Prostate cancer is the most common form of cancer that affects Canadian men. 1 in 8 men will be diagnosed with prostate cancer in their lifetime. With the increasing incidence of prostate cancer in Canada, surgical interventions such as radical prostatectomy are being performed more frequently. While prostatectomy is generally effective, the majority of men will experience some degree of urinary incontinence and erectile dysfunction following surgery.
Stress urinary incontinence is the most common type of incontinence following prostatectomy. Stress urinary incontinence is the involuntary loss of urine on effort, physical exertion, or sneezing and coughing. While there are a number of causes that can contribute to incontinence following prostate surgery, the majority of cases are secondary to weakness of the external sphincter muscle. The external sphincter is part of the pelvic floor and is one of two muscles that act like valves in the urinary system to maintain continence. Weakness in the external sphincter following surgery will therefore lead to the passage urine with any actions that increase pressure on the bladder. Pelvic floor physiotherapy can help strengthen the pelvic floor muscles to promote continence.
Erectile dysfunction is another common surgical complication that affects 50 percent of men following prostatectomy. It often results from nerve damage that occurred at the time of surgery or from post-operative swelling. Pelvic floor muscle exercises following surgery can help promote blood flow, decrease swelling, and improve muscle strength to speed up recovery of function and promote overall pelvic health.
Pelvic floor physiotherapy can identify dysfunction in the male pelvic floor following surgery and help men locate and activate the correct muscles to minimize and treat urinary incontinence and erectile dysfunction. An individualized physiotherapy treatment plan will be made based on your symptoms, assessment findings, and personal goals. Treatment may include education on the pelvic floor muscles, soft tissue treatment techniques, pelvic floor muscle strengthening exercises, core strengthening exercises, and modalities as need.
Chronic Prostatitis /Chronic Pelvic Pain Syndrome
Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) is a common condition that affects between 2-10 percent of all adult men. Most men diagnosed with prostatitis have CPPS rather than acute or bacterial prostatitis. There are many causes of CP/CPPS; therefore, it is important to first consult your family physician if you experience symptoms of pelvic pain to exclude other serious disease.
While the name suggests inflammation of the prostate gland, it is unclear to what degree the prostate is involved. Symptoms begin with pain in the pelvic region. This may include pain in the perineum, abdomen, testicles, penis, pelvic floor muscles, and pelvic joints. Tight and painful pelvic floor muscles can cause changes in the nerve pathways that send pain messages to the brain. The brain relays these messages back to the pelvic organs, which in return respond abnormally. This can result in urological symptoms such as voiding, bowel, and sexual dysfunction. Symptoms that persist for greater than 3-6 months are termed chronic pelvic pain syndrome.
Pelvic floor physiotherapy can help you identify and understand the underlying problem. A trained physiotherapist can help you learn to manage your pelvic pain and relieve pelvic floor muscle tension through therapeutic stretches and relaxation exercises. Physiotherapy can help you get in touch with your pelvic floor muscles in a positive way to help reduce pain and restore function.