Preparing for a Prostatectomy

November 22, 2022

Why should I see a Pelvic Health Physiotherapist?

Urinary incontinence and erectile dysfunction are common side effects of prostate surgery.

Urinary incontinence

During your surgery, the sphincter muscle that keeps the bladder tightly closed can be affected, allowing urine to leak from your bladder. This usually occurs during activities which increase pressure in the abdomen and on to the bladder such as lifting, coughing, sneezing, standing up from a chair etc.

The vast majority of men will regain bladder control in the  weeks and months following surgery.

A Pelvic Health Physiotherapist can teach you to train your pelvic floor muscles which may speed up your recovery and reduce your leakage.

Erectile dysfunction

The nerves that control erections can go into shock after your surgery. This can take many months or years to recover.

A Pelvic Health Physiotherapist can help guide you in penile rehabilitation to improve blood flow to the penis, maintain penile length, and improve sexual function.

Pelvic Floor Muscle Exercises

The pelvic floor muscles stretch like a hammock between your pubic bone and your tailbone. They support your pelvic organs  and help with bladder and bowel control.

Your Pelvic Health Physiotherapist will prescribe a pelvic floor exercise program specifically for you. Training these muscles before your surgery can help you regain continence more quickly. If you were unable to train these muscles before your surgery, you can begin once your catheter is removed.

To contract your pelvic floor muscles;

- Shorten your penis like you are trying to stop the flow of urine. You should also feel your testicles lift.

- You can practice in front of a mirror to allow you to see this movement.

- Concentrate on contracting the front of your pelvic floor and minimise tightening around your anus.

- It is important not to hold your breath, or contract other muscles such as your abdominals and buttocks.

- Performing quick contractions, particularly before a cough or sneeze is also helpful.

Post-op Advice

Incontinence Pads

You will need to purchase pads prior to your surgery. Most men require pull-up type pants initially and progress to wearing pads. These can be purchased from the pharmacy or the supermarket and are designed specifically for men.

Catheter

Your catheter will remain in place for approximately 1 week. You should not perform pelvic floor muscle exercises while the catheter is in. These exercises can re-commence after the catheter is removed.

Bowels

Avoid constipation!!!! Your surgical site does not want you to strain. Have some stool softeners, like Movicol ready just in case you need it.

Fluid

Avoid reducing your water intake to lessen your leakage.

A healthy bladder requires 1-2L of fluid per day. It may be helpful to avoid drinks that irritate your bladder (such as coffee, soft drinks and alcohol).

Exercise

Gentle walking is great for post-op recovery. Start slowly (~10 min) and gradually build up. Listen to your body. If you are feeling fatigued, rest! Do not over do it. Avoid lifting in the first 6 weeks. Ask your surgeon if there is a specific weight limit to what you can lift, and for how long.

When to see your Pelvic Health Physiotherapist?

You can contact your physiotherapist if you have any questions regarding your symptoms during your recovery.

Consult your physiotherapist approximately 5-7 days after your catheter is removed. This allows time for your bladder to settle after removal of the catheter.