Pelvic floor training after prostate surgery
Short answer: This is the one area where the evidence points the other way from the marketing. MAPS, the largest randomised trial, found that formal one-to-one pelvic floor muscle training produced no better continence at 12 months than standard care after radical prostatectomy or TURP. That does not mean the exercises are useless — everyone in both arms was told to do them — it means paying for intensive supervision on top did not add measurable benefit. If you are recovering from prostate surgery, follow the team who operated on you, not an app.
Search for kegels and prostate surgery and you will find a great deal of confident encouragement, much of it from people selling apps and devices. The best evidence is less flattering, and since we sell an app ourselves, this page states it plainly.
What MAPS found
Cathryn Glazener and colleagues ran two parallel randomised controlled trials, published in The Lancet in 2011, in men with urinary incontinence after radical prostatectomy and after transurethral resection of the prostate. Men were randomised either to formal one-to-one pelvic floor muscle training delivered by a therapist, or to standard care.
At 12 months, both groups had similarly high rates of incontinence. The intensive, individually taught programme did not beat standard care.
What that does and does not mean
The result is frequently reported as "kegels don't work after prostate surgery", which overstates it in one direction, and ignored entirely by the products sold into this market, which overstates it in the other. Both arms of the trial received the usual post-operative advice, including pelvic floor instruction. What was randomised was the addition of formal one-to-one therapy.
So the fair reading is narrow and still important:
- Basic pelvic floor advice remains part of standard post-operative care in most centres.
- Adding intensive supervised training on top did not improve continence at a year.
- Most men recover substantially over that year regardless — which is what makes personal testimony so unreliable here, and why the trial was needed.
That last point deserves emphasis. When a condition improves on its own over months, anything you happen to be doing during those months collects the credit. It is the single easiest way to build a convincing and wrong story about a treatment, and it is the reason "I did kegels and got better" and "kegels work" are different claims.
Why we are not the right tool for this
VitalityRise is a general wellness app for men without a specific medical condition. It has not been tested in post-prostatectomy patients, and neither has any other consumer app in this category.
Post-surgical recovery differs from general training in ways that matter: timing relative to catheter removal, what was actually done to your anatomy, whether nerves were spared, and what your continence baseline is. All of that sits with the team who operated on you. A timer on a phone knows none of it.
If you were sent home with pelvic floor instructions, follow those. If you were not and want them, ask your urology team or a specialist pelvic health physiotherapist — that referral is the useful purchase here, not a subscription.
What about erections after surgery?
Erectile dysfunction after radical prostatectomy usually stems from damage or trauma to the cavernous nerves that run alongside the prostate. That is a neural injury, mechanistically distinct from the veno-occlusive problem that pelvic floor training addresses in men who have not had surgery. Some reviews describe modest benefit from pelvic floor work within structured penile rehabilitation programmes, but this is genuinely specialist territory with active debate about what works, and it is managed alongside PDE5 inhibitors, vacuum devices and timing decisions that only your urologist can make.
The general evidence on pelvic floor training and erectile function comes from men without prostate surgery, and it should not be read across to this population.
If you are here for someone else
The genuinely useful things after prostate surgery are unglamorous: follow the surgical team's protocol, ask for a referral to a pelvic health physiotherapist if incontinence is not improving on the expected timeline, and know that most improvement happens across the first year. Continence that has not improved at all by twelve months is a reason to go back and ask what else is available, because there are surgical options.
Sources
- Glazener C, Boachie C, Buckley B, et al. Urinary incontinence in men after formal one-to-one pelvic-floor muscle training following radical prostatectomy or transurethral resection of the prostate (MAPS): two parallel randomised controlled trials. Lancet 2011;378(9788):328–337.
- Sahin E, Brand A, Cetindag EN, Messelink B, Yosmaoglu HB. Pelvic physical therapy for male sexual disorders: a narrative review. Int J Impot Res 2025;37:941–949.
Common questions
Do kegels help after prostate surgery?
Most men regain continence over the months after surgery whether or not they receive formal training, and the largest randomised trial found no difference in continence at 12 months between men given intensive one-to-one pelvic floor training and men given standard care. Basic pelvic floor advice remains part of standard care in most centres; what MAPS tested and did not support was adding formal supervised therapy on top.
What is the MAPS trial?
Two parallel randomised controlled trials led by Cathryn Glazener, published in The Lancet in 2011, testing formal one-to-one pelvic floor muscle training against standard care for urinary incontinence after radical prostatectomy and after transurethral resection of the prostate. It reported similar high rates of incontinence at 12 months in both groups.
How long does incontinence last after prostatectomy?
It is usual immediately after surgery and improves over months, with most recovery in the first year. Because that natural improvement is substantial, it is easy to attribute it to whatever you happened to be doing at the time — which is exactly why a randomised comparison was needed and why its result surprised people.
Should I use a kegel app after prostate surgery?
We would not recommend ours for it. Post-surgical rehabilitation is a clinical situation with a specific timeline, specific precautions and a surgical team who know what was done to your anatomy. A general fitness app built for a healthy population is not the right instrument, and no consumer app in this category has been tested in post-prostatectomy patients.
Can pelvic floor exercises help erections after prostate surgery?
Erectile dysfunction after radical prostatectomy is usually caused by damage to the cavernous nerves running alongside the prostate, which is a different mechanism from the venous and muscular ones pelvic floor training addresses. Some reviews report modest benefit as part of penile rehabilitation programmes, but this is a specialist area and the right people to ask are the urology team managing your recovery.
Does this mean pelvic floor training doesn't work at all?
No, and the distinction matters. MAPS tested one specific thing — added formal therapy for post-surgical incontinence — in one specific population. The trials supporting pelvic floor training for erectile dysfunction in men without prostate surgery are separate, and they were positive.