Men who are approaching surgery for prostate cancer (radical prostatectomy) are usually advised (by their surgeon) to practise pelvic floor muscle exercises in preparation. The normal bladder control provided by urinary sphincters is changed significantly by the surgery. This means that many men experience incontinence when their urinary catheter is removed. It is not possible to predict how much of a problem this will be, nor how long it will last. Your surgeon will be able to provide more information about what to expect.
After prostatectomy men usually need to consciously use their pelvic floor muscles to assist their bladder control. It is very helpful if men learn how to locate these muscles before the operation. The pelvic floor muscles are not altered at all by the surgery, and are usually in good condition to begin with. Knowing where they are and how to use them appropriately after surgery assists the recovery process.
Erectile dysfunction is an unfortunate and very common side effect of radical prostatectomy. In some men this recovers spontaneously over time, in other men this does not occur without help. Sensation in the penis is not lost – and it is possible to have an orgasm even without an erection. Erectile dysfunction can cause great anxiety and stress for the individual and also for his wife or partner. It is very important to be able to access advice about rehabilitation of erectile function. Don’t let embarrassment get in the way of seeking help for this problem. Health professionals involved in your care want to help you to maximise your quality of life during and after your cancer treatment. The degree of recovery of erections depends upon many factors – these can be discussed with your surgeon or at your physiotherapy appointment.
Sometimes men do not attend physiotherapy before their surgery, and are referred (or self-refer) afterwards. Often improvements can be made in terms of fluid intake, bowel habits, lifestyle, exercise technique, and voiding (bladder emptying) practices that improve their situation.
Prostatectomy side effects are some of the many conditions that can be helped by a suitably trained Pelvic Health Physiotherapist.