Three exercises cover most of it. One builds endurance, one builds speed, and one you use at the exact moment you would leak. Here is each one, with the dose.
Bladder control comes from the external sphincter, the part of your pelvic floor you can control. Train it three ways: slow holds for endurance, quick squeezes for speed, and the Knack, the squeeze you do right before a cough, a sneeze, standing up, or lifting.
Then move the work from lying down to sitting, standing, and walking, because upright is where you leak.
Imagine stopping the flow of urine, or holding back gas. You should feel a gentle squeeze and lift deep in the pelvis. Your belly stays soft. You keep breathing. Use the urine cue as a picture only. Do not practice by stopping your stream on the toilet.
A kegel is small. Nothing on the outside of your body should move. If you feel yourself pushing down or out, you are doing it backwards. Think lift, not push.
Lie on your back with your knees bent and your feet flat. Gently squeeze and lift. Hold for two to three seconds. Let go completely and rest for ten seconds. Do five of those, three times a day.
Slow holds build endurance. They are what holds steady through a long walk. Over the weeks, the holds get longer.
Same position. Quickly squeeze and release. Think of it as a quick pulse. Do not hold. Just contract and let go. Do five in a row. Rest fifteen seconds. Repeat three sets, twice a day.
Quick squeezes train the fast fibers, the ones that catch a sneeze or a cough. Without them, a cough still gets through.
Notice when you leak. Standing up. Coughing. Sneezing. Lifting. Those are pressure moments, and they are predictable.
So brace first. Squeeze the pelvic floor, then stand. Squeeze, then cough. Squeeze, then lift. Every one is a free rep. No sets needed.
Dr. Meg Cochran, DPT shows the Knack, the squeeze you do right before a cough, a sneeze, or standing up.
Lying down is the easiest position. Gravity is on your side. Most men are dry on their back long before they are dry on their feet.
So the work has to move. Lying, then sitting, then standing, then walking. Each one is harder than the last. Each one is closer to real life.
Cutting back makes urine more concentrated, which irritates the bladder and makes urgency worse. Keep drinking water. Ease up on coffee, tea, and alcohol for now. All of them irritate the bladder.
Relaxing matters as much as squeezing. End each session with five slow belly breaths and let the pelvic floor soften and drop.
If the exercises cause pain, or you have pelvic pain to begin with, stop and see a pelvic floor physical therapist. Some men need to learn to relax this muscle before they strengthen it.
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Dr. Meg Cochran is a licensed Doctor of Physical Therapy specializing in pelvic floor rehabilitation, and treats men after prostate surgery through Where You Are Physical Therapy in Oxford, Mississippi.
This article is educational and is not medical advice, a diagnosis, or a substitute for in-person care. Follow your surgical team's instructions. If you have urgent symptoms including severe pain, fever, unexpected bleeding, or a sudden change in function, contact your healthcare provider.
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