Physiotherapy before and after prostate cancer surgery


Urinary incontinence, or leakage, is to be expected after prostate surgery. It may be a mild problem, needing pads to manage it for only a few weeks, or more severe and requiring protective pads for up to a year. The pelvic floor muscles control the bladder and flow of urine. Exercising them effectively will help men regain bladder control earlier. Ideally, the exercises are started before surgery, but they can also help bladder control if started after surgery.


Impact of prostate surgery on bladder control

Urinary incontinence is to be expected after prostate surgery as some of the muscles responsible for bladder control are removed with the prostate. After surgery, urine may leak unexpectedly, especially with physical activity, coughing or sneezing. How much urine leaks and how long this incontinence lasts is hard to predict. Incontinence pads will be needed after the catheter is removed, sometimes for only a few weeks - but, for some men, it will take up to a year to recover control. For a few men, incontinence remains a long-term problem.


The pelvic floor

What are the pelvic floor muscles?

The pelvic floor is a round layer of muscle at the base of the pelvis. They support the pelvic organs (bladder and rectum) and control the openings of the bladder and bowel. The pelvic floor muscles also play a role in gaining and maintaining erections. The muscles that control the bladder are especially important after prostate surgery.


Finding the pelvic floor muscles

Sit on your hands and find the sitting bones in the middle of each buttock. The pelvic floor muscles stretch between them. Now stand up and find the pubic bone, at the base of the penis, and the coccyx (tailbone), at the bottom of the spine. The pelvic floor muscles extend from front to back and from side to side between these bones, forming a supportive layer. When tightened, the muscles lift the bladder and bowel inside the pelvis; they shorten the penis and close the anus (back passage). When urinating, contracting the pelvic floor muscles should stop the flow of urine.


Why should men exercise their pelvic floor muscles?

Urine leakage can be reduced by learning how to exercise the pelvic floor muscles correctly. For those men having prostate cancer surgery, this brochure is a good start. However, for best results, consult a pelvic floor physiotherapist. The pelvic floor muscles are hard to identify inside the body, so expert help will ensure best possible technique and training. It can boost confidence knowing how to do the exercises correctly. It can be a difficult time waiting for surgery and being proactive with pelvic floor exercises can help men cope.


Exercises

Exercise 1: technique


Exercise 2: daily workout


Exercise 3: the pelvic floor in action


What general exercise is recommended?


General exercise advice after surgery


The APA and men's health

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Media

The Senior online - Hey fellas, work that pelvic floor

Busselton Mail online - Dunsborough icecream maker puts focus on men's health

Freemantle Gazette online Physiotherapy aids recovery


APA podcast channel

Professor Paul Hodges chats with Shan Morrison and Patricia Neumann, both specialist continence and women’s health physiotherapists as awarded by the Australian College of Physiotherapists, about his latest venture, growing our understanding of the male pelvic floor, an area of research that remains 10 years behind it’s female counterpart.

This podcast was recorded at the Australian Physiotherapy Association's CONNECT 2015 conference. This channel brings you the latest in clinical academic and health leadership, giving you access to preeminent physiotherapy research from Australia, and across the globe.


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Download the brochure


Resources

Prostate Cancer Foundation of Australia (PCFA)

PCFA is dedicated to reducing the impact of prostate cancer on Australian men, their partners and families, recognising the diversity of the Australian community. The PCFA website provides information and facilitates support groups for men and women affected by prostate cancer.

prostate.org.au

1800 220 099

 

National Continence Helpline

The Helpline is a free service managed by the Continence Foundation of Australia and staffed by continence nurse advisors who provide advice, resources and information about local continence services.

continence.org.au

1800 33 00 66

 

Special thanks to Shan Morrison and Patricia Neumann for their contribution to the clinical content.