The Role of Pelvic Floor Physical Therapy in Recovery Post-Prostatectomy

Prostatectomy, the surgical removal of the prostate gland, is a common treatment for prostate cancer and other prostate-related conditions.

While the procedure can be lifesaving, it often comes with post-surgical challenges such as urinary incontinence, pelvic pain, and erectile dysfunction. Fortunately, physical therapy—specifically pelvic floor physical therapy—plays a crucial role in helping men regain control over their bodies and improve their quality of life after surgery.

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Understanding Post-prostatectomy Challenges

After a prostatectomy, the body undergoes significant changes that could lead to several complications, including:

Urinary Incontinence: The prostate gland plays a role in urinary control. After its removal, men may experience stress urinary incontinence (leakage during activities like coughing, sneezing, or exercising) due to weakened pelvic floor muscles.
Pelvic Pain and Tightness: The surgery can cause scar tissue formation and muscle tension, leading to pelvic discomfort.
Erectile Dysfunction: The nerves and blood vessels responsible for erections are often affected by the surgery, which can lead to difficulties with sexual function.
Core and Postural Weakness: Abdominal muscles and overall core stability may be weakened, impacting posture and movement efficiency.

Man exercises using a cable machine post-prostatectomy, assisted by a pelvic floor physical therapist in a gym. Bright resistance bands and weights are visible. Both appear focused.

6 Ways that pelvic floor Physical Therapy Helps in Recovery

A specialized physical therapy program, particularly one focused on the pelvic floor, can address these challenges and aid in the recovery process. Here’s how:

1. Pelvic Floor Muscle Training (PFMT)

The pelvic floor muscles play a critical role in bladder and bowel control, as well as sexual function. A physical therapist trained in pelvic health can teach targeted exercises to strengthen these muscles, improving continence and sexual function. However, it’s crucial to learn proper technique, as incorrectly performing Kegels can be ineffective or even counterproductive.

2. Biofeedback and Electrical Stimulation

Biofeedback therapy helps patients become more aware of their pelvic floor muscles and learn how to properly engage and relax them. In some cases, electrical stimulation can be used to activate weak muscles and enhance recovery.

3. Bladder Retraining and Behavioral Strategies

A physical therapist can guide patients through bladder retraining exercises to gradually increase bladder capacity and reduce urgency. Strategies like timed voiding, fluid management, and dietary adjustments can also help manage incontinence.

4. Scar Tissue Mobilization and Manual Therapy

Soft tissue techniques, such as myofascial release and scar tissue mobilization, can reduce pain, improve flexibility, and prevent adhesions that may contribute to discomfort.

5. Core and Postural Strengthening

A strong core supports pelvic function. Physical therapy often includes exercises targeting the deep abdominal muscles, lower back, and hips to improve stability, posture, and overall strength.

6. Erectile Dysfunction Rehabilitation

Since the nerves responsible for erections may be impacted during surgery, physical therapy can help restore function through exercises that promote blood flow and neuromuscular recovery. Pelvic floor strengthening, in combination with medical treatments such as medications or vacuum erection devices, can support erectile function.

When to Start Physical Therapy

Ideally, men should begin pelvic floor physical therapy before surgery to learn proper techniques and strengthen the muscles beforehand. However, it’s never too late to start—many men benefit from therapy even months or years after surgery. Most physicians recommend beginning post-surgical therapy once initial healing has occurred, typically around 2–4 weeks post-op.

Before you have a referral, we offer a complimentary screening to identify issues and areas of concern. We can also treat for up to 30 days prior to receiving a prescription, thanks to direct access laws that were passed in 2024.

Free Pelvic Health Screening

The Long-Term Benefits of Physical Therapy

With consistency and guidance from a skilled therapist, men can experience:

Improved urinary control and fewer leaks
Reduced pelvic pain and discomfort
Better sexual function and confidence
Enhanced core strength and stability
Overall improved quality of life

Our Final Thoughts

Recovering from a prostatectomy can be challenging, but physical therapy provides an effective, non-invasive way to regain function and confidence. If you or someone you know is facing post-prostatectomy concerns, consulting with a pelvic health physical therapist can be a game-changer in the recovery process.

If you’re considering physical therapy after prostate surgery, talk to your doctor about a referral or seek out a specialist in pelvic health rehabilitation. Your recovery is in your hands, and with the right support, you can get back to living life to the fullest.

If you already have a referral or prescription for pelvic floor physical therapy, request an appointment below!

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