Pelvic floor dysfunction is on the rise and unfortunately is impacting men who are younger than the traditionally known age. We should not allow age to be the excuse for all different things that are declining in our age and start looking at what else puts us at a disadvantage.
At this juncture in my professional life and having been in practice for over 25 years I can comfortably say that blaming age for so many of our issues is simply a cop-out!! I am, therefore, going to spare you what you already know as the supposed associated signs and symptoms, and instead look at the factors that are generally missed in treating pelvic floor dysfunction.
Pelvic floor dysfunction in men is no different than in women when it comes to the concepts behind the cause. It is obvious that men don’t get pregnant BUT they can get weak pelvic floor muscles just like pregnant women may, which then leads to the weakening of the floor of the pelvis.
In order to understand what pelvic floor dysfunction is we need to understand some basic information about the pelvis, pelvic floor, and the influencers of the involved structures.
If you think of your pelvis as a bowl with 2 holes (and their associated sphincters) to the outside (penis and anus), there are muscles that line the inside of the bowl which are the pelvic floor muscles. I will spare you the names but let’s say that there are more than one or two and they are all involved when walking.
What Influences the Pelvic Floor in Men?
The pelvic floor is not suspended in the air and is influenced by all body parts that are connected to the pelvis itself. Your hips, the joints of the pelvis called SI joint or sacroiliac joints, the lower back, the lower portion of the mid-back, as well as the connective tissues connecting the joints to each other and to the pelvis all impact the integrity of the pelvic floor.
The pelvic floor is also influenced by the internal organs that are held in the “bowl”; which are the bladder, prostate, lower intestines, bulbourethral glands, and their size and shape matter.
For instance, an enlarged prostate can add more weight than the floor is able to handle. Over a course of time which 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 lifestyle is another huge influencer of the pelvic floor and contributor to pelvic floor dysfunction. Our sedentary lifestyle dictates forward flexion which compromises our posture, leads to our lack of walking, compresses our internal organs which lead to their enlargement due to inflammation, and then there is gravity that certainly becomes our disadvantage. I have explored and dissected the concept of lifestyle and its influence on the brain and how that influences our movement in detail here.
Our breathing apparatus is another influencer of the pelvic floor and its dysfunction. When the pelvis, lower back, and hips don’t move as they are designed to (due to injuries, habits, and lifestyle for instance), then our posture is compromised and the basic requirement of effective breathing which we are born with is no longer in place. Here is a video of what I am talking about:
Breath is so important in keeping an even load of the internal organs within the pelvic inlet or the ‘bowl’ by engaging the abdominal and pelvic diaphragm properly. A dysfunctional pelvic diaphragm means a dysfunctional floor and its associated signs and symptoms.
Another influencer of the pelvic floor is the nerves exiting the lower back spine and going to not only the internal organs but the muscles of the area including the ones in charge of the sphincters. Anything that compromises those muscles may lead to pelvic floor dysfunction.
Let me tell you, a disc bulge in almost all cases is benign, and not every disc herniation is doomed to end in pelvic floor dysfunction. This, therefore, varies from case to case and is the reason why it is crucial to see a health care practitioner who looks at your presentation with a wide lens.
Pelvic floor dysfunction has to do with the floor and the floor influencers. Watch this video to really understand what is going on:
How to Treat Pelvic Floor Dysfunction in Men?
Chances are high that by the time you are reading this blog, you have already 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 ‘work’ some of the muscles involved in pelvic floor dysfunction. You may have resorted to wearing adult diapers, pads, or leak-proof underwear. You may be thinking your age is catching up, but what if you are not that old? What is old btw?
In my practice, I treat pelvic floor dysfunction; that means not just incontinence (in fact, I don’t treat incontinence per se but our treatment seems to help many with that issue) but all associated subtle and not-so-subtle issues that get missed.
Remember, if you catch a problem at the beginning, it is much easier to fix and prevent further damage. Pelvic floor dysfunction does not need to be a life sentence and with the right approach and right presentation, it will be easily fixed.