Pelvic Floor Muscle Weakness in Men: Symptoms, Causes and Treatment
Men also have pelvic floor muscles that surround the urethra, the anus and the base of the penis. These muscles play a role in controlling urine and stools and in sexual function. When the muscles weaken or do not work properly, complaints such as urinary leakage can occur. This article explains the causes, symptoms and treatment options of pelvic floor muscle weakness in men.
The Role of the Pelvic Floor Muscles in Men
In men, the pelvic floor muscles are a group of muscles that extend from the pubic bone to the tailbone. They support the bladder and the bowel, help control urine and stools, and play a part in erection and ejaculation.
Causes of Weakness
- Prostate surgery, especially surgery for prostate cancer
- Ageing
- Excess weight
- A chronic cough (for example due to smoking) and chronic constipation
- Frequent heavy lifting
- Some diseases of the nervous system, and surgery or radiotherapy to the pelvic area
Symptoms
- Urinary leakage when coughing, sneezing or exerting oneself
- Dribbling after passing urine
- A sudden, strong urge to pass urine
- Difficulty holding in wind or stools
- In some people, a contribution to erection problems
These symptoms can have many causes other than the pelvic floor. Erection problems in particular must always be assessed by a doctor, as they can be an early sign of cardiovascular disease, diabetes or hormonal disorders.
Diagnosis
The assessment is usually carried out by a urologist. The complaints are discussed and a physical examination is performed; if necessary, a urine test, a bladder diary (recording how often and how much urine is passed over a few days), an ultrasound and tests that assess urinary function (urodynamics) may be requested. A pelvic floor physiotherapist can also assess the strength of the pelvic floor muscles.
Treatment Options
- Pelvic floor muscle exercises: These are the first-line treatment, especially for urinary leakage after prostate surgery; they are more effective when done with a physiotherapist.
- Biofeedback: It shows on a screen whether the muscles are working correctly, helping the exercises to be done properly.
- Lifestyle changes: Losing weight, preventing constipation, reducing alcohol and caffeine, and stopping smoking can reduce the complaints.
- Medication: For some urinary and erection problems the doctor may recommend medication; medicines should only be used on a doctor's advice.
- Surgery: For severe urinary leakage that continues despite other treatments, a urologist may consider surgical options.
There are also chair-type devices that work the pelvic floor muscles with electromagnetic stimulation; the evidence on the effectiveness of these methods is limited, and they do not replace exercise and physiotherapy.
How Do Men Do Pelvic Floor Exercises?
To find the pelvic floor muscles, you can try squeezing and lifting them inwards and upwards as if you were trying to hold in wind or slow the flow of urine; at the same time you may feel the base of the penis being drawn in slightly. The muscles are held for a few seconds and then relaxed for the same length of time; the abdominal, buttock and thigh muscles should stay relaxed and you should not hold your breath. For detailed instructions you can read our article Pelvic Floor Muscle Exercises (Kegel): How to Do Them and Who They Are For.
When Should a Doctor Be Consulted?
A doctor should be consulted if urinary leakage affects daily life, or if there is blood in the urine, pain or burning when passing urine, inability to hold in stools or erection problems. Being unable to pass urine and seeing blood in the urine are situations that need to be assessed without delay.
Author: Op. Dr. Yücel Sarıaltın