MENS HEALTH: Male Incontinence - an issue to be talked about

Welcome to Active Physiotherapy Wagga and thanks for taking the time to read our Blog! My name is Matt Lewington and I am one of Active Physiotherapy’s Men’s Health physio’s.

Yes men do suffer from urinary incontinence and in many ways it is more catastrophic than it is for women. BUT… there are strategies that can be used to reduce or stop incontinence and sexual dysfunction. Today’s blog will go through some of the strategies used to help address the incontinence that may occur after prostate surgery.

The male pelvic floor is different from the female pelvic floor in that it doesn't have a portal known as the vagina. The other, and more important, difference is the mechanical advantage created by the longer urethra in men which allows the pelvic floor muscles to sit in a more effective position.

So how do we find our pelvic floor muscles? The following information has been gathered from the Continence Foundation of Australia.

Technique 1: Controlling the flow

When you go to the toilet try stopping the flow of your urine mid flow. If you can do this then you are using the right muscles. BUT… DO NOT DO THIS REPETITIVELY!! This is not an exercise, just a way to identify your pelvic floor muscles. If you have troubles performing this step you may need to see one of our Men’s Health physio’s to retrain your pelvic floor muscles.

Technique 2: Visualisation

Stand in front of a mirror with your clothes off. If you are tightening the right muscles you should see the base of the penis draw inwards and the scrotum lift upwards. Coincidently the rectum will tighten as well but this is not the focus of the exercise.

Getting the right technique

Correct technique is the MOST IMPORTANT when doing pelvic floor exercises. You should feel a ‘’lift & squeeze’’ in your pelvis and you should keep breathing normally with your abdominal muscles relaxed. Once you master the correct technique it's time to progress.

Exercising your pelvic floor muscles

Once you have mastered the correct technique you should aim to hold your contraction for 10 seconds. Once you can achieve this you should aim to complete 10 repetitions, eventually progressing to 3 times daily. Make sure you continue to breathe!! You should start the exercises while lying down, your physiotherapist will then progress you to sitting, standing, walking and other functional activities as you are ready.

Some recent research by the University of Queensland found that “shorten your penis’’ was the best cue for getting correct pelvic floor contraction.

Pre-op pelvic floor exercises:

Due to the  nature of prostate cancer and the urgency to have the prostate removed it is not always possible to see a physiotherapist prior to your operation. If you do however have the time it is hugely beneficial to your post op recovery. Research shows that men who can effectively contract their pelvic floor prior to surgery will regain continence more quickly than men who are unable to contract their pelvic floor preoperatively.

Your Hospital Stay:

If your surgery takes place at Calvary Hospital in Wagga Wagga you will be seen by one of Active Physiotherapy’s physiotherapists during your stay as an inpatient. This helps with continuity of care throughout your treatment, both in and out of hospital.

Post-Op bladder diary:

Keeping this diary will allow you to see how well your bladder is storing after your surgery and will also allow your physiotherapist to identify specific causes of your incontinence (caffeine, alcohol, increased intake, constipation).

Hopefully there are plenty of men out there who have found this blog helpful. If you wish to discuss anything further please feel free to call me on (02) 6925 7734 or email me directly at mail@activephysiowagga.com.au - All consultations and discussions are 100% confidential. I look forward to hearing from you and working with you towards achieving a greater quality of life!