Anatomy and continence
The prostate is a gland that is shaped like a walnut and sits below the bladder. The urethra travels from the bladder, through the center of the prostate and along the length of the penis. Along each side of the prostate are nerves and blood vessels that help control erectile function. The control of urine is largely performed by the muscles surrounding the urethra, and the nerves that act on them, which contract to "kink the hose".
What happens after prostate removal?
After the surgery, you will have a catheter in place, which may stay in for 7-10 days.
The most common side effects after removal are urinary incontinence and erectile dysfunction.
Urinary incontinence effects around 98% of men and can take 3-12 months to resolve. This is due to the changes in smooth muscle and pressure on the urethra, resulting in needing the pelvic floor muscles to compensate for the change.
Erectile dysfunction will also be problematic for the majority of men and outcome depends largely on whether the surgeon has managed to spare the nerves during the procedure. This will be dictated by the severity of the cancer and whether it has spread. After successful nerve sparing procedures, there is often temporary nerve damage and swelling and it can sometimes take up to 2 years for the nerves to fully heal. Assistance from medications such as Viagra or penile injections and manual stimulation or vacuum penile pumps can help erectile function return.
The role of Physiotherapy
Our recommendation is to meet with you for an initial appointment around 6 weeks before your surgery. On this initial appointment we ensure you understand what the likely impacts of surgery will be, and give education on continence and time frames for recovery, different types of continence supports, bladder training and fluid intake advice, general physical activity advice and teach you how to correctly start training your pelvic floor muscles.
We then recommend having at least three follow up appointments;
Pricing:
Initial 60 minute appointment: $150
Follow up 30 minute appointments: $80
The prostate is a gland that is shaped like a walnut and sits below the bladder. The urethra travels from the bladder, through the center of the prostate and along the length of the penis. Along each side of the prostate are nerves and blood vessels that help control erectile function. The control of urine is largely performed by the muscles surrounding the urethra, and the nerves that act on them, which contract to "kink the hose".
What happens after prostate removal?
After the surgery, you will have a catheter in place, which may stay in for 7-10 days.
The most common side effects after removal are urinary incontinence and erectile dysfunction.
Urinary incontinence effects around 98% of men and can take 3-12 months to resolve. This is due to the changes in smooth muscle and pressure on the urethra, resulting in needing the pelvic floor muscles to compensate for the change.
Erectile dysfunction will also be problematic for the majority of men and outcome depends largely on whether the surgeon has managed to spare the nerves during the procedure. This will be dictated by the severity of the cancer and whether it has spread. After successful nerve sparing procedures, there is often temporary nerve damage and swelling and it can sometimes take up to 2 years for the nerves to fully heal. Assistance from medications such as Viagra or penile injections and manual stimulation or vacuum penile pumps can help erectile function return.
The role of Physiotherapy
Our recommendation is to meet with you for an initial appointment around 6 weeks before your surgery. On this initial appointment we ensure you understand what the likely impacts of surgery will be, and give education on continence and time frames for recovery, different types of continence supports, bladder training and fluid intake advice, general physical activity advice and teach you how to correctly start training your pelvic floor muscles.
We then recommend having at least three follow up appointments;
- After catheter removal (2-3 weeks post surgery)- to review fluid intake and bladder training, adjust your pelvic floor strengthening program, discuss erectile function and options for this and begin an appropriate return to exercise program
- 6-8 weeks post surgery- to review continence and start weaning pads if able, review exercise and whether you can begin other abdominal exercises, review erectile dysfunction options and return to work plan if required
- 16-20 weeks post surgery- to review continence and pad weaning, ongoing assistance with penile rehabilitation and consider any further referrals if necessary
Pricing:
Initial 60 minute appointment: $150
Follow up 30 minute appointments: $80
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