Medical Q&As

Prostate surgery - pelvic floor exercises?

My husband has recently had surgery to remove his prostate. He has had a very positive outcome and is recovering well. It is 4 weeks now since his surgery and he is doing exercises to regain bladder control. A number of years ago I had a hysterectomy and was also advised to allow the bladder to fill and resist going immediately I felt the need to go. Does this advice also apply to a man?

It is not unusual for a man to experience some degree of urinary incontinence after a prostatectomy. The degree of incontinence depends on the type of surgery the man has undergone. It can also depend on the length of time that a urinary catheter was left in situ after the operation. The exercises you referred to are known as pelvic floor exercises and they can help to improve the degree of bladder control. The pelvic floor muscles might usefully be compared to a hammock upon which the bladder rests. The urethra or outflow tube from the bladder passes through this layer and if the muscle tone is weak urine can leak from the bladder out through the urethra. Pelvic floor exercises improve the tone in the “hammock” or pelvic floor muscles in much the same way as exercising in the gym improves muscle tone and strength of the particular muscles being exercised. The exercise that you outline in your question would be of help to your husband but there are two simple additional exercises that should help to strengthen the muscles in the pelvic floor. Firstly, your husband should try to stop his urine in mid flow. He should then count to three while holding his urine and then allow it to flow again. He might initially find that he is not able to stop the flow for very long but with regular practicing of the exercise each time he urinates the degree of control will improve. Another exercise that he should try is to imagine that he is trying to stop passing flatus or wind through his anus. By tightening up these muscles he is using a different set of muscles in his pelvic floor. This second exercise can be practiced several times each day while driving the car, standing at a bus stop or even sitting down at home watching television. Your husband might feel some slight discomfort or the muscles might even feel tired but with repeated practice these mild symptoms will disappear. It is important that your husband be patient with these exercises because it may take some weeks before he notices any improvement in his current situation.