Pelvic Floor Therapy for Men: Emsella After Prostate Surgery

The recovery challenge men aren't warned enough about

When a man undergoes a radical prostatectomy — whether open, laparoscopic, or robotic — he is usually counseled about the possibility of incontinence and erectile changes during recovery. What patients are often less prepared for is how long that recovery can take, and how isolating the experience can feel. Pads, leakage during exercise, urgency that arrives without warning — these are common postoperative realities. They tend to improve with time. But "tends to improve" leaves a lot of men managing daily leakage for months or years.

Why pelvic floor strength matters after prostate surgery

Before surgery, urinary continence in men is supported by two sphincters: an internal sphincter near the prostate, and an external sphincter formed by pelvic floor musculature. The prostatectomy itself necessarily disrupts the internal sphincter region. After surgery, the external sphincter — and the surrounding pelvic floor — bear far more of the continence burden. If those muscles are deconditioned, the result is leakage. If they are strong and well-coordinated, the result is continence.

Why standard kegel programs are hard for men

Most men have never been taught how to find or contract their pelvic floor. Without biofeedback, a significant portion of patients perform kegels incorrectly — often bearing down rather than lifting up. Even when done correctly, voluntary kegels recruit only a subset of the relevant musculature. Pelvic floor physical therapy helps, and we recommend it where available — but consistent results are hard to come by, and many patients give up before they see meaningful change.

How Emsella works for men

You sit fully clothed on the Emsella chair for 28 minutes. The chair generates a focused HIFEM field that triggers thousands of supramaximal contractions across the entire pelvic floor — roughly 11,000 per session. These contractions engage muscle groups voluntary effort rarely reaches and re-educate the neuromuscular pathways that need to be retrained after surgery. Unlike kegels, the work does not depend on you having mastered the contraction yourself — the device produces it directly.

What the research shows

Published studies on Emsella in men with post-prostatectomy incontinence consistently show meaningful improvement in pad usage, leakage episodes, and quality-of-life scores. Outcomes are best when treatment begins after initial surgical healing but before the leakage has been ignored for years — though improvement is documented in long-standing cases as well. Some men also report improvement in erectile function, likely related to strengthening the bulbocavernosus and surrounding musculature involved in maintaining an erection.

The protocol and what to expect

Six sessions over three weeks, two per week. You remain fully clothed. There are no needles, no medications, no recovery time. Most patients feel a strong tingling and pelvic floor contraction sensation that becomes familiar after the first visit. Improvement often begins after the second or third session and continues to develop for weeks after the final treatment. Maintenance sessions, typically twice a year, help preserve the gains.

Why a medical setting matters for this conversation

Post-prostate incontinence is a medical issue, and it deserves a medical setting. At Bromberg Wellness, every patient is evaluated by Dr. Bromberg before treatment, and the consultation takes urinary and sexual health concerns as seriously as anything else. We coordinate with your urologist when appropriate. The conversation is private, the treatment is comfortable, and the goal is the same one you walked in with — getting your life back.