Pelvic floor exercises after raclical prostatectorny

Prostate cancer is the rnost comûlon cancer in rnen in the UK. Treatrnent with radical prostatectorny rnay produce risk factors that corrrmonly include urinary incontinence and erectile dysfunction. Post-prostatectorny incontinence can be classifìed as either stress urinary incontinence, urge urinary incontinence or post-micturition dribble. Evidence has shown that these ernbarrassing conditions rnay be treated successfully with pre-operative and post-operative pelvic floor exercises, which include 'the knack', urge suppression, fluid advice and a post-void contraction for post-rnicturition dribble. New evidence suggests that rnen with erectile dysfunction rnay benefìt frorn the sarne pelvic floor exercises. Key worcls: Pelvic floor exercises r Urinary incontinence r Erectile dysfunction r Prostate cancer ' r'ostrìte c¿rncer is lhe niosl colÌllloll c:urccr il rtrcll in thc UI{, with nrole than 41 000 ncw c¿rses and , 9000 clcaths fì'onr the clisersc crch ycrir' (C:rnccr l\cscalch UK, 20 t2). R;rdicrl prostarcctonry is incleasiugiy bcconrilg thc prcfcrrccl tlertllìelìt fol 1ocllised prostâtc crìncer llow that nervc-spirriDg techniclucs cln I'relp to llr:csclvc potetlcy rlncl contincncc. Tl-rc wholc plostate glrud is rcnrovecl thr:ougl'r r supr:apubic incision (opcl prostrtcctollly), 1:rparoscopic ot' lobot-assisted surgcly ancl thc folur¡rtior of ul ¿rrr¿rstonrosis belween thc urethl'¿r :uicl thc blaclclcr'. The lisk f,rctors :rftcl mdical prostxtcctorny incluclc r-r lir lly incontincn cc ¿rncl ercc lile dysfunction. In :t lalgc tl'ial of 533 rucn cr¡ncluctccl by Glazencl ct rr1 (2011), it was flor-rncl th:rt :rftel r':rclicrrl prost:itectonry lì9% suilerecl fi'om nrinlly incontinerrcc 6 wccks rfter surger-y. Of thesc, [J6% of the gr:oup rrrndor-niscc] to receive four scssions of pelvic flool exclciscs :uid tì9% of thc controls still suflelecl urirury lcaklge 3 months hter. Post-prost:rtcctorrry incoutine nce shonld be tr-c¿rted rccolcling to thc prcsenting synptoms. Following r-rclical pl'os t¿ì tectollìy, patieDts t nay hrve stress ur.in :rry inc on tiDeltc e clnc to bl:rcldel neck sphincter d:irnagc, orLlrjge r-uinar.y ilcontincncc, or a combin¿itìon of both typcs. Thcy rrray hrvc post-mictulitiotr dribblc but thcy rnay have also expcliencccl this befor-c sl1r.Ílery. Prolcssor (ìr,rcc ì)orcy is (Ìrrsultltt ì)hysiothcrrpìst, NuflìcLrl Hospitrl, TitLtLltor, Sorlcrsct ' rLt'ltÍtil -fot ptthlilttiott AyíI 10Ii The intern¿rl ure thlal sphincter at the blaclclcr ncck is clrltrrged in al1 forms of pt'ostâtcctolny :rnd corrtillc¡cc rclies ol 2r co1ìlpctcrìt cxterurl urclhlll sphilctcr, rcinfol.ccrl by the pelvic flool muscul:rture. The extclnal tu-cthlll sphincter nray be weakelcd fi'om disuse c1r-rr-ing thc pcriod rvhcn tbc uretlu¿r w¿ìs colrìpressed by an enlargcd