Pelvic floor physical therapy before and after prostate surgery in NYC
Prostate surgery can affect bladder control and sexual function. Pelvic floor physical therapy helps you prepare beforehand and rebuild afterward, with one-on-one guidance from a Doctor of Physical Therapy. The best time to start is before your surgery date.
Or call (929) 590-3445. Talk to a clinician first. No referral needed.
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Medically reviewed by Dr. Adam Gvili, PT, DPT, on November 5, 2026
Does this sound familiar?
- You have a prostatectomy scheduled and want to prepare
- Leaking when you cough, sneeze, stand up or lift
- Using pads and wanting to need fewer
- A sudden urge to go, or getting up at night more often
- Changes in erections after surgery
- Not sure whether you’re doing Kegels correctly
Why the pelvic floor matters after prostate surgery
The prostate sits just above the pelvic floor, and part of the system that keeps urine in is affected during surgery. Afterward, the pelvic floor muscles have to do more of that work. Learning to find, coordinate and strengthen them, at the right time and in the right way, is a core part of recovery.
When to see a doctor first
Follow your surgeon’s instructions first. Call your surgeon or doctor if you have a fever, blood clots in your urine, you cannot pass urine, or new or worsening pain. Physical therapy works alongside your surgical team, not instead of it.
Before surgery and after surgery
Before surgery. The best time to start is soon after diagnosis, ideally at least 5 weeks before surgery. Research on men who trained before a prostatectomy found they leaked less afterward and regained bladder control faster than men who didn’t. Starting early means you learn to find and use the right muscles while nothing hurts and nothing has changed yet. You go into surgery with a plan for the first weeks afterward.
After surgery. We restart once your catheter is out and your surgeon clears you, usually within the first one to two weeks. From there we build on that foundation: coordination, strength and control during everyday movements. Most men work with us for about 3 months after surgery. If you’ve already had surgery, it’s not too late to start.
How we evaluate it
1. Free 15-minute call. Tell us about your symptoms and what you’ve already tried. We’ll let you know if we’re the right fit.
2. First visit (45 minutes). Your physical therapist will:
- Take a full history of your symptoms, tests and past treatments
- Assess the muscles, nerves and soft tissue involved, including the pelvic floor
- Explain what they found and your plan before you leave
The pelvic floor is a group of muscles that sit inside the pelvis, so the most accurate way to assess and treat them is directly. If it would help, your therapist may suggest an internal exam: one finger, in the rectum, always at your comfort. We explain each step before we do it, check in with you throughout, and you can pause, stop or say no at any time. Most people expect it to be uncomfortable and are surprised by how manageable it is.
What treatment can involve
- Learning to find and contract the right pelvic floor muscles, including the urethral sphincter and the muscles that draw up the penis and lift the testicles, and learning to relax them
- Real-time, hands-on feedback, so you know you’re doing it right
- Quick and sustained contractions, trained in standing, that build in strength and endurance over time
- Bladder control strategies for coughing, lifting and standing up
- Guidance on fluids, caffeine, bladder habits, daily walking and staying active before and after surgery
- Support for sexual function as part of your recovery plan
- A home program from your first visit, so you can keep progressing on your own
Your team
Dr. Adam Gvili, PT, DPT, Founder. Every visit is 45 minutes, one-on-one, with your own physical therapist.
Dr. Joseph Mendoza, PT, DPTPelvic Floor Physical Therapist
Dr. Sam Vargas, PT, DPTPelvic Floor Physical Therapist
Frequently asked questions
Ideally a few weeks before surgery. If you’ve already had surgery, you can start once your surgeon clears you.
Many men have some leaking at first, and how much and for how long varies. Pelvic floor training is one of the main things that can help, and starting before surgery may help bladder control return sooner.
You can, but many men contract the wrong muscles or hold their breath without realizing it. An evaluation gives you the confidence that you’re doing everything correctly and have a plan for success.
Yes. Some men have no change in their erections after prostate surgery, and others do. The pelvic floor muscles, particularly the bulbocavernosus and ischiocavernosus, help keep blood in the penis and make erections firmer. Improving the coordination and strength of these muscles is part of supporting erectile function. We work alongside your urologist, who manages medications and other erection treatments, so you have a full plan for your recovery.
No. You can book directly. If you’re already seeing a doctor, let us know who they are. We’ll keep them in the loop, because the best care happens when your whole team is working together.
We’re an out-of-network practice. We’ll give you a superbill to submit to your insurance for possible reimbursement. A superbill is a medical receipt with procedure codes that shows your insurer what happened during your session. If your insurance needs supporting documentation, we’ll send it promptly. What you get back depends on your plan.
Going deeper: prostate surgery recovery
Leaking when you stand up or lift
These are the moments when pressure in your abdomen rises suddenly. Part of training is learning to tighten the pelvic floor just before that happens, so it becomes automatic over time.
Why relaxing matters too
A pelvic floor that’s tight all the time tires out and can cause its own symptoms. Good recovery means being able to both contract and relax the muscles.
After radiation
Radiation for prostate cancer can also affect bladder and bowel control. Talk it through with us on your free call.
Related reading: erectile dysfunction and urinary frequency and urgency. You can also see all the conditions we treat.
Talk to a clinician first
Start with a free 15-minute call. Tell us what’s going on, and we’ll tell you honestly whether we think we can help.
Or call (929) 590-3445. Talk to a clinician first. No referral needed.