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The prostate is a male reproductive organ which sits at the bottom of the bladder and helps to maintain continence by supporting the bladder and the urethra. If partly or fully removed as part of prostate cancer treatment, 99% of blokes will then experience incontinence. It could happen when you laugh, sneeze or are active when lifting or gardening.

Incontinence will usually improve with time, but you can regain control faster by improving the strength of your pelvic floor muscles.

If you don’t, leaking might continue. Our pelvic floor physiotherapists help you gain control by helping you identify and strengthen the pelvic floor muscles effectively. With a bespoke rehabilitation program designed for you, you can regain stability and strength.

Conditions we treat

The first step in starting the flow is to relax the muscles under the bladder and in the pelvic floor. Delaying in starting is common with aging or with prostate issues. But 30% of men who can pass urine in private can have trouble passing in public situations.

Flow may stop and start and slow down to a trickle as the bladder empties.  An enlarged prostate can sometimes be the cause of this problem

Post void dribble.  This is due to pooling in the water pipe (the urethra). Simple techniques can help to empty the pipe completely and thereby reducing wet patches on trousers.

This symptom sometimes indicates the presence of residual urine but is not always accurate at predicting this.

After prostate surgery sometimes there can be an increase in the frequency of passing urine.  Drinking large volumes of fluid, especially tea, coffee, chocolate drinks or alcohol in the evenings can mean a person has to empty the bladder more often. Diuretic medication like frusimide, can cause increased frequency.  Increased frequency can also arise simply because of an effect of aging on the kidneys and bladder. An overactive bladder or infection may also be the cause. Determining the cause will help us to figure out the best treatment for this problem. We may request you complete a record of your fluid intake and your urine output so we can accurately assess your bladder function.

This means there is an urgent desire to empty the bladder, with the fear of leaking if you don’t reach the toilet on time. Often this can be due to an overactive or irritable bladder. This can happen with aging, but also if the bladder outlet is obstructed by the prostate. Nerve problems to the bladder innervation can also cause it.

Leakage of urine on coughing, straining or exertion such as lifting, gardening, or with a golf swing. It can be due to damage to the supportive muscles that are affected after a prostate operation, and problems with the nerves after surgery.

 

Services related to prostate problems or surgery

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Pelvic Floor strengthening for men

Identifying the pelvic floor muscles and knowing how to feel a definite squeeze and lift action is the first part of being able to strengthen these muscles. Even men who feel just a small movement because of muscle weakness can improve! At first, you will likely perform these exercises in lying or sitting. As these muscles strengthen you will progress to more functional positions such as standing. Your therapist will design a program specific to you.
We use technology such as EMG biofeedback to show how strong the muscles are and help teach you how to get the best activation for the perfect program for you. Optimisation of pevic floor muscle strength will take 3-4 months of regular training of the muscles.
Remember to use your muscles whenever you exert yourself during daily activities. Pelvic floor muscle exercises can not only increase the ability to hold urine, but it can also help control an unruly overactive bladder.

Behavioural and bladder retraining

The volume of urine passed each time by a normal adult will vary from around 250 – 400mls or about 2 cups. Most people with normal bladder habits can hold on for 3-4 hours between toilet trips. Most younger adults can go through the night without voiding (passing urine / peeing)
Bladder retraining is for people who suffer from an urgent need to pass small amounts of urine more frequently than normal and may experience leakage with urgency. Some people with no urgency pass urine frequently and they too may benefit from bladder retraining.
The aim is to improve bladder control and increase the amount of urinary the bladder can comfortably hold without urgency/frequency or leakage of urine. We help to retrain the way you respond to the urgent desire to pass urine and teach you how to suppress the urge until it is convenient to pass.
We may request a bladder diary to record the type of fluid you drank, the volume and the time, as well as the volume and timings of the urine you pass. We will request you to document the bladder sensation you feel when you need to go to the bathroom, and any episodes of urinary leakage.

Functional techniques to empty bladder better and prevent leakage

Learning how to empty the pipe (urethra) properly can help prevent the few drops that sneak out after you have finished emptying the bladder.
Learning how to use the muscles when you need them, and having them work properly with the rest of the urinary system can help significantly to reduce leaking.

LIfes changes
Lifestyle changes

Aim to do at least 30 minutes of exercise most days. Not only can this help prevent constipation, but it will help keep the pelvic floor toned and help you maintain a healthy body weight.  We can give you more specific advice about appropriate exercise.

We may ask you to keep a record of the types and frequency of your bowel motions, so we can see the habits you are in. We can then help advise about any change that you could make to improve your bowel routine and habits.

Book an appointment

Take the first step and book your appointment 60 minute appointment, which is always 1:1, and involves a treatment tailored to you exact needs.

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Wondering if we can help? Give our trained staff a call!
We can answer your detailed questions, and if we're not a great fit for you, we can provide resources and recommendations for treatment options.

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