Prostate cancer is the second most common cancer in men and the incidence increases exponentially after the age of 50. An intervention frequently used for treating prostate cancer is a surgical procedure called radical prostatectomy, which removes the prostate gland and some surrounding tissues. Prostate surgery is a major cause of urinary incontinence in men and a substantial percentage of men will experience urinary incontinence following. Other factors besides the surgical method have an impact on the chance of urinary incontinence post-op, including age, size of the prostate, severity of the tumor, and amount of leakage after the catheter removal. The International Continence Society defines urinary incontinence as “involuntary leakage of urine that has been diagnosed objectively and is associated with additional hygienic and social problems”. Pelvic floor physical therapy (PFPT) offers a way to handle the new onset of symptoms and to eliminate urinary leakage.
PFPT focuses on educating about what the pelvic floor is and how those muscles play a role in controlling the flow of urine. There are multiple strategies a PF therapist can employ in order to prevent / manage incontinence, including but not limited to PF muscle strengthening/motor control, core strengthening, pressure management skills and bladder habits to provide the most benefit and relief from urinary symptoms. Studies show that good neuromuscular coordination appears to be of immense importance for normal pelvic floor muscle function and PFPT can provide the guidance needed to learn how to control the pelvic floor musculature. Having a PFPT program can improve or even fully restore continence no matter the degree of severity. Since there are no side effects or risks from therapy, research advises that PFPT should be offered to all patients with incontinence from day 1 after catheter removal, because treatment is “most effective during the first 4 months after surgical intervention”. The tools provided during therapy can help prevent leakage and allow the person to return to their daily activities without worry or limitation. PFPT is commonly seen as a therapy only for women, but everyone has a pelvis and all are welcome to get the help they need in order to live the life they want.
Rajkowska-Labon E, Bakuła S, Kucharzewski M, Sliwiński Z. Efficacy of physiotherapy for urinary incontinence following Prostate cancer surgery. BioMed research international. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017841/. Published 2014. Accessed February 21, 2022.
Van Kampen M, De Weerdt W, Van Poppel H, De Ridder D, Feys H, Baert L. Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: A randomised controlled trial. Rehabilitation Oncology. 2001;19(2):28. doi:10.1097/01893697-200119020-00019