What is the Pelvic Floor?
The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch from the tail bone at the back to the pubic bone in front. A man’s pelvic floor supports the bladder and the bowel. The urethra (bladder outlet) and the rectum (back passage) pass through the pelvic floor. The pelvic floor muscles play an important role in bladder and bowel control. The pelvic floor is also thought to play a role in maintaining an erection.
How to contract the Pelvic Floor Muscles
The first thing to do is to correctly identify the muscles that need to be exercised.
- Sit comfortably with the muscles of your thighs, buttocks and abdomen relaxed.
- Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea or wind. You should be able to feel the muscle move. Try not to squeeze your buttocks or tighten your thighs or tummy muscles.
- Now imagine you are passing urine, trying to stop the flow mid-stream, then restarting it. Do not try to stop the stream when you are actually passing water as this may, if repeated, cause problems with correct emptying. If your technique is correct, each time that you tighten your pelvic floor muscles you may feel a dip at the base of your penis, and your scrotum move up slightly. If you are unable to feel a definite squeeze and lift action of your pelvic floor muscles, you should seek professional help to get your pelvic floor muscles working correctly .
Even men with very weak pelvic floor muscles can be taught these exercises by a physiotherapist or continence advisor with expertise in this area.
Doing Pelvic Floor Exercises
Now you can find your pelvic floor muscles, here are the exercises to do:
- Your pelvic floor muscles need to have stamina. So sit, stand or lie with your knees slightly apart. Slowly tighten and pull up the pelvic floor muscles as hard as you can. Try lifting and squeezing them as long as you can. Rest for 4 seconds and then repeat the contraction. Build up your strength until you can do 10 slow contractions at a time, holding them for 10 seconds each with rests of 4 seconds in between.
- Your pelvic floor muscles also need to react quickly to sudden stresses from coughing, laughing or exercise that puts pressure on the bladder. So practise some quick contractions, drawing in the pelvic floor and holding it for just one second before relaxing. Try to achieve a strong muscle tightening with up to ten quick contractions in succession.
Aim to do a set of slow contractions (exercise 1) followed by a set of quick contractions (exercise 2) 3-4 times each day. It takes time for exercise to make muscles stronger. You are unlikely to notice any improvement for several weeks – so stick at it! You will need to exercise regularly for at least 3 months before the muscles gain their full strength.
Make the exercises a daily routine
You should start these exercises prior to your surgery, and then recommence them once the catheter is removed.
Once you have learnt how to do these exercises, they should be done regularly. It might be helpful to have at least five regular times during the day for doing the exercises – for example, after going to the toilet, when having a drink, when lying in bed. You need to tighten your pelvic floor muscles also while you are getting up from a chair, coughing or lifting. Some men find that tightening before they do such things, helps them to regain control.
Good results take time. In order to build up your pelvic floor muscles to their maximum strength you will need to work hard at these exercises. You may not notice an improvement for several weeks and you will not reach your maximum performance for a few months. When you have recovered control of your bladder you should continue doing the exercises twice a day for life.
Other tips to help your Pelvic Floor
- Share the lifting of heavy loads.
- Avoid constipation and prevent any straining during a bowel movement.
- Seek medical advice for hay-fever, asthma and bronchitis to reduce sneezing and coughing.
- Keep your weight within the recommended limits
Acknowledgments to the Bladder and Bowel Foundation