Physiotherapy before and after prostate cancer treatment

Prostate cancer treatment can have a significant impact on bladder, bowel, and sexual function. Almost 100% of men will experience some degree of urinary incontinence (leakage) and erectile dysfunction after prostatectomy surgery. Research has shown that pelvic floor assessment using transperineal real-time ultrasound before surgery can improve early post-op continence. After surgery, pelvic floor physiotherapy can help you to get dry faster.

How physiotherapy can help

We work with men before and after prostate cancer treatment to support:

• Bladder control (including leakage or urgency)

• Pelvic floor muscle function

• Recovery after prostate surgery (prostatectomy)

• Return to exercise and daily activities

• Sexual function and confidence

• Management of pelvic pain or discomfort

Treatment is always individualised and tailored to your goals, symptoms, and stage of care.

Before treatment (“prehabilitation”)

If you’re preparing for prostate surgery or radiation therapy, starting physiotherapy beforehand can make a meaningful difference to your recovery.

We focus on:

• Teaching you how to correctly activate your pelvic floor muscles*

• Building strength and endurance ahead of surgery

• Education about what to expect after treatment

• Strategies to reduce early post-operative leakage

*Transperineal real-time ultrasound is the best assessment tool available for pelvic floor function, and can improve early post-op continence by teaching you how to correctly activate your pelvic floor muscles. Our physiotherapist Melissa has extensive experience in transperineal ultrasound and can provide this as part of your management.

After prostate cancer treatment

After treatment, it’s common to experience changes in bladder and sexual function. Following prostatectomy (surgery), almost 100% of men will experience urinary incontinence immediately following catheter removal, about 50% of men will be ‘dry’ by 6 months post-op, and ~90% of men will be ‘dry’ by 1 year post-op. While you are likely to regain continence at some point even without physiotherapy input, research has shown that high quality pelvic floor muscle training (which is best done with an experienced physiotherapist) may help you to achieve continence sooner.

Physiotherapy may also help with:

Urgency and frequency
Some people experience a sudden need to rush to the toilet or need to go more often. This can be a result of reduced bladder capacity post-op, sensitive bladder lining, or the muscle in the bladder wall (detrusor) being overactive. We can help retrain bladder habits and improve control.

Return to exercise
We support a safe return to gym, running, lifting, and sport without worsening symptoms.

Erectile function
We can assist with education about use of vacuum erection devices (VED) to support your erectile rehabilitation.

What to expect

Your sessions are private, respectful, and tailored to your comfort level.

At your initial appointment, we will:

• Talk through your symptoms, goals, and treatment history

• Assess pelvic floor function (this usually includes a transperineal or transabdominal ultrasound with your consent)

• Provide personalised management strategies to work towards your goals

You’ll leave with clear, practical strategies you can start straight away.

When should I see a pelvic health physiotherapist?

You can attend physiotherapy at any stage:

• Before surgery or radiation therapy

• Immediately after treatment

• Months or even years later if symptoms persist

It’s never “too late” to improve bladder control, confidence, and quality of life.