Supporting Men’s Health After Prostate Cancer: A Pelvic Floor Physiotherapist’s Perspective
Prostate cancer treatment can affect parts of the body most men don’t expect, especially the muscles that control bladder, bowel, and sexual function. This is where pelvic floor physiotherapy can make a meaningful difference. While much of the focus (rightly) goes to the medical and surgical aspects of treatment, physiotherapy plays a critical, yet often overlooked, role in restoring quality of life after prostate cancer.
Let’s talk about why.
Why the Pelvic Floor Matters in Prostate Cancer Recovery
The prostate gland sits just below the bladder and surrounds the urethra, the tube that carries urine out of the body. When the prostate is removed or treated (via surgery, radiation, or hormone therapy), nearby structures, including the pelvic floor muscles, are often affected.
These muscles are essential for bladder and bowel control, sexual function, and core stability. After prostate cancer treatment, common side effects can include:
- Urinary incontinence (leakage)
- Erectile dysfunction
- Pelvic pain or discomfort
- Changes in bowel habits
- Psychological impacts, such as anxiety or decreased confidence
Pelvic floor physiotherapy can offer tools and strategies to address all of these concerns.
What Does Pelvic Floor Physiotherapy Involve?
Education is the first step, helping to understand the anatomy and the changes that occur after treatment, which empowers recovery. Next, a thorough assessment is conducted to tailor treatment to each individual’s unique needs. This may include:
Pelvic Floor Muscle Training: Many people think of “kegels,” but it’s not always that simple. Some men overuse the wrong muscles or struggle to activate their pelvic floor at all. Correct guidance is essential to help isolate and strengthen these muscles effectively, improving bladder and bowel control.
Bladder Retraining & Behavioural Strategies: Managing changes in bladder habits after prostate cancer treatment can be challenging. Through bladder retraining, personalized behavioural strategies, and lifestyle modifications, support is provided to help reduce urgency, frequency, and leakage.
Support for Sexual Health: Sexual recovery after prostate cancer can be daunting. While some changes may be inevitable, physiotherapy can help improve blood flow, muscle function, and confidence, often in collaboration with other healthcare providers (i.e. urologists, sex therapists).
Scar Tissue & Pain Management: Whether resulting from surgery or radiation, manual therapy and movement-based techniques can play an important role in reducing scar tissue restrictions and relieving pelvic or abdominal discomfort.
Whole-Body Rehab: Treatment goes beyond the pelvis. Core strength, breathing patterns, posture, and overall physical activity all play important roles in supporting recovery. Taking a holistic approach helps address the whole picture for better outcomes.
When Should You See a Pelvic Health Physio?
Many people are surprised to learn that pelvic floor physiotherapy can begin before prostate cancer treatment even starts. In fact, seeing a physiotherapist early, ideally before surgery or radiation, can set the foundation for a smoother recovery. This approach, often called prehabilitation, helps you learn how to properly engage your pelvic floor muscles, build strength in advance, and understand what to expect post-treatment. Research shows that this can lead to better outcomes, especially when it comes to bladder control and overall function after prostatectomy.
But if you’re already post-treatment, it’s never too late. Whether you’re weeks or years into recovery, pelvic floor physiotherapy can still make a meaningful difference.
Breaking the Silence Around Men’s Pelvic Health
One of the biggest hurdles I see is that men often don’t talk about these issues or even know help exists. Incontinence, erectile challenges, and pelvic discomfort aren’t just “things to live with.” You deserve support, and you’re not alone. Pelvic floor physiotherapy is a safe, respectful, and evidence-based approach to reclaiming your function and confidence.
Final Thoughts
Prostate cancer changes your life, but it doesn’t have to define it. With the right support, men can recover strength, control, and a renewed sense of wellbeing. If you or a loved one are facing or recovering from prostate cancer, know that pelvic floor physiotherapy has a place in your healing journey.