By Rachel Garrod
This issue’s article is inspired by a conversation with a good friend of mine who has recently undergone radical prostatectomy for prostate cancer. He’s fine now by the way. But one thing he was most impressed with was the effectiveness of the pelvic floor exercises he was taught.
The exercises, often referred to as Kegels after the gynaecologist who devised them, target the muscles of the pelvic floor that run like a hammock from the pubic bone to the coccyx.
These muscles support the bladder and bowel in men and additionally the uterus in women.
Weakness in the pelvic floor muscles can lead to urinary and faecal incontinence and difficulty holding back wind. So it’s really essential they are strong! They are frequently taught to women after childbirth or as a treatment for urinary incontinence.
Most women will have heard of them even if they are a little unsure precisely how to perform them. But Kegels are also effective at treating male urinary incontinence and can even improve erectile dysfunction. One study of 55 men with erectile dysfunction found that 40 per cent of them regained normal function after three months of performing the exercises.
35 per cent reported improvements in function and only 25 per cent felt them to be of no benefit. Other outcomes were improvements in the strength of the anal sphincter and in quality of life.
(Oh, and their partner’s quality of life improved too!) Research has also shown that men who did Kegels over an eight-week period had less than half as many weekly incontinence episodes as they had prior to starting the exercises.
The first step in practising Kegels is to identify where the pelvic floor muscles are. The easiest way to do this is to try shutting off your pee mid-flow; it’s the pelvic floor muscles that enable you to do this. Try to target the muscles specifically; imagine them like an elevator rising up from the anus to the pubic bone.
Avoid clenching your buttocks or holding your tummy in. Once you can do the exercises, practice three sets of 10 every day, and in eight to 12 weeks you should start to notice benefits. And the great thing about Kegels is you can do them anywhere, anytime, and no one will know!
Physiotherapy lecturer and counsellor Rachel Garrod can be contacted
at: Tel. (+34) 652 281 122; firstname.lastname@example.org
Improved Sounds and Neural Advances Medical Minutes by John Schieszer
A PILL TO PREVENT HEARING LOSS
It may soon be possible to take a pill to prevent hearing loss. Researchers have discovered that inhibiting an enzyme called cyclin-dependent kinase 2 (CDK2) may help protect against from noise-induced or drug-induced hearing loss. In animal studies, investigators have found that CDK2 inhibitors prevent the death of inner ear cells.
According to the World Health Organisation, 360 million people worldwide suffer from hearing loss caused by congenital defects or other factors. These factors include infectious disease, use of certain medicines or exposure to excessive noise. Yet, there are currently no effective drugs that have been shown to prevent or treat hearing loss.
A team of researchers at St. Jude Children’s Research Hospital in the United States screened more than 4,000 drugs for their ability to protect cochlear cells from the chemotherapy agent cisplatin. Cisplatin is used to treat a variety of cancers, but causes irreversible hearing loss in up to 70 per cent of patients. The researchers identified multiple compounds that protected cochlear cells from cisplatin, several of which are already approved to treat other conditions.
Three of the 10 most effective compounds were inhibitors of an enzyme called CDK2. One of these CDK2 inhibitors, kenpaullone, was more effective than four other compounds that are currently in clinical trials for treating hearing loss. Injecting kenpaullone into the middle ear protected both mice and rats from cisplatin induced hearing loss.
In addition, kenpaullone protected the hearing of mice to noise as loud as 100 dB. “Given that 100-dB noise is in the range of noise insults commonly experienced by people in our society, kenpaullone could have significant clinical application in treating noise-inducedhearing loss,” said study investigator Dr. Jian Zuo, who is with St. Jude’s Research Hospital in Memphis (Tennessee).
WALKING AWAY FROM DEMENTIA
Women who have high physical fitness levels at middle age may have a significantly lower risk of develop dementia decades later compared to women who are moderately fit, according to a new Swedish study published in the journal Neurology.
The researchers found in their study that when the highly fit women suffered from dementia they developed the disease an average of 11 years later (age 90) than women who were moderately fit (age 79).
“These findings are exciting because it’s possible that improving people’s cardiovascular fitness in middle age could delay or even prevent them from developing dementia,” said study author Helena Hörder, PhD, of the University of Gothenburg in Sweden.
For the study, 191 women (average age of 50) took a bicycle exercise test until they were exhausted, to measure their peak cardiovascular capacity.
The average peak workload was measured at 103 watts. A total of 40 women met the criteria for a high fitness level, or 120 watts or higher. A total of 92 women were in the medium fitness category and 59 women were in the low fitness category. Over the next 44 years, the women were tested for dementia six times.
During that time, 44 of the women developed dementia.
However, only five per cent of the highly fit women developed dementia, compared to 25 per cent of moderately fit women and 32 per cent of the women with low fitness.
The highly fit women were 88 per cent less likely to develop dementia than the moderately fit women.
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.
He can be reached at email@example.com.