Prostate Cancer and Your Pelvic Floor
Prostate Cancer and Your Pelvic Floor
Prostate cancer
A radical prostatectomy is the surgical removal of the prostate gland and may be an advised treatment option for prostate cancer. After a radical prostatectomy, men can have problems with bladder control (the bladder can leak urine unexpectedly) and erectile dysfunction. This blog will give you some basic information about urethral and pelvic floor muscle training to help you prepare for and recover from prostate surgery.
What is the pelvic floor?
The pelvic floor is a group of muscles at the base of the pelvis, creating a muscular hammock. These muscles support your bladder and bowel and are important for continence and sexual function, including arousal, sensation, erectile function, and orgasm/ejaculation.
Exercising and strengthening the pelvic floor muscles before and after surgery can reduce the amount of incontinence (leakage) you experience and help you to regain urinary control sooner after surgery. Pelvic floor exercises can also help to hasten the recovery of your erectile function.
The importance of pelvic floor exercises
Bladder leakage can occur post-prostatectomy because the internal and external urethral sphincter muscles, which help control the bladder, can be disrupted when the prostate gland is removed. Luckily, there is a back-up system, the pelvic floor muscles! Recent high-quality evidence shows that pelvic floor and urethral exercises performed before and after surgery can help you regain bladder control sooner. In fact, 94 per cent of men regain bladder control within three to six months after surgery.
Do I need to see a physiotherapist for my pelvic floor?
Level 1A evidence (which is the highest level of research) tells us that pelvic floor physiotherapy done before and after surgery is the best way to improve urinary incontinence in men post prostate surgery.
So, why can’t you just do it yourself???
Research shows that supervised pelvic floor exercises (i.e. under the guidance of a trained health professional) is more effective at reducing incontinence post prostate surgery, when compared to unsupervised pelvic floor exercises (i.e. reading from a pamphlet). In fact, practising from a pamphlet is just as ineffective as performing no pelvic floor exercises at all!
Therefore, the evidence is clear! All men should have a pelvic floor muscle assessment with a pelvic floor physiotherapist to have exercises prescribed and monitored before and after prostate surgery.
What happens in a pelvic floor physiotherapy appointment?
Your pelvic floor physiotherapist will conduct a detailed subjective assessment including questions about your medical history, bladder and bowel health, sexual function, exercise habits and goals for recovery.
A pelvic floor assessment might include an ultrasound assessment via the lower tummy or perineum (space between the scrotum and the back passage). This will allow your physiotherapist to see how well you contract the pelvic floor muscles, how effective they are and coach you on correct technique.
Your assessment may also include looking holistically at your posture, how you move and your general strength and conditioning.
What’s next?
Book an appointment with one of our Pelvic Floor Physiotherapists as soon as you can before your prostate surgery.
We advise having an appointment two to six weeks before your prostate surgery and a follow-up appointment two weeks after your surgery.
The number of post-op appointments will vary depending on your progress.
Our physiotherapy team are here to help you through your pre/post prostate surgery journey so feel free to mention any concerns during your appointments.
Physiotherapy assessments can be made online HERE or by emailing info@thepelvicstudio.com. You can also call us on 6224 7195.