Men's pelvic health · Portland Metro
Physical therapy for incontinence after prostate surgery in Portland Metro
Most men leak after a radical prostatectomy, and pelvic floor training is the standard of care for getting control back. The problem is that most men are handed a pamphlet and never shown how.
- Private pay with superbills for out-of-network reimbursement
- No referral needed (unrestricted direct access)
- Video visits anywhere in Portland Metro
About the condition
Leaking after prostate surgery: what is going on.
The prostate sits below the bladder, and removing it takes away one of the two mechanisms that keep urine in. The remaining one is the external sphincter and the pelvic floor, and after surgery those muscles have to do a job they never had to do alone. Nearly every man leaks in the first weeks, especially with standing up, coughing, and walking. Most regain control within a year, and pelvic floor training shortens that time and improves the final result.
Guided pelvic floor physical therapy, ideally started before surgery and resumed as soon as the catheter is removed, is recommended by urology guidelines. Men who learn the right technique, rather than guessing at Kegels, do better.
Common experiences
What people with leaking after prostate surgery often describe
These are the patterns Dr. Shalem hears most often. Any of them is a reason to book a discovery call.
Leaking with standing up from a chair or getting out of a car
Leaking with coughing, sneezing, or walking
Dribbling at the end of urination
Leaking during sexual activity
Needing pads months after surgery
Uncertainty about whether the exercises are being done correctly
Treatment
How physical therapy addresses it.
The program teaches how to find and correctly contract the pelvic floor, builds endurance and quick-response strength, times the contraction to the moments that cause leaking, and progresses to walking, lifting, and exercise. Bladder habits and fluid timing are adjusted. Dr. Shalem coordinates with the urologist and works within post-surgical restrictions.
What a video visit looks like
Dr. Shalem guides a self-assessment of pelvic floor contraction on camera and checks technique at each visit, which is what most men have never had. A simple leak log tracks progress.
Coverage in Oregon
Insurance and pricing
Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.
Private pay
Visits in Oregon are private pay. We provide a superbill you can submit to your insurer for out-of-network reimbursement. HSA and FSA cards accepted. Rates are quoted on the free discovery call.
Referrals
Oregon allows you to see a physical therapist for evaluation and treatment without a physician referral, with no visit limit. Some insurance plans still ask for one, and we check that for you.
Multnomah, Washington, Clackamas, and Columbia counties are seen by video.
Questions
Questions people ask about leaking after prostate surgery
How it works
How a virtual visit works
Dr. Shalem guides a self-assessment of pelvic floor contraction on camera and checks technique at each visit, which is what most men have never had. A simple leak log tracks progress.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
- A phone, tablet, or laptop with a camera
- A private room
- A mat or towel
- About an hour
Questions
Leaking after prostate surgery questions in Portland Metro
When should I start after surgery?
As soon as the catheter is out and the urologist clears it, usually within one to two weeks. Starting before surgery, when possible, improves results further.
It has been a year and I still leak. Is it too late?
No. Men who start pelvic floor training a year or more after surgery still improve. For persistent leakage, we also coordinate with the urologist about other options.
Does this help after radiation?
Yes. Radiation causes different changes, including urgency and tissue stiffness, and the program is adjusted for that.
Do I need a referral for physical therapy in Oregon?
Oregon allows you to see a physical therapist for evaluation and treatment without a physician referral, with no visit limit. Some insurance plans still ask for one, and we check that for you.
What insurance do you take in Oregon?
Private pay: Visits in Oregon are private pay. We provide a superbill you can submit to your insurer for out-of-network reimbursement. HSA and FSA cards accepted. Rates are quoted on the free discovery call.
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Oregon.
Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
More about Dr. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.