Pelvic Floor Physical Therapy for Men With Erectile Dysfunction

Erectile dysfunction, the inability to achieve or maintain an erection for satisfactory sexual performance, can have dramatic negative effects on a male’s quality of life. Erectile dysfunction can often be caused by dysfunction or atrophy of the ischiocavernosus muscle, a primary muscle responsible for maintaining penile rigidity that is found along the length of the penile shaft. These symptoms can be mild resulting in difficulty maintaining potency to severe resulting in the inability to achieve penetration. An erection consists of two phases: the vascular phase and the muscular phase. During the muscular phase or rigidity phase, the ischiocavernosus reflex can trigger ischiocavernosus contractions that create pressure by compressing the corpus cavernosum. The corpus cavernosum is composed of spongy erectile tissue and is responsible for facilitating erections by filling with blood and preventing compression of the urethra during erections. This process maintains penile rigidity during intercourse. The ischiocavernosus muscle can be strengthened like any other striated, skeletal muscles in the body. ¹

Studies support the use of pelvic floor physical therapy for treatment of men with erectile dysfunction:

Erectile dysfunction may also occur due to specific co-morbidities. Men post radical prostatectomies are at high risk for developing erectile dysfunction due to intraoperative injury to neurovascular bundles. Prota et al observed the effects of pelvic floor biofeedback training in 52 men post-radical prostatectomy and its effects on recovering erectile function. Men in the treatment group began receiving pelvic floor biofeedback on post-op day 15 once a week for 30 min sessions for a total of 12 weeks by a physical therapist. Results showed that time to recover the ability to achieve an erection were significantly lower in the treatment group versus control group. Additionally at 12 months post op, more subjects in the treatment group were considered potent versus the control group. Thus, early pelvic floor biofeedback muscle training post-op radical prostatectomy has a significant impact on recovery of erectile dysfunction. ⁴

Erectile dysfunction can be a common complaint among men with heart disease and may be an early marker of symptomatic cardiovascular disease. Sedentary lifestyle can increase the risk of erectile dysfunction by two-threefold. Men post-acute myocardial infarction (heart attack) experiencing erectile dysfunction who are at low cardiovascular status can benefit from an unsupervised home-based walking program four times a week for symptom improvement while also increasing functional capacity. Physical therapists are qualified in helping develop optimal home- based walking programs for patients that are enjoyable and easy to do alone, with a friend or partner. ⁵

If you are a man experiencing pelvic floor issues such as erectile dysfunction physical therapy can benefit as part of your overall treatment plan. The team at New Dimensions Physical Therapy can help fully evaluate your pelvic floor function, taking in orthopedic and cardiovascular considerations to help conservatively improve your symptoms. We use evidence- based research to help our patients achieve their optimal level of function.

Lila Abbate, PT, DPT, MS, OCS, WCS

Andrea Wood, PT, DPT

References:

1. Lavoisier P, Roy P, Dantony E, et al. Pelvic-Floor Muscle Rehabilitation in Erectile Dysfunction and Premature Ejaculation. Phys Ther. 2014; 94(12):1731-1743

2. Dorey G, Speakman M, Feneley R, et al. Randomized controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. British Journal of General Practice. Nov 2004; 819-825

3. Van Kampen M, De Weerdt W, Claes H, et al. Treatment of Erectile Dysfunction by Perineal Exercise, Electromyographic Biofeedback, and Electrical Stimulation. Physical Therapy. 2003;83(6): 536-543.

4. Prota C, Gomes CM, Ribeiro LHS, et al. Early postoperative pelvic-floor biofeedback improves erectile function in men undergoing radical prostatectomy: a prospective, randomized, controlled trial. International Journal of Impotence Research. 2012; 24: 174-178.

5. Begot I, Peixoto TC, Gonzaga LR. A home based walking program improves erectile dysfunction in men with an acute myocardial infarction. Am J Cardiol. 2015; 1;115(5): 571-575.

Lila Abbate is Teaching in Australia!

Lila Abbate, a well known physical therapist in pelvic health, will be teaching an all star line up of courses in Australia. This is a great opportunity to gather a high amount of knowledge and help provide the missing links in a lot of patients’ cases.

 

 

 

You can purchase tickets at the following link:

Purchase Tickets Here!

Course Series:: 8:30 AM-4PM

Bowel Pathology, Function, Dysfunction and the Pelvic Floor: November 5-6, 2016.

Coccyx Pain, Evaluation, and Treatment: November 7-8, 2016

Pelvic Pain: November 10-11, 2016

 

Location:

Active Physiotherapy MacKay

3/43 Gregory Street , Mackay, Australia

About Lila Abbate:

Dr. Lila Bartkowski-Abbate, PT, DPT, MS, OCS, WCS, PRPC is the Director/Owner of New Dimensions Physical Therapy. Dr. Abbate graduated from Touro College in Dix Hills, NY with a Bachelors of Science (BS) in Health Sciences and a Masters of Arts (MA) in Physical Therapy in 1997.  She completed her Advanced Masters in Manual Orthopedic Physical Therapy (MS) at Touro College, Bayshore, NY in 2003 and continued to pursue her Doctor of Physical Therapy (DPT) in 2005.  Currently, Dr. Abbate is working toward her PhD at Nova Southeastern University in Ft. Lauderdale, Florida and plans to conduct research in Women’s and Men’s Pelvic Pain topic.  Dr. Abbate is also a Physical Therapy Board-Certified Specialist in Orthopedics (OCS) and Women’s Health (WCS) deemed by the American Physical Therapy Association in 2004 and 2011, respectively.  Dr. Abbate has experience as full-time faculty at Touro College, Manhattan Campus from 2003 – 2006 teaching the biomechanical approach to orthopedic dysfunction, therapeutic exercise as well as massage/soft tissues work that highlighted trigger point work, scar management and myofascial release. She is also the instructor of the women’s health elective at Columbia University’s Program in Physical Therapy.  Dr. Abbate is currently faculty with the Herman & Wallace Pelvic Rehabilitation Institute teaching pelvic physical therapy nationally and is certified as a pelvic floor practitioner (PRPC).  She is member of the American Physical Therapy Association, American Urogynecology Association, International Pelvic Pain Society and the National Vulvodynia Association.

Disfunción Sexual, Cáncer de Mama y el Papel de laTerapia Física

En los Estados Unidos, hay más que 2.8 millones mujeres quienes han recibido o están recibiendo tratamiento para el cáncer de mama. Aunque los efectos asociados con los tratamientos – incluyendo las trombosis linfáticas,fatiga, linfedema, y estrés emocional– además, casi 77% de los sobrevivientes del cáncer de mama también tienen disfunción sexual aun tres años o más después de su primer diagnosis. Este incluye dificultades con la excitación y el deseo, dolor con penetración, atrofia, sequedad, estenosis vaginal, la incapacidad de llegar a un clímax y otras síntomas. No importa si Usted es pre- o postmenopáusica, éstas síntomas merecen la atención de su grupo de apoyo medical.

Hoy día, hay poca evidencia definitiva con respecto a los tratamientos farmacológicos para las síntomas de disfunción sexual asociadas con el cáncer de mama. En el primer estudio escudriñando la eficacia de la terapia de reemplazo hormonal, descubrieron que el riesgo de la reaparición del cáncer de mama subió, pero en un estudio seguimiento 10 años después no encontraron un aumento del riesgo. Hay otras opciones farmacológicas, como la testosterona, el DHEA y Tibolone. La presentación de cada paciente es distinta, y el tratamiento farmacológico es algo que Usted debe discutir con su médico. Pero, si las medicinas no son efectivos, no las recomienda su médico, no son suficientes para todas las síntomas que tiene, o solamente no prefiere ese tipo de tratamiento, hay otras opciones disponible para Usted, incluyendo fisioterapia con énfasis en el piso pélvico.

Si Usted tiene las síntomas de disfunción sexual, especialmente sequedad de la vagina, dolor con penetración o la incapacidad de llegar a un climax, después del tratamiento del cáncer de mama, una terapista física con especialización en el piso pélvico puede realizar una evaluación para descubrir el origen del disfunción, darle información científico con respecto a los lubricantes y las hidratantes apropiados y las posiciones sexuales mejores para disminuir el dolor, y ayudarle en aliviar sus síntomas para realizar su salud sexual óptima. En un estudio realizado en 2013, descubrieron que haciendo ejercicios para relajar el piso pélvico en combinación con una hidratante y un lubricante apropiado, mejoró el dolor con penetración, la función sexual y la calidad de vida en general. El entrenamiento de los músculos del piso pélvico, junto con recomendaciones con respecto a la lubricación y la hidratación, pasó con una terapista física en la primera y la cuarta semana, pero la mayoría de los tratamientos fueron realizados desde la comodidad del hogar.

Si Usted tiene estas síntomas y quiere aliviarlas, haga una cita con una terapista con especialización en el tratamiento del piso pélvico en New DimensionsPhysicalTherapy hoy para volver a la función óptima, físicamente y sexualmente. Sólo haga click en la ficha “RequestanAppointment” y llene la forma. Se aceptamos Medicare, y si Usted quiere que su cita este realizado en español, simplemente ponga su solicitud en la caja de la descripción de sus preocupaciones (“Pleaseprovide a short description of yourcondition”) y nos encantaría acomodarse.

Justine Payne, PT, DPT

Sexual Dysfunction, Breast Cancer and the Role of Physical Therapy

There are more than 2.8 million women living in the United States today who are either being treated or have completed treatment for breast cancer. While the side effects associated with these treatments are taxing enough – possibly including axillary web syndrome, lymphedema, cancer-related fatigue, and emotional distress – in addition, up to 77% of breast cancer survivors also qualify for a diagnosis of sexual dysfunction even three years or longer after their initial diagnosis. This includes anything from difficulties with arousal and desire to pain with intercourse (dyspareunia), medication-induced atrophy or dryness, vaginal stenosis and hypo-orgasmia, among other symptoms. Whether you are pre- or post-menopausal, these side effects deserve the attention of your healthcare support staff.

Currently there is conflicting evidence regarding the efficacy of medications to treat sexual dysfunction in breast cancer survivors. Hormone Replacement Therapy (HRT) has been studied as a treatment for relief of symptoms of sexual dysfunction, and while there was an increased risk of reoccurrence of breast cancer in the initial study, a ten-year follow-up study did not show a significantly higher recurrence rate in the group treated with HRT. Other pharmacological interventions tested in breast cancer survivors include topical testosterone, DHEA and Tibolone, among others. Every patient is distinct, and pharmacological intervention is a potential treatment that should be discussed with your physician. However, if medications are ineffective, not recommended, insufficient for all of your symptoms or simply not your treatment of choice, there are alternatives available, including pelvic floor physical therapy.

If you are currently experiencing symptoms of sexual dysfunction, especially vaginal dryness, pain with intercourse, and /or anorgasmia, a pelvic floor physical therapist can perform an evaluation to determine the source of your dysfunction, provide scientifically supported education regarding proper moisturizers and lubricants and optimal positioning for decreased pain, and assist you in alleviating your symptoms to achieve optimal sexual function. A study performed in 2013 found that performing pelvic floor muscle (PFM) relaxation exercises, in combination with an appropriate moisturizer and lubricant, significantly improved pain with intercourse, sexual function and general quality of life in women with a history of breast cancer. Training in PFM relaxation, along with recommendations for lubrication and moisturizers, took place with a physical therapist during the first and fourth weeks, but otherwise the participants carried out the treatments from the comfort of their own homes.

If you are experiencing these symptoms, set up an evaluation with a specialized pelvic floor physical therapist today to begin your path back to optimal physical and sexual function.

Lila Abbate PT, DPT, OCS, WCS

Justine Payne, PT, DPT

References:

“U.S. Breast Cancer Statistics.” Breastcancer.org. N.p., 11 May 2015. Web. 24 June 2015.

Bober SL, Varela VS. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol 2012;30:3712-9.

Fahlén M, Fornander T, Johansson H, Johansson U, Rutgvist LE, Wilking N, et al. Hormone replacement therapy after breast cancer: 10 year follow up of the Stockholm randomized trial. Eur J Cancer, 2013;49(1):52-9.

Heath A, Massa L, Sebba N, Westbrook K. Sexual Health for Breast Cancer Survivors. Combined Sections Meeting, 2015. Indianapolis, IN.

Holmberg L, Iversen OE, Rudenstam CM, Hammar M, Kumpulainen E, Jaskiewicz J, et al. Increased risk of recurrence after hormone replacement therapy in breast cancer survivors. J Natl Cancer Inst, 2008; 100(7): 475-82.

Juraskova I, et al. The acceptability, feasibility, and efficacy (Phase I/II Study) of the OVERcome (olive oil, vaginal exercise, and moisturizer) intervention to improve dyspareunia and alleviate sexual problems in women with breast cancer. J Sex Med. 2013; 10: 2549-2558

Pinto AC. Sexuality and breast cancer: prime time for young patients. J Thorac Dis, 2013; 5(S1): S81-6.

Raggio GA, Butryn ML, Arigo D, Mikorski R, Palmer SC. Prevalence and correlates of sexual mobidity in long-term breast cancer survivors. Psychology & Health, 2014; 29(6): 632-50.

Scoliosis and Pelvic Pain: Treating the Whole Body to Improve Outcomes

Many people when they think of scoliosis think of the standard forward bend test as a kid at annual scoliosis screenings. They think if they passed these screenings earlier in life, scoliosis is something they do not have to worry about. However, there are many individuals with scoliosis who do not display severe spinal curvatures and may never know they have it despite being screened as children. Many people exhibit mild curvatures that do not cause obvious pain or any pain at all. However, if you have pelvic pain and scoliosis, there could be a link with directing parts of physical therapy treatment towards your scoliosis to help optimize outcomes.¹

Scoliosis is a musculoskeletal deformity of the spine that causes it to curve to one side and creates a problem with movement. The curve can appear as a “C” shape or an “S” shape. Scoliosis can be classified as structural or functional. Structural scoliosis is a curvature of the spine that does not go away with position changes. Adolescent idiopathic scoliosis (AIS), a type of structural scoliosis, occurs in patients from 10 years old until they reach skeletal maturity.  In adulthood, AIS can continue to progress or adult degenerative scoliosis may occur.² If you are over 40, increased age has been associated with an increased prevalence of scoliosis.³ ⁴ Functional scoliosis is a curvature of the spine due to elements not involving the spine such as muscle imbalances, leg length discrepancy, or poor postural habits.² ⁵  

Symptoms of scoliosis include:²

• One hip or shoulder higher than the other
• Uneven shoulder blades
• A “rib hump” and feeling like one side of your ribs is sticking out more
• One arm hanging longer than the other
• Legs appear uneven
• The above listed are accompanied by back pain or breathing difficulty/asymmetry

The prevalence of scoliosis in patients referred to a clinic with pelvic pain has been found to be high. Scoliosis may contribute to pelvic pain by influencing the pelvis, muscles, and surrounding joints. Pelvic pain can be highly associated with pain in the hip flexors, quadratus lumborum, abdominals, piriformis, and levator ani. Scoliosis may impact all these muscles negatively secondary to causing pelvic obliquity, leg length discrepancy, muscle imbalances, and postural faults.¹ Additionally, scoliosis may impact the respiratory system secondary to decreased chest mobility and asymmetrical inspiration. Impaired breathing patterns and lack of diaphragm usage can impact the pelvic floor negatively secondary to the pelvic floor and diaphragm’s close relationship.⁶ ⁷ Many studies have found a higher rate of occurrence of back pain and inguinal pain in patients with scoliosis then those without.¹ ⁸

Treating the muscles surrounding the scoliosis and postural retraining exercises may help decrease pelvic pain and back pain, especially in the case of a functional scoliosis. If breathing is asymmetrical or impaired, physical therapists can provide proper resisted breathing and strengthening exercises to improve respiratory function and postural control.⁷ In cases of structural scoliosis, collaboration with physical therapy and a medical team may lead to better outcomes on pelvic pain.

There is a reason why your physical therapist may be focusing treatment at your mid back or lumbar spine in order to help decrease your pelvic pain. Good posture is one of the keystones to optimal musculoskeletal health. The team at New Dimensions Physical Therapy can provide you with a thorough postural assessment when considering causes of your pelvic pain and prescribe the appropriate postural strengthening and breathing corrective exercises. Manual therapy to help decrease symptoms and pain can also be provided as needed. Addressing the body as a whole system is key to helping heal chronic pelvic pain cases.

Lila Abbate PT, DPT, OCS, WCS

Andrea Wood, PT, DPT

References:

1. Tate, L. Prevalence of scoliosis in a pelvic pain cohort. J Womens Health Phys Therap. 2015; 39(1): 3-9.

2. Seattle Children’s. (2015). What Is Scoliosis? Retreived from http://www.seattlechildrens.org/medical-conditions/bone-joint-muscle-conditions/spinal-conditions-treatment/scoliosis/

3. Kebaish KM, Neubauer PR, Voros GD, et al. Scoliosis in adults aged forty years and older: prevalence and relation-ship to age, race, and gender. Spine. 2011;36(9):731–736.

4. Urrutia J, Diaz-Ledezma C, Espinosa J, Berven SH. Lumbar scoliosis in postmenopausal women: prevalence and relationship with bone density, age, and body mass index. Spine. 2011;36(9):737–740

5. Raczkowski J, Daniszewska B, Zolynski K. Functional scoliosis caused by leg length discrepancy. Arch Med Sci. 2010;6(3):393-398.

6. Mohammadi P, Akbari M, Sarrafzadeh J, et al. Comparison of respiratory muscles activity and exercise capacity in patients with idiopathic scoliosis and healthy individuals. Physiother Theory Pract. 2014;30(8):552-556.

7. Kim JJ, Song GB, Park EC. Effects of swiss ball exercise and resistance exercise on respiratory function and trunk control ability in patients with scoliosis. J Phys Ther Sci. 2015l 27(6):1775-1778.

8. Sato T, Hirano T, Ito T, et al. Back pain in adolescents with idiopathic scoliosis: epidemiological study for 43,630 pupils in Niigata City, Japan. Eur Spine J. 2010;20(2):274–279

Overcoming Painful Intercourse: Women’s Health Physical Therapists Should be Part of Your Medical Team

If you have pain with intercourse you likely do not talk about it or you may think it is normal. If occurring, you may endure it or avoid the activity all together. These responses can lead to significant emotional and psychological repercussions. You may not even know where to start or may be too embarrassed to bring it up to your physician. You also probably have no idea a physical therapist specialized in women’s health can play a significant role in reducing your pain.

The medical term for painful intercourse is dyspareunia. Dyspareunia is recurring or persisting pain with sexual activity that can cause significant distress or conflict. It occurs in approximately 10-20% of women in the US. There can be two types of dyspareunia, one occurring with initial penetration and the other occurring with deep penetration.¹

 Common causes of dyspareunia include:¹

• Pregnancy (especially during the second half) ²
• Postpartum trauma
• Vaginal atrophy post menopause (affects 50% of postmenopausal women due to decrease in estrogen)
• Vaginismus (involuntary contraction of the pelvic floor muscles that limits vaginal entry)
• Vulvodynia (pain localized to the vagina and supporting structures)
• Orthopedic issues
• Dermatologic disease (examples include lichen sclerosis and psoriasis)
• Endometriosis
• Interstitial Cystitis
• Perivaginal infections¹

All of the above listed conditions are unique issues that come with varied treatments. However, a common problem that can occur in all of the above issues are pelvic floor muscles functioning inappropriately.¹ Treating and retraining the pelvic floor muscles are where women’s health physical therapists play a role as part of the medical team.  In a sample of 132 women that examined the effects of a multidisciplinary program consisting of pelvic floor physical therapy, medical management, and psychological intervention for vulvodynia, strong significant effects were reported in reduction of dyspareunia, sex related distress, sexual arousal, and overall sexual functioning. Thus, a multidisciplinary approach to painful intercourse including pelvic floor physical therapy can have positive outcomes. ³

If you are considering surgery for painful intercourse issues you also may want to discuss trying pelvic floor physical therapy with your physician before surgery to see if it is a viable option. In a sample of 90 patients with a history of sexual dysfunction researchers compared patients who underwent a surgical procedure versus pelvic floor physical therapy alone. Orgasm and dyspareunia improved significantly in the physical therapy group and dyspareunia was more painful in the surgical group. Therefore, pelvic floor physical therapy may be a good option to try before considering surgical procedures if your doctor thinks you are an appropriate candidate. ⁴

Physical therapy treatment for dyspareunia can include soft tissue mobilization to internal and external muscles, pelvic floor muscle retraining exercises, dilator programs, biofeedback, and orthopedic exercises. ⁵ Women’s health physical therapists also can provide options for positions during intercourse based off orthopedic considerations or pain locations. Partner and patient education about dyspareunia is also important secondary to partner responses to pain and women’s maladaptive beliefs regarding vaginal penetration being found as strong predictors to sexual pain behaviors. ⁶ It is important to address all the factors contributing to dyspareunia with your medical team for success. If you feel you are suffering from dyspareunia, you don’t have to. The team at New Dimension’s Physical Therapy can help improve your symptoms and direct you on the right track for treatment. Painful intercourse is not normal and there are many viable conservative treatment options to help.

Lila Abbate PT, DPT, OCS, WCS

Andrea Wood, PT, DPT

References:

1. Seehusen D, Baird D, Bode, D. Dyspareunia in women.Am Fam Physician. 2014; 90(7): 465-470.
2. Galazka I, Drosdzol-Cop A, Naworska B, et al. Changes in the sexual function during pregnancy. J Sex Med. 2015; 12(2): 445-454.
3. Brotto LA, Yong P, Smith KB, et al. Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. J Sex Med. 2015; 12(1) 238-247.
4. Eftekhar T, Sohrabi M, Haghollahi F et al. Comparison effect of physiotherapy with surgery on sexual function in patients with pelvic floor disorder: a randomized clinical trial. Iran J Reprod Med. 2014; 12(1): 7-14
5. Ensor W, Newton Roberta. The role of biofeedback and soft tissue mobilization in the treatment of dyspareunia: a systematic review. J Womens Health Phys Therap. 2014; 38(2): 74-80
6. Brauer M, Lakeman M, Van Lunsen R, et al. Predictors of task-persistent and fear-avoiding behaviors in women with sexual pain disorders. J Sex Med. 2014; 11(12): 3051-3063.

 

 

Pelvic Organ Prolapse

Pelvic organ prolapse is a descent of the pelvic floor structures.  Watch this video to understand some of your symptoms and you have encountered as well as complaints that you have discussed with your physician.  Physical therapy can help in many ways help to treat your pelvic organ prolapse symptoms.

June is POP Awareness Month. APOPS is working to shift awareness of POP impact with a video blog page on our website. Every day during the month of June, we will post a short video about pelvic organ prolapse to shift recognition forward.

http://pelvicorganprolapsesupport.org/video-blog

Lila Abbate PT, DPT, OCS, WCS

Pre-Natal/Post-Partum, Constipation Radio Show

Here is the website. Listen to the podcast!
http://podcast.healthywealthysmart.com

Lila Abbate PT, DPT, OCS, WCS

What To Expect On Your First Pelvic Floor PT Visit

You’ve made your first appointment for pelvic floor physical therapy and no doubt have questions about what will take place.  Our physical therapists are specially trained and have extensive experience treating pelvic floor dysfunction.  Here’s what you can expect during your first visit to our office.

As part of your initial appointment, the physical therapist will conduct a comprehensive evaluation,    beginning with a complete medical history.  You will be asked about:

• the state of your health in general;

• the medications you are currently taking;

• the nature of your problem and how it has an impact on your life;

• the treatments you have tried to date;

• the surgeries or procedures you have undergone;

• issues specifically related to your problem such as the intensity of your pain;

• what makes your pain worse;

• how many times you use the toilet each day; and

• whether it is painful to urinate, have a bowel movement or have sexual relations.

We understand that some of these topics may seem very personal and difficult for you to discuss.  However, this information is very important as it will enable your physical therapist to thoroughly understand your problem, provide an accurate diagnosis and develop a personalized treatment program.

Next, the physical therapist will evaluate your posture and conduct a musculoskeletal assessment to see how well your muscles and joints move.  In addition, an internal examination will be performed to check your pelvic floor muscles to identify factors which may contribute to or result from your condition.  If at any point you feel uncomfortable or in pain, let your physical therapist know immediately.

Based on the information you share and the findings of the evaluation, a plan of care will be created for you.  This treatment plan, which will likely consist of various components depending upon your condition, will be carried out during your following physical therapy sessions.

We encourage you to ask questions or voice any concerns throughout your treatment.  Pelvic floor physical therapy is a relationship between partners.  Working together, you and the physical therapist can help you meet your recovery goals.

Lila Abbate PT, DPT, OCS, WCS

Recurrent Urinary Tract Infections

Urinary tract infections are common.  According to statistics, 60% of women in their lifetime and 5 – 20% of men over age 50 will suffer from urinary tract infections.¹ However, the feeling of frequent infections that occur numerous times within a year, or even after intercourse, and having your urine specimen come back negative, may be the signs of a muscle problem.

Tight pelvic floor muscles that are contracting continuously may be producing lactic acid.² It is the same “acid burn” that is felt when you work out at the gym doing leg squats or lunges.  The continual contraction of a muscle unit, made up of actin and myosin, produces a by-product called lactic acid.  When working out at the gym, the burning makes us realize that we are working the muscle to its maximum potential and we are working it very hard and it is near its fatigue.  However, to feel the same burning sensation in your pelvis, can lead us to believe that something is wrong and the sensation is very uncomfortable.  The muscle contraction and relaxation during the intercourse moment allows the lactic acid to release and hence the feeling of burning is present or will increase.  Some men and women can feel this without intercourse activity and can also feel additional symptoms of urinary urgency and frequency, with accompanied burning, just like a urinary tract infection.

If you feel that this clinical presentation may be close to your symptoms, you always should be medically cleared at some point – either before starting or early in your physical therapy treatments.  It is recommended that you see your local urologist, urogynecologist or gynecologist for urine and pelvic screening and testing.  If your medical tests come out negative, you may have a muscle problem.  Please contact us at New Dimensions Physical Therapy for a physical therapy evaluation.

Lila Abbate PT, DPT, OCS, WCS

References:

1. http://en.wikipedia.org/wiki/Urinary_tract_infection#Epidemiology, January 9, 2011.