Men’s Pelvic Floor Health

Written By georgia allen

Bladder, Bowel, Sexual Function & Pelvic Pain Support

Pelvic floor dysfunction is not just a women’s health issue.

Men can experience pelvic floor problems at any stage of life - including urinary leakage, bladder urgency, pelvic pain, erectile dysfunction, constipation, and post-prostate surgery symptoms.

At Peak Flo Physio, we provide evidence-based pelvic health assessment and treatment tailored specifically to men.

What Is the Male Pelvic Floor?

The pelvic floor is a group of muscles and connective tissues that form a supportive sling at the base of the pelvis.

In men, these muscles support:

  • The bladder

  • The rectum

  • The prostate

  • The urethra

They play an essential role in:

  • Urinary control

  • Bowel continence

  • Sexual function

  • Pelvic stability

  • Core coordination

The pelvic floor must be able to:

  • Contract

  • Relax

  • Lengthen

  • Coordinate with breathing

  • Respond automatically during movement

When this balance is disrupted, symptoms can develop.

Common Men’s Pelvic Floor Conditions

Urinary Incontinence

Men may experience:

  • Leakage after prostate surgery

  • Stress incontinence (leakage with coughing or lifting)

  • Post-void dribble

  • Urinary hesitancy

Pelvic floor rehabilitation is first-line treatment for post-prostatectomy incontinence.

Bladder Urgency & Overactive Bladder

Bladder urgency is the sudden, difficult-to-delay need to urinate.

In men, urgency may be influenced by:

  • Bladder muscle overactivity

  • Pelvic floor tension

  • Post-surgical changes

  • Nervous system overactivity

Many men are told to “strengthen,” but in some cases the pelvic floor is already too tight.

Proper assessment determines whether strengthening or relaxation is appropriate.

Bladder Pain Syndrome (Interstitial Cystitis)

Bladder Pain Syndrome (BPS) involves:

  • Bladder or pelvic pain

  • Urinary urgency

  • Increased frequency

  • Pain that improves after voiding

In men, this condition is often mislabelled as chronic prostatitis.

Pelvic floor overactivity is common in men with bladder pain, and physiotherapy may help reduce muscular guarding and improve bladder tolerance.

Management is multidisciplinary and individualised.

Chronic Pelvic Pain Syndrome (CPPS)

Chronic pelvic pain may present as:

  • Perineal pain

  • Testicular pain

  • Penile pain

  • Tailbone pain

  • Lower abdominal pain

Pelvic floor muscle tension is frequently involved. Treatment may include down-training, breathing strategies, manual therapy, and nervous system regulation.

Erectile Dysfunction & Ejaculatory Concerns

The pelvic floor contributes to:

  • Erectile rigidity

  • Ejaculatory control

  • Blood flow regulation

In some cases, pelvic floor strengthening improves erectile function. In other cases, excessive tension contributes to pain or dysfunction. Assessment guides the correct approach.

Constipation & Bowel Dysfunction

The pelvic floor must relax to allow stool to pass.

If coordination is impaired, men may experience:

  • Straining

  • Incomplete emptying

  • Thin stools

  • Pelvic pressure

Treatment focuses on coordination and mechanics - not just fibre intake.

Is It Weakness or Tightness?

One of the most common misconceptions in men’s pelvic health is that all pelvic floor problems are due to weakness.

In reality, dysfunction may involve:

  • Weakness

  • Tightness

  • Poor coordination

  • Fatigue

  • Delayed timing

  • Nervous system sensitisation

Doing unsupervised Kegels can sometimes worsen symptoms. Professional assessment is essential.

What to Expect at Peak Flo Physio

Your assessment may include:

  • Detailed symptom history

  • Bladder and bowel screening

  • Movement and breathing assessment

  • Pelvic floor muscle evaluation (via abdominal ultrasound primarily)

  • Post-surgical rehabilitation planning

Treatment is tailored to your presentation and goals.

Evidence-Based Treatment May Include

  • Pelvic floor strengthening (when indicated)

  • Pelvic floor relaxation and down-training

  • Manual therapy

  • Bladder retraining

  • Urge suppression strategies

  • Post-prostatectomy rehabilitation

  • Bowel mechanics education

  • Load and exercise modification

  • Nervous system regulation techniques

Treatment is progressive and individualised.

When Should You See a Pelvic Health Physiotherapist?

Seek assessment if you experience:

  • Leakage after prostate surgery

  • Persistent urinary urgency

  • Bladder pain

  • Chronic pelvic pain

  • Erectile dysfunction with pelvic symptoms

  • Ongoing constipation

  • Pain with sitting

It is recommended to see a pelvic floor physio before AND after prostate surgery even if you are asympatomic. Early intervention improves long-term outcomes.

Why Choose Peak Flo Physio?

  • Evidence-based care

  • Individualised treatment plans

  • Experience in male pelvic health

  • Post-prostatectomy rehabilitation support

  • Discreet, professional environment

Men’s pelvic health concerns are common - and treatable.

Frequently Asked Questions

Do men have pelvic floor muscles?

Yes. Men have a complex pelvic floor system that supports bladder, bowel, and sexual function.

Are Kegels always helpful?

Not always. If the pelvic floor is tight or poorly coordinated, strengthening alone may worsen symptoms.

Can pelvic physiotherapy help after prostate surgery?

Yes. Pelvic floor rehabilitation is first-line treatment for post-prostatectomy urinary incontinence.

Is bladder urgency always prostate related?

No. Urgency can be influenced by bladder signalling and pelvic floor tension, not just prostate enlargement.

Book an Appointment

If you are experiencing pelvic floor symptoms, early assessment can make a significant difference.

Book an appointment with Peak Flo Physio to receive personalised, evidence-based care.

georgia allen
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Pelvic Floor Physiotherapy Before and After Prostate Surgery