Pelvic Floor Dysfunction

Men can also suffer with pelvic floor problems. It is thought that 1 in 6 men have pelvic floor dysfunction. This is often related to prostate problems and 70% of men will suffer incontinence following prostatectomy (removal of the prostate).

However other potential causes include:

•Surgery for bladder or bowel problems

•Increased prostate size

•Pelvic pain (chronic)

•Recurrent pelvic infections

•Constipation

•Being overweight

•Heavy lifting

•Prolonged coughing (such as smoker's cough, bronchitis or asthma)

•Generally poor fitness.

Bladder

Stress incontinence is most common after prostatectomy. It is the involuntary loss of urine during any physical stress or exertion. This could be minor exertion like standing from a chair to a major stress like lifting something heavy. It is caused by an increase in pressure in the tummy which then pushes on the bladder. The pelvic floor muscle is then not strong enough to withstand this pressure.

Urgency and urge incontinence can also occur. You may notice an overwhelming urge to empty your bladder and possibly leak before you reach the toilet.

You might be aware you are going to the toilet more often in the day or at night time.

 

Poor urinary flow and incomplete emptying. This could be related to the prostate or could be a sign the pelvic floor is too tight.

You might notice you urine flow has slowed down and you are unable to fully empty your bladder.

How I can help...

After an assessment of your symptoms, habits and goals, a physical assessment of your pelvic floor may be completed and a treatment plan devised. Treatments may include:

  • Pelvic floor muscle re-training

  • Bladder re-training

  • Fluid management

  • Dietary advice

  • Re-education of breathing patterns

  • Activity modification

  • Soft tissue release.

Bowel

Constipation is very common in males and can be defined as a difficulty in opening your bowels with a need to strain. If you open your bowels less than three times a week you are classed as having constipation.

Incontinence is less common but can occur if the pelvic floor or anal sphincter muscles are weak. You may have an uncontrollable urge to open your bowels and not make it to the toilet in time. Sometimes you can have leakage from the bowel without a conscious feeling of urgency. This can also happen during physical activity.

​You may struggle to fully clean yourself after a bowel movement or have staining in your underwear.

How I can help...

After an assessment of your symptoms and a physical assessment of your pelvic floor muscle, I can devise an appropriate treatment program. Treatments may include:

  • Pelvic floor muscle re-training

  • Anal sphincter exercises

  • Strategies to help ease constipation and fully empty your bowels

  • Breathing pattern re-education

  • Soft tissue release.

Prostatectomy

During the surgery it is important to take wide margins to ensure all of the cancer is removed. Unfortunately this causes trauma to the muscles and incontinence can occur.

Stress incontinence is the most common complaint and you may leak with activity. You may also experience more urgency and frequency from your bladder and sometimes not get to the toilet on time.

Occasionally the muscles can become overly tight and cause pain and difficulty in emptying your bladder and/or bowels.

How I can help...

I will work with you to reach your specific goals and after a full physical assessment I can devise a treatment program. Treatments may include:

  • Pelvic floor muscle re-training

  • Bladder re-training

  • Fluid management

  • Anal sphincter exercises

  • Breathing pattern re-education

  • Modifications of activity and exercise.

Sexual Dysfunction

Changes in the pelvic floor muscle can contribute to changes in erection and altered ejaculation. Erections occur from complex interactions of many body systems but the pelvic floor muscles have a vital role.

It is thought that they help to maintain the rigidity of the penis and therefore a weak pelvic floor will not contract strongly enough to maintain the erection.

If the pelvic floor muscles are too tight, it is thought that they compress the opening and affect blood flow to the penis.

Prostate surgery will weaken the muscles and affect the nerve supply. This can be devastating for men at any age and often it is just accepted as a problem that they have to live with. Physio can potentially reduce symptoms, by improving the function of the pelvic floor muscle.

How I can help...

I will work with you to achieve your specific goals and assess the function of the pelvic floor muscle. I can then devise a treatment program. Treatments may include:

  • Pelvic floor muscle re-training

  • Re-education of breathing patterns

  • Down-training of the pelvic floor muscle

  • Soft tissue muscle release.

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