Factsheet No.

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Pelvic Floor Exercises for Men

Introduction Many men experience a variety of problems with their urinary system, leading to unwanted leakage of urine. Some also have difficulty controlling wind or leakage from the bowels. Often this is due to a weakness of the muscles of the pelvic floor, which have an important function in preventing these troublesome conditions. The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tail bone at the back to the pubic bone in front. A mans pelvic floor supports the bladder and the bowel. The urethra (bladder outlet) and the rectum (back passage) pass through the pelvic floor muscles. 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. Why the Pelvic Floor Muscles get Weak The pelvic floor muscles can be weakened by: Some operations for an enlarged prostate gland Continual straining to empty your bowels, usually due to constipation Persistent heavy lifting A chronic cough, such as smokers cough or chronic bronchitis and asthma Being overweight Lack of general fitness Neurological damage (e.g., after a stroke or spinal injury, or resulting from multiple sclerosis or other conditions) can also produce poor pelvic muscle function. People in this group should seek advice from a healthcare professional. Pelvic Floor Exercises You can improve control of your bladder and bowel by doing exercises to strengthen your pelvic floor muscles. These exercises may also be useful in conjunction with a bladder training programme aimed at improving bladder control in people who
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experience the urgent need to pass urine frequently and may not always make it in time. Bladder training is explained in Continence Foundation factsheet on The Overactive Bladder. How to Contract the Pelvic Floor Muscles The first thing to do is to correctly identify the muscles that need to be exercised. 1. Sit or lie comfortably with muscles of your thighs, buttocks and abdomen relaxed. 2. Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea or wind. Relax it. Practice this movement several times until you are sure you are exercising the correct muscle. Try not to squeeze your buttocks or tighten your thighs or tummy muscles.

3. Imagine you are passing urine, trying to stop the flow mid-stream, then restarting it. (You can do this for real if you wish, but do so only to learn which muscles are the correct ones to use and then do it no more than once a week to check your progress, otherwise it may interfere with normal bladder emptying.) If your technique is correct, each time that you tighten your pelvic floor muscles you may feel the base of your penis move up slightly towards your abdomen.

If you are unable to feel a definite squeeze and lift action of your pelvic floor muscles (or are unable to even slow the stream of urine as described in point 3), you should seek professional help to get your pelvic floor muscles working correctly - see the final section of this factsheet. Even men with very weak pelvic floor muscles can be taught these exercises by a physiotherapist or continence advisor with expertise in this area.

Make the Exercises a Daily Routine Once you have learnt how to do these exercises, they should be done regularly, giving each set your full attention. 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 will wish 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 will probably 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 or bowel 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 right range for your height and age. Seeking Help To achieve your best results you may need to seek help from a physiotherapist or continence advisor. A physiotherapist or a continence advisor trained in the necessary technique may suggest the use of electrotherapy, using a mild electric current to help in stimulate your pelvic floor contractions. It is entirely safe and does not hurt, merely giving a tingling sensation.

Doing Pelvic Floor Exercises Now that you can feel the muscles working, you can start to exercise them: 1. Tighten and draw in strongly the muscles around the anus and the urethra all at once. Lift them up inside. Try and hold this contraction strongly as you count to five, then release slowly and relax for a few seconds. You should have a definite feeling of letting go. 2. Repeat (squeeze and lift) and relax. It is important to rest in between each contraction. If you find it easy to hold the contraction for a count of five, try to hold for longer - up to ten seconds. 3. Repeat this as many times as you are able up to a maximum of 8-10 squeezes. Make each tightening a strong, slow and controlled contraction. 4. Now do five to ten short, fast, but strong contractions, pulling up and immediately letting go. 5. Do this whole exercise routine at least 4-5 times every day. You can do it in a variety of positions - lying, sitting, standing, walking. While doing the exercises: DO NOT hold your breath. DO NOT push down instead of squeezing and lifting up. DO NOT tighten your tummy, buttocks or thighs. Do your exercises well. The quality is important. Fewer good exercises will be more beneficial than many half-hearted ones.

FURTHER HELP If your problems persist despite doing the exercises, you should seek professional help. Contact your doctor or your local continence advisor, whose name and contact details are available from the Continence Foundation Helpline or the website (see next page).
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The Continence Foundation 307 Hatton Square, 16 Baldwins Gardens London EC1N 7RJ Tel: 020 7404 6875 Fax: 020 7404 6876 Email: continence-help@dial.pipex.com Website: www.continence-foundation.org.uk The Foundation has a range of literature that may be of help - see next page. Send an s.a.e. asking for a free copy of the complete publications list. Helpline: 0845 345 0165 Monday - Friday 9.30am - 1.00pm The Helpline nurses offer confidential advice and information on the causes and treatment of difficulty with bladder and bowel control and on products that can help manage it. They can also tell you where to find your local NHS continence advisor (specialist nurse) or check the website. Incontact United House North Road London N7 9DP Tel: 0870 770 3246 Fax: 0870 770 3249 Email: info@incontact.org Website: www.incontact.org A support organisation for people with bladder and bowel control problems.

Other factsheets in this series (each 1):

1: The Confused Incontinent Person at Home 2: Penile Sheaths 3: Washable Pads and Pants 4: Washable Bedpads 5: Advice for Relatives of People in Residential and Nursing Homes 6: Bladder Control after a Prostate Operation 7: Faecal Incontinence and Constipation 8: Controlling Wind and Smells 9: Sphincter Exercises to Aid Bowel Control 10: Skin Care for People with Bowel Problems 11: Your Sphincter Repair Operation 12: The Overactive Bladder 13: What is Urodynamics? 16: Nocturia 17: After-Dribble 18: An Introduction to Bladder Control Problems 19: The Pelvic Floor and Stress Incontinence Send an A5 stamped addressed envelope to the Continence Foundation for copies of any of these leaflets and a complete list of our publications.

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