Which muscles are involuntarily in action?
Pelvic floor exercises for men
There is often silence about urinary incontinence in men. Targeted pelvic floor training can help bring the uncomfortable loss of urine back under control after prostate surgery or urge incontinence.
What is the pelvic floor?
The pelvic floor is a palm-sized, flat muscle group that closes off the abdominal cavity in three layers downwards. It serves to stabilize and secure the position of the abdominal and reproductive organs and is not visible from the outside. In men, the urethra and anal canal pass through the pelvic floor muscles, which merge into the urethral or intestinal sphincter at these points. The pelvic floor can be trained like any other arbitrarily controllable muscle. The pelvic floor is well trained if there is no involuntary leakage of urine when coughing, laughing and lifting heavy loads.
+++ More on the topic: pelvic floor gymnastics +++
What are the tasks of the pelvic floor?
- Tense (Continence of the bladder and rectum)
- Relax (Urination, bowel movements, sexual intercourse)
- Counter hold reflective (If there is an increase in pressure in the abdomen, e.g. when coughing, sneezing or carrying heavy loads, reflexive countermeasures are necessary to prevent urine leakage.)
Pelvic floor training against urinary incontinence
At the end of the 1940s, pelvic floor training was developed by the US urologist Arnold Kegel to treat patients with urinary incontinence. These reported improved urinary retention, but also - as a positive side effect - improved sensory intensity in the genital area.
A targeted strengthening of the pelvic floor muscles has established itself as a supportive therapy for stress urinary incontinence in men, which can occur after radical prostate surgery for prostate cancer. By tensing and relaxing, the muscles can be strengthened and the problem of involuntary urine leakage can be brought back under control. The goal is to regain full bladder control.
Pelvic floor training for better erectile function
A well-trained pelvic floor also improves erectile function. By strengthening the muscles, the blood outflow from the erectile tissue decreases, which increases the stability and endurance of the erection.
When does pelvic floor training make sense?
- Supportive therapy for urge incontinence (urination training)
- After prostate operations, the pelvic floor may weaken and the urethral sphincter may lose its ability to close completely. Ideally, you should start exercising before prostate surgery and continue training as soon as possible after the operation.
- To improve erectile function
+++ More on the subject: taboo subject incontinence +++
How is the pelvic floor trained?
Exercise once a day for 15 minutes. Correct implementation should be learned under the guidance of a physiotherapist. Later, the exercises can also be incorporated independently into everyday situations (sitting or standing). It takes patience and consistency in pelvic floor training, as it can take a few months for symptoms to improve or for continence to be restored.
Before the exercises
In advance, it is important to know where exactly the pelvic floor muscles are. The perception test (in the supine position with legs up) is only used to find the muscle area to be trained and is not a separate exercise. The pubic-coccyx muscle (Musculus pubococcygeus) is responsible for the closure of the urethra and can be localized by consciously stopping the urine stream. The urinary stream should not be interrupted for training purposes and only very rarely. The area of the penis, testicles and anus contracts a little. The buttocks, thighs and abdominal muscles remain relaxed.
Five exercises for a trained pelvic floor
1.Light tension (lying on your back with your legs straight)
The pelvic floor is tensed for 3–5 seconds so that a slight tension can be felt. Tensing the pelvic floor means lifting it up, as if one were “sucking” the perineum into the pelvis, as if trying to suppress the urge to urinate and defecate. Repetition: 8-10 times
2. Greater tension (lying on your back with your legs straight)
The pelvic floor is now tense for 3–5 seconds so that the tension can be clearly felt. Repetition: 8-10 times
3rd combination exercise (lying on your back with straight legs)
Slight tension - release tension - stronger tension. Repetition: 8-10 times
4. Elevator exercise (lying on your back with your legs straight)
In this exercise it helps to imagine that the lower abdomen is a multi-storey house and the pelvic floor "an elevator". Take the elevator to the first floor by gently tensing the pelvic floor for 3 seconds, followed by more tension for 3 seconds - The lift is now on the second floor. Then the tension is slowly released - with stops in between - and the basic tension is reached again. Repetition: 8-10 times
5. Tensioning the front area of the pelvic floor (while sitting)
During this exercise, the front area of the pelvic floor is tensed more intensely. In addition to tensioning the pelvic floor, an attempt should be made to pull the penis towards the navel for 3–5 seconds. Repetition: 8–10 times
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Dr. Erik Randall Huber, FEBU, FECSM
Nicole Kolisch (2016), Astrid Leitner (2020)
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