Yes, gentlemen, you have a perineum, too! And it plays a key role, especially after prostate surgery.

Urinary leakage is common in these cases, but it’s usually temporary, and pelvic floor rehabilitation helps you regain control more quickly.

It’s still a taboo subject, but we’re addressing it here simply and without embarrassment.

And if you’re reading this article for a loved one, it’s for you, too 💙

Please read this first: This article is for informational purposes only and is not a substitute for medical advice. If you have any questions about your symptoms or treatment, please consult your urologist or primary care physician.

Prostate Cancer in a Few Words

60,000

Key figure: In France, approximately 60,000 new cases of prostate cancer were diagnosed in 2018.

It is the most common cancer in men. Among the possible treatments, radical prostatectomy—that is, the surgical removal of the prostate—is one of the most common options.

It is effective, but it can affect urinary continence.

Why Do Leaks Occur After Surgery?

The prostate is located just below the bladder, surrounding the beginning of the urethra.

→ In men, urinary continence relies on several “barriers”: the bladder neck, the prostate itself, and the urinary sphincter, a muscle supported by the perineum.

When the prostate is removed, one of these barriers is lost. The sphincter and the perineum must then maintain continence on their own, and they need time to adjust. This is why leakage often occurs when the urinary catheter is removed, particularly during physical exertion—such as coughing, standing up, or lifting a heavy object.

Rest assured: this is usually temporary.

Key Figures

90% of patients

⇒ According to a study published in the journal *European Urology*, more than 90% of patients are completely continent one year after surgery.

9 to 16%

⇒ According to a more recent meta-analysis, persistent incontinence affects 9 to 16% of patients.

In other words, the vast majority of men regain their continence. The time it takes varies from a few days to several months depending on the individual, and that is precisely where rehabilitation makes a difference.

Perineal rehabilitation: the first-line treatment

According to the recommendations of the European Association of Urology, pelvic floor rehabilitation is the first-line treatment for urinary incontinence following prostatectomy. Specifically:

→ Before surgery, your urologist may recommend a few sessions to help you learn how to locate and contract your pelvic floor muscles. This way, you’ll be ready as soon as you return home.
→ After surgery, rehabilitation is led by a physical therapist. It combines strengthening exercises to be done at home with, in some cases, biofeedback—a technique that allows you to visualize your muscle activity on a screen to better control them.

If leakage persists, electrostimulation may be recommended with the urologist’s approval to strengthen the sphincter.

For men, biofeedback and electrical stimulation are performed using an anal probe connected to a device. The procedure is painless, carried out in a medical setting, and the physical therapist will explain everything to you at every step.

Our expertise: At Sugar International, our line of rehabilitation catheters was designed by a therapist specializing in urogynecology. For 30 years, we have been supporting professionals who help their patients regain comfort and confidence.

To conclude

After prostate surgery, urinary leakage is common, but in the vast majority of cases it is temporary.

Perineal rehabilitation is the first-line treatment for regaining control more quickly.

The best course of action: talk to your urologist about it, if possible even before the surgery.

The perineum has no gender, and taking care of it is nothing to be ashamed of! 💪

⇒ To learn more, (re)read our article “Perineum: 8 Common Myths It’s Time to Debunk” and “The Perineum: Definition, Role, and Importance for Health ⬈”.