Doing pelvic floor muscle exercises should help improve continence problems in men. Exercises should be practiced regularly, and it may take some weeks for the benefit to be seen. See your doctor for a medical check and advice if urinary symptoms do not improve.
The pelvic floor is the layer of muscle stretching from the pubic bone in the front to the tail bone at the back and forming the floor of the pelvis. It is the main support structure for the pelvic organs.
A toned pelvic floor supports the bladder and bowel and helps close off the bladder and bowel outlets to help prevent leakage, with relaxation of the pelvic floor muscles allowing effective bladder and bowel emptying. In addition, a functional pelvic floor may enhance the ability to maintain an erection.
Factors contributing to pelvic floor muscle weakness:
- some types of prostate surgery
- neurological problems
- parkinson's disease
- urinary retention
- persistent straining to empty the bladder or bowel with or without constipation
- persistent heavy lifting
- a chronic cough (from smoking, chronic bronchitis or asthma)
- being overweight
- lack of regular exercise.
Once the pelvic floor muscles become weak, your ability to hold urine and/or wind during physical activity is compromised. Like any other muscle of the body the more you use and exercise them, the better they will function.
The best results will be achieved by seeking help from a physiotherapist (with training in continence) who will design an individual training programme especially suited to you. Pelvic floor exercises may also be useful for people on a bladder training programme.
Pelvic floor training programme
The first step is to correctly identify the muscles. Sit comfortably – your thighs, buttocks and tummy muscles should be relaxed. Lift and squeeze inside as if you are trying to hold back urine, or wind from the back passage.
- If you are unable to feel a definite squeeze and lift action of your pelvic floor, don't worry. Even people with very weak muscles can be taught these exercises.
- If you feel unsure whether you have identified the correct muscles, try to stop your flow when passing urine, then restart it. Only do this to identify the correct muscles to use — this is a test, NOT an exercise.
- If you are unable to feel a definite tighten and lift action in your pelvic floor muscles you should seek professional advice.
At first you may need to perform these exercises while sitting. As the muscles strengthen you can progress to exercise standing up. Like any activity, start with what you can achieve and progress from there. Remember to use your muscles whenever you exert yourself during your daily activities. If you can feel the muscles working, exercise them by:
- Squeezing/tightening and drawing in and up around both your anus (back passage) and urethra (bladder outlet). Lift up inside and try to hold this contraction strongly for as long as you can (1 - 10 seconds). Keep breathing! Now release and relax. You should have a definite feeling of letting go.
- Rest 10 - 20 seconds - repeat Step 1, and remember it is important to rest. If you find it easy to hold, try to hold longer and repeat as many as you are able. Work towards 12 long, strong holds.
- Now try 5 - 10 short, fast and strong contractions.
- do NOT hold your breath
- do NOT push down instead of squeeze and lift
- do NOT pull your tummy in tightly
- do NOT tighten your buttocks and thighs
Try to set aside 5 - 10 minutes in your day for this exercise routine, and remember, quality is important. A few good contractions are more beneficial than many half-hearted ones and good results take time and effort.
Remember to use the muscles when you need them most. That is, always tighten before you cough, sneeze, lift, bend, get up out of a chair, etc.
How do I improve on my exercises?
Increase the length of time and number of holds you do in succession before experiencing muscle fatigue. Work towards 12 long, strong holds. Increase the number of short, fast contractions – always do your maximum number of quality contractions.
You should anticipate that improvement in pelvic floor muscle strength will take 3 - 6 months of regular exercises.
Some helpful hints
- keep your weight within a healthy range for your height and age
- seek medical advice for chronic cough
- develop good bowel habits.
There are health professionals qualified to help you with bladder control problems. Ask your GP for advice or contact the New Zealand Continence Association (Phone 0800 650 659)
How Physio can help Pelvic floor disorders Physiotherapy New Zealand, 2015
Pelvic Floor Muscles - a patients guide Family Doctor NZ, 2015
Pelvic Floor Exercise Guide Physiotherapy NZ
Pelvic Floor Factsheet Physiotherapy NZ