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The Irate Prostate

Men, do you or have you ever experienced pelvic pain, urinary problems, sexual dysfunction, and other health issues, like feeling tired and depressed, or do you know someone who has experienced these symptoms? These are 4 symptoms of prostatitis. What is prostatitis? According to the Prostatitis Foundation, prostatitis is an inflammation of the prostate gland often resulting in swelling or pain. The prostate is a reproductive gland located just beneath the bladder, in front of the rectum. It wraps around the urethra, a tube that carries urine from the bladder. The prostate produces most of a male’s semen. Up to 50% of men in the US with experience prostatitis in their lives.

Prostatitis is diagnosed by a physician through urinalysis, and a prostate exam. Physicians may also do a prostate specific antigen test through blood testing. Both prostatitis and prostate cancer can elevate a patient’s PSA level.

There are several different types of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis, chronic pelvic pain non-bacterial inflammatory, and non-inflammatory prostatitis, and asymptomatic inflammatory prostatitis. Acute bacterial prostatitis may be as a result of bacteria, a virus, or an STD, Symptoms may include fever and chills, LBP, frequent and painful urination, weak urinary stream, and infrequent urination, which is best treated with antibiotics, bed rest, stool softener, and increased fluid intake. Chronic prostatitis may be caused by a bacteria or inflammation of the prostate. Symptoms may include frequent bladder infections, frequent urination, and persistent pain in the lower abdomen or back, which is treated with medications, often antibiotics, and changes in diet, biofeedback, and nonprescription supplements.

Non-bacterial prostatitis may be due to pelvic floor dysfunction, usually pelvic floor muscle tightness, trigger points, and myofascial and connective tissue restrictions. Some urologists believe that the pelvic floor dysfunction is an involuntary reaction to the pain of an underlying infection. Even if the work up and lab tests come up negative, some urologists view that there must be an underlying, undetectable treatment for nonbacterial prostatitis. THis can include physical therapy, anti-inflammatory medications or muscle relaxants, taking hot baths, drinking extra fluids, and relaxation techniques. Physical therapy for prostatitis includes manual therapy, stretching, pelvic floor muscle retraining, core stabilization, postural re-education, and other modalities in order to stretch out and relax the pelvic floor muscles in order to reduce symptoms.

Physical therapy can be a great treatment technique for bacterial prostatitis in treating the pelvic floor muscle dysfunction secondary to any infection, bacteria, or STD, as long as those medical issues are or have been treated.

—FAQ

Frequently Asked Questions

Pelvic Floor Disorders and Treatment

What is pelvic floor dysfunction and why does it happen?

Pelvic floor dysfunction is extremely common and occurs when the muscles, tissues, or nerves of the pelvic floor are weakened, tightened, or injured by trauma, chronic strain, or overuse. Pelvic floor disorders can result from traumatic injury such as a fall, from sporting activity, surgery, or childbirth. They can also happen from more chronic issues, such as infection or chronic inflammation such as endometriosis. Pelvic floor disorders can be a consequence of poor alignment or posture, overuse, or improper movement. The pelvic floor muscles surround the urethra, rectum, vagina and prostate; therefore, if there is a dysfunction in these muscles it can result in urinary, bowel, or sexual dysfunction in people of all ages.

Who should I see to get a proper diagnosis?

Many healthcare providers don’t assess – or don’t know how to assess – the pelvic floor muscles and nerves, so it’s important to get a proper diagnosis from a practitioner who specializes in pelvic floor dysfunction and pelvic pain. Too often patients tell us that they’ve been to 10 different doctors and healthcare providers and their symptoms have not improved, or have worsened. Find a specialist right away and get on the path to healing as quickly as possible.

Why do healthcare providers miss (or misdiagnose) pelvic floor dysfunction?

Long story short, the medical practice is divided into areas of the body: Urology. Orthopedics. Gynecology. But the body itself doesn’t have walls; every system interacts with everything else. Sometimes providers are so laser-focused on what they treat that they miss the whole picture. 

As more and more research emphasizes the importance of physical therapy as part of a complete treatment regimen, more and more physicians are learning how to recognize and treat pelvic floor disorder. In the meantime, if you’re not getting relief from your current treatment, make an appointment with a pelvic floor specialist to learn more.

How does pelvic floor dysfunction affect sex?

Pelvic floor muscles have a huge impact on sex. Muscles that are shortened or tight and are unable to elongate will not allow for good blood flow into the genitals. This can result in pain, weaker erections, diminished sensation, inability to orgasm, and even decreased lubrication. Pelvic floor PT can help with these issues by enhancing blood flow and improving muscle function. 

How can pelvic floor dysfunction cause bloating?

Pelvic floor dysfunction, a condition characterized by the inability to correctly relax and coordinate pelvic floor muscles, can significantly contribute to bloating due to its impact on gastrointestinal functions. When these muscles are not functioning properly, it can impact the ease of emptying and make it difficult for your body to pass stool and gas through the intestines. This obstruction leads to an accumulation of waste and gas in the gastrointestinal tract, causing bloating and abdominal discomfort.

Is it true there’s internal massage?

There can be. We do perform internal soft tissue mobilization of the pelvic muscles that are inside your pelvis and are accessible only through the vagina or rectum. We never do internal treatment without your consent and understanding.

What makes someone a pelvic floor PT vs a regular PT?

All pelvic PTs get additional training in pelvic floor internal treatment through continuing education and at our clinic. 

We pride ourselves on the level of training we provide, not just at the beginning but throughout the time our therapists spend at Beyond Basics. We know that learning is a life-long process.  We also provide additional training in physiology of the GI system and urinary system as well as sexual health and function and nutritional training. Most PT programs and schools do not provide the depth and breadth of knowledge that we provide all our PTs at Beyond Basics.

Get help now from a pelvic floor therapist.

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