Life After Prostatectomy and Other Urological Surgeries, 10 Weeks From Incontinence to Continence by Vanita Gaglani, Osmosis Publishing, Melbourne, FL, 2014, paperback, 209 pages, $19.99.

This book outlines Vanita Gaglani's technique. Ms Gaglani is a physical therapist (PT) with experience in treating men after prostate surgery. The book is organized into 2 parts, with the first part being a review of anatomy, physiology, and bladder function. The anatomy is a little confusing and includes a discussion of pelvic floor, sphincter, and nerve damage (most of which do not occur with a typical prostate surgery). Fluid instructions include a long discussion of different types of milk. It is suggested that cow milk is preferred, but the influence of milk on the bladder is not clear. Kegel exercises are described, assigning no more than 8 sets of 10 contractions per day. Some of the exercises, such as the posterior pelvic floor muscle contractions and the elevator exercise, are taken from the treatment of female pelvic floor muscle weakness. It is also suggested that patients perform Kegel exercises in many situations during the day, such as when watching TV or when driving the car. Various types of exercises are described and include back, front, and combined contractions, quick contractions, cough and overflow exercises such as hip rotation, ball squeeze, band abduction, and abdominal and leg exercises (straight leg raise and squats).

Part 2 summarizes the weekly program and then discusses each week in detail. Preoperative instructions are provided, and men are encouraged at each level to continue with the program. Each week has suggestions for Kegel exercise prescription, additional exercises, pad use, and expected progress. The repetition of information is purposeful throughout the book. This is a patient education book; unfortunately, it does not include many references. The book provides a lot of information and exercises and may be too much for some patients. Parts of the text may include words and concepts above the average reading level of patients. The text does outline a progressive decreasing use of pads, which seems to be very helpful.

This book outlines 1 program of recovery after prostate surgery. It is interesting to read and may give PTs ideas they can incorporate into their own rehabilitation programs for men after prostate surgery.

Prostate Recovery Map: Men's Action Plan by Craig Allingham, Redsok International Publishers, 2014, Amazon paperback, 64 pages, $14.75.

Craig Allingham is a men's physiotherapist from Australia who has written a wonderful book to guide men through recovery after prostate surgery. This text outlines 5 levels of exercise and activities beginning in the preoperative period and extending to the late postoperative time. The pelvic floor muscle exercise is described, with encouragement to palpate at the perineal body externally for feedback on the contraction. Correct technique is stressed, including the role of the abdominals and breathing. An exercise prescription is provided, including number of contractions, position, and intensity of hold (starting with 30% effort to maximize quality of contractions). The program progresses with advice for increasing endurance, incorporating exercise for fast twitch muscle, and functional exercises. Level 3 introduces bladder training and urge suppression. Level 4 adds fluid modifications, weight loss, and more functional contractions. Finally, a high level of abdominal exercises that incorporate the contraction of pelvic floor muscle completes the program. Although not all men will need this level of training, it is helpful for younger men. Craig has created simple, low-tech videos that complement the text.

Simple anatomy and physiology are included, as well as some of the risk factors and reasons why leakage might persist. Encouragement is given throughout the book to persist in the exercises and overall health. Erectile dysfunction is also covered in a complete and sensitive manor. This patient education book is concise, complete, and easy to read. It brings a level of lightness to the discussion, which may be welcomed by many men. It is not referenced but is based on research (what little we have on the subject) and many hours of treating men in the clinic. This is a book written by a man for men. I believe there are men who are very worried about the surgery and outcome and who would greatly benefit from this book.

I would highly recommend every PT treating postprostatectomy urinary incontinence have a copy of this book. It is helpful in developing your own treatment strategies and is helpful to have a resource for your patients.

Beth Shelly, PT, DPT, WCS, BCB-PMD

Moline, Illinois

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