Men's pelvic health · South Florida

Physical therapy for incontinence after prostate surgery in South Florida

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.

  • Aetna and Medicare in-network; private pay with superbills for other plans
  • No referral needed to start (30-day direct access)
  • Video visits anywhere in South Florida
A man sitting on his sofa at home during a video physical therapy visit on a laptop

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 Florida

Insurance and pricing

Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.

Aetna

In-network (Aetna designated provider). Most Aetna plans cover physical therapy with a copay or coinsurance; we confirm yours before the first visit.

Medicare

In-network with traditional Medicare. Medicare Advantage plans vary; ask on the discovery call.

Private pay

Available for any other plan. We provide a superbill you can submit for out-of-network reimbursement. HSA and FSA cards accepted.

Referrals

Florida allows you to start physical therapy without a referral. If care continues past 30 days for a condition no physician has seen you for, we help you get a quick practitioner review so treatment can continue.

In-home visits are available throughout Miami-Dade County with no travel fee. Broward, Palm Beach, Monroe, and everywhere else in South Florida are seen by video.

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.

A man sitting on his sofa at home during a video physical therapy visit on a laptop
  1. Discovery call

    15 minutes, free, by phone

    A short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.

  2. Evaluation

    60 minutes, by video

    Dr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.

  3. Your plan

    Same visit

    You leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.

  4. Follow-ups

    45 minutes, every 1 to 2 weeks

    Progress 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 South Florida

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 Florida?

Florida allows you to start physical therapy without a referral. If care continues past 30 days for a condition no physician has seen you for, we help you get a quick practitioner review so treatment can continue.

What insurance do you take in Florida?

Aetna: In-network (Aetna designated provider). Most Aetna plans cover physical therapy with a copay or coinsurance; we confirm yours before the first visit. Medicare: In-network with traditional Medicare. Medicare Advantage plans vary; ask on the discovery call. Private pay: Available for any other plan. We provide a superbill you can submit for out-of-network reimbursement. HSA and FSA cards accepted.

Dr. Elana Shalem, DPT

Your physical therapist

Dr. Elana Shalem, DPT

Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Florida.

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. Shalem

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