Cancer of the prostate has been diagnosed and a treatment plan has been established. Possibilities are : irradiation, brachyherapy, operation or medication. All of these can influence the way you poo, pee or make love.
It is possible that in the trajectory to the correct diagnosis things already had changed : peeing more often, less powerful or during the night ; pooing more often ; anal complaints ; problems having an erection ; coming less easily ; or experiencing pain.
Most men will be reeling with shock when confronted with a diagnosis of prostate cancer. The confidence in their healthy body will be eroded. What’s going to happen…?
In preparation for their treatment many urologists are now referring men with prostate cancer to the pelvic floor physiotherapist.
The treatment options may be discussed with the pelvic floor physiotherapist, who can explain further using pictures and other information materials. Possible complications from the various treatment methods are discussed, of note, urinary incontinence and impotence.
Optimal condition of the pelvic floor is essential for the healing process
However, most men do not aware that they have a pelvic floor in the first place and have no idea what that means for them.
It is preferable to get that information before the treatment for prostate cancer starts : where is the pelvic floor located, what is the muscular power and, more essential, what is the optimal relaxation of the pelvic floor. Good coordination of the pelvic floor is essential after the operation. Especially in the case of urinary loss, correct contraction of the pelvic floor during a moment of elevated abdominal pressure (as in coughing, sneezing, lifting etc.) can prevent this loss.
The pelvic floor physiotherapist will guide and prescribe exercises and will be able to measure the tension in the pelvic floor with biofeedback technology.
Of course, this could be done after the operation, but by then swelling and pain might hinder the coordination of the pelvic floor.
Also, the pelvic floor therapist will discuss the sexual consequences of an operation, not only for the patient but also for his partner. Because talking about sex is pretty hard for most people and precisely therefore it is good to have these conversations with with a care giver, preferably, together with the partner, and before the treatment/operation.
The pelvic floor physical therapist will be involved in the post-operative healing process. Activities are answering questions, giving advice, monitoring the pelvic floor function and where needed conferring with the primary responsible physician.