Prostate Cancer

Pelvic Health Physiotherapy

During & After Prostate Cancer Treatment

As you are likely to be aware there are some side effects to treatment which may vary depending on the type of treatment you have. These generally affect bladder control, bowel function and sexual function. Pelvic health physiotherapy aims to help improve these and improve your quality of life in the short and long term.

 Evidence suggests incontinence can be as high as 80% immediately after surgery.

The good news is…

  • Our understanding of men’s continence mechanism has advanced greatly in the last few years.

  • We can use pelvic floor muscle training to prevent and treat incontinence.

  • We can tailor training to target specific muscles likely to be involved to help overcome incontinence.

  • Doing these types of exercises before prostatectomy reduces the odds of leaking post surgery.

  • The reason for bladder leakage or urinary incontinence after treatment for prostate cancer can be multifactorial.

    In terms of the muscles there is a specific way the muscular components contribute to your ability to control your bladder. Before treatment (prostatectomy) these worked automatically. After your prostatectomy you will need to learn how to coordinate this system manually.

    Practicing this before surgery can be beneficial to train the sequence and increase connection, strength and coordination therefore optimising muscle function. Doing this before can make a big difference as it takes time to gain strength to make a difference. The is called Prehabilitation and is done before many other surgeries like joint replacements.

    If you have already had a prostatectomy, pelvic health physiotherapy can also help you to coordinate the muscles and tailor your pelvic floor exercises to your specific needs.

    Targeted pelvic floor muscle training helps prevent and treat urinary incontinence.

    Doing targeted and tailored pelvic floor exercises BEFORE prostatectomy reduces the odds of leaking at 3 months post surgery by 36%.

  • • Follows principles of motor learning and exercise physiology.

    • Targeted exercise based on new understanding of the mechanism of incontinence in men.

    • Based on assessment of your pelvic floor - we make sure you are doing exercises correctly and targeting the right area of the pelvic floor and in the right sequence for best results.

    • Addresses your specific issues and progress strengthening accordingly.

    • Graduate exercises from low intensity to high intensity.

    • Integrates functional activation for use during activity and unexpected challenges e.g. sit to stand, cough/sneeze bending lifting and exercise.

    • Utilises bladder retraining and urge management as required.

    • May include use of a clamp and protocol for use and weaning.

    • Tailored core and general exercise.

    • Maintenance program for long term care.

    • Includes penile rehabilitation for those wishing to optimise sexual function recovery.

  • • Prehabilitation – any time before hand - optimal 4- 6 weeks before gives you the opportunity to increase awareness, connection and conditioning prior to surgery to help prevent and treat urinary incontinence.

    Doing targeted and tailored pelvic floor exercises BEFORE prostatectomy reduces the odds of leaking at 3 months post surgery by 36%.

    • Post Prostatectomy – start pelvic floor muscle training as soon as catheter removed not before. Seeing a pelvic health physio any time from 4 weeks post-surgery.

  • It is still a great idea to see a pelvic health physiotherapist for some help and targeted training. That might mean working on patterns of activation, coordination, strength, endurance or functional use of the pelvic floor muscles.

  • Bowels may be affected immediately after surgery and often this will manifest as constipation.

    Long term bowel function is more likely to be affected by radiation therapy.

    Pelvic health physiotherapy can help manage both of these issues.

  • This is a way to support and maintain penile tissue and prevent unwanted side effects after a prostatectomy while we wait to see what the nerve recovery might be. This will be discussed in clinic based on assessment. These may also be implemented post radiation treatment if required.