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Pelvic Care: A Referral Guide for Urologists
Urinary incontinence remains one of the most common and distressing complications following radical prostatectomy.
While many patients regain continence within the first year, a significant proportion continue to experience bothersome leakage, urgency, or reduced pelvic floor control well beyond the immediate post-operative period.
For urologists managing this patient group, non-invasive pelvic floor rehabilitation is worth considering as a structured, conservative referral pathway.
The Post-Prostatectomy Continence Challenge
Radical prostatectomy - whether it is open, laparoscopic, or robot-assisted - disrupts the structures supporting urinary continence, and pelvic floor muscle weakness is a major contributing factor to post-operative incontinence.
Patients are frequently advised to perform pelvic floor exercises, but adherence and correct technique are common barriers.
Many men have never engaged in structured pelvic floor training before surgery and struggle to isolate or sustain the correct contractions on their own.
Where Electromagnetic Pelvic Floor Therapy Fits In
Electromagnetic pelvic floor chair therapy offers a way to address this adherence and technique gap.
Our Pelvic chair uses focused electromagnetic stimulation to induce thousands of involuntary pelvic floor contractions in a single, approximately 30-minute session. This is a volume and intensity that is very difficult for patients to replicate through unsupervised Kegel exercises alone.
Because the treatment requires no undressing, no needles, and no recovery time, it is a practical option for men who may otherwise be reluctant to engage with pelvic floor physiotherapy alone.
Clinical Presentations Suitable for Referral
This pathway may be appropriate for post-prostatectomy patients presenting with:
- Bladder urgency or frequency following catheter removal
- General pelvic floor weakness impacting recovery
- Patient-reported erectile dysfunction where pelvic floor strength is a contributing factor
- Persistent stress or urge urinary incontinence
- Reduced confidence in returning to normal activity due to leakage concerns
What Happens Before Treatment Begins
Every patient undergoes a consultation and screening prior to starting therapy, covering symptoms, surgical and medical history, and treatment goals.
A safety screen is also completed to rule out contraindications such as pacemakers or other implanted neurostimulators, hip implants, active malignancies, or medication pumps.
No formal referral letter is required, but urologists are welcome to provide surgical notes or relevant post-operative reports to help tailor the treatment plan.
Typical Treatment Course
Most patients begin with a programme of one session per week for approximately six weeks.
Men recovering from prostate surgery, particularly those with more significant or persistent incontinence, may be advised to extend beyond the standard six sessions based on their response to treatment.
Some patients report early improvements in urgency and leakage within the first two to three sessions, though the full programme is generally recommended for the best and most durable results.
An Alternative First Step, Not a Replacement for Specialist Care
Non-invasive pelvic floor therapy is positioned as a alternative, adjunctive option within the broader post-prostatectomy recovery pathway in support of pelvic floor rehabilitation alongside, not instead of, ongoing urological follow-up.
It offers a low-risk, well-tolerated option to introduce early in the recovery journey, before considering more invasive continence interventions.
Referring a Patient
Pelvic Care has branches across South Africa, including Gauteng, the Western Cape, KwaZulu-Natal, and several other provinces, with select branches operated by physiotherapists, biokineticists, or doctors offering additional therapeutic services.
To discuss a referral pathway for your post-prostatectomy patients or to learn more about screening protocols, contact your nearest branch via WhatsApp, phone, or email.
*This article is intended as general clinical information for referring practitioners and does not constitute medical advice for individual patients.*
