Post-Prostatectomy MOT

Recovering after prostate cancer surgery can be physically, emotionally and practically challenging. Many men are told to do their pelvic floor exercises and then left with unanswered questions — Am I doing them correctly? Why am I still leaking? When can I reduce my pads? What about erections? When can I get back to normal life?

The Post-Prostatectomy MOT is a specialist men’s health physiotherapy-led recovery check-up designed to answer exactly those questions. Your appointment may bring together pelvic floor ultrasound imaging, functional pelvic floor assessment, bladder retraining, pad-weaning advice, erectile rehabilitation, Somaerect vacuum pump guidance, sexual leakage strategies and return-to-activity planning.

This is more than a pelvic floor exercise appointment. It is a complete recovery review designed to help you understand what is working, what may need to change, and what to do next.

Pelvic floor exercises matter after a prostatectomy — but many men are never shown whether they are actually doing them correctly. Some men brace too hard, hold their breath, tighten their buttocks or thighs, push down instead of lifting, or can’t fully relax afterwards. Others perform them perfectly lying down, but can’t use them when it counts.

That matters, because leakage rarely happens while you’re lying on a treatment bed. It happens when you stand up, walk, cough, sneeze, bend, lift, climb stairs, exercise or tire later in the day. So the MOT takes a functional approach: not just whether you can contract your pelvic floor in the clinic, but whether it works when you actually need it.

One of the key parts of the MOT is the use of ultrasound imaging where appropriate. It lets us assess your pelvic floor and give you real-time feedback — you can see the muscles working on screen while you learn to improve your technique.

It helps answer the questions that matter:

• Is the pelvic floor lifting correctly, and are you using the right muscles?
• Are you pushing down rather than lifting, or using too much effort?
• Are you holding your breath, and can you fully relax after contracting?
• Does your technique hold up in different positions?

For many men, seeing the pelvic floor working is both reassuring and practical. Instead of guessing, you understand what’s happening and what needs to change.

After surgery, some men develop habits that make recovery harder — going “just in case”, cutting fluids for fear of leaking, passing urine very often, or rushing to the toilet with urgency. As part of the MOT we review how often you go, your fluid and caffeine intake, urgency, night-time symptoms and your confidence leaving the house — then help you rebuild a healthier bladder pattern.

“When can I stop wearing pads?” is one of the most common questions we hear. Some men stay in pads longer than they need to; others reduce too quickly and lose confidence. We look at how many you use, when and how much you leak, what triggers it, and whether you’re ready — then give you a realistic, manageable pad-weaning plan. The aim isn’t to rush you. It’s fewer pads, less anxiety and more freedom.

Erectile dysfunction is common after a prostatectomy and can be one of the hardest parts of recovery. As part of the MOT we can discuss erectile rehabilitation and the role of the Somaerect vacuum erection device — how it’s used after surgery, how regular blood flow may support recovery, how to use it safely and how often, common mistakes, and how it fits alongside medication or a conversation with your GP or urologist.

Some men also experience urinary leakage during arousal or orgasm — known as climacturia. It can feel embarrassing, but it’s a recognised side effect of surgery and something we discuss openly. Your MOT may include advice on bladder preparation before sex, pelvic floor timing, practical strategies and communication. Many men feel real relief simply knowing they’re not the only one.

Recovery isn’t only about continence — it’s about returning to normal life: walking without worrying about leakage, work, travel, the gym, golf, running, cycling, lifting confidently, sex, and feeling like yourself again.

Your MOT includes return-to-activity planning based on your operation, symptoms, current fitness, leakage pattern and the things that matter to you. We build in standing pelvic floor work, timing during movement, “the Knack” before coughing or lifting, sit-to-stand control, and activity- and sport-specific progressions — so you return safely and confidently, without unnecessary fear or restriction.