Have you had surgery for prostate cancer and found yourself dealing with unexpected bladder leaks? You are not alone. Post-prostatectomy incontinence is one of the most common symptoms men experience after prostate surgery, and it can have a real impact on daily life and confidence.
We shear from men every week who feel frustrated, embarrassed or worried that things will never improve. The good news is that for many men, pelvic floor exercises can make a significant difference. In this guide, we will explain why bladder leaks happen after prostate cancer surgery, how pelvic floor exercises work and how to perform them effectively. As a leak proof underwear brand supporting men with incontinence every day, we have seen first hand how the right routine combined with the right protection can help restore confidence and control.
Understanding post-prostatectomy incontinence after prostate cancer surgery
Post-prostatectomy incontinence refers to bladder leaks that occur after the prostate gland has been surgically removed to treat prostate cancer.
During surgery, the prostate is removed from around the urethra. Although surgeons work carefully to preserve surrounding structures, the urinary sphincter and supporting muscles can be affected. This can lead to stress incontinence, where urine leaks during coughing, standing, lifting or exercise.
Why bladder leaks happen after surgery
There are three main reasons men experience bladder leaks after prostate cancer treatment:
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Weakening of the external urinary sphincter
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Temporary nerve disruption
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Loss of structural support around the urethra
A pattern we often hear from customers is this: “I’m dry when I wake up, but as soon as I start moving around, I leak.” That is classic stress incontinence. The pelvic floor muscles are simply not yet strong enough to handle pressure changes.
The encouraging news is that these muscles can be retrained.
What are pelvic floor muscles and why do they matter?
The pelvic floor muscles form a supportive hammock at the base of the pelvis. In men, they:
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Support the bladder and bowel
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Help control the release of urine
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Contribute to sexual function
After prostate cancer surgery, these muscles often have to work harder because part of the urinary control system has been removed.
When these muscles are weak or poorly coordinated, bladder leaks are more likely. When they are strengthened through targeted pelvic floor exercises, control often improves significantly.
We have supported men who felt disheartened at three months post surgery but saw real progress by month six after committing to a structured exercise plan.
How to identify your pelvic floor muscles correctly
Before starting pelvic floor exercises, it is essential to locate the correct muscles.
One way to identify them is to imagine trying to stop passing wind while also stopping the flow of urine. The muscles you tighten are your pelvic floor muscles.
However, do not regularly stop your urine mid stream as a training method. This is just for identification and can interfere with normal bladder function if done repeatedly.
Common mistakes we hear about include:
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Tightening the buttocks instead
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Holding the breath
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Tensing the stomach muscles excessively
If in doubt, a specialist pelvic health physiotherapist can provide invaluable guidance.
Step by step guide to effective pelvic floor exercises for post-prostatectomy incontinence
Consistency matters more than intensity. It is better to do the exercises correctly and regularly than to overdo them.
1. Slow contractions
These build endurance.
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Tighten your pelvic floor muscles gently.
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Hold for a count of 5.
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Breathe normally.
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Relax fully for 5 seconds.
Repeat 10 times.
Gradually build up to holding for 10 seconds. This improves your ability to maintain control throughout the day.
2. Fast contractions
These help prevent bladder leaks during sudden movements.
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Tighten the pelvic floor muscles quickly.
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Hold for 1 second.
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Relax completely.
Repeat 10 times.
These are especially useful before coughing, standing up or lifting.
3. The “brace before you move” technique
One of the most powerful habits we see men adopt is tightening the pelvic floor just before activities that trigger leaks.
For example:
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Before standing from a chair
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Before sneezing
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Before lifting shopping bags
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Before exercise
This pre contraction can dramatically reduce bladder leaks.
Creating a daily pelvic floor routine
Men often ask us, “How often should I do these exercises?”
A commonly recommended structure is:
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10 slow contractions
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10 fast contractions
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3 times per day
Morning, afternoon and evening works well for many people.
Linking exercises to daily habits makes them easier to remember. For example:
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After brushing your teeth
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While waiting for the kettle to boil
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During advert breaks on television
The key is repetition and patience.
How long before pelvic floor exercises improve symptoms?
Recovery timelines vary. Some men notice improvement within a few weeks. For others, it may take several months.
Factors that influence progress include:
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Age
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Overall health
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Pre surgery fitness
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Severity of incontinence
We have seen men who were using multiple pads a day reduce to occasional light bladder leaks over time. The shift in confidence is often as significant as the physical improvement.
One customer told us he avoided the gym entirely after prostate cancer treatment. Six months into consistent pelvic floor exercises, combined with discreet leak proof underwear, he returned to strength training and felt in control again.
Combining pelvic floor exercises with lifestyle strategies
Pelvic floor training works best alongside other supportive habits.
Maintain a healthy weight
Excess weight increases pressure on the bladder and pelvic floor. Gradual weight management can reduce symptoms.
Stay active
Gentle exercise supports circulation and overall recovery. Walking and swimming are particularly helpful in the early stages.
Manage fluid intake sensibly
Do not drastically reduce fluids, as this can irritate the bladder. Instead:
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Spread fluids evenly through the day
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Limit excessive caffeine
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Avoid large amounts of fluid late at night
Use reliable protection while recovering
Building strength takes time. During this period, using well designed leak proof underwear can provide security without bulk.
Many men tell us that once they stop worrying about visible leaks, they feel more relaxed and motivated to continue their pelvic floor exercises. Confidence and physical recovery often go hand in hand.
When to seek professional support for post-prostatectomy incontinence
If bladder leaks persist beyond 6 to 12 months, or if symptoms are severe, it is important to speak to your GP or urology team.
You may benefit from:
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Referral to a pelvic health physiotherapist
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Medication to calm an overactive bladder
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Further assessment of urinary function
Persistent symptoms do not mean failure. They simply mean you may need additional support.
Post-prostatectomy incontinence is a common symptom after prostate cancer surgery. Bladder leaks occur because the muscles and structures responsible for urinary control have been altered. The good news is that pelvic floor exercises can significantly improve strength, coordination and control.
By performing slow and fast contractions daily, using the brace before you move technique and staying consistent, many men regain confidence over time. Recovery is rarely instant, but steady effort makes a real difference.
Be patient with yourself. Your body has been through major treatment and healing takes time.
If you are working on pelvic floor exercises and want discreet protection while your body recovers, explore our range of leak proof underwear designed specifically for men with bladder leaks after prostate cancer treatment.