Dr Ian Smith - Urological Surgeon

BSc (Med) MBBS FRACS (Urol)

Urology - Pelvic Floor Exercises

As a Urologist I recommend my patients undertake pelvic floor exercises pre and post surgery to assist in managing urinary continence. 

Why are Pelvic Floor Muscles Important?

The Prostate gland sits at the base of the bladder where the urethra and bladder neck join. The prostate plays a role in maintaining continence and after it is removed most men experience a weakening in this region.
It is normal to experience incontinence (wetting accidents) immediately post prostatectomy and preparing yourself for this is important. Typically this resolves over time and most incontinence issues post procedure are resolved within 3 – 6 months.

How to identify your Pelvic Floor Muscles
You have been using your pelvic floor muscles your whole life, but after this procedure you need to focus your ability to activate these muscles on demand.
The muscles you use if you try and stop or slow the flow of urine when voiding are your pelvic floor muscles. It is important you only do this to identify these muscles. Stopping urination can disrupt the bladders ability to empty completely.

Exercises
While standing or sitting, squeeze the muscles around your back passage as if you are trying to stop passing wind. Relax, then repeat. Your thigh, bottom and stomach should remain relaxed during this process.
Try and increase your strength. See if you can work up to holding the squeezed muscles for 10 counts then repeat. It is normal to only be able to hold this squeeze for 2-3 counts post procedure.

Urge incontinence training.
When you feel the bladder is going to leak try and pre-emptively squeeze your pelvic floor muscle. This may happen when you are exerting yourself or undertaking a specific movement or sport.
When to start
You can start practicing these exercises prior to the surgery so you get a better understanding of the muscles involved. Do not, however, start these exercises while the catheter is still inserted post procedure, as this can irritate the catheter.
It is safe to commence these exercises once the catheter has been removed and the more you practice them the easier they will become.
Repeating these exercises regularly will strengthen your urinary sphincter. It is recommended you try and do them every 2 hours.
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