Pelvic floor therapy for men, starting with pelvic floor muscle training, is a standard part of regaining bladder control after prostate surgery. The American Urological Association (AUA) says leakage is expected at first and generally improves to near baseline by 12 months. It recommends offering pelvic floor muscle training right after surgery, with surgery considered later if leakage does not improve.
Why Bladder Leaks Happen After Prostate Surgery
Leaking urine after prostate surgery is expected in the short term. It is often stress incontinence: leakage when a cough, sneeze, laugh or exercise puts pressure on the bladder. The National Association For Continence notes that in men, stress incontinence often follows a radical prostatectomy (surgery to remove the prostate).
Bladder control problems also become more common with age. Up to 1 in 3 men over 65 have urinary incontinence, according to the NIDDK. If you are dealing with leaks, you are far from alone. The article on stress urinary incontinence and why it happens explains how this type of leakage works.
Pelvic floor basics for men
Men have a pelvic floor too. It is a group of muscles at the base of the pelvis that supports the bladder and helps hold urine in. Many men never think about these muscles until after surgery. Pelvic floor muscle training aims to strengthen them so they can better support bladder control while the body recovers.
What the Urology Guideline Recommends
The AUA guideline on incontinence after prostate treatment (2019, amended 2024) sets out clear milestones. Your urologist will tailor them to you, but knowing them helps you ask the right questions at each stage.
| Time after surgery | What the AUA guideline says | What you can do |
|---|---|---|
| Right after surgery | Pelvic floor muscle training should be offered | Ask your care team to teach you, or to refer you to a pelvic floor physical therapist |
| The first months | Leakage is expected in the short term | Keep up your exercises and note whether leaks are getting better |
| Around 6 months | If leakage is not improving, surgery may be offered | Tell your urologist how you are doing |
| Around 12 months | Leakage generally improves to near baseline by this point; if it is still a problem, surgery should be offered | Ask about the artificial urinary sphincter and the male sling |
The surgical options the guideline covers include the artificial urinary sphincter and the male sling. To see how these compare with less invasive steps, read the guide to bladder leakage treatment options, from Kegels to surgery.
Pelvic Floor Muscle Training for Men
Pelvic floor muscle training, often called Kegels, is the first step after prostate surgery. MedlinePlus describes the basic method:
- Find the right muscles: they are the ones you use to stop urine midstream or to hold in gas.
- Squeeze those muscles for 3 to 5 seconds.
- Relax for 3 to 5 seconds.
- Repeat 10 times, three times a day.
Keep your stomach, thighs and buttocks relaxed and breathe normally while you squeeze. Do not practice while urinating; stopping the flow is only a way to find the muscles. According to MedlinePlus, people who do these exercises regularly may notice fewer symptoms after 4 to 6 weeks, and it can take a few months.
It is easy to tense the wrong muscles, such as the buttocks or stomach, without realizing it. A pelvic floor physical therapist can check your technique, and pelvic floor physical therapists work with men too. If you have been doing Kegels faithfully without much change, read why Kegels may not be working and what to try next. To weigh hands-on therapy against a chair-based approach, see pelvic floor chair therapy vs pelvic floor physical therapy.
Where Pelvic Floor Chair Therapy Fits for Men
Pelvic floor chair therapy at Elume is provided by Restore Innovations, an independent practice located within Elume Medspa. Restore Innovations sees men as well as women, but one fact comes first. According to the manufacturer, the chair relies on an FDA clearance for the treatment of urinary incontinence in women. That clearance covers women, not men, and we could find no FDA clearance for this use in men. So men talk through whether chair therapy is suitable for them at the free consultation, and keep their urologist informed.
Here is how it works. You sit fully clothed on the Pelvic Wave chair while an electromagnetic field in the seat, reaching up to 4 inches deep, causes involuntary pelvic floor muscle contractions: more than 5,600 in a 20 minute session, according to the manufacturer. There are no probes, wires or electrodes, and nothing is inserted. Because the contractions are involuntary, they do not depend on finding the muscles yourself. A full program is 24 sessions over 8 weeks, about three a week, supervised by a certified Pelvic Wave operator.
The evidence is limited, and the main research has been in women. A 2021 meta-analysis of six small sham-controlled trials found magnetic stimulation reduced stress leakage in women compared with a placebo treatment, although the authors flagged study-quality problems. None of those trials used the Pelvic Wave chair, and none included men. Magnetic chairs are not part of the NIH treatment ladder, and some insurers, including Aetna, classify magnetic pelvic floor stimulation as experimental.
Chair therapy is not suitable for anyone with an implanted pacemaker or defibrillator, or a history of cardiac arrhythmia or atrial fibrillation, and anyone with metal or electronic implants should raise them at the consultation. Some men consider it when exercises have not helped enough or are hard to do correctly. It should sit alongside, not replace, the care your urologist recommends. The pelvic floor therapy page has more on the program.
When to See a Doctor
Keep your urologist updated on how your bladder control is recovering, especially if leakage is not getting better in the months after surgery. See a doctor promptly if you notice blood in your urine, pain or burning when you urinate, a fever, sudden new symptoms, trouble emptying your bladder, or leakage that started after a new medicine. These can point to a problem that needs its own care.
Frequently Asked Questions
Can men do pelvic floor therapy?
Yes. Men have pelvic floor muscles too, and the AUA recommends offering pelvic floor muscle training right after prostate surgery. Pelvic floor physical therapists work with men, and Restore Innovations also sees men, who discuss whether chair therapy suits them at a free consultation.
How long does it take to regain bladder control after prostate surgery?
It differs from person to person. The AUA guideline says leakage is expected in the short term and generally improves to near baseline by 12 months. If leakage is not improving by around 6 months, talk to your urologist about next steps.
Does the pelvic floor chair’s FDA clearance cover men?
No. The chair’s FDA clearance covers the treatment of urinary incontinence in women, not men. Men talk through whether chair therapy is suitable at the free consultation and should keep their urologist informed.
What happens if leakage has not improved a year after surgery?
The AUA guideline says surgery should be offered if leakage is still a problem at one year, and it may be offered from about 6 months if things are not improving. The surgical options include the artificial urinary sphincter and the male sling. Your urologist can explain which, if either, fits your situation.
Will insurance pay for pelvic floor chair therapy?
Often not. Some insurers, including Aetna, classify magnetic pelvic floor stimulation as experimental, so chair therapy is usually self-pay. Check with your plan, and know that Restore Innovations explains the full cost of any recommended plan before the first session.
Talk It Through With Restore Innovations
If leaks after prostate surgery are wearing on you, a first conversation is free. Restore Innovations sees men as well as women, by appointment only. You can book a free 15 minute phone consultation (they call you) or a free 30 minute consultation in person at the suite inside Elume Medspa, 3925 Blenheim Blvd, Suite 53-D, Fairfax, VA 22030. You can also call (571) 299-8780. Bring any questions from your urologist, and if a plan is recommended, the full cost is explained before your first session.
Sources
- Incontinence After Prostate Treatment: AUA/GURS/SUFU Guideline, American Urological Association (2024)
- We Count: bladder and bowel health facts, National Association For Continence (accessed 2026)
- Bladder Control Problems and Urinary Incontinence, NIDDK (accessed 2026)
- Kegel exercises: self-care, MedlinePlus (accessed 2026)
- 510(k) premarket notification K973096, U.S. Food and Drug Administration (1998)
- Efficacy of magnetic stimulation for female stress urinary incontinence: a meta-analysis, Therapeutic Advances in Urology (2021)
- Clinical Policy Bulletin 0223 on urinary incontinence treatments, Aetna (accessed 2026)