Pelvic Floor Muscle Training for Men

WHAT ARE THE PELVIC FLOOR MUSCLES?

The floor of the pelvis is made up of layers of muscles and other tissues. These layers stretch like a hammock from the tailbone at the back, to the pubic bone at the front.

A man’s pelvic floor muscles support his bladder and bowel (colon). The urethra (urine tube) and the anus (back passage) pass through the pelvic floor muscles. Pelvic floor muscles help control the bladder and bowel. They may also help with sexual function.

It is vital to keep pelvic floor muscles strong.

SHOULD I DO PELVIC FLOOR MUSCLE TRAINING?

Do you have stress incontinence?

Men who wet themselves when they cough, sneeze or are active have stress incontinence. They may find pelvic floor muscle training improves this problem.

Do you have an overactive bladder with urgency?

Men who have an urgent need to pass urine more often may have an overactive bladder. This symptom is called urgency. When men leak with this urgency, it is called urge incontinence. Pelvic floor muscle training can help with these problems.

Do you have poor bowel control?

Men who have problems with bowel control may find pelvic floor muscle training helpful. It can help strengthen the muscles that close the anus (back passage). These muscles are part of the pelvic floor muscles.

Men of all ages need to have strong pelvic floor muscles.

Pelvic floor muscles can be made weaker by:

• constipation
• being overweight
• heavy lifting including lifting weights at the gym
• coughing that goes on for a long time such as with asthma, bronchitis or a chronic cough
• surgery for bladder and bowel problems.

WHERE ARE MY PELVIC FLOOR MUSCLES?

The first thing to do is to find out which muscles you need to train. Here are four things you can try:

1. Try to stop the stream of urine when standing at the toilet to empty your bladder. Then start your stream again. You can do this to learn which muscles are the right ones to use — but do this only once a week. Your bladder may not empty the way it should if you stop and start your stream too often. You need active pelvic floor muscles to be able to stop your urine flow.
2. Sit or lie down with the muscles of your thighs, stomach and buttocks relaxed.
3. Squeeze the ring of muscle around the anus (back passage) as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks.
4. Stand in front of a mirror with no clothes on. Pull in your pelvic floor muscles strongly and hold them. You should see the penis draw in. Your scrotum should lift up.

Your doctor, continence physiotherapist or continence nurse advisor will help you to get your pelvic floor muscles working the right way. Ask them for help if you:

• don’t feel a distinct ‘squeeze and lift’ of your pelvic floor muscles
• can’t stop your stream of urine
• do not see any lift of your scrotum and penis.

All men can benefit from pelvic floor muscle training. Training gives you better control of your pelvic floor muscles. This helps improve bladder and bowel control.

HOW DO I DO PELVIC FLOOR MUSCLE TRAINING?

Now that you can feel the muscles working, you can:

• use your muscles to pull your scrotum upwards
• squeeze and draw in the muscles around your urethra (urine tube) and anus (back passage) at the same time. Lift your scrotum up. You should have a sense of lift each time you squeeze your pelvic floor muscles. Try to hold the muscles strongly and tightly for as long as you can. Then let them go. Relax and rest for a few seconds. You should have a distinct feeling of letting go
• repeat the squeeze and lift and letting go. It is best to rest for about eight seconds in between each squeeze of the muscles. Try to hold for about eight seconds. If you can’t hold for eight, just hold for as long as you can
• repeat this squeeze and lift as many times as you can. Try to aim for between eight to twelve squeezes
• aim to do three sets of eight to twelve squeezes each, with a rest in between. A training program is three sets of up to eight to twelve squeezes
• do this whole training program every day. Try sets while lying down, sitting or standing.

Use your pelvic floor muscles as part of your daily routine. You can brace your pelvic floor muscles to avoid leaking. This is called ‘the knack’. Try to brace your pelvic floor muscles before you do physical tasks such as lifting things, swinging your golf club, or digging in the garden. Brace your pelvic floor muscles before doing anything likely to make you leak.

While doing pelvic floor muscle training:

• do not hold your breath
• only squeeze and lift
• do not tighten your buttocks
• do not use your tummy muscles.

DO YOUR PELVIC FLOOR MUSCLE TRAINING THE RIGHT WAY

Fewer strong squeezes are better than a lot of half-hearted ones. If you are not sure that you are doing the squeezes right, seek help. Ask for help from your continence physiotherapist or continence nurse advisor. Seek help if you do not see a change in your symptoms after three months.

MAKE THE TRAINING PART OF YOUR DAILY LIFE

Once you learn how to do pelvic floor muscle squeezes do them often. Every day is best. Give each set of squeezes your full focus. Make a regular time to do your pelvic floor muscle squeezes. This might be after going to the toilet, when having a drink or when lying in bed.

Other things you can do to help your pelvic floor muscles:

• Use ‘the knack’. This is when you brace your pelvic floor muscles by squeezing up and holding each time before you cough, sneeze or lift anything.
• Always share the lifting of heavy loads. Take care lifting weights at the gym.
• Eat two pieces of fruit and five serves of vegetables daily.
• Drink fluid every day. Fluid is everything you drink. Fluid includes milk, juice and soup. The best fluid to drink is water.
• Avoid constipation.
• Don’t strain when using your bowels or emptying your bladder.
• If you have hay fever, asthma or bronchitis see your doctor. Your doctor may help to ease sneezing and coughing.
• Keep your weight within the right range for your height and age.

SEEK HELP

You are not alone. Poor bladder and bowel control can be cured or better managed with the right treatment. If you do nothing, it might get worse.

Phone expert advisors on the National Continence Helpline for free:

• advice
• resources
• information about local services.

1800 33 00 66* (8am–8pm Monday to Friday AEST)

To arrange for an interpreter through the Translating and Interpreting Service (TIS National), phone 13 14 50 Monday to Friday and ask for the National Continence Helpline. Information in other languages is also available from continence.org.au/other-languages

For more information: continence.org.au, pelvicfloorfirst.org.au, health.gov.au/bladder-bowel

* Calls from mobiles are charged at applicable rates