Prostate surgery whether it’s for cancer (like a radical prostatectomy), benign prostatic hyperplasia (BPH), or another condition—can be a life-saving and necessary intervention. But many men are surprised by the side effects that follow, especially when it comes to urinary control and sexual function. That’s where pelvic floor physical therapy (PFPT) comes in.
Why the Pelvic Floor Matters After Prostate Surgery
The pelvic floor muscles form a sling at the bottom of the pelvis and play a key role in supporting the bladder and bowel, maintaining continence, and even contributing to erectile function.
After prostate surgery, especially when the prostate is removed, these muscles may have to take on more responsibility than they’re used to. Additionally, nerve damage and changes in anatomy can cause weakness or dysfunction in the area.
Common Post-Op Issues Pelvic Floor PT Can Address
- Urinary Incontinence
- Leakage when you cough, sneeze, laugh, or lift something? This is called stress urinary incontinence, and it’s extremely common after prostate surgery.
- Some men also experience urge incontinence, or a sudden, strong need to urinate.
- Pelvic Pain or Discomfort
- Surgery can irritate nerves and muscles in the pelvic region. PFPT can help calm down the area and reduce tension or scar tissue-related discomfort.
- Erectile Dysfunction
- The pelvic floor muscles are involved in achieving and maintaining erections. Strengthening them may help improve blood flow and erectile response post-op.
We Consider the Gold Standard of Care For Prostate Surgery is seeing a pelvic floor physical therapist both BEFORE and AFTER surgery
When to Start Pelvic Floor PT:
Ideally, start pelvic floor PT before surgery (called “prehab”) to build awareness and strength in the muscles. But if you’ve already had surgery, it’s never too late to start—whether it’s been 6 weeks or 6 years.
Benefits of Pelvic Floor PT After Prostate Surgery
- Improved bladder control
- Faster return to continence
- Better pelvic awareness and muscle coordination
- Reduced pelvic pain or discomfort
- Support for sexual function
- Improved quality of life and confidence
What to Expect in Pelvic Floor PT After Prostate Surgery
Your pelvic floor physical therapist will tailor a program based on your unique symptoms and goals. Common components include:
- Pelvic floor muscle training (PFMT) — including how to properly do a Kegel (hint: most people do it wrong)
- Bladder retraining to help improve urgency and frequency
- Breathing, posture, and core work to reduce pressure on the bladder and improve coordination
- Scar tissue mobilization and manual therapy to address tension or discomfort
- Education on lifestyle and bladder habits to support healing and prevent setbacks
Prostate Surgery Preparedness Class
Knowing Prostate surgery is a major surgery, we have designed a Class that will include:
Pre-Surgery Preparation: A clear understanding of what to expect before, during, and after surgery.
Post-Surgery Recovery: Practical tools for managing pain, enhancing mobility, and strengthening the pelvic floor to support long-term healing.
Setting Expectations: Addressing the mental and emotional challenges of surgery, while also providing expert guidance on lifestyle modifications to support recovery.
Our first Class will be June 24th 2025 at 6:30 PM and you can check the website for future Prostate Prep Classes as we will be offering this class multiple times a year.
Pelvic floor physical therapy is one of the most underutilized but powerful tools for recovery after prostate surgery. If you’re struggling with urinary leakage, urgency, or pelvic discomfort, don’t just “wait it out.” The right support can make all the difference.
