Pelvic Floor Exercises For Men Facing Prostate Surgery: The Sooner The Better

by Linda McClelland


Men about to undergo prostate cancer surgery should begin a program of pelvic floor muscle exercises (also known as kegel exercises) before surgery, and continue afterwards. That's the new recommendation from the Expert Committees on the Adult Conservative Management of Incontinence at the International Consultation on Incontinence, Paris, 2008.

This expert recommendation follows a number of research studies that have shown that the sooner men begin pelvic floor exercises after surgery, the less likely they are to experience the very common side effects of long-term incontinence and erectile dysfunction. Men who have learned and practised the correct exercise techniques prior to surgery are able to start exercises immediately after surgery, and therefore give themselves a head start in recovery.

Prostate surgery, for both benign and malignant conditions, has common side-effects of urinary incontinence and erectile dysfunction. Most patients suffer from these side-effects immediately after surgery, and whilst some experience a gradual improvement, studies show that a substantial proportion are still suffering from these distressing problems five years later. In the longer term, sufferers often resort to drugs, mechanical devices and even more surgery in their efforts to find solutions, but easy exercises immediately after surgery, and continued for the following months, are a much less expensive and damaging option.

So what is the correct technique for men wanting to exercise their pelvic floor muscles?

Identify the pelvic floor muscles:

Firstly, find the appropriate muscles around the anus and the urethra (the "tube' that carries the urine from the bladder when passing urine).

Sit or lie down comfortably with the muscles of the thighs, bottom and stomach relaxed. Tighten the ring of muscle around the anus, but do not squeeze the "cheeks" of the backside.

To feel these muscles around the urethra, try to stop the flow of urine mid-stream, and then restart it. It is very important that this is done only in order to identify the muscles in the first place. If done frequently, this could affect the ability to pass urine.

Exercise the pelvic floor muscles:

Once the pelvic floor muscles have been located, try to exercise them:

* Tighten and pull in the muscles around the anus and urethra, lifting up the muscles inside at the same time

* Count to five, then release the muscles, and relax. There should be a definite feeling of letting go.

* Repeat this contraction for no more than 8 to 10 squeezes, resting for 10 seconds after each contraction.

* Finish with 5 to 10 short, strong squeezes in quick succession.

* Repeat the slow and quick squeezes around four to five times a day.

Whilst some men find it easy to exercise these muscles, others find it very hard to identify, isolate and contract their pelvic floor muscles without help. Professional help is available from your medical practitioner or from a physical therapist who specializes in pelvic floor work. Exercise programs on DVD, and exercise aids and devices can also be useful for men who prefer to exercise in privacy at home.

So if you, or someone you care about, is facing prostate surgery, follow the recommendation of the experts and make sure that pelvic floor (kegel) exercises are on the agenda. Start sooner, not later, and maximize the chance of a full recovery and a return to a high quality of life after surgery..