Perineal rehabilitation for men is not a field well known to the general public. Although more commonly used in women, this approach is very useful for certain male conditions.
Radical prostatectomy is one of the most common conditions seen perineal rehabilitation for men. This surgery involves the removal of the prostate following prostate cancer, or for other medical reasons. Read on to learn more about the importance of rehabilitation for this condition.
Most men will only be recommended perineal rehabilitation after surgery. However, like any surgery, the body recovers more quickly and easily if exercises are done pre-operatively. This is a good time to learn more about the upcoming surgery, the pelvic floor and how to properly contract and optimize it.
The physiotherapist will also have the opportunity to give you advice and exercises to apply in the few weeks following surgery, since it is recommended to start physiotherapy only 6 weeks after the operation. So you won’t waste any time during these weeks, as you’ll already have exercises to do.
Perineal reeducation allows you to be mentally and physically ready for the surgery, and to recover more quickly in the weeks that follow.
Follow-up perineal rehabilitation is usually performed 6 weeks after surgery. It is suggested that you wait to allow the affected tissues and scars to heal properly. While you’re waiting for your follow-up, and if you did perineal reeducation before surgery, you can start pelvic floor exercises when the urinary catheter is removed. Read the next section carefully to find out what to expect after surgery.
A urinary catheter will be installed for the first few days following surgery (usually 10 days). Once the catheter is removed, there is a good chance that you will experience some urine leakage; this is normal. Urinary leakage is a frequent consequence of this type of operation. Without intervention, and in most cases, it will disappear after 1 year. If perineal reeducation is started after surgery, the duration of the leakage is significantly reduced. Pelvic floor optimization will enable you to :
When a leakage is present, certain types of protection can be used. The most commonly used are incontinence pants, absorbent shells, absorbent pads, and underwear with built-in protection. It’s advisable not to keep protection on for too long when it’s wet, to avoid infection and skin irritation. It’s also important to remember that pads are there to catch leaks, not to avoid going to the bathroom. You should continue to go to the bathroom as normal to encourage continence.
Urinary condoms are less recommended, as they create a more humid environment and are therefore more prone to irritation and infection. Some people will also tend to let their bladder constantly empty into the bag, so they won’t go to the toilet. This negatively affects continence.
Some nerves may be damaged during surgery. It is therefore possible that your ability to achieve and/or maintain an erection may be affected following surgery. Whether this ability returns depends on the level of nerve damage, whether you had radiation therapy before surgery, your age, your previous abilities and other factors. If this is your case, talk to your surgeon or doctor about medication. Daily masturbation also promotes the return of erections.
You may experience some pain in the area following surgery. This pain should subside in the days/weeks following the procedure. If they persist, contact your doctor.
Pain may also be caused by scarring. During your physiotherapy follow-up, you will be shown techniques for mobilizing scars if they need to be worked on.
The most important thing to remember is to do perineal reeducation before and after surgery to ensure complete healing and a quicker return to activities/sports/work.
For more information, advice or any other question concerning the pelvic floor, don’t hesitate to book a free 15-minute telephone consultation or make an appointment with Stéphanie, our perineal rehabilitation physiotherapist at La Prairie Clinic.
