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Pelvic Floor Therapy - Pre & Post Prostatectomy

Updated: Jun 5


Prostate Cancer & The Pelvic Floor

Prostate cancer is the second most common form of cancer, with an estimated 270,000 diagnoses in the US this year. If your doctor has suggested a prostatectomy, you may be wondering about how this will affect your sex life, bowel and bladder habits, and overall confidence. Luckily, pelvic floor therapy can help. 

During a prostatectomy aspects of the pelvic floor, including the urethral sphincter, are altered. This can unfortunately create pelvic floor dysfunction, including urinary incontinence and erectile dysfunction. 

If you’re finding that you’re suddenly leaking urine after prostatectomy, you’re not alone. Urinary incontinence can be found in up to 87% of people after surgery.

Why You Should "Prehab" Instead of Just "Rehab"

Many people come to pelvic floor therapy after surgery once they already have a problem. Seeing a pelvic floor therapist before surgery allows you to gain more insight into your specific strengths and weaknesses. "Prehab" visits allow you to begin connecting with your pelvic floor and deep core and helps give you an idea of what to expect post-prostatectomy. Working on your core and pelvic floor muscles prior to surgery helps start the strengthening process to shorten your recovery time and regain your urinary continence faster.


Goals during prehabilitation:

  1. Improve your bowel and bladder habits

  2. Teach you diaphragmatic breathing

  3. Work on your core stability

  4. Improve your spine, hip, and pelvic floor mobility

  5. Evaluate and improve pelvic floor strength and endurance

Therapy Techniques Post-Prostatectomy

Bladder habits - After prostatectomy, you may have a weak stream, or you may have difficulty in initiating a stream. A pelvic floor therapist will collaborate with you on an appropriate plan for healthy bladder habits.

This might include:

  • Keeping track of how long your stream is

  • Timing the intervals in between urination

  • Avoiding bladder irritants like excessive carbonated beverages, caffeine, or alcohol

  • Making sure you’re getting enough hydration. 

Pelvic floor muscle training - You may be reading about Kegels, but we’d caution you to run to them right away without checking in with a pelvic floor PT or OT first. Many people perform kegels incorrectly by using the wrong muscles, too many muscles, or by pushing the muscles in the opposite direction. Other people have overactivity in their pelvic floor, which means we have to work on lengthening the muscles before we strengthen them. Your pelvic floor therapist will be able to assess if you need a combination of pelvic floor muscle relaxation and strengthening and will work with you to make sure you’re doing them correctly. We also work on incorporating Kegels into functional tasks as much as possible. 

Core and lower body mobility and strengthening - Maybe your hips have always been tight. Or your sacroliliac joint had already been a little wonky. If you’re experiencing incontinence post-prostatectomy, you will most likely benefit from some combination of mobility and strengthening work, which may or may not include glute, adductor, or deep core training. 

Erectile Dysfunction (ED)- If you’re experiencing ED after surgery, pelvic floor therapy is a great tool. We approach sexual dysfunction through a biopsychosocial lens, meaning we work to understand the emotional and social impacts ED can have on a person. We can help teach you to properly lengthen and strengthen your pelvic floor muscles, which will benefit erection strength and endurance.


If you are planning a prostatectomy or have already had one, pelvic floor therapy is a great tool to help navigate and understand what is happening to your body and address all the symptoms you may be experiencing. We can help you recover quicker and get back to feeling like yourself again.


If you have pelvic health concerns and would like to see how our therapists at Embrace can help, follow the link to schedule your free discovery call.

embrace pelvic floor physical therapy

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