Continence Recovery After Prostate Surgery
Men’s health pelvic floor physiotherapist = Your key to success.
If you don’t have a pelvic floor physiotherapist on your team yet - Do this step first.
Ask your urologist or GP for a referral. Make sure the physio you see has a lot of experience specifically in helping men regain continence after Prostatectomy.
The advice you need to activate the right muscles is specific. You need a specialist, not a generalist.
The best time to start pelvic floor exercises is before surgery (known as ‘prehab’)
But, it is never too late to begin.
If you have been diligently doing the recommended exercises but it’s now more than a year after surgery and you don’t feel you’re getting anywhere, check in with your Physiotherapist.
They might be able to do an ultrasound to make sure you are activating the right muscles. There are also other options to consider at this stage, such as getting an artificial urinary sphincter.
You don’t need to suffer and struggle.
If you’d rather get specialist advice and support over the phone for free: call the Continence Foundation free helpline, 8am-8pm.
Alan and Fiona White have also written a comprehensive article including where you can get pads/incontinence products from in Australia.
Maximise your Kegel (pelvic floor) exercises.
Men’s health expert physiotherapist, Dr. Jo Milios, recommends these three simple methods:
Think and visualise ‘Nuts to your Guts’ as you do the pelvic floor lift. Research shows this visualisation helps men engage the correct muscles (ref: Gerard Greene, 2019)
Do pelvic floor exercises during activities you might experience leakage, such as sitting to standing, walking, coughing, sneezing.
Do a few contractions and releases in a row and time yourself - Dr. Milios’ research found 10 contractions performed in under 10 seconds led to great results.
Can you start penile rehabilitation and have sex while recovering continence?
Yes you can. It is safe to do so.
Doing penile rehabilitation and enjoying sexual activity will not negatively impact your continence recovery.
In fact, pelvic floor exercises positively impact erectile function - and using a vacuum device activates the pelvic floor. Therefore attending to both areas of physical recovery can benefit both.
The literature suggests starting penile rehabilitation early after surgery is beneficial (- when you medical team advises in your situation it is safe to do so).
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