Exercise for Urinary Incontinence following Prostate Cancer Surgery

Pelvic Floor Exercise for Men

Pelvic Floor contractions, often called Kegels, can be very helpful for strengthening the muscles of the pelvic floor. The challenge is figuring out what you are actually doing and how to contract the muscle.

Pelvic floor exercises can help men strengthen the pelvic floor and increase or reestablish urinary control. If you have issues related to your prostate, such as an enlarged prostate, discuss with your doctor to determine the best course of action and whether pelvic floor exercise is an appropriate part of your treatment plan.

In men, the front muscle of the pelvic floor surrounds the shaft of the lower penis; the back muscle surrounds the rectum; and the center point is crossed at the perineal body. Pelvic floor exercises engage the entire region, strengthening the muscles throughout the pelvic floor. Pelvic floor exercises involve the contraction of the rectum, as if suppressing gas, and the contraction of the urethra, as if stopping the flow of urine. A properly executed pelvic floor exercise should include a slight movement of the penile head and a small lifted feeling at the perineal body.

When you perform a pelvic floor exercise, close your rectum (as if preventing a bowel movement), and then use the penile muscles to lift the penis and tighten the urethra (as if stopping the flow of urine). The strongest feel of the contraction will be in the rectum, and when done correctly, you will feel the rectum pull inward. With a full contraction of this area, you have performed one repetition. Next, slowly and with control, release. Then, release further, letting go of any residual tension in your pelvic muscles.

The easiest way to figure out what you are doing is to imagine how you “hold in” gas when you are in public. Another simple way to make sure you are contracting the right muscles is that, the next time you are urinating, try to stop the flow of urine mid-stream. You should not do this on a regular basis, as it can cause bacteria to move back up the urethra and is bad for your bladder. But you can try it once or twice to make sure you are isolating the right muscles.

Once you’ve figured out how to contract the right muscle, make a deliberate effort to contract – you will feel like you are lifting up your rectum, into the core of your body, and slightly lifting your penis. Hold for a count of three, and release.

14 Replies

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  •  I have had urinary incontinence for 4 months. I only use 1 pad per day, but I want it to be totally gone. My urologist wants me to have physical therapy. I agreed. I will keep you posted. I use Kegel exercises, but I need more help. I have a lady therapist. I have met her and she is great. My urologist sends all his prostate surgery patients to her.

    She told me to do 90 Kegel exercises per day to be effective. 30 in the morning, 30 in the after, and 30 in the evening.

    I had my first therapy on April 28. I go back in 3 weeks. Meanwhile, I have to do homework. I keep a journal of my exercises to keep me on track.

    I am doing better. Each day I see a slight improvement over the day before.

  • My catheter was removed on December 21, 2015 after 4 weeks. Incontinence began right away. I soaked several pads each day. It got better as time passed.

  • I use Myrbetric tabs once a day and from time to time I need it, then for a while I do not. I keep a small black camera case with three pads in the trunk of my car to be used when needed.

  • Bob,

    Good description on how to do pelvic floor exercises.  I liked how you described the exercise.  I also tell men to stand at the toilet and let their urine flow, then start and stop the urine flow using only their muscles. 

    Joel

  • Thanks. Good advice.

  • Thank you for a great explanation!!  I did my kegals before and after surgery.  My doc said 3 reps of 10 each several times a day.  Either sitting or walking.  My incontinence went from diapers to pads to underwear.  I used to go "commando" but don't have that level of confidence.  I still on occasion have a squirt or leak upon a simple movement or exertion.  It keeps me on my toes to be prepared.  I feel fortunate.

  • You are welcome. Thanks for sharing.

  • Thanks.

  • thanks for the great description

  • jimreilly You're welcome. They are helping me a lot.

  • The exercises helped me after surgery.  I also used a device which is placed in the crotch area and then squeeze the "wings" together.  It helped to focus, but not necessary to get good results.  I had good control until after 43 radiation treatments.  Now have problems in both bowel areas.  On the urination side, a  small pad is sufficient and my leakage occurs primarily when rising after sitting for a long period or with lifting.  Must concentrate to contract before these actions.  Radiation (which was ineffective for the cancer) has resulted with IBS symptoms.  Adds an hour to getting started in the morning.  Think I will get back to a regular exercise schedule and see if that will help again. 

  • Shepard Good luck. Thanks for sharing.

  • Yes. Kegels help for sure. I have had 72 radiations and the outside two-thirds of my urethra inside my penis has become wrinkled on the inside (ischemic spongiofibrosis). I catheterize once a week for 3 minutes and it smooths it all out. Yet at some times I have urinary incontinence, so for 3 days I take Myrbetric once daily. Thanks for the help.

  • You're welcome.

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