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Not Just a Female Issue! Common Symptoms, Diagnoses and Treatment for Men

Men often feel alone if they are experiencing pelvic pain/pelvic floor dysfunction. Most of the time, men go to a variety of doctors searching for an answer to their symptoms. Often times, men are passed from one specialist to another (primary care, urology, internists, gastroenterologists, etc), have tests and imaging done, cultures taken and are told, "everything looks normal." This is incredibly frustrating, and while it is a good thing that nothing comes back as abnormal on tests, there is still no explanation for the pelvic pain. With no relief from pain/symptoms, and no answers from healthcare professionals, it is normal to turn to the internet. However, most of the research is focused on women, further leading men to feeling isolated. Furthermore, there are many pelvic health physical therapists who do not have a lot of experience treating males, so finding someone that can help can be difficult. However, guys, know you are not alone and not only are there physical therapists who can help you, you do not have to live with your symptoms forever! Here we will  go over some common symptoms of pelvic floor dysfunction, common diagnoses and how to treat these conditions. How Do I Know if I Have Pelvic Floor Dysfunction?Every person's symptoms are different, but there is some common ground. You may find that your symptoms change during the day or vary in intensity - that is common! If you have any of these listed symptoms, a pelvic health physical therapist may be able to help you. 

Common DiagnosesProstatitis: This is one of the most common diagnoses for men under age 50. It accounts for 2 million healthcare provider visits per year and can affect up to 10-15% of men (for more info). Sometimes, this is caused by a bacterial infection and a course of antibiotics clears up your symptoms. However, with chronic prostatitis, there is no bacterial infection so antibiotics will not help. This is when a pelvic health physical therapist can help. Pudendal Neuralgia:  The pudendal nerve innervates the bottom half of the penis, the perineum, part of the scrotum, some of the pelvic floor muscles and around the anus. The pudendal nerve travels through the pelvic floor muscles and can become irritated if the pelvic floor muscles are very tight. Constant or long term compression of the pudendal nerve, such as incorrect sitting or bicycle riding, can cause pudendal nerve symptoms as well. 

Muscle Tension of the Pelvic Floor:Often times, the pelvic floor muscles get too tight, which prevents you from using them correctly. There are many reasons why the pelvic floor can get tight, which you and your physical therapist will try to determine during the evaluation. Some common reasons are include trauma, surgery, long duration sitting, heavy lifting, sudden increase in activity level, previous infections, scar tissue, and stress. This tightness and poor coordination of the pelvic floor often leads to the symptoms you are experiencing. 

Genitofemoral Neuralgia: This nerve is responsible for providing sensation to the top half of the penis, part of the scrotum, the top of the thigh and groin. If this nerve is irritated it can cause pain in any of these areas. Tight abdominal muscles, back pain, poor mobility of the spine, and trauma to the abdomen can contribute to these symptoms.Complications Post-Prostatectomy: There are several different types of prostatectomies now, however urinary incontinence is very common after this procedure. Up to 75% of men have urinary incontinence 1 year after surgery and up to 50% still suffer from urinary incontinence after 2 years. What Do I Do Now?This is not an exhaustive list of pelvic floor symptoms and diagnoses, however a pelvic health physical therapist should be well-versed in this. Treatment will vary from person to person, but the evaluation process is largely the same in order to determine what needs to be addressed. Refer back to our blog post about what to expect during a pelvic floor assessment to learn about the evaluation process. Once you and your physical therapist determine what is going on, treatment will focus on trying to restore normal function of the pelvic floor. Manual therapy, relaxation, strengthening and coordination techniques will be used to improve the function of your pelvic floor along with the rest of your body. Throughout the treatment, you should understand what is being done and why, and your home program should help to maintain the progress you gain during your session. You are not alone, you are not broken and there are people out there to help you through this!