Pelvic Floor Exercises After Prostate Surgery: Why They Matter and How to Start
By Duncan Hill, Men’s Health Physiotherapist, Inline Physio Moorooka, Brisbane · Last updated November 2026
Pelvic floor exercises are one of the most effective ways to reduce leaking after prostate surgery. Men who learn the right technique, ideally before their operation, usually regain bladder control sooner and with more confidence.
This Movember, we’re focusing on recovery after prostate cancer treatment. If you’ve had your prostate removed, or you have surgery coming up, someone has probably mentioned “pelvic floor exercises” in passing. Maybe it was a line on your discharge sheet, or a quick “do your squeezes” from the nurse. What often gets lost is how much these muscles matter, and how much better the results can be when you train them properly.
Why do men leak after prostate surgery?
Leaking after a prostatectomy happens because part of the system that keeps you dry is removed with the prostate. It’s common, it’s expected, and for most men it improves.
Your prostate sits just below your bladder, wrapped around the urethra (the tube urine passes through). Together with a ring of muscle called the urethral sphincter, it helps keep you dry. Once the prostate is removed, leaking is common in the weeks and months after surgery, especially when you cough, sneeze, stand up or lift something.
The Prostate Cancer Foundation of Australia notes that leakage can be mild and last only a few weeks, or more severe and need pads for up to a year (PCFA). Most men regain bladder control within 6–12 months, and pelvic floor exercises are key to that recovery (Pelvic Floor First).
Leaking isn’t a sign that something has gone wrong. It’s a sign that the remaining muscles need to step up.
What does the pelvic floor do after a prostatectomy?
After a prostatectomy, the pelvic floor muscles take on more of the job of keeping you dry. Think of them as your backup system.
Your pelvic floor is a sling of muscles running from your pubic bone at the front to your tailbone at the back. It supports your bladder and bowel, and works with the sphincter to control the flow of urine. A stronger, better-coordinated pelvic floor can help you regain control sooner and gives you more confidence getting back to work, exercise and everyday life. Some men also find it supports their erectile recovery.
When should I start pelvic floor exercises?
The best time to start pelvic floor exercises is before prostate surgery, ideally at least 2–3 weeks beforehand. After surgery, most men restart once the catheter is out.
Starting early means you learn the technique while you’re feeling well, not for the first time while you’re sore, tired and wearing a catheter. Australian research found men who did pelvic floor exercises before surgery had a 36% lower chance of incontinence three months after surgery than men who started afterwards (Pelvic Floor First). A Queensland Health pre-surgery program at Redcliffe Hospital also found that starting more than three weeks before surgery was linked to better continence outcomes (Clinical Excellence Queensland).
After surgery, check with your surgeon first. Exercising while the catheter is in can irritate the bladder, so most men wait until it’s removed. From there, the goal is building strength, endurance and timing, so the muscles switch on right when you need them.
How do men do pelvic floor exercises correctly?
To do a pelvic floor exercise, gently draw up and in as if stopping the flow of urine, hold for a few seconds while breathing normally, then fully relax.
Sit or lie down comfortably. Then:
- Gently draw up and in, as if you’re stopping the flow of urine. You may feel the base of your penis lift slightly.
- Hold for a few seconds while breathing normally.
- Let go completely, and rest for the same amount of time.
- Repeat a few times.
Quality beats quantity. A gentle, accurate squeeze is far more useful than a hard one.
What are the most common pelvic floor exercise mistakes?
The most common mistakes are holding your breath, using the wrong muscles, not relaxing fully and giving up too early.
- Holding your breath. Your pelvic floor and your breathing work together, so keep breathing throughout.
- Squeezing your buttocks or thighs. If your glutes are doing the work, your pelvic floor isn’t.
- Not relaxing fully. Letting go matters as much as squeezing. A muscle that can’t relax can’t contract well.
- Giving up too early. Progress can take weeks to months, and consistency is what gets results.
What happens in a men’s health physio assessment?
A men’s health physiotherapy assessment checks that you’re using the right muscles and gives you a program matched to your stage of recovery.
Many men believe they’re doing the exercise correctly, but without feedback it’s hard to know. At Inline Physio, Duncan will:
- check you’re activating the right muscles, often using real-time ultrasound so you can watch them working on screen
- build a program matched to your stage of recovery, whether that’s before surgery or months after
- progress you from lying down to standing, walking and lifting, so your control carries over into real life
- track your improvement and adjust the program as you go
You’ll leave knowing exactly what to do, how often, and how to tell it’s working.
Book a men’s health physio in Brisbane
Whether your surgery is coming up or you’re already recovering, it’s never too early or too late to start. Duncan sees men for pelvic floor rehabilitation at Inline Physio Moorooka, and patients from across Brisbane are welcome to book.
BOOK YOUR PELVIC HEALTH ASSESSMENT HERE
Know someone heading into prostate surgery? Share this article with them. It might be the most useful thing they read before their operation.
Looking forward to helping you soon!
Duncan Hill
Men’s Health Physiotherapist
Inline Physio Moorooka
FAQs
How long does incontinence last after prostate surgery? It varies from man to man. Some men need pads for only a few weeks, while others leak for up to a year. Most men regain bladder control within 6–12 months, and pelvic floor training can help speed this up.
Should I start pelvic floor exercises before prostate surgery? Yes. Starting at least 2–3 weeks before surgery is ideal. Men who train before surgery tend to regain control sooner than men who start afterwards, and it means you already know the technique when you get home from hospital.
When can I start pelvic floor exercises after prostate surgery? Most men start once the catheter has been removed. Exercising while the catheter is in can irritate the bladder. Always check with your surgeon first.
How often should I do pelvic floor exercises? It depends on your stage of recovery and how strong and coordinated your muscles are. A men’s health physio will set the number of squeezes, hold times and sessions per day for you, and progress them as you improve.
Can pelvic floor exercises help with erectile function after a prostatectomy? They may help. The pelvic floor muscles play a role in erections, and some men find training them supports their erectile recovery. Talk to your urologist about erectile rehabilitation too, as it often involves more than exercise.
How do I know if I’m doing pelvic floor exercises correctly? You should feel a gentle lift and draw-in at the base of your penis, without holding your breath or tensing your buttocks or thighs. The most reliable way to check is with a men’s health physio, who can use real-time ultrasound so you can see the muscles working.
Do I need a referral to see a men’s health physio in Brisbane? No, you can book directly with Inline Physio without a referral. If you’d like to use a Medicare care plan or DVA funding, you’ll need a referral from your GP.
Where can I see a men’s health physio in Brisbane? Duncan Hill sees men for pelvic floor and prostate surgery rehabilitation at Inline Physio Moorooka.