You may be surprised to know that about 1 in 3 men who visit the GP have trouble controlling their bladder or bowel. Incontinence is likely to affect closer to 2 in 3 men, as many men feel embarrassed to discuss it even with their doctor. This is very unfortunate as there are effective treatments available, like physiotherapy and pelvic floor strengthening exercises, which can cure or improve symptoms for almost all men who seek help.
What is your pelvic floor?
Your pelvic floor is the group of muscles and ligaments that sit at the base of your pelvis. It has several important functions, including control of your bladder and bowel, sexual function, and spinal health.
Try these tips to help you switch on your pelvic floor muscles:
- Imagine stopping the flow of urine
- Imagine walking into cold water, feeling your scrotum lift into your body (“nuts to guts”)
- Try to draw your penis into your body
- Imagine trying to lift a towel on your penis
- To activate the external anal sphincter muscle that helps control your bowel, imagine stopping wind and feel the anal opening close.
Just like other types of exercise, pelvic floor muscle training needs to be specific to your body and your goals. For example, if you have trouble deferring the need to urinate you may need to work on the endurance element of pelvic floor muscle function.
How do you know if you need help with your pelvic floor?
Here are some common signs that your pelvic floor muscles are not working well:
- Needing to use the bathroom more frequently than seems normal to you (e.g. more than 8 times during the day, more than once during the night after going to bed)
- Rushing to the toilet with the strong urge to go
- Leaking urine when you need to go, when you cough and sneeze, or at other times
- Having difficulty with sexual arousal, erections, or orgasms
- Constipation and straining to pass bowel motions
- Bowel urgency or accidents with your bowel
- Recurrent back, hip, or pelvic pain
If you are experiencing any of these symptoms or any other difficulties with your bladder, bowel, or sexual function, it is a good idea to speak with your GP or your physiotherapist. They can refer you for assessment by a Continence and Men’s Health physiotherapist if appropriate.
What about the pelvic floor after prostate surgery?
It is common for men to experience bladder weakness or leakage after prostate surgery (prostatectomy or TURP). Sexual dysfunction like difficulty getting an erection is also a common complication. These complications occur because of damage to the sphincter muscle that closes the urethra, and/or to the nerves and blood vessels in the area. There is strong evidence that physiotherapy treatment can help you recover sexual and bladder function after your surgery.
If you are planning to have prostate surgery, your surgeon should provide information about pelvic floor strengthening before and after the operation. This is best done under the supervision of a specially trained men’s health physiotherapist who can perform a real time ultrasound assessment (transperineal ultrasound is best) and an individualized exercise programme.
Where can I find out more?
If you have any questions about the information here, please ask your treating physiotherapist or your GP for advice. Here are some reliable websites that you may also find helpful:
Continence Foundation of Australia
Pelvic Floor First
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