Why men need to seek out Pelvic floor therapy?

Pelvic floor physiotherapy (or “rehab”) can help men recover from incontinence after prostate surgery, and from pelvic pain.

Pelvic floor physiotherapy is usually prescribed for women who, after a few pregnancies, tend to leak urine.

But men can leak, too, especially after surgery for prostate cancer. Men can also suffer from chronic pelvic pain. physiotherapy specific to the pelvic floor muscles can provide relief.

What is the pelvic floor?

The pelvic floor comprises muscles and connective tissue that support abdominal organs, control the bowels and bladder and are involved in sexual function.

What pelvic-related problems are typical for men?

The two main symptoms that send men to pelvic floor physiotherapy are incontinence (inability to control urination) and pelvic pain.

Incontinence typically stems from problems with a man’s prostate gland. If he has an enlarged prostate – a common condition as men age – the prostate can pinch the urethra. Then the bladder has to work harder to push urine out when it needs to empty and the bladder muscles thicken and become overactive. The result: leaking urine.

Men who have had surgery for prostate cancer have incontinence at least temporarily after their surgery. Some men who receive radiation therapy for prostate cancer can also experience incontinence. Somewhere between half and two-thirds of the control mechanism for urination is lost as part of (prostate removal), basically all men will have some degree of incontinence for a period of time after removal of the prostate. But they can regain control with physiotherapy. “It has become evident from a lot of very well-done studies that the earlier we get men into therapy, the quicker their continence or urinary control returns. Better surgical techniques, including robotic surgery, and earlier use of physiotherapy mean that today, about 90 percent of men regain control over urination after prostate removal.

Another common pelvic problem for men is chronic (ongoing) pelvic pain. Pain can come from the bladder, rectum or prostate (the latter is sometimes called prostatitis). Pain tends to make muscles tighten up, like a constant cramp, and this becomes an uncomfortable cycle: pain leads to muscle tension, which causes more pain.

What is pelvic floor physiotherapy like?

There are many aspects to pelvic floor rehab:

Education and a frank conversation. The therapist gives men a basic education about their pelvic floor, an often mysterious part of anatomy.

Men don’t tend to think about their pelvic floor whereas women know a lot about their pelvic floor. By the time a woman sees a urologist due to incontinence, she’s probably had several children and her obstetrician has recommended pelvic floor exercise. Men simply don’t have that experience.

On the first visit, the physiotherapist has a discussion with men: They ask about their pain symptoms, what their urination is like, what their bowel movements are like, what their sexual activity is like because all of those things can be affected by pelvic floor symptoms

Men with questions about any part of pelvic floor rehab can call or email the physiotherapist before the first visit to talk through any concerns.

A physical check. The therapist will check strength, flexibility and range of motion in the back, pelvis and hips.

An internal exam. Often the therapist will do a rectal exam with a gloved finger, to feel whether the muscles are weak or in spasm, or have some other dysfunction. Rehab may also involve massaging certain muscles.

Exercises targeting the right muscles. For incontinence, pelvic floor rehab aims to strengthen the muscles controlling urination. For pelvic pain, the aim is coaxing tight muscles to relax. Both will involve exercises that, with practice, will retrain pelvic floor muscles to function properly.

Kegel contractions, for example, retrain muscles after prostate surgery. Imagine stopping the flow of urine mid-stream: that’s a Kegel contraction. Therapy will include a quick series of these contractions, to strengthen the “fast-twitch” muscle fibers and learning to hold a contraction for a longer period of time, to strengthen “slow-twitch” fibers.

There are other exercises beyond Kegels that a therapist will teach men so they can target pelvic floor muscles.

How long do most men need to go to pelvic floor rehab?

Regular sessions for about 20 weeks, sometimes longer, can help men dramatically strengthen control over urination. If prostate surgery goes smoothly, regular physiotherapy can resolve incontinence. If surgery had complications, therapy may not completely “cure” incontinence but can improve it significantly.

Pelvic pain can have many factors, so resolving it may take six months or longer. Behavioral, lifestyle or emotional challenges are often part of the problem, and men may need to tackle one or more of those issues in addition to getting physiotherapy. For example, a type-A personality with a high-stress life may need to make life changes and learn to manage stress in addition to getting physiotherapy, to prevent pain flare-ups.

The frequency of in-person visits to the therapist tapers off as the patient makes progress, especially if he is consistently doing his exercises at home between visits.

What would you say to men who dread discussing urination, bowel movements or sex with a doctor?

You have to take care of yourself. Don’t ignore your symptoms, because urinary symptoms are very common in men, and they could be quite problematic later on.

If you have symptoms that just don’t seem to go away and the simple stuff (i.e., antibiotics) doesn’t seem to be doing what it should, talk to a doctor. Men should mention these symptoms during a regular physical, at least. A referral for pelvic floor physiotherapy can help. For an assessment of your pelvic floor, call PCA on 0813 028 0496.

Here’s why men are less likely to see a health professional than women

That pang in your left abdomen has returned. Will you take an ibuprofen and power through the day, or make an appointment with your general physician? As it turns out, your gender is likely to inform which (if any) action you take next. Studies show, women are more likely than men to seek out health care.

The result of forgoing routine health care is just what you might suspect; limited care is one factor contributing to serious diagnoses and shorter life spans for men.

So, why exactly are men resisting trips to the doctor? And, more importantly: What can we do about it?

What’s Keeping Men from Seeking Care?

When asked why they don’t get routine medical care such as an annual physical, men often report vague issues like a busy schedule. But we suspect there’s more to it than that. When researchers dug a little deeper, they discovered a few common themes popping up around this troubling trend.

Macho Attitude

According to Harvard and Rutgers, men who self-report traditional views on masculinity are also less likely to get consistent health care. There appears to be a correlation between holding the belief that men should be strong and self-reliant (and slow to show emotion) and resisting routine exams.

Fear of Diagnosis

Many men also report a fear of diagnosis. In a 2016 online survey, more than 20% of respondents said being nervous to find out what could be wrong was a roadblock to scheduling an annual exam. Unfortunately, waiting on symptoms to become acutely painful or otherwise unavoidable is not a good health plan.

Uncomfortable with Exams

In the same survey, men reported being uncomfortable with certain body exams. In particular, rectal exams and other invasive tests are apt to give men pause about seeking preventative care. This issue may be tied into the idea of masculinity as well. After all, some intimate exams make us feel vulnerable.

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