Men’s Pelvic Health

It isn't always obvious.

The pelvic floor works closely with your bladder, bowel, abdominal muscles, hips, spine, breathing system, and nervous system. Dysfunction can therefore show up in ways that don't immediately seem muscular.

Urinary leakage or urgency, difficulty starting or stopping your urine stream, constipation, pelvic or genital pain, pain with sitting, pain with ejaculation, and symptoms that change with exercise, stress, or body position can all potentially have a pelvic floor component.

A pelvic health physical therapy evaluation helps us determine whether your pelvic floor and the surrounding musculoskeletal and nervous systems may be contributing to your symptoms.

Depending on your symptoms and diagnosis, pelvic floor physical therapy may help you:

• Improve bladder control and reduce urinary leakage

• Recover bladder function after prostatectomy

• Reduce urinary urgency and frequency

• Improve your ability to empty your bladder

• Reduce pelvic, perineal, testicular, penile, rectal, or tailbone pain

• Decrease pelvic floor muscle tension and spasm

• Improve bowel movements and reduce straining

• Reduce pain with erections, intercourse, or ejaculation

• Improve pelvic floor coordination during sexual activity

• Return to exercise, lifting, running, golf, cycling, or other activities with greater confidence

• Better understand your symptoms and how to manage them independently

Yes. Pelvic floor therapy after prostatectomy is one of the most common reasons men seek pelvic PT.

The pelvic floor plays an important role in urinary continence, and prostate surgery changes how the urinary continence system functions. Rehabilitation isn't simply about doing as many Kegels as possible.

We assess how well you're finding, contracting, relaxing, and coordinating the appropriate muscles and how your pelvic floor responds during coughing, standing, walking, lifting, exercising, and other activities that may trigger leakage.

Pelvic floor therapy can also begin before prostate surgery so you understand how to use these muscles before your procedure.

No. Kegels are only one exercise, and they're not appropriate for every pelvic floor problem.

Some people need strengthening while others have pelvic floor muscles that are already working too hard and need help relaxing. Others have adequate strength but poor timing or coordination.

If your pelvic floor is already tight or overactive, repeatedly squeezing it without understanding the underlying problem may not help.

A pelvic PT will help you determine what your pelvic floor actually needs rather than assuming everyone needs the same exercise.

Urologists and pelvic floor physical therapists have different, but complementary roles.

A urologist is a physician who evaluates and treats conditions involving the urinary and male reproductive systems. They can order diagnostic testing, diagnose medical conditions, prescribe medications, and perform procedures or surgery when appropriate.

A pelvic floor physical therapist evaluates the musculoskeletal and movement-related components of bladder, bowel, pelvic, and sexual symptoms.

Many patients benefit from working with both. If we identify symptoms that warrant further medical evaluation, we'll recommend that you follow up with the appropriate provider.

No, you don't need to know whether your symptoms are caused by prostatitis, pudendal neuralgia, pelvic floor muscle tension, weakness, or another pelvic floor dysfunction before coming to see us.

You can schedule a pelvic floor PT evaluation based on your symptoms alone. We'll evaluate the musculoskeletal and pelvic floor components and let you know if we think additional medical evaluation would be helpful.

While an internal pelvic floor examination can provide useful information about pelvic floor muscle strength, tension, tenderness, coordination, and function, it is never required.

We'll explain what we're recommending, why we think it may be useful, and what alternatives are available. You decide what you're comfortable with, and consent can be changed at any time. There is still a great deal we can assess and treat externally.

It can.

Pain with erections, intercourse, orgasm, or ejaculation may sometimes involve excessive pelvic floor muscle tension, muscle spasm, nerve irritation, scar tissue, or difficulty coordinating the pelvic floor.

Treatment depends on what we find during your evaluation and may include pelvic floor relaxation, manual therapy, mobility work, nervous-system strategies, nerve mobility, breathing mechanics, and addressing contributing problems in the hips, spine, abdomen, or surrounding tissues.

Because sexual pain can also have medical causes, we may recommend coordinating care with your physician or urologist, when appropriate.

No. Having symptoms for a long time doesn't automatically mean they're permanent.

Chronic symptoms can become more complicated because muscles, nerves, movement patterns, habits, and the nervous system may all adapt over time. That may mean rehabilitation takes time as well, but chronicity alone isn't a reason not to seek treatment.

Pelvic health physical therapists receive additional education in bladder, bowel, sexual, and pelvic floor function. A traditional orthopedic physical therapist may be excellent at treating a hip, knee, shoulder, or back injury but may not routinely evaluate pelvic floor muscle function or understand how it relates to urinary leakage, constipation, prostate surgery, genital pain, or sexual dysfunction.

At Monterey Pelvic Health, pelvic health isn't an add-on service. It's what we do.

We look at the pelvic floor as part of your whole body, including your hips, spine, abdomen, breathing mechanics, movement, nervous system, bladder and bowel habits, and lifestyle.

Some of the most common reasons men seek pelvic floor therapy include:

• Urinary leakage after prostatectomy

• Urinary urgency and frequency

• Overactive bladder

• Post-void dribbling

• Chronic pelvic pain

• Prostatitis/chronic pelvic pain syndrome

• Tight or hypertonic pelvic floor muscles

• Testicular, penile, perineal, or rectal pain

• Pudendal neuralgia

• Pain with sitting

• Pain during or after ejaculation

• Constipation or difficulty emptying the bowels

• Tailbone pain

• Returning to exercise after pelvic or abdominal surgery

You don't need to decide whether your symptoms "count" as a pelvic floor problem before contacting us. If you're unsure whether pelvic PT is appropriate, our team can help point you in the right direction.