The Male Pelvic Floor

The pelvic floor stretches like a muscular trampoline from front to back (pubic bone to tail bone) and from side to side (sitting bone to sitting bone). The pelvic floor supports urogenital organs such as the bladder and bowel in addition to the colon and intestine. The male pelvic floor has two openings – the urethra and the anus. The urethra and anus have sphincters which reinforce the openings to control urine flow, stool and wind.

Male Urinary Function

There are two ways that men control urine function:

1. The Prostate Muscle. The prostate gland is a mix of muscle and gland tissue wrapped around the urethra (tube that carries urine from the bladder to the penis). The urethra is a soft pliable tube that can be kinked by pinching the penis or by muscles around the tube contracting. When the tube is kinked the flow of urine is stopped. Problems arise with urine flow when the prostate becomes enlarged, swollen or tumorous as this puts extra pressure on the tube which impedes urine flow. Men with an enlarged or problematic prostate usually experience increased frequency (going to the toilet more often), urinary urgency (not being able to hold onto a wee) or a weak stream. MOST MEN RELY ON THE PROSTATE MUSCLE TO CONTROL FLOW.
2. The Pelvic Floor. The urethral sphincter is at the base of the penis in the pelvic floor. It functions to contract and tighten when the bladder fills up as to kink the tube and stop the flow of urine.

How urine loss occurs

As men get older it is common for the prostate to become enlarged, swollen and sometimes tumorous. According to Cancer Council Australia in 2012, the risk of being diagnosed with prostate cancer by the age of 85 was 1 in 5 men and of all prostate diagnoses made; 85{a6c7b425888b7c6f1a6f6a56734ac1b8857b8c58f25bd7859cf6bc78df1c400b} of them were over 65 years of age. There are many forms of treatment depending on the stage and type of cancer however commonly, the prostate gland is removed entirely.

This in turn removes the prostate muscle also which, up until now for many men has been controlling urine flow. As the PELVIC FLOOR hasn’t been used for this purpose it has become lazy and doesn’t know how to contract to stop flow so unfortunately these men can experience embarrassing and uncontrollable urine leakage.

How to control urine leakage

The pelvic floor must learn how to work again. This involves retraining functional patterns, strength and endurance so that the pelvic floor can begin to function automatically for you. At Integrated Pelvic Physiotherapy we take you through a simple, easy to understand rehabilitation programme to retrain the function, strength and endurance of the pelvic floor so that your urine leakage can be controlled.

Some tips to regain continence:

• Question the urges (signals) your bladder is telling you – not panicking and going on every urge is a good place to start!
• Reduce caffeine, alcohol and fizzy drinks as much as possible
• Ensure that you are emptying your bladder completely
• Ensure that you are drinking sufficient water… the thought “Less in = Less out” is not a good idea as this will concentrate the urine furthermore which will make the bladder irritable therefore needing to empty more often

NOTE: If you or someone you know is about to go through prostate cancer surgery ensure that they see a pelvic floor physiotherapist prior to the surgery as this significantly decreases the amount and likelihood of urine leakage.

If you would like more information or to book an appointment with one of our pelvic floor physiotherapists, please don’t hesitate to contact us on (07) 5441 4764.

Sources: Australian Institute of Health and Welfare & Australasian Association of Cancer Registries 2012. Cancer in Australia: An overview 2012. Cancer series no. 74. Cat. no. CAN 70. Canberra AIHW.

Other resources:
Cancer Council Website: http://www.cancer.org.au/about-cancer/types-of-cancer/prostate-cancer.html

Prostate Cancer Institute: http://www.prostatecancer.org.au/PCI/Home.html

Prostate Cancer Foundation of Australia: http://www.prostate.org.au