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Prostate Cancer Surgery – Bladder Control

prostate cancer surgery


Removal of the prostate can impact the function of the pelvic floor muscles and their ability to control the bladder resulting in leakage of urine.

The degree to which each man experiences this problem varies greatly from just a few weeks of minimal leakage to feeling a complete loss of control in the first few weeks and many months to becoming dry. There might be a small leak each time you stand from a chair, cough or sneeze or a feeling of limited sensation of when you need to wee, or a feeling that you just “can’t turn off the tap”.

What is happening to the body?

Removal of the prostate means there is less of a buffer between the bladder and the pelvic floor muscles. The muscles can take a while to cope with a different feeling of the weight of the bladder. Also, the removal of a small part of the urethra that travels through the prostate means that a small part of the muscle around the urethra is removed so that the remaining muscle needs to work harder.

How can physiotherapy help?

A specially trained Men’s Pelvic Health physiotherapist can teach you how to use the pelvic floor muscles correctly and how to strengthen them. The muscles that men use to prevent leakage are a little different to the ones that women use. We can use the real time ultrasound to visualise the three key muscles and teach you how to activate them correctly.

Men who are able to start their pelvic floor exercises before surgery are shown to have a better outcome following surgery so if you have the opportunity, please come to see us beforehand. After surgery we can see you once the catheter is removed. Pelvic floor exercises are also an important part of return to sexual function.

The pelvic floor muscles that are important to leakage are the striated urethral sphincter, the bulbocavernosous and the puborectalis. They work together to create a “kink in the hose” of the urethera.

prostate cancer bladder control

Image from Stafford et al, Journal of Urology 2012

Should you have any questions or wish to speak with one of our Men's Pelvic Health physiotherapists, get in touch with us today on 02 9907 0321.