Highland Physical Therapy

Prostatectomy and the Pelvic Floor- Part 1

Prostate cancer is the second most common type of cancer to affect North American men (1). Approximately 1 in 9 men in the US will be diagnosed with prostate cancer at some point in their lives. While it is less common for diagnosis in men under the age of 50, 1 in 59 men age 50-59 will be diagnosed with prostate cancer, and the rate shoots up to 1 in 13 for men age 70-79.  Risk factors for prostate cancer include age, family history of cancer, genetic factors, race, lifestyle and dietary habits. 60% of all prostate cancers are diagnosed in men over age 60. African American men are 76% more likely to develop prostate cancer compared to white men, and more likely to die from the disease, obesity also increases the risk of prostate cancer as well as the risk of more serious side effects (2).
If you or a loved one have recently been diagnosed with prostate cancer, there is good news! Prostate cancer is a relatively slow growing cancer and so the chances of catching it early and undergoing less invasive treatment is quite high. The 10 year survival rate after prostate cancer treatment (surgery or a combination of surgery and radiation or chemo) is >95% (3). The downside of this good news, is that if you experience unpleasant side effects from surgery- like urinary incontinence or erectile dysfunction- you have a long time to deal with those things. ​Most of us, unless we have issues, never even think about our pelvic floor and the important job it does. For most men, the prostate does such a  good job at supporting continence (or the ability to withhold urine) that the pelvic floor may not be performing optimally, and you may never be aware of it. Remove part or all of this vital structure and BAM! Urine leakage, erectile dysfunction, pain, difficulty completing your usual activities are all possible. ​

Again, there is good news! A specially trained pelvic floor physical therapist can help. The pelvic floor is a complicated structure, and the answer to incontinence is not always the popular “kegel” exercise. While kegels are a type of pelvic floor strengthening, some men benefit more from learning how to relax a tight pelvic floor, while others need to learn how to better coordinate their pelvic floor with other body areas. So while kegels are a good starting place, some men may find that these exercises alone do not solve their pelvic issues. ​
An ideal physical therapy program would involve a pre-operative assessment to determine your baseline function. This  may include the strength and flexibility of your pelvic floor, back, hips and core. Your physical therapist can then create an individualized plan to assist you in any areas of concern prior to your surgery. Your therapist will also instruct you in a safe post-surgery exercise program to begin right away. In addition to pre-operative education and exercise, it is beneficial to see your physical therapist as soon as you are cleared to do so by your surgeon to head off any problems that you are experiencing including pain, incontinence or sexual dysfunction as well as aid in the healing of scars and introduce a safe plan to return to usual activities. Your physical therapist may use minimally invasive diagnostic and treatment tools including ultrasound to assess the structure and function of your pelvic floor muscles to get you feeling your best before or after your prostatectomy. ​​At Highland Physical Therapy, we understand that prostate cancer treatment and recovery can be overwhelming. A physical therapist can help you understand how your pelvic floor muscles are working and how to get them working their best so you can return to the things that are meaningful for you after this surgery. Whether that’s being able to travel and visit friends and family without frequent trips to the bathroom, returning to an exercise routine without pain or leakage or having a meaningful relationship with an intimate partner.

You may be thinking, I had a prostatectomy a while ago, but I am still having some of these issues, is physical therapy for me? The answer most likely is yes! It is never too late to improve your pelvic floor function and an examination to determine your specific trouble areas can be the most helpful starting point for you. 

Give us a call today, If you are preparing for surgery, already recovering from prostatectomy or have had symptoms for a while, or if you have questions about if pelvic floor physical therapy is right for you.You can schedule a free, no commitment discovery visit to do just that!

​Stay tuned in the coming weeks for part 2 and 3 of this blog series where I talk more specifically about post prostatectomy incontinence and erectile dysfunction and how physical therapy can help you take control of both!
1. American Cancer Society stats
2. Prostate Cancer Foundation- prostate cancer patient guide
Matthew, A., Lutzky-Cohen, N., Jamnicky, L., Currie, K., Gentile, A., Mina, D. S., Fleshner, N., Finelli, A., Hamilton, R., Kulkarni, G., Jewett, M., Zlotta, A., Trachtenberg, J., Yang, Z., & Elterman, D. (2018). The Prostate Cancer Rehabilitation Clinic: a biopsychosocial clinic for sexual dysfunction after radical prostatectomy. Current oncology (Toronto, Ont.), 25(6), 393–402. https://doi.org/10.3747/co.25.4111

Author – Kristen Topliff, DPT

I just moved to Pocatello from Twin Falls, with my husband who now works for Lamb Weston. I grew up in Nebraska and attended Wayne State College and University of Nebraska Medical School getting my physical therapy degree. 
I specialize in pelvic floor health for both men and women. I also like to help people with problems in their knees or hips and to help runners keep going.In my free time, I like to go camping, fishing and hiking with my 2 kids, husband and  dogs.Write something about yourself. No need to be fancy, just an overview.

4 thoughts on “Prostatectomy and the Pelvic Floor- Part 1”

  1. My dad has been thinking about getting some better treatment for his prostate cancer because it is causing him a lot of pain. He would really like to get some treatment from a professional to make sure that he can relieve his pain. I liked what you said about how it can be treated more effectively when they catch it early with screening. It was interesting to learn about how he can reduce his pain by making sure that he does the right kinds of exercises to help his pelvic floor work better.

  2. A combination of tantric massage, mindfulness, and bodywork, this holistic therapy works with the whole body, mind and sexual energy in a powerful way. Get support with sexual dysfunction issues such as erectile dysfunction, premature ejaculation and vaginismus, relax and open up to more pleasure. Learn to re-direct sexual energy through the body. Heal from sexual and other traumas.

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