MENS HEALTH 

Men and bladder control 
Difficulties with passing urine are common as men age, often due to benign (non-cancerous) enlargement of the prostate gland. Other causes include medications, an overactive bladder, nerve problems, surgery, bladder outlet restriction and some medical conditions. However these problems are not always confined to older men. Many younger men may experience frequency and urgency of the bladder. 
 
What flow problems can men encounter? 
One in three men over 50 years of age experiences some difficulty in passing water. The way men pass water changes gradually as they get older, so at first they may not notice there is a problem. Typical changes include: 
 
Difficulty or delay in starting to pass water 
A smaller and weaker urinary stream, so it takes longer to pass water than it used to 
After finishing, a bit more urine trickles out 
A feeling of not quite having emptied the bladder 
 
Storage symptoms or overactive bladder symptoms: 
Increased frequency of bladder emptying 
Urgency alone or with urge incontinence (leakage) 
Stress incontinence (leakage) 
 
Increased frequency of bladder emptying: 
This refers to passing urine more often than usual in the daytime, and if there is also a need to get up at night, this is termed nocturia. Contributing factors can include: 
Fluid amount and type 
Cold weather 
Diuretics ('water' pills) 
Overactive bladder 
 
Urgency alone or with urge incontinence: 
This means the urgent desire to empty the bladder, which if not responded to promptly, might lead to leakage of urine before reaching the toilet 
 
Stress incontinence: 
This refers to leakage on coughing, straining or any exertion, and is uncommon in men. 
Spinal injury/ Prostate surgery: Stress incontinence can occur if nerve damage has occurred due to spinal injury, or if the urethral muscles are damaged after a prostate operation. You should discuss this with your doctor and the urologist 
 
Pelvic / Perineal pain 
Pelvic pain in men can be caused by problems with many different structures in the pelvic area. Some of these conditions can occur in both men and women, and others occur exclusively in men. 
 
Myofascial pain syndrome 
Pelvic joint dysfunction 
Coccydynia 
Prostatitis is an inflammation of the prostate gland, often resulting in swelling or pain. Prostatitis can result in four significant symptoms: pain, urination problems, sexual dysfunction, and general health problems, such as feeling tired and depressed. 
 
Post Radical Prostatectomy 
Following Radical Prostate surgery there can problems with regards to bladder control. We will see men prior to their surgery to assess their Pelvic Floor Muscle strength and function and to go through every aspect of the surgery and the impact that it may have on their bladder function. We will then review them post-surgery and assist them back to full function regarding their bladder and pelvic floor muscles strength/function. Katrina works alongside very eminent local Urological Surgeons whom she has worked with for over 15 years. 
 
Erectile Dysfunction 
Not being able to get an erection is called Erectile Dysfunction (ED). It is common and in most cases can be treated. 
Most men will experience an erection problem at least once. This could be due to stress, exhaustion, too much alcohol or simply not feeling like sex. 
Persistent erectile dysfunction (ED) is estimated to affect about 10% of men at any one time. 
Although age itself isn't a cause of erectile dysfunction (ED), the risk nevertheless increases as you get older: 18% of 50—59 year olds have trouble with their erections compared with 7% of 18—29 year olds. 
 
What causes it? 
There are two main causes of ED: physical and psychological. The majority of cases are physical but it is also apparent that many men with ED can quickly start to feel anxious, stressed or depressed. These feelings can easily make the symptoms of ED worse. 
The main physical causes are: 
Diabetes 
Inadequate blood flow 
Regular heavy drinking 
The side-effects of prescribed drugs 
Spinal cord injury 
Prostate gland surgery (or other surgery around the pelvis). 
Chronic Pelvic pain 
Cycling 
 
The main psychological causes of ED are: 
Relationship problems 
Stress and anxiety 
Depression (90% of men affected by depression also have complete or moderate ED) 
 
Physiotherapy Treatment: 
Recent research suggests that pelvic floor exercises are highly effective in helping men who have problems developing and sustaining an erection. 
 
A study from the University of West of England, Bristol, suggests that the exercises can help both men with erectile dysfunction (impotence) and premature ejaculation, and also those who experience 'dribbling' after urinating. 
 
On top of this, experts believe the exercises can also help improve the quality of orgasm – the UK-based Impotence Association says the workout may 'increase awareness of sexual sensations and enhance enjoyment'. 
 
Physiotherapy Treatments available for Men's Health 
Directed pelvic floor muscle retraining 
Bladder training 
Fluid / diet advice for bladder and bowel issues 
Musculoskeletal work for pelvic pain 
Realtime Ultrasound Scanning 
 
Please don't suffer in silence