Pelvic Floor Symptom
Post-Prostatectomy Pain
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
Your cancer treatment went well, but recovery is harder than expected. There may be pelvic or perineal pain, pain at the tip of the penis, leaking, or changes in erections. The pelvic floor carries much more of the load after the prostate is removed, and how it recovers shapes all of these symptoms.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Post-Prostatectomy Pain
Radical prostatectomy removes the prostate to treat prostate cancer. Afterward, the pelvic floor and external urinary sphincter take over much of the job of holding urine. Leaking is common during recovery, and erections often change because of nerve effects from surgery.
Pain after prostatectomy is less discussed but common. The pelvic floor can overwork and tighten while trying to control leaking, leading to perineal, rectal and penile pain. Scar tissue and nerve irritation from surgery can add pain. Some men develop pain with orgasm or a pulling sensation at the base of the penis.
Your urologist and oncologist manage cancer follow-up and medical recovery. Dr. Gordon treats the pelvic floor tension, trigger points and nerve contributors to pain, and coordinates with your pelvic floor PT on continence training.
Post-Prostatectomy Pain at a Glance
Common symptoms
Pelvic and perineal pain, penile pain, leaking, erection changes
Why the pelvic floor matters
It takes over more of the job of continence after the prostate is removed
Common pelvic floor issue
An overworked, tight pelvic floor from trying to control leaks
When to start
Usually after catheter removal and clearance from your urologist
What Dr. Gordon addresses
Pelvic floor tension, trigger points, scar tissue, nerve irritation
The Gap in Care
What Tests Check, and What They Can Miss
Post-prostatectomy care focuses on cancer follow-up, continence and erections. Pelvic pain from an overworked pelvic floor is often overlooked.
What routine testing is looking for
- Cancer recurrence and PSA
- Strictures at the surgical connection
- Infection
- Wound complications
What often keeps symptoms going
- A pelvic floor that overworks to control leaking
- Trigger points that cause perineal and penile pain
- Scar tissue from surgery
- Nerve irritation affecting erections and sensation
- Bracing during daily activity
These are assessed with a pelvic floor exam once you are cleared after surgery.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Perineal or rectal pain
Aching between the scrotum and anus or in the rectum.
Penile pain
Pain at the tip or base of the penis.
Leaking
Leaking with coughing, standing or activity.
Erection changes
Weaker or absent erections.
Pain with orgasm
Discomfort during or after orgasm.
Pelvic tightness
A clenched or tight feeling in the pelvis.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Overworked pelvic floor
The pelvic floor tightens constantly to control leaks and becomes painful.
Trigger points
Trigger points refer pain to the perineum and penis.
Surgical scar tissue
Scar tissue restricts movement and irritates nerves.
Nerve effects
Nerves supplying the penis can be affected by surgery.
Your First Visit
How Dr. Gordon Evaluates Post-Prostatectomy Pain
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your surgery details, pathology, PSA follow-up and recovery timeline.
External pelvic and abdominal assessment
Assessment of incisions, abdomen, perineum, hips and inner thighs.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Continence and activity review
Dr. Gordon reviews leaking patterns, activity and pain triggers.
Plan and coordination
A clear plan, plus communication with your urologist or pelvic floor PT when that helps your care.
When to see a physician first
- Fever or chills with pelvic or urinary symptoms
- Inability to urinate
- Visible blood in the urine or semen
- Sudden, severe testicular pain or swelling
- A new lump in the testicle
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for post-prostatectomy pain, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment releases an overworked pelvic floor and trigger points while supporting healthy continence function. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along pudendal and sacral pathways to support nerve recovery and calm pain.
See servicesBetween visits
Recovery Plan & Team Coordination
Coordinated care with your urologist and pelvic floor PT on continence and erectile recovery.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Dr. Gordon is a wonderful doctor who has an eclectic treatment approach to healing, using a myriad of therapies from the ancient art of acupuncture to the latest state-of-the-art technologies. ... I have also noticed improved urinary/prostate function."
Gary de Sesa, Google Review
Post-Prostatectomy Pain Questions
Answers About Post-Prostatectomy Pain
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Usually after catheter removal and clearance from your urologist.
A pelvic floor that is overworked and tight controls leaks less well. Balanced treatment improves both pain and function.
Pelvic floor and nerve care can support recovery alongside your urologist's plan.
Yes. Dr. Gordon coordinates on continence training.
Many men need eight to twelve sessions.
Yes, with coordination with your care team.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For post-prostatectomy pain, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the internal pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped, and nothing internal is done without your clear consent. You can pause or stop at any time.
Yes. Many men put off care for pelvic and genital symptoms because the topic feels awkward. Dr. Gordon keeps things straightforward and clinical, explains every step, and treats adults of all genders and identities in a respectful, welcoming setting.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a urologist for these symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Post-Prostatectomy Pain
Book an evaluation with Dr. Gordon and address the pelvic floor side of your prostatectomy recovery.
Early morning, evening and weekend appointments available. Free on-site parking.
Further Reading
Pain After Prostate Surgery: The Pelvic Floor Side of Recovery
From the blog: Leaking gets most of the attention after prostate surgery, but pelvic pain can happen too. Why the pelvic floor can tighten, and how muscle care fits with PT.
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