Kegels for Men: Why the Pelvic Floor Matters

The pelvic floor is a sheet of muscle running from your tailbone to your pubic bone, and it does two jobs men care about: it helps control urine flow, and it helps trap blood in the penis during an erection. After prostate surgery it’s often the only part of that system still fully intact — which is exactly why strengthening it is worth your time.

Most men have never been told they have a pelvic floor. Most women have.

What these muscles actually do

Urinary control. The pelvic floor muscles support the urethra and help close it. After a prostatectomy, the internal sphincter is typically affected by the surgery, which means the external sphincter and surrounding pelvic floor take on more of the work of staying dry. This is why so many men leak after surgery and why pelvic floor training is standard in recovery.

Erectile function. Less well known. Two of these muscles — the ischiocavernosus and bulbospongiosus — wrap around the base of the penis. When they contract, they compress the veins that would otherwise let blood drain out, which helps maintain rigidity once blood is in.

Think of it this way: blood flow gets the blood in. The pelvic floor helps keep it there.

Ejaculation and orgasm. These muscles are involved in the contractions of orgasm, which is part of why sensation can change when they’re weak.

Do Kegels actually help erections?

Reasonably well, and it’s better evidence than most men expect. Pelvic floor muscle training has been studied for erectile dysfunction and has shown improvement in men with erectile difficulty, particularly where venous leak is involved — meaning blood gets in but drains out too quickly.

But I want to be clear about the limits, because I’d rather set expectations honestly.

Kegels help the mechanism that holds blood in. They do not repair damaged nerves, they don’t widen narrowed arteries, and they don’t restore blood flow to tissue that isn’t getting it. For a man after prostate surgery, that means Kegels are one component of recovery, not the whole of it.

The men who do well combine both: blood flow work to bring oxygenated blood into the tissue, and pelvic floor work to support the mechanism that holds it.

Finding the right muscles

This is where most men go wrong, so take your time here.

Method one: Stop your urine flow midstream. The muscles you just used are the ones. Do this once to identify them, not as a regular exercise — repeatedly interrupting urination isn’t good for the bladder.

Method two: Tighten the muscles you’d use to stop yourself from passing gas. Same muscle group.

What you should feel: a lifting and drawing-in sensation at the base of the pelvis. Some men notice a slight movement at the base of the penis or the scrotum.

What you should not be doing: tightening your buttocks, your thighs, or your stomach. This is the most common mistake. If your abdomen is clenching or your body is visibly moving, you’re recruiting the wrong muscles and getting little benefit.

And breathe throughout. Men hold their breath instinctively during this, which defeats the purpose.

How to do them

The basic pattern:

• Tighten for three seconds
• Relax for three seconds
• Repeat ten times
• That’s one set

Three sets is a reasonable session. You can do them sitting, standing, or lying down, and nobody can tell you’re doing them — which means waiting rooms, traffic lights, and desk chairs all work.

The relaxation matters as much as the contraction. A pelvic floor that’s chronically tense can cause its own problems, including pain. You’re training the muscle to work, not to stay permanently clenched.

Consistency beats intensity. Same principle as everything else in recovery. Daily moderate work outperforms occasional heroic effort.

When to start after prostate surgery

Many surgeons recommend beginning before surgery. Going into the operation with a strong pelvic floor tends to mean better and faster continence recovery afterward — the same logic as prehabilitation on the blood flow side.

After surgery, timing depends on your surgeon and on catheter removal. Ask directly, and ask whether they recommend a pelvic floor physical therapist.

That last point is worth emphasizing. Pelvic floor physical therapists exist for men, and most men have no idea. If you’re struggling with continence months after surgery, or you’re unsure whether you’re doing these correctly, a few sessions with a specialist is often more useful than a year of guessing. They can confirm you’re activating the right muscles, which is the thing most men get wrong on their own.

Where this fits with penile rehabilitation

Two different jobs, both needed.

Penile rehabilitation brings oxygenated blood into the tissue on a schedule, maintaining tissue health during the period when your body has lost its own ability to do it. This addresses what happens to the tissue itself.

Pelvic floor training strengthens the muscles that support urinary control and help hold blood in place during an erection.

Neither replaces the other. The pelvic floor can’t help if there’s no blood flow to work with, and blood flow alone doesn’t address the holding mechanism or the urinary side.

This is also why CBH works alongside pelvic floor physical therapists rather than in competition with them. Pelvic floor therapy restores the muscle. Penile rehabilitation restores the circulation. Men who get both do better than men who get either alone.

What to expect

Improvement is gradual. Muscle training takes weeks to months to show meaningful change, and continence recovery after prostatectomy commonly continues improving over six to twelve months.

If you’re leaking, that generally improves. If it isn’t improving after several months of consistent work, that’s a reason to see a pelvic floor physical therapist rather than to keep doing more of the same.

Questions?

Call or text me at 947.224.7342. If you want help finding a pelvic floor physical therapist in your area, I work with a number of them and I’m glad to point you somewhere. I’m a prostate cancer survivor myself, and I’ll help whether or not you order anything.

Frequently Asked Questions

Do Kegel exercises help erectile dysfunction in men? Pelvic floor training has shown improvement in erectile function, particularly where blood drains out of the penis too quickly. It strengthens the muscles that help hold blood in place, but it doesn’t repair nerve damage or restore blood flow to the tissue.

How do I find my pelvic floor muscles? Stop your urine flow midstream once to identify them, or tighten the muscles you’d use to stop yourself passing gas. You should feel a lifting sensation without tightening your buttocks, thighs, or stomach.

How many Kegels should a man do? A common pattern is tightening for three seconds, relaxing for three seconds, ten repetitions per set, three sets per session. Consistency matters more than volume.

When should I start Kegels after prostate surgery? Many surgeons recommend starting before surgery to improve continence recovery afterward. After surgery, timing depends on catheter removal and your surgeon’s guidance.

Can Kegels fix incontinence after prostate surgery? They’re a standard part of recovery and help most men. Continence commonly continues improving over six to twelve months. If it isn’t improving with consistent work, a pelvic floor physical therapist is the right next step.