Male Incontinence after prostate cancer – management plan

Incontinence (loss of control of the bladder) is often hidden by men, as they often don’t know it can be cured and there is help out there.

There are 2 types of incontinence:

Stress incontinence is a loss of bladder control with a sudden increase in pressure, like a cough or a laugh.
Urge incontinence is a loss of bladder control where you first feel the urge to go and you are unable to defer voiding or hold on.

The good news is that both problems are treatable with the right exercise program and education.

East Gosford Physiotherapy & Sports Injury Centre and East Gosford Oncology & Physiotherapy has specially trained male physiotherapists who can help you work through these problems – Men 4 Men who understand and can help.

The male physiotherapists and exercise physiologists at East Gosford Physiotherapy & Sports Injury Centre and East Gosford Oncology & Physiotherapy can offer a Prostate Cancer Rehabilitation Plan to help you recover from the effects of treatment or surgery.

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Pre and post-surgery education and pelvic floor exercise prescription

The comprehensive prostate cancer rehabilitation program at East Gosford Physiotherapy & Sports Injury Centre includes the following:

1. Pre-operative Physiotherapy
includes pelvic floor exercise advice and education prior to radical prostatectomy. It is beneficial to get the exercise program in place before the stress and trauma of surgery. It includes biofeedback so you “know” the muscles working correctly, and you can practice prior to surgery, so you are ready for the period after your catheter is removed post-surgery.

The pre-operative radical prostatectomy program involves a thorough assessment, pelvic floor and bladder education, and feedback on your ability to perform your pelvic floor exercises correctly. We supply you with exercise handouts, a complementary ebook (available as a download below) and links to our YouTube channel for video education on pelvic floor exercises.

2. Post-operative Physiotherapy
includes pelvic floor rehabilitation and bladder control training, which speeds up the recovery from radical prostatectomy and restores continence and bladder control as quickly as possible. It involves education about postural and core muscles to make pelvic floor rehabilitation more efficient.

The post-operative radical prostatectomy program involves further assessment by a specially trained male pelvic floor physiotherapist to deal with any persisting incontinence or problems. He will provide you with instruction and a specific training program to restore the muscle control in your pelvic floor to control leakage. All aspects of post radical prostatectomy can be discussed and managed including pad usage, bladder charts, scar management and erectile dysfunction

This is “muscle training” and once you know what muscles to use and how to use them, a home exercise program will be provided to help you develop the strength and endurance needed to “keep dry” and stop using pads.

We also advise men diagnosed with prostate cancer to exercise regularly and to improve general health and wellness, including postural and core muscle awareness and improvement, general fitness and strategies to deal with chronic disease issues and pain.

Our Back on Track program (see link below) is ideally suited to men either pre-operatively (to lose some weight and get their body fitter for surgery) and definitely post operatively to help you become fit and strong again and integrate your pelvic floor exercises back into life with normal movements and exercise.

Our Prostate Cancer – Strong Survivor exercise programs are also designed to help you manage the side effects of other prostate cancer treatments such as hormone (ADT) and radiation therapy. (see Physiotherapy management of the side effects of hormone and Radiation Therapy for Prostate cancer)

Regular exercise has also been shown to improve mental health and anxiety associated with the stress of a cancer diagnosis.

We will also provide you with advice on general regular exercise, which has been scientifically shown to increase cancer survival rates by 50% (Demark-Wahnefried W, 2006).

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Hormone Therapy and Radiation Therapy
Managing the side effects with physio

Hormone Treatment for prostate cancer is also known as Androgen Deprivation Therapy (ADT) and works by reducing your testosterone and slowing prostate cancer growth. This is often the choice if prostate cancer is advanced and has spread from your prostate margin.

There are many side effects from ADT including loss of bone density, muscle loss, reduced libido, fatigue, hot flushes, weight gain and mood swings.
This can also lead to poor motivation with exercise.
Physiotherapy has an important role in helping men manage the effect of ADT, as we are able to design an exercise program that will help you improve strength and bone density, help manage your fatigue, and help with motivation.
Radiation Therapy is another form of prostate cancer treatment, and you will be advised by your doctor of what is best for you.
Physiotherapy has a role in helping men manage the side effects of Radiation Therapy such as urinary incontinence, bowel problems and fatigue. Our Men 4 Men program has specially trained male physios to help you learn how to strengthen your pelvic floor muscles and integrate this with general exercise and activity

East Gosford Physiotherapy has developed an exercise program to help men manage the effects of ADT and Radiation Therapy.

We have individual and group exercise options available and we advise that you have an initial assessment with our male physio or Exercise physiologist to develop a plan.

Our Back on Track program is ideally suited to help you re-start a safe exercise program and stay motivated.
We can help you manage your treatment side effect and become a Strong Survivor.

Download The Back on Track Program Flyer Here

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Active Surveillance
Management of Prostate Cancer

Active Surveillance is a conservative approach to managing prostate cancer that is considered for individuals with low-risk prostate cancer.

Download the Prostate Cancer Rehabilitation e-Book here

This strategy involves closely monitoring the cancer’s progression through regular medical check-ups, imaging, and periodic biopsies. It aims to avoid treatments like surgery or radiation therapy if possible and your urologist will monitor you closely and make decisions about your treatment when required.

The Role of Men’s Health Physiotherapy in Active Surveillance for Prostate Cancer

How can Physiotherapy assist you during your Active Surveillance?

1. Urinary Continence Management: One of the potential side effects of prostate cancer and its treatments is urinary incontinence. East Gosford Physio can help you strengthen the pelvic floor muscles, which play a crucial role in bladder control. Through tailored exercises and strategies, patients can enhance their urinary continence, allowing them to better manage this aspect of their health.

2. Sexual Function Improvement: Active surveillance involves regular monitoring, which can be emotionally taxing for patients. East Gosford Physio can offer guidance on exercises and techniques that aid in maintaining or improving sexual function, focusing on the pelvic muscles and promoting blood flow to the area.

3. Pelvic Pain Management: Some individuals undergoing active surveillance may experience pelvic pain or discomfort. Our Men’s Health physios are skilled in assessing and addressing pelvic pain through a variety of manual techniques, stretches and exercises that target specific areas of concern.

4. Psychological Support: The journey through active surveillance can be emotionally challenging. Our Men’s Health Physiotherapists understand the challenging issues associated with Prostate cancer and provide a safe space for patients to discuss their concerns and feelings relating to their condition. This psychological support can contribute to improved mental well-being and overall quality of life.

5. Help with improving Fitness and strength: East Gosford Physio has developed a program to help men stay fit and well through their cancer journey. Our program -Back on Track is ideally suited to men who need some advice on exercise and help with motivation to exercise. We can then direct you to our Keep Moving – Strong Survivors program which is a safe and effective exercise class available for men under Active Surveillance to keep exercising in a fun and social environment.

New instructional videos for Pelvic Floor exercises

Part 1

Part 2

Part 3 Get in touch

Contact East Gosford Physiotherapy & Sports Injury Centre + East Gosford Oncology Physiotherapy today on (02) 4323 7499 to make an appointment with a specialist MEN 4 MEN Physiotherapist for treatment and advice on male pelvic floor muscle and incontinence control.