What are pelvic floor muscles?
The pelvic floor muscles stretch from the pubic bone at the front of your body, underneath your bladder and bowel, to the bottom of your spine (see diagram below). They act as a sling, supporting the bladder and bowel and helping to control when you urinate (wee) or empty your bowels. They also help with erectile function. Pelvic floor muscle exercises help to strengthen these muscles.
How do pelvic floor muscle exercises help with urinary problems?
Strong pelvic floor muscles may help with some urinary problems, including:
- leaking urine – this could be just a few drops, or a steady flow throughout the day (urinary incontinence)
- leaking urine when you go to sit down or stand up, cough, sneeze or bend forwards (stress incontinence)
- a sudden urge to urinate (urgency), and sometimes leaking before you get to the toilet (urge incontinence)
- needing to urinate more often than usual (frequency), including several times at night (nocturia)
- dribbling urine after you finish urinating (after-dribble)
- leaking a little urine when you get sexually aroused or when you orgasm (climacturia).
Some men find pelvic floor muscle exercises help with problems getting or keeping an erection after treatment for prostate cancer. Some men also find they help to improve the quality of their erections.
The exercises may also help with bowel problems such as needing to rush to the toilet, leakage (faecal incontinence), or passing a lot of wind.
What can cause these problems?
If you’ve had certain treatments for prostate cancer, such as surgery to remove the prostate (radical prostatectomy), you might have some urinary problems. You might also have urinary problems if you’ve had surgery for an enlarged prostate, such as an operation called a transurethral resection of the prostate (TURP).
Obesity, constipation (difficulty emptying your bowels) and coughing a lot – due to smoking, for example – can all put an extra strain on the pelvic floor muscles, which can make problems worse.
Some men might get bowel problems after radiotherapy to treat prostate cancer. And several treatments for prostate cancer, including surgery and radiotherapy, can cause erection problems.
I leaked a lot of urine for a few months after my surgery. It was a steady flow throughout the day and the night. But I’m fine now. I worked really hard on my pelvic floor and I’m convinced this turned things around.
When should I start the exercises?
If you’re having radiotherapy to treat prostate cancer, it’s safe to do pelvic floor exercises during and after your course of treatment. You can talk to any health professional about pelvic floor exercises, including your doctor or nurse. They will be able to help answer any questions you may have, or they may refer you to a continence advisor or men’s health physiotherapist.
If you’re going to have surgery for prostate cancer or an enlarged prostate, it’s a good idea to start doing the exercises four to six weeks before the surgery. This will help you to do them properly after your treatment. It might also help you to stop leaking urine sooner.
After surgery, you’ll have a tube called a catheter to drain urine from your bladder. You should try not to do pelvic floor muscle exercises while you have a catheter in. You can start doing pelvic floor muscle exercises as soon as your catheter has been removed. They’re safe to do, and won’t hurt or cause any damage. But like all muscles, pelvic floor muscles can become tired so try not to overdo it.
If you had your surgery a while ago but still have urinary problems, starting the exercises could still help. You should also speak to your doctor or nurse, as there may be other treatments that could help.
How do I find my pelvic floor muscles?
It’s important to find the right muscles before you start doing pelvic floor muscle exercises. You can do this when you’re sitting, standing or lying down – whatever you find most comfortable, as long as you relax your thighs and buttocks.
If you want to do this when you are sitting, sit forward on a chair with your feet on the floor, shoulder width apart.
If you are standing up, stand with your feet shoulder width apart. You may want to try standing with your back against a wall, knees slightly bent. This is a good starting position when finding your pelvic floor muscles.
If you prefer to find your pelvic floor muscles when you are lying down, lie on your back with your knees bent and slightly apart, and your feet apart on the floor.
- Tighten the ring of muscle around the opening to your back passage (anus) as if you’re trying to control wind. Then relax. Make sure you don’t squeeze your buttocks together, and try not to tighten your thigh muscles or abdominal (stomach) muscles. And try not to hold your breath – just keep breathing normally.
- At the same time, imagine you’re urinating and tighten your muscles as if you’re trying to stop mid-flow, then relax. You can try this once or twice while you’re actually urinating if this helps you to find the right muscles – but don’t do this all the time as it could cause problems emptying your bladder.
- If you’re tightening the right muscles, you should feel a dip at the base of your penis and feel your scrotum (the skin around the testicles) move up a little. You might find it helpful to do the exercises in front of a mirror to begin with, so you can see the base of your penis and your scrotum move.
- You can also check if you’re using the right muscles by touching the skin just behind the scrotum. You should feel the muscles lift up and away from your fingers when you tighten them. If you feel the muscles pushing down, you aren’t doing the exercises properly.
How do I do the exercises?
Make sure you’ve found the right muscles, and you know what it feels like to tighten them, before trying these exercises. There are two sets of exercises – slow and fast. You can practice doing them while sitting, standing or lying down – whichever you prefer. But when you feel able and ready you should try to do these exercises standing.
- Slowly tighten the muscles as hard as you can so you feel a lifting sensation.
- Try to hold this lift for 10 seconds. Keep breathing normally.
- Slowly relax the muscles and rest for 10 seconds.
- Aim to repeat the lift and rest up to 10 times.
You might find that you can’t hold the lift for 10 seconds to start with. Just hold it for as long as you can and try to build up to 10 seconds. It’s more important to do the exercises properly than to do them for the full 10 seconds
- Repeat the same action but this time, try tightening the muscles as quickly as possible.
- Hold the lift for one second and then let go.
- Try to do up to 10 of these short, fast lifts.
Try to concentrate while you’re doing the exercises. Remember to breathe normally. If you don’t do them properly, they might not help.
Get help if you need it
If you’d like more advice on how to do pelvic floor muscle exercises, or you’re finding them difficult, ask your doctor, nurse or GP to refer you to a continence advisor or men’s health physiotherapist. They specialise in problems with leaking urine and can help you with the exercises.
How often should I do the exercises?
There’s no fixed advice on how often you should do pelvic floor muscle exercises. Speak to your doctor continence advisor, men’s health physiotherapist or nurse to see what they suggest. You may want to try doing a set of slow and fast exercises three times a day. And try to make them part of your daily routine.
Don’t overdo it. Pelvic floor muscles are like any other muscles – they can get tired if you do too many exercises. You might notice that you leak more urine towards the end of the day, as your muscles get tired. This should get better with time as the muscles get stronger.
I set an alarm on my phone to remind me to do my exercises, because it’s so easy to forget.
It might help to tighten your pelvic floor muscles at certain times.
- When you leak urine. Tighten the muscles strongly before and during activities that cause you to leak urine – for example, when getting up from a chair, lifting, bending, coughing or sneezing. Over time, this might help to prevent urine leaking.
- After urinating. Tighten your pelvic floor muscles strongly after you urinate. This should get rid of any urine that’s left in the urethra (the tube you urinate through) and avoid any dribbling afterwards.
It’s important to be patient and keep doing the exercises. It takes time to see an improvement – it won’t happen overnight. You might see a small improvement each week, but it can take up to three months before you notice a real difference. The exercises might not work for some men, but there are other things that might help if they don’t work for you.
You’ll need to keep doing the exercises for the rest of your life, but once your pelvic floor muscles are strong, you should be able to do fewer exercises. Keep doing some exercises each day – otherwise the muscles will get weaker again.
You may want to download the NHS recommended Squeezy App for men. Squeezy is a self-management app to help people with urinary incontinence do their pelvic floor muscle exercises.
Pelvic floor exercises still work for me 10 years after my prostate surgery.
What else can help?
If pelvic floor muscle exercises don’t help to improve your urinary problems, there are treatments available and things you can do to help yourself. You may find it helpful to use our how to manage urinary problems online guide. It provides practical tips to help you get on with your life.
The following tips might help you control when you urinate.
- If you often need to pee during the night, try to drink less in the two hours before you go to bed.
- But make sure you drink plenty of fluids during the day (about 3-4 pints a day). If your urine is dark, this could be a sign that you need to drink more.
- Avoid fizzy drinks, alcohol and drinks that contain caffeine (tea, coffee and cola), as these can irritate the bladder.
- If you get a sudden urge to urinate, try tightening your pelvic floor muscles and holding. Wait calmly until the urge passes, then walk slowly to the toilet. Don’t rush as you walk, as this could make you more likely to leak urine.
- A technique called bladder retraining might also help if you get sudden urges to urinate. Read more about this in our fact sheet, Urinary problems after prostate cancer treatment.
The following things can help reduce the pressure on your pelvic floor muscles.
- Try to maintain a healthy weight and level of fitness. Being overweight can put pressure on your pelvic floor muscles. This could make you leak more urine. You may find our information on Diet and physical activity helpful.
- Physical activity can help you to stay fit and keep to a healthy weight. Some types of exercise such as Pilates and yoga may also help to strengthen the pelvic floor muscles.
- Eat plenty of foods that contains fibre and drink plenty of fluids to avoid constipation (difficulty emptying your bowels), as this can put pressure on your pelvic floor muscles.
- If you smoke, try to stop as this can cause coughing, which puts pressure on your pelvic floor muscles. The NHS website has more information about stopping smoking.
- Speak to your doctor if you have hay fever, asthma or bronchitis. It might help your pelvic floor muscles to reduce sneezing and coughing.
- Avoid heavy lifting. If you have to lift something heavy, tighten your pelvic floor muscles at the same time. This can help to prevent leaking urine.
- This is a way of monitoring your pelvic floor muscles while you do the exercises. Your continence advisor or men’s health physiotherapist might suggest biofeedback if you’re struggling to find the right muscles or to do the exercises. But many clinics don’t offer biofeedback.
- There are different types of biofeedback. You may have an ultrasound scan of your tummy (abdomen) or on the area between your testicles and back passage (perineum). This will show if you’re doing the exercises correctly.
- If you’re offered biofeedback, your continence advisor or men’s health physiotherapist will talk to you about the type of biofeedback you will have and what to expect.
More help dealing with urinary problems
Urinary problems can be hard to deal with. If you have any worries or questions about urinary problems or pelvic floor exercises, speak to your GP, specialist nurse or continence nurse.
Being diagnosed and living with prostate cancer can change how you feel about life. If you or your loved one is dealing with prostate cancer you may feel scared, stressed or even angry. There is no ‘right’ way to feel and everyone reacts differently.
Visit our wellbeing hub for information to help support you in looking after your emotional, mental, and physical wellbeing. If you are close to someone with prostate cancer, find out more about how you can support someone with prostate cancer and where to get more information.
You can also speak, in confidence, to our Specialist Nurses. It can sometimes help to talk to other men living with prostate cancer. We have a range of services that can help put you in touch with someone who’s been there and understands what you’re going through. Visit our Who can help page to find out more.
Updated: April 2022 | To be reviewed: April 2025
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- Declan Cahill, Consultant Urologist, The Royal Marsden.
- Gerard Green, Specialist Pelvic Health Physiotherapist, London Men’s Health Physiotherapy Clinic
- Elaine Hazell Clinical Nurse Specialist, Functional Urology Centre, Guys and St Thomas’ NHS Hospital Foundation Trust
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