Combination of bladder training and Kegel exercises to reduce urinary incontinence in patients after TURP

Abstract

Continence and bladder care are essential components of healthcare to improve patient quality of life. Bladder training and Kegel exercises are commonly used together to manage urinary incontinence. Bladder training aims to increase the interval between the urge to urinate and actual voiding, thereby improving bladder control and reducing urinary frequency. Kegel exercises strengthen the pelvic floor muscles, which support the bladder, rectum, and other pelvic organs, and help reduce accidental urine leakage. Both interventions are effective behavioral therapies and are often recommended as first-line approaches, particularly for stress and urge incontinence. The aim of this research is to determine the effectiveness of combined bladder training and Kegel exercises as nursing interventions to treat urinary incontinence in patients with BPH post-TURP. Mr. N, a 61-year-old male with BPH post-TURP, presented with complaints of pain during urination, difficulty initiating urination, weak or interrupted urine flow, dribbling at the end of urination, a sensation of incomplete bladder emptying, and increased urinary frequency, including nocturia. His vital signs were blood pressure 159/101 mmHg, temperature 36°C, pulse 69 beats per minute, and respiratory rate 20 breaths per minute. Prior to illness, his urinary output was three times per day with a total volume of 900 cc. After the TURP procedure, he was fitted with an irrigation catheter, producing approximately 4000 cc over 8 hours. One day post-TURP, his urine output was 900 cc/day, with urine appearing dark yellow, non-viscous, and slightly reddish. The combination therapy of bladder training and Kegel exercises was performed twice daily for three consecutive days. Evaluation showed consistent improvement in the two primary nursing diagnoses: urinary incontinence and acute pain. Both problems decreased progressively and were resolved by the third day of intervention.

Keywords: Bladder training, BPH, Kegel exercise, TURP, Urological Nursing