I. Voiding comes before continence when retention is possible.
Leakage may be protective in overflow. Strength work can worsen retention if emptying is not confirmed.

II. Internal assessment is helpful. It is not required to downtrain.
External perineal contact, towel-roll sitting, and pressure cueing can reintroduce pelvic expansion without violating surgical constraints.

III. Psychosocial profile sets the dosage ceiling.
The gladiator patient will overdo anything you prescribe. Give a small drill that cannot harm him, then turn it into a controlled “skills test” across positions.

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I. Paracelsus: “The dose makes the poison.”
The right intervention at the wrong dose becomes the problem.

II. Leonardo da Vinci: “Simplicity is the ultimate sophistication.”
The simplest plan is often the only plan a high-drive nervous system can follow.

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What is the smallest, safest intervention that will produce clean feedback by next visit?

With care,

Team IPC