After Prostate Removal, Men Can Benefit from Pelvic Floor Therapy

Pelvic floor therapy isn’t just a treatment for women who have urinary incontinence. Men who have prostate issues also can benefit from these exercises. 

The pelvic floor is like a hammock inside your pelvis, supporting the urethra, anus, and in women, the uterus, constantly contracting and relaxing to hold in or release urine, stool and gas. Pelvic floor therapy is a targeted exercise regimen that focuses on regaining control of the pelvic floor following a trauma to the area.

Both women and men can benefit. 

Incontinence in Men

In men, most issues of incontinence and pelvic pain occur because of a disruption of the pelvic floor. This can happen following procedures such as: 

• Prostatectomy, where the entire prostate is removed due to cancer

• Transurethral resection of the prostate (TURP), which treats a benign enlarged prostate 

These side effects are often temporary, but between 6 percent and 8 percent of men will develop persistent incontinence as a result of these procedures. 

How Likely Is Incontinence?

Even before surgery, physicians can assess a patient’s likelihood of developing incontinence based on certain criteria, including: 

• Existing issues — If a patient is already experiencing leakage, the likelihood those issues will continue is greater. 

• Age — The older you are, the weaker your pelvic floor muscles will be. 

• Urethra length — Men with shorter urethras have increased rates of incontinence. 

• History of radiation — Having radiation before or after the procedure can increase chances of developing incontinence. 

• Obesity — The more a patient weighs, the higher their chances of incontinence after prostate removal due to the extra abdominal fat pressing down on the pelvic floor, further weakening the muscles. 

• Nervous system involvement — In a nerve-sparing surgery, the surgeon will try to sweep the nerve-containing muscles off the prostate before removing it. The chances of developing incontinence are slightly less with nerve-sparing prostatectomy. However, sometimes a non-nerve-sparing prostatectomy is necessary, especially when prostates are extremely enlarged, or the cancer has moved outside the prostate.   

• Benign vs. malignant procedures — The rate of incontinence during removal of benign tumors is significantly less than removing the whole prostate.  

How Can Pelvic Floor Therapy Help Men?

Akin to a strong core easing back pain and improving posture, strengthening muscles around the urethra can aid in treating incontinence. 

Pelvic floor therapy, sometimes known as Kegel exercises, are small movements done in repetition before and after surgery to strengthen the core muscles in your pelvis. The key is to keep your belly and abdominal muscles relaxed, as one of the biggest mistakes people make is focusing on the abdominal muscles instead of the pelvic core. 

Your doctor will likely encourage you to begin these exercises the day your procedure is booked, as strengthening the pelvic floor muscles before surgery can aid in recovery. 

When To See Your Doctor

A doctor will determine whether you are suffering from urge or stress incontinence. Urge incontinence is an overactive bladder, while stress incontinence is when you have leakage of urine with coughing, sneezing or straining. 

Men don’t typically require pelvic floor therapy for simply having difficulty urinating. A good percentage of patients can often alleviate symptoms with changes in habits, such as reducing stress, caffeine intake and water consumption before bed. 

Focusing on developing good habits, such as exercising and keeping a healthy weight, can contribute to fewer issues with your urinary stream, whether or not you’ve had surgery.