If you have been diagnosed with prostate cancer and are having surgery to remove the prostate gland (i.e. prostatectomy), you will likely have many things on your mind. Whilst there may seem to be more pressing things to deal with than pelvic floor exercises, the reality is that the earlier you can start this the better in terms of the situation you may find yourself after surgery in relation to urinary incontinence. It can be difficult to acknowledge the importance of this before surgery whilst you are still continent and there benefits of addressing this now aren’t obvious.
“The best time to start doing pelvic floor exercises is now, for those having prostatectomy“
The reality is that the majority of men having prostatectomy will experience some degree of urinary incontinence and erectile dysfunction following surgery. Whilst the majority will regain this function in due course, it appears that those who are able to start doing pelvic floor exercises prior to surgery have fewer issues following surgery.
Most men aren’t particularly well attuned to their body, so when it comes to pelvic floor muscles most don’t even know where they are let alone how to contract them or use them. It is far easier to learn how to use these when everything down there is working fine. Doing this makes it far easier for men to know what they are supposed to do after surgery and what it should feel like.
If you imagine what things may be like after prostate surgery, you will likely be a bit sore in your pelvic region, you will have wounds that are healing and you may generally be feeling a bit off or fatigued. None of these things make it particularly easy to learn how to contract your pelvic floor muscles. In fact, it makes things particularly difficult. So, if you already know how to contract your pelvic floor and what it should feel like to do so, you will be much better placed to just get on with doing your pelvic floor exercises.
The best way to learn how to do pelvic floor exercises is to consult with an experienced men’s health physiotherapist who is able to assess you using real-time ultrasound to see whether your muscles are actually able to contract well or not. This is much easier to do when your pelvic region isn’t tender (as we need to apply the ultrasound head on your lower abdomen or between your legs) and when you are actually continent. It can still be done, just not as easily.
Additionally, the sooner you are able to get started, the more you are able to practise and refine your pelvic floor contraction such that it becomes second nature. It also gives your body a chance to condition your pelvic floor muscles – in the same way that your muscles get stronger by doing exercises in the gym.
In outlining the above, hopefully you can see that starting your pelvic floor exercises as soon as possible once you know you are going to have prostate surgery the better. This may not seem all that important prior to surgery to start pelvic floor exercises as you will more than likely or have any issues with your continence, however those that do typically have less issues after surgery.
Note: if you have had surgery and weren’t in a position to start pelvic floor exercises prior to surgery, this does not mean that you have missed your opportunity. Learning how to contract your pelvic floor and starting a program of pelvic floor exercises is still very important. In this situation, it is imperative that you consult with an experienced men’s health physiotherapist who can guide you through pelvic floor contractions and assess whether you are doing it right (it can be difficult to know whether you are doing it correctly without tools to assess this properly).