Pelvic floor exercises, also known as Kegel exercises, strengthen the muscles that support the bladder and control urine flow. When performed correctly and consistently, these exercises can help improve urinary incontinence symptoms. This guide explains how to identify and train your pelvic floor muscles, why they are particularly important before and after prostate surgery, and when to consult a urologist for further evaluation.
Understanding Your Pelvic Floor
The pelvic floor is made up of layers of muscles that stretch from the tailbone to the pubic bone. These muscles support the bladder, bowel, and reproductive organs, and play a key role in urinary control.
Functions of the pelvic floor include:
- Supporting pelvic organs: Helping keep the bladder and surrounding organs in position.
- Controlling bladder function: Preventing urine leakage by maintaining closure pressure at the urethra.
- Responding to physical stress: Contracting during activities like coughing or lifting to prevent stress-related leaks.
These muscles may weaken due to ageing, surgery (such as prostatectomy), or chronic straining, which can lead to urinary leakage.
How Pelvic Floor Exercises Help Urinary Incontinence
Pelvic floor exercises are commonly recommended for the following types of urinary incontinence:
- Stress incontinence: Leakage during coughing, sneezing, laughing, or exercise due to weakened pelvic floor support.
- Urge incontinence: Sudden, strong urges to urinate that may be accompanied by leakage. Strengthening may help improve control.
- Mixed incontinence: A combination of stress and urge symptoms that often responds to pelvic floor training.
- Overflow incontinence: While primarily managed medically, exercises may assist with improving bladder emptying in some cases.
For men recovering from prostate procedures such as TURP, HoLEP, or radical prostatectomy, these exercises can support bladder control and shorten the duration of post-operative incontinence.
Benefits of Pelvic Floor Exercise Before Surgery
Beginning pelvic floor training before prostate surgery has been shown to improve post-operative bladder control and recovery. Strengthening these muscles in advance helps patients gain better awareness and control, which can lead to faster return of continence after procedures such as TURP, HoLEP, or prostatectomy.
Pelvic Floor Exercise Technique
Start by learning how to activate the correct pelvic floor muscles. Avoid activating surrounding muscles such as the thighs or buttocks. Focus solely on the pelvic floor area. These exercises should be performed consistently.
Starting Position: Begin lying down with knees bent and feet flat to reduce gravity. As you gain control, progress to sitting or standing.
Squeeze: Tighten your pelvic floor muscles as if trying to stop the flow of urine. Hold for 3–5 seconds while breathing normally.
Release: Fully relax the muscles for 3–5 seconds between each contraction.
Repetitions: Start with 5–10 squeezes, three times a day. Gradually work up to 10-second holds.
8-Week Progression
Maintaining a consistent daily routine is key for long-term improvement. To build strength gradually:
Weeks 1–2: Focus on finding the right muscles. Do short 3-second holds while lying down.
Weeks 3–4: Increase hold time to 5 seconds. Introduce a few quick 1-second contractions.
Weeks 5–8: Aim for 8–10 second holds. Start practising exercises in sitting and standing positions.
After Week 8: Begin using contractions during functional tasks, such as before coughing or lifting.
When to Expect Improvement
Improvements may be more gradual after prostate surgery, but persistence is important.
After 1 month: Increased muscle awareness and control, though symptoms may persist.
6–12 weeks: Many people notice fewer leakage episodes and improved urgency control.
3–6 months: Maximum benefits are typically seen with consistent daily training.
Long-term: Continued practice is important to maintain gains.
When to Seek Professional Help
Consult a urologist if you experience any of the following:
- No improvement after 3 months: Persistent symptoms may indicate other underlying conditions requiring investigation.
- Worsening symptoms: Increased leakage or new urinary issues warrant a thorough evaluation.
- Pain or discomfort during exercises: This may signal incorrect technique or another pelvic issue.
- Uncertainty about technique: A urologist can refer you to a pelvic floor physiotherapist if specialised assessment or biofeedback is needed.
Conclusion
Pelvic floor exercises are a simple, non-invasive strategy to manage urinary incontinence. When performed regularly and correctly, they can improve control and reduce leakage.
For men preparing for or recovering from prostate surgery, these exercises play an important role in restoring bladder function.
Dr. Lee, a qualified urologist in Singapore, provides personalised post-surgical care and incontinence management, guiding patients through safe and effective pelvic floor training.
If you are experiencing urinary leakage or planning prostate surgery, schedule a consultation with Dr. Lee for tailored support and long-term continence care.
