Urinary incontinence, which is the involuntary leakage of urine, is an issue that affects many men.
It is often caused by:
- Prostate issues, including post-prostatectomy
- Neurological conditions such as a stroke or spinal cord injury
- And other conditions that damage the muscles and nerves involved in bladder control.
Unfortunately, as it is considered to be a private and sensitive issue, a lot of these cases can go untreated. Did you know, however, that physiotherapy plays a pivotal role in managing urinary incontinence?
Physiotherapists understand the sensitive nature of this condition, and through respectful care, they can provide techniques that put you back in control of your bladder and regain confidence.
Let’s explore how.
Pelvic floor muscles
To understand how physiotherapy can help with urinary incontinence, we need to know what the pelvic floor muscles are and their role in urination. In men, the pelvic floor is a group of muscles that support the bladder, bowel and prostrate, located in between the pubic bone and tail bone.
Now imagine the male urethra, the tube that passes urine from the bladder and out of the body, as a hose. In order to turn off the hose, the pelvic floor muscles, which form a horseshoe shape around the urethra, contract, kinking it and preventing the tap from leaking. When the pelvic floor muscles are dysfunctional, they are unable to close off the tap fully which leads to the symptoms of urinary incontinence.
Pelvic floor muscle training (PFMT)
Pelvic floor muscles are like any other muscle in the body. Therefore, the best way to get them stronger is through strength exercises. PFMT are exercises in which the pelvic floor muscles contract and relax to improve muscle strength and endurance. Try to do these exercises early during the day when the muscles are less fatigued and on an empty bladder. Practice these exercises by following the instructions below:
- Start by lying down and breathe normally, keeping your stomach, legs and bottom relaxed.
- Slowly and gently, squeeze your pelvic floor muscles by imagining you are holding in wind and lifting up your testicles from a cold plate underneath.
- Hold this position for 5 seconds. Count aloud to ensure you do not hold your breath.
- Rest and relax your muscles for 5 seconds and repeat for 8 repetitions total. Do this 3 sets daily with a 1-minute rest in between.
PFMT has been proven to be effective in men where studies used pad tests to demonstrate a clinically significant reduction in the amount of urinary leakage after pelvic floor exercises.
Role of Physiotherapy
Firstly, physiotherapists will assess pelvic floor strength, endurance and urinary leakage. This can be done non-invasively and can be measured using questionnaires.
To help you better engage these muscles, physiotherapists will provide education on the structure of the pelvic floor where a better understanding of the pelvic floor will help one to correctly identify and contract the correct muscles.
For those having difficulty with PFMT, physiotherapists can provide a wide array of techniques such as cues, biofeedback and manual guidance to help with these exercises. With the guidance of a physiotherapist, these exercises can be progressed as your muscles improve, helping you return to normal function.
It’s also important to note that PFMT is not the sole treatment for urinary incontinence. Activity modification, bladder training and postural education are also some of the many things, physiotherapists can assist with for treating urinary incontinence.
It is important to remember that urinary incontinence is a very common issue and that there is no shame in seeking help. Physiotherapy has been clinically proven to effectively treat urinary incontinence in men, so if you are experiencing symptoms of urinary incontinence, visiting a physiotherapist is the first step towards effective treatment and regaining control over your body.
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References:
- Dorey, C. (2015). Restoring pelvic floor function in men: review of RCTs https://pubmed.ncbi.nlm.nih.gov/16301945/
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