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The Male Pelvic Floor (YES, men have them too!)

If you are already feeling slightly puzzled, the answer is YES males do have a pelvic floor! And, where there are muscles, tendons and connective tissue there can be dysfunction. Although pelvic floor dysfunction in males has been found to be less common than that demonstrated in those with female anatomy, secondary to anatomical considerations (shorter urethra), hormonal influence (i.e. estrogen) and bodily functions to include pregnancy and childbirth, it is still prevalent and something that pelvic physical therapy can help address!


So How Common is Pelvic Floor Dysfunction in Males?

Despite the lack of open conversation about it, male pelvic floor dysfunction is a relatively common condition characterized by the impaired function of muscles, nerves, or connective tissues in the pelvic floor. It can lead to various symptoms, including urinary or fecal incontinence, pelvic pain, erectile dysfunction, and difficulty with bowel movements. While precise prevalence rates vary, research suggests that male pelvic floor dysfunction affects a significant number of men, with estimates ranging from 10% to 20% of the male population.


The Anatomy of the Male Pelvic Floor

The male pelvic floor refers to a group of muscles, ligaments, and tissues that support the organs within the pelvis. It plays a crucial role in maintaining urinary, bowel and sexual function. The key structures in the male pelvic floor include the pelvic diaphragm, urogenital diaphragm, and associated muscles.


The pelvic diaphragm is composed of two main muscles: the levator ani and coccygeus muscles. The levator ani is further divided into three parts: pubococcygeus, iliococcygeus, and puborectalis muscles. These muscles form a hammock-like structure that supports the pelvic organs, including the bladder and rectum.


The urogenital diaphragm is situated below the pelvic diaphragm and consists of the external urethral sphincter, which controls urinary continence, and the bulbospongiosus and ischiocavernosus muscles, which surround the base of the penis. These muscles are involved in the control of urination and ejaculation.


Other important structures in the male pelvic floor include the prostate gland, seminal vesicles, and the rectum. The prostate gland is located just below the bladder and surrounds the urethra, contributing to semen production. The seminal vesicles are responsible for producing and storing seminal fluid (i.e. semen). The rectum, on the other hand, is the lower part of the large intestine and aids in the elimination of waste.


Overall, the male pelvic floor is a complex network of muscles and organs that work together to support urinary and sexual function, as well as bowel control. Proper functioning of these structures is essential for overall male health.


Common Dysfunction of the Male Pelvic Floor

  1. Urinary Incontinence: Urinary incontinence in men can occur due to weakened or damaged pelvic floor muscles, commonly caused by prostate surgery and/or surgery of the pelvic and lower abdominal region. Symptoms include involuntary leakage of urine, difficulty controlling bladder function, and frequent urination.

  2. Erectile Dysfunction: Erectile dysfunction (ED) can be related to pelvic floor dysfunction, particularly after prostate surgery. It can result from nerve damage or impaired blood flow to the penis. Symptoms include difficulty achieving or maintaining an erection, reduced sexual desire, and performance anxiety.

  3. Chronic Pelvic Pain Syndrome: This condition involves persistent pain in the pelvic region, often without a clear cause. Pelvic floor muscle tension or spasms can contribute to the pain. Symptoms may include ongoing pelvic pain, discomfort during sexual activity, and/or urinary or bowel problems.

  4. Fecal Incontinence: Fecal incontinence is the inability to control bowel movements, leading to unintentional leakage of stool. It can be caused by weak pelvic floor muscles, nerve damage, or trauma to the anal sphincter. Symptoms include accidental passage of stool, urgency, and difficulty controlling bowel movements.

Note: It's important to consult with a healthcare professional for proper diagnosis and treatment of any pelvic floor dysfunction.


How Do I Know If I Have Pelvic Floor Dysfunction?


Common symptoms of pelvic floor muscle dysfunction in men include urinary incontinence (leakage of urine), frequent urination, difficulty initiating or maintaining urine flow, erectile dysfunction, pain or discomfort in the pelvic region, and bowel dysfunction such as constipation or difficulty with bowel movements.


Pelvic Physical Therapy for Male Pelvic Floor Dysfunction


If you are currently experiencing any of the symptoms as noted above you may benefit from the receival of pelvic physical therapy services! With completion of a subjective and thorough objective examination your pelvic physical therapy specialist will help identify the factors which may be contributing to your persistent symptoms post-surgically and help develop a treatment approach to address these symptoms and help you regain back control of your pelvic health!

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