Still Wearing Pads Months After Prostate Surgery? When Physiotherapy Can Help

Sep 25

6 min read

For many men, using pads immediately after prostate surgery is expected.

What often comes as a surprise is still relying on pads months later.

You may have assumed that leakage would be gone within a few weeks. Instead, you find yourself planning your day around pad changes, checking for nearby toilets, carrying spare pads, or wondering whether your recovery is progressing normally.

This often leads to an understandable question:

“Should I still be wearing pads at this stage?”

The answer depends on several factors, including how long it has been since surgery, how much leakage is occurring, and whether recovery continues to improve over time.

From a physiotherapist’s perspective, ongoing pad use is not necessarily a sign that something is wrong, but it can be a sign that further assessment may be worthwhile.

Is It Normal to Wear Pads After Prostate Surgery?

In the early stages of recovery, many men experience some degree of urinary leakage.

Pads often become a practical way of managing symptoms while the body heals and continence gradually improves. This can be especially common after prostate surgery, where bladder control may be affected by changes to the urinary sphincter, pelvic floor muscles, and surrounding tissues.

Recovery, however, is rarely immediate.

Some men stop using pads relatively quickly, while others continue to rely on them for much longer. The important question is not simply whether pads are still being used, but whether there is meaningful improvement over time.

For example:

Are you using fewer pads than before?
Is leakage less severe than it was a few months ago?
Are certain activities becoming easier?
Are you more confident leaving the house?
Can you walk, work, or exercise with fewer concerns?

These signs often provide a better indication of progress than pad use alone.

If urinary leakage is still affecting your daily life, you may find it helpful to read more about urinary incontinence treatment and how physiotherapy can support bladder control.

When Does Pad Dependence Become a Concern?

There is no single timeline that applies to everyone.

However, assessment may be worth considering if:

You are still heavily reliant on pads several months after surgery
Leakage is preventing you from returning to normal activities
Progress seems to have stalled
You feel unsure whether your recovery is moving in the right direction
You have never had your pelvic floor function assessed
You are avoiding exercise, travel, or social activities because of leakage

Many men assume they simply need to wait longer. In some cases, more time is helpful. In others, there may be factors that are limiting recovery and could benefit from targeted rehabilitation.

A men’s health physiotherapy assessment can help identify whether your pelvic floor, breathing, movement patterns, or exercise strategy may be affecting your recovery.

What If I Have Improved a Little, But Not Enough?

This is an extremely common scenario.

You may have gone from several pads per day to one or two pads per day.

Technically, things are better.

But if you are still:

Avoiding exercise
Worried about leakage in public
Carrying spare pads everywhere
Planning activities around symptoms
Feeling anxious about longer walks, meetings, or travel
Unsure whether you can return to your usual lifestyle

Then the issue may still be having a significant impact on your quality of life.

Many men delay seeking help because they feel they have improved “enough”.

The more important question is:

Have you recovered to a level that allows you to live the way you want to live?

If the answer is no, it may be time to have a more detailed assessment.

A Common Assumption: “I’m Already Doing Pelvic Floor Exercises”

One of the most common things we hear is:

“I’ve been doing my exercises, so I thought there wasn’t much else I could do.”

This is understandable.

However, physiotherapists often discover that recovery is being influenced by factors beyond simple exercise compliance.

For example:

The exercises may not be targeting the correct muscles
Breathing patterns may be affecting pressure management
Pelvic floor timing may be insufficient during movement
Endurance may be the main limitation rather than strength
Exercise progression may be inappropriate for the recovery stage
The pelvic floor may be overworking instead of coordinating well

This is why assessment is often more valuable than simply doing more repetitions.

Doing “more” pelvic floor exercises is not always the answer. Doing the right exercises, in the right way, at the right stage of recovery, is usually far more helpful.

What Does Physiotherapy Look For?

A physiotherapy assessment focuses on understanding why leakage is still occurring.

Areas that may be explored include:

Pelvic floor muscle function
Muscle endurance
Coordination and timing
Walking and movement patterns
Breathing mechanics
Pressure management
Exercise technique
Recovery history
Bladder and bowel habits
Confidence during daily activities

The goal is to identify barriers to recovery rather than simply measuring symptom severity.

Many men are surprised to learn that small adjustments in technique or rehabilitation strategy can sometimes make a meaningful difference.

At PhysioMatters Singapore, we may use Real Time Ultrasound Imagery (RTUS) as part of assessment and treatment. This allows you and your physiotherapist to view muscle action on screen in real time, helping you better understand whether the correct muscles are working.

Signs That Physiotherapy May Be Helpful

You may benefit from assessment if:

You are still wearing pads regularly
Leakage affects your confidence
Symptoms are limiting social activities
Exercise feels difficult or unpredictable
You are unsure whether your current exercises are correct
Recovery has plateaued
You want a clearer rehabilitation plan
You are reducing your lifestyle because of leakage

Importantly, seeking physiotherapy does not mean your recovery has failed.

It simply means you are looking for additional guidance to help optimise recovery.

If you are unsure what a first appointment involves, our what to expect page explains how physiotherapy sessions are usually structured.

It Is Not Just About the Number of Pads

One mistake many men make is focusing exclusively on pad count.

While pad usage can be useful, recovery is often about much more than that.

Physiotherapists also consider:

Confidence during movement
Activity participation
Exercise tolerance
Walking endurance
Lifestyle goals
Work and travel demands
Functional independence

Two men using the same number of pads may have very different experiences and rehabilitation needs.

For example, one man using one pad per day may feel confident and active, while another may avoid leaving home because he is worried about leakage. Their pad count may look similar, but their recovery needs are very different.

This is why treatment plans should be individualised.

Could Assessment Still Help If Surgery Was Months Ago?

Absolutely.

Many men assume they have missed their opportunity because several months, or even longer, have passed since surgery.

Physiotherapists frequently assess men at various stages of recovery. The purpose is not simply to measure progress, but to identify factors that may still be influencing symptoms and determine whether targeted rehabilitation could be beneficial.

Even if your surgery was some time ago, assessment may help clarify:

Whether your pelvic floor exercises are effective
Whether you need strength, endurance, relaxation, or coordination work
Whether leakage is linked to movement, fatigue, urgency, or pressure
Whether your current programme needs to be progressed or adjusted

It is rarely just about “waiting it out”.

When Should You Consider Seeking Help?

A useful question is not:

“Am I still wearing pads?”

Instead, ask:

“Am I recovering the way I expected to?”

If the answer is no, assessment may provide valuable information.

Persistent pad dependence can affect confidence, activity levels, travel, work, exercise, intimacy, and overall quality of life. Understanding why symptoms are continuing is often the first step towards improving them.

Recovery Is About More Than Managing the Symptoms

Pads can be a useful short-term tool during recovery, but most men hope to become less dependent on them over time.

If leakage is still affecting your confidence or daily activities months after surgery, it may be worth exploring whether further rehabilitation could help.

At PhysioMatters Singapore, we help men understand why recovery may have slowed. Using assessment tools such as Real Time Ultrasound Imagery, we assess factors contributing to ongoing leakage and develop personalised rehabilitation strategies designed to improve bladder control, confidence, and quality of life over time.

References

American Urological Association (AUA/GURS/SUFU). Incontinence after Prostate Treatment Guideline. Amended 2024. https://www.auanet.org/guidelines-and-quality/guidelines/incontinence-after-prostate-treatment
Yu K, Bu F, Jian T, Liu Z, Hu R, Chen S, Lu J. Urinary Incontinence Rehabilitation After Radical Prostatectomy: A Systematic Review and Network Meta-analysis. 2024. https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1307434/full
Terek-Derszniak M, Biskup M, Skowronek T, Nowak M, Falana J, Jaskulski J, et al. Continence Recovery After Radical Prostatectomy: Personalized Rehabilitation and Predictors of Treatment Outcome. 2025. https://www.mdpi.com/2075-4418/15/22/2881

Contact Information

Email: hello@physiomatters.com.sg

Tele: +65 9352 9067

Address: 360 Orchard Road #10-07 International Building, 238869