Men's Pelvic Health Physiotherapy

Mens pelvic health physiotherapy is a relatively new field of physiotherapy. Just like Women, Men have pelvic floor muscles and these muscles can be affected by a variety of factors. Injury or pathology in and around the pelvic floor can cause pain, bladder and bowel problems as well as sexual dysfunction. Pierre Roscher is our Physiotherapist with a special interest in Men's Pelvic Health

Pelvic Health Conditions in Men

Physiotherapy after Prostate Cancer

Pre-op Prostatectomy

How long before my operation should I have a Pelvic Physiotherapy consultation? A preoperative Pelvic Physiotherapy consultation should ideally be done at least 30 days before a scheduled prostatectomy. This ensures that there is enough time for the pelvic floor muscles to start adapting to the “new normal” after the operation. 30 Days is how long it has shown for optimal motor learning to take place of the male pelvic floor. What if I didn't have my pre-operative session? You may start your rehab once your catheter has been removed. Book a consultation with your pelvic Physiotherapist for the day after your catheter removal. Will I be negatively affected if I don't start exercising my pelvic floor 30 days before my surgery? There is a lot of hard work that goes into a strong and healthy pelvic floor. In the long term, you will not be negatively affected, you may just take longer to regain your continence.

Post-Op Prostatectomy

What does Post prostatectomy Physiotherapy entail? An in-depth Assessment A pelvic floor assessment with real-time ultrasound A tailored pelvic floor exercise program Incontinence specific rehabilitation Sexual Dysfunction specific rehabilitation When do I start My Post Prostatectomy Rehab? Once your catheter has been removed, it is safe for you to start your rehabilitation. How long do I need to do post-prostatectomy rehab for? You need to keep doing your rehab intensively until you are completely dry (continent) and you have regained a normal urination pattern. You also need to aim to regain as much sexual function as possible. I advise all my patients to adopt a pelvic exercise program for life, as men tend to lose pelvic floor strength and control as they get older. How long do I need to consult a pelvic Physiotherapist for? Ideally one pre-operative consultation Ideally, a consultation after the catheter has been removed The follow-ups depend on each patient copes with the rehabilitation, but may each be a few weeks apart

Post Radiation

Pelvic Physiotherapy after radiotherapy is sadly not as mainstream as post prostatectomy physiotherapy. The reason for this is that the side effects are delayed, and mainly only start creeping up on patients between 2-5 years after their treatment. What are the Side effects of Radiation Therapy? The 3 main side effects are Incontinence (Urge/Frequency) , sexual dysfunction and related musculoskeletal pain in the pelvis What does Post Radiotherapy Physiotherapy entail? An in-depth Assessment A pelvic floor assessment with real-time ultrasound A tailored pelvic floor exercise program Incontinence specific rehabilitation Sexual Dysfunction specific rehabilitation Musculoskeletal Treatment for Pelvic Pain

Pelvic Floor Rehabilitation

Incontinence in Men

We treat a variety of different types of incontinence including stress incontinence, Urge Incontinence, Urge Frequency Incontinence and mixed incontinence. The key is that we use our assessment methods to determine the type of incontinence a patient may present with. What Is Male Stress Incontinence? Stress incontinence occurs when the pressure applied onto the bladder is so that it forces the bladder closure mechanisms to temporarily fail, and then urine leaks out of the bladder and urethra. These pressures could be due to a cough, a sneeze, jumping running, or a structural change to the pelvic floor muscles such as a Prostatectomy. What is Male Urgency, Frequency? Urgency, Frequency is when a man has an abnormal urge to urinate more frequently than normally. There is a sense of urgency to be able to reach a toilet, and the normal bladder patterns and routine is affected. What is Male Urge Incontinence? Urge incontinence is when a man has a strong urge to urinate and cannot defer it and then is unable to make it to the toilet on time therefore leaks. What is Post-op Incontinence (TURP)? A postoperative complication due to trauma in and around the urethra, leading to temporary/intermittent incontinence.

Sexual Dysfunction in Men

Sexual dysfunction and more specifically Erectile dysfunction in Men is common, but largely left untreated as it is such a taboo subject. What Causes Sexual Dysfunction? Pain, pelvic floor dysfunction, radiation therapy to the prostate and surround, surgery to the pelvis and prostate to name a few. What are the common Sexual Dysfunction Conditions we treat? Orgasmic Dysfunction Ejaculatory Pain Abnormal Penile Curvatures Penile Length Shortening Issues Incontinence during Sexual Stimulation Climacturia or Orgasm Associated Incontinence Penile and Scrotal Pain

Male Pelvic Pain

What is Pelvic Pain? Pelvic Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage,or described in terms of such damage. By its very nature, pelvic pain syndromes, (specifically urogenital syndromes) are more than a physical phenomenon. Rather, they represent a complex physical, emotional, sexual, and interpersonal combination associated with negative patient outcomes What areas are common Pelvic Pain areas? – Perineum (63%) – Testicular (48%) – Pubic (42%) – Penis (32%) What are the symptoms of Pelvic Pain? – Urinary Pain/Frequency – Rectal pain post bowel movement/constipation/golf ball in rectum – Perineal symptoms (sitting on a block of wood) – Ejaculation pain What Can Cause Pelvic Pain? – Bladder and Urethra (interstitial cystitis) – Prostate (chronic prostatitis) – Penis – Testicles – Pelvic Bones (SIJ dysfunction etc.) – Pelvic Floor Muscles (just like any muscle) – Nerves in Pelvis (pudendal neuralgia) – Digestive System (Constipation)