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More kegels aren’t automatically better. Sometimes the muscles giving you trouble need to relax.
Pelvic floor training can help some guys get better erections, last longer or get bladder control back after prostate surgery. That doesn’t mean every dick problem needs you squeezing harder. Find out what the muscles are actually doing before you turn an internet rep count into your new hobby.[1][2][6]
How to use this page
Give the clinician a timeline that includes erections, ejaculation, pain, peeing and bowel changes. Mention prostate surgery and exercises you’ve tried, especially ones that made it worse. Find out whether you’re working on strength, coordination or being able to relax, and how you’ll check the result. Symptoms alone don’t tell you whether these muscles need strength, coordination or help relaxing. ‘More reps’ isn’t an assessment.[3][6]
Pelvic floor training can help erections
A small randomized trial enrolled 55 men with erectile dysfunction, with a median age of about 59. One group got pelvic floor exercises, pressure feedback and lifestyle advice. The other started with lifestyle advice alone. At three months, the exercise group had a bigger improvement in erection scores. That supports the program they actually used, not a claim that random contractions fix everybody.[1]
The control group got the active treatment later too. After that crossover, 40 percent of participants reached normal function. That’s where the often quoted figure comes from. It wasn’t a clean comparison of 40 percent cured by kegels versus nobody getting better without them. Read that part before somebody sells you a personal success rate.[1]
The premature ejaculation evidence has limits
A 2019 review found ten trials of pelvic floor training for erections or premature ejaculation. They suggested benefit, but quality was low to moderate and the programs varied too much to combine the results. The researchers couldn’t name one best program either. It points toward a benefit, but it doesn’t tell you which exact program to use.[2]
So when somebody gives you the exact number of squeezes to stop finishing too fast, that review didn’t establish their recipe. It also left out men with previous major urological surgery or neurological injury. You can’t just hand those results to a guy recovering from prostate surgery and call his plan sorted.[2]
Sometimes the job is learning to let go
Sometimes strength isn’t the problem. A clinician can check tenderness and whether the muscles contract and relax. Pain, urinary symptoms and bowel trouble can overlap, but that doesn’t let you diagnose an overactive pelvic floor from the symptom list. The European urology guideline specifically says history alone isn’t enough. You still need somebody to check.[3]
With pelvic pain and overactive muscles, specialist physical therapy may work on relaxation and coordination. Blindly adding contractions is doing a different job. Your dick being in the neighborhood doesn’t turn every pelvic muscle into something that needs a harder workout.[4]
A review found ten studies of treatment for an overactive pelvic floor, including four randomized trials. It suggested physical therapy can help, but most studies had substantial weaknesses. The studies mixed different conditions and included men and women. You can’t turn that into ten strong trials all finding the same result for guys with the same problem.[5]
After prostate surgery, follow the recovery plan
Leakage after radical prostatectomy needs its own plan. The American Urological Association recommends offering pelvic floor exercises or training in the immediate recovery period, checking the type of leakage and discussing the available treatments with the patient. Work that out with the surgical team. The guy on the forum doesn’t know your recovery just because he had surgery too.[6]
An older review of eight studies found improved continence with training after this surgery, with differences between the studies. It didn’t establish that every supervised program beats every home program. Training can be reasonable without anybody promising the date you’ll be dry. Get the plan, then judge what’s actually changing.[7]
Get checked before turning it into a workout
New pain or trouble peeing needs medical assessment. Don’t respond with a forum diagnosis and a harder squeeze. Pelvic pain can come from outside the muscles too. Any examination should be explained beforehand and done with your consent, not sprung on you while you’re wondering what you just agreed to.[3]
Find a clinician or physical therapist trained in male pelvic health. Agree on the target and what should bring you back for review. Better erections, leakage after surgery and a painful overactive floor aren’t interchangeable jobs. Do the agreed training and report the actual result, including anything worse. Nobody needs your personal best rep count if the problem hasn’t improved.[3][4][6]
Sources
- Dorey and colleagues, 2004: pelvic floor exercises and feedback for erectile dysfunction. Complete PubMed abstract. Small trial with later crossover, not personal cure odds or the full paper.
- Myers and Smith, 2019: pelvic floor training for erections and premature ejaculation. Complete PubMed abstract. Ten varied trials, low to moderate quality, no identified best program.
- European Association of Urology: pelvic pain assessment. Selected history and examination sections, not the entire guideline or an individual diagnosis.
- European Association of Urology: pelvic pain treatment. Selected physical therapy and pelvic floor recommendations. Existing physical therapy scope reused, not a new complete evidence review.
- Van Reijn Baggen and colleagues, 2022: physical therapy for an overactive pelvic floor. Complete PubMed abstract. Mixed conditions and populations, not the full paper or a male only cure estimate.
- AUA, GURS and SUFU: incontinence after prostate treatment, amended 2024. Selected official indexed recommendations. Direct PDF access failed, not a full guideline read.
- Arroyo Fernandez and colleagues, 2015: training and continence after prostatectomy. Complete PubMed abstract. Eight studies, not a personal forecast, a home exercise prescription or a full bias review.