Prostatectomy surgery is a surgical procedure where the prostate is removed, usually due to prostate cancer. Because the prostate is located right under the bladder and very close to the urethra, urinary incontinence (urine leakage) can be a side effect after surgery lasting for several months to a year. Sometimes, the urinary incontinence resolves around the one year mark. But, can physical therapy speed up the recovery?
Yes it can! Research indicates that pelvic floor physical therapy should be the first-line approach in addressing incontinence after surgery, and it should be addressed early. One research study noted that pelvic floor muscle training decreases time with incontinence (Filocamo et al, 2005). This study found that rehab should start very soon after surgery (within 1 month). More patients using a pelvic muscle training protocol achieved continence within 1-6 months after surgery than those not using the protocol. So, someone could avoid multiple months of leaking simply by retraining their muscles and going to pelvic floor therapy.
What’s the protocol that helped with incontinence? In the research, the protocols varied. One study had subjects see a physical therapist once per week performing muscle re-education and biofeedback training (using a visual to help the muscles contract) with a home program of pelvic floor contractions in a variety of positions. The subjects continued once per week until they regained continence (Filocamo et al, 2005). In another study, the subjects saw a pelvic floor therapist for only 4 sessions over 12 months. They learned to isolate the pelvic floor contraction, perform 3 sets of exercises with 5 second hold/ 10 second relax in varying positions, and practice “the knack” technique (contract before you leak) (Van Kampen et al, 2000). The common element to these protocols? The subjects saw a pelvic trained physical therapist to help them with their muscular contraction and to build an appropriate home program.
So, if you are going to be having a prostatectomy any time soon, please contact our office or your local pelvic floor physical therapy clinic to discuss post surgical options. If you want to read the research used for this post, see the resources below (the articles are free on google scholar):
Filocamo, M. T., Marzi, V. L., Del Popolo, G., Cecconi, F., Marzocco, M., Tosto, A., & Nicita, G. (2005). Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. European urology, 48(5), 734-738.
Van Kampen, M., De Weerdt, W. V. P. H., Van Poppel, H., De Ridder, D., Feys, H., & Baert, L. (2000). Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomised controlled trial. The Lancet, 355(9198), 98-102.