Kegel exercises for men: strengthening your pelvic floor muscles
Laughing, lifting, sitting, or sneezing – these are just some of the times you use your pelvic floor muscles, without thinking much about it. These are also the muscles that help you control your urine (pee). After prostate cancer treatment, you may need to focus on strengthening these muscles, because they may have damaged during treatment.
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 exercises (Kegels) 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 doctor or care team may recommend targeted exercises to help strengthen the muscles back up. These movements are called pelvic floor muscle exercises, or Kegels.
Kegels after prostatectomy 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 exercises – before or after prostate cancer?
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 Kegels
Identify the muscles to target with your pelvic floor 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 that you're urinating (peeing). 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. 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.
Two types of pelvic floor exercises
Quick and rhythmic
Contract for 1 second and release pelvic floor muscles repeatedly.
Develops pelvic floor strength.
Prevent stress incontinence.
Long (squeeze/tighten and hold)
Contract and hold for 5 seconds (you can count 1 one thousand, 2 one thousand, 3 one thousand, and so on), relax and repeat.
Develop pelvic floor tone and endurance.
These exercises:
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 doctor or incontinence nurse before engaging in any Kegel exercises.
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.
Sample weekly Kegel exercise plan
Position: lying
Reps: 10
Sets: 2
Type of contraction: quick
Length of contraction: 1 second
Rest between contractions: 2 seconds
Position: lying
Reps: 10
Sets: 2
Type of contraction: quick 5 reps and long 5 reps
Length of contraction: quick 1 second and long 5 seconds
Rest between contractions: quick 2 seconds and long 10 seconds
Position: sitting
Reps: 30
Sets: 2
Type of contraction: quick 15 reps and long 15 reps
Length of contraction: quick 1 second and long 5 seconds
Rest between contractions: quick 2 seconds and long 10 seconds
Position: standing
Reps: 50
Sets: 2
Type of contraction: quick 25 reps and long 25 reps
Length of contraction: quick 1 second and long 5 seconds
Rest between contractions: quick 2 seconds and long 10 seconds
