Pelvic floor exercises after prostate surgery: a step-by-step plan

After a radical prostatectomy, many men find they cannot fully control their bladder for a while. This is a common and usually temporary effect of the operation. Pelvic floor exercises are an important part of recovery — but timing matters, and your care team's plan comes first.

Why leaking happens after surgery

After the operation, you will usually have a catheter for about 7 to 10 days. When it is removed, most men cannot fully control their bladder at first, because surgery can cause swelling or damage to the urinary sphincter, the pelvic floor muscles and the nerves that control them (Prostate Cancer UK). Most men regain bladder control over time — often within 6 to 12 months — and pelvic floor exercises help with this (Pelvic Floor First).

Before surgery: start early

It is a good idea to start the exercises 4 to 6 weeks before your operation, so you know how to do them properly afterwards (Prostate Cancer UK). Preparing in this way helps reduce how much, and for how long, urine leaks after the operation (CUH).

While the catheter is in — don't exercise

Doing pelvic floor exercises with a catheter in place can irritate the bladder and cause discomfort (Pelvic Floor First). You can start as soon as the catheter has been removed (Prostate Cancer UK). If your surgeon or nurse has given you different instructions, follow them.

After catheter removal: how to do them

1. Find the muscles: tighten the ring around your back passage as if holding in wind, and at the same time imagine stopping your urine flow. The base of the penis should draw in slightly and the scrotum lift.
2. Slow: squeeze and hold for up to 10 seconds, then relax and rest for 10 seconds. Up to 10 times.
3. Fast: squeeze for 1 second, then let go. Up to 10 times.
4. Breathe normally and do not squeeze your buttocks or thighs. When you feel able, do the exercises standing up (Prostate Cancer UK).

If you cannot hold for 10 seconds yet, hold for as long as you can — good technique matters more than the time.

During the day

• Tighten the muscles strongly before and during activities that make you leak: getting up from a chair, lifting, bending, coughing or sneezing.
• Squeeze after you pee to clear urine left in the urethra.
• Don't overdo it. Tired muscles can mean more leaking towards the end of the day; this is common and should improve as the muscles get stronger (Prostate Cancer UK).

What guidelines and research say

For stress incontinence after prostatectomy, NICE recommends supervised pelvic floor muscle training, continued for at least 3 months before other options are considered (NICE CG97).

The research is mixed. A Cochrane review found that men's symptoms improve over time whatever the management, and that training was not shown to be better than control for men who already had incontinence. For programmes offered to all men after surgery there was moderate evidence of benefit, but pad-test data did not support it, and the authors concluded that the value of conservative approaches remains uncertain (Anderson et al., 2015).

If leaking continues

Progress can be slow — it can take up to three months to notice a real difference (Prostate Cancer UK). If you still leak 6 to 12 months after surgery and the exercises have not helped, ask your urologist about other options, such as containment products, a sling operation or an artificial urinary sphincter (Prostate Cancer UK).

Get urgent help

If you suddenly and painfully cannot pee, contact your doctor or go to A&E straight away, and tell them about your surgery (Prostate Cancer UK).

Recovering erections after surgery is a separate topic; discuss it with your care team.

KegelFit offers a Kegel exercise timer and video workouts for the pelvic floor. It helps you stay on track, but it does not replace your care team's plan, measure muscle strength or check your technique. Free to download, with in-app purchases: Google Play · App Store.

Sources

1. Prostate Cancer UK. Pelvic floor muscle exercises (updated April 2025). https://prostatecanceruk.org/prostate-information-and-support/living-with-prostate-cancer/pelvic-floor-muscle-exercises
2. Prostate Cancer UK. Urinary problems after prostate cancer treatment. https://prostatecanceruk.org/prostate-information-and-support/living-with-prostate-cancer/urinary-problems
3. Continence Health Australia. Pelvic Floor First: Prostate surgery. https://www.pelvicfloorfirst.org.au/pages/had-prostate-surgery.html
4. Cambridge University Hospitals NHS. Pelvic floor exercises in men: frequently asked questions (version 11, 13 September 2024). https://www.cuh.nhs.uk/patient-information/pelvic-floor-exercises-in-men-frequently-asked-questions/
5. NICE. Lower urinary tract symptoms in men: management (CG97). https://www.nice.org.uk/guidance/cg97
6. Anderson CA, et al. Conservative management for postprostatectomy urinary incontinence. Cochrane Database Syst Rev. 2015;1:CD001843. https://doi.org/10.1002/14651858.CD001843.pub5