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The combination of Peter Dornan’s physiotherapy background and his firsthand experience of post prostatectomy complications has resulted in an effective incontinence management strategy.
Peter Dornan is a Brisbane physiotherapist and founder of the Brisbane Prostate Cancer Support Network.
Peter’s personal experience of post prostatectomy incontinence led him on a quest to develop an effective, unique approach to its management. After traveling to the United States in search of information on the complication’s underlying causes, Peter returned to Australia and developed an aggressive series of exercises aimed at controlling incontinence. His personal success at overcoming incontinence encouraged him to develop a comprehensive program to help other men with incontinence, which he describes in his book, Conquering Incontinence (see below).
Incontinence – An aggressive approach to treatment.*
Peter says, “The prime focus of the program is to develop highly efficient neuromuscular and vascular systems that control all of the structures that form the pelvic and abdominal cavities, including pelvic floor muscles.” He adds that there are seven ‘command centres’ and thirteen reflexes involved in continence control.
It is essential that a specific intense system of exercises be undertaken to improve all reflex circuitry relating to this control.
According to Peter, recent evidence suggests that the main damage during surgery is probably to the blood vessels supplying the nerves, possibly one reason for long-term neural deficiency. “In view of this speculation, the extended hypothesis of this program is to dynamically and functionally retrain elements of
the local vascular, muscular and neural systems to the extent that a collateral circulation may be introduced, therefore leading to a more normal bladder control situation,” he says.
Further, recent research has shown a strong link between abdominal muscle activity and pelvic floor activity. It is therefore important to integrate abdominal exercises and pelvic floor exercises.
Peter’s program aims to achieve four goals:
• Gain control, strength, power, endurance and speed of muscle contraction of the pelvic floor muscles.
• Dynamically and functionally retrain and integrate the pelvic floor muscles and abdominal muscles.
• Dynamically and functionally retrain components of the reflex circuitry mechanism involved with continence.
• Aerobically condition elements of the local vascular system supplying neural and other structures in the pelvic region.
by Peter Dornan (Published by Allen & Unwin)
Conquering Incontinence is written for all people with continence problems. The book describes
the structures of organs, muscles and tissues that help maintain continence. It describes Peter’s
physical technique that promotes increased circulation, enhances neuromuscular reflex activity
of the urinary system and improves muscular control of the abdominal and pelvic regions. The
book also contains a number of case histories (including his own) of those who have successfully
overcome severe incontinence using the management approach described in the book.
*Adapted from an article by Peter Dornan for the Prostate Cancer Foundation of Australia newsletter.