Surgery in the pelvis - prostate, bladder, bowel - changes the working conditions of the pelvic floor: it removes or shifts structures, leaves a scar and takes the patient out of activity for several weeks. Physiotherapy accompanies that from both sides: preparation before the operation and guidance afterwards.
Before surgery, what matters most is learning a correct pelvic floor contraction and checking that the patient is not squeezing his buttocks, abdomen and adductors instead - which is very common, and harder to correct after an operation. Afterwards, once the treating doctor agrees, we return to training and add scar work and a graded return to lifting and exertion.
The timings are set by the operating surgeon, not the physiotherapist - we return to nothing against his instructions. My part is making sure the return is planned, rather than based on what seems safe to whom.
Therapy
- History and assessment before the procedure
- Functional examination of the pelvic floor muscles
- Learning a correct contraction before surgery
- Restarting training after the catheter comes out
- Work on the surgical scar
- A staged return to lifting, sport and intimacy
- A home programme