, but I wanted to say that I'm so sorry to hear about all these troubles.

Best of luck finding a solution!

[Query]

Did some online research.

Some medical experts say to strengthen pelvic floor muscles for BPH. Others say that is bad, stretch them instead.

At least one study https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/210484 says the more hours of physical activity, the less urinary retention problems - but moderate intensity exercises are best. But some studies say high intensity exercise is bad.

It also said inactivity (watching TV) is bad. I often watch a lot of TV and browse the web a lot.

Some "experts" advocate the Mediterranean Diet. I eat chicken too often, don't eat enough oil or beans or fiber.

I was told by my doctors to drink a lot of water, for Diabetes, to reduce blood sugar, and after surgery or with a catheter, to prevent dehydration. But some people say for people with BPH, too much water before bed is bad. Huh.

Some medical sources say HoLEP is better than TURP. Maybe my urologist or hospital is out of date?

[Query]

I answered my questions at Google Scholar: recent studies disagree on almost everything!

E.g., there is a strong inverse correlation between men with prostate problems and current exercise, and a strong correlation between inactivity (e.g., watching TV, Internet), so perhaps that is how they respond to the problem, but a less clear relationship between worsening of prostate problems and exercise.

I will spend much more time on light to moderate exercise, including some skating, less on TV and Internet, try a Mediterranean diet, use my bladder as though urinating 2 or 3 times a day (it felt weak at the void test, perhaps relying on a catheter weakens the muscles?), and do pelvic floor stretches, starting now.

I will discuss drug therapies, facilities, and TURP vs laser surgeries at my next appointment with my current urologist.

[AlbaNY]

I'm sorry you are dealing with this.  I know another skater with prostate problems, but I do not know what was recommended to him aside from the fact he bundles up more than otherwise for skating.  (I'm sceptical that cold has any bearing on it, but he is convinced chill is the underlying cause for it.)

In short, no help from me, but I am very interested in the bit about hip turn out and pelvic floor muscle strength. 

I'm not sure how much turn out I have.  I always thought very little since I am pigeon toed when walking, but I'm not so certain.  As a woman who has given birth (and with a grandmother who had trouble with pelvic floor...) I have a some concern in the back of my mind about decades ahead.  Of course people basically never used to even discuss these matters either, so it's a bit new to even find conversation about it.

[Query]

Alba: the website was talking about MALE hockey players. Not sure any of that applies to females.

If you were capable of no turn out it would be difficult to skate. Based on what you have done, I would guess you have some.

Maybe walking pigeon toed could be as much a matter of shoes (e.g., heel height) and walking gait as anything else? If I try to put one foot in front of the other (advocated in a popular hiking book as an efficient walking gait, also used by many racewalkers), my toes point a bit inwards.

[AlbaNY]

Query, some of it must apply to females too?  I'm not a medical professional, so I don't know. 

My toes point inside so much that Coach cheerful and I joked about my being just about, almost, able to do a reverse spread eagle. 
I didn't mean I had zero turn out, but I doubt I could ever do a good spread eagle or cantilever?  I am however happily surprised by how much turn out I seem to actually have after all. 

As for you, exercise is so good for everyone, so I vote do as much skating as you can.

[Query]

Males are much more likely to have the problem due to hormones. Supposedly, females are more likely to have the opposite problem.

But maybe a doctor could tell you if it is a likely issue for you.

[Query]

Yeah! My urologist has ok'd return to normal activities, including skating, swimming...

He did say to do it gradually, not to do full intensity at first.

[AlbaNY]

Congrats on being able to get back to it!

[Bill_S]

That's great news!