Men’s Health

What is Men’s Health?

Men’s health is a global problem and a new frontier for physiotherapy. It refers to any issues that are related to the male pelvis and the surrounding area and it is not only about the prostate.  Men can develop problems with their bladder, bowel, sexual organs, and pelvic floor muscles too. Some of the common problems that men can experience and seek pelvic floor physiotherapy are:

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Prostate enlargement and cancer

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Pre and post-prostatectomy issues

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Urinary and bowel incontinence
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Overactive bladder
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Postvoid dribbling
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Erectile dysfunction (ED)
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Ejaculatory dysfunction
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Peyronie’s disease
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Chronic pelvic, testicular, and penile pain
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Prostate enlargement and cancer

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Pre and post-prostatectomy issues

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Urinary and bowel incontinence
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Overactive bladder
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Postvoid dribbling
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Erectile dysfunction (ED)
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Ejaculatory dysfunction
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Peyronie’s disease
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Chronic pelvic, testicular, and penile pain

What is Pelvic Floor Physiotherapy?

Pelvic floor physiotherapy for men is a specialized area of physiotherapy that requires post-graduate training in the assessment and treatment of male pelvic floor. We use our advanced physiotherapy skills to find out what is causing the problem and design and deliver a customized plan. We are an essential part of the health care team to improve men’s pelvic and sexual health.

What to expect at your first Pelvic Floor Physiotherapy appointment:

The assessment takes place in a private room and we begin by listening to your story and your current symptoms and functional restrictions. We will ask specific questions that are sensitive in nature but important to know such as:

  • Bladder and bowel health
  • Pain with intercourse or voiding
  • Incontinence (leaking of urine or bowel with movements or laughing/coughing)
  • Sexual health (ability to have erections, pain with orgasm)
  • Stress and anxiety level

After taking a detailed history we perform a physical examination to determine what is causing your pelvic floor dysfunction and that involves looking at your:

  • Posture
  • Breathing pattern
  • Mobility of your spine and hips
  • Pelvic floor muscle tone and strength (this is usually done by a digital rectal exam with your consent)
A detailed treatment plan is designed from the assessment findings and you are educated on what is causing your dysfunction and what you can do about it and types of treatments that can help.

Types of Physiotherapy Treatments for Men’s Health?

  • Pelvic floor muscle strengthening and relaxation exercises
  • Vacuum constriction devices (penile vacuum pump), use of penile clamps
  • Shockwave therapy for ED and Peyronie’s disease
  • Hands-on work on the pelvic floor muscles, low back, and tailbone causing pain and urgency
  • Bladder training
  • Customized exercise program
  • Penile rehabilitation program

What is Erectile Dysfunction (Ed) and how do Pelvic Floor Physiotherapists treat it?

ED is the inability to attain or sustain an erection due to a variety of reasons. One of the common underlying causes is poor blood flow to the penis which can be a result of aging or disease or surgery.

Goal of treatment is to increase penile blood flow and improve pelvic floor muscle strength, and this is achieved by combining the following:

  • Specific pelvic floor muscle exercises to improve erection function
  • Shockwave Therapy
  • Vacuum constriction devices

What exactly is Shockwave Therapy and how does It Improve Ed?

Shockwave therapy is a very successful, non-invasive therapy that uses a handheld device to deliver low -frequency, acoustic shockwaves (not electrical shocks) to the base and shaft of the penis. The shockwaves break down any restrictions in the tissue, stimulate new blood vessels to grow in the area and therefore improve blood flow and quality of erections.

FAQ

Does Shockwave Therapy hurt?
Most men tolerate the treatment very well. The sensation is like “small elastics hitting you”. If the skin is very sensitive, some men choose to put a numbing cream before the treatment.
Who provides the Shockwave treatments?
The treatment is provided by Registered Physiotherapists who have taken extensive postgraduate training in pelvic health and have studied the GainsWave protocol for ED.
How long does each treatment take?
We schedule 30mins appointments and in that time we review and progress your pelvic floor exercises and provide the shockwave treatment. Shockwave treatment is 15 to 20 minutes long.
How many treatments do I need?
This is specific to each patient but generally 6-8 treatments have shown to be effective.
Is a referral required?
A doctor’s note is not needed to see a pelvic floor physiotherapist. However, we do recommend that you see your doctor if you notice any changes to your bladder, bowel, and sexual health.
Will the treatments be covered by my Insurance Company?
Pelvic Health Physiotherapy is eligible for insurance coverage under physiotherapy and we provide direct billing for most insurance companies.
What does research say?
There is high-level research evidence showing that pelvic floor physiotherapy yields good prognosis when utilized prior to prostate surgery and at onset of any bladder and sexual dysfunction.

Recent study published in BMC Urology in 2019 showed that:

A pelvic floor muscle exercise program commenced prior to prostate surgery enhanced post-surgical measures of pelvic floor muscle function, reduced incontinence and improved quality of life.

The Early Use of Vacuum Therapy for Penile Rehabilitation After Radical Prostatectomy: Systematic Review and Meta-Analysis published in American Journal of Men’s Health in 2018 showed that early use of vacuum therapy appears to have excellent therapeutic effect on post radical prostatectomy patients and no serious side effects were identified

Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo controlled study Anne B. Olsen, Marie Persiani, Sidsel Boie, Milad Hanna and Lars Lund published in 2014 in Scandinavian Journal of Urology showed that shockwave therapy does yield positive results in men with ED and further long term studies need to be conducted.

Things that most men wish they knew?
  • That they have a pelvic floor
  • Any change in erectile function may indicate onset of heart disease
  • Physiotherapy is not something men would think of to help their ED. However, specialized pelvic floor physiotherapy focused on the pelvic floor muscles improves erection function
  • Starting pelvic floor muscle exercise program prior to prostate surgery improves incontinence and quality of life
  • Drinking alcohol especially beer can worsen urinary incontinence
  • Regular exercise after prostate cancer diagnosis can lead to lower prostate cancer mortality

Please contact us for more information! Our clinics are located near Oakville Trafalgar Memorial Hospital and near Alderwood Plaza Etobicoke.

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Pelvic Health