Pelvic Floor Exercises for Men

Your GP or healthcare professional has advised you that you would benefit from doing pelvic floor exercises.

This leaflet tells you about your pelvic floor and explains how to do exercises to help strengthen it.

What is the pelvic floor muscle?

The pelvic floor is a made up of layers of muscles, stretching like a hammock from your pubic bone to the bottom of your tailbone (see diagram below). It provides the floor to your pelvis.

These muscles help to hold your bladder and bowel in position. They prevent leakage from your bladder and bowel, only relaxing when your bladder or bowel is emptying.

The pelvic floor muscle controls the openings to the organs which pass through it:

• The urethra (the tube which passes your urine through).

• The anus (the back passage, through which you open your bowels).

Sometimes your pelvic floor can weaken. If this happens you may have some symptoms which include:

• Stress urinary incontinence. This is where you leak urine when you cough, laugh or sneeze.

• A need to go to the toilet more often (referred to as frequency) during the day and night.

• Urge urinary incontinence. This is where you have an urgent need to go to the toilet but do not make it in time.

• An inability to control the passage of wind from your back passage.

Why should I do pelvic floor exercises?

Sometimes we can take our pelvic floor muscles for granted. If we neglect them they can become weaker, causing problems.

Pelvic floor muscles may become weak due to:

• Lack of exercise. The pelvic floor muscles need regular exercise to maintain good muscle tone, just like other muscles in the body. If they are not exercised, they may become stretched, weak and no longer work properly, leading to the symptoms mentioned above.

• Pelvic surgery, such as surgery to reduce your prostate gland.

• Straining to open your bowels. The ‘pushing down’ movement when you strain to open your bowels can overstretch your pelvic floor and make it weaker.
  
• Being overweight. Extra weight puts more pressure on your pelvic floor. Your doctor or nurse will be able to tell you whether you are an acceptable weight for your height and what you should do if you are overweight.

• Having a chronic cough. Every cough bounces on your pelvic floor, so persistent coughing can damage and overstretch the muscles.

Pelvic floor exercises can help strengthen your muscles so they can give your organs support again. This will improve your bladder and bowel control and should help to reduce or stop any leakage.

Strong pelvic floor muscles help to achieve erection and may prevent premature ejaculation.

There are 2 ways of doing these exercises. You will need to do both.

Slow exercises

You should:

• Sit comfortably with your knees slightly apart.

• Imagine you are trying to stop yourself passing wind from your bowel by squeezing and lifting the muscles around your anus (back passage). You should be able to feel the muscle move and the skin around your anus tightening and being pulled up.

Make sure you do not clench your buttock muscles while you do this.

• Next, imagine you are sitting on the toilet trying to stop passing urine, almost like you are “zipping up” inside. You should be using the same muscles you used before.

• Join both of these exercises together to strengthen your pelvic floor. This is called pulling up your pelvic floor. Hold for a count of 5 seconds, then relax for 5 seconds. Try not to hold your breath and breathe normally.

• Then slowly relax and let go.

• You should repeat this slow exercise 8 times.

You may not be able to hold for 5 seconds at first, but try your best and keep practising.

After resting for 2 minutes, you can start your fast exercises.

Fast exercises

You should:

• quickly tighten and pull up your pelvic floor muscles as before, then let them relax straight away.

• repeat 8 times or until your muscles feel tired.

Do these exercises at least 3 times every day.

Once you feel confident in doing these exercises, try doing them in other positions, such as standing and squatting. Remember to tighten your pelvic floor muscle during and after any activity that makes you leak, such as rising from a chair or coughing, so that tightening becomes an automatic reaction.

While performing the exercises it is important not to:

• squeeze your buttocks together
• bring your knees together
• hold your breath
• lift your shoulders, eyebrows or toes upwards.

If you do any of these things listed above, you will not contract (tighten) your muscles correctly.

Do not expect instant results. It may take several weeks of regular exercises to regain the strength in your pelvic floor muscles. It is recommended that you continue the exercises for 3 months before considering other options.

How can I check I am doing the exercises properly?

To check that you are doing the exercises correctly, stand in front of a mirror and do a contraction. You should see your penis dip downwards. You should be able to visibly see and feel your scrotum (testicles) lift upwards.

Every 2 weeks, you should test the strength of your pelvic floor by stopping the flow of urine mid-stream.

You may not be able to completely stop the flow of urine to begin with, but you may notice that you are able to slow the flow down.

Gradually over the weeks, you should notice an improvement. It is important that you do not do this test more than once a fortnight as it may cause problems with your bladder.

You should continue to do these exercises every day for the rest of your life. It is important you continue to enjoy life and not allow your bladder to control your life.

It may take several weeks of regular exercises to regain the strength in your pelvic floor muscles. Do not expect instant results!

What if my bladder is not emptying properly?

You may leak a few drops of urine after you think you have emptied your bladder (called after dribble). This often happens just as you are putting your trousers back on, so they get wet.

The best way to deal with this is to push the last few drops of urine out by squeezing your pelvic floor muscle. After passing urine, wait for a few seconds to allow your bladder to empty.

Place the fingertips of one hand close to your anus. Keeping a gentle pressure, draw your fingers forward towards the base of your penis. This pushes any remaining urine forward to where it can be emptied by shaking in the usual manner.

Repeat this twice to make sure that your urethra has been properly emptied.

Contact numbers

If you should need further advice or have any questions or worries, you should talk to your nurse or continence nurse.

North Tees and Hartlepool NHS Foundation Trust

Specialist Pelvic Health Team

SPA Telephone: 01429 522500
Monday to Friday 08:30 a.m. – 04:30 p.m.

Further information is available from:

Bladder & Bowel Community

Forward House
17 High Street
Henley-in-Arden
B95 5AA
Email: [email protected]
Home Delivery Service: 0800 031 5406

Bladder & Bowel UK

Burrows House
10 Priestley Road
Wardley Industrial Estate
Worsley
M28 2LY
General enquiries Telephone: 0161 607 8219
Website: www.bbuk.org.uk/
Email: [email protected]

RADAR KEYS (for disabled toilet access)

11 Church Street
Exmouth
EX8 1PE
General enquiries Telephone: 01395 222588
Website: www.radarkeys.org
Email: [email protected]

Information used in the development of this leaflet

National Institute for Health and Care Excellence (NICE) (2015). Lower urinary tract symptoms in men; management. Clinical guideline CG97.

https://www.nice.org.uk/guidance/cg97

Department of Health (2000) Good Practice in Continence Services. https://www.nhs.uk/chq/documents/2015%20uploads/dh%20-%20good%20practice%20in%20continence%20services.pdf

Abrams, Khoury S, Wein A.  The 1st International consultation on incontinence, co-sponsored by the WHO, Monaco; Health publication 1999.

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