If you’ve had prostate surgery and were told to “just do your Kegels and wait,” you’re not alone. But here’s the truth many men aren’t told clearly enough:
Recovery after prostatectomy is not passive.
Doing nothing is still a choice, and not usually the best one.
The good news? There are things you can do to support healing, blood flow, and long-term sexual function, and it’s never “too early” or “too late” to start.
Let’s talk about what post-prostatectomy rehabilitation actually means, in plain language.
What Happens After Prostate Surgery?
During prostate removal, the nerves and blood vessels that help create erections can be irritated, stretched, or temporarily “stunned.” Even with nerve-sparing surgery, this healing process can take many months , sometimes up to two years.
During that time:
- Erections may be weak, inconsistent, or absent
- Penile tissue may get less blood flow
- Length and firmness can change
- Confidence and desire can take a hit (totally normal, by the way)
This doesn’t mean recovery isn’t happening, it means your body needs support.
Why Rehabilitation Matters (Yes, Even If Erections Aren’t Happening Yet)
Think of penile rehab like physical therapy after knee surgery. You wouldn’t expect strength to magically return without movement, blood flow, and training, and the penis works the same way.
Rehabilitation helps:
- Maintain blood flow to healthy tissue
- Prevent tissue stiffening or scarring
- Reduce shrinkage or loss of length
- Support nerve healing
- Preserve long-term erectile potential
In short: it helps keep the tissue healthy while the nerves recover.
What Does Penile Rehabilitation Actually Include?
- Mechanical Support (Penile Pumps)
A vacuum device gently draws blood into the penis. This isn’t about performance, it’s about circulation.
Benefits include:
- Stretching and nourishing penile tissue
- Supporting oxygen delivery
- Preventing long periods of “disuse”
Many men are surprised by how helpful (and straightforward) these devices can be.
- Medications (Even If They Don’t “Work” Yet)
Low-dose medications like Cialis or Viagra are often used not just for erections, but to:
- Improve blood vessel health
- Encourage circulation
- Support tissue quality
Important note: these meds don’t force an erection if the nerves aren’t ready but they still help behind the scenes.
- Sexual Stimulation & Orgasm (Yes, Really)
Even without a firm erection, arousal and orgasm matter and are possible.
Why?
- They increase blood flow
- They activate brain-body sexual pathways
- They help the nervous system relearn arousal patterns
After prostate surgery, orgasms will be “dry” (no ejaculation). That’s normal, and it doesn’t mean pleasure is gone, albeit the sensation will likely be different, still good, but different.
- Pelvic Floor Physical Therapy (More Than Kegels)
The pelvic floor plays a major role in:
- Erections
- Orgasm
- Blood flow
- Bladder control
But here’s the key: more Kegels is not always better.
Some men need:
- Better coordination
- Relaxation, not just strength
- Training that integrates breathing, posture, and movement
A pelvic health physical therapist can assess what your body actually needs, instead of guessing.
- Cardiovascular Exercise (Your Heart Helps Your Erections)
Erections depend on healthy blood vessels. Walking, cycling, swimming, or other cardio:
- Improves circulation
- Supports nerve health
- Enhances energy and mood
- Benefits erections and overall recovery
What’s good for your heart is good for your penis. Full stop.
The Big Takeaway
Recovery after prostate surgery isn’t just about waiting and hoping.
It’s about:
✔ Supporting your body while it heals
✔ Keeping tissue healthy
✔ Staying engaged in the process
✔ Knowing that progress can be slow — and still meaningful
You deserve clear guidance, not silence.
If no one has talked to you about these options yet, that doesn’t mean you missed your chance. It just means it’s time to ask better questions.
And if you’re thinking, “I wish someone told me this sooner”, you’re not behind. You’re right on time.
In Health,
Dr. Tara