How do I retrain my bladder after prostate removal?

Man seated and talking to physical therapist about retraining the bladder and pelvic floor after prostate removal surgery
Author| Dr. Maureen O’Keefe, DPT pelvic health physical therapist specializing in recovery of bladder control, bowel function and intimacy related concerns after prostatectomy and radiation therapy.

How do I retrain my bladder after prostate removal?

We are so glad you found this page and hope that the information in this article helps you learn about some of the things you can do to retrain your bladder after prostate removal. We are Purple Mountain Physical Therapy, a specialty pelvic health clinic located in Grand Rapids, Michigan. We offer in-person and telehealth visits to men who are facing prostate cancer and experiencing bladder control issues following treatment. Physical therapy after prostatectomy and radiation therapy retrains bladder control and bowel control (for men who have bowel problems after radiation). There are also things you can do at home to help your bladder control recover after prostate cancer treatment. Here we will provide you information, including research backed recommendations for retraining bladder control after prostate removal, and tips you can implement today to help bladder control. Call 616-516-4334 to speak with one of our staff or submit your questions here. 

Read on to learn more about how to retrain your bladder plus some tips that you can implement at home!

If you are interested in learning more about physical therapy after prostatectomy, whether you would like an in-person visit or telehealth appointment, you can reach out to our staff at 616-516-4334 or contact us here.

If you are finding this article because you are going to have or already have had a prostate removal or radiation therapy, we’ve included helpful information here about retraining your bladder, pelvic floor muscle training and other considerations.

Our licensed physical therapists who specialize in bladder, bowel, pelvic pain and intimacy rehabilitation treat men before and after prostate removal as well as men who experience chronic prostatitis pain or other bladder, bowel or pelvic pain conditions. Bladder retraining physical therapy before and after prostatectomy is effective and works to decrease your incontinence, retrain your bladder function and improve your pain. For our patients, we also address erectile dysfunction and teach you what you can do at home to preserve your erectile tissues while your recovery is happening. If you are interested in learning more about pelvic PT treatments to retrain bladder control after prostate removal or radiation treatment, call us at 616-516-4334 to speak with one of our staff or contact us here. Our physical therapists have post-graduate training and experience specific to male pelvic and prostate rehabilitation.

Physical therapy helps retrain the bladder after prostate removal.

Your bladder control will be impaired following your surgery to remove your prostate. This tends to be true even for men who have very experienced surgeons using nerve sparing techniques. The removal of the prostate disrupts your urethra and may change your bladder neck, which makes it harder to control your urine. The pelvic floor muscles are the key muscles that hold your urine in. Pelvic physical therapy will assess these muscles and teach you how to rehabilitate them. At Purple Mountain PT, our pelvic physical therapists are experienced in rehabilitation after prostatectomy and radiation therapy. If you are interested in inquiring about cost and availability of our licensed physical therapists, contact us here or call 616-516-4334.

Our physical therapists will begin your pelvic floor muscle training therapy to retrain your bladder control at your first appointment.

We find that men do not know how to control their pelvic floor muscles. We recommend that you come to physical therapy for two visits before you have your prostatectomy. That way, we can help you figure out where these muscles are and we teach you how to begin training them. This is called “prehab” and we have research supporting that these two visits, in conjunction with 12 weeks of post-prostatectomy physical therapy will retrain your bladder control and recover your continence quicker than if you don’t have physical therapy. If you are interested in inquiring about our PT for prostate cancer rehabilitation and working with our licensed physical therapists, contact us here or call 616-516-4334.

In one recent study examining how to retrain the bladder after prostate removal, intensive pelvic floor physical therapy helped these men control their urine quicker than men who did not have bladder retraining PT.

Losing urine unexpectedly is depressing and anxiety producing. If you want to improve this problem, work with one of our licensed pelvic physical therapists to help you get better control. Each appointment is upto 55 minutes in length, private and with your doctor of physical therapy. We never bounce you around to other providers nor do we leave you alone to exercise by yourself while we treat another patient. Your treatment will be guided by your physical therapist and include extensive training to your pelvic floor muscles, core and breathing so that you can retrain bladder control after prostate removal. If you are interested in inquiring about our PT for pelvic floor muscle training, retraining bladder control and addressing any other issues (pain, bowel control, intimacy) that we provide in-person or via telehealth, contact us here or call 616-516-4334.

Why it is recommended to start physical therapy before your prostate removal. Research shows that Prehab helps you do better after surgery!

Before you’ve had surgery or radiation, you have an opportunity to discover where your bladder control muscles are located and begin practicing using these muscles, before the area is discombobulated from surgery or radiation. Two physical therapy prehab visits are what the research has recommended and can be invaluable to begin your pelvic floor muscle training exercises. If you are interested in inquiring about our prehab physical therapy for men facing prostate cancer treatment, contact us here or call 616-516-4334.

Doing pelvic floor bladder retraining exercises correctly, without using the wrong muscles, and without straining the bladder, prostate and pelvic region is an important part of your recovery.

Our pelvic physical therapists will work with you and teach you how to begin to train these muscles that help bladder control. The exercises are not easy, but with the experienced eyes of our licensed pelvic physical therapist, you will get the hang of how to engage the correct muscles. To inquire about our bladder retraining physical therapy, offered in-person or via telehealth, contact us here or call 616-516-4334.

Research has found that two prehab visits are beneficial and give you a plan for what to do following your prostatectomy or prostate radiation treatment.

Some men miss this window of opportunity to commence bladder retraining physical therapy and pelvic floor muscle training prior to their procedures. We can still help you if you don’t complete prehab, but our patients tell us that these two visits before their prostate removal are really helpful. If you are interested in inquiring about our PT for pelvic floor muscle training, retraining bladder control and addressing any other issues (pain, bowel control, intimacy) that we provide in-person or via telehealth, contact us here or call 616-516-4334.

Participants who underwent radical prostatectomy were divided into two groups and pelvic floor muscle training physical therapy began before their surgery for two visits and continued after surgery, for 12 weeks. 

Control Group 1: Completed some pelvic floor training exercises. Not as intense or specific as Group 2

  • Control Group: 3 sets of exercise/day. Received basic and low intensity physical therapy instruction for their pelvic floor exercises. This included a PT appointment showing them pelvic floor muscle exercise instruction over 2 visits and instructions to complete daily pelvic floor muscle training at home. They were told to complete 3 sets of 10 exercises a day, lying down sitting or standing up. Basically, this group did 30 Kegels a day, holding them for 1o seconds and resting 10 seconds between each exercise.

Intervention Group 2: Completed more intense and focused pelvic floor training exercises under the guidance of a physical therapist and daily at home. Experienced quicker retraining of bladder control

  • Intervention group that completed more intensive physical therapy pelvic floor exercises when supervised for proper technique: 6 sets of exercises/day, targeting all pelvic floor muscle fibers. This group also received two PT visits prior to their surgery and 12 weeks of post-operative bladder retraining physical therapy. The pelvic floor exercises and bladder retraining for this group were more intense and extensive than Group 1. These men completed 6 sets of 10 pelvic floor exercises at home; different exercises than the first group completed. Their physical therapist instructed them in very detailed technique to properly engage the pelvic floor muscles without cheating. The exercises in this group were more intense, specifically targeting both the fast twitch and slow twitch muscle fibers of the pelvic floor. Compared to the first group, these men completed 12 weeks of more repetitions every day and held them for longer duration. The men in this group completed these exercises in standing. Participants were guided in physical therapy to avoid muscular substitution patterns and “cheating” with things like holding their breath, squeezing their glutes or other mal-adaptive techniques.

Group 2, the more intensive and specific pelvic floor muscle training program with a physical therapist got men back to controlling their urine faster!

The men in the intervention group with more intensive physical therapy and pelvic floor muscle training had better urinary incontinence improvement than the men in the control group. 

2 weeks post op men who are dry (continent): Group 1: 4% Group 2: 14%

6 weeks post-op men who are dry (continent): Group 1: 11% Group 2: 32%

12 weeks post-op men who are dry (continent): Group 1: 43% Group 2: 74%

Our pelvic PTs are experienced in providing this intensive pelvic training physical therapy to retrain bladder control after prostate removal. If you are interested in inquiring about our PT for prostate cancer rehabilitation and working with our licensed physical therapists, contact us here or call 616-516-4334. 

Completing intensive pelvic floor training exercises, under the supervision of a physical therapist and daily at home, helps retraining of bladder control and faster return of urinary continence. 

If you would like to know how to do these exercises, our licensed physical therapists are here to customize a bladder control rehab program for you. We will ensure you are correctly completing the pelvic floor training exercises and that you are not straining your surgical or irradiated area. We provide comprehensive treatment, so if you also have back, hip or abdominal concerns, we treat that as well. You will be given a focused home program to complete, as well. If you have questions about our bladder physical therapy program for men following prostate removal or radiation therapy contact us here or call 616-516-4334.

If you are wondering how to retrain bladder control after prostate removal, the research has been clear that you would benefit from pelvic physical therapy that includes specific and intensive pelvic floor training exercises.

Our PTs at Purple Mountain PT will teach you how to do these exercises. When in an appointment, we provide one-on-one care. This means that we never leave your side. We make certain you are completing the exercises properly, which is crucial for your recovery. Most of the men we work with “cheat” (not on purpose!) with contracting the wrong muscles, instead of the pelvic floor muscles. Working together, we will help you retrain your bladder control and resolve pelvic floor muscle dysfunction. We tell you what to do at home, because you will need to be committed to doing these exercises daily at home for about 12 weeks and sometimes longer. Most men tell us that their PT has given them hope, decreased their depression and helped them to feel they have something to work towards. If you are interested in inquiring about our PT for pelvic floor muscle training, retraining bladder control and addressing any other issues (pain, bowel control, intimacy), contact us here or call 616-516-4334.

Our physical therapists are here to treat your bladder system and retrain bladder control!

Because our licensed physical therapists specialize in pelvic health, bladder, bowel and intimacy rehabilitation methods, we offer treatment that helps men following prostate removal. We provide holistic treatment to optimize bladder function. If you are interested learning more about pelvic floor muscle training, retraining bladder function and addressing any other issues (pain, bowel control, intimacy), contact us here or call 616-516-4334.

Your bladder needs to be able to:

  • Fill up with urine: We will help you retrain your bladder’s capacity to stretch and fill up.
  • Calmly hold the urine: Our physical therapy program for overactive bladder and urinary frequency and urgency help men following prostate removal and even men who simply have overactive bladder problems, unrelated to bladder cancer. After prostate removal, the continuous and insensible leakage of urine is a problem that our pelvic floor muscle training physical therapy can improve.
  • Empty the urine without difficulty: This is an important part of retraining your bladder and we will teach you and ensure that you are urinating with the optimal, relaxed technique that does not strain your pelvic floor, surgical area or bladder.
  • Empty fully: For your health, to avoid urinary tract infections, we want you to fully empty your bladder every time you urinate. Our bladder retraining physical therapy includes treatment to optimize the bladder muscle’s ability to fill up, hold urine and empty fully.

If you would like to receive physical therapy that helps your bladder recover its ability to fill up with urine, hold urine and empty, please call our office to speak with one of our staff. We can be reached at 616-516-4334 or contact us here. 

Physical Therapy care following prostatectomy or radiation treatment will include specific training in how to control your urine, advice and procedures at home to preserve your erectile tissue and treatment to help fecal seepage, if you had radiation and experience this problem

At Purple Mountain PT, your appointments are in a private, comfortable treatment room or in our private gym space for exercise-based performance. They are one-on-one with your physical therapist, meaning that we never leave you with a lesser trained staff member. You are welcome to bring your spouse or partner and men have told us this has been helpful to have another set of ears to hear everything we teach you. If you are interested in working with our pelvic PTs who can support your prostatectomy recovery, please call our office to speak with one of our staff. We can be reached at 616-516-4334 or contact us here. 

If you are unable to come to physical therapy, we offer a paid phone consultation to give you recommendations on bladder retraining.

Over the years, sometimes friends or family, who live across the country, would reach out for information about what they can do before their surgery or afterwards to help incontinence, pain, bladder function and erectile function. Friends and family over the years have given positive feedback and gratitude that the phone consultation is helpful; as a result, we offer a paid phone consultation option for individuals who would like to learn more about how to take care of their bladder control, bowel issues, erectile considerations and other concerns before and after prostatectomy or radiation treatment or during watchful waiting (active monitoring). If you may be interested in having a paid phone consultation with one of our pelvic PTs, call our office at 616-516-4334 or contact us here.

Tips you can implement for bladder retraining after prostate removal.

  1.  Drink enough water to not be thirsty. We advise that you do NOT limit your water intake. Talk to your medical team to find out how much water they feel is best for you. We cannot specifically tell you how much you need, but, in general, for bladder retraining you need sufficient water to allow your bladder to fill up, hold urine and empty fully. If you are always limiting your fluid intake your bladder may never experience this opportunity to fill up.
  2. Avoid bladder irritants. Some drinks or foods irritate the bladder and can make it easier to have urinary incontinence after prostate removal. In general, we advise no alcohol until you are fully continent. Coffee and caffeine should be limited to zero or one drink/day.
  3. If you are going to have a bladder irritant, dilute it with a glass of water beforehand.
  4. Try to urinate about every two hours. Emptying your bladder more often than this is not retraining your bladder. If you are constantly dribbling and losing urine, talk to your doctor about options to help this. There are some devices that may help you during this recovery period.
  5. Walk for exercise. We know you may leak, but we encourage walking every day for half an hour or more. Walking does activate and help rehabilitate the pelvic floor and hip muscles and this is part of your bladder retraining.
  6. Relax when you urinate. Be conscientious to relax when urinating. Don’t push your urine out. Even at the end of urinating, do not push those last bits of urine out. Instead, to retrain your pelvic floor muscles and bladder control, we recommend teaching yourself to relax when urinating.
  7. Talk to your physician about what you should be doing to preserve erectile tissue. Your erectile tissue benefits from erections and blood flow. Often physicians provide you with a prescription for erectile dysfunction, but you are not given clear instructions about the value of taking this to preserve erectile tissue. Ask your doctor about this.
  8. Don’t ignore abdominal or pelvic pain. More often than you might think, our patients also experience abdominal pain (from robotic scars and the surgery), penile pain, perineal pain or anal pain. If this is the case, mention it to your provider and know that pelvic PT can help you. We specialize in treating male chronic pelvic pain, such as chronic prostatitis, testicular pain and tailbone pain. Don’t ignore your pain, physical therapy can help you.

To talk to one of our staff, call our office at 616-516-4334 or contact us here.

All of our licensed PTs at Purple Mountain PT have training specific to male pelvic health rehabilitation, prostate cancer recovery and retraining bladder control after prostate removal. 

This is an important distinction that sets Purple Mountain PT apart from others. We have not simply adapted “women’s health” PT to our men. We have specific male-focused pelvic health and prostate cancer rehabilitation training and experience helping men just like you. We love this work and consider it an honor to help you retrain your bladder control and address other prostatectomy rehab needs. If you may be interested in learning more about our pelvic PT program to retrain bladder control after prostate removal, call our office at 616-516-4334 or contact us here.

All of the doctors of physical here at Purple Mountain PT have completed extensive post-graduate male-specific pelvic education for how to retrain the bladder after prostate removal and other pelvic floor problems that men experience.

We believe that physical therapy after prostatectomy, to retrain bladder control, should be standard of care. We know this is a difficult time in your life and we believe that you deserve to be fully supported by the experienced eye of our pelvic physical therapists. If you are sitting at home, unhappy with your bladder control and uncertain how to retrain your bladder after prostate removal?Our patients express gratitude to us and tell us that this treatment has improved their depression and anxiety regarding their urinary incontinence and erectile dysfunction. If you are interested in working with our pelvic PTs who can offer you this type of physical therapy care after prostatectomy, please call our office to speak with one of our staff. We can be reached at 616-516-4334 or contact us here. 

Peace,

Dr. Maureen O’Keefe, DPT physical therapist specializing in pelvic rehabilitation for over two decades.

If you are curious about pelvic health physical therapy, these articles may be of interest to you:

Physical Therapy after Prostatectomy

Pelvic PT for Testicular Pain (Orchialgia) in Grand Rapids

Pelvic Pain PT in Grand Rapids

Urinary Incontinence Treatment in Grand Rapids

References:

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Christen WG, Gaziano JM, Hennekens CH. Design of Physicians’ Health Study II: A randomized trial of beta-carotene, vitamins E and C, and multivitamins, in prevention of cancer, cardiovascular disease, and eye disease, and review of results of completed trials. Ann Epidemiol. 2000;10:125–134.

Milios, J.E., Ackland, T.R. & Green, D.J. Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence. BMC Urol 19, 116 (2019).

Scott KM, Gosai E, Bradley MH, et al. Individualized pelvic physical therapy for the treatment of post-prostatectomy stress urinary incontinence and pelvic pain. [published online December 5, 2019]. Int Urol Nephrol. doi: 10.1007/s11255-019-02343-7.

Shikanov SA. A prospective report of changes in prostate cancer related quality of life after robotic prostatectomy. J Psych Oncol. 2011;29:1157–67.

Stark JR, Perner S, Stampfer MJ, Sinnott JA, Finn S, Eisenstein AS, Ma J, Fiorentino M, Kurth T, Loda M, Giovannucci EL, Rubin MA, Mucci LA. Gleason score and lethal prostate cancer: does 3 + 4 = 4 + 3? J Clin Oncol. 2009 Jul 20;27(21):3459-64.

Weber BA, Roberts BL, Mills TL. Physical and emotional predictors of depression after radical prostatectomy. Amer J Mens Health. 2008;2(2):165–71.