Pelvic floor exercises – why do them?


on all fours sitting up

You’re pretty sure to have some incontinence after prostate treatment


Every man undergoing prostate surgery (and some other prostate treatments) will experience some incontinence afterwards. It’s inevitable. Getting those muscles to work again is going to require a lot of effort from you. But it will be a whole lot easier if you’ve learned what to do before you have surgery – and practised it. The muscles I’m talking about are your pelvic floor muscles – the ones that control your sphincters.

Recent research shows that recovering from incontinence after prostate surgery takes at least three months. In some men it can take up to 18 months or even two years. Unfortunately some will never recover from it because their surgeon has had to cut the nerves which control their muscles.


Pelvic floor exercises can help with recovery


What this means is that even though things aren’t working, you do need to carry on doing the exercises day and night. As often as you possibly can. Seven days a week, every single week for up to two years before you are completely dry.

It’s a long battle, but believe me, having been there and done it, it is worth it!

Even though I’m now ‘dry’ I still do the exercises as part of my daily physical routine. This is to ensure that all my muscles including the pelvic floor ones are fully toned and functional.

I was lucky but not everyone regains their continence. Read Eric’s story here.


Aren’t pelvic floor exercises for women?


Urinary incontinence is a very common condition in women. It’s said that as many as one in five women suffer from it, often as a result of childbirth. For men it’s most likely to occur after surgery in the pelvic region such as surgery for prostate cancer

Strengthening and learning to control the pelvic floor muscles can greatly help to reduce the effects of incontinence which are very common after prostate surgery. However, because urinary incontinence is so widespread in women, the vast majority of pelvic floor exercises you’ll find described are designed for women.

They come with over-simplistic instructions such as “just keep squeezing your bum cheeks”. More complex routines take the form of tensing the pelvic floor, holding it for five seconds, letting go, and repeating this four or five times in a row, several times a day. As many people have found out, these simplistic routines simply do not work, particularly for men.


Kegel exercises


Pelvic floor exercises have been attributed to Dr Arnold Kegel, but this is incorrect! People have been doing pelvic floor exercises to try and manage incontinence for centuries as it seems to be the obvious thing to do. Dr Kegel was a gynaecologist and urologist who treated women who suffered from incontinence and because of his work these exercises are sometimes incorrectly known as “Kegel exercises”.

Realising that simply encouraging women to squeeze their bum cheeks or their pelvic floor (if they could distinguish between the two) didn’t work for many women, Dr Kegel invented a gadget called a manometer. One end of the manometer was placed into the vagina and the woman was asked to squeeze on it while watching a meter attached to its other end.

The goal was to strengthen the muscles that were doing the squeezing and the manometer enabled them to assess and monitor their progress in doing this.

Dr Kegel understood the importance of developing awareness of which muscles in the pelvic floor need to be exercised to prevent incontinence. But identifying only the muscles that stop urination, is extremely difficult for many people.

Some people advocate trying to stop the flow several times while you’re peeing so that you learn which the muscles are and can practise controlling them.


Why pelvic floor exercises often fail


The problem is that people don’t usually think about identifying, controlling and strengthening their pelvic floor muscles until they have a problem. Until we have an incontinence problem we pee without being aware of which muscles we’re using to do what.

So pelvic floor exercises often fail because we don’t start them until it’s too late to develop our awareness of which the muscles are that we need to control. The muscles have become weak and/or damaged or the nerves controlling them have been disrupted as in the case with prostate surgery.

We can’t develop this conscious control because the nerve supply and muscles have already “lost it”. This can mean being left with permanent incontinence.

The other reason why pelvic floor exercises fail is perseverance. After surgery trying to stop the urine flow and finding you can’t, then trying to learn how to squeeze the right muscles and finding you can’t, makes people disheartened and depressed and so they give up.


Learn to do them BEFORE YOUR SURGERY


It’s really important to learn to do it BEFORE your surgery. Learn where to find those muscles and how to control them while they are strong and their nerve supplies haven’t been disrupted. If you can achieve this then you’ll find it much easier after surgery to re-train those muscles.




Finally as with so many medical conditions the mantra is NEVER EVER GIVE UP! Do the exercises regularly before you have your surgery. Don’t leave it until after you’ve had the procedure to try to find the correct muscles and exercise them, as it will probably be too late.

You may find that they don’t work and you then face a long recovery period suffering from incontinence and in some cases permanent incontinence.