Has anyone tried therapy prior to RARP to prepare for incontinence

Buy this book off of Amazon and follow the instructions: Life After Prostate Cancer by Vanita Gaglani. She is an experienced pelvic floor PT and has treated thousands of men for incontinence. I have found her book to be invaluable. She gives pre op instructions and the 10 weeks post op to achieve continence. Kegels are only a small part of regaining continence. Diet, core exercises, pad usage etc are critical as well. The book was recommended to me by my urologist 4 years ago prior to surgery.

My husband started doing kegel and some core exercises 3 mos before surgery and is still doing them now 6 weeks post surgery. His incontinence is minor and getting better every day (knock the wood). He started with about 70 ml per day squirting and now it is less than 30 ml per day. Yesterday it was 22 ml . Most cases of incontinence resolve by 3 mos and the rest continue to improve till about 95 % of men regain incontinence by 1 year mark.

We were told to do exercises prior to surgery. I guess every doctor has his own protocol. We could not afford personal PT sessions but situation is good anyways. 🧿 Even if it stays this minor amount it definitely will not interfere with any activity or life in general. But, since trend is obviously downward, I expect that he will have full continence by 6 mos ( unless he has to have salvage radiation too soon).

68 years old and 11 months post RARP, No therapy prior to surgery , but i did kegals and increased my cardio exercises to 5 or 6 days a week 4 months prior to the surgery. Watched my diet and ended up losing some weight and getting body mass into the healthier range. Surgeon told my wife after the RARP that” your husband was easy to work on”.
No incontinence at all when the catheter was pulled. Still working on the ED but improvement is steady.

Hi,

I would recommend pelvic floor therapy as I think it has helped my husband.

My husband had pelvic floor therapy prior to his radical prostatectomy on 2/28/2025. He performed the exercises for a few weeks prior to his surgery and resumed his exercises after catheter removal. He was using like 6 heavy pads a day after his surgery but was able to get down to one thin Tena pad and I credit that to his excellent pelvic floor therapist and my husband's commitment to doing the exercises as prescribed by his therapist. My husband also has a very positive attitude and we are a TEAM on this journey so we work together and he WILL be dry..... I would recommend going to a pelvic floor therapist prior to the surgery so you are not overwhelmed after you have the catheter removed. This will give you a chance to get familiar with the exercises before-hand.

That is an EXCELLENT book! I bought that for my husband prior to his surgery. I would also check out some of her YouTube videos. She has a lot of good advice. I keep referring to her book on my husband's journey to get totally dry! And I agree, diet, core exercises, pad usage IS critical along with the kegels. My husband has incorporated daily core exercises into his routine. I wish I could get him to stop eating red meat because I think it would help him but that is the one thing that I cannot accomplish.

I'm really surprised to hear that one surgeon recommended AGAINST doing pelvic floor exercises, aka Kegels, before surgery.
At my center of excellence I received a referral to a pelvic physical therapist and had one appointment with her. As I had already been doing Kegels, she watched me to see if I was doing it correctly. Kind of funny, she had me sort of wrap up my junk beforehand, then came into the room at watched my perineum, etc. as I did them. (What a great job for a young woman, no?)
Anyway, she seemed to approve of my technique, and we decided to reserve remaining appointments for AFTER the procedure, some time following catheter removal of course.

There are several helpful Youtubes that explain how to do it, specifically for men. I liked one that has you cover your balls with your palm, and reach down with two fingers to feel your perineum, where you can actually feel the muscles tense up as you do the maneuver. Also, be advised that you can really only tense up for maybe up to five seconds at a time; some of the videos seem to expect your holding them much longer, which is unrealistic. I also found it helpful to practice this while standing in the shower, under warm water, and I could also feel around behind onto my butt to feel my anus tensing as well, as there are muscles involved there as well, but it seems like it just tightens anyway.
I've been doing these exercises for six weeks now for my upcoming surgery, and I can nearly lift a bowling bowl just using my butt!
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(...kidding!)