Physical therapist discusses her work in men undergoing prostatectomy

In this video, Vanita Gaglani, RPT, gives an overview of her clinic and discusses the importance of seeing a pelvic floor physical therapist prior to undergoing radical prostatectomy. Gaglani is a registered physical therapist and owner of Vanita’s Rehab in Melbourne, Florida. She was interviewed during the Desai Sethi Urology Institute Urology on the Beach meeting in Miami Beach, Florida.

Please provide an overview of your clinic.

Basically, my whole practice is focused on the pelvic floor, the bowel, and the bladder, but 99% is men who have had a radical prostatectomy. My main focus in my practice is to get them dry and back to their normal life without using pads or Depends or going to the bathroom. I use a multi-pronged approach. I focus on behavior modification, nutrition, hydration, and exercise. Exercise is not just Kegels; there are about 24 other exercises that all are required to make a man dry.

Why is it important to see a pelvic floor physical therapist prior to prostate surgery?

It is important to go to a therapist before surgery for several reasons. One is to know what causes bladder [aggravation], so that when you go for surgery, you are already prepared [so] that your bladder does not go into spasms, and you leak more. Second is what to eat, what to drink, what precautions to follow. The reasons the precautions are important is because [there are 5] cuts on the belly, and a person feels perfectly all right, but the pelvic floor is not healed, and it is a challenge for men not to go out and do activities like canoeing or yard work or golf, and then also having them do exercises in a correct manner. Kegels are great, but they are really geared toward women. And if men do similar Kegels, instead of getting dry, they'll start [having] more leakage. The reason being, [some] women have had children, and the pelvic floor is stretched out, and it needs to be hypertrophied and brought back in position, because the elasticity of the pelvic floor is lost. Men did not have children, so the pelvic floor needs to learn how to work with the bladder. It's a totally different concept. It is like a tendon transplant. When you move 1 tendon to another body, you have to first learn how to work it before you start pushing it or doing strenuous activity with it. So Kegels, in the end, will be more challenging, but initially they have to be started on a slow pace, and then slowly the endurance of the pelvic floor has to be picked up.

This transcript was AI generated and edited by human editors for clarity.