Hi friends! It’s common that we talk about the pelvic floor muscles in reference to those with female anatomy, but did you know everyone has pelvic floor muscles? Yes, those with male anatomy have pelvic floor muscles, too! While there are many similarities in the anatomy and the way the muscles work, there are some big differences. This means that the treatment for urinary incontinence in males may be different from females.
In this blog, we will use the terms male and female to refer to anatomical terms, but we recognize that individuals born with vaginas may not identify as female, and individuals born with penises may not identify as male.
The differences in male and female anatomy mean that some treatment strategies and research may be good for one gender but not as beneficial for the other. Much of the research that has been done on urinary incontinence has been done with females and we are finding that that is not always applicable to males (Stanford,2012).
In males, the muscles of the pelvic floor that help to keep pressure on the urethra to prevent urinary leakage are (Stanford, 2016):
Puborectalis
Striated urethral sphincter
Bulbocavernosus
When men with urinary incontinence see a healthcare provider, they are often told to exercise the pelvic floor muscles by “tightening around the anus” which helps to engage the puborectalis muscle. A few other common cues are to “elevate the scrotum” and to “stop the flow of urine” (Stafford, 2016). Each of these cues provides more engagement of one muscle over the others. Research is finding that to stop urinary leakage, it is important to be able to engage the muscle called the striated urethral sphincter. While the other muscles play an important role, you can think of the striated urethral sphincter as the MVP of the team that works to stop any leakage.
One study used ultrasound imaging to see in real time what happens with the pelvic floor muscles and the urethra with different verbal cues. Researchers found that telling males to “shorten the penis” provided the best pressure on the urethra and best activation of the striated urethral sphincter to help prevent urinary leakage (Stafford, 2016). The study also found that telling individuals to “elevate the bladder” created more intra-abdominal pressure. Creating more pressure within the abdomen makes it harder to stop leakage, especially when caused by stress urinary incontinence (Stafford, 2016).
While the right cues can help engage the proper muscles, urinary incontinence can be caused by many other issues aside from pelvic floor muscle weakness. If you are experiencing incontinence, it’s important to talk with your healthcare providers. A pelvic floor therapist can be a great resource to help address many of the causes of urinary incontinence. Ask for a referral to a provider near you, or find one at www.mypfm.com/find-a-pt.
To learn more about your pelvic floor muscles, check out these great resources:
Watch our YouTube playlist on Male Bodies and Your Pelvic Floor
Watch Netflix for Your Pelvic Floor at Pelvic Flicks
Learn more about your pelvic floor on our Instagram
Visit our Amazon store for our favorite pelvic health products
Sign up for our email newsletter
For providers, check out myPFM Academy to learn more so you can better help your clients. With two membership options, you have access to courses, a growing library of patient handouts, hundreds of custom sharable images and infographics, and multilingual resources. At myPFM Academy you’ll find courses like:
High Intensity PFMT Before & After Prostatectomy Improves Outcomes with Dr. Joanne Milios, PT, DPT
Intro to Male Pelvic Health with Gerard Greene, MSc (Manip Physio), MMACP, PG Cert HEd
Written by Emily Reul, PT, DPT
References
Stafford RE et al. Pattern of activation of pelvic floor muscles in men differs with verbal instructions. Neurourol Urodyn. 2016;35(4):457-63.
Stafford RE et al. Novel insight into the dynamics of male pelvic floor contractions through transperineal ultrasound imaging. J Urol. 2012;188(4):1224-1230.