Pelvic Floor Physical Therapy *(male anatomy)

[wwboy]

Hello all. Another question related to the Botox question I posed in another thread...but different enough that I thought it could use its own thread...

Have any of you with male plumbing experimented with pelvic floor physical therapy, specifically for Overactive Bladder? This is something I understand is quite common for people with female anatomy - and perhaps for other problems like stress incontinence. But my primary care doctor suggested I look into it for my current set of issues; and when I talked with the URO about it, he didn’t seem to think he knew of any PTs who worked with males.

I like the idea of this, if I could learn some effective tools, because it isn’t about taking drugs and seems to be a more sustainable long-term approach. The medication I’m taking now has significantly improved my urgency and frequency during the day; but I’m still experiencing night accidents. I’m wondering if this kind of therapy could help throw it over the edge.

Any male-anatomy persons here have any experience with PT? Thanks

[Patrick]

I have had several cycles of pelvic floor physical therapy. When my urologist found evidence that my pelvic floor nerves were not working properly, he sent me for the first cycle. At first it was extremely embarrassing; however, the pain, when it hit, soon took over. If you can surmount the embarrassment, and if you have an accurate idea of what to expect and the limitations of what it can do for you, you are ahead of the game. I see it as another item in the toolkit I need to use to manage my incontinence issues every day.

[JDinVirginia]

wwboy, I have had the PT and do Kegel exercises several times a week, more often when possible. They definitely have helped my pelvic floor. The key is doing them correctly. Many people find this to be difficult unless first coached by a professional. You need to have realistic expectations with regard to the outcome. They will help but the extent varies greatly from one person to the next.

--John

[wwboy]

Thanks for the feedback, I’m going to look more into it.
Interestingly enough, my urologist wasn’t immediately aware of any therapists in our area who work with men - apparently women are far more common candidates for this than men are. I did some hunting on my own to minor success. Part of my trouble is that I live in a rural area, with limited specialized medical resources in the area.

[wwboy]

Just an update. I ended up finding someone in my area who works with men and I have a consult scheduled. I’ve been doing some more reading on this and it appears that there’s some encouraging work and research in this area. As my problems are less severe than some others I’ve read on this board, I’m hopeful it will help me. In particular, I’ve read that for a lot of men, tension and tightness are the culprits - especially for athletes. I exercise quite a lot, run marathons, etc - and I’m now highly suspecting that I might have some problems with tightness or adhesions happening down there that might be to blame. Anyways, I have some hope.

I’ll share more about my experience once I end up having it...but for now I’m feeling curious and optimistic.

One site that had a great deal of articles about pelvic floor health and incontinence in both men and women is here: https://www.pelvicpainrehab.com/ — apparently the main person behind it, Stephanie Predergast (sp?), is quite a leader in the field. Anyways, for what it’s worth, I thought I’d share the update.

[wwboy]

Another update. I had a first visit and honestly I’m not sure this is going to be helpful. I had high hopes - but all this therapist wants to do with me is core strengthening exercises and some very mild massage. I have to be honest that I have little faith it’ll help - feels kind of like an unregulated herbal remedy type of treatment to me. With all do respect to people who are drawn to that type of thing. I just feel like if that kind of thing is so effective, doctors would use it. But anyways, this person is a DPT with training in pelvic floor. So I’m going to try a few appointments. But we shall see.

I guess I’m learning why so few here seemed to have positive things to say.

[JDinVirginia]

wwboy, unfortunately it appears that you did not find the right therapist for your needs. There are very good ones out there. Mine was a Ph.D. physical therapist in a specialty clinic specializing in pelvic disorders for both men and women. You are correct that more women have pelvic disorders than men. Keep looking.

--John

[Patrick]

May I echo JD's recommendation. Along with most other occupations, the quality of physical therapists varies tremendously. But please continue to search. It can offer you a useful tool for coping.

[wwboy]

Hi all, thank you for your replies. Very helpful.

I've gone now to this clinic a half dozen times. The way it works is that the three or four? PTs do pelvic floor work and they kind of see each others patients and share insights and information and ideas with one another. It's an interesting setup. What is nice about it is that scheduling is much more flexible than it might otherwise be. In the few times, I've gone now, I've grown to trust them more...the initial person as well as their colleagues. I'm not sure if I prefer one over the other yet.

One observation I made the last time I went is that the more I talk about these issues w/ professionals...matter-of-factly, casually, calmly, using specific and/or clinical words and descriptions, the less embarrassed about it I feel. That is encouraging. Another observation is that I feel like this therapy might be starting to help. At my last appointment, the therapist spent a lot of time doing muscle release on my lower abdomen and around/near my bladder. Everything has felt very very very tight there for years and I felt very relaxed after she was done. I kind of have a hunch that might have something to do with my issues.

Anyways, one question/concern that I have, that came up I wanted to ask...related to the second observation here ^^^...for those of you who have experience. This kind of therapy is quite personal...I mean, I don't know if anyone but my wife and myself have touched me in these areas. I was horrified at my last appointment when I started to feel like my male genitals were beginning to "respond" to this touch. Her hands never touched my genitals, but they were nearby...as you'd expect for pelvic floor therapy. Here me, there was no arousal; it is not a sexualized environment, I wasn't thinking those things...but my body seemed to be having a mind of its own. Anyways, the last 10-15 minutes of the session, I found myself tensing up a whole bunch and having all this fear and anxiety about it really really responding. I felt like I was 15 years old again. It was kind of awful. I didn't say anything, and neither did the therapist. But I felt very awkward, and almost like I did something wrong, even though I know I didn't... I have no idea if she even noticed, although her hands were very close to that area so I suppose she might've. I certainly was VERY VERY aware and embarrassed.

Have any of you had this experience? what did you do? What should I do? Should I ask the therapist about it? Should I ask about what if it were to happen in the future? Should I ask if there's a way to drape or hold things in place to prevent it? Should I just ignore it?

Thanks for your help.

[wwboy]

May I echo JD's recommendation. Along with most other occupations, the quality of physical therapists varies tremendously. But please continue to search. It can offer you a useful tool for coping.

Do you have any ideas about how to find someone good? I really struggled finding anyone who would work with a male patient at all...I’m in a rural area, so it’s a challenge :/ I’m driving an hour each way as it is to the one i found! Ugh...