Prostate Cancer Rehabilitation & Recovery Support for Men
1 in 7 Men Will Be Diagnosed with Prostate Cancer in Their Lifetime. Are You Prepared for What Comes Next?

If you’re scheduled for a prostatectomy or undergoing radiation therapy for prostate cancer, you may already be concerned about the physical and emotional side effects that can follow. Many men experience:
• Bladder leakage (medical term: urinary incontinence)
• Erectile dysfunction and loss of libido
• Loss of penile length
• Nighttime urination (medical term: nocturia)
• Perineal pain (pain between the genitals and anus) or lower abdominal discomfort is common after prostate surgery and often improves with perineal massage.

But here’s the good news: recovery is possible—and you don’t have to go it alone. Our physiotherapy-led pre- and rehabilitation program help men take control of their recovery with confidence and support.

 

 

Upcoming Release! “Moving from Kegels to HEgels: The 2025 Approach to Understanding Pelvic Floor Health in Prostate Cancer Recovery”
This isn’t your typical Kegel handout. Moving from Kegels to HEgels offers a fresh, evidence-based guide designed for men navigating prostate cancer treatment and recovery. Whether you’re preparing for surgery (prehab) or rebuilding strength and continence afterward (rehab), this book equips you with knowledge to take charge of your pelvic health with clarity and confidence.

Inside, you’ll discover:
• What to expect when working with a pelvic health physiotherapist
• The 7-Step Prostate Pro Program for structured, progressive recovery
• How to move beyond traditional Kegels by mastering the HE-gel
• Bladder and bowel health strategies, hydration and nutrition tips
• The importance of posture and pelvic positioning for optimal pelvic floor muscle performance
• The reason why relaxation is crucial for supporting healing and pelvic health
• Why early penile rehabilitation is vital to preserving erectile tissues
• Targeted exercises to optimize pelvic floor muscle function

Whether you’re weeks away from surgery or months into recovery, this educational guide offers insights and tools that you may explore with your healthcare provider, should they be appropriate for your care.

Please Note: This eBook is for educational purposes only and is not a substitute for individualized medical care. Always consult your healthcare provider.
© 2025 Knew Life Physiotherapy. All rights reserved.

Please email [email protected] to join our notification list and be the first to know when the eBook is available for instant download!

 

 

Scheduled for Prostate Cancer surgery (prostatectomy)? Perhaps you are curious about your post operative male anatomy changes.

Watch this video to learn how pelvic floor physio can help prevent or combat surgical side effects:

RADIATION THERAPY & PELVIC HEALTH: WHAT YOU SHOULD KNOW

What Causes Urinary Incontinence Post-Radiation?

The Gift That Keeps Giving
Radiation-related changes can progress and accumulate over time, even long after treatment ends. This delayed and ongoing tissue response is a hallmark of radiation injury.

Key Mechanisms Leading to Incontinence and Erectile Dysfunction:
Radiation Fibrosis is the primary driver of both urinary incontinence and erectile dysfunction post-radiation. Radiation causes all affected tissues to stiffen—leading to increased rigidity and decreased elasticity.
• Pelvic Floor Muscles (PFMs): Reduced contractility and motor control
• Urethra: Fibrosis, stiffness, and strictures
• Bladder: Fibrosis leads to decreased capacity and early urgency—often noticeable around 18 months post-treatment
• Blood Vessels: Mucosal vascular damage compromises healing and tissue health
• Surrounding Tissues: Scar tissue replaces smooth muscle, disrupting mechanics and compliance of pelvic structures; this delayed healing is dose-dependent

Radiation Therapy Types:
• External Beam Radiation Therapy (EBRT)
• Brachytherapy (Seed Implantation): Notably reduces urethral length, increasing risk of complications
Acute & Long-Term Effects on the Lower Urinary Tract (LUT):
• Acute: Edema
• Long-term: Strictures

Strictures and Surgical Challenges
• Anastomotic Strictures have declined since the introduction of robotic surgical techniques.
• Brachytherapy carries the highest prevalence of strictures.
• Urethroplasty success rates are lower in radiated patients, and even successful repairs often result in higher rates of post-operative incontinence.

But There Is Hope—Exercise!
Therapeutic exercise may help:
• Prevent fibrotic changes in pelvic floor muscles
• Improve circulation and tissue health
• Manage inflammation and preserve function

Early intervention and consistent pelvic health rehabilitation can make a measurable difference in outcomes.

 

 

NOCTURIA

Nocturia Got You Up at Night?
Frequent nighttime urination—known as nocturia—is more than just a nuisance. It can interfere with sleep quality and worsen incontinence. Learn what causes it, how it’s connected to pelvic floor health, and how physiotherapy can help.
Here are 5 evidence-informed approaches I often recommend, tailored to the unique changes that occur after prostate surgery:

1. Fluid Timing and Management
• Why it matters: Many men unknowingly consume most of their fluids later in the day, increasing nighttime bladder filling.
• Action steps:
• Front-load fluid intake earlier in the day.
• Stop drinking 2–3 hours before bed, except for medications.
• Track intake and output for patterns.

2. Bladder Training and Urge Suppression Techniques
• Why it matters: The bladder can become overactive or hypersensitive post-surgery. Training can help increase bladder capacity and control.
• Action steps:
• Delay voiding gradually during the day to build capacity.
• Use urge suppression strategies (e.g., pelvic floor contractions, deep breathing, distraction techniques) when you feel the urge but it’s not yet time to void.
• Avoid “just-in-case” peeing before bed if not needed.

3. Pelvic Floor Muscle Training (PFMT)
• Why it matters: The pelvic floor muscles (PFMs) support the bladder and urethra. After surgery, these muscles can weaken or lose coordination.
• Action steps:
• Learn coordinated, functional pelvic floor contractions (not just Kegels—think HEgels: strength + coordination + relaxation).
• Emphasize timing and control, especially with urgency or when transitioning positions (e.g., standing up from bed).
• Work with a pelvic floor physiotherapist for guided rehab.

4. Address Underlying Contributors
• Why it matters: Nocturia can be multifactorial, including non-urological causes.
• Common culprits:
• Sleep apnea (frequently underdiagnosed in men with nocturia)
• Medications (especially diuretics taken late in the day)
• Swollen legs or fluid retention
• Action steps:
• Elevate legs during the day or use compression stockings to reduce nighttime fluid shift.
• Discuss meds and potential sleep disorders with your physician.

5. Optimize Sleep Hygiene
• Why it matters: Sometimes, people wake due to poor sleep and then decide to void “while they’re up,” reinforcing a habit loop.
• Action steps:
• Establish a regular bedtime routine.
• Reduce screen time before bed and create a cool, dark sleeping environment.
• Avoid caffeine and alcohol, especially in the afternoon and evening, as they irritate the bladder.

Click here to read more about the causes, symptoms, and management of Nocturia.

 

At our clinic, we have helped thousands of men regain control of these symptoms and get back to living normally again! We would be thrilled to have you take this rehabilitative step and return to the activities you love.

 

For more information, watch the video below about how to manage bladder leakage and ED following prostate cancer treatments.

Prostate Pro! Fitness Program

Prostate cancer is common and treatments like surgery and radiation can cause physical and emotional challenges. Our fitness program, tailored for men with prostate cancer, aims to address these issues, improve quality of life, and support recovery.