Pelvic floor muscle exercises can help to restore bladder control after treatments for prostate cancer.
Ideally, the exercises should be started before you have surgery, and resumed after your operation, once the urinary catheter has been removed. You should not attempt to perform the exercises while your catheter is still in place.
Pelvic floor muscle exercises can be done lying on your back with your knees bent and apart, and your feet flat on the ground. They can also be done while you are sitting or standing.
To perform pelvic floor muscle exercises:
- squeeze the muscles around the anus as though you are trying to stop yourself passing wind;
- squeeze the muscles around your urethra as though you are trying to stop yourself passing urine; and
- lift these muscles up inside you.
All of the above areas should be contracting at the same time, and there should be no movement or tilt of your pelvis when you are performing the exercises. Do not hold your breath or tighten your abdominal (tummy) muscles. Pelvic floor muscle exercises should not include active contraction of your buttock muscles or the muscles of your inner thighs.
A health professional working in the area of incontinence can provide you with an individualised bladder control programme based on your symptoms.
A pelvic floor exercise and bladder control programme should include the following:
- sets of the above exercises, up to 10 repetitions done at maximal contraction, holding each contraction for 5-10 seconds;
- sets of the above exercises done rapidly to improve speed and strength;
- long periods of sustained muscle contraction, but at about half maximal strength (for example, while walking);
- functional muscle contractions — you contract the muscles of the pelvic floor and the lower abdominals at times of increased abdominal pressure, such as when coughing, sneezing or getting up from a seated position;
- urge control techniques — you learn to suppress the urge to urinate by doing the pelvic floor muscle contractions as well as using a number of distraction techniques; and
- postural awareness and control — pelvic muscles work more effectively when you are sitting upright as opposed to slumping or slouching.
Exercises should be practised daily.
You can assess whether you are doing the exercises correctly by looking at the movement of the pelvic floor muscles. This is best done with a hand mirror while reclining on the bed.
If you are doing the exercises correctly, you should be able to see the anus contracting and lifting, the area around the base of your penis dipping in towards the abdomen, the scrotum lifting, and the drawing up of both testicles.