Regaining Control After Prostate Surgery: How Virtual Physical Therapy Can Help

If you’ve recently had a prostatectomy, or are getting ready for one, you’ve probably heard a lot about leakage, pelvic floor muscles, and recovery time. You might also be wondering when you will feel like yourself again.

The answer is that recovery is a process. However, many people heal back to their pre-surgical function and most importantly, physical therapy can help you get there more reliably. Whether you meet your therapist in person or virtually, pelvic floor physical therapy can reduce incontinence, improve pelvic control, and help you move forward with confidence (Rapp, 2023).

What Is a Prostatectomy?

A prostatectomy is a surgery that removes part or all of the prostate gland—either partial (simple) or complete (radical). It’s usually done to treat prostate cancer or an enlarged prostate.

After surgery, it’s normal to experience changes in your bladder and pelvic function, especially urinary leakage (incontinence). But “normal” doesn’t have to mean permanent.

Common Symptoms After Prostate Surgery

Post-prostatectomy recovery can include:

• Pelvic pain or tightness
• Urinary leakage (especially when coughing, sneezing, or laughing)
• Scar tissue or stiffness
• Erectile or sexual dysfunction

Among these, stress incontinence—that pesky leaking when you move—is the most common. It’s frustrating, yes, but also treatable with the right kind of physical therapy support. The right support can ensure you get back to your favorite activities, once cleared from post-surgical precautions, without the fear of leakage or reliance on Depends.

How Physical Therapy Supports Recovery

Think of pelvic floor PT as your body’s personal trainer before and after surgery. It helps:

• Reduce pelvic pain
• Strengthen and retrain your pelvic floor
• Restore bladder control and confidence

Starting physical therapy before surgery—sometimes called “pre-hab”—can set you up for faster recovery. Studies show men who begin pelvic floor exercises ahead of surgery have less incontinence and pelvic floor muscle loss afterward (Milios, 2019).

And while some surgeons hand out exercise sheets, which can be a good start, educational and supervised sessions with a pelvic health PT lead to significantly better outcomes (Baumann, 2021). In short: guided support beats the “wing it at home” approach every time. And safe physical therapy treatment can begin as soon as one week after catheter removal.

Why Go Virtual?

Virtual physical therapy lets you heal comfortably from home, especially in those first few weeks after surgery. You’ll still work one-on-one with a licensed PT—just without the commute or clinic waiting room.

Here’s what makes virtual PT for prostatectomy recovery so effective:

• Convenience: Attend from home, where you’re most comfortable, while recovering from surgery.
• Consistency: Easier scheduling means fewer missed sessions.
• Personalized feedback: Your PT can still observe your form, guide you through exercises, and make real-time adjustments.
• Comparable results: Research shows virtual PT is just as effective as in-person care for prostate surgery recovery (Martini, 2024).

Plus, pelvic health PTs specializing in men’s care can be hard to find. Virtual care makes expert help accessible—no long drives, no awkward waiting rooms, and no “Did I do this right?” guesswork.

What Happens in a Virtual Session?

A typical virtual appointment starts with a check-in: how you’re feeling, what’s improving, and what’s still challenging. From there, your PT might cover:

• Pelvic floor and core strengthening exercises
• Self-tissue mobilization and gentle stretching
• Bladder retraining strategies and bathroom habits
• Breathwork and pressure control techniques
• Education on movement, recovery, and realistic timelines

If you’re pre-surgery, your PT will focus on building pelvic floor strength and coordination to prepare your body. If you’re post-surgery, the goal shifts to restoring control and reducing leakage.

Most patients meet with their PT once a week for 8–12 weeks—sometimes more, sometimes less. And here’s the best part: those who complete PT have much higher odds of fully resolving post-surgical leakage.

The Bottom Line

You don’t have to “just live with” urinary leakage and countless Depends after prostate surgery. With the right guidance, your recovery can be smoother, faster, and a lot more comfortable.

Virtual pelvic floor physical therapy gives you expert support from home—helping you regain control, confidence, and (yes) your favorite pants.

References

Milios JE, Ackland TR, Green DJ. Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence. BMC Urology. 2019;19(1):116. doi:10.1186/s12894-019-0546-5.

Baumann FT, Reimer N, Gockeln T, et al. Supervised pelvic floor muscle exercise is more effective than unsupervised exercise at improving urinary incontinence in prostate cancer patients following radical prostatectomy – a systematic review and meta-analysis. Disability and Rehabilitation. 2021;44(19):5374–5385. https://doi.org/10.1080/09638288.2021.1937717

Rapp DE, Hutchison D, Jones MK, DeNovio A, Greene KL. Novel online comprehensive pelvic floor therapy program following prostatectomy. Translational Andrology and Urology. 2023;12(12):1775–1784. doi:10.21037/tau-23-436

Martini A, et al. Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study. Journal of Medical Internet Research. 2024;26:e55429. doi:10.2196/55429

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