Bladder
Overactive bladder.
This is the problem of needing to empty the bladder urgently for fear of leakage. Interestingly, in men, this problem is as common as it is in women but men experience actual leakage of urine associated with urgency much, much less. The urgency in itself can however be debilitating. If you think you are going to the toilet too often and bothered by urgency then its worth getting help sooner rather than later and often success comes quite quickly.
Nocturia
We shouldn’t have to go to the toilet at night if we stop drinking roughly 2 hours before bed: this is because the bladder has an ability to hold good volumes or urine and the body naturally slows down urine production when we go to sleep.
If you get up to go to the toilet and it is a problem for you, that is reason enough to get help. There are multiple causes of the frequency which might be just poor sleep, other health issues, a small capacity bladder, prostate issues, the problem of making too much urine at night relative to the day…….this can all be worked out for you on a path to finding solutions.
Difficulty emptying.
Most men will be having regular G.P. checks of prostate health. Enlargement of the prostate is one of the common causes of slow flow and difficulty emptying. But there are other factors too so if prostate is deemed normal and you’re not happy emptying, we might look at whether your pelvic floor relaxes enough to enable emptying. An overactive bladder sometimes feels like there should be lots of urine emptying when in fact there is only a trickly to come out…..All of this needs to be looked at so solutions can be found.
Note, we have ultrasound in our rooms so can check whether you actually empty properly or not.
If there are concerns we will refer back to your G.P for investigation.
Prostate
Pelvic floor exercise is recommended for all men pre and post prostate surgery for cancer. This aims to prevent leakage and urgency issues. The most usual type of leakage after the surgery is called
“stress urinary incontinence”. This refers to leakage when there is pressure above the bladder and the closing mechanism of the bladder has been weakened by the surgery. For example pressure above the bladder occurs when you cough, sneeze, do impact exercise, move suddenly, even getting out of a chair might put enough pressure on the bladder to cause leakage.
As noted above, in the absence of surgery, an enlarged prostate can cause difficulty emptying and overactive bladder symptoms. Find out how to manage the problem instead of inadvertently making it worse .
Erectile Dysfunction
Erectile function is a complex combination of mental and physical factors and we aim not to try and claim that simple pelvic floor exercise alone will address this issue. Nevertheless, studies do show that pelvic floor muscles play a part so it is reasonable to have help with a strengthening program if needed.
Erectile function can be affected typically by Prostate surgery. If you feel you are not making the progress you need in this area it is reasonable to ask us for help.
If the erectile function is affected by pain, we can work on solving the pain problem on the path to improving the erectile function.
Pelvic Pain
Men can experience pain anywhere in the pelvis: coccyx, hips, testicular region, anus, bladder etc. You may have been diagnosed with “pudendal neuralgia”. Any pain in the pelvis can ve assessed to find solutions with us.
Prostatitis is often diagnosed and treated by Doctors but pain might not resolve. We will check whether you have tight pelvic floor muscles secondary to the pain and work on relieving this to relieve pain.
Sexual Pain
This is pain related specifically to any sexual function. If not managed, pain will often affect libido and erectile function. It is worth addressing this before the problem becomes chronic and more difficult to manage.
Bowel
Constipation
There are many reasons for constipation. Many of us will experience it now and then when diet changes or daily routines change but the bowel quickly recovers. The important thing is not to strain to empty the bowel over time since this causes other issues such as haemorrhoids or even rectal prolapse (the inner lining of the rectum slides out after emptying). If constipation is an issue, Physio will help work out what the problems are and especially try and find out if your pelvic floor muscles are not relaxing enough to allow emptying. Usually management is a combination of understanding how it should work, at what part of the whole body system things have gone awry and then you can get yourself onto a path back to regularity.
Faecal Incontinence/bowel leakage.
Ironically, T\this is a problem that can be caused by chronic constipation. Why? When the bowel is blocked, it is easy for looser stool to leak around the blockage.
Faecal incontinence can loss associated with loose, urgent stool. Or it might be small loss causing soiling of underwear after emptying. This tells us that the bowel may not be emptying as effectively as it should be. Our aim is to find out why you are not emptying well and correct it so that the soiling doesn’t happen.
These problems do tend to get worse with aging: men’s muscles deteriorate without exercise just like women’s muscles. Thinning of muscles with age is called “sarcopenia”. So pelvic floor muscle training is all the more important and yet men are rarely taught how to exercise these muscles. It is never too late to learn.
Musculoskeletal
Coccyx pain
Coccyx pain is often present after a fall onto the coccyx and a Doctor will usually send you for an x-ray if there has been trauma. But coccyx pain can be present long after any trauma has healed. The pain might start after prolonged sitting that you are not used to. Sometimes the pain is very much joint related and sometimes it is pelvic floor muscle tension around the coccyx causing pain. We can assess this for you.
Sacroiliac joint pain. (SIJ pain)
Most physios will assess these joints for you. Our area of interest enables us to give very detailed assessment of the pelvic floor which applies force to the SIJ joints from the inside, working with and responding to the muscles working on the outside. Most of the people we see have had pain for a long time and are not progressing well with other treatment approaches. Often other treatment approaches seem only to give temporary relief. Our aim is to look at the bigger picture and help you onto a better self management path.
Chronic hip and pelvic pain
As with SIJ pain above, the problems we see are usually chronic in nature and have not been fixed elsewhere. You need to understand that bigger picture and be able to help yourself rather than be reliant on therapies that only give temporary relief.
