An integrated rehabilitation program for men who have had prostate cancer surgery. Regain urinary continence and sexual function with an individualized protocol, led by a urologic oncologist and a pelvic floor physiotherapist dedicated exclusively to male post-operative urological care.
Removing the prostate disrupts the anatomy of the pelvic floor and the urinary sphincter. Specialized pelvic floor physiotherapy targets precisely these mechanisms.
Leaks when coughing, sneezing, lifting weights or changing position. This is the most frequent symptom and the one that responds best to supervised pelvic floor training.
A sudden urge to urinate, with or without leakage, associated with detrusor overactivity in the early post-operative period.
Erectile dysfunction, reduced orgasm and climacturia (urine leakage during orgasm) respond well to pelvic rehabilitation combined with penile rehabilitation.
Pain when sitting, muscle tension and a feeling of “heaviness” in the perineum. Myofascial release and postural re-education are part of the protocol.
Prolonged use of protection affects self-esteem, social life and return to work. The goal is progressive: reduce pads down to zero.
Fear of leaks limits physical activity, travel and intimacy. Structured rehabilitation restores predictability and confidence.
We don't use slogans. We use evidence. Below are the most robust findings from the international literature of the last 5 years.
A systematic review of 21 studies showed that patients who undergo PFMT are almost 3 times more likely to regain continence after radical prostatectomy than those who do no pelvic exercise.
Park JJ et al. Efficacy of Pelvic Floor Exercise for Post-prostatectomy Incontinence: Systematic Review and Meta-analysis. Urology, 2022. DOI
A Brazilian systematic review of 16 articles and 7 randomized clinical trials concluded that EMG biofeedback combined with PFMT speeds up recovery of continence and reduces pad weight.
Novais CCS et al. The impact of using electromyographic biofeedback on pelvic floor rehabilitation in men with post-prostatectomy urinary incontinence: a meta-analysis. Clinics (São Paulo), 2025. DOI
A statistical comparison of 13 rehabilitation strategies showed that combining PFMT + biofeedback + electrical stimulation produces the greatest objective reduction in pad weight and the greatest improvement in urinary quality of life (ICIQ-UI-SF).
Zhao L et al. Comparative efficacy of multimodal physical therapies for urinary incontinence after radical prostatectomy: a systematic review and network meta-analysis. Int J Surg, 2025. DOI
A recent meta-analysis showed that preoperative PFMT significantly improves recovery of continence at 3 months after surgery — a critical window for returning to social and professional activities.
Terzoni S et al. Preoperative Pelvic Muscle Training for Continence Recovery After Prostatectomy: Yet Another Meta-Analysis? Neurourol Urodyn, 2025. DOI
A cumulative analysis of 26 articles demonstrated that guided programs (with biofeedback and/or electrical stimulation) speed up objective recovery — measured by 24-hour pad weight — in the first three months after surgery.
Sciarra A et al. A biofeedback-guided programme or pelvic floor muscle electric stimulation can improve early recovery of urinary continence after radical prostatectomy. Int J Clin Pract, 2021. DOI
A randomized study of 71 patients showed that combining classic PFMT with the Knack maneuver (pelvic contraction before exertion) and lifestyle guidance (fluid intake, weight control, reduction of bladder irritants) produces the best outcome at 8 weeks.
Gerlegiz ENA et al. Lifestyle recommendations and pelvic floor muscle training with Knack maneuver for post-prostatectomy urinary incontinence: a randomized controlled trial. Support Care Cancer, 2025. DOI
Full references on PubMed. International guidelines from the American Urological Association (AUA) and the European Association of Urology (EAU) recommend pelvic floor muscle training as first-line therapy for post-prostatectomy urinary incontinence.
What sets Clínica Uro Onco apart is the real integration between the urologist who operated (or will operate) on you and a dedicated pelvic floor physiotherapist. Cross-evaluations, an aligned protocol and shared clinical decisions.
Urologist subspecialized in uro-oncology and robotic surgery. He leads surgical planning, urinary sphincter assessment and penile rehabilitation, and decides the ideal timing for each stage of pelvic floor physiotherapy together with Dr. Dalila.
Physiotherapist specializing in male pelvic rehabilitation after urological surgery. She performs a detailed functional assessment, supervised exercises, electromyographic biofeedback, electrical stimulation and individualized postural re-education, with a protocol adapted to each post-surgical phase.
Each phase has clinical objectives, functional goals and progression criteria defined by consensus between the urologist and the physiotherapist.
We are the only practice in São Paulo that brings together, at the same address, urologic oncology and male pelvic floor physiotherapy dedicated exclusively to recovery after prostatectomy.
The urologist and the physiotherapist discuss your case together. Nothing gets lost between the doctor's office and the physiotherapy room.
We follow the best practices from the AUA, the EAU and recent meta-analyses — not a generic protocol copied from women's health clinics.
Continence and sexual function are addressed in parallel, with specialized guidance on erectile dysfunction after prostatectomy.
If you have not had surgery yet, we start physiotherapy before the operation. This is the window with the greatest statistical impact on continence at 3 months.
Calibrated equipment and individualized protocols, not applied on an assembly-line basis. Each patient receives the resource from which he benefits most.
Operated on by another urologist? No problem. Pelvic floor physiotherapy at Clínica Uro Onco welcomes patients from any provider.
“What struck me most was not the technique itself — it was the feeling that everyone was speaking the same language. Dr. Bruno knew exactly what the physiotherapist was doing. By 3 months after surgery I was no longer using pads. It was the best investment I made in my recovery.”
The answers below were prepared by the Clínica Uro Onco team based on international guidelines (AUA / EAU) and recent meta-analyses.
Ideally, pelvic floor physiotherapy begins before surgery (preoperative phase), continues right after the urinary catheter is removed and extends for 3 to 6 months after surgery.
Evidence from meta-analyses published in 2021 and 2025 shows that starting pelvic floor muscle training before surgery significantly increases the chances of regaining urinary continence in the first 3 months.
Terzoni S et al. Neurourol Urodyn, 2025 · DOIYes — and the evidence is high-level. A 2022 meta-analysis of 21 studies showed that pelvic floor muscle training (PFMT) increases the chance of regaining urinary continence after radical prostatectomy by almost 3 times (OR 2.97; 95% CI 1.28–6.91).
When combined with electromyographic biofeedback or electrical stimulation, the results are even better: RR 1.78 (95% CI 1.29–2.45) for the chance of continence, according to a 2025 Brazilian meta-analysis.
Park JJ et al. Urology, 2022 · DOI | Novais CCS et al. Clinics (SP), 2025 · DOIThe most recent evidence (a network meta-analysis published in 2025 in the International Journal of Surgery) shows that the combination of PFMT + biofeedback + electrical stimulation produces the greatest reduction in pad weight (–134 g per 24 h; 95% CI –187.80 to –81.02) and the greatest improvement in quality of life (ICIQ-UI-SF).
Electrical stimulation + biofeedback ranks first for recovery of continence (SUCRA 89.9%). That is why we work with an individualized multimodal protocol — not a single technique applied to every patient.
Zhao L et al. Int J Surg, 2025 · DOIThe number of sessions varies according to the severity of incontinence, neuromuscular response and functional goals.
On average, the complete protocol involves 8 to 16 supervised sessions over 3 to 6 months, combined with daily home exercises. The initial assessment with Dr. Dalila defines the individualized plan, including weekly frequency, resources (biofeedback, electrical stimulation) and discharge criteria.
Yes. Recent studies show that pelvic floor muscle training contributes to:
· improved erectile rigidity, especially when integrated into a multimodal sexual rehabilitation program;
· reduced climacturia (urine leakage during orgasm);
· better ejaculatory control and perception of orgasm.
At Clínica Uro Onco, penile rehabilitation is led by Dr. Bruno Benigno in parallel with Dr. Dalila's pelvic program, with adjuvant medication when indicated.
Yes. Post-prostatectomy pelvic floor physiotherapy at Clínica Uro Onco welcomes both patients operated on by Dr. Bruno Benigno and patients who had surgery elsewhere.
Simply book an initial assessment and bring your pathology report and surgical details (date, approach — open, laparoscopic or robotic — and technique used, if known).
Clínica Uro Onco is located at Rua Borges Lagoa, 1070, Conjunto 131, Cobertura — Vila Clementino, São Paulo/SP, near Santa Cruz metro station, with easy parking nearby.
You can book a post-prostatectomy pelvic floor physiotherapy assessment:
· via WhatsApp: (11) 99590-1506
· by phone: (11) 2769-3929
Book your assessment via WhatsApp. Within one business day we will get back to you with available times and let you know which documents to bring to your first appointment.
Book an assessment now · (11) 99590-1506In-person care in Vila Mariana · Telemedicine available for the initial assessment · Support for patients from all over Brazil
Medical content reviewed by Dr. Bruno Benigno, urologist and uro-oncologist (CRM-SP 126.265 · RQE 60022), based on AUA, EAU and NCCN guidelines. Last reviewed:
