Male Pelvic Floor Dysfunction - How To Know If PT Is Right For You
Many men come to The Pelvic Model with urinary symptoms. It is common for them to go to urologists first to find answers, and subsequently be given a round or multiple rounds of antibiotics with minimal to no relief. Here we will talk about chronic pelvic pain syndrome (CPPS) and non-bacterial prostatitis as it relates to pelvic floor physical therapy.
What is Nonbacterial Prostatitis/CP/CPPS?
The National Institute of Health (NIH) notes that chronic prostatitis/CPPS is category III in regards to prostatitis, and this category does not have a clear bacterial etiology. Further, the term ‘prostatitis’ may be a misnomer because other anatomical structures are at play and not the prostate. For instance, the pelvic floor can create prostate-like symptoms.
It is noted in journal articles that CP and/or CPPS actually make up the vast majority of cases of prostatitis (>90%). (Pause) Let me say that again. A VAST, greater than 90% majority of those who have prostatitis is actually CP/CPPS/non-bacterial prostatitis. So what do these penis owners experience?
Pain in the pelvic floor
Pain in the testicular region
Pain in the penis region
Pain in the perineum (area between genitals and rectum)
Pain with urination
Pain with or after ejaculation
“Golf ball in rectum” sensation
Pain with sitting
Poor urinary flow
These symptoms can be severe enough to give a highly negative impact on someone’s life, as you can imagine. The pain can be confusing due to the amount of antibiotics being prescribed with no relief of symptoms. The discomfort that it causes can be relentless as well causing many of these patients to go into a spiral. However, because CP/CPPS is not an infection, we should be looking at other options for treatment that are not antibiotics.
NIH currently recognises that this condition is more accurately diagnosed as not “prostatitis,” but pelvic floor dysfunction. Because the symptoms are confusing and can cause patients to spiral, anxiety related to this condition can further cause muscle guarding of the pelvic floor muscles, and now the patient has entered a negative feedback loop.
What is Interstitial Cystitis?
Many of these people have also been diagnosed with Interstitial Cystitis (IC), and they display much of the symptoms up above. For more information in interstitial cystitis click here. Currently, the American Urological Association (AUA) has pelvic floor physical therapy as grade A evidence in treating interstitial cystitis.
Obviously, when a person with male anatomy experiences these symptoms, they first stop at the urology office. What does that visit look like?
Those who are experiencing these symptoms most likely will undergo a urine sample. Here, the doctor is analyzing the urine to determine if there is an infection. The person experiencing these symptoms may have PSA (prostate specific antigen) tested. This is a protein found in the prostate, and this is usually screened to rule in/out prostate cancer. Your doctor may also order blood samples to rule in/out further infections. The final test a urologist may perform is called the 4-glass test, which is the standard method of assessing inflammation and/or bacteria in the lower urinary tract for those who are experiencing CPPS. However, most urologists do not perform this test because it takes a long time and is difficult to perform. Therefore, some urologists may just opt to give antibiotics sans test.
What happens when tests come back negative?
First, if all theses are coming out negative, this means that you do not need to take antibiotics because antibiotics are for infections. Further, it is now time to scope out your area for a pelvic floor physical therapist. There are many websites like pelvic guru https://pelvicguru.com/directory/ and pelvic rehab https://pelvicrehab.com/ that have directories to find yourself a pelvic PT. The tough part is that not all pelvic floor physical therapists treat those with male anatomy. Surely, on their sites, you can toggle it to see which therapists near you are able to help you out.
Here at Pelvic Model, all therapists are fortunately trained to treat men and those with male anatomy. We understand the nuances in urinary dysfunction and pelvic floor dysfunction, and we can help guide your journey to healing. If you are interested in learning more or scheduling an appointment with us, call us at (323) 403-0234 or click here to schedule an appointment. Further, click here for more information on male pelvic floor dysfunction.
