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originally published: January, 2016

birmingham health physiotherapy
Prostate Surgery, Urinary Incontinence & Physiotherapy

How we can help

Prostate Surgery, Urinary Incontinence and Physiotherapy and how it might it relate to you?


Prostate cancer is very common with an estimated incidence of 1 in 8 in the UK. Older men, those with a family history and Black men are more at risk. What are the risk factors, check out this great infomatic from Prostate Cancer UK http://www.prostatecanceruk.org

Initially the most important decisions will be made between you and your doctor or specialist nurse as to the best treatment of choice for you. A great resource on prostate cancer is provided by Prostate Cancer UK




Following your surgery or treatment there will be great relief that the cancer has been treated or removed however a common complication is Urinary Incontinence.


Urinary Incontinence
Men’s Health Physiotherapy Clinic, Birmingham, UK

Urinary Incontinence is the inability to control your urine flow and the common types are Stress ( leakage on activity ) and urge ( the bladder needs to empty when it doesn’t really need to , the signals to the bladder have been distorted or mixed up). Here is a great fact sheet from http://www.prostatecanceruk.org

http://prostatecanceruk.org/prostate-information/our-publications/publications/urinary- problems-after-prostate-cancer-treatment

Urinary incontinence is a common side affect post surgery and can be a source or much distress and anxiety. It can be particularly difficult to deal with as prior to surgery most men are fully continent and have never had to think about how their “equipment or waterworks “ worked!. Post surgery urinary control can be affected due to lack of bladder control ( the prostate helped with this) , weak pelvic floor muscles ( yes men have them too) lack of blood supply to the area , nerves to the area may not function properly and cancer is very stressful which doesn’t help you pee properly.

Isn’t Pelvic Floor rehab helpful for women with Urinary Incontinence?
Great news, women with stress incontinence do really well with pelvic floor physiotherapy. Men post prostate surgery also do well with specialist Men’s Health Pelvic Physiotherapy.

Few key facts on the Male Pelvic Floor

  1. You have one
  2. Before progressing read point 1 again
  3. It has both sprint fibres ( Usain Bolt) and endurance fibres ( Mo Farah)
  4. It needs to be trained with other muscles like your abdominals and hip muscles, co-

    ordinating with breathing is also key. Breathing helps everything.

  5. Your pelvic floor needs to be strong ( exercise helps ) and a good blood supply (

    exercise helps)

  6. 6. A strong fit pelvic floor is essential for a good erection ( is there ever a bad one!)


What has this got to do with Physiotherapy?
If you had a sports injury like a torn or strained calf muscle you’d probably think physiotherapy or exercise would help and it would. Look at your Pelvic Floor like any other muscle , it makes things more simple.

Like any muscle (think Calf muscles) if they have become weak or damaged from the surgery and this is common they can be strengthened. They also have to work harder after the surgery once the prostate is removed. The prostate helps your urine control and once it has been removed ( one type of surgery ) the pelvic muscles have to work harder to compensate for this. Think of it like a sports injury , If Leonel Messi tears his cruciate ligament ( prostate ) then he will have to work very very hard on his Quadriceps muscles ( Pelvic floor ) to compensate. Otherwise his knee ( erection ) won’t work very well. As he trains his quads ( pelvic floor) his control will improve as will yours ! This will also help your erection but that’s for another day perhaps.


US pelvic floor


  1. Pelvic Floor rehabilitation using ultrasound imaging technology. We will look at your pelvic floor muscles on an Ultra Sound machine. Think pregnancy scans. It’s notjust a case of tighten down there but quite a specialised progressive programme involving different types of Pelvic Floor muscles ( Usain Bolt sprint Pelvic floor muscles and Mo Farah long distance Pelvic Floor muscles)
  1. Getting you working both types of muscles in positions of sitting, standing ( harder than you think)
  2. Combining your pelvic muscles with abdominal and hip muscle exercises. This will then progress to more high level abdominal work.
  3. Pelvic floor +: this is getting you to work your pelvic floor during normal exercises and activities. This is more fun.
  4. Exercise to relax and allow you to switch the volume down a bit in your head, yoga , meditation or what you enjoy doing. Our Men’s Health Physio clinic is based at the Barefoot Yoga studio in Harborne and all our patients and clients comment on how tranquil, relaxing and very non clinical it is.
  5. Prostate Progressive Exer Programme ( PEP ) “ Preparing you to be in a much better place”


We know exercise helps with blood flow, stress and strengthening and you’ll feel better doing something normal . You will get to do general exercise with other people like you who have had prostate surgery. We know that group exercise works really well for other conditions and there is also a big social element. Your partner may also want to attend some of the social events also as they are a big part of this also. We are also happy for your partner to attend to meet us if you want at any time as they will also have questions they want answered also.

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