Men Have a Pelvic Floor Too!

Most men think that kegels are only for women. Indeed, most men don’t think about their pelvic floor until they have a problem with it. When the male pelvic floor becomes problematic, these are some common issues that can happen: 

• Leaking of urine (urinary incontinence)
• Leaking of stools (fecal incontinence)
• Urgency (sudden and strong urge to go)
• Erectile dysfunction 
• Dribbling after urination
• Pelvic pain (including scrotal, testicular, perineal pain)

What do your pelvic floor muscles do? 

The male pelvic floor supports the pelvic organs including the bowel, bladder and prostate. They contract when there is an increase in intra-abdominal pressure, for example when you sneeze or cough or lift something heavy, thereby preventing any urinary or fecal leakage. They relax when you have a bowel movement or urinate to allow total emptying. They are also central to maintaining core stability, erectile and sexual function. 

What causes pelvic floor muscle dysfunction? 

There are several reasons why the pelvic floor cause problems, including: 

• Prostate surgery: affects muscles and nerves around the prostate 
• Repetitive heavy lifting: muscles can get fatigued or damaged with chronic heavy lifting
• Chronic coughs: repeated strain on pelvic floor muscles can cause muscles to weaken
• Being overweight: puts additional pressure and load on pelvic floor muscles
• Chronic constipation: straining to poop can cause pelvic floor muscles to weaken
• Aging process: natural process of ageing causes muscle to lose mass and strength
• Chronic pain: leading to increased muscle tension
• Trauma, stress and anxiety: leading to increased muscle tension

Are Kegels the answer? 

It depends! If your pelvic floor muscles are weak, maybe. If they are tight, or hypertonic, kegels might not be the answer. And usually it is more than the pelvic floor muscles involved: our bodies work as a system, meaning there are usually other contributing factors to pelvic floor dysfunction including poor mobility, decreased core strength, problems with coordination. Research has also shown that 30% of people don’t perform a Kegel correctly the first time they do it (Zanetti et al., 2007).

What can you do? 

Studies have shown that strengthening the pelvic floor muscles can improve post-prostatectomy incontinence, dribbling after urination, and erectile function (Dorey, 2005). However not all pelvic floor problems require strengthening. In the case of hypertonic muscles, you would need to re-learn neuromuscular control of the muscles through the guidance of a pelvic floor therapist. A physical therapist can also help you determine if there are other contributing factors to your symptoms. It is usually multi-factorial. Pelvic floor physical therapists also work closely with other specialists such as urologists and your primary provider if further medical attention is required. 

A qualified pelvic floor physical therapist can help you determine the best course of action to address your symptoms! You can reach out to our Pelvic Health Navigator at (402) 717-7358 or visit our website for more information. 

References:

Dorey G. Restoring pelvic floor function in men: review of RCTs. Br J Nurs. 2005 Oct 27-Nov 9;14(19):1014-8, 1020-1. doi: 10.12968/bjon.2005.14.19.19944. PMID: 16301945.

Zanetti MR, Castro Rde A, Rotta AL, Santos PD, Sartori M, Girão MJ. Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence. Sao Paulo Med J. 2007 Sep 06;125(5):265-9.