Men's Health Physiotherapy Sydney

Prostate cancer is the most commonly diagnosed male cancer.  It has a higher prevalence in men than breast cancer does in women.
The prostate gland is a walnut sized gland, which is located at the very base of the bladder. 

One of the treatment options for prostate cancer is radical prostatectomy, complete surgical removal of this gland. This is a very successful way of eradicating the cancer but it can lead to long-term issues of urinary incontinence and erectile dysfunction.

At Sydney Men’s Health Physiotherapy our focus has been on using real time ultrasound (RTUS) as a biofeedback tool to allow men to visualise the pelvic floor muscles (PFM) moving. In this way we can more accurately teach the ‘feel’ of a good quality pelvic floor muscle contraction. Repetition of a high quality technique is much more likely to produce better outcomes than repetition of a poor technique.  Once good technique has been perfected we develop a tailored progressive strength program that will develop the strength of the voluntary muscle system.

It is important that the two functions of the pelvic floor are trained in separate ways.

1. Endurance - targets postural control and ability to contract for long periods of time
2. Strength – developed via a progressive, guided strength program

Just like all strength programs you have to make sure you are being challenged up to, but not beyond, your capacity.  Again we utilise the ultrasound to objectively test how hard you are able to work so we get the optimal strength development outcomes for you.

A visualisation of our model of care is shown below.

Stuart and his team at SMHP are producing ground-breaking research in this area, looking at new and innovative ways of optimising pelvic floor health.  The outcomes of this research will see significant clinical improvements in continence and erectile function following prostatectomy.

Urinary Incontinence

Incontinence issues (stress, frequency and urgency) and irritable bladders are dealt with in a similar fashion as above, ensuring that pelvic floor muscle tone is optimised.  But here we also focus on bladder retraining.  By utilising both physical, mental and cognitive behavioural strategies we aim to defer the urge to urinate, restore more normal urinary function and settle bladder irritability. 

Post micturition dribble is what can happens when, after you have finished urinating and have zipped up, a small amount of urine drips out of your penis.  The volume of urine leaking out can vary from very small and insignificant to quite volumous and disabling.  Although the mainstay here is also pelvic floor muscle training there are other strategies we can educate you about to assist with management of this embarrassing issue.

Erectile Dysfunction

Erectile dysfunction (ED) is a complex medical condition and will often need to be assessed in a multimodal fashion by specialist mens health physicians, clinical psychologists and urologists as well as by physiotherapists.    There is considerable data to suggest that PFM strengthening is effective for some people with erectile dysfunction and it can do no harm to optimise pelvic floor muscle health to improve ED outcomes.

Chronic Pelvic Pain

Chronic pelvic pain is persistent pain located in and around the pelvic floor (perineal) region.  It is thought it may be due to excessive tightness in muscular tissue and can cause significant pain and disability.  Treatment involves a thorough examination of the muscular and ligamentous tissue in and around the pelvis and targeted release of localised myofascial trigger points. (hyperexcitable regions within the muscle fibres).