The Pelvic Health Physical Therapy and the Prostatectomy

Abstract

Considering prostate adenocarcinoma, the cancer of higher incidence in men, having as treatment of choice the prostatectomy, and the high prevalence of urinary incontinence (UI) and erectile dysfunction (ED) after the surgery, the physiotherapy becomes an eligible treatment for such alterations. The rehabilitation of postprostatectomy effort urinary incontinence is considered a recommendation grade B. Erectile dysfunction has as its first line of treatment penile vacuum therapy. Pelvic health physical therapy has as its main tool the rehabilitation of the pelvic floor muscles (PFM), which can be assisted by biofeedback and electrotherapy. The training of these muscles accelerates the recovery process of post-prostatectomy stress urinary incontinence and has greater therapeutic relevance when the physiotherapeutic treatment is initiated in the pre-surgical period. Post-micturition dribble is also treated by training the pelvic floor muscles. Urinary urgency, associated or not with incontinence, can be treated with electrotherapy, which is considered second or third line of treatment. Erectile rehabilitation has two physical resources of treatment, physical therapy, one through the vacuum and the other of the shock wave. Both penile vacuum therapy and shock wave therapy are considered the first line of treatment in the approach to erectile dysfunction.