Many people are surprised when they learn men have pelvic floor muscles. Not only that, men can also have pelvic floor problems.

Where are the pelvic floor muscles?
The pelvic floor muscles are like a hammock that sits at the bottom of the pelvis. They extend from the pubic bone at the front to the tailbone at the back.

What are the functions of the pelvic floor muscles?
The pelvic floor muscles:
• help control the bladder and the bowel (stop you from having accidents)
• help empty the bladder and the bowel (helping you hold on until a time that suits to go to the toilet)
• have a role in sexual function – the pelvic floor helps to clamp off the veins to keep the blood in the penis during an erection.
• help control ejaculation.
• contribute to support and stability around the pelvis and trunk
• help to keep the bladder and bowel in the right place

What sorts of things go wrong?
The pelvic floor muscles are really important and when things aren’t right there can be quite distressing symptoms.

Two things can go wrong with the pelvic floor. The first is that the muscles can become weak and / or lengthened. They are not able to generate much strength, or able to hold on for very long. The sorts of problems you might see include bladder leakage and problems controlling the bowel.

The other issue is that the muscles can become overactive or too tight. This can cause symptoms such as pelvic or genital pain. It can also lead to problems emptying the bladder and the bowel, bladder frequency or urgency, and ejaculatory and erectile dysfunction.

Why see a pelvic health physiotherapist?
Pelvic health physiotherapists have an important role to play in the treatment of male pelvic floor dysfunction. There are three groups of men that we work with.

1. Men who undergo radical prostatectomy (removal of the prostate gland, in men with prostate cancer)
Following the surgery, almost all men have significant loss of bladder control, and loss of erectile function. Pelvic health physios can help improve pelvic floor muscle strength endurance and function, and in so doing improve bladder control. Treatment has been shown to reduce the amount of leakage, and the length of time these men experience it for. Your physio will also be able to advise on self-help measures to aid return of erectile function.

2.Men who experience bladder and bowel problems
Pelvic health physiotherapists have special skills and training to help with:

Bladder problems:
-poor bladder control
-frequent use of the toilet
-wet pants
-having to rush to the toilet, and perhaps not making it

Bowel problems:
-loss of control of the bowel or having accidents
-passing wind at the wrong time
-problems emptying the bowel
-constipation and straining
-urgency to get to the toilet

3.Men with pelvic pain and sexual dysfunction (Chronic Pelvic Pain Syndrome)
There is a lack of awareness about the role of the pelvic floor as a contributing factor to pelvic pain in men. We often see men who have put up with quite distressing symptoms for some time, because they did not know what help was available.

If the pelvic floor muscles become overactive it can cause pain in the genital region (groin, testicles, penis, anus), pain with sitting, pain with erections or ejaculation. There can also be associated bladder and bowel pain.

Factors that may have contributed to the development of chronic pelvic pain include:
-stress and anxiety
-irritation or injury / compression of nerves
-infection of the prostate or bladder
-overuse of the core muscles
-bike riding
-trauma or surgery to the pelvic area

What can you expect from a pelvic health physiotherapy appointment?
We understand that these issues can be embarrassing and hard to discuss. We will do our best to help you feel at ease. Getting the right help can make a huge difference to your quality of life.

The first session is an hour so we can carry out a thorough assessment, and make a treatment plan to meet your goals. We will be able to help you understand why you have pain, and provide treatment to help resolve it. There is a focus on self-help management, as well as manual therapy in the clinic.

Contact us here and ask for Liz, our Men’s Health Physiotherapist, or call us on (04) 891 0595