Men don't usually think about their pelvic health until something goes wrong. In fact, many men are surprised to learn that they have a pelvic floor at all! This hammock of muscles runs from the pubic bone in the front to the tailbone in the back, and as such, has an important role in bowel, bladder, and sexual health. Just like other muscles, these can get tight, weak, or sore.
For the male pelvic floor, the main issues that we see and treat at Beacon Therapy are:
- Pain - often related to hypertonic muscles that do not relax. Male pelvic pain is often misdiagnosed as prostatitis and treated unsuccessfully with antibiotics for a prolonged period before they are sent to a physiotherapist for pelvic floor muscle evaluation.
- Incontinence - often following prostate treatment. Between 1/2 and 2/3 of bladder control can be lost after prostate surgery. With early use of physiotherapy, 90% of men regain control of urination after prostate removal.
Types of Pelvic Floor Issues
Pelvic floor muscles that are short and tight need stretching to help move the tailbone away from the pubic bone. Exercises, along with breathing exercises, can help lengthen these muscles. Sometimes pelvic floor muscles can be weak as well.
Weak pelvic floor muscles benefit from strengthening exercises. Kegel exercises, most often associated with women after childbirth, are also helpful in treating men. Stronger, well-toned pelvic floor muscles can help in treating such conditions as incontinence, urgency, post void dribble, erection difficulties, and even premature ejaculation.
Overactive and irritable pelvic floor muscles can be taught to relax. Most often, pain is the problem, but sometimes urinary urgency and frequency can also occur. Hands-on techniques help to relax painful knots, and breathing and awareness exercises can be useful in helping the muscles settle down to reduce pain and restore function.
There are times when the issue is not the pelvic floor, however. The culprits may be habits or activities that trigger the symptoms instead. Sometimes it is overuse of certain muscles during particular activities. Sometimes it's eating or voiding habits that lead to pain or voiding problems. During your assessment with Lois, she will cover the range of possibilities so that you get the most suitable treatment.
Your First Visit
When you book your initial visit, you will be emailed a link to complete our intake form. Please fill it in prior to coming in. This will give Lois prior knowledge of the matter at hand, as well as a full health history that allows her to know what modifications might be needed, or if this treatment is right for you.
The initial assessment consists of two parts, the ultrasound assessment and the internal examination. Prior to beginning the assessment, the entire examination will be explained and you will be asked for your informed consent to continue. This consent can be rescinded at any time during the examination.
The first part consists of a thorough examination including the use of Real-time Ultrasound Imaging will be done. To enable viewing of your pelvic floor through the abdominal wall, you need to come to the appointment with a full bladder.
Bladder Filling Protocol
Empty your bladder one hour before your scheduled appointment. Then immediately drink 12 ounces of water. Do not void again until after your RTUS assessment.
The second part consists of an internal examination of the pelvic floor muscles. The purpose of this assessment is to evaluate how the pelvic floor muscles and connective tissue are working. You will be asked to undress from the waist down in a curtained cubicle and lie on the physiotherapy plinth. A drape will be provided to cover yourself. A clean technique, using non-latex gloves will be employed throughout the assessment. One finger is inserted into the rectum to assess the pelvic floor in terms of muscle strength, co-ordination and tone, connective tissue laxity, scarring and adhesions.
Immediately following the assessment, a detailed explanation of your condition along with treatment options will be discussed with you. Treatment can include pelvic floor exercises, biofeedback with ultrasound imaging, core muscle re-training, behavioural changes to diet and toiletting patterns, muscular stimulation, myofascial release and education.
These are shorter visits and will be used to carry out the treatment plan outlined in the assessment. You do not need to have a full bladder for these appointments unless you have been told to do so.
Booking Your Appointments
All of our bookings are done online. For instructions about how to make an appointment, visit our FAQ page or click here. Remember, you can add yourself to the wait list should you not find an appointment time that suits you and we will contact you if slots open up.