Physical Therapy After Prostatectomy

Many men with prostate cancer elect to have a prostatectomy – the complete removal of the prostate.  This type of surgery does help eliminate the cancer, however a prostatectomy also causes a number of other undesirable consequences, sometimes including incontinence. Not every man will experience incontinence after a prostatectomy, but those who do may suffer from it for up to 2 years after surgery. In rare cases, this may last even longer.

One way to help reduce incontinence after surgery is to enlist the help of a physical therapist.  A physical therapist trained in pelvic floor dysfunction can help men learn how to normalize pelvic muscle function by strengthening and/or relaxing their pelvic floor.

The pelvic floor is made up of a tightly woven web of muscles, located in the base of the pelvis between the pubic bone and tailbone. These muscles help support the main pelvic organs, control bladder and bowel function, and are involved in sexual function.

 When these muscles weaken (as they do after a prostatectomy), they may have trouble performing as they should.

Kegel exercises help to strengthen the muscles of the pelvic floor

Alternatively, some men experience overactive pelvic floors, or muscle tightness postoperatively. And while it may seem counterintuitive, this tightening can also lead to stress incontinence, since it prevents the muscles from contracting and relaxing as they should.

Is it effective?

Very. A recent study looked at prostatectomy patients who had some type of pelvic floor dysfunction post surgery. After receiving individual physical therapy for their specific type of pelvic floor dysfunction 87% of the patients showed significant improvement in their incontinence.

Besides improvements in incontinence, patients also showed a decrease in pelvic pain.

What to expect

Everyone is different, which means a skilled pelvic floor therapist will work with you specifically to develop a treatment plan just for you.

At your appointment, your physical therapist will begin by asking you about your medical history, habits and the symptoms you are experiencing. They will then likely perform a medical exam, and will assess your pelvic floor strength.

Your physical therapist will help you to develop a treatment plan that may include kegels and will work with you over a period of time as you regain strength in your pelvic floor. Alternatively, if you have an overactive pelvic floor, they will show you ways you can relax it to allow your muscles to properly contract as they should, eventually alleviating stress incontinence symptoms.

It’s important to be consistent with your exercises and to not get discouraged if you don’t see improvements right away.  Building up your pelvic floor muscles takes time, but if you follow your physical therapists instructions, you’ll begin to see progress.

Note:

You can learn more about kegels for men in our guide here.  However, we want to stress that every man is different, and in cases where you have an overactive pelvic floor, kegels may do more harm than good. Prior to starting any type of exercise, be sure to see a trained physical therapist who can give you a proper evaluation and advise you on which exercises will work best for your condition.