What Happens During Prostate Surgery
Radical prostatectomy involves removing the entire prostate gland to treat prostate cancer. The prostate wraps around the urethra and sits near the nerves and muscles that control bladder function and erectile response. Even with nerve-sparing surgical techniques, the trauma and inflammation from surgery temporarily disrupts these delicate structures, resulting in incontinence and erectile dysfunction for many men in the immediate post-operative period.
The good news: your body heals. Most men recover bladder control naturally within three to six months. However, pelvic floor physical therapy accelerates recovery and improves long-term outcomes, particularly for those with persistent incontinence.
Post-Prostatectomy Incontinence and How PT Helps
Urinary incontinence after prostatectomy occurs because the muscles controlling the urethra have been stretched and weakened by surgery. These muscles must relearn how to function. Pelvic floor physical therapy teaches you to consciously engage and strengthen the muscles responsible for bladder control, progressively improving your ability to prevent leakage during activity, coughing, sneezing, and eventually during all daily tasks.
Dr. Meg works with you to:
- Identify your pelvic floor muscles — learning where they are and how to feel them contracting
- Build strength and endurance — progressing from short, weak contractions to longer, stronger holds
- Coordinate with breathing and movement — applying pelvic floor control during functional activities like standing, walking, coughing
- Reestablish normal bladder function — working toward consistent dryness throughout the day and night
Erectile Dysfunction After Prostatectomy
Many men experience erectile dysfunction following prostatectomy due to nerve injury or reduced blood flow to the penis. While some men regain function as nerves heal, others benefit significantly from pelvic floor therapy. A strong, functional pelvic floor is essential for erectile rigidity and sustained erections. These muscles work as a "squeeze valve" that traps blood in the corpus cavernosum, the tissue responsible for erections.
Physical therapy can help by strengthening the bulbospongiosus and ischiocavernosus muscles, which directly support erectile function. Combined with pelvic floor relaxation work to reduce tension that may impair blood flow, this creates a comprehensive approach to restoring sexual function.
Prehabilitation: The Best Start
If you know you're having prostate surgery, starting pelvic floor physical therapy before your operation is one of the best decisions you can make. Prehabilitation strengthens your pelvic floor in advance, primes your nervous system, and gives your muscles a head start. Men who complete pre-operative PT consistently report faster recovery, shorter periods of incontinence, and better long-term continence outcomes.
Even if you're already past surgery, starting PT early—within the first few weeks—accelerates recovery. The earlier you engage these muscles, the faster your nervous system relearns their function.
Why In-Home Therapy Works Best for Post-Prostatectomy Recovery
Recovery from prostate cancer surgery is both physical and emotional. Many men feel self-conscious about discussing incontinence or erectile dysfunction in a clinical setting. Mobile pelvic floor PT brings care directly to your home in Oxford, eliminating the awkwardness of waiting rooms and clinic visits. You work one-on-one with Dr. Meg in complete privacy, allowing you to be fully honest about your symptoms and concerns. This comfort and privacy often translate to better engagement, faster progress, and superior outcomes.
The Post-Prostatectomy Recovery Timeline
Most men experience incontinence immediately after catheter removal. Week two typically brings noticeable improvement. By six weeks, many men have regained control. By three months, the majority are mostly or completely dry. Full recovery can take six to twelve months for some men.
With pelvic floor PT, these timelines often accelerate. Men starting therapy early frequently report significant improvement within four to eight weeks of consistent practice. The key is consistency—daily exercises yield better results than sporadic effort.
Life After Prostatectomy PT
Successful pelvic floor therapy restores not just continence, but confidence. You'll return to activities without worry, enjoy intimate relationships, and live without the limitations incontinence imposes. Dr. Meg's approach is thorough, evidence-based, and tailored to your specific recovery goals—whether that's regaining bladder control, restoring sexual function, or both.