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Men’s Health

Pelvic Floor Dysfunction

Pelvic floor dysfunction in males is more common than often thought. One of the most common syndromes diagnosed, Chronic Prostatitis, affects up to 50% of men. Prostatitis is not completely understood, with many possible etiologies. However, according to the latest research, as many as 90% of cases may be caused by tightness in the muscles of the pelvic floor. The muscles of the male pelvic floor are involved in bladder, bowel and sexual activities and when they become “dysfunctional” they may affect any of those systems. A dysfunctional muscle maybe too weak, too tight, or lack the necessary neuromotor coordination to do its job. For pelvic floor muscles, this means that there may be symptoms of pain or dysfunction such as abnormal bladder or bowel movements, by excess (incontinence) or defect (retention, constipation), or inability to have normal sexual function.

Pelvic Floor Dysfunction Symptoms

Symptoms can be very varied, but in general males can experience one or more of thefollowing:

 Urinary frequency and urgency
 Pain or burning with urination
 Reduced urinary stream and hesitancy
 Pain between the anus and scrotum, or in the genitals
 Pain or discomfort during or after ejaculation
 Pain with sitting
 Pain above the pubic bone
 Coccyx pain
 Low back pain
 Groin pain
 Discomfort with bowel movements
 Erectile dysfunction
 Anxiety, depression, increased pain with stress

Treatment for Pelvic Floor Dysfunction

  • Manual therapy: involves techniques aimed at reducing muscle tone, releasing muscular trigger points, improving circulation and reducing inflammation, and improving the range of motion in pelvic, hip, and spinal joints. Joint and nerve mobilizations, lymphatic drainage massage, muscle energy techniques, and myofascial release are some examples of manual techniques normally used in pelvic floor therapy.
  • Pelvic floor muscle re-education with biofeedback: weak pelvic floor muscles will require exercising (kegels) whereas tight muscles will require relaxation techniques. Biofeedback provides a visual representation of the activity of the pelvic floor muscles measured via external or internal electrodes, which is helpful for patients to understand what pelvic floor muscles are really doing when they either attempt to release or to contract them.
  • E-stim: In some cases, pelvic floor muscles are too weak or patients have poor awareness of the region. Electric stimulation may help in the initial phases to gain strength or sensation.
  • Bladder behavioral reeducation: to normalize symptoms such as frequency, urgency and nocturia.
  • Mind-body techniques: therapeutic postures, breathing, and exercises/stretches based on Yoga, Pilates and the Hypopressive method to address core instability, pelvic pressure, muscle tension, improve circulation or rest.

What to Expect

Your first visit will include a thorough history of your present symptoms and previous medical experience. The therapists at Shift will listen closely to your experience and work with you to devise a framework for your care. Following the history, an evaluation will be performed in order to focus on the root causes of your symptoms.

We will perform a full assessment of your posture, focusing on the alignment of your pelvis and the range of motion of the lumbar spine and the hip joints. We will test the tone, strength and coordination of external muscles that may have influence in your pelvic floor, such as abdominal, thoracic and hip muscles.

The evaluation of the pelvic floor muscles normally involves intrarectal examination. If is not something you are comfortable with, the activity of pelvic floor muscles can be estimated externally with biofeedback.

Common Pelvic Floor Dysfunction Conditions We Treat

Urinary Incontinence after prostate cancer surgery
Prostatitis/Pudendal nerve entrapment/Chronic Pelvic Pain Syndrome
Chronic Constipation
Anism
Overactive Bladder
Interstitial Cystitis

 

Urinary Incontinence after Prostate Cancer Surgery

Urinary incontinence is one of the most commonly reported side effects of prostate surgery. While some males recover continence progressively during the first 6 weeks, according to literature, (Risk of Urinary Incontinence Following Prostatectomy), 59% of males remain incontinent after that period.
Learn More >>

Prostatitis/ Pudendal nerve entrapment/ Chronic Pelvic Pain Syndrome

Prostatitis and Pudendal Nerve Entrapment are some examples of commonly diagnosed chronic pelvic pain syndromes in males. Prostatitis is one of the most frequent urologic syndromes diagnosed. Up to 50 % of adult men have had symptoms of prostatitis in the lifetime. In the majority of cases, chronic prostatitis is nonbacterial and is caused by tightness of the muscles of the pelvic floor. Pelvic floor muscles can develop “trigger points” which are painful muscle “knots” that mimic the symptoms normally attributed to prostatitis, such as pain and urinary or genital symptoms. These pelvic symptoms are termed “chronic pelvic pain syndrome” or CPPS.

Testimonial

“I came to Irene needing help. After weeks of aches and irritation
associated with the condition, diet modifications and stretches and other
attempts to alleviate the discomfort and pain, and heavy research into the
problem, I learned about chronic male pelvic floor pain and began to
suspect it as a cause. With some trepidation, I booked an appointment with
Irene and I’m so glad I did. Within a matter of months my symptoms had
substantially improved, and she had taught me a whole host of exercises
and techniques to use at home to supplement her therapy and continue to
long-term maintenance process. She also helped de-mystify the complex
relationships between posture, muscles, exercise stress and the male
pelvic floor. She approaches her craft with veteran skill, a foundation in
body mechanics, warmth and humor. This treatment can be delicate and
uncomfortable, but Irene is calm, gentle, matter-of-fact and methodical
about her work, thereby making the atmosphere a relaxed one. I am in debt
to Irene for how she has helped me and feel so lucky to have found her.” – Chris W.

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