Post-Prostatectomy
Physiotherapy After Prostatectomy
The most common surgery for benign prostatic hyperplasia (prostate enlargement) is called a transurethral prostatectomy (TURP). This surgery is done with resectoscope that is inserted into the penis to remove prostate tissue. Radical prostatectomy (removal of the prostate) may be performed for prostate cancer.
Physiotherapy Pre and Post-Prostatectomy
In some cases, there is a period of time where men experience urinary incontinence after surgery. Physiotherapy training of the pelvic floor muscles before surgery has been shown to shorten the amount of time men experience incontinence symptoms (Burgio et al., 2006). Training activation and coordination of the pelvic floor, abdominal wall and breathing patterns may be helpful in restoring optimal function after your prostatectomy. Physiotherapists can guide you in this training to ensure you are doing the exercises properly.
What is normal bladder function?
A typical adult can hold 300-400ml of urine with an average of 8 voids during the day and one at night. During urination, the pelvic floor muscles relax (there should be no need for straining) and the flow of urine should be strong, continuous, clear (not cloudy or bloody) and pain free. The ability to delay the need for urination should also be present, especially at night.
Exercises Pre and Post prostatectomy
After your physiotherapy assessment, you may need to work on the endurance or strength of your pelvic floor muscles. Alternatively, you may need to work on relaxing your pelvic floor muscles if they are overactive or “too tight”.
What are the pelvic floor muscles?
In men, the pelvic floor muscles that are most important to maintaining urinary continence are bulbospongiosus and the external urethral sphincter. These muscles shorten to create pressure in the urethra that stops urine from exiting the bladder.
How do we activate and exercise these muscles?
The most effective cues to activate the muscles of the pelvic floor that control urinary continence include “stopping the flow of urine” or “shortening the penis”. Both of these encourage a closing of the urethra by shortening the muscles which stops urine flow. Studies have shown that not all men respond the same to these cues so it is important that a trained physiotherapist helps find the best cue for you.
When should I see a physiotherapist?
It is wise to have a pre-operative examination by a physiotherapist in order to determine how effectively you are able to activate your pelvic floor muscles and to minimize any non-optimal activation patterns that may be present before you undergo surgery. If needed, it is easier to learn a new muscle activation strategy when you are not actively healing from a procedure.
After surgery, many men follow-up for treatments to work on engaging their pelvic floor muscles and to work on reducing any symptoms of urinary incontinence or dysfunction should it arise.
For Chronic Pelvic Pain Syndrome/Chronic Prostatitis;
Downtown Vancouver Physiotherapy Clinic
Electra Health – 970 Burrard Street, Vancouver BC
Open 7 days a week from 8 am to 8 pm
604-685-4325 (HEAL)
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