Pelvic Floor Therapy for Incontinence
Incontinence is a regular side effect of radical prostatectomy surgery.
However, the majority of patients experience the return of normal function
with time. Patients who have continued problems with urinary incontinence
often improve with physical therapy.
Physical therapists work with prostatectomy patients to teach them appropriate
pelvic floor muscle exercises that serve to squeeze the urethra and prevent
the leakage of urine. Prior to surgery, closure of the urethra occurs
primarily where it passes through the prostate, but this closure mechanism
is removed with the surgery. Physical therapy is occasionally ordered
prior to the prostatectomy surgery to allow patients to learn the proper
technique. Otherwise, therapy typically begins about 8 to 10 weeks after surgery.
Physical therapy begins with an evaluation which and testing of the strength
and duration of the pelvic floor contractions.
Therapy concentrates on isolation of the pelvic floor from other muscle
groups that are commonly activated when a patient attempts to contract
the pelvic floor. These muscles include the abdominals, hip and thigh
muscle groups. Some of these muscle groups can work in opposition to the
pelvic floor; for example, the abdominal muscles can increase the pressure
placed on the bladder which can increase, not decrease leakage. Biofeedback
is often used in therapy to allow a visual reference to the contraction.
Based on the performance of the pelvic floor, a program of home exercises
is developed and taught to the patient. For example, a patient with a
weak pelvic floor often needs to begin exercises while lying down and
can progress with time to sitting, and standing, and then to exercises
with other activities such as during a golf swing.
Post-Prostatectomy Erectile Dysfunction Rehabilitation
Treatment to restore erectile function should be a part of every patient’s
recovery plan following prostatectomy, but early return of erectile function
is not always possible. St. Joseph Hospital physicians are committed to
a program of early erectile dysfunction rehabilitation for patients after
Physicians often use a combined approach including oral medication, intra-urethral
suppositories and vacuum erection devices. When these approaches are not
sufficient, the use of penile injection therapy or insertion of a penile
prosthesis may be appropriate. The recovery of erectile ability may not
be complete for as long as two years, even though some patients recover
much sooner. Age and erectile ability prior to surgery are important determinants
of postoperative recovery of erections sufficient for intercourse.
Current and future studies of post-prostatectomy erectile dysfunction
are focusing on improving penile rehabilitation, enhancing nerve regeneration
and preserving penile length. In addition, researchers are developing
drugs to help protect the nerves spared during prostatectomy, a novel
approach that may help prevent post-prostatectomy erectile dysfunction.
Preoperative Robotic Prostatectomy and Radiation Treatment Class
1st Monday of every month from 3 - 4 p.m.
This free class provides preoperative education to patients and their families
prior to surgery for prostatectomy. Patients undergoing radiation treatment
for prostate disease will also be supported, as management and rehabilitation
needs are very similar.
to register call 714-734-6261