Bladder leakage after prostate surgery and pelvic floor exercises

Leaking urine is common after surgery to remove the prostate for cancer (radical prostatectomy) and after some operations for an enlarged prostate. For most men it improves noticeably over weeks and months. Working the pelvic floor muscles is one of the most important ways to support that recovery.

Why does leaking happen?

The prostate is a gland just below the bladder that surrounds the urethra and helps hold urine in. When it is removed or reduced, that support is lost and the pelvic floor muscles and the outer sphincter of the urethra take on more of the work. Until they adapt to this new load, leaks can happen, especially when coughing, sneezing, standing up or lifting.

When should you start?

Sources such as Prostate Cancer UK recommend starting the exercises before surgery if possible. That way you learn the muscle and the technique beforehand and find it easier to continue afterwards. After surgery, men usually resume the exercises once the catheter is removed; agree the timing with your surgeon or physiotherapist.

How do you find the muscle?

• Imagine stopping yourself passing wind by drawing the back passage in and up.
• Imagine stopping the flow of urine (just imagine it; don’t use it as an exercise).
• A correct squeeze makes the base of the penis lift slightly and the testicles rise a little.
• Keep your tummy, buttocks and legs relaxed, and don’t hold your breath.

An example programme

Start with the hold you can manage and build up gradually:

• Long squeezes: Squeeze, hold for a few seconds (aim for 10), then relax completely.
• Short squeezes: Squeeze quickly and let go.
• How often: Several sets a day; start lying down, then sitting and standing.
• In daily life: Make a habit of squeezing just before you cough, stand up or lift something.

Patience and tracking

Recovery time varies: weeks for some men, months for others. Noting leaks and how many pads you use helps you see your progress and talk to your doctor more effectively. If there is no clear improvement after several months, discuss other options with your urologist and a pelvic health physiotherapist.

When to contact your doctor straight away

If you have blood in your urine, fever, burning, cannot pass urine or have severe pain, contact the team that did your surgery without waiting.

How PelviQ supports your recovery routine

After prostate surgery, what matters most is doing pelvic floor exercises regularly and correctly. PelviQ is designed to support you through this:

• Men’s version pads: The pads in the PelviQ set are designed specifically for men.
• EMS to recognise the muscle: Feeling the pelvic floor can be harder after surgery. EMS pads help you notice what a contraction feels like.
• Start before surgery: The guided Kegel videos in PelviQ App let you learn the muscle and the technique beforehand.
• Consistency and records: Reminders help you keep going, and your history shows how regularly you have trained, which helps in check-ups with your doctor.

Ask your surgeon or physiotherapist when you can start using the device after surgery.

For details, see Bladder control and the pelvic floor in men.

Sources

• Prostate Cancer UK — Pelvic floor muscle exercises
• Mayo Clinic — Kegel exercises for men
• NIDDK — Kegel Exercises

This article is for general information and does not replace medical diagnosis or treatment. See a healthcare professional if you have pain, bleeding, fever or ongoing symptoms.