Bladder leakage (urinary incontinence) is a common side effect following the surgical removal of the prostate gland (radical prostatectomy) in the treatment of prostate cancer. Our pelvic health physiotherapists work closely with your urologist and GP to help manage any urinary incontinence that you may be experiencing.
It has been well established that pelvic floor muscle training improves bladder control and speeds up the return to normal urinary function following prostatectomy when compared to doing no training at all.
Just like attending ‘pre-hab’ physiotherapy in preparation for knee, hip or back surgery, pelvic floor muscle training is essential for optimising pelvic floor muscle function for good coordination, strength and conditioning. After all, the pelvic floor muscle is a skeletal muscle like any other and responds well to structured and progressive training. This results in an improved ability to effectively control the bladder post-operatively.
During the prostatectomy procedure nerves that supply the penis can be traumatised and can take 1-3 years to recover. Penile rehabilitation is considered an important part of post – operative management. Penile rehabilitation includes pelvic floor exercises along with other strategies to optimise penile length and erectile function (eg vacuum erectile devices – VEDs). The old adage: ‘if you don’t use it, you lose it’ applies, even if you are not sexually active – optimal penile health is important for urinary function and mental health!
Do you wee more than 6x per day?
Do you feel you have a bit of difficulty with emptying your bladder?
Do you have terrible urgency to get to the toilet and find yourself rushing to get there?
Are you afraid you may leak…..you may even leak at times, a little bit before you make it?
Is your bladder ruling your life?!
Our pelvic health physiotherapists can help to determine what may be causing these symptoms, some of which include prostate related symptoms, overactive pelvic floor muscles or inappropriate fluid intake and poor bladder and bowel habits. Often times many of these symptoms can be alleviated by simple methods once you know how.
Pelvic pain in men includes pain in the lower abdomen, in the penis/testicles/perineum (area between the testicles and back passage) and in the back passage. Men have described a range of symptoms that include but are not limited to:
- pain associated with ejaculation
- pain in the back passage that feels like ‘sitting on a golf ball’
- general aching pain ‘down there’ that gets worse with sitting, anxiety or stress
Sometimes this pain can start after being generally sick for a longer period of time than normal (ie difficulty getting over a bad flu etc), it may have been associated with a sexually transmitted infection or for what appears….no reason at all.
Often, initially the pain is in a small area and comes and goes, over time this seems to get worse and can be present for most of the time and take up more areas around/in the pelvis. By this stage a man has been for many tests and specialist appointments; you may have been told there is nothing wrong, and/or – you may have even been diagnosed with ‘prostatitis’, had a course of antibiotics – felt better for a time and then the pain has returned.
Pain that is present for longer than 3 months is called a ‘chronic or persistent pain syndrome’. Persistent pain can be related to a number of factors including over protective pelvic floor muscles, poor posture, activity reduction or cessation of your normal exercise/activity (for fear of making it worse), anxiety and stress.
Current management for chronic or persistent pain involves a mind-body, holistic approach. Physiotherapy assessment includes consideration of pelvic floor muscle function, low back and lower limb muscles along with movement analysis and non-physical factors such as thoughts, beliefs and behaviours related to pain.
Treatment is informed by the assessment and is tailored to your specific needs. There is a strong emphasis on pain education to help you understand your pain experience and to improve your confidence with managing pain, along with a specific exercise program to get you on the road to recovery.
See the following link for more information on pelvic pain in men:
You will communicate with one of our sensitive and caring admin team members initially who will book you an appointment with the physiotherapist who will help you the most. Alchemy prioritises patient confidentiality and we understand that your concerns are very private in nature so we ensure that you will feel confident and reassured when discussing your condition with our admin team members.
Our pelvic health physiotherapists are highly experienced and trained and have a thorough understanding of the complex nature of pelvic health conditions including incontinence, erectile dysfunction and pelvic pain.
Initial Physiotherapy Consultation
All of your consultations will be carried out in a private room and all information will remain strictly confidential. Your physiotherapist will initially ask you specific questions related to your concerns and any other relevant details that will help to inform your diagnosis and treatment plan. Following this, your physiotherapist will ask your consent to a physical exam which may include real time ultrasound assessment and in some cases a digital rectal examination to gain a detailed assessment of your pelvic floor muscle function. During this time, we make it a priority that you feel in control and comfortable. Please click here for more information regarding Pelvic Floor Assessments.
Diagnosis and Treatment
Your physiotherapist will explain the findings of the assessment and with you, will develop a tailored and effective treatment plan that will help you with your specific concerns. This typically involves a lot of education to ensure that you understand your condition and from there, are able to set meaningful goals for recovery.
How many sessions will I need?
Everyone is different, however pelvic floor physiotherapy has a strong emphasis on education and self management. Depending on your condition, you may need to attend clinic based treatment for a few weeks consecutively, to reviewing every 2 weeks, 4 weeks or 6 weeks. It is common to have at least 5-6 sessions spread out over a period of 3-6 months.
Our men’s health physiotherapists are: