Hope and Healing for Male Pelvic Pain, Incontinence and Pelvic Dysfunction
Contrary to popular belief, pelvic floor dysfunctions are not limited to females.
The physical therapists at Sarton Physical Therapy have extensive training in both female and male pelvic floor dysfunctions and routinely treat males who have pelvic floor dysfunction.
Read one man's transformation at Sarton Physical Therapy
"I am 95% pain free, off of the Vicodin, back to gardening and ready to surf this summer."
By a strange chain of events my wife ended up at a hand therapist’s office because of a broken finger. My wife mentioned that I was schedule to have surgery and the therapist mentioned Sarton Physical Therapy. I made an appointment and met with Julie Sarton. To make a long story shorter I have been visiting the clinic for 5 months. I am 95% pain free, off of the Vicodin, back to gardening and ready to surf this summer. Julie and the therapists at Sarton Physical Therapy have saved me from another surgery, from the side effects of pain medications and given me my life back. I can’t say enough about the wonderful therapists and staff at Sarton.
My family doctor and my new urologist were both amazed by the results from treatment at Sarton. The pelvic floor and its importance to good health does not seem to be a topic of much importance in medical school.
San Clemente, CA
Common Dysfunctions Successfully Treated in Males with Pelvic Floor Dysfunction
Pelvic Pain and Sexual Pain Dysfunctions
- Pelvic floor tension myalgia/ pelvic floor muscle spasm
- Chronic pelvic pain syndrome
- Chronic Prostatitis
- Pudendal neuralgia
- Pain with ejaculation or erection
- Testicular, scrotal, penile, or groin pain
- Coccyx or tailbone pain
- Pubic symphysis pain
- Lumbosacral strain
- Abdominal wall hernia
- Piriformis syndrome
- Low back, hip, groin, or pelvic pain that have not responded to conventional physical therapy
Bowel and/or Bladder Dysfunctions
- Interstitial cystitis
- Urinary urgency and/or frequency
- Urinary retention or incomplete emptying
- Urinary incontinence
- Fecal incontinence
- Chronic Constipation/Outlet dysfunction
Post-Surgical Pain or Dysfunction
- Post-prostatectomy urinary incontinence
- Adhesions / scar tissue after urologic, intestinal, or cancer-related surgeries
Some prostatitis syndromes are also characterized by pelvic floor muscle spasm and can lead to pain and urinary symptoms.
Urinary urgency and/or frequency: increased daytime voiding of greater than 5-8x/day with small volume of urine output or increased nighttime voiding of greater than 1x/night disturbing sleep.
Urinary retention or incomplete emptying: inability to fully empty bladder despite urge to urinate, slow stream, and may also be accompanied by urinary hesitancy.
Urinary incontinence: involuntary loss of urine.
Fecal incontinence: involuntary loss of feces.
Chronic Constipation/Outlet dysfunction: any decrease in normal (specific to the patient)bowel movement frequency or inability to evacuate with the urge to have a bowel movement. Chronic constipation is also usually accompanied by straining to have a bowel movement with increased bloating and gas as a result from a non-relaxing pelvic floor muscle group.
Low back, hip, groin, or pelvic pain that has not responded to conventional physical therapy: if you have undergone extensive conventional physical therapy without results, and your pain and symptoms are accompanied by any other pelvic floor related diagnosis (i.e. urinary urgency, coccyx/tailbone pain, etc.) you may benefit from a pelvic floor physical therapy assessment to rule in or out pelvic floor muscle spasm as a contributing factor to your pain and symptoms.
Male Pelvic Pain/ Chronic Prostatitis
Pudendal Neuropathy/ Neuralgia
With the help of Julie Sarton as well as Dr. Jerome Weiss I came to understand that my symptoms were a form of pudendal neuralgia, likely caused by a combination of factors, including a history of intense involvement in athletics and cycling as well as long hours on the computer for professional writing and research. I also came to understand that, unlike other injuries I had experienced, nerves are complex and take a long time to heal. This was not going to improve with a few weeks or even months of medication, therapy, and rest. It was going to be a long journey requiring patience, persistence, and commitment over a period of years.
It’s now been almost two years since the initial onset of symptoms and over 18 months since I began a consistent and diligent treatment plan with Julie.... I have increased my sitting tolerance from 5 minutes to 90 minutes and have made numerous lifestyle adjustments which have allowed me to maintain a sense of normalcy in my daily work and activities.
Among the many things I have learned from Julie, perhaps the most important has been to accept and even embrace the process. I’ve learned to make pudendal neuralgia my hobby—to study it, be fascinated by it, and to learn as much as I can about my body and how it’s responding to various treatments. I tracked my condition and progress with three different tools: (1) a simple journal with 2-3 entries per week regarding observations or patterns with my symptoms; (2) a monthly spreadsheet with a daily entry regarding the level of pain tolerance (on a scale of 1-10); and (3) a spreadsheet where I capture data from weekly functional sit tests, timing how long I can sit without symptoms in relationship to the various changes in treatment or other circumstances.
I attribute my progress to a combination of lifestyle adjustments (standing work station, bar-height tables at restaurants, carpooling and lying down in the back seat, swimming instead of running and biking, etc), dietary choices (avoiding lactose which was causing some distension and placing additional pressure on the pelvic floor), physical therapy (weekly appointments for both internal and external work), and independent exercises (skin rolling, perineal massage, deep diaphragmatic breathing, careful stretching). There is no easy answer or quick fix other than the daily commitment to avoid compressing the nerve and reverse the cycle of muscle spasms that is causing this neuropathy. While I can’t predict the road ahead, I’m committed for the long haul and thankful for the knowledge I’m gaining each day to influence my own health and recovery process.
As John Wooden (legendary UCLA basketball coach) writes in one of my favorite quotes: … “When you improve a little each day, eventually big things occur. . . .Not tomorrow, not the next day, but eventually a big gain is made. Don’t look for the big, quick improvement. Seek the small improvement one day at a time. That’s the only way it happens–and when it happens it lasts.”
For any physician who works in this area, the strengthening of the pelvic floor muscles is the answer for a normal life. Ms. Espanola, though tiny displays tremendous strength and sensitivity in this delicate area of our bodies. I strongly recommend your services below to all my doctors and their colleagues. SP
Cyclist's Syndrome is a common term for symptoms of pudendal nerve irritation or pudendal neuralgia. Symptoms can include: pain in “sit bones”, perineum, genitals, and/or anus, pain with sitting/cycling, urinary, bowel, and/or sexual dysfunction, and/or feeling of foreign object in rectum or perineum. Cycling can lead to pudendal nerve irritation by compression (on the horn of the bike seat) and tension (through repetitive hip flexion).
Chronic pelvic pain in men is commonly referred to as Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) and is also known as chronic nonbacterial prostatitis. Men in this category have no known infection, but do have extensive pelvic pain lasting more than 3 months.
Chronic pelvic pain is a complex and debilitating condition affecting up to 8% of men in the United States.
The incidence of Pudendal Neuralgia (estimated by the International Pudendal Neuropathy Association) is 1 in 100,000 of the general population but some sources report up to 4% of the population. More women affected than men (7:3), but most health care practitioners that regularly treat patients with pudendal neuralgia believe the actual incidence is significantly higher than reported in the literature.
When the coccyx is injured from trauma, such as a fall, it can be misaligned or immobile. Due to the fact that pelvic floor muscles attach onto the coccyx, they can also become impaired. Injury to these muscles often causes them to become hypertonic with trigger point presence which can cause pain in and around the coccyx. A pelvic floor physical therapist can successfully treat coccyx pain by releasing the pelvic floor muscle trigger points and then mobilizing the tailbone.