04 June, Jane Simpson, Continence Nurse -
Recent research by the Urology Foundation found that two-thirds of the British public doesn’t know what the prostate does. This needs to change. Through this article I want to help men understand the relationship between the prostate gland and the pelvic floor better.
The prostate is a small gland about the size of a walnut and it sits just below your bladder and in front of your rectum. Your prostate gland is very close to your pelvic floor muscles.
The male pelvic floor is a hammock of muscle stretching from your tailbone at the back to the pubic bone at the front. It is a very important for your health and wellbeing but it is probably something that you rarely think about until it stops working properly. Your urethra and your anus both pass through your pelvic floor and your pelvic floor works to keep you continent, stop you passing wind at inappropriate times and plays an important part in erectile function and orgasms.
If you are struggling with male incontinence, you are not alone. It can occasionally happen after a TURP or, more commonly, following a radical prostatectomy for prostate cancer. One of the main issues surrounding this is that it is just not talked about. For instance, one of my recent patients once told me:
‘My prostate first made its presence felt during my mid-fifties, when “having a wee” suddenly ceased to be what it was. What had always been a powerful jet dwindled to a mere trickle and three or four effortful tries were needed before my bladder felt empty. Like most men when things go wrong below the belt, I was overcome with squeamish embarrassment and told no one.’
The taboo around this problem needs to end and there is plenty you can do to reverse symptoms of incontinence. But first you need to find your pelvic floor muscles and you can do this in two stages.
Next time you go to have a wee, try to stop the flow of your urine midstream and contract your muscles upward and inwards, squeeze, lift and hold and then let go. Stopping and starting your flow of urine is not good for you, it’s used just as a test so only do it to learn which muscles are the right ones. It can also help to stand naked in front of a mirror and watch the base of your penis; it should appear to be being sucked into your body and your testicles should be moving as though they are contracting up towards your perineum. Then, try to imagine you are controlling an attack of diarrhoea or imagine you are in a lift full of people and you want to pass wind. Try to pull up the muscles around the back passage or anus.
Now you’ve identified your pelvic floor muscles, you can start the rehabilitation process.
Contract your muscles all together, squeeze, lift and hold for the count of five (if you can only contract for two seconds, that’s fine, and build up to ten seconds over time) and then gently let go. Now pause for the count of five. Repeat this until you have done five sets of contractions. You should aim to keep your stomach, thigh and buttock muscles relaxed and try to only use your pelvic floor muscles.
Aim to do this at least twice a day - when cleaning your teeth is a good time as then you will never forget! Doing these exercises regularly is the best way for you to keep in control of your continence.
The Pelvic Floor Bible by Jane Simpson is published by Penguin Life, priced £9.99
Find out more about prostate cancer on our urology health pages.
