Before prostate cancer treatment, you probably used your pelvic floor muscles unknowingly. After treatment, it can be a different story if muscles and nerves around the prostate were damaged. Now, when you laugh, lift, sit, sneeze or cough, you may find yourself leaking urine.
The good news is that problems with leaking urine don't have to be permanent, and pelvic floor muscle exercises (or Kegels) may greatly help.
What are pelvic floor/ Kegel exercises and why do they matter?
You engage your pelvic floor muscles daily, but it's also important to understand where they are and what they do.
Pelvic floor muscles are located right around the prostate. Their main job is to support your bladder and help you stay in control of your urine flow. When prostate cancer treatment disturbs the pelvic floor muscles, your care team may recommend targeted exercises to help strengthen the muscles back up. These movements are called pelvic floor muscle exercises, or Kegels.
Kegels are meant to help you notice and train your pelvic floor muscles, so you can build up your ability to control urine flow. In addition, Kegels have also been shown to help with leaking urine. Every person’s recovery after treatment may differ, but Kegels can help make small improvements or prevent leaks from worsening. Don’t lose hope if you’re healing slower than you'd like.
When should I start doing
pelvic floor/ Kegel exercises?
Important: Do not try Kegel exercises if you currently have a catheter inside your penis. This is not safe.
For the best outcome, start training before you have prostate cancer treatment. Learn how to do the exercises and get your muscles familiar with the movement. After treatment, you should be able to get back to training right away, unless you still have a catheter (thin tube) in your penis. Once the catheter has been removed, you should be able to start Kegels right away to help with leakage.
Getting started with pelvic
floor/ Kegel exercises
Identify the muscles you need to target with your Kegel exercises:
You can either sit, stand or lie down in a comfortable position. Pick any position where you can relax the muscles in your thighs, buttocks and abdomen. Your pelvic floor muscles stretch under your bladder and bowel.
Imagine you are urinating (weeing). Try to stop mid-flow, hold for a second, and then release. Repeat this a few times. Don’t do this while actually urinating as it can cause problems emptying your bladder if you do it too often.
Tighten the ring of muscle around your anus as if you are trying not to pass wind (flatulence). Hold it for a second then relax. Try not to squeeze your buttocks together or engage your thighs and abdomen. If you are tightening the right muscles, you should feel a dip at the base of your penis and feel your scrotum move slightly.
There are two types of pelvic floor/
Kegel exercises:
1. Quick and rhythmic
contract and release repeatedly
develops pelvic floor strength
important for preventing stress incontinence
2. Long (squeeze/tighten and hold)
contract, hold for a few seconds, and then relax
develops pelvic floor tone/endurance
count 1 one thousand, 2 one thousand, 3 one thousand, etc...
aim for a contraction of 5 seconds
Now that you know more about the types of Kegel exercises (quick and long), below is a sample weekly exercise plan. This plan is only an example, and you should consult your care team before engaging in any Kegel exercises.
Sample weekly pelvic floor/
Kegel exercise plan
Position: Lying down
Type of contraction: Quick (contract and release quickly)
1 set = 5 contractions
Hold each contraction for: 1 second
Rest between each contraction for: 2 seconds
Do 2 sets (10 contractions total)
Position: Lying down
Type of contraction: Quick (contract and release quickly)
1 set = 5 contractions
Hold each contraction for: 1 second
Rest between each contraction for: 2 seconds
Do 2 sets (10 contractions total)
Type of contraction: Long (squeeze, tighten and hold)
1 set = 5 contractions
Hold each contraction for: 5 seconds
Rest between each contraction for: 10 seconds
Do 2 sets (10 contractions total)
Position: Sitting down
Type of contraction: Quick (contract and release quickly)
1 set = 15 contractions
Hold each contraction for: 1 second
Rest between each contraction for: 2 seconds
Do 2 sets (30 contractions total)
Type of contraction: Long (squeeze, tighten and hold)
1 set = 15 contractions
Hold each contraction for: 5 seconds
Rest between each contraction for: 10 seconds
Do 2 sets (30 contractions total)
Position: Standing up
Type of contraction: Quick (contract and release quickly)
1 set = 25 contractions
Hold each contraction for: 1 second
Rest between each contraction for: 2 seconds
Do 2 sets (50 contractions total)
Type of contraction: Long (squeeze, tighten and hold)
1 set = 25 contractions
Hold each contraction for: 5 seconds
Rest between each contraction for: 10 seconds
Do 2 sets (50 contractions total)
Once you have set a plan with your doctor or care team, remember to be consistent. Set a reminder to do your exercises daily, and check-in with your team to help monitor progress.
