Kirk, a 20-year-old college student walked into my office. I was the fourth urologist he had seen. He has symptoms that are similar to having a urinary tract infection — frequency, urgency, some burning, and pain “right were you sit” at the end of his shift as a security guard. He also had some pain with intercourse, but only with certain positions.
The previous three urologists had worked him up as a urinary tract infection, as appropriate — checked his urine, cultured it, looked inside his bladder, and got a CT scan to check for kidney stones. All were negative. He was given antibiotics, but that didn’t really help.
So he was sent to me. After going through all of his symptoms and history (again … the patient, as you can imagine, is quite frustrated at this point), I diagnosed him with pelvic floor dysfunction.
Since then, he has been working with our pelvic physical therapist and some of the things we found:
- He doesn’t use his abdominal muscles.
- He overworks his pelvic floor.
- He walks like a bear (confirmed by his friends as it turns out) which means he doesn’t use his pelvic, hip, abdominal, and back muscles correctly every time he walks. Just imagine how often one walks.
Unfortunately, Kirk is not unusual. Many men carry the diagnosis of pelvic floor dysfunction but don’t know it. For one thing, if you put “pelvic pain” as a diagnosis, it only refers to women (in our big book of codes). As if men don’t have a pelvis.
Women are very aware of their pelvis — between the pelvic exams, pregnancy, knowing and performing Kegel exercises, and incontinence and prolapse issues — oh, let me tell you, women know they have a pelvis. They may not necessarily be treating it correctly either, but at least they know they have one.
So, this is a call to all men. I work with our own pelvic physical therapist at Froedtert & The Medical College of Wisconsin, and several others around town and the state and here is a call to men to be their own advocates for pelvic floor health:
- Know you have pelvic floor muscles and a pelvis
- Pelvic floor muscles are important for continence (to prevent urinary leakage) and sexual function
- Pelvic floor muscles may be involved in prostatitis, lower urinary tract symptoms, and groin pain.
- Know what Kegels are; do them correctly; don’t overdo it.
* Thanks to Debbie and Sherese from The Continence and Pelvic Wellness Clinic for sharing their article with me.