Post-prostatectomy, now what?

Post-prostatectomy, now what?

By: Dr. Marin Cole

First of all, what is the prostate gland and why is it important? The prostate gland lies just below the bladder and surrounds the top portion of the tube (urethra) that drains urine out of the bladder. It is a major gland in males that is responsible for producing over half of the fluid involved in ejaculation. The prostate also helps to squeeze this fluid during ejaculation out of the urethra. The relevance of the location and function of the gland when it comes to removal of the prostate gland during a prostatectomy is two fold. First of all we take away an anatomical support around the urethra, which means less control of urine draining from the bladder down the urethra, and now there is decreased fluid production and excretion during ejaculation. What does this mean for you? After a prostatectomy you will likely notice a big difference during masturbation and intercourse in regards to your ability to ejaculate fluid, and you will likely notice a change in bladder control. 

And how can a physical therapist help with these side effects of a prostatectomy? I’m glad you asked!

I am a pelvic floor physical therapist which means that I can teach you about how the pelvic floor functions to control your urine, especially when it comes to leaking urine! As mentioned above, the prostate gland can be viewed as a sort of cushion around the urethra that helps to control the draining of urine into the urethra and out of the penis when you go pee, so now that you’ve removed the “cushion” support around the urethra, the pelvic floor has more of a responsibility than it is used to. I can train you how to PROPERLY contract and relax your pelvic floor to avoid leaking when you’re headed to the bathroom, when you’re lifting up something heavy, and when you’re getting up from sitting! There is SO MUCH MORE that I will go over with my patients but what it really comes down to is learning to better coordinate your muscles that connect to your pelvis–your pelvic floor, your core, your hips, your back, and even your diaphragm–so that you can perform the activities that YOU want to be doing without fear of leaking! 

When it comes to changes in ejaculation or even changes in ability to achieve an erection this is something that is more complex and often involves working with both a physical therapist as well as your urologist to find the right solution for you, but we can work on the pelvic floor muscles that are specifically involved in blood flow into the penis to improve erection! 

So, if you have had a prostatectomy, or if you are scheduled to have one in the future, and your doctor hasn’t talked to you about physical therapy, ask them to write a referral for you and get in to to see a pelvic floor physical therapist ASAP, you will be so grateful you did this for yourself!