Male designed pelvic floor anatomy: where and how?
The male pelvic floor is located at the bottom of the pelvis and has three main functions:
- Sexual function – promoting and maintaining an erection and helping with orgasm;
- Continence – helping to prevent leaking of urine and stool. Additionally, the pelvic floor has to be able to voluntarily relax so the bladder can empty;
- Support – supporting the pelvic organs (bladder, prostate and rectum) in the pelvic cavity.
Pelvic floor physiotherapy can have a role in these three functions.
Sexual function problems
An erection is a complex phenomenon that results from the coordination of several body systems such as the neural, endocrine, psychological, neurovascular, immune and muscular systems. A healthy pelvic floor is designed to help the blood flow into the penis and, once this pressure increases to a level when the firmness of the tissues is sufficient, a muscle known as the bulbospongiosus is designed to contract. This phenomenon assures the maintenance of an erection. Moreover, the pelvic floor has a crucial role during ejaculation and orgasm via producing rhythmic contractions and relaxations.
If this harmonious system gets impacted in any way (e.g. a tight pelvic floor), the sensitivity of the tissues, as well as the quality of the erection and orgasm, can be impacted. Common complaints are flaccid erections, early ejaculation and pain during erection and ejaculation or orgasm.
Bowel and anal pain
Although it isn’t widely spoken of, male designed bodies can also have pain in their pelvis. The pelvic floor links the abdomen to the lower back, the pelvic bones and the hips. It works like a bowl for the organs above it and can also have an impact on your bowel function.
The pelvic floor is originally designed to relax during defecation. The posture we adopt as well as the way we help the stools to move through the rectum during defecation are crucial for a healthy bowel function. Common complaints from patients with poor pelvic floor coordination are pain before, during and after defecation and a history of repeated hemorrhoids and anal fissures. Pelvic floor physiotherapists can help improve defecation dynamics.
Pain in the base of the penis or anus while sitting is also a common complaint. A change in the curvature of the penis (Peyronie’s disease) can also be a source of penile pain. Pelvic floor physiotherapy has been shown to have a role in helping to decrease the pain levels and improve penile curvature.
Continence
A healthy pelvic floor muscle is one that can voluntarily relax, allowing for complete emptying of the bladder, urethra and bowel. When the pelvic floor muscles voluntary contract, they prevent leaking of urine and stools.
The pelvic floor can be impacted by many conditions, as well ageing. A pelvic floor that is “tighter” can be linked with conditions such as overactive bladder and increased urinary urgency (this is a feeling you may get when you suddenly have to go to the toilet and you aren’t able to defer this feeling). Problems with leaking can also be a result of other pelvic conditions such as constipation.
Common complaints from patients with continence related pelvic floor problems are leaking during activities or after emptying the bladder, a constant or sudden feeling of wanting to empty the bladder, difficulties in starting to void, leaking stools and smearing underwear.
Pelvic floor physiotherapy for during and after prostate/urologic cancer treatment
Prostate and bladder cancer treatment can have a great impact on pelvic health. Pelvic floor physiotherapy can help prepare for surgery, as well as with the side effects from surgery, radiation, chemotherapy and hormone therapy.
These treatments can have a great impact on continence mechanisms and sexual function. Pelvic floor physiotherapy can help male designed bodies to improve continence and sexual function via pelvic floor strengthening/coordination as well as finding new ways to promote erection and sexual function.
It is important to know that despite having had treatment for cancer, the pelvic floor and the urethra can compensate in the pressure mechanisms that assure your continence and sexual function. Research has shown that pelvic physiotherapy can be highly beneficial for those during and after prostate cancer treatment.
In summary…
Pelvic floor physiotherapy is designed to help everyone who has a pelvic floor regardless of gender, age, sexual orientation and sexual identity. A healthy pelvic floor is designed to work easily and without effort. If you find yourself straining to empty your bladder or bowel, have difficulties with creating or maintaining an erection or if you feel pain during sex or when emptying your bladder or bowel, there is chance that your pelvic floor may be involved. Seeing an Alana Physiotherapist is an excellent step in helping address your pelvic health conditions.