Physical Therapy and the Prostate

By Fiona McMahon

We hear a lot about prostate cancer nowadays, as we should. Prostate cancer is an extremely common form of cancer, which affects 1 in 7 men in the United States, according to the American Cancer Society. Over the years, the approach to the treatment of prostate cancer has evolved from a more surgery and radiation focused treatment, to more of a philosophy of watchful waiting. The driving factor behind this decision is that prostate cancer is usually a slow growing cancer that is discovered late in life, and therefore  a diagnosis of prostate cancer in a 65 year old man is not as likely as other cancers to have a significant impact on his lifespan.

Regardless of this new approach to the treatment, there are still many men whose cases require medical and surgical intervention. Prostate cancer is often treated surgically by removing the prostate either through a laparoscopic procedure or an open procedure. Men may prefer the laparoscopic removal of the prostate because it has been shown to cause less bleeding and it allows the surgeon to better be able to visualize the nerves responsible for erections. Other treatments for prostate cancer include cryotherapy, hormonal therapy, radiation, and chemotherapy.

Surgery carries side effects, which can have a profound effect on your life but usually these side effects will go away over time. Side effects that generally go away include urinary incontinence and erectile dysfunction. Some permanent effects from prostatectomy surgery are dry orgasm (orgasm without ejaculate) and loss of fertility. This is because when the prostate is removed, the surgeon must cut the connection between the testicles and the urethra. Because this connection is removed, the sperm that is produced has no way to exit the penis to fertilize an egg.  Some men may chose to cryopreserve or “bank” their sperm prior to surgery.

The ability to achieve an erection and control your bladder returns spontaneously for many men after they undergo treatment for prostate cancer. The return of these abilities can take anywhere from 6 to 12 months. Many men find that waiting for half a year to a year for these functions to return is simply too long. They also often struggle when they compare themselves to other men who have recovered faster. Recently, there have been many studies looking at ways to expedite the return of urinary and sexual function in men who have been treated for prostate cancer.

Urinary incontinence is a frequent side effect of surgery for prostate cancer. In a 2010 study Centemero and colleagues found that participants who completed a pelvic floor muscle strengthening program before and after their prostate removal surgery experienced urinary incontinence for a significantly shorter period of time post-operatively than those who began pelvic floor muscle training after they had had their prostate removal surgery. These results were also reinforced by the work of Hischhorn and colleagues, who found that men who had received pelvic floor training prior to their prostatectomy reported significantly fewer issues with urinary incontinence.

Men have many of the same pelvic floor muscles as females do. Male pelvic floor muscle strength has also found to be an important factor in the ability to have an erection, remain continent, and avoid dribbling urine after one voids his bladder. These muscles can be trained to be stronger, relax better, and behave more effectively to help alleviate urinary and sexual symptoms following prostate cancer treatment. It is possible that strengthening your pelvic floor muscles may expedite your recovery. In a 2004 article by Siegal, pelvic floor muscle strength was found to be stronger in men without issues of erectile dysfunction, urinary dribbling, and incontinence.

The research shows that men can take an active role in speeding up their recovery from prostate cancer by participating in a pelvic floor rehab program with a qualified pelvic floor practitioner. We offer these services at Beyond Basics, so feel free to learn more about them here. By strengthening weakened muscles, stretching tight muscles, allowing for better coordination through biofeedback, pelvic floor physical therapy can help you feel like you sooner.

Sources

American Cancer Society

www.americancancersociety.org/prostatecancer. Accessed: March 10, 2015

Centemero A, Rigatti L, Giraudo D. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: A randomised controlled study. Eur Urol. 2010 Jun;57(6):1039-43

Hirschhorn A, Kolt G, Brooks A.

A multicomponent theory-based intervention improves uptake of pelvic floor muscle training before radical prostatectomy: a ‘before and after’ cohort study. BJU Int. 2014;113:383-392

Siegal A. Pelvic floor muscle training in males: practical applications. Urology. 2014 Jul;84(1):1-7

2 thoughts on “Physical Therapy and the Prostate

  1. Linda Coen

    I was wondering something. I know you use cold laser therapy for breaking up scar tissue. What kind of cold laser do you use? How strong is the laser?

  2. Pingback: September is Prostate Cancer Awareness Month | Beyond Basics Physical Therapy

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