Pelvic physical therapy

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I was referred for pelvic physical therapy to help with urge incontinence and symptoms of chronic prostatitis. It’s been going on 6 months at this point so hopefully this physical therapy will work. The urologist actually didn’t know all that it entailed and wondering if anyone can provide more info. What do they do and was it effective? Thanks!

 

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@geldy
Hi there
You'll be doing kegel exercises
To tighten the area.
It works for some people but its not a cure.
I have chronic prostatitis/ cpps
Its something you'll have most likely for life.
The best thing you can do is manage stress and anxiety also ask your doctor about oxybutynun for urination issues.
If this is new to you I'm here to listen and help.

 

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I had pelvic PT about five years ago (45 year old male at the time - I'm still male, but no longer 45). I found it helpful overall.

My physical therapist mostly did deep massage on my abdomen to work on trigger points, on the theory that against wall tightness was contributing to my interstitial cystitis pain. I don't necessarily agree with her theory, but it did help a lot with my pain levels. We did some relaxation techniques ad well. She did one session of rectal massage, which also helped but was not very comfortable (I have ulcerative colitis, so my rectum is often inflamed). Because of the physical discomfort, we did not continue with the rectal part, which I understand is typically part of pelvic PT.

I probably had a dozen or so therapy sessions, and I had significant reduction in pain after each one. I don't think I got a long-term benefit from the PT, although I'm not necessarily a typical patient because of various other health issues, so your mileage may vary.

Each session took about an hour. We started by talking over symptoms - how much pain was I having, where did it hurt, that sort of thing. Then she woukd take me through some stretches to help loosen up the abdominal muscles, followed by deep massage of my abdominal area where I could feel her getting deep enough to be moving around the organs in my abdomen. The one time she did rectal work, it came after this, and involved her putting a finger in my rectum and massaging the muscles around my anus. After the massage we did relaxation techniques and more stretches. She'd send me home with a list of stretches to do, which I kept up with for a little while but dropped later when it seemed like they weren't really helping.

There only embarrassing parts were that I frequently had urges and some leakage during the massage, and of course having a finger in my rectum is always awkward. I made sure to empty my bladder just before each session and changed into a light pull-up and sweatpants that wouldn't be in the way of abdominal massage. Having had ulcerative colitis for thirty-some years, I've gotten over most of my embarrassment over having a finger in my bottom, but there's no way around the awkwardness of it. That's probably the worst part for most people.

 

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@ltapilot
I've been there also.
Frequent urination during PT is quite a pain to deal with.
I always thought I was leaking during.

 

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I have been incontinent totally again since age 19, I do not have any sensation of the need or when voiding. I had back surgery in 2016, I was healing and one day I was in a meeting and I felt a sensation, I thought holy crap I feel myself wetting myself as in I was coming out. I bet I went 5 shades of red thinking everyone could tell I was wetting myself. I was so excited that I was feeling this sensation, yet when I felt myself wetting I felt I had to have to change my diaper right away. Like I said I was excited called my Dr. I told her what was happening and she told me straight out that the possibility of regaining any type of control was slim to none as my muscles have almost for sure atrophied. I did not preface that I am now age 47 and been totally incontinent since as I mentioned age 19. I kept on my Dr. and she said I can send you to a pelvic floor specialist. I started and she did some massaging and she kept asking me to concentrate on feeling any muscle of squeezing of my Sphincter muscles. She after a couple visits a week for three weeks and having homework trying exercises. I went back and she started electrical stimulation and was a very intrusive and embarrassing probes in uncomfortable areas that well were inside if you get what I am saying. I started being able to isolate my different muscles and they were measured I was actually making progress. When I was in shower and began urinating I actually slowed down the flow couldn’t come close to stopping the flow. I was going for treatment for like four months, I was at an appointment where I was on my side and she was doing her thing. I started wetting and she said try and slow it, I was just laying on my side diaper open and I realized I wasn’t feeling the sensation of wetting. I just that day lost all my sensations again, I was very devastated. I have not gotten the sensation again since that day.. I still try and isolate those muscles. Sorry so long but I really feel if I had any sensation of feeling, I could have built up some sort of control! If you have sensations I would so recommend going and trying out the treatment!!! What I would give to have the opportunity to work hard daily to gain some sort of feeling sensation and have the hope of possibly gain some control. Give it shot!!

 

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Thanks WBwayne,
That has to be so frustrating when you are making progress and can start feeling things working and then it suddenly stops. So sorry that is going on. Are you going to go back to see them anymore or are you going to try something different?

Thanks for the posts everyone.

Jim

 

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Thanks WBwayne,
That has to be so frustrating when you are making progress and can start feeling things working and then it suddenly stops. So sorry that is going on. Are you going to go back to see them anymore or are you going to try something different?

Thanks for the posts everyone.

Jim

 

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The sensation coming back was due to my back surgery, my nerves are run through and sometimes in the outside of my spine. These nerves are what are the issue that cause the incontinence, my spine surgeon wants to do another surgery which I will never have another spinal surgery. After I had the first spine surgery, I had a spinal fluid leak and had to have another surgery had some complications and when I was able to get up a couple days later I had a seizure. I have had seizures ever since the second surgery. No thanks to another surgery!!

 

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Wow, that’s terrible. Pretty sure I would be rethinking another surgery too. Is there another doctor you could get a second opinion from? See what they recommend?

 

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Yes, do get a second opinion. Anyone who has read my posts will know I'm one for second opinions. And that's even if you have to go across town to another doctor or hospital, etc. It'll be worth the ride!

 

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Thanks everyone for the input. I have my first PT sessions early next month. I'm at least over some of the embarrassment of leakage and diapers at this point. Hopefully this will get things somewhat better even though I'm not looking forward to internal exams etc.