Pelvic Floor Physical Therapy for Men: Post-Prostatectomy Surgery

Joseph Rosi
March 16, 2023
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Patients will have erectile dysfunction and urinary incontinence following their prostatectomy procedure requiring male pelvic physical therapy to address these issues. Pelvic physical therapy for male patients for male pelvic health consists of strengthening the muscles and their supportive tissues, which surround the prostate gland and urinary bladder.

Pelvic Floor Physical Therapy for Men Post-Prostatectomy Surgery

After surgery, men will experience unwanted episodes of loss of urinary control and erectile dysfunction. If you would like to learn more about prostatectomies you can follow this link to find out more

Prior to surgery, men have a prostate that aids in bladder control along with the pelvic floor. Once the prostate is removed, the pelvic floor has to become stronger to overcome the pressure that was once assisted by the prostate. 

Pelvic floor physical therapy helps you regain control of your pelvic floor for bladder control and sexual health. This occurs due to the removal of the prostate which in turn places greater stress on the pelvic floor to stop the flow of urine. Naturally, when we move, cough, sneeze, etc. we exert downward pressure on the abdomen and bladder which stresses urinary control. 

By careful progression and strengthening of the pelvic floor, men are able to regain control of their bladder, so they can resume all the activities they enjoyed prior to the surgery. Strengthening is only part of the equation though. 

The pelvic floor muscles need to be ready to contract while you move, so you don’t leak with movement. But more importantly, you will want the ability to stay dry throughout the day. This is where endurance comes in. 

As for erectile function, the pelvic floor acts as a hammock that relaxes and depresses in order to allow blood flow into the pelvis. In order to maintain an erection for penetrable sex, the pelvic floor then tightens and maintains the blood flow in the chambers of the penis until climax occurs. 

For many men, they don’t have the strength, endurance, or coordination to use their pelvic floor in this capacity following the surgery. Because of this, it is recommended that they use a penis pump in order to maintain blood flow in the chambers and maintain healthy penile tissue and length. The whole idea of “if you don’t use it, you lose it” applies here, and we’re not just talking about function, we’re talking about length too. And nobody wants that!

What To Expect From a Pelvic Floor Physical Therapy Session

In order to get on a treatment plan, you will first go through a confidential consultation. Your therapist will take extreme measures to make sure you feel comfortable sharing your story, frustrations, and goals with them, as that is exactly what we specialize in.

After your initial consultation, you and your therapist will agree on the best treatment plan. Then your therapist will get you started on a plan designed specifically for re-training the pelvic floor muscles. This can involve a number of methods such as using biofeedback, strengthening exercises to the pelvic floor muscles and learning relaxation techniques for over-dominant muscles. Improving your nutrition and lifestyle factors would also help. Each session is 100% specific to you, your goals, and your current abilities.

After a thorough history, your therapist will move on to an objective exam and assessment to see how you are moving, but more importantly give you educational information on life factors and daily stressors that play a huge role in the recovery after a prostatectomy surgery, such as fluid intake. This will play a vital role in your recovery and be important information for you to have from the start.

As for the pelvic floor assessment, your pelvic floor physical therapist will make sure that you are appropriately draped and examine your pelvic floor. They will test your muscle strength, endurance, coordination, and power to see where you are in relation to expected levels needed for daily function and recreational activities. From there, your pelvic floor physical therapist will sit down with you and come up with an actionable treatment plan.

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The Benefits of a Pelvic Floor Physical Therapy Program

The greatest benefit and factor of a successful pelvic floor physical therapy program for men is adherence.  Without a doubt, you can have the best plan in the world, but if you don’t follow it, you won’t get the results.  Each plan is specific to the person as each person will present a little differently; however, the main goals are the same.  The main goal is to build stronger pelvic floor muscles with increased endurance to last throughout your life’s greatest adventures, not limit you from them.  To do that, you will need to play an active role in your recovery.

How Do You Do Pelvic Floor Physical Therapy at Home?

Your pelvic floor physical therapist will show you what you need to do and give you the tools to succeed with your plan. This includes completing all the aspects of your plan. This differs from a “normal” physical therapy plan in the sense that normally when someone has homework to do from a physical therapist, it is typically solely exercise. 

At Alinea Performance, we address those lifestyle and nutritional factors we mentioned above. They play a big role in your overall recovery. One of the ways to measure your progress is what is known as your pad weight.

How Long Does It Take for Pelvic Floor Therapy To Work?

Like most recoveries, it happens gradually and we show you how to measure this. We will have you start with measuring your pad weight. This is the weight of the pad after an extended period of time to see how much urine you lost. Over time, you should see a gradual decline. Studies show upwards of 74% of men are continent within 12 weeks following their prostatectomy surgery given that they were adherent in their therapy plan.

Who Would Benefit From Pelvic Floor Physical Therapy

Erectile Dysfunction is when an erection is hard to achieve and maintain, causing sexual intercourse to be difficult. This condition may be due to the pelvic surgery but could also indicate cardiovascular disease, prostate cancer treatment itself (radiation), depression/anxiety of losing libido after surgery, nerve damage during surgery, diabetes mellitus or heart failure. Physical Therapy can treat these conditions by increasing blood flow through strengthening exercises for example- kegels.

Male Incontinence is the involuntary loss of urine during the day or night. Following a prostatectomy surgery, it is referred to as stress urinary incontinence. This issue can be caused by pelvic floor muscle weakness and spasms causing lack of control over bladder contractions. Pelvic floor muscles need rehabilitation after this type of procedure, which usually involves kegel exercises to strengthen the pelvic muscles to assist in regaining bladder control.

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Conclusion

Pelvic floor physical therapy is a specialized treatment that is aimed to help male patients who have erectile dysfunction or urinary incontinence issues. Your physical therapist teach you how to strengthen the muscles and their supportive tissues, which surround the prostate gland and urinary bladder.

About Alinea Performance

Mobile physical therapy allows us to easily provide physical therapy to Tampa, FL, and Baton Rouge, CA and the surrounding area. Physical therapy keeps you living the life you want to live, and helps train you for the life you want to lead. Massage, acupuncture and chiropractic care, and even some other physical therapy practices only treat the symptoms of a condition. You end up coming back for months without feeling better, but when you pair massage, acupuncture and/or chiropractic care with physical therapy you can use them to enhance your road to recovery.

We offer outpatient physical therapy for sports medicine, lower back pain, stretches for sciatica, hip labral tears, arthritis, male pelvic health and men’s pelvic pain. We can also help you find a MVA attorney to help you claim a settlement for a car accident. For the best physical therapy near you, click the button below to call Alinea Performance. Call today to schedule an appointment and eliminate your pain, regardless of how long it’s limited you.

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Dr Joseph Rosi II, DPT, Cert DN, CSCS

Dr. Rosi was born and raised in Dayton, OH. He graduated from The University of Findlay with a dual degree – a Bachelors of Science in Kinesiology as well as a Bachelors of Arts in Spanish where he was immersed in the culture and lived in Costa Rica while studying at La Universidad de Costa Rica- San Pedro.  He then returned to University of Findlay and continued to graduate school to pursue his Doctor of Physical Therapy degree. During this time he completed mission work in Nicaragua, in which he served many young families who were unable to access the most basic forms of healthcare. 

After graduation, he set out to continue to learn and enhance his hands-on clinical skills, where he spent the next two years completing a Manual Therapy Certification from The University of Saint Augustine in St. Augustine, FL.  During this time he also completed his certification in Dry Needling from the American Academy of Manipulative Therapy. He also took coursework and furthered his specialty into male pelvic health. During this time he traveled, learned and worked in many different clinics in multiple states including Ohio, Texas, Indiana, South Carolina, New Mexico, California, and now Florida where Alinea Performance was born.

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