Men's Pelvic Health
We often hear of pelvic floor physiotherapy related to women’s health issues...but men have pelvic health issues too!
"Men’s pelvic health" is a specific area of physiotherapy focusing on the management and treatment of pelvic floor dysfunction.
The two main reasons why men seek out pelvic health physiotherapy are for urinary incontinence following prostate surgery and for pelvic pain conditions.
Urinary Incontinence after prostate surgery
Men will often have issues with urinary incontinence after surgery for prostate cancer.
Urinary incontinence is to be expected after prostate surgery as the muscles responsible for bladder control are removed with the prostate. It may be mild, needing pads to manage it for only a few weeks, or more severe and requiring protective pads for up to a year. For a few men, incontinence remains a long-term problem.
The pelvic floor muscles control the bladder and the flow of urine. Exercising them effectively can help men regain bladder control earlier. Ideally, the exercises are started before surgery, but they can also help bladder control if started after surgery.
How Physiotherapy Can Help Pre/Post Prostatectomy
Pelvic floor physical therapy teaches patients to coordinate the use of their pelvic floor muscles with functional activities including exercise, sitting, standing, home and daily activities.
Seeking a pelvic floor physiotherapy assessment before a prostatectomy surgery has a number of benefits for recovery. The pelvic floor muscles are hard to identify, so a Physiotherapist will ensure best possible technique and training for you. This also helps with your confidence in managing your post surgical rehabilitation.
Chronic Pelvic Pain
It is important to understand that pelvic pain problems may not necessarily be linked to pelvic floor muscles and should be properly assessed.
Pelvic pain can be described as ongoing symptoms in the pelvic area, abdomen, anorectal area, scrotum or testicles. There may also be pain with sexual activity, when passing urine or with a bowel movement.
You may have already been assessed by your primary care provider or urologist and have received negative findings. You may have had a diagnosis of chronic prostatitis and given antibiotics, but you still have pain. This can be both good news and frustrating news as the pain and symptoms remain despite the negative tests.
Conditions that can cause pelvic pain:
- Prostate enlargement
- Nerve entrapment
- Prostatitis (inflammation of the prostate gland, in which prostate can feel sore and irritated).
- Coccydynia (pain and tenderness around the tail bone/coccyx).
- Overactive pelvic floor muscles can also cause pain, similar to a knot if your thigh. This may make it difficult for you to relax these muscles to go to the toilet.
Risk factors for pelvic pain include:
- Acute prostatitis
- Excessive loading of the abdominal muscles e.g. abdominal crunches, heavy lifting
- Stress
Pelvic pain symptoms:
- Urinary/fecal incontinence
- Urinary urgency (strong urges to go to the toilet)
- Difficulty emptying bladder or bowels
- Coccyx pain
- Penile, pelvic or testicular pain
- Constipation
- Painful ejaculation
- Urinary frequency (peeing more than 8-10x per day)
What to Expect: Pelvic Floor Physiotherapy
Jane Hendriksen can assess and treat pelvic health issues in both men and women.
On the first visit, Jane will take a full history and conduct a physical assessment. This includes a check of strength, flexibility and range of motion in the back, pelvis and hips.
An internal exam (if required/consented to) can be a part of your assessment.
Your treatment could involve hands on manual therapy, exercise prescription, education, and lifestyle modifications. Each treatment plan is specific to patient needs and your assessment findings.
