Physical Therapy for Chronic Male Pelvic Pain and Erectile Dysfunction
As a pelvic floor physical therapist in Austin, I often find that people are surprised to hear that I treat men, but men are a large part of my patient population. At Sullivan Physical Therapy, a specialized pelvic floor therapy clinic, we regularly see men for chronic pelvic pain issues and erectile dysfunction.
Chronic pelvic pain is defined as pain in the lower abdominal and/or pelvic area lasting more than 6 months. It is a persistent pain and is often associated with negative effects on cognition, behavior, sexual function, and emotion. Non-malignant causes of pelvic pain can include bacterial infection, inflammation, nerve injury (post-surgical, for example), organ dysfunction and musculoskeletal issues. It is often very difficult to point to the one event or condition that started the pain process.
Chronic pelvic pain encompasses a host of symptoms including pain in the perineum with sitting, penile or testicle pain with erection or ejaculation, and pain with bowel movements. Symptoms can also include urinary urgency and frequency. These symptoms can lead to daily difficulty with work, exercise and home responsibilities. They may also experience decreases in erectile function and libido secondary to the pain, fear and anxiety associated with painful erection or ejaculation. Due to their symptoms, many men present to our clinic having been misdiagnosed with prostatitis and having undergone several rounds of antibiotics with little improvement or return of symptoms when finished with medication. In most of these patients medical treatment has been used to address the symptoms, but not the cause of the pain. With pelvic floor physical therapy we address myofascial trigger points and muscle tension in the pelvic floor muscles as well as surrounding abdominal, back, leg and buttock musculature, which are often key contributors to chronic pelvic pain. Imagine having tension and trigger points in your neck and shoulder muscles and how painful that can be. Now imagine that same tension in your pelvic floor muscles. When these muscles are unable to relax appropriately it can cause difficulty and pain with voiding the bladder, bowels and with sexual activity.
Treatment for these issues often includes manual therapy to address muscle tension as well as postural re-training, stretching and instruction in relaxation exercises for key muscle groups.
Erectile dysfunction can be associated with chronic pelvic pain, but in contrast, men may also experience erectile dysfunction with weakness of their pelvic floor muscles. Muscles of the pelvic floor surround the base of the penis internally and with erection they contract to hold the blood there and maintain the erection. Weakness in these muscles can cause difficulty maintaining an erection, and a strengthening program for these pelvic floor muscles may be needed. We may utilize pelvic floor muscle contraction or “Kegel” exercises in combination with biofeedback.
I have seen how physical therapy can help men who have been suffering with chronic pelvic pain and erectile dysfunction. If you are living with these issues, please talk to your doctor about getting a referral to be evaluated by a pelvic floor physical therapist.
Cody McNeely, PT, DPTPhysical Therapist, Sullivan Physical Therapy