Prostatectomy Pain: What You Should Know About Recovery

Prostatectomy Pain: What You Should Know About Recovery

If you’re preparing for a prostatectomy or have just had one, you’re probably wondering: “How much pain will I feel—and how long will it last?” That’s a very normal question. A prostatectomy, often used to treat prostate cancer, is a common surgery that can be life-saving. But like any major operation, it comes with its own recovery process.

The good news is this: while prostatectomy pain is part of healing, most men find it gets better more quickly than they expect. Let’s walk through what recovery usually looks like, what side effects are common, and how tools like physical therapy can help you get back on your feet.

Why Prostate Surgery Happens

Doctors most often perform prostate surgery to treat prostate cancer. The procedure removes the prostate gland, and when caught early, it can be very effective. Certain risk factors, such as underlying health conditions like diabetes or autoimmune diseases, may influence the decision to proceed with surgery or additional treatments. In some cases, doctors may also add treatments like hormone therapy or radiation to ensure they address all cancer cells. If there are remaining cancer cells or complications after surgery, further treatment such as radiotherapy or hormone therapy may be necessary to achieve complete eradication of the disease.

While surgery is an important step in treatment, it can also bring short-term challenges such as pain, urinary leakage, and changes in sexual function.

Types of Prostate Surgery

  • Prostatectomy as a Surgical Procedure – Prostatectomy is a surgical procedure to remove the prostate gland, and there are several possible approaches, each with its own advantages and considerations.
  • Open Radical Prostatectomy – This traditional approach involves a single larger incision in the lower abdomen to access and remove the prostate. Open radical prostatectomy is often compared to minimally invasive techniques, with differences in recovery time, pain, and potential complications.
  • Radical Retropubic Prostatectomy – A type of open surgery performed through an incision in the lower abdomen, allowing direct access to the prostate. This surgical procedure is commonly used and enables the surgeon to remove nearby lymph nodes if necessary.
  • Laparoscopic Surgery – Laparoscopic surgery is a minimally invasive technique that uses small incisions, a laparoscope (a thin tube with a camera), and specialized instruments to perform procedures such as prostatectomy.
  • Laparoscopic Radical Prostatectomy – This minimally invasive approach uses laparoscopic surgery to remove the prostate. Laparoscopic radical prostatectomy is less invasive than open surgery and is often compared to robotic radical prostatectomy.
  • Robotic Radical Prostatectomy – A form of minimally invasive surgery where the surgeon uses robotic assistance to perform the procedure with enhanced precision. Robotic radical prostatectomy may offer benefits such as reduced blood loss, less pain, and faster recovery compared to traditional methods.
  • Laparoscopic/Robotic Prostatectomy – A minimally invasive approach with small abdominal incisions. Usually comes with less lower abdominal pain and a quicker recovery.
  • Radical Perineal Prostatectomy – Done through an incision between the scrotum and anus. Effective in some cases but can cause more localized discomfort.

What Pain Feels Like

Most men describe prostatectomy pain as:

  • A sore or pulling feeling in the lower abdomen
  • Discomfort when sitting, moving, or standing
  • Irritation or bladder spasms while the urinary catheter is in place or when it’s removed, often due to the presence of the catheter itself
  • Some trouble with bowel movements in the first week or two

After surgery, the urinary catheter acts as a urine drain, carrying urine from the bladder while the area heals.

Post-Operative Care

After prostate cancer surgery, such as a radical prostatectomy, following a thorough post-operative care plan is crucial for a safe and effective recovery. Your care team will provide specific instructions tailored to your needs, but there are some general guidelines that most patients should keep in mind.

First, take care of your surgical incisions by keeping the area clean and dry. Watch for signs of infection, such as redness, swelling, or unusual discharge, and let your doctor know if you notice anything concerning. Avoid soaking in baths or swimming pools until your healthcare provider says it’s safe.

Activity restrictions are common after surgery. While gentle movement, like short walks, helps prevent blood clots and supports healing, you should avoid heavy lifting, strenuous exercise, or sudden movements for several weeks. Listen to your body and gradually increase your activity level as you feel stronger.

Managing pain is another important part of post-operative care. Take pain medications as prescribed, and don’t hesitate to reach out to your care team if you experience severe pain or discomfort that isn’t improving. Staying ahead of pain can help you move more comfortably and recover faster.

Regular follow-up appointments are essential after prostate cancer treatment. Your doctor will monitor your progress, check your PSA blood test results, and watch for any signs of complications or remaining cancer cells. These visits are also a good time to discuss any concerns about urinary control, sexual function, or emotional well-being.

Finally, don’t underestimate the value of support—whether from family, friends, or professional counselors. Recovering from prostate cancer surgery is a journey, and having a strong support system can make a big difference in your overall well-being.

By following your post-operative care plan and staying in close contact with your healthcare team, you’ll give yourself the best chance for a smooth recovery and a return to normal life.

The First Few Weeks of Recovery

Recovery looks different for everyone, but common experiences in the first few weeks after surgery include:

  • Urinary leakage, especially when coughing or sneezing
  • Fatigue and a slower pace than usual
  • Mild abdominal swelling or tenderness
  • Some discomfort when going to the bathroom

During this time, a catheter is placed to help the bladder heal, and it is connected to a drainage system that includes a leg bag for daytime use and a night bag for overnight urine collection. The leg bag is worn discreetly under clothing and should be emptied regularly, while the night bag is larger and designed for use while sleeping. Proper care of both bags is important to prevent infection and ensure effective drainage.

The catheter is usually removed within 1–2 weeks. When the catheter is removed, you may feel a brief sensation, and it is common to experience some urine leakage or frequent urination as your bladder and pelvic muscles adjust. The process of having the catheter removed is straightforward, and your care team will provide instructions for post-removal care.

Frequent urination is also common in the initial weeks after surgery as the bladder’s capacity and control improve. Temporary weight gain may occur due to fluid shifts after surgery, but this usually resolves within about a week. Gentle activity—like short walks—is important to keep blood moving and prevent blood clots (DVT).

Catheter Removal and Urinary Leakage

When the catheter comes out, it’s common to have difficulty controlling urine flow. This happens because your pelvic floor muscles need time to regain strength. The sphincter muscles, especially the external sphincter, play a crucial role in maintaining urinary control, and strengthening these muscles is important for preventing leakage.

Urinary incontinence is a common complication after catheter removal, which can affect physical comfort, emotional well-being, and social activities. Your care team may suggest pelvic floor exercises (like Kegels), supportive underwear, or absorbent pads for peace of mind. Recovery is gradual, but with consistency, most men see big improvements over time.

How Physical Therapy Helps Prostatectomy Pain

One of the most powerful tools for recovery is pelvic floor physical therapy. After surgery, the muscles supporting your bladder and pelvic region—including those around the pubic bone, a key anatomical landmark—may be weak, leading to pain and leakage.

A pelvic floor therapist can guide you through targeted exercises that:

  • Strengthen bladder-control muscles
  • Reduce leakage when coughing or lifting
  • Easelower abdominal soreness
  • Support healthy bowel movements
  • Help restore sexual function by improving blood flow and nerve response (note: removal of the seminal vesicles during surgery can affect ejaculation and orgasm sensations)

Think of it as rehab for your pelvic region. Just like athletes train to recover after injury, you can retrain your body to heal more comfortably.

👉 For expert care, Pelvis NYC offers specialized pelvic health therapy for men, helping patients manage pain, regain bladder control, and return to normal life with confidence.

prostatectomy pain

Bowel Movements and Bathroom Issues

Having a regular bowel movement is an important part of recovery after surgery and can help prevent complications such as constipation or diarrhea. Constipation and discomfort with bowel movements are common after surgery, especially with pain medication. Staying hydrated, eating fiber-rich foods, and using stool softeners (if your doctor recommends them) can make things easier.

Potential Complications

Most recoveries go smoothly, but possible complications include:

  • Blood clots such as deep vein thrombosis (DVT) if mobility is limited; prevention includes early movement, compression stockings, and medication to reduce the increased risk of clots.
  • Urinary tract infection is a common concern while the urinary tract heals, especially with catheter use, and there is an increased risk of infection after surgery. If symptoms arise, a urine culture may be performed to diagnose the infection and guide treatment.
  • Lymph fluid buildup causing swelling, which can occur after removal of lymph nodes or a lymph node during surgery, sometimes leading to fluid pooling in the patient’s abdomen.

In severe cases, complications like infection or fluid buildup in the patient’s abdomen may require specialized intervention.

Follow your doctor’s instructions closely, take medications as prescribed, and contact your provider if you notice unusual pain, infection signs, or trouble with erections.

Sometimes, radiation may also be recommended after surgery to lower the risk of cancer returning. Radiation induced complications, such as cystitis or tissue changes, can also occur and may require specific management.

Returning to Sexual Activity

Intimacy is a major concern for many men after prostate surgery. Nerve damage during the procedure can affect erections, making them weaker at first. Recovery can take months, but many men improve with medications, devices, or therapies designed to support sexual function. However, certain medications may not be suitable for men with a history of heart disease, so patients should discuss these options with their doctor. Patience and open communication with your partner and doctor are key.

Long-Term Pain and Support

While most men feel significantly better after a few weeks, some experience ongoing prostatectomy pain from scar tissue or nerve irritation. If that happens, your doctor can recommend treatments to help. In severe cases, further treatment such as additional therapies or interventions may be necessary to manage persistent pain or complications.

Regular follow-up care is also essential. Expect PSA blood tests and routine check-ins to monitor recovery. If urinary leakage, erectile dysfunction, or emotional stress continue, support through physical therapy or counseling can make a big difference.

Final Thoughts on Prostatectomy Pain: Healing Takes Time

Recovering from prostate surgery is as much about patience as it is about physical healing. There will be ups and downs, but with time, most men regain control, reduce pain, and return to the activities that matter most.

👉 Here’s the bottom line:

  • Prostatectomy pain is normal but usually improves quickly.
  • The first few weeks are the toughest.
  • Physical therapy speeds recovery and helps with leakage and intimacy.
  • With the right care, most men return to normal life—including sexual activity.

Vaginal Muscle Spasms: Expert Guide from Dr. Samantha Vargas

Vaginal Muscle Spasms: Expert Guide from Dr. Samantha Vargas

Suppose you’ve been living with pelvic pain, bladder leaks, or discomfort during intimacy. In that case, you may be experiencing something that’s rarely talked about but far more common than you think — vaginal muscle spasms.

At Pelvis NYC, we help women overcome these symptoms in a supportive, judgment-free environment. Our pelvic pain specialists — including experienced physicians and pelvic floor physical therapists — diagnose and treat pelvic floor disorders with personalized, comprehensive care. Many women come to us believing these issues are just part of getting older, part of being a mom, or something they have to “tough out.” The truth is, vaginal muscle spasms are not a normal part of life — and you can treat them.

Our lead female pelvic floor physical therapist, Dr. Samantha Vargas, PT, DPT, is here to help you take back control of your pelvic health. As part of your evaluation, Dr. Vargas will perform a thorough physical exam to identify the underlying cause of your symptoms and guide your treatment plan. Our personalized approach is designed to relieve pain and restore your pelvic health.

Introduction to Pelvic Floor Muscles

The pelvic floor muscles are a group of muscles located at the base of your pelvis, forming a supportive hammock for your pelvic organs—including the bladder, uterus, vagina, and rectum. These muscles work in harmony with your abdominal and hip muscles to provide stability, support, and control for essential functions like urination, bowel movements, and sexual activity.

When your pelvic floor muscles are healthy, they contract and relax as needed, helping you maintain continence, support your pelvic organs, and enjoy pain-free movement. However, if these muscles become too tight, too weak, or lose their coordination, you may experience pelvic floor muscle spasms and other symptoms of pelvic floor muscle dysfunction. This can lead to muscle spasms, discomfort, and issues with bladder, bowel, or sexual health.

Understanding the vital role of your pelvic floor muscles is the first step in recognizing when something isn’t quite right. If you notice other symptoms such as pelvic pain, difficulty with bowel movements, or changes in bladder habits, it may be a sign of pelvic floor muscle dysfunction—and a reason to seek expert care.

What Are Vaginal Muscle Spasms?

Your pelvic floor is a network of muscles that support your bladder, uterus, and rectum. These muscles should work in balance — contracting when needed, relaxing when it’s time to release.

When the muscles around the vagina contract involuntarily, either constantly or intermittently, this is known as vaginal muscle spasms (a type of muscle spasm or involuntary contraction). These spasms can cause pelvic pain, bladder or bowel problems, and sexual discomfort.

Vaginal muscle spasms are a type of pelvic muscle spasm and are sometimes referred to as vaginal spasms.

Unlike a fleeting cramp, ongoing involuntary contractions or muscle contractions can lead to persistent symptoms and can worsen over time if left untreated.

Common Signs You Might Have Vaginal Muscle Spasms

Patients at Pelvis NYC often come in with one or more of the following symptoms:

  • A feeling of incomplete bowel movements
  • Urine or stool leakage
  • Lower back, pelvic, or genital pain
  • Pain or burning during urination
  • Trouble starting your urine stream
  • Painful intercourse or discomfort afterward

A gentle vaginal exam may be performed to assess the pelvic floor muscles and the vaginal opening for areas of tenderness or spasm.

During a pelvic floor assessment, these spasms often feel like tight, rope-like bands of muscle deep inside the pelvic area — much like knots you might find in your shoulders, but in a much more sensitive location. Diagnostic tests can help determine if symptoms are due to muscle spasms or if there is an infection present.

Chronic Pelvic Pain

Chronic pelvic pain is often one of the most frustrating symptoms associated with vaginal muscle spasms. This pain can feel dull, aching, or sharp, and it may radiate into the lower back, hips, or thighs. Ongoing pain is a hallmark of chronic pelvic pain, highlighting its persistent and disruptive nature.

For many women, chronic pelvic pain develops gradually and is dismissed as “normal” period pain, lingering postpartum discomfort, or simply part of aging. In reality, tight pelvic floor muscles can create ongoing irritation of nearby nerves and tissues, perpetuating the pain cycle.

Emotional pelvic pain and mental health factors can also contribute to or exacerbate chronic pelvic pain, making it important to address both physical and psychological aspects for effective treatment.

At Pelvis NYC, we focus on identifying whether pelvic floor tension is contributing to your chronic pelvic pain and creating a tailored plan to break that cycle.

Pelvic Floor Spasms

Pelvic floor spasms occur when any of the pelvic floor muscles contract involuntarily, often without your conscious awareness. Vaginal muscle spasms are one type of pelvic floor spasm, but they can also affect the muscles around the rectum and urethra. Pelvic floor spasms are one of several pelvic floor disorders that can affect women, including incontinence and prolapse, each with different causes and symptoms.

These spasms can make daily activities — like sitting, walking, or using the bathroom — uncomfortable or even painful. They can also be linked to bladder urgency, bowel issues, or sexual discomfort.

Our treatment approach focuses on restoring flexibility and coordination to these muscles through hands-on therapy, neuromuscular re-education, and personalized exercises. We use evidence-based methods to treat pelvic muscle spasms and restore function, ensuring each patient receives care tailored to their specific pelvic floor disorder.

Interstitial Cystitis and Pelvic Floor Tension

Interstitial cystitis (IC) — also called painful bladder syndrome — is a chronic bladder condition that can cause pelvic pain, frequent urination, and a constant feeling of needing to go.

What many women don’t realize is that pelvic floor spasms and vaginal muscle tension often co-exist with IC. Tight pelvic muscles can irritate the bladder and surrounding nerves, making symptoms worse. Symptoms of interstitial cystitis can mimic those of a urinary tract infection, but diagnostic tests often show no infection is present. Overactive bladder symptoms, such as urgency and urinary frequency, can also be linked to pelvic floor tension and spasms.

At Pelvis NYC, we work closely with IC patients to release pelvic floor tension, improve bladder habits, and reduce overall pelvic pain — creating a more complete approach to symptom management.

Why Do Vaginal Muscle Spasms Happen?

Identifying the underlying cause of vaginal muscle spasms is essential for effective treatment. The causes are often layered and can include:

  • Childbirth — especially long or traumatic deliveries
  • Pelvic surgeries — pelvic surgery can be a potential cause, as it may leave scar tissue or alter pelvic anatomy
  • Pelvic inflammatory disease — can contribute to pelvic pain and muscle spasms
  • Chronic straining from constipation or heavy lifting
  • Hormonal changes during menopause
  • Injury or falls — physical trauma, including injury or falls, even years after the event, as well as emotional or physical trauma, can trigger muscle spasms
  • High intensity exercise — can cause muscle tightness or trauma in the pelvic region
  • Frequent “just in case” bathroom trips
  • Genetics — naturally weaker connective tissue
  • Neurological conditions like Parkinson’s disease

Psychological trauma and nervous system dysfunction can also play a role in developing muscle spasms, as abnormal nerve signaling may perpetuate pain and involuntary contractions.

Reduced blood flow to the pelvic region and muscles surrounding the vagina can lead to increased lactic acid, contributing to pain and muscle tightness. Spasms can affect the pelvic muscle and vaginal muscles, impacting sexual intercourse, penetrative sex, and bowel movement. Chronic spasms may result in fecal incontinence, and muscle relaxants may be considered for severe cases.

Pelvic Health and Wellness

Pelvic health and wellness go far beyond just the absence of pain—they encompass your physical, emotional, and mental well-being. When pelvic floor muscles are functioning optimally, they support your daily activities, sexual health, and overall comfort. However, pelvic floor muscle spasms, sometimes felt as pelvic floor muscle twitches, can disrupt this balance and lead to a range of challenges.

Tight pelvic floor muscles or weak pelvic floor muscles can cause pelvic pain, make vaginal penetration uncomfortable, and interfere with normal bowel movements or bladder control. These symptoms of pelvic floor muscle dysfunction can impact your confidence, relationships, and quality of life.

Pelvic floor physical therapy is a proven, effective way to address these issues. Through a combination of manual therapy, stretching, relaxation exercises, and biofeedback, physical therapy helps restore normal muscle function and significantly reduce pelvic pain. Education about how to use and care for your pelvic floor muscles is also a key part of the process, empowering you to take control of your pelvic health.

By prioritizing pelvic health and wellness, you’re taking an important step toward relieving symptoms, improving function, and enhancing your overall well-being. Whether you’re experiencing pelvic floor muscle spasms, ongoing pelvic pain, or other symptoms of pelvic floor dysfunction, comprehensive physical therapy can help you regain comfort and confidence in your body.

Meet Dr. Samantha Vargas, PT, DPT — Female Pelvic Floor Specialist at Pelvis NYC

With a foundation in biomechanics and a passion for movement, Dr. Samantha Vargas began her career treating athletes — from NCAA Division I sports to professional baseball and rugby players. After earning her Doctorate in Physical Therapy and completing a prestigious sports residency at the University of Delaware, she became a board-certified sports clinical specialist.

Over time, Dr. Sam noticed a recurring theme: many of her female patients — whether athletes, active women, or new mothers — were quietly struggling with pelvic floor dysfunction, often dismissed or misunderstood by other providers.

Determined to change that, she pursued advanced pelvic floor rehabilitation training to help women address issues like pelvic pain, incontinence, sexual dysfunction, postpartum recovery, and prolapse. Today, Dr. Sam blends her sports medicine expertise with pelvic health care — using biomechanics, manual therapy, neuromuscular re-education, and customized exercise programs to meet each woman’s unique needs.

Her approach is compassionate, confidential, and stigma-free. Whether you want to return to sport, recover after childbirth, or simply live without pain, she’s committed to helping you restore function, alleviate discomfort, and reclaim confidence in your body.

Vaginal Muscle Spasms Treatment in NYC | Dr. Samantha Vargas

How We Treat Vaginal Muscle Spasms at Pelvis NYC

We personalize every woman’s care plan, which may include:

  • Pelvic floor physical therapy — hands-on release, stretching, and coordination training provided by physical therapists who specialize in pelvic health
  • Breathing and relaxation techniques — to reduce muscle tension
  • Postural and movement retraining — to support long-term relief
  • Lifestyle modifications — including healthy bladder and bowel habits
  • Physician collaboration — for medications like muscle relaxers if needed
  • Trigger point injections — for persistent pelvic muscle spasms and pain relief
  • Vaginal dilators — to gradually relax vaginal muscles and improve comfort during penetration
  • Vaginal estrogen — to improve tissue health and reduce symptoms of dryness or atrophy, especially in post-menopausal women

Your provider may perform a pelvic exam to guide treatment decisions and monitor your progress.

Our goal is to treat the root cause, not just mask symptoms — so you can get lasting results without unnecessary medication, injections, or surgery.

Take the First Step Toward Relief

Vaginal muscle spasms, chronic pelvic pain, pelvic floor spasms, and interstitial cystitis can feel overwhelming — but they are treatable. At Pelvis NYC, a female pelvic floor specialist provides care and understands the unique challenges women face.

You don’t have to live with pelvic pain or bladder and bowel issues. Relief is possible — and you deserve care that champions your needs.

📅 Schedule your consultation with Dr. Samantha Vargas, PT, DPT at Pelvis NYC today.

Treatment of Prostatitis: A Complete Guide for Long-Term Relief

Treatment of Prostatitis: A Complete Guide for Long-Term Relief

Prostatitis isn’t a topic most guys are comfortable discussing—but if you’ve been dealing with pelvic pain, painful urination, or discomfort during sex, it’s time to face it head-on. Recognizing prostatitis symptoms early is crucial for seeking appropriate treatment and improving outcomes. The treatment of prostatitis isn’t about popping pills and hoping for the best. It’s about understanding your body, getting the right diagnosis, and taking control of your health. And yes, physical therapy plays a bigger role than most men realize.

What Is Prostatitis?

Prostatitis means inflammation of the prostate gland. It can hit men in their 20s, 40s, or 60s. There are distinct forms, including acute and chronic prostatitis. Acute prostatitis presents suddenly with severe symptoms, while chronic prostatitis involves recurrent or persistent symptoms that may be more subtle or intermittent. Symptoms vary, but here’s what most guys report:

Different types of prostatitis call for different approaches, and understanding the best treatment of prostatitis depends on an accurate diagnosis.

Chronic Bacterial Prostatitis: The Stubborn Infection

This type is caused by lingering bacteria. You might feel like you have a UTI that never fully goes away. It creeps in slowly, and it keeps coming back. Recurrent infection and recurrent urinary tract infections are common in chronic bacterial prostatitis, often leading to persistent or episodic symptoms. Chronic infection can develop if the initial treatment is incomplete, making it difficult to fully eradicate the bacteria. Escherichia coli is the most common bacterial cause of chronic bacterial prostatitis. Treating chronic bacterial prostatitis is challenging and often requires prolonged antibiotic therapy to prevent recurrence.

What it feels like:

  • Dull ache in the pelvis or perineum
  • Recurrent UTIs
  • Feeling like you’re never fully emptying your bladder
  • Incomplete bladder emptying
  • Recurrent symptoms

Treatment plan:

  • Antibiotic therapy (long-term, 4-6 weeks or more): Appropriate antibiotic treatment is essential for bacterial prostatitis, targeting bacteria that penetrate prostatic tissue. The choice and duration of antibiotics should be based on pathogen sensitivity to ensure effective drug delivery into the prostatic tissue and reduce the risk of relapse.
  • Symptomatic treatment: This includes medications tailored to individual symptoms, such as nonsteroidal anti inflammatory drugs (NSAIDs) for pain relief, paracetamol, and alpha-adrenergic antagonists.
  • Anti-inflammatory meds
  • Prostate drainage or massage (yes, it’s a thing)
  • Pelvic floor physical therapy to help calm the aftershocks

If symptoms do not improve, monitor for complications such as prostatic abscess, which may require additional intervention.

Even after the infection is gone, many guys still deal with pain. That’s when physical therapy becomes a key component in the treatment of prostatitis.

Chronic Pelvic Pain Syndrome (CPPS): The Muscle-Tension Monster

This is the most common type of prostatitis. It is often referred to as chronic nonbacterial prostatitis or chronic abacterial prostatitis, terms that are frequently used interchangeably with chronic pelvic pain syndrome (CPPS). Prostatitis chronic pelvic pain is now recognized as a distinct syndrome, characterized by pelvic pain, urinary symptoms, and sometimes features similar to prostatitis. Interstitial cystitis is another condition with overlapping symptoms, making diagnosis challenging. Urinary symptoms may be related to issues at the bladder neck or due to bladder outlet obstruction, both of which should be considered during evaluation. Prostate inflammation and prostatic inflammation are possible contributors to the symptoms experienced in this condition. No bacteria. No infection. Just pain, tension, and frustration. It often gets misdiagnosed, and guys bounce from one doctor to another with no answers.

Symptoms include:

  • Aching in the pelvis, groin, or lower back
  • Pain during or after sex
  • Urinary issues without infection
  • Urinary obstruction (difficulty starting or maintaining urine flow, possibly due to bladder neck involvement)
  • Urinary retention (inability to fully empty the bladder, which can be a complication of prostatic swelling)
  • Feeling tight, stressed, or inflamed down there

The real issue?

Often, it’s your pelvic floor muscles going haywire. They’re tight, overworked, and stuck in a pattern of dysfunction. Dysfunction in the pelvic floor and surrounding prostatic tissue can also contribute to these symptoms.

What works:

  • Pelvic floor physical therapy – internal and external manual release
  • Breath training to reset your nervous system
  • Postural correction to get your body in sync
  • Trigger point therapy to release deep muscle knots
  • Symptomatic treatment of prostatitis with medications like paracetamol, NSAIDs, or alpha-adrenergic antagonists may help manage pain and urinary symptoms

Chronic Prostatitis: When It Won’t Go Away

If you’ve had pelvic pain or urinary symptoms for more than three months, welcome to the club nobody wants to join.

Many patients diagnosed with chronic prostatitis face significant challenges in clinical practice, as the condition often involves chronic infection and recurrent symptoms that can be difficult to manage. The National Institutes of Health classification system is commonly used to categorize prostatitis, reflecting the complexity and heterogeneity of patient profiles. Chronic prostatitis is also discussed within the broader context of digestive and kidney diseases, including kidney diseases, due to their impact on urological health and overall well-being.

Chronic prostatitis might be bacterial or non-bacterial. What matters most is that it’s ongoing, and it’s affecting your quality of life.

The fix?

You need a multifaceted approach:

  • Find out if there’s an infection
  • If infection is found, treatment of prostatitis with appropriate antibiotics is crucial, selecting antibiotics based on the causative agent
  • If not, shift focus to muscles, nerves, and lifestyle
  • Add in targeted physical therapy
  • Look at stress, diet, and mobility

Prostatitis treatments should be tailored to the underlying cause, using a symptom-focused strategy.

It’s not about being tough. It’s about being smart.

Diagnostic Tests: Know What You’re Dealing With

Prostatitis diagnosis begins with a thorough review of your medical history and a careful physical examination. Evaluating risk factors, such as previous urinary tract infections, recent procedures, or other underlying conditions, is essential for accurate assessment.

You can’t treat what you haven’t properly diagnosed. Testing may include:

  • Urinalysis and culture to check for urinary tract infection and urinary tract infections, as well as to analyze white blood cells.
  • Semen analysis for infection and inflammation.
  • PSA blood test (prostate specific antigen and serum prostate specific antigen) to help differentiate prostatitis from prostate cancer, though PSA can be mildly elevated in prostatitis.
  • Prostate fluid test including analysis of prostatic fluid, prostatic secretions, and prostate secretions for white blood cells and bacteria.
  • Imaging in complicated cases, or to assess for enlarged prostate or other abnormalities.

It is important to rule out benign prostatic hyperplasia, prostate cancer, and other conditions as part of the diagnostic process. Screening for sexually transmitted diseases may also be warranted.

And here’s something most urologists don’t talk about: pelvic floor dysfunction. It’s often the missing piece in the treatment of prostatitis, and it doesn’t show up on a lab report. That’s why a pelvic floor assessment by a trained physical therapist is gold.

Asymptomatic Prostatitis: No Symptoms, But Still There

Sometimes, prostatitis shows up in lab results when you’re not even feeling it. Prostate inflammation may be detected in asymptomatic cases through laboratory testing, such as during a fertility check or PSA test.

Should you worry?

  • Not always
  • But it’s worth monitoring
  • A pelvic floor check might still be smart

The Power of Physical Therapy in Treating Prostatitis

Here’s the deal: If you’ve ruled out infection and you’re still in pain, there’s a high chance your pelvic floor is the problem.

Physical therapy isn’t just for athletes. It’s for men like you who are tired of:

  • Waking up with pelvic tightness
  • Dreading urination or sex
  • Feeling like no one takes their pain seriously

At Pelvis NYC, we offer:

  • Internal and external manual therapy
  • Tailored exercise plans
  • Stress management techniques
  • Real talk, real solutions

We don’t just treat symptoms. We treat men who are ready to reclaim their health.

Treatment of Prostatitis: Effective Options and Management Strategies

Managing Psychological Symptoms: Mind Over Matter

Why your mental health matters

Let’s be real—dealing with chronic prostatitis, chronic bacterial prostatitis, or chronic pelvic pain syndrome (CPPS) isn’t just a physical battle. The constant pelvic pain, unpredictable symptoms, and frustration of not getting clear answers can take a serious toll on your mental health. Anxiety, stress, and even depression are common companions for men facing chronic prostatitis or nonbacterial prostatitis.

Ignoring these psychological symptoms doesn’t make them go away—in fact, it can make treating prostatitis even harder. When your mind is weighed down by worry or hopelessness, your body feels it too. That’s why addressing mental health is just as important as tackling the physical side of pelvic pain syndrome CPPS or bacterial prostatitis. By recognizing the emotional impact, you give yourself a better shot at real, lasting relief.

Strategies for coping and support

So, how do you take care of your mind while managing prostatitis? Start by building a toolkit of strategies that target both stress and symptom control:

  • Stress management techniques: Simple practices like meditation, deep breathing, or mindfulness can help calm your nervous system and reduce anxiety. Even a few minutes a day can make a difference.
  • Cognitive-behavioral therapy (CBT): Working with a therapist trained in CBT can help you break the cycle of negative thoughts and behaviors that often come with chronic prostatitis, acute bacterial prostatitis, or asymptomatic inflammatory prostatitis.
  • Support groups: Connecting with other men who understand what you’re going through can be a game-changer. Sharing experiences and advice helps you feel less alone and more empowered.
  • Pelvic floor physical therapy: While it’s great for physical symptoms, pelvic floor PT can also ease psychological symptoms by giving you more control over your body and reducing the stress that comes with chronic pain.

Remember, managing psychological symptoms is not a sign of weakness—it’s a smart, proactive step in treating prostatitis, whether you’re dealing with bacterial infections, chronic prostatitis, or any of the prostatitis syndromes. Work with your healthcare provider to create a plan that supports both your body and your mind. You deserve to feel better—inside and out.

Ready to Take Action?

You’ve read enough. Now it’s time to do something about it.

If you’re dealing with prostatitis—whether it’s your first flare-up or you’ve been living with it for years—you don’t have to keep suffering.

👉 Pelvis NYC has your back (and your pelvis). Book a consultation with our expert pelvic floor physical therapists who understand what you’re going through.

Take the first step. Get strong. Get answers. And get better.

Related Blog: Prostatectomy Pain: What You Should Know About Recovery

Complete Guide to Athletic Pubalgia

Complete Guide to Athletic Pubalgia

I’ve seen firsthand how frustrating chronic groin pain can be—whether you’re an elite athlete or just trying to get back to weekend pickup games. Athletic pubalgia (often called a “sports hernia”) is a clinical entity with evolving diagnostic criteria and is sometimes referred to as Gilmore’s groin. This condition affects many athletes across various sports and is really a spectrum of soft-tissue injuries around the pubic bone, not a true hernia at all. The affected area is typically the lower abdomen and groin region. It pops up in both men and women, can masquerade as other conditions (like prostatitis in men or postpartum pelvic pain in women), and thrives on core weakness and compensatory movement patterns.

The good news? With the right blend of manual therapy, movement retraining, pelvic-floor work, and progressive loading, most folks get back to what they love—pain-free.

What Is Athletic Pubalgia?

Athletic pubalgia is a chronic groin-pain syndrome caused by strains or tears of muscles and tendons at their pubic attachments—most often the obliques, rectus abdominis, and adductors, including the adductor longus. The pubic symphysis acts as a pivot point between abdominal and groin muscles at these attachments. The conjoint tendon also plays a significant role in the pathophysiology of this condition.

athletic pubalgia

It’s a “core muscle injury” that leads to pain with twisting, cutting, kicking, or even coughing. Athletic pubalgia is sometimes referred to as sportsman’s hernia and is considered a form of groin disruption. Inguinal pain is a common symptom and may be present alongside lower abdominal and groin pain. Pain may be reproduced during a sit up or resisted sit up, and hip extension can also exacerbate symptoms.

Core Muscle Injury — What That Really Means

It is a more accurate, all-encompassing term that explains the dysfunction at the heart of this condition:

  • It occurs where deep abdominal and groin muscles anchor to the pelvis—commonly the rectus abdominis and adductor tendons.
  • Over time, repetitive twisting, kicking, or sprinting stresses the core, creating small tears or imbalances that trigger chronic pain.
  • This injury often coexists with adductor strains or hip pathology, making accurate diagnosis essential.

Sports Hernia/ Athletic Pubalgia: Understanding the Terminology

  • Sports Hernia: The term popularized by media and patients to describe groin tissue injury without a true protruding hernia.
  • Athletic Pubalgia: The preferred medical term reflecting the location (pubis) and mechanism (athletic activity).

Both labels point to the same underlying pathology—and you’ll see both used by clinicians, researchers, and sports-med resources.

How Sports Hernias Occur

Repeated rotations, high-impact stops, and muscle imbalances overload the abdominals and adductors, and these injuries often require sudden changes in direction or forceful movements. As core weakness persists, stress funnels into the pubic attachments and sports hernias occur—silent yet painful injuries. Activities that increase intra-abdominal pressure, such as coughing, sneezing, or heavy lifting, can also trigger symptoms. Sports activity and sporting activity involving repetitive twisting and turning are common causes, especially in professional athletes who are particularly at risk due to the demands of their sport.

Causes and Risk Factors

Athletic pubalgia, commonly referred to as a sports hernia, develops when the soft tissues of the lower abdominal wall and groin area—especially the abdominal muscles and adductor muscles—are subjected to excessive strain. Unlike a true hernia, there’s no visible bulge, but the pain and dysfunction are very real. The root cause is often a weakening or tearing of the abdominal wall near the inguinal canal, where the conjoined tendon and pubic bone serve as critical anchor points for muscle attachments.

Sports hernias occur most frequently in athletes who participate in sports that demand explosive movements, rapid changes in direction, and powerful twisting motions—think soccer, football, ice hockey, and tennis. These activities place repeated stress on the lower abdominal muscles and adductor group, making them vulnerable to injury. Chronic groin pain and lower abdominal pain often develop gradually, but can also be triggered by a single, forceful movement.

Certain anatomical and biomechanical factors can increase the risk. Individuals with femoroacetabular impingement, labral tears, or a history of core muscle injury are more likely to experience groin pain and develop sports hernias. The structure of the inguinal canal, the strength of the conjoined tendon, and the balance between the abdominal wall and adductor muscles all play a role in susceptibility. Understanding these risk factors is key for both prevention and early intervention, helping athletes and active individuals avoid the cycle of chronic pain and repeated groin injury.

Who Is Affected by Athletic Pubalgia?

  • Male athletes: Often misdiagnosed as inguinal hernia or prostatitis because of overlapping pelvic-floor pain. A thorough review of medical history is essential for accurate diagnosis, especially since symptoms may overlap with other conditions.
  • Women: Particularly postpartum or high-level athletes with underlying pelvic instability; internal pelvic-floor work is frequently indicated.

Symptoms & Diagnosis

  • Pain: Dull, burning, or sharp ache in lower abdomen/groin that worsens with sprinting, twisting, sit-ups, or coughs. Patients are often experiencing pain that is chronic and worsens with activity.
  • No visible bulge: Unlike an inguinal hernia, there’s often no outward protrusion.
  • Diagnostic tools:
  • Physical examination: A thorough physical examination is crucial, including specific maneuvers to reproduce symptoms, such as resisted adduction and abdominal tests.
  • MRI: Gold standard for detecting soft-tissue tears or edema (68–98% sensitivity).
  • Ultrasound: Dynamic but operator-dependent.

Core Weakness & Pathomechanics

We often see a pattern of core instability, compensatory hip movement, and chronic pelvic loading driving symptoms. When the transverse abdominis, obliques, and pelvic floor aren’t firing synchronously, stress funnels into the pubic attachments—resulting in micro-tears and pain.

Conservative (Non-Surgical) Management

  1. Early rest & modalities (ice, NSAIDs) for 7–10 days as part of conservative therapy, which is the first-line approach for most cases.
  2. Phase I (Weeks 1–2): Gentle stretching, manual soft-tissue release, hip mobility.
  3. Phase II (Weeks 3–6): Core-stability drills (planks, dead bugs), isometric adductor holds, pelvic-floor retraining.
  4. Phase III (>6 weeks): Progressive loading, plyometrics, sport-specific drills—only if pain-free.

Outcomes: Up to 80–90% return-to-sport within 3–4 months when following structured rehab. Manual therapy added to exercise speeds return by ~4–5 weeks. While conservative treatment is often effective, some cases may require surgical intervention if symptoms persist.

When Surgery Is Needed

Indications include symptom persistence after 3 months of conservative care and confirmed pubic-wall deficiency on imaging.

  • Surgical procedures: Options include open repair, laparoscopic surgery (a minimally invasive surgical procedure), and pelvic floor repair techniques. Laparoscopic surgery is often compared to open surgery, with the minimally invasive approach potentially allowing for faster recovery and lower complication rates.
  • Open vs laparoscopic repair: Both yield >90% return-to-sport; laparoscopic may allow return in 3–5 weeks.
  • Adductor tenotomy: The adductor longus tendon is often targeted in this procedure, especially if persistent inner-thigh pain remains post-repair.
  • Conjoint tendon repair: During surgical repair, the conjoint tendon is evaluated and repaired if necessary, as abnormalities or tears can contribute to groin pain.
  • Surgical outcomes: Key measures include return to sport rates, symptom relief, complication rates, and overall patient satisfaction.
  • Surgical rehabilitation: A structured rehabilitation program is essential after surgery to restore function and performance, particularly for athletes.

Special Focus: Women & Postpartum

Postpartum pelvic-floor weakness and ligament laxity frequently complicate athletic pubalgia in women. Integrating internal pelvic-floor therapy with core and hip work is key—and outcomes are on par with male cohorts when this holistic approach is used.

athletic pubalgia

Dr. Gvili’s Integrated Rehab Model

sports hernia athletic pubalgia

First-line care focuses on restoring core-muscle injury through:

  • Manual therapy and soft tissue release
  • Core drills: planks, dead bugs, side‑planks
  • Pelvic‑floor retraining
  • Hip/adductor strengthening
  • Neuromuscular retraining and movement pattern correction
  • Sport-specific progressive loading

Studies show 65–90% of athletes improve within 4–8 weeks. ([turn0search9] [turn0search11])

Phase breakdown:

  • Weeks 1–2: Rest, ice, NSAIDs
  • Weeks 3–6: Core and pelvic strengthening
  • Post‑week 6: Return to sport progression, when pain-free

Outcomes: Conservative care yields up to 90% return-to-sport within 3–4 months; adding manual therapy can quicken recovery by 4–5 weeks.

Prevention and Future Directions

Preventing athletic pubalgia starts with a proactive approach to strengthening and protecting the core and groin area. Regular physical therapy that targets the abdominal muscles, adductor muscles, and hip flexors is essential for building resilience and reducing the risk of sports hernias. Incorporating dynamic stretching, foam rolling, and mobility work into your daily routine can help maintain flexibility and relieve muscle tension, which in turn helps prevent chronic groin pain.

Modifying sports activities to avoid excessive strain—such as limiting sudden changes in direction or high-impact twisting movements—can also lower the risk of injury, especially for those with a history of groin pain or previous core muscle injuries. Early intervention is crucial: advances in diagnostic tools like magnetic resonance imaging (MRI) now allow for more accurate and timely identification of sports hernias, enabling targeted treatment before pain becomes chronic.

Looking ahead, research is focused on refining both surgical and non-surgical treatment options. Minimally invasive surgical procedures and innovative rehabilitation protocols are being developed to improve outcomes and speed up recovery. Personalized rehabilitation plans, tailored to the individual’s specific injury, sport, and goals, are becoming the standard of care, helping athletes return to play safely and reducing the risk of re-injury. By staying informed and proactive, athletes and clinicians can work together to prevent groin pain and ensure long-term health in the groin area.

Key Takeaways

  • Athletic pubalgia isn’t a classic hernia—think soft-tissue injury around the pubis.
  • Core weakness + compensatory patterns underlie most cases.
  • Conservative rehab (manual therapy + core/pelvic-floor work) helps ~90% recover without surgery.
  • Surgical repair is highly successful (>90% RTP) when rehab fails.
  • Tailored pelvic-floor integration is essential for women and postpartum athletes.

Ready to tackle that stubborn groin pain? Dr. Adam Gvili at Pelvis NYC is here to collaborate—feel free to refer your toughest athletic pubalgia cases or reach out for a case discussion!

Can UroLift Cause Erectile Dysfunction? Your Guide to Better Understanding

Can UroLift Cause Erectile Dysfunction? Your Guide to Better Understanding

A Physical Therapist’s Take on BPH Treatment, Sexual Function & Recovery

Can UroLift Cause Erectile Dysfunction?

Let’s tackle this right out of the gate—can Urolift cause erectile dysfunction?- the short answer is no. The UroLift System is designed to relieve urinary symptoms caused by BPH (Benign Prostatic Hyperplasia) without affecting erectile function. Clinical studies show that UroLift does not cause new, sustained erectile dysfunction, setting it apart from other BPH treatments.

As a pelvic health PT, I work with men post-procedure and see firsthand that erectile dysfunction (ED) after UroLift is rare and typically unrelated to the procedure itself.

But does that mean it never affects your performance? Not exactly.

While the mechanical side of erections remains safe, some men report temporary issues due to:

  • Pelvic floor tension
  • Anxiety
  • Post-op inflammation
  • Pre-existing sexual health concerns

Most of this is manageable with pelvic rehab, relaxation techniques, and time. Importantly, UroLift is not associated with new sexual dysfunction, and the treatment effect on sexual function is minimal compared to other BPH therapies like TURP or laser, which have higher rates of sexual side effects.

What You Should Know About Erectile Dysfunction

ED is complex—it’s not just about the penis; it’s about nerves, blood flow, pelvic floor muscles, emotions, and overall health.

From my clinical perspective, men who experience ED post-UroLift often:

  • Already had mild ED
  • Are dealing with stress, performance anxiety, or prostate-related tension
  • Experience tight pelvic muscles that interfere with function

The good news? Physical therapy can help. We work on improving blood flow, relaxing the pelvic floor, and restoring confidence.

Understanding BPH Treatment and Sexual Health

BPH affects about 50% of men over age 50, and the number one symptom is disrupted urination—urgency, frequency, dribbling, or incomplete emptying.

Unfortunately, many treatments for BPH have a dark side: they can mess with your sex life.

Common BPH treatments and their sexual side effects:

TreatmentInvasive?Risk of ED?Risk of Retrograde Ejaculation?
TURPYesModerateHigh
Laser therapyYesModerateModerate
Medications (alpha-blockers, 5-ARIs)NoPossibleLow–Moderate
UroLiftNoVery LowVery Low ✅

Therapies such as TURP, laser, and even medication are associated with a higher risk of sexual side effects, including erectile and ejaculatory dysfunction, compared to UroLift®. UroLift® stands out as a minimally invasive alternative to traditional surgical options, with clinical data showing it does not cause new or lasting ejaculatory dysfunction.

Why Sexual Function Matters in BPH Treatment

It’s not just about urination—it’s about feeling like yourself again.

As a therapist, I’ve seen men recover their urinary confidence but still feel “off” because of unexpected sexual challenges. That’s why sexual function should always be part of the conversation around BPH treatment options.

UroLift shines here because it:

  • Preserves erectile function
  • Maintains ejaculation
  • Doesn’t involve hormones or cutting tissue
  • Allows for quicker recovery compared to invasive procedures
  • Helps patients avoid major surgery and is a safer alternative to most traditional surgical options

Exploring BPH Treatment Options (The Balanced View)

Before committing to a treatment, it’s wise to understand your options. It’s important to consider other BPH treatment options, such as medications, minimally invasive procedures, and traditional surgeries, to find what best fits your needs.

Medications
Medications are often the first line of therapy for BPH. BPH medications, such as alpha-blockers and 5-alpha-reductase inhibitors, can help relieve symptoms by relaxing the muscles of the prostate and bladder or by shrinking the prostate. However, some patients may experience side effects or may not achieve sufficient relief with medication alone.

Ultimately, the best approach is chosen after you and your doctor decide together based on your symptoms and preferences.

✅ Lifestyle + Watchful Waiting

Mild symptoms? Start here. Diet, hydration, bladder training, and pelvic floor therapy can help.

✅ Medications

Options like tamsulosin or finasteride, which are examples of BPH medications, are common but can cause dizziness, low libido, or ED in some men.

✅ Surgical Interventions

  • TURP: Effective but carries sexual side effects
  • Laser therapy: Less invasive than TURP but still risky
  • Prostatic urethral lift (UroLift): A minimally invasive treatment performed as an outpatient procedure, office-based, and sex-sparing

What Is the Prostatic Urethral Lift (UroLift System)?

The UroLift System deploys permanent implants made from standard surgical implantable materials to lift and hold prostate tissue away from the urethra. Think of it like opening curtains to let urine flow freely again.

Why Patients Love It:

Patients typically experience a quick recovery, minimal side effects, and preservation of sexual function after UroLift, making it a preferred choice for many.

  • No hospital stay
  • No cutting
  • No catheter (in most cases)
  • Sexual function stays intact
  • Quick return to work and life

For men who are sexually active and concerned about side effects, UroLift is often the first-line option I recommend in collaboration with their urologist.

Minimally Invasive with Solid Clinical Data

UroLift is FDA-approved and backed by some of the most robust clinical data in the BPH space. Clinical studies have demonstrated the effectiveness of UroLift as a minimally invasive treatment for treating BPH, providing evidence-based support for its safety and efficacy.

Key Stats from Clinical Trials:

  • 5-year data shows durable symptom relief
  • Patients report symptom relief after UroLift treatment
  • No new cases of ED reported in trials
  • High patient satisfaction
  • Improved urinary flow and quality of life

If you’re into data (and who isn’t when it’s your body), here’s what one of the leading studies showed:

“Erectile and ejaculatory function were preserved in 100% of sexually active men treated with UroLift.” — Journal of Sexual Medicine, 2019

How This Treatment Affects Daily Life

The goal of any BPH procedure shouldn’t just be symptom relief—it should be a return to normal life, including:

  • Better sleep (less nighttime peeing)
  • More confidence in social settings
  • Renewed sexual energy
  • Less anxiety about “accidents”

After UroLift, the most common side effects include urinary discomfort, pelvic pain, burning with urination, and blood in the urine. Most symptoms are mild to moderate and typically resolve within a few weeks. Symptoms related to the procedure are temporary, and most patients have their symptoms resolved within a short period.

Most of my patients report feeling lighter, more in control, and more themselves within weeks of UroLift.

And when they pair it with pelvic physical therapy? The results are even better.

What to Expect During UroLift Treatment

If you’re considering the UroLift System, you’ll be glad to know it’s a minimally invasive procedure designed with your comfort and convenience in mind. The entire treatment usually takes less than an hour, and it’s performed right in your urologist’s office or an ambulatory surgery center.

Here’s how it works: Using the UroLift delivery device, your doctor will deploy tiny, permanent implants that gently lift and hold the enlarged prostate tissue away from your urethra. This relieves the obstruction caused by benign prostatic hyperplasia (BPH) and allows urine to flow more freely—no cutting or removal of prostate tissue required.

The procedure can be done under local or general anesthesia, depending on your needs and your doctor’s recommendation. Most patients experience only minimal discomfort, and you’ll typically be able to go home the same day—often without the need for a catheter. Many patients experience symptom relief within just a few weeks after the procedure, and you can expect to get back to your normal routine quickly.

For men looking for a straightforward, effective way to address BPH symptoms and enlarged prostate tissue, UroLift offers a path to symptom relief with minimal downtime and a fast return to daily life.

Finding the Right Healthcare Provider for UroLift

Selecting the right healthcare provider is a crucial step in your journey to relief from BPH symptoms. The UroLift System consists of a specialized delivery device and permanent implants, and it’s important to choose a urologist who is experienced in performing this minimally invasive procedure.

Start by asking your primary care physician for a referral or searching online for urologists in your area who offer the UroLift System treatment. Look for providers who have a track record of success with the procedure and who can clearly explain how the UroLift System works to relieve obstruction caused by enlarged prostate tissue.

A knowledgeable provider will answer all your questions about benign prostatic hyperplasia, the UroLift System, and what to expect before, during, and after treatment. By partnering with an experienced urologist, you’ll be setting yourself up for the best possible outcome—achieving symptom relief and getting back to your life with confidence.

The Role and Importance of Physical Therapy in the Question: Can Urolift Cause Erectile Dysfunction?

As a pelvic health physical therapist, I’ve seen how targeted rehab can make a huge difference post-UroLift.
PT addresses pelvic floor tension, improves circulation, reduces anxiety, and promotes healthy muscle coordination. We also help men regain confidence and sexual function after BPH treatments. Personalized therapy programs can accelerate recovery, reduce post-operative discomfort, and improve outcomes for both urinary and sexual health.

can urolift cause erectile dysfunction

Rehab with Pelvic Floor Therapy After UroLift

Recovery doesn’t end once the UroLift procedure is over — rehab is where your body integrates the change. That’s why pelvic floor therapy is so valuable in the post-op phase.

I work with men to retrain muscles that may have been compensating for years of straining or dysfunction. After UroLift, some patients develop tightness, guarding, or overactive muscles as their body adjusts to the improved urinary flow. Addressing this early leads to better long-term outcomes.

What does rehab look like?

Typical post-UroLift pelvic floor rehab may include:

  • Pelvic floor relaxation and retraining exercises
  • Manual therapy for the lower back, hips, and perineum
  • Breathwork and core coordination drills
  • Education on bladder habits, voiding posture, and fluid timing

Many men are surprised by how much PT can enhance their confidence—not just physically, but sexually and emotionally too. Think of it as the final step in reclaiming your comfort, control, and quality of life after BPH treatment.

Final Thoughts on Can Urolift Cause Erectile Dysfunction

If you’re on the fence about UroLift, here’s my take:

If you want to fix your flow and keep your mojo, it’s one of the best options out there.

But don’t go it alone.

Discomfort varies greatly between individuals, but the procedure typically helps minimize discomfort for most patients.

Talk to your urologist. Talk to a pelvic therapist. Support your recovery, mentally and physically, and you’ll be back to peak performance in no time.Ready to take the next step? Visit Pelvis NYC to schedule a consultation with a specialist who understands your body and your goals.

Pelvic Wall Therapy: A Physical Therapist’s Complete Guide to Healing

A Physical Therapist’s Complete Guide to Healing

Pelvic wall therapy, more commonly referred to as pelvic floor physical therapy (PFPT), is gaining traction as a transformative approach to managing a wide range of pelvic health issues. Despite the growing attention, confusion still exists about what pelvic wall therapy entails, who it’s for, and why it’s a first-line treatment backed by research and medical professionals alike.

As a Doctor of Physical Therapy specializing in pelvic health, I’ve seen the profound impact that this form of therapy can have. This guide will walk you through everything you need to know about pelvic wall therapy.

What Is Pelvic Floor Therapy?

Pelvic floor therapy is a subset of physical therapy that focuses on treating conditions caused by dysfunction of the pelvic floor muscles. The pelvic floor consists of muscles and connective tissue that support the bladder, uterus (or prostate), rectum, and other pelvic organs. These muscles and connective tissue form a hammock-like structure that supports vital internal organs and is attached to the pubic bone and the pelvis, providing stability to the pelvic region.

In women, the pelvic floor also supports the vagina, along with other reproductive organs. Whether the muscles are too weak (hypotonic), too tight (hypertonic), or poorly coordinated, therapy can help retrain them. Dysfunction can involve muscle weakness or muscle spasms, leading to pelvic floor disorder and a range of pelvic floor disorders. These conditions can affect sexual function, and in men, may contribute to erectile dysfunction. This process improves function and alleviates common but often misunderstood.

pelvic wall therapy

Pelvic Floor Physical Therapy: How It Works

When people think of pelvic floor physical therapy, Kegels are often the first thing that comes to mind. While Kegels (pelvic floor contractions) can be beneficial for some patients, they are far from a one-size-fits-all solution, and in many cases, they’re not even appropriate, especially for those with pelvic floor overactivity or pain.

Pelvic floor physical therapy is a specialized therapy offering a range of treatment options tailored to each patient. This comprehensive, individualized approach goes far beyond simple exercises. An individualized plan is created based on a thorough assessment to relieve symptoms and reduce pain. The therapy addresses the full complexity of pelvic floor dysfunction by targeting muscular imbalances, nervous system regulation, postural alignment, and behavioral habits that contribute to symptoms. Treatment may include exercise to strengthen pelvic floor muscles, target specific muscles, and train for activities such as heavy lifting. Here’s what that approach often includes:

Internal and External Assessments

During the first appointment, therapists evaluate pelvic floor muscles through both external (abdomen, hips, back) and internal (vaginal or rectal) exams, and an internal exam may be performed as part of the assessment to check muscle tone, strength, and coordination. This helps identify tightness, weakness, prolapse, or scar tissue that may be contributing to symptoms.

Based on assessment findings and patient comfort, both internal and external therapy options are considered to create a comprehensive treatment plan.

Manual Therapy

Hands-on techniques—like myofascial release, trigger point therapy, and scar tissue mobilization—are used to relieve pain, improve circulation, and restore normal muscle function. These may be applied internally or externally. External therapy, including joint mobilization, may be used to address issues in the sacroiliac joint and other areas to improve mobility and support pelvic health.

pelvic wall therapy

Biofeedback

This technology uses special sensors attached to the body to monitor the activity of specific pelvic floor muscles. The results are displayed in real time on a computer screen, giving patients immediate feedback on how their pelvic floor muscles are functioning. This helps them learn how to properly contract and relax these muscles. It’s particularly effective for retraining coordination and improving control.

Neuromuscular Reeducation

Therapists help retrain how the pelvic floor works with the core, diaphragm, and posture. This often involves movement-based exercises that integrate breathing, lifting, and stability training for better overall control.

Tailored Pelvic Floor Exercises

Rather than one-size-fits-all Kegels, therapists prescribe tailored pelvic floor exercises that may include Kegel exercises and relaxation techniques, depending on whether the muscles are tight, weak, or poorly coordinated. These can include strengthening, relaxation, or endurance work depending on your goals.

Behavioral Coaching

Simple lifestyle changes—like improving posture, toilet habits, or breathing patterns—can have a major impact. Therapists guide patients on daily routines that reduce strain on the pelvic floor and support healing.

Collaborative Care

When needed, pelvic health therapists work alongside urologists, gynecologists, and other specialists to ensure comprehensive care, especially for complex conditions like interstitial cystitis or chronic pelvic pain.

Recognizing the Symptoms of Pelvic Floor Dysfunction

Many people live with pelvic floor dysfunction without even realizing it. Symptoms can vary based on whether the muscles are too tight or too weak. Common symptoms include:

  • Urinary incontinence (leakage during sneezing, laughing, or running)
  • Overactive bladder (frequent, urgent need to urinate)
  • Pelvic organ prolapse (a sensation of bulging or heaviness)
  • Chronic pelvic pain
  • Pain during intercourse or gynecological exams
  • Constipation or straining during bowel movements
  • Low back, hip, or tailbone pain with no clear orthopedic cause

If you’re experiencing one or more of these symptoms, pelvic wall therapy may help relieve symptoms and improve your quality of life.

Why Physical Therapy Is the First Line of Treatment

For those experiencing pelvic floor issues, physical therapy is often recommended before surgical or pharmaceutical interventions. Physical therapists play a crucial role in providing expert care, assessing each patient’s needs, and guiding them through a range of treatment options tailored to their condition. It’s a low-risk, high-reward strategy that’s supported by extensive research.

pelvic wall therapy

A 2024 review published in Frontiers in Global Women’s Health highlighted that pelvic floor physical therapy is significantly effective in treating pelvic floor dysfunction—including urinary incontinence, pelvic pain, and sexual dysfunction—without adverse side effects.

Unlike medications that mask symptoms, physical therapy addresses the root cause: the muscle imbalance or coordination dysfunction at the heart of the issue.

How We Treat Pelvic Floor Dysfunction in Clinical Practice

As a pelvic health physical therapist, I assess not only the pelvic muscles themselves, but also the surrounding structures that influence function. Each patient receives an individualized plan based on their specific pelvic floor disorder, taking into account their medical history, examination findings, and personal goals. Treatment plans typically include:

  • Manual therapy for trigger points and soft tissue tension
  • Postural correction and diaphragmatic breathing
  • Pelvic floor exercises that focus on both strength and relaxation, addressing muscle weakness as well as tightness
  • Scar tissue mobilization (postpartum or post-surgical)
  • Biofeedback and electrical stimulation as needed
  • Internal therapy for appropriate cases, when the patient is comfortable
  • Education on bladder and bowel behavior modification

Each treatment plan is customized. For example, some patients need to learn how to relax the pelvic muscles—not tighten them—especially those with chronic pain or interstitial cystitis.

Pelvic Floor Exercises: More Than Just Kegels

Pelvic floor exercises are foundational in therapy, but they must be done correctly and under the right circumstances. Not everyone should do Kegels. For individuals with overactive (tight) pelvic muscles, relaxation exercises and down-training are more appropriate.

Examples of common exercises include:

  • Slow and fast Kegels (for strengthening, when appropriate)
  • Deep core and gluteal activation
  • Bridge and squat progressions
  • Child’s pose breathing and pelvic drop stretches

Your therapist will evaluate your baseline and recommend exercises that meet your body’s specific needs.

Managing Chronic Pelvic Pain and Interstitial Cystitis with Therapy

Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition characterized by bladder pressure, pain, and frequent urination. While the exact cause is unknown, pelvic floor dysfunction is a common underlying factor, and IC is considered one of several pelvic floor disorders that can be addressed with therapy.

Research shows that physical therapy focusing on myofascial release and trigger point therapy can significantly reduce symptoms in people with IC. Internal therapy, such as internal vaginal or rectal release techniques, is often included in the treatment plan—alongside behavior changes and bladder retraining. The goal of therapy is to relieve symptoms and reduce pain, improving overall quality of life.

Patients with IC often respond best to a multidisciplinary approach involving PT, dietary changes, and pain psychology.

When Should You Start Pelvic Floor Therapy?

Early intervention is ideal. However, it’s never too late to seek help. You should consider seeing a pelvic health physical therapist if you:

  • Experience urinary or bowel leakage
  • Have pelvic pressure or notice a bulge
  • Feel pain with sex or during pelvic exams
  • Suffer from chronic pelvic or lower back pain
  • Are recovering from childbirth, abdominal surgery, or pelvic trauma

Postpartum recovery is especially critical. Studies show that initiating pelvic floor therapy within the first 6–12 weeks postpartum can prevent long-term issues such as prolapse, diastasis recti, and bladder dysfunction.

What Does a Pelvic Therapy Session Look Like?

A typical pelvic floor physical therapy session may include:

  • Review of symptoms and daily habits
  • Reassessment of posture, breathing, and muscle tone
  • Guided pelvic floor exercises or manual therapy, including internal and external therapy as appropriate
  • Education on self-care tools (perineal massage, dilators, postural changes)
  • Progress tracking and goal-setting

Therapy is typically done once per week for 6 to 10 weeks, depending on your condition and response to treatment.

Conclusion: Take the First Step Toward Pelvic Health

Pelvic wall therapy is a safe, effective, evidence-based path to healing pelvic floor dysfunction. Whether you’re a new mom, recovering from surgery, or managing chronic pain or interstitial cystitis, pelvic floor physical therapy offers real hope without relying on medications or surgery.

As a PT, I’ve seen how profoundly this therapy can change lives. Don’t wait for symptoms to worsen. With tailored guidance, pelvic floor rehabilitation can restore function, reduce pain, and help you reclaim control over your body.

pelvic wall therapy

Ready to take the first step? Visit Pelvis NYC to schedule an evaluation with a specialized pelvic health therapist and start your journey to recovery.

Varicocele: What Guys Should Know About This “Silent” Issue

Varicocele: What Guys Should Know About This “Silent” Issue

Most men don’t want to talk about their balls, especially if something feels weird or off down there. But if you’ve ever felt a strange heaviness, dull ache, or swelling in your scrotum, you might be dealing with something called a varicocele.

It’s more common than you’d think. About 1 in 7 men will get one, and for guys dealing with fertility issues, that number jumps to nearly 1 in 2.

So let’s break it down—what varicoceles are, why they matter, what you can do about them, and how physical therapy (yep, really) can be part of the solution.

The Male Reproductive System

Before we go deeper, let’s quickly break down how the male reproductive system works—and why something like a varicocele can quietly throw the whole thing off.

The main parts of the male reproductive system include the testicles, which are responsible for making sperm and testosterone; the epididymis, where sperm mature; and the vas deferens, which transports sperm during ejaculation. Supporting glands like the seminal vesicles and prostate add fluid that makes up semen, helping sperm survive their journey.

All of this needs to work in sync. But here’s the catch: sperm production is extremely sensitive, especially to heat, pressure, and blood flow. That’s why your testicles hang outside the body in the first place: to stay a few degrees cooler than your core temperature.

So when something like a varicocele causes enlarged veins and increased heat around the testicles, it can throw off that delicate balance. The result? Poor sperm health.

That’s where a semen analysis comes in.

If you’re trying to conceive and it’s taking longer than expected (usually six to twelve months), doctors often order this test to get a read on:

  • Sperm count – how many sperm are in your semen
  • Motility – how well your sperm swim
  • Morphology – how normal they look in size and shape
  • Volume and consistency of the semen itself

If any of those numbers are off, a varicocele is one of the first things a urologist will look for—because it’s such a common, correctable cause of male infertility.

So… What Is a Varicocele?

A varicocele is a varicose vein—but in your scrotum, not your legs. The veins that carry blood away from your testicles get enlarged and twisted, usually on the left side, thanks to how our plumbing is built.

You might feel:

  • A weird dragging sensation in your groin
  • A dull ache after standing or working out
  • Swelling or even a “bag of worms” feel (yeah, it’s as weird as it sounds)
  • Or maybe… nothing at all

And that’s what makes varicoceles so tricky. Some guys don’t notice anything until they and their partner start trying for a baby, and suddenly, a semen analysis throws up red flags.

Varicocele Symptoms: What to Watch For

Not all varicoceles cause noticeable pain or discomfort, which is why many men don’t even realize they have one until a fertility issue arises. But when symptoms do show up, they can include a dull, aching pain or a sense of heaviness in the scrotum. Some men notice a visible or palpable lump, often described as feeling like a “bag of worms” (strange but accurate), and swelling or asymmetry in the testicles, most commonly on the left side. Discomfort may become more noticeable after standing for long periods, lifting weights, or during physical activity.

In many cases, the first clue comes during a fertility workup, when a doctor orders a semen analysis and finds issues like low sperm count or abnormal motility. That’s often when the varicocele diagnosis comes into focus, turning what seemed like a minor issue into a much more pressing concern.

How Does Varicocele Affect Fertility?

Here’s where it gets serious. Varicoceles can mess with your male reproductive system in a few important ways:

  1. Raises testicle temperature → Sperm don’t develop properly in heat
  2. Reduces oxygen and blood flow → Leads to oxidative stress, damaging sperm DNA
  3. Impaired hormone regulation → May lower testosterone over time

📊 Studies show that varicoceles are present in 40% of men with abnormal semen parameters, and treating them can improve both sperm quality and pregnancy rates.

How Is a Varicocele Diagnosed?

Doctors typically diagnose a varicocele during a physical exam or scrotal ultrasound. You may be asked to stand and perform a Valsalva maneuver (basically bearing down) so they can check for vein enlargement.

It’s often graded from Grade 1 (small) to Grade 3 (large), and those grades help determine the need for medical treatment.

Varicocele Treatment Options: What Can You Do?

Not every varicocele needs to be treated. But if you’re in pain, your semen quality is poor, or you’re trying to conceive without luck, here’s what you can consider:

Watchful Waiting

If your varicocele is small and symptom-free, doctors may suggest monitoring it regularly, especially if you’re not trying to have kids right now.

Medical Treatment: Varicocele Surgery

If you’re dealing with pain or fertility problems, varicocele surgery (aka varicocelectomy) is often recommended. It involves tying off the enlarged veins to restore normal blood flow.

There are a few surgical techniques:

  • Microsurgical varicocelectomy – highest success, lowest risk
  • Laparoscopic surgery
  • Percutaneous embolization – a minimally invasive option using a catheter

According to the American Urological Association, surgery improves semen quality in 60–80% of men and boosts natural pregnancy rates in many couples.

How Can Physical Therapy Help Varicocele?

This is where things get interesting. Most men are never told that pelvic physical therapy can support recovery and manage symptoms, sometimes even before considering surgery.

1. Pain Management

Chronic testicular or pelvic pain isn’t always about the veins. Sometimes, it’s due to muscle tension, nerve entrapment, or poor posture.

A men’s health PT can release tension in the:

These techniques relieve pressure and improve blood flow.

2. Post-Surgical Recovery

After varicocele repair, PT helps you:

  • Regain core strength
  • Reduce scar tissue adhesions
  • Return to pain-free sex, sports, and workouts

🧠 Fact: About 30–50% of men with varicocele-related pain continue to feel discomfort even after surgery (AUA Guidelines, 2021). Physical therapy can address muscular and nerve-based causes that surgery doesn’t fix.

3. Pelvic Floor Rehabilitation

Pelvic floor dysfunction in men can mimic varicocele pain, worsen congestion, and impair urinary/sexual function.

Men’s health PTs use techniques like:

  • Biofeedback
  • Internal release (yes, men have pelvic floors too!)
  • Diaphragmatic breathing to improve circulation

4. Lifestyle Support

PTs can guide you in:

  • Movements that improve venous return
  • Anti-inflammatory routines (breathing, stretching)
  • Advice on compression, lifting techniques, and posture

What the Research Says

  • 2018 Review (Andrologia): Varicocele-related pain is often neuromuscular, not purely vascular. Conservative therapies like PT should be part of the care plan.
  • 2021 Study (Urology Journal): Men undergoing PT after varicocelectomy reported faster pain relief and improved daily function.
  • Pelvic PT Research (Hodges, 2020): The pelvic floor is central to venous and lymphatic return, a key factor in varicocele symptom management.

When Should You See a PT?

You should consider seeing a pelvic health PT if:

  • You’ve had surgery but still have discomfort
  • You’re dealing with testicular or groin pain that doesn’t seem to improve
  • You want to explore non-surgical options before going under the knife
  • You’ve noticed that posture, movement, or stress makes symptoms worse

There’s Help—You Just Have to Ask

A varicocele isn’t the end of the world—but it’s also not something to brush off. Whether it’s causing pain, fertility issues, or just messing with your peace of mind, you deserve answers and real solutions.

Between surgical treatment, lifestyle changes, and physical therapy, there are more options than you think. The key is getting the right diagnosis and building a team that helps you move forward—without shame, fear, or guesswork.

Ready to Take the Next Step?

If you’re dealing with testicular pain, fertility struggles, or just want answers about your body, you don’t have to navigate it alone. At Pelvis NYC, we specialize in male pelvic health, offering personalized, expert-led care that supports your recovery, improves blood flow, and helps you feel like yourself again.

Whether you’re preparing for varicocele treatment, recovering from surgery, or exploring non-invasive options, our team is here to help you move forward confidently and pain-free.👉 Book a private consultation today at Pelvis NYC and take control of your health, your fertility, and your future.

Varicocele- How PT can help?

Male Pelvic Floor: The Hidden Foundation of Men’s Health

Male Pelvic Floor: The Hidden Foundation of Men’s Health

When we think of men’s health, we often focus on biceps, six-packs, or heart health. Yet hidden deep within your core lies a powerful network that influences bladder control, erectile function, and posture—the male pelvic floor. While this area is often overlooked or labeled “women’s health,” men absolutely have pelvic floor muscles, and training them can transform performance, recovery, and daily comfort.

From boosting your lifts to extending your staying power in the bedroom, from post-prostate recovery to aging gracefully, your pelvic floor plays a critical role. In this guide, we’ll find out what it is, why it matters, how to work it intentionally, and how to avoid common pitfalls. Understanding and training these muscles can unlock new levels of confidence, vitality, and well-being.

What’s the Pelvic Floor—and Why It Powers Men’s Health

The pelvic floor is a group of muscles and connective tissues that form a sling at the base of the pelvis. The pelvic floor muscles form a supportive sling that helps maintain continence and sexual function.

In men, these muscles support the bladder, rectum, and prostate, and play a key role in sexual and urinary functions. Anatomically, the pelvic floor muscles stretch from the pubic bone at the front to the tail bone (coccyx) at the back, and from one ischial tuberosity to the other, providing a strong base. The urethra passes through the pelvic floor muscles, and their strength is important for urinary control. In addition to muscles, other tissue such as connective tissue also supports the bladder and bowel.

male pelvic floor

Main male pelvic floor muscles include:

  • Pubococcygeus (PC) – Supports the bladder and contributes to ejaculation control.
  • Bulbocavernosus – Affects erections and ejaculation.
  • Ischiocavernosus – Helps maintain penile rigidity.
  • External urethral sphincter – Controls the flow of urine.
  • Levator ani group – Lifts and stabilizes the pelvic organs.

Together, these muscles work to manage pressure in the abdomen, support internal organs, and help control bodily functions. They also coordinate with the deep core, diaphragm, and glutes.

Do Men Have Pelvic Floor Muscles?

Yes—men absolutely have pelvic floor muscles, even though they’re less frequently discussed in public health. In fact, these muscles are vital for:

  • Urinary continence
  • Fecal continence
  • Sexual function and orgasmic intensity
  • Postural support
  • Lower back health

Pelvic floor muscles support the bladder, bowel, and sexual function, helping maintain continence and core stability.

Ignoring pelvic floor health can lead to long-term issues that range from incontinence to erectile dysfunction and chronic pelvic pain.

Male Pelvic Floor Dysfunction: Signs & Symptoms

Pelvic floor dysfunction in men is often underdiagnosed. A weak pelvic floor or weak pelvic floor muscles can result from injury, aging, or lifestyle factors, and may lead to issues with continence and pelvic support. It can stem from weakness, tension, nerve damage, or poor coordination of the pelvic muscles.

A tense pelvic floor, also known as a hypertonic pelvic floor, occurs when the muscles are overly tight, leading to symptoms such as pain, constipation, and urinary issues.

Common Symptoms:

  • Leaking urine, especially after urination (post-micturition dribble)
  • Urgency or frequent urination
  • Inability to fully empty the bladder
  • Erectile dysfunction (ED)
  • Premature ejaculation
  • Pain in the penis, perineum, rectum, or tailbone
  • Constipation, straining to defecate, or difficulty moving the bowels

These issues can affect young and older men alike—often without them realizing the pelvic floor is to blame.

How the Male Pelvic Floor Muscles Work

The male pelvic floor muscles work as a supportive foundation for your pelvic organs, including the bladder, bowel, and rectum. These muscles form a hammock-like structure at the base of your pelvis, contracting and relaxing to help you control the flow of urine and feces, and to support sexual function. When you need to hold in urine or prevent passing gas, your pelvic floor muscles contract; when it’s time to urinate or have a bowel movement, they relax. This coordination is also crucial for sexual performance, as strong pelvic floor muscles can enhance erections and ejaculation.

If your pelvic floor muscles become weak or are not functioning properly, you may experience issues like urinary incontinence, fecal incontinence, or erectile dysfunction. Weakened pelvic floor muscles can make it harder to control your bladder and bowel, leading to leaks or accidents. The good news is that regular pelvic floor exercises, such as Kegel exercises, can help strengthen these muscles, improve bladder and bowel control, and support better sexual health. By making pelvic floor training a part of your routine, you can help ensure these essential muscles work efficiently throughout your life.

Finding and Contracting Your Pelvic Floor Muscles

Finding your pelvic floor muscles is the first step to effective pelvic floor training. To locate the correct muscles, try to stop the flow of urine midstream or imagine you’re trying to prevent yourself from passing gas. The muscles you engage in these moments are your pelvic floor muscles. To contract them, squeeze your pelvic floor as if you’re stopping urine or holding in gas, hold the squeeze for a few seconds, then relax. Repeat this process several times, focusing on using only the pelvic floor muscles and not your thighs, buttocks, or abdomen.

It’s important to use the correct muscles when performing Kegel exercises. Using the wrong muscles can make the exercises less effective or even cause discomfort. If you’re unsure whether you’re targeting the right muscles or if you have trouble isolating them, don’t hesitate to seek guidance from a physical therapist or healthcare provider. They can help you learn how to squeeze your pelvic floor properly and ensure you’re getting the most benefit from your exercises.

How the Male Pelvic Floor Muscles Work

The pelvic floor is dynamic. When you contract the pelvic floor muscles, they create a lift, which can be seen as an upward movement of the penis and testicles. It tightens to help you hold in urine or gas, and it relaxes to let you urinate or pass a bowel movement. During sexual activity, these muscles are also responsible for generating and controlling erections and ejaculations.

Proper function requires both strength and relaxation. If the muscles are too weak, you might experience leaks or erectile problems. If they’re too tense, it can lead to pain and urinary retention. Like any other muscle group, training and balance are key.

Kegel Workout for Men: The Core of the Pelvic Region

Kegel exercises, first introduced by Dr. Arnold Kegel in the 1940s, were designed to strengthen the pelvic floor. While popularized for women, Kegels are equally beneficial for men.

Performing a kegel exercise regularly, such as during daily routines, can help prevent urinary leakage.

🛠️ How to Do Kegels/ Pelvic Floor Exercises Correctly:

  1. Identify the musclesTry to stop the flow of urine mid-stream. The muscles you engage are your pelvic floor.
  2. Contract and holdSqueeze the muscles for 5–10 seconds, then relax for the same duration. Squeezing the pelvic floor muscles is the key movement in Kegel exercises and helps ensure proper muscle engagement.
  3. RepetitionDo 3 sets of 10 reps daily. Perform them lying down at first, then progress to sitting and standing.
  4. Breathe normallyAvoid holding your breath or tightening your buttocks or thighs.

❗️Note: Stopping urine mid-flow should only be used to identify muscles, not as a regular practice—it can interfere with bladder function.

Proven Benefits of Pelvic Floor Training in Men

✅ Urinary Control

  • Especially beneficial after prostate surgery (e.g., radical prostatectomy).
  • Can reduce urinary leakage and urgency.

✅ Erectile Function

  • Strengthens the bulbocavernosus muscle, which improves blood retention in the penis.
  • A 2005 clinical trial found that pelvic floor muscle training significantly improved ED in 40% of men within 3 months.

✅ Ejaculatory Control

  • Enhances awareness and control during sex.
  • Reduces premature ejaculation through muscle timing.

✅ Chronic Pelvic Pain Relief

  • Helps relax tense or overactive pelvic muscles.
  • Effective when combined with pelvic floor physical therapy and biofeedback.

Don’t Overdo It: The Problem of Overactive Pelvic Floors

Just like any muscle, the pelvic floor can be too tight. Men who constantly “hold in” tension may experience:

  • Painful urination or ejaculation
  • Testicular or perineal discomfort
  • Constipation
  • Urinary hesitancy

Tension in the pelvic floor muscles can also affect the back passage (rectum), leading to problems with continence and bowel movements.

If that sounds like you, relaxation techniques are more important than strengthening:

  • Diaphragmatic (deep belly) breathing
  • Gentle yoga or stretching
  • Manual therapy by a pelvic floor physical therapist

Other Exercises That Support the Pelvic Floor

In addition to Kegels, incorporating other functional movements can help strengthen the muscles that work closely with the pelvic floor. Exercises like glute bridges are particularly effective because they engage the glutes and lower back while encouraging pelvic stability. Squats are another excellent choice—they activate the core, hips, and thighs, which all contribute to better pelvic support. Strengthening the transverse abdominis, the deepest abdominal muscle, is also key; this can be done through controlled core exercises that emphasize deep breathing and core engagement. Movements like dead bugs and other core stabilizing drills help coordinate the pelvic floor with surrounding muscles, improving overall control and function.

Preventing Pelvic Floor Injuries and Health Issues

Taking steps to prevent pelvic floor injuries and health issues can make a big difference in your long-term well-being. One of the most effective strategies is to perform Kegel exercises regularly, which helps strengthen your pelvic floor muscles and supports better bladder and bowel control. In addition to exercising, maintaining a healthy weight reduces unnecessary pressure on your pelvic floor. Avoiding repeated heavy lifting and managing chronic coughs, such as a smoker’s cough, can also help protect these muscles from strain and injury.

If you experience symptoms like urinary incontinence, fecal incontinence, or pelvic pain, it’s important to seek advice from a healthcare professional. Early intervention can prevent minor issues from becoming more serious. Remember, your pelvic floor muscles play a vital role in controlling your bladder and bowel, so taking care of them through regular exercise and healthy lifestyle choices is key to preventing pain and incontinence.

Treatment Options for Pelvic Floor Dysfunction

male pelvic floor exercises

If you’re dealing with pelvic floor dysfunction, there are several treatment options available depending on the cause and severity of your symptoms. For mild cases, performing Kegel exercises as part of a regular exercise routine can help strengthen your pelvic floor muscles and improve bladder and bowel control. If you need additional support, physical therapy with a specialist can provide targeted exercises, biofeedback, or even electrical stimulation to help retrain your muscles.

In some situations, medication or surgery may be necessary to address underlying issues like severe urinary incontinence or fecal incontinence. Your healthcare provider can help you determine the best treatment plan for your needs, whether that involves adjusting your exercise routine, making lifestyle changes, or exploring medical interventions. Don’t hesitate to reach out to a healthcare provider if you’re experiencing symptoms—early treatment can make a significant difference in your recovery and quality of life.

ℹ️ Myth Buster | Quick Q&A

Myth: “Kegels are only for women.”
Truth: Men’s pelvic floors benefit equally—improving leaks, erections, and sexual stamina.

Myth: “Stronger is always better.”
Truth: When pelvic floor muscles are too tight, they restrict function—balance, not just strength, is key.

Final Thoughts: It’s Time to Talk About It

male pelvic floor therapists in Pelvis NYC

The male pelvic floor is a vital yet often ignored part of men’s health. These muscles affect your ability to control urine, enjoy sex, support your core, and recover from surgery or injury. Understanding their function—and learning how to train them—can dramatically improve your quality of life.

Whether you’re managing a specific issue or just want to optimize your long-term health, pelvic floor care is an investment worth making. Start with small steps. Stay consistent. And don’t be afraid to seek support—your body will thank you.

✅ Ready to take your pelvic health seriously?

👉 Connect with the experts at Pelvis NYC—a leading pelvic floor physical therapy clinic specializing in men’s pelvic health, sexual dysfunction, post-surgical rehab, and core optimization. Their evidence-based, personalized programs are designed to help you regain control, eliminate discomfort, and elevate your quality of life.

Your pelvic floor matters. Make it a priority—start with Pelvis NYC today.

Kegel Workout for Men: Boost Sexual Health and Reclaim Control

Kegel Workout for Men: Boost Sexual Health and Reclaim Control

Introduction: Why Every Man Needs a Pelvic Floor Stronghold

In the world of fitness, men often focus on building biceps, core strength, or cardiovascular endurance. But there’s a small, invisible group of muscles that can dramatically improve everything from your bladder control to sexual stamina—and it’s one most men aren’t even aware of. We’re talking about the pelvic floor muscles, and the way to train them is through something called the Kegel workout for men.

Once thought to be exclusively for women, Kegel exercises for men have gained traction thanks to increasing awareness in urology and sexual health, and even on platforms like Reddit and men’s wellness groups. This guide will walk you through Kegel workout for men, explain how these exercises address erectile dysfunction and premature ejaculation, and introduce how working with a healthcare provider, like the specialists at Pelvis NYC—can elevate your results.

Understanding Your Pelvic Floor Muscles and How They Work

Importance of kegel workout for men for their Pelvic Floor Muscles

The first—but most crucial—step is understanding what the pelvic floor muscles do. Picture a hammock supporting your bladder, prostate, and rectum. These muscles also support your bowel and are essential for controlling both bladder and bowel functions, including during a bowel movement. Strengthening these muscles with Kegel exercises:

  • Helps manage bladder leaks when you cough, sneeze, or laugh
  • Supports bladder and bowel control
  • Enables firmer, more sustainable erections
  • Helps control ejaculation timing
  • Reduces pelvic tension, discomfort, or chronic pain

That’s why kegel exercises go beyond mere fitness—they support fundamental aspects of men’s sexual health and day-to-day well-being.

What Is a Kegel Workout for Men?

Named after Dr. Arnold Kegel, who developed these exercises in the 1940s for women post-childbirth, Kegels are designed to strengthen the pelvic floor muscles. These muscles form a supportive hammock at the base of the pelvis and are responsible for controlling urination, stabilizing the core, and supporting sexual function.

For men, strengthening the pelvic floor can:
  • Improve urinary control (especially after prostate surgery or with age)
  • Enhance erections and sexual stamina
  • Help with premature ejaculation
  • Support prostate health
  • Reduce the risk of pelvic pain and incontinence

Men’s Kegel exercises are especially effective for managing urinary incontinence, urine leakage, and leaking urine, which can occur after prostate surgery or during activities like coughing or lifting. Regular practice of these exercises can also help improve the urine stream by training the muscles used to stop urine flow. Additionally, men’s Kegel exercises are beneficial for treating fecal incontinence and overall urinary or fecal incontinence, supporting better pelvic health and reducing symptoms of incontinence.

So why are most men not already doing this?

The answer is simple: awareness and stigma. Many men don’t know these exercises exist, and those who do often assume they’re just for women. But new research, urological guidelines, and even anecdotal success stories are beginning to change that narrative.

What Does Kegel Workout for Men Mean?

The pelvic floor muscles—particularly the pubococcygeus (PC) muscle—play a crucial role in urinary and sexual functions. When these muscles are weak, you may experience leaks after urination, poor erection strength, or lack of control during sex.

Kegel exercises involve repeatedly contracting (squeezing) and relaxing these muscles, much like you would train a bicep curl at the gym. Performing Kegels involves a specific contraction and relaxation of the pelvic floor muscles. It is important to focus on performing Kegels correctly, as improper technique—such as engaging the wrong muscles—can lead to ineffective results or discomfort. When performing Kegels, avoid engaging the buttock muscles, stomach, or stomach muscles; only the pelvic floor muscles should be working. If you feel pain while performing Kegels, stop the exercise and consult a healthcare provider. Over time, this builds strength and endurance, which translates into better control and responsiveness.

The Impact on Erectile Dysfunction and Premature Ejaculation on Kegel Workout for Men

Pelvic floor weakness is often linked to erectile dysfunction (ED). Strengthened muscles improve blood flow and structural support, which can significantly reduce ED symptoms. In fact, men using regular pelvic workouts often report firmer, longer-lasting erections.

Regarding premature ejaculation, you gain a powerful tool: better awareness of pelvic contractions. This allows you to consciously delay climax, enhancing both control and satisfaction.

By adding reliable kegel exercises for men into your wellness plan, you’re supporting sexual health on multiple fronts—with minimal effort and no pills.

Finding the Right Muscles: A Crucial First Step

Before you begin training, you need to find your pelvic floor and identify your pelvic floor muscle accurately. Here’s how (whether you call it urination or pee):

  • The urine stop test: While you urinate, try to stop or slow your urine stream midway. The muscles you use are the pelvic floor. (Only try this once; doing it repeatedly can harm your bladder.)
  • Gas prevention method: Imagine trying to hold in or prevent yourself from passing gas. That internal clench—without engaging your abs or glutes—is the target.
  • Visual cue: When done correctly, you may see the base of your penis retract slightly or your testicles lift a bit, as these pelvic floor muscles support the genital area.

Avoid contracting your thighs, buttocks, or abs. The focus should be internal, deep in your pelvis.

The same ones you use to stop urination, control your urine stream, or delay ejaculation are the pelvic floor muscles targeted by a kegel exercise.

Step-by-Step Kegel Workout for Men

Now that you’ve identified the correct muscles, it’s time to build a consistent routine. Like any fitness regimen, progress comes with regular, mindful practice. Kegel exercises can help strengthen the pelvic floor and improve bladder and bowel control.

Beginner Routine (Weeks 1–3)

  • Find a quiet place to lie down or sit.
  • Contract the pelvic floor and hold for 3–5 seconds.
  • Relax for 5 seconds.
  • Repeat 10 times, 3 times per day.

Be patient. Early sessions may feel awkward or weak. That’s completely normal.

Intermediate Routine (Weeks 4–6)

  • Increase your hold time to 8–10 seconds.
  • Add quick pulses (rapid contractions and releases) for 10–15 reps.
  • Practice in different positions: sitting, standing, or while walking.

Advanced Routine (Week 7 and beyond)

  • Incorporate Kegels into daily movement, such as walking, driving, or exercising.
  • Hold contractions during sex to improve control.
  • Combine with deep core work—like planks—to activate more muscle fibers.

Consistency is key. Most men begin to see real improvements in 4–6 weeks.

Hidden and Underrated Benefits of Kegel Workout for Men

The well-known benefits of Kegels—like better bladder control and improved erections—are just the beginning. Strong pelvic floor muscles provide essential muscles support for the bladder, bowel, and genital area, helping to maintain continence and overall pelvic health. There are several lesser-discussed advantages that are gaining recognition in both medical circles and online communities:

1. Relief from Chronic Pelvic Pain and Prostatitis

Men suffering from chronic prostatitis or pelvic floor dysfunction often report decreased pain and improved quality of life through pelvic floor physical therapy, which includes Kegels. According to a 2016 Cochrane Review, pelvic floor exercises significantly reduce pelvic pain and urinary symptoms.

2. Improved Post-Surgical Recovery

Men recovering from prostatectomy (prostate removal surgery) often experience urinary leakage. Studies from Harvard Health and Mayo Clinic show that patients who began pelvic floor exercises immediately after surgery regained continence faster than those who didn’t.

3. “Coregasms” and Unexpected Pleasure

In fitness circles—and Reddit threads—some men have reported involuntary orgasms triggered during intense core exercises involving pelvic engagement (like leg raises or planks). These are known as “coregasms,” and they may be amplified by a strong pelvic floor.

“I thought I was the only one… turns out it’s real! Planks + Kegels = mind blown.” — Reddit user on r/fitness

4. Posture and Lower Back Support

The pelvic floor is part of your deep core. Strengthening it contributes to better posture, spinal alignment, and lower back health, especially when paired with glute and abdominal training.

Advanced Techniques: Biofeedback, EMSELLA, and Devices

Once you’ve mastered the basics, there are tools and therapies that can further enhance your results.

📈 Biofeedback Devices

These tools (e.g., Perifit, Elvie for Men) provide real-time feedback to ensure you’re activating the right muscles. Used in physical therapy settings, they help correct form and measure improvement.

⚡ EMSELLA Chair

This high-tech device, available in urology and wellness clinics, uses electromagnetic pulses to contract your pelvic muscles—equivalent to doing 11,000 Kegels in one session. It’s painless, non-invasive, and popular among men post-surgery or those who want to jumpstart results.

🧪 Research-Backed Results

  • A 2019 study published in Urology Journal reported that 61% of men saw improvement in premature ejaculation after 12 weeks of pelvic floor training.
  • Another clinical trial showed a 40% improvement in erectile strength in men doing daily Kegels.

Common Mistakes Men Make with Kegels

Even a simple exercise can go wrong if done improperly. Here’s what to avoid:

  • Overtraining: Doing Kegels too frequently can lead to tension or even pain.
  • Wrong muscles: If your abs, thighs, or butt are sore—you’re not doing them right.
  • Holding breath: This increases intra-abdominal pressure and reduces effectiveness.
  • Expecting overnight results: Like any muscle, the pelvic floor needs time to strengthen.

Stick with it. The reward is long-term, not instant.

Real Talk from Reddit & Men’s Health Forums

One of the most underrated places for firsthand experience is Reddit. Threads in r/pelvicfloor and r/AskMen are filled with stories, struggles, and successes.

“I was skeptical, but now I can last twice as long in bed. Wish I started sooner.” — Reddit user

“Three months of Kegels helped my post-surgery leakage more than anything else. I can go on a run again without worrying.” — User in prostate cancer recovery forum

You’re not alone. Thousands of men are now incorporating Kegels as part of their health routine, just like push-ups or cardio.

Conclusion: Why Every Man Should Do Kegels

If you’re still wondering whether Kegel workouts are worth it—the answer is a resounding yes.

From improved urinary control and stronger erections to post-surgical recovery and even unexpected benefits like posture and orgasm quality, Kegels are a low-risk, high-reward investment in your body.

You don’t need a gym, expensive gear, or even a lot of time. Just consistency, awareness, and patience.

When to Consult a Healthcare Provider

Kegels are safe and natural, but certain situations demand professional insight:

  • Persistent incontinence, despite consistent home exercise
  • Post-surgical conditions (e.g., post-prostatectomy)
  • Chronic pelvic or rectal pain
  • No improvement in sexual symptoms after several months

A dedicated Kegel workout for men is a no-cost, powerful tool that boosts your daily life—bladder control, sexual performance, and confidence, included.

But for optimal results, especially concerning erectile dysfunction or premature ejaculation, consider working with pros. Dr. Adam Gvili and Dr. Josh Weber at Pelvis NYC design pelvic floor therapy that’s tailored to your specific needs, and backed by medical science and advanced treatment options.

kegel workout for men- Dr. Adam Gvili and Dr. Josh Weber of Pelvis NYC

👉Click here to book with Pelvis NYC now—and let Dr. Gvili and Dr. Weber guide your path to better bladder, stronger erections, and lasting sexual health.

Let’s break the stigma around men’s pelvic health—with science, strategy, and skill.

Are you a woman looking for pelvic floor exercises tailored to your needs?
Check out our women’s guide: Kegel Workout for Women: How to Strengthen Your Pelvic Floor

Kegel Workout for Women: How to Strengthen Your Pelvic Floor

Kegel Workout for Women: How to Strengthen Your Pelvic Floor

In today’s health-conscious world, Kegel workout for women are gaining recognition for their powerful yet simple impact on overall wellness. Whether you’re navigating postpartum recovery, dealing with bladder control issues, or simply aiming to boost core and sexual health, pelvic floor exercises can offer long-term, life-enhancing benefits.

This comprehensive guide will help you find your pelvic floor, perform Kegel exercises correctly, and make them part of your daily routine—while avoiding the common mistake of activating other muscles.

What Are Pelvic Floor Muscles?

Your pelvic floor muscles are a group of muscles that act like a sling, supporting the bladder, uterus, and rectum. It is important to identify and exercise the correct muscles to ensure effective pelvic floor strengthening. These muscles play a vital role in bladder control, core stability, posture, sexual function, and childbirth recovery. When these muscles weaken—due to aging, pregnancy, heavy lifting, or inactivity—you may experience issues like urinary incontinence, pelvic organ prolapse, or decreased sexual satisfaction.

Why Kegel Workout For Women Matters

Kegel exercises strengthen the pelvic floor, offering benefits such as:

  • Strengthening pelvic floor muscles, which support pelvic organs and improve overall pelvic health
  • Improved blood circulation to the pelvic area, which may enhance arousal, lubrication, and sensation
  • Support for bowel function and help in managing fecal incontinence
  • Reduced urinary incontinence and better control over the urge to urinate, helping to prevent leaks
  • Faster postpartum recovery
  • Improved sexual function
  • Support during menopause
  • Prevention of pelvic organ prolapse

How to Find the Right Muscles or Find Your Pelvic Floor

Before starting your Kegel workout, it’s critical to find the right muscles.

Here’s how:

  • The bathroom test: Try to stop the flow of urine midstream. The muscles used here are your pelvic floor muscles. (Only use this method to identify muscles, not as a regular exercise.)
  • Gas-hold trick: Imagine you’re trying not to pass gas. The muscles that contract are also part of your pelvic floor.
  • Physical Awareness: Place a finger inside your vagina and gently contract your pelvic muscles around it to confirm you’re targeting the right area.

If you’re squeezing your abdomen, thighs, or buttocks—you’re using other muscles, which won’t help your pelvic floor and may cause strain. Always avoid tightening your abdomen, thighs, or buttocks to ensure only your pelvic floor muscles are engaged.

How to Do a Kegel Workout for Women Correctly

Let’s break it down into a simple how-to guide:

  1. Empty your bladder before starting. Do not perform Kegel exercises while urinating or try to stop your urine stream, as this can interfere with emptying fully and may increase the risk of urinary tract infection.
  2. Contract your pelvic floor muscles (as if lifting them upward).
  3. Hold the contraction for 3–5 seconds.
  4. Release slowly and completely for 3–5 seconds. It is important to relax your pelvic floor muscles fully after each contraction.
  5. Repeat 10–15 times per set.
  6. Aim for 3 sets per day.

Keep breathing naturally. Don’t hold your breath. Avoid engaging your abs, legs, or glutes.

Gradually increasing the number of sets over time can help prevent strain and improve the effectiveness of your Kegel exercises.

The Importance of a Step-by-Step Guide

A step-by-step guide is invaluable when starting kegel exercises, especially for those new to pelvic floor muscle training. By following a clear, structured approach, you can ensure you’re engaging the right muscles—your pelvic floor muscles—rather than accidentally tightening your buttock muscles or abdomen. This precision is essential, as only the pelvic floor muscles support your bladder, uterus, and rectum, and are responsible for improving bladder control and overall pelvic health.

A well-designed step-by-step guide helps you practice kegel exercises correctly, making it easier to develop a consistent exercise routine. With each step, you’ll gain confidence in your technique, avoid common pitfalls, and maximize the benefits of your efforts. Whether you’re aiming to strengthen your pelvic floor, prevent issues like urinary incontinence, or simply support your core, a step-by-step guide is your roadmap to success.

Integrating Kegel Workout Into Your Daily Routine

Consistency is key. The beauty of Kegel workouts for women is that you can do them discreetly—anytime, anywhere.

Ideas for practice:

  • While brushing your teeth
  • During commercials
  • At red lights
  • While working at your desk
  • While relaxing on the couch
  • Before bed

Try pairing them with existing habits to build a consistent daily routine.

Being Aware of Other Muscles

When performing kegel exercises, it’s important to focus solely on your pelvic floor muscles and avoid engaging other muscles, such as your thighs, buttock muscles, or abdomen. Many people unintentionally tighten these areas, which can reduce the effectiveness of the exercises and even cause unnecessary strain. To ensure you’re isolating the pelvic floor, try practicing kegels in different positions—sitting, standing, or lying down—and pay close attention to which muscles are contracting.

If you’re unsure whether you’re performing kegel exercises correctly, a physical therapist can provide expert guidance. They can help you identify and activate the pelvic floor muscles while keeping other muscles relaxed, ensuring you get the most out of your exercise routine. Remember, the goal is to strengthen the pelvic floor, not the surrounding muscles.

Common Mistakes to Avoid While Doing Kegel Workout for Women

  • Using the wrong muscles—like your abs or thighs
  • Overtraining—this can fatigue your pelvic floor
  • Holding your breath—it builds pressure instead of control
  • Being inconsistent—it takes daily effort to see results
  • Experiencing pain during or after Kegel exercises may indicate improper technique and should be avoided. If you feel pain, stop and consult a healthcare professional.
  • Incorrect technique or excessive strain can contribute to stress incontinence, causing urine leakage during activities like coughing, sneezing, or laughing. Proper form is essential to prevent this.

Advanced Tips and Variations

Kegel exercises are simple exercises that most women can perform to strengthen their pelvic floor muscles.

Once you’ve mastered basic Kegels, consider adding variations:

1. Elevator Kegels

Imagine lifting your pelvic muscles in slow stages (like floors on an elevator).

2. Quick Flicks

Rapidly tighten and release the muscles for 10 reps—this builds fast muscle reaction.

3. Functional Kegels

Engage your pelvic floor before lifting, sneezing, or jumping.

For an added challenge, try using a vaginal cone. Insert the vaginal cone and contract your pelvic muscles to hold it in place while standing or walking. This tool can help improve the effectiveness of your pelvic floor muscle training routine.

Staying Motivated on Your Kegel Journey

Maintaining motivation is key to making kegel exercises a lasting part of your daily life. Start by setting realistic goals and tracking your progress—whether it’s improved bladder control, reduced urinary incontinence, or enhanced sexual function. Begin with just a few minutes of kegel exercises each day, and gradually increase the duration and frequency as your pelvic health improves.

A healthcare professional can help you create a personalized exercise regimen, offering support and encouragement along the way. Understanding the many benefits of kegel exercises—from better bladder health to increased confidence—can also keep you inspired. By staying committed and motivated, you’ll be well on your way to stronger pelvic floor muscles and a healthier, more vibrant you.

When to See a Professional

If you’re unsure whether you’re doing Kegels properly or if symptoms persist, consult a pelvic floor physical therapist. They can offer biofeedback, evaluate your muscle control, and guide you through a tailored plan.

Final Thoughts: Empower Your Core from Within

Mastering the Kegel workout for women is one of the most empowering, low-effort ways to improve your quality of life. From better bladder control to more enjoyable intimacy and improved posture, the benefits are well worth the few minutes a day it takes.

Keep in mind that it may take a few months of consistent practice to notice significant results from Kegel workouts.

Start small. Be consistent. Listen to your body. And remember—stronger pelvic floor muscles mean a stronger, more confident you.

Ready to Take the Next Step?

If you want personalized guidance or are experiencing pelvic floor issues, remember that many factors—such as pregnancy, childbirth, surgery, and aging—can affect pelvic floor health. Professional guidance is especially important for concerns related to a woman’s vagina. The experts at Pelvis NYC are here to help. Their specialized physical therapists offer customized pelvic floor therapy tailored to your needs.

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Visit Pelvis NYC today to book a consultation and start your journey toward better pelvic health and lasting relief.

Related Blog: The Ultimate Kegels Workout: Strengthen Your Core and Vaginal Muscle Spasms: Expert Guide from Dr. Samantha Vargas