Category: Pelvic Floor for Men

If you’re preparing for a prostatectomy or have just had one, you’re probably wondering: “How much pain will I feel—and how long will it last?” That’s a very normal question. A prostatectomy, often used to treat prostate cancer, is a common surgery that can be life-saving. But like any major operation, it comes with its own recovery process.

The good news is this: while prostatectomy pain is part of healing, most men find it gets better more quickly than they expect. Let’s walk through what recovery usually looks like, what side effects are common, and how tools like physical therapy can help you get back on your feet.

Why Prostate Surgery Happens

Doctors most often perform prostate surgery to treat prostate cancer. The procedure removes the prostate gland, and when caught early, it can be very effective. Certain risk factors, such as underlying health conditions like diabetes or autoimmune diseases, may influence the decision to proceed with surgery or additional treatments. In some cases, doctors may also add treatments like hormone therapy or radiation to ensure they address all cancer cells. If there are remaining cancer cells or complications after surgery, further treatment such as radiotherapy or hormone therapy may be necessary to achieve complete eradication of the disease.

While surgery is an important step in treatment, it can also bring short-term challenges such as pain, urinary leakage, and changes in sexual function.

Types of Prostate Surgery

• Prostatectomy as a Surgical Procedure – Prostatectomy is a surgical procedure to remove the prostate gland, and there are several possible approaches, each with its own advantages and considerations.
• Open Radical Prostatectomy – This traditional approach involves a single larger incision in the lower abdomen to access and remove the prostate. Open radical prostatectomy is often compared to minimally invasive techniques, with differences in recovery time, pain, and potential complications.
• Radical Retropubic Prostatectomy – A type of open surgery performed through an incision in the lower abdomen, allowing direct access to the prostate. This surgical procedure is commonly used and enables the surgeon to remove nearby lymph nodes if necessary.
• Laparoscopic Surgery – Laparoscopic surgery is a minimally invasive technique that uses small incisions, a laparoscope (a thin tube with a camera), and specialized instruments to perform procedures such as prostatectomy.
• Laparoscopic Radical Prostatectomy – This minimally invasive approach uses laparoscopic surgery to remove the prostate. Laparoscopic radical prostatectomy is less invasive than open surgery and is often compared to robotic radical prostatectomy.
• Robotic Radical Prostatectomy – A form of minimally invasive surgery where the surgeon uses robotic assistance to perform the procedure with enhanced precision. Robotic radical prostatectomy may offer benefits such as reduced blood loss, less pain, and faster recovery compared to traditional methods.
• Laparoscopic/Robotic Prostatectomy – A minimally invasive approach with small abdominal incisions. Usually comes with less lower abdominal pain and a quicker recovery.
• Radical Perineal Prostatectomy – Done through an incision between the scrotum and anus. Effective in some cases but can cause more localized discomfort.

What Pain Feels Like

Most men describe prostatectomy pain as:

• A sore or pulling feeling in the lower abdomen
• Discomfort when sitting, moving, or standing
• Irritation or bladder spasms while the urinary catheter is in place or when it’s removed, often due to the presence of the catheter itself
• Some trouble with bowel movements in the first week or two

After surgery, the urinary catheter acts as a urine drain, carrying urine from the bladder while the area heals.

Post-Operative Care

After prostate cancer surgery, such as a radical prostatectomy, following a thorough post-operative care plan is crucial for a safe and effective recovery. Your care team will provide specific instructions tailored to your needs, but there are some general guidelines that most patients should keep in mind.

First, take care of your surgical incisions by keeping the area clean and dry. Watch for signs of infection, such as redness, swelling, or unusual discharge, and let your doctor know if you notice anything concerning. Avoid soaking in baths or swimming pools until your healthcare provider says it’s safe.

Activity restrictions are common after surgery. While gentle movement, like short walks, helps prevent blood clots and supports healing, you should avoid heavy lifting, strenuous exercise, or sudden movements for several weeks. Listen to your body and gradually increase your activity level as you feel stronger.

Managing pain is another important part of post-operative care. Take pain medications as prescribed, and don’t hesitate to reach out to your care team if you experience severe pain or discomfort that isn’t improving. Staying ahead of pain can help you move more comfortably and recover faster.

Regular follow-up appointments are essential after prostate cancer treatment. Your doctor will monitor your progress, check your PSA blood test results, and watch for any signs of complications or remaining cancer cells. These visits are also a good time to discuss any concerns about urinary control, sexual function, or emotional well-being.

Finally, don’t underestimate the value of support—whether from family, friends, or professional counselors. Recovering from prostate cancer surgery is a journey, and having a strong support system can make a big difference in your overall well-being.

By following your post-operative care plan and staying in close contact with your healthcare team, you’ll give yourself the best chance for a smooth recovery and a return to normal life.

The First Few Weeks of Recovery

Recovery looks different for everyone, but common experiences in the first few weeks after surgery include:

• Urinary leakage, especially when coughing or sneezing
• Fatigue and a slower pace than usual
• Mild abdominal swelling or tenderness
• Some discomfort when going to the bathroom

During this time, a catheter is placed to help the bladder heal, and it is connected to a drainage system that includes a leg bag for daytime use and a night bag for overnight urine collection. The leg bag is worn discreetly under clothing and should be emptied regularly, while the night bag is larger and designed for use while sleeping. Proper care of both bags is important to prevent infection and ensure effective drainage.

The catheter is usually removed within 1–2 weeks. When the catheter is removed, you may feel a brief sensation, and it is common to experience some urine leakage or frequent urination as your bladder and pelvic muscles adjust. The process of having the catheter removed is straightforward, and your care team will provide instructions for post-removal care.

Frequent urination is also common in the initial weeks after surgery as the bladder’s capacity and control improve. Temporary weight gain may occur due to fluid shifts after surgery, but this usually resolves within about a week. Gentle activity—like short walks—is important to keep blood moving and prevent blood clots (DVT).

Catheter Removal and Urinary Leakage

When the catheter comes out, it’s common to have difficulty controlling urine flow. This happens because your pelvic floor muscles need time to regain strength. The sphincter muscles, especially the external sphincter, play a crucial role in maintaining urinary control, and strengthening these muscles is important for preventing leakage.

Urinary incontinence is a common complication after catheter removal, which can affect physical comfort, emotional well-being, and social activities. Your care team may suggest pelvic floor exercises (like Kegels), supportive underwear, or absorbent pads for peace of mind. Recovery is gradual, but with consistency, most men see big improvements over time.

How Physical Therapy Helps Prostatectomy Pain

One of the most powerful tools for recovery is pelvic floor physical therapy. After surgery, the muscles supporting your bladder and pelvic region—including those around the pubic bone, a key anatomical landmark—may be weak, leading to pain and leakage.

A pelvic floor therapist can guide you through targeted exercises that:

• Strengthen bladder-control muscles
• Reduce leakage when coughing or lifting
• Easelower abdominal soreness
• Support healthy bowel movements
• Help restore sexual function by improving blood flow and nerve response (note: removal of the seminal vesicles during surgery can affect ejaculation and orgasm sensations)

Think of it as rehab for your pelvic region. Just like athletes train to recover after injury, you can retrain your body to heal more comfortably.

👉 For expert care, Pelvis NYC offers specialized pelvic health therapy for men, helping patients manage pain, regain bladder control, and return to normal life with confidence.

Bowel Movements and Bathroom Issues

Having a regular bowel movement is an important part of recovery after surgery and can help prevent complications such as constipation or diarrhea. Constipation and discomfort with bowel movements are common after surgery, especially with pain medication. Staying hydrated, eating fiber-rich foods, and using stool softeners (if your doctor recommends them) can make things easier.

Potential Complications

Most recoveries go smoothly, but possible complications include:

• Blood clots such as deep vein thrombosis (DVT) if mobility is limited; prevention includes early movement, compression stockings, and medication to reduce the increased risk of clots.
• Urinary tract infection is a common concern while the urinary tract heals, especially with catheter use, and there is an increased risk of infection after surgery. If symptoms arise, a urine culture may be performed to diagnose the infection and guide treatment.
• Lymph fluid buildup causing swelling, which can occur after removal of lymph nodes or a lymph node during surgery, sometimes leading to fluid pooling in the patient’s abdomen.

In severe cases, complications like infection or fluid buildup in the patient’s abdomen may require specialized intervention.

Follow your doctor’s instructions closely, take medications as prescribed, and contact your provider if you notice unusual pain, infection signs, or trouble with erections.

Sometimes, radiation may also be recommended after surgery to lower the risk of cancer returning. Radiation induced complications, such as cystitis or tissue changes, can also occur and may require specific management.

Returning to Sexual Activity

Intimacy is a major concern for many men after prostate surgery. Nerve damage during the procedure can affect erections, making them weaker at first. Recovery can take months, but many men improve with medications, devices, or therapies designed to support sexual function. However, certain medications may not be suitable for men with a history of heart disease, so patients should discuss these options with their doctor. Patience and open communication with your partner and doctor are key.

Long-Term Pain and Support

While most men feel significantly better after a few weeks, some experience ongoing prostatectomy pain from scar tissue or nerve irritation. If that happens, your doctor can recommend treatments to help. In severe cases, further treatment such as additional therapies or interventions may be necessary to manage persistent pain or complications.

Regular follow-up care is also essential. Expect PSA blood tests and routine check-ins to monitor recovery. If urinary leakage, erectile dysfunction, or emotional stress continue, support through physical therapy or counseling can make a big difference.

Final Thoughts on Prostatectomy Pain: Healing Takes Time

Recovering from prostate surgery is as much about patience as it is about physical healing. There will be ups and downs, but with time, most men regain control, reduce pain, and return to the activities that matter most.

👉 Here’s the bottom line:

• Prostatectomy pain is normal but usually improves quickly.
• The first few weeks are the toughest.
• Physical therapy speeds recovery and helps with leakage and intimacy.
• With the right care, most men return to normal life—including sexual activity.

What Is Prostatitis?

Prostatitis means inflammation of the prostate gland. It can hit men in their 20s, 40s, or 60s. There are distinct forms, including acute and chronic prostatitis. Acute prostatitis presents suddenly with severe symptoms, while chronic prostatitis involves recurrent or persistent symptoms that may be more subtle or intermittent. Symptoms vary, but here’s what most guys report:

• Pelvic or lower back pain (a type of genitourinary pain)
• Burning during urination
• Frequent urges to pee
• Lower urinary tract symptoms
• Painful ejaculation
• Erectile dysfunction

Different types of prostatitis call for different approaches, and understanding the best treatment of prostatitis depends on an accurate diagnosis.

Chronic Bacterial Prostatitis: The Stubborn Infection

This type is caused by lingering bacteria. You might feel like you have a UTI that never fully goes away. It creeps in slowly, and it keeps coming back. Recurrent infection and recurrent urinary tract infections are common in chronic bacterial prostatitis, often leading to persistent or episodic symptoms. Chronic infection can develop if the initial treatment is incomplete, making it difficult to fully eradicate the bacteria. Escherichia coli is the most common bacterial cause of chronic bacterial prostatitis. Treating chronic bacterial prostatitis is challenging and often requires prolonged antibiotic therapy to prevent recurrence.

What it feels like:

• Dull ache in the pelvis or perineum
• Recurrent UTIs
• Feeling like you’re never fully emptying your bladder
• Incomplete bladder emptying
• Recurrent symptoms

Treatment plan:

• Antibiotic therapy (long-term, 4-6 weeks or more): Appropriate antibiotic treatment is essential for bacterial prostatitis, targeting bacteria that penetrate prostatic tissue. The choice and duration of antibiotics should be based on pathogen sensitivity to ensure effective drug delivery into the prostatic tissue and reduce the risk of relapse.
• Symptomatic treatment: This includes medications tailored to individual symptoms, such as nonsteroidal anti inflammatory drugs (NSAIDs) for pain relief, paracetamol, and alpha-adrenergic antagonists.
• Anti-inflammatory meds
• Prostate drainage or massage (yes, it’s a thing)
• Pelvic floor physical therapy to help calm the aftershocks

If symptoms do not improve, monitor for complications such as prostatic abscess, which may require additional intervention.

Even after the infection is gone, many guys still deal with pain. That’s when physical therapy becomes a key component in the treatment of prostatitis.

Chronic Pelvic Pain Syndrome (CPPS): The Muscle-Tension Monster

This is the most common type of prostatitis. It is often referred to as chronic nonbacterial prostatitis or chronic abacterial prostatitis, terms that are frequently used interchangeably with chronic pelvic pain syndrome (CPPS). Prostatitis chronic pelvic pain is now recognized as a distinct syndrome, characterized by pelvic pain, urinary symptoms, and sometimes features similar to prostatitis. Interstitial cystitis is another condition with overlapping symptoms, making diagnosis challenging. Urinary symptoms may be related to issues at the bladder neck or due to bladder outlet obstruction, both of which should be considered during evaluation. Prostate inflammation and prostatic inflammation are possible contributors to the symptoms experienced in this condition. No bacteria. No infection. Just pain, tension, and frustration. It often gets misdiagnosed, and guys bounce from one doctor to another with no answers.

Symptoms include:

• Aching in the pelvis, groin, or lower back
• Pain during or after sex
• Urinary issues without infection
• Urinary obstruction (difficulty starting or maintaining urine flow, possibly due to bladder neck involvement)
• Urinary retention (inability to fully empty the bladder, which can be a complication of prostatic swelling)
• Feeling tight, stressed, or inflamed down there

The real issue?

Often, it’s your pelvic floor muscles going haywire. They’re tight, overworked, and stuck in a pattern of dysfunction. Dysfunction in the pelvic floor and surrounding prostatic tissue can also contribute to these symptoms.

What works:

• Pelvic floor physical therapy – internal and external manual release
• Breath training to reset your nervous system
• Postural correction to get your body in sync
• Trigger point therapy to release deep muscle knots
• Symptomatic treatment of prostatitis with medications like paracetamol, NSAIDs, or alpha-adrenergic antagonists may help manage pain and urinary symptoms

Chronic Prostatitis: When It Won’t Go Away

If you’ve had pelvic pain or urinary symptoms for more than three months, welcome to the club nobody wants to join.

Many patients diagnosed with chronic prostatitis face significant challenges in clinical practice, as the condition often involves chronic infection and recurrent symptoms that can be difficult to manage. The National Institutes of Health classification system is commonly used to categorize prostatitis, reflecting the complexity and heterogeneity of patient profiles. Chronic prostatitis is also discussed within the broader context of digestive and kidney diseases, including kidney diseases, due to their impact on urological health and overall well-being.

Chronic prostatitis might be bacterial or non-bacterial. What matters most is that it’s ongoing, and it’s affecting your quality of life.

The fix?

You need a multifaceted approach:

• Find out if there’s an infection
• If infection is found, treatment of prostatitis with appropriate antibiotics is crucial, selecting antibiotics based on the causative agent
• If not, shift focus to muscles, nerves, and lifestyle
• Add in targeted physical therapy
• Look at stress, diet, and mobility

Prostatitis treatments should be tailored to the underlying cause, using a symptom-focused strategy.

It’s not about being tough. It’s about being smart.

Diagnostic Tests: Know What You’re Dealing With

Prostatitis diagnosis begins with a thorough review of your medical history and a careful physical examination. Evaluating risk factors, such as previous urinary tract infections, recent procedures, or other underlying conditions, is essential for accurate assessment.

You can’t treat what you haven’t properly diagnosed. Testing may include:

• Urinalysis and culture to check for urinary tract infection and urinary tract infections, as well as to analyze white blood cells.
• Semen analysis for infection and inflammation.
• PSA blood test (prostate specific antigen and serum prostate specific antigen) to help differentiate prostatitis from prostate cancer, though PSA can be mildly elevated in prostatitis.
• Prostate fluid test including analysis of prostatic fluid, prostatic secretions, and prostate secretions for white blood cells and bacteria.
• Imaging in complicated cases, or to assess for enlarged prostate or other abnormalities.

It is important to rule out benign prostatic hyperplasia, prostate cancer, and other conditions as part of the diagnostic process. Screening for sexually transmitted diseases may also be warranted.

And here’s something most urologists don’t talk about: pelvic floor dysfunction. It’s often the missing piece in the treatment of prostatitis, and it doesn’t show up on a lab report. That’s why a pelvic floor assessment by a trained physical therapist is gold.

Asymptomatic Prostatitis: No Symptoms, But Still There

Sometimes, prostatitis shows up in lab results when you’re not even feeling it. Prostate inflammation may be detected in asymptomatic cases through laboratory testing, such as during a fertility check or PSA test.

Should you worry?

• Not always
• But it’s worth monitoring
• A pelvic floor check might still be smart

The Power of Physical Therapy in Treating Prostatitis

Here’s the deal: If you’ve ruled out infection and you’re still in pain, there’s a high chance your pelvic floor is the problem.

Physical therapy isn’t just for athletes. It’s for men like you who are tired of:

• Waking up with pelvic tightness
• Dreading urination or sex
• Feeling like no one takes their pain seriously

At Pelvis NYC, we offer:

• Internal and external manual therapy
• Tailored exercise plans
• Stress management techniques
• Real talk, real solutions

We don’t just treat symptoms. We treat men who are ready to reclaim their health.

Managing Psychological Symptoms: Mind Over Matter

Why your mental health matters

Let’s be real—dealing with chronic prostatitis, chronic bacterial prostatitis, or chronic pelvic pain syndrome (CPPS) isn’t just a physical battle. The constant pelvic pain, unpredictable symptoms, and frustration of not getting clear answers can take a serious toll on your mental health. Anxiety, stress, and even depression are common companions for men facing chronic prostatitis or nonbacterial prostatitis.

Ignoring these psychological symptoms doesn’t make them go away—in fact, it can make treating prostatitis even harder. When your mind is weighed down by worry or hopelessness, your body feels it too. That’s why addressing mental health is just as important as tackling the physical side of pelvic pain syndrome CPPS or bacterial prostatitis. By recognizing the emotional impact, you give yourself a better shot at real, lasting relief.

Strategies for coping and support

So, how do you take care of your mind while managing prostatitis? Start by building a toolkit of strategies that target both stress and symptom control:

• Stress management techniques: Simple practices like meditation, deep breathing, or mindfulness can help calm your nervous system and reduce anxiety. Even a few minutes a day can make a difference.
• Cognitive-behavioral therapy (CBT): Working with a therapist trained in CBT can help you break the cycle of negative thoughts and behaviors that often come with chronic prostatitis, acute bacterial prostatitis, or asymptomatic inflammatory prostatitis.
• Support groups: Connecting with other men who understand what you’re going through can be a game-changer. Sharing experiences and advice helps you feel less alone and more empowered.
• Pelvic floor physical therapy: While it’s great for physical symptoms, pelvic floor PT can also ease psychological symptoms by giving you more control over your body and reducing the stress that comes with chronic pain.

Remember, managing psychological symptoms is not a sign of weakness—it’s a smart, proactive step in treating prostatitis, whether you’re dealing with bacterial infections, chronic prostatitis, or any of the prostatitis syndromes. Work with your healthcare provider to create a plan that supports both your body and your mind. You deserve to feel better—inside and out.

Ready to Take Action?

You’ve read enough. Now it’s time to do something about it.

If you’re dealing with prostatitis—whether it’s your first flare-up or you’ve been living with it for years—you don’t have to keep suffering.

👉 Pelvis NYC has your back (and your pelvis). Book a consultation with our expert pelvic floor physical therapists who understand what you’re going through.

Take the first step. Get strong. Get answers. And get better.

Related Blog: Prostatectomy Pain: What You Should Know About Recovery