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Pelvic floor exercises before and after prostatectomy | CION Cancer Clinics
Pelvic floor exercises, often called Kegels, are the one thing you can do yourself that speeds the return of bladder control after prostate surgery. Start them before the operation, restart them as soon as the catheter is out, and do them every day for months. This page shows how to find the right muscle, how to squeeze it, the mistakes that waste the effort, and when exercises alone are not enough. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Do pelvic floor exercises really help after a prostatectomy?
- How do you find the right muscle and squeeze it?
- Before the operation and after the catheter, compared
- Four mistakes that stop the exercises working
- Things men tell us, and what is actually true
- When exercises are not enough, and what this page cannot tell you
- Common questions about pelvic floor exercises after prostate surgery
The short answer
Do pelvic floor exercises really help after a prostatectomy?
Yes. Pelvic floor exercises, often called Kegels, are the one thing you can do yourself that speeds the return of bladder control after prostate surgery. Men who start them before the operation and restart them as soon as the catheter is out tend to get dry sooner than men who wait.
What the exercise actually trains
The prostate used to help hold urine in. Once it is gone, the job falls to a ring of muscle called the sphincter and to the sheet of muscle across the floor of the pelvis. That sheet can be trained like any other muscle. A stronger, quicker pelvic floor closes the tube before a cough or a step forces urine out.
Why starting before surgery matters
Before the operation you can feel the muscle clearly and learn the squeeze without pain or a catheter in the way. That learning carries over. After surgery, when everything is sore and swollen, you are repeating a movement you already know rather than trying to find it for the first time.
The exercises do not replace surgery, and they cannot undo damage to the sphincter itself. They make the most of what is there.How to do it
How do you find the right muscle and squeeze it?
Find the muscle
Sit or lie down. Imagine you are trying to stop passing wind, and at the same time trying to stop the flow of urine mid-stream. You should feel a lift at the back passage and the base of the penis. The belly, buttocks and thighs stay soft.
The slow squeeze
Tighten the muscle and hold it for a few seconds while breathing normally. Then let go fully and rest for as long as you held. Repeat several times. As the weeks pass, hold for longer.
The quick squeeze
Tighten hard and let go straight away, several times in a row. This trains the fast reaction that catches a cough or a sneeze. Both kinds of squeeze matter, so do both every session.
Use it before you need it
Once the squeeze is familiar, do it just before you stand up, cough, lift or laugh. This habit, sometimes called the knack, is what turns exercise into fewer leaks in daily life.
Not sure whether this applies to you?
Ask an oncologistTwo phases
Before the operation and after the catheter, compared
Before surgery
After the catheter is out
Before: learn the squeeze and build the habit, several short sessions a day
After: restart gently the day the catheter is removed, unless your surgeon says otherwise
Before: stopping urine mid-stream once, only to find the muscle
After: never practise on the toilet; it teaches the bladder to empty badly
Before: aim for a firm hold and a full release each time
After: shorter holds at first; soreness is expected, sharp pain is not
Before: a physiotherapist visit if you cannot feel the lift
After: a physiotherapist visit if pad use has stopped falling
Getting it wrong
Four mistakes that stop the exercises working
Most men who say the exercises did nothing were doing one of these.
Holding your breath
Holding the breath pushes down on the bladder, which is the opposite of what you want. Count out loud, or talk, while you squeeze. If you cannot speak, you are straining rather than lifting.
Bearing down
Pushing as if opening the bowels feels like effort but works the wrong way. The correct movement is a lift inwards and upwards. If the belly bulges, you are pushing, not squeezing.
Using the wrong muscles
Clenching the buttocks or thighs feels strong and does nothing for the bladder. Put a hand on your buttock while you practise. If it tightens, relax it and try again with a smaller movement.
Exercising with the catheter in
Squeezing on a catheter can irritate the join the surgeon has made between bladder and tube. Most teams ask you to wait until the catheter is out. Ask yours.
If you were told to start with the catheter in place, follow your own surgeon's advice over this page.Leave a number, we will call you
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Did you know
The pelvic floor tires like any other muscle. Doing a hundred squeezes in one go trains it less well than short sessions spread through the day, and it can leave you leaking more that evening. Little and often beats one long effort.
Commonly believed
Things men tell us, and what is actually true
"These are women's exercises."
Men have the same sheet of muscle across the pelvis, and after prostate surgery it is doing more work than it has ever done. The exercises are the standard advice for every man having this operation, whatever his age or fitness.
"I did them for a fortnight and nothing changed."
Muscle takes weeks to strengthen, and the sphincter is also healing on its own timetable. Judge progress by the pad count month to month, not day to day. Most men see the change over months, not weeks.
"More squeezes means faster recovery."
Beyond a sensible daily amount, more does not help and a tired pelvic floor leaks more. Quality of each squeeze, a full release between them and the habit of squeezing before effort matter more than the total.
Being straight with you
When exercises are not enough, and what this page cannot tell you
This page cannot tell you how quickly you will recover, or whether the exercises alone will get you dry. For most men they do. For some, the sphincter was damaged or was weak to begin with, and no amount of training will fully close the gap. Those men need a different conversation, and having it early is better than another year of pads.
When to ask for a physiotherapist
If you cannot feel the muscle lift at all, if the pad count has not fallen for a couple of months, or if you are leaking heavily well past the early period, ask for a referral to a physiotherapist who treats pelvic floor problems. They can check you are using the right muscle, and some use a small sensor that shows the squeeze on a screen, which helps men who cannot feel it.
What the exercises cannot fix
Urgency, the sudden need to rush, is a bladder problem rather than a muscle problem and usually needs a different approach. Leaking at orgasm is caused by the missing valve and is not something the pelvic floor can close. Both are worth naming to your surgeon so the right thing is offered.
Never do the exercises through sharp pain, and stop and tell your team if you see fresh blood in the urine after a session.Questions we are asked
Common questions about pelvic floor exercises after prostate surgery
How many should I do, and how often?
Your surgeon or physiotherapist will give you a routine, and their numbers override anything here. A common pattern is a short set of slow squeezes and a short set of quick ones, repeated a few times spread through the day. What matters most is doing them every day, correctly, for months.
When should I start after the operation?
Most teams say the day the catheter comes out, starting gently and building up. Some surgeons prefer a few days of rest first. Ask before you leave hospital, and write the answer down, because it is easy to forget in the first tired week at home.
Can I do them lying down, or do I have to stand?
Start lying down or sitting, where the muscle is easiest to feel. As you get stronger, do some standing, because that is when you leak. Eventually do them while walking, since a muscle trained only at rest is not ready for real life.
How do I know I am squeezing the right muscle?
You should feel the back passage tighten and the base of the penis lift slightly, with no movement in the belly, buttocks or thighs. If you are unsure, a physiotherapist can check in one visit. Guessing for months is the most common way men waste the effort.
My father is 72. Is it too late for him to benefit?
No. Older men build muscle more slowly, but they still build it, and the exercises help at any age. What matters is that he learns the squeeze properly and keeps going. A family member reminding him at set times each day makes a real difference.
Is there an app or a device that helps?
Reminder apps help many men stick to the routine, and that is their main value. Devices that measure the squeeze are useful mainly under a physiotherapist's guidance. None of them replaces learning the correct movement in the first place.
Do the exercises help erections too?
They may help a little, because the same muscles support blood flow in the penis, but the evidence is thinner than for bladder control. Do not rely on them alone for that. Ask your surgeon about a separate plan for erections, which is usually started early after surgery.
Can I stop once I am dry?
Most teams suggest keeping a lighter routine going for good, because the muscle weakens again if it is not used, and a heavy cold or weight gain can bring leaks back. A few squeezes each day, plus the habit of squeezing before a cough or a lift, is enough for most men.
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Sources
- NHS — Prostate cancer: treatment
- Cancer Research UK — Surgery for prostate cancer
- American Cancer Society — Surgery for prostate cancer
- Macmillan Cancer Support — Prostate cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Urinary Incontinence After ProstatectomyWhy the leaking happens in the first placeWhen Does Continence Come Back?The milestones to expect month by monthPads, Sheaths and Managing LeakageGetting on with life while the muscle recoversFitness, Tests and PrehabilitationThe other things worth doing before the operationPenile Rehabilitation After Prostate SurgeryThe separate plan for erections
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