Men's Health

At Symmetry Physiotherapy we offer a comprehensive range of services for men including:


Prostate

The Prostate exists only in men and is a gland that surrounds the urethra. It is approximately the size of a walnut and is part of the male reproductive system. This gland can get bigger as men age and therefore create problems with the bladder and urination.

Changes to the Prostate can include:
  • Prostatitis (swelling and soreness of the prostate)
  • Benign Prostatic Hyperplasia (BPH) – Gradual increase in size of the Prostate as men age
  • Prostate Cancer – This is confirmed with a blood test (PSA test) and a Prostate examination.

When the Prostate increases in size, it can cause blocking of the urethra. This in turn causes the bladder to work harder and can result in an overactive bladder, with or without leaking of urine. Other symptoms can include increased frequency of urination, urinating much smaller amounts, dribbling after urination, burning during urination, difficulty commencing urination and feelings of incomplete emptying.

Prostate problems are often treated with surgery. If the Prostate is removed (along with the natural support of the urethra) then urinary incontinence may occur. Damage to the Pelvic Floor Muscles may also occur during surgery, resulting in a weakness to the muscles.

If you are experiencing issues or changes relating to bladder control or habits, contact your local G.P. or physiotherapist for assessment. Physiotherapy can assist in regulating bladder habits, pelvic floor rehabilitation and more. If you require surgical removal of your Prostate gland, physiotherapist driven pelvic floor muscle rehabilitation can provide a foundation for stability and strength to assist in an improved recovery outcome.


Incontinence

The prevalence of urinary incontinence in men is similar to that of women. Stress urinary incontinence and an overactive bladder are the two main conditions faced. Symptoms are generally managed in a similar fashion to that of women, with a focus on pelvic floor muscle rehabilitation, bladder and lifestyle retraining, provision of continence aids and more.

Stress Urinary Incontinence
Stress incontinence is the involuntary leakage of urine or faeces on effort, exertion, or a sneeze or cough and can happen when the pelvic floor muscles are weak. In men, symptoms of stress incontinence can have a rapid onset post surgically and create quality of life and self esteem issues.

Stress incontinence is the most common of the incontinence disorders. The good news is that there is high level research that supports pelvic floor muscle training for treating this condition.

At Symmetry Physiotherapy we offer a range of treatments for helping stress incontinence:
  • Pelvic floor muscle training – There are great benefits pre and post surgically for men
  • Electrical stimulation
  • Fluid intake advice
  • Dietary advice
We have excellent success rates in assisting patients who suffer from stress incontinence

Urge Urinary Incontinence
Urge urinary incontinence is when you experience leakage due to an involuntary contraction of the bladder muscle. Urge incontinence may be a symptom of a condition called overactive bladder.

Treatment for urge incontinence is slightly different than for stress incontinence as the bladder also needs to be retrained.

Sometimes bladder retraining and pelvic floor muscle retraining does not fix or reduce the urgency problem and in these cases medication can assist. Your physiotherapist will liaise with your GP or specialist and discuss the merits of including medication in your management plan.

You can also experience faecal urge incontinence and this is also managed with pelvic floor muscle training and we assist you with dietary and fluid planning to minimize accidents.

For more information visit the Continence Foundation of Australia.

Post Surgery

Post Prostatectomy Incontinence.

Urinary incontinence after the removal of the Prostate gland is common. This is mainly because the intrinsic sphincter of the urethra loses its supports from the Prostate once it has been removed.

Loss of urethral support may be accompanied by an overactive bladder which occurs when the detrusor muscle (surrounding the bladder) becomes highly contractile and gives the sensation of urge with or without leakage. An overactive bladder may develop prior to surgery or may develop post-surgically. Other issues can also include incomplete emptying when the pelvic floor muscles are not strong enough to propel urine through the urethra, causing pooling.

Physiotherapy can assist in retraining your bladder as well as strengthening your pelvic floor muscles to assist in urethral support. Assessment and guidance on a pelvic floor muscle exercise program is recommended prior to surgery so that you can begin to condition your muscles and are familiar on how to use them appropriately.

Post surgically, it is recommended you visit a pelvic floor physiotherapist approximately 2 days after the removal of your catheter. Ideally you should begin the pelvic floor muscle exercise program before the operation, to allow the learning of a correct contraction whilst you are pain free.


Strength and bone density changes

When people age, the body absorbs minerals from bones at a rate faster than they can be replenished. This results in decreased bone mass and density, and increases the risk of a fracture. This is mostly caused by hormonal changes in the aging process, but can also be contributed to by illness, decreased mobility and diet.

For men bone density loss is most pronounced from 60 years old and muscle mass also begins to decline. There is some good news however with specific strength and balance training you can slow the decline and actually increase muscle mass. Weight bearing and resistance exercises can assist in maintaining strength, flexibility, balance and mobility. Our physiotherapists can assist in preparing an exercise program specific to your needs.


Pelvic Floor related sexual dysfunction

The pelvic floor muscles also play an important role in men's sexual dysfunction. Two areas that are commonly affected by poor pelvic floor muscle activation and control are erectile dysfunction and premature ejaculation.

1. Erectile Dysfunction (ED)

Erectile dysfunction prevents adequate rigidity of the penis suitable for sexual intercourse. It is commonly linked to increasing age and other age-related conditions. There are many risk factors that contribute to ED, one of which is weakness of the pelvic floor muscles.

During penile erection, two major pelvic floor muscles are active (the ischicavernosus and bulbocavernosus muscles). These muscles work hard to increase pressure within the penis to help maintain its rigidity. More specifically, the deep dorsal vein on the penis is compressed to prevent outflow of blood. If these muscles are weak or dysfunctional, this can result in compromised rigidity and the inability to maintain an erection.

Pelvic Floor Physiotherapy can assist in assessment and training of the muscles involved during intercourse. However, it is recommended you seek medical assistance to exclude other factors before commencing rehabilitation.

2. Premature ejaculation

The pelvic floor muscles also play a role in the ejaculatory phase of intercourse. Contractions of the bulbocavernosus muscle coordinated with relaxation of the bladder neck and external urinary sphincter allow ejaculation. If the pelvic floor muscles are weak or dysfunctional, this disrupts the physiological coordination and may cause premature ejaculation.

Pelvic Floor Physiotherapy can assist in assessment and training of the muscles involved during intercourse. However, it is recommended you seek medical assistance to exclude other factors before commencing rehabilitation.

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