Pelvic floor physical therapy isn’t just for women. In fact, at Hudson Valley Physical Therapy, we treat men daily for a variety of pelvic floor dysfunctions.

 

While overall pelvic health awareness for females seems to be on the rise, we often see quite a lag in treatment for males. It’s not uncommon that our male patients suffer for years and see a variety of healthcare practitioners before referral to physical therapy. 

 

Males have pelvic floors too, and their pelvic floors aren’t all that different from the female pelvic floor with only a couple of different muscles. Both males and females have three layers of muscles that make up the pelvic floor. In both sexes, these muscles have support, sphincteric, stability, sexual and pressure regulation function. 

 

 

The male pelvic floor model is shown on the left, female on the right. Not all that different!

 

So why may a male need pelvic floor physical therapy? Part 1.

Post prostatectomy urinary incontinence

 

Prostate cancer is the most common male cancer in the US affecting nearly 1 in 7 males (Center for Disease Control). Radical prostatectomy (removal of the prostate) remains a common treatment route for many men.

 

Urinary incontinence is a risk factor following surgery. Inability to control loss of urine following surgery varies from continuous leakage during the day to leakage with transitional movements and impact activity. 

 

Pelvic floor physical therapy can help. Research looking at pre-hab (physical therapy pre surgery) found that doing pelvic PT before surgery helped men regain continence faster post-op (Chang et. al, 2015). In another study, men who underwent treatment in PT following surgery became continent sooner than the control group with more men in the pelvic PT group regaining continence (Marchiori et. al, 2010).

 

Erectile dysfunction

 

Erectile dysfunction (ED) affects about 30 million men according to the NIH. The pelvic floor muscles assist in the ability to have and maintain an erection. That being said, it is important to speak to your healthcare provider to rule out serious conditions like cardiovascular disease and diabetes before seeing a physical therapist.

 

In a study of over 200 men, pelvic floor physical was beneficial in improving erectile dysfunction (Lavoisier et. al, 2014). 

 

Generally, these two conditions require pelvic floor strengthening, but in some cases relaxing the pelvic floor may be necessary. It is important to see a trained pelvic physical therapist to create an individualized treatment plan. 

A comprehensive treatment includes things like (but not limited to):

 

Pelvic floor strengthening

Posture

Post surgical scar mobilization

Breath work 

Lifting mechanics 

Lower extremity range of motion/ strengthening

Pain management

 

If you or a loved one are experiencing either of these conditions, seek the help of a pelvic PT. 

 

Keep in mind, for many male pelvic floor conditions strengthening is not the answer, and instead the pelvic floor needs relaxation training.

 

In our next blog, I will be flipping the coin and talking about conditions like urinary retention/ difficulty initiating a urine stream, male pelvic pain, and constipation. 

 

-Megan Fosko PT, DPT

 

Chang et. al, 2015, European Urology, 69(3), 460-467.

 

Marchiori D, Bertaccini A, Manferrari F, et al., 2010, Pelvic floor rehabilitation for continence recovery after radical prostatectomy:role of a personal training re-educational program. Anticancer Res. 2010(30), 553–553

Pierre Lavoisier, Pascal Roy, Emmanuelle Dantony, Antoine Watrelot, Jean Ruggeri, Sébastien Dumoulin, Pelvic-Floor Muscle Rehabilitation in Erectile Dysfunction and Premature Ejaculation, 2014, Physical Therapy, 94(12), 1731–1743, https://doi.org/10.2522/ptj.20130354