Incontinence and pelvic floor dysfunction are impacting younger men more than ever before while traditionally, it was older men with an enlarged prostate who were the patients seeking care. The reason is the sedentary lifestyle that is putting us more at a disconnect with the design of our body than anything else. Age blaming is no longer an excuse!

Unfortunately, incontinence is looked at as if it is all by itself whereas it is one of the many forms of pelvic floor dysfunction which is seen both in men and women. To treat male incontinence, we need to understand pelvic floor dysfunction better.

What is the Pelvic Floor? 

Yes, men have a pelvic floor too. Pelvic floor muscles are more than the perineum, the space between the penis and anus. Pelvic floor muscles line the whole inside of your pelvic inlet which is the inside part of your pelvis.

men pelvic floor dysfunction

What Influences Male Incontinence?

Pelvic floor muscles are heavily influenced by walking, sexual intercourse, breathing, and posture. The pelvic floor is influenced by all body parts that are connected to the pelvis itself. Your hips, the sacroiliac joints in the back, and pubic symphysis in the front (where the pubic bone is), the lower back, the lower portion of the mid-back, all the way down to the connective tissues (the white portions of the diagram below that are not a part of the muscles) all impact the integrity of the pelvic floor. 

male pelvic floor dysfunction

The internal organs: bladder, prostate, lower intestines, and bulbourethral glands, sit in the ‘bowl’ and impact the pelvic floor. The more enlarged or compressed they are, the more pressure they exert on the muscles of the perineum, and the less mobility will be in the joints of the pelvis. An enlarged prostate can add more weight than the floor is able to handle. Over a course of time, coupled with a pelvic tilt (due to poor posture) and gravity, may lead to symptoms such as pain with urination, incontinence, lower back, and/or SI joint pain.

Our sedentary lifestyle encourages a forward flexion posture which front-loads our spine and its connection to the pelvis in most cases. The center of gravity shifts from the ideal position along the plumb line to that of a forward or backward placement. This also negatively impacts the brain and its command for upright-against-gravity which now decreases the chances of postural improvement. This is explained fully as Postural Neurology.

Our work posture is another factor; for instance, a carpenter or a roofer, wearing a tool belt is more inclined to have a tilted pelvis which means tilted pelvic diaphragm. The pelvic diaphragm is different than the pelvic floor but the two are a part of the same ‘story’.

Our breathing is a heavy influence on pelvic floor dysfunction and incontinence in men. We are not talking about any breathing! Clearly, you are breathing or you would not have been alive! I am talking about the type of breathing that we all innately did as babies. That means that we are programmed to breathe  a certain way but lose that for reasons I won’t discuss here in this blog. Proper biological breathing involves breathing in and out through the nose and not the mouth; it involves the abdominal and pelvic diaphragms and it requires creating a ‘barrel’ that is nice and strong just as it once was!

A dysfunctional pelvic diaphragm means a dysfunctional floor and its associated signs and symptoms.

The pelvic floor and bladder are innervated by nerves that exit the lower back and sacrum. The health of these nerves at the point of exit, along its way, and how they are connected to the pelvic muscles and bladder plays a role. Any interference to these nerves functions leads to malfunctions such as incontinence.

Now that you understand incontinence is a manifestation of pelvic floor dysfunction, watch this video to see how in our office, we use Emsella Chair to address the weakness in the pelvic floor as PART of the treatment of pelvic floor dysfunction.

Incontinence Treatment in Men?

You have seen a urogynecologist, have tried different medications, perhaps even used an external device with an attached catheter that you manually insert through your penis to address your incontinence. You may have resorted to wearing adult diapers, pads, or leak-proof underwear. Stop blaming the age and don’t give up.

After a thorough evaluation of your posture and movement patterns involving your lower back, sacroiliac joints, hips, and lower part of your mid-back, your breathing status, and quality of your musculature involvement, looking at the history of previous injuries, and what you have done to address them, your level of dysfunction is determined.

No matter what causes your incontinence, I treat all presentations of pelvic floor dysfunction the same. A combination of, Postural Neurology exercises, neurokinesiology exercises, Emsella Chair Kegel’s (400 Kegel’s per minute), proper Biological breathing treatment, lifestyle habit modification discussion, nutritional focus on muscular recovery, evaluation of medication, and possible collaboration with your prescribing physician for elimination or modification, are all done to effectively address not only the cause of incontinence and pelvic floor dysfunction but the FEEDERS of the cause as well.

I understand how frustrating it is to feel hopeless and to think that you have to live with incontinence and my many years of working with patients in physical medicine, getting my expertise in Postural Neurology and Neurokinesiology combined with the latest and the best technology in the field, I have been able to help many with pelvic floor dysfunction and incontinence as its presentation. If you are ready to take action, contact my office.