Overcome Your Condition With Someone You Trust

Pelvic floor dysfunction. This condition, which is relatively unheard of in the male world, unless you’ve experienced it for yourself, is tough for anyone to talk about much less deal with. You may be interested to know, that in fact, you are not alone! For example, many men who have had a prostatectomy will have short term urinary incontinence and for some, this may last a little longer.

Male pelvic floor dysfunction is not limited to, but includes:

  • Urinary incontinence after a prostatectomy
  • Erectile dysfunction  (often after a prostatectomy)
  • Urinary urgency and frequency (over active bladder)
  • Chronic constipation
  • Faecal incontinence
  • Pelvic pain

Pelvic floor physiotherapy can help you to gain control, improve your current situation and restore your quality of life.

There are very few physiotherapists, if any, in the Illawarra who have a special interest in Mens Health. Zoë Mills is an experienced musculoskeletal physiotherapist and exercise physiologist with post-graduate qualifications in pelvic floor rehabilitation from Melbourne University. She works in Sydney part-time, predominantly treating men with pelvic floor dysfunction, particularly pre and post prostatectomy.  

Zoe has a good understanding of male pelvic floor dysfunction from a clinical, academic and emotional/psychological perspective. She understands the impact pelvic floor dysfunction can have on your quality of life. Zoe strives, through a sensitive examination and individualised treatment; to help you gain control and get back to the things you love doing.

Zoë often works in conjunction with specialists, such as Urologists, Colorectal Surgeons, Psychologists, Pain Physicians and General Practitioners. She has a good understanding of surgery, and pathways of care having recently attended operating theatre to observe a robotic prostatectomy!

Zoe is easy to talk to and understands the embarrassment a man may feel when having to discuss water works or erectile dysfunction issues. But once you come in and meet her, you’ll know you’re finally on the right track. 

Why Haven’t My Prior Treatments Worked?

Many patients who come to us with pelvic floor dysfunction have been given a pamphlet to teach them how to do pelvic floor exercises.  This is like being given a pamphlet on how to play tennis; you can read about how to do it, but when it comes to actually physically doing it, you need one on one instruction and verbal feedback. Many men are unaware that they actually have a pelvic floor! Lots of men think that the pelvic floor is women’s business and initially they have difficulty locating theirs. In this instance, Zoe often uses real time ultrasound, which is a non-invasive way of imaging your pelvic floor muscles. And, VIOLA!  All of a sudden you GET IT!!

Another common problem is that men often get their instruction on how to do pelvic floor exercises over the internet. Most of this type of instruction is incorrect, cueing men to very strongly squeeze their back passage. This is important of course if you have faecal incontinence, but may not be entirely helpful if you have urinary incontinence. The cue of a ‘strong’ squeeze is often problematic in itself as we can ‘overdo’ the contraction and end up making your incontinence or pelvic pain worse!

What Makes Us Different?

Many people don’t even realize that their condition may be quite common, but if not common, there is certainly specific information with regards to your condition. If you have limited genito-pelvic awareness then it’s pretty tough to address the problem and work to solve it. At RehWork, we’ll sit down with you and fill in the gaps in your understanding of your body. Once our patients are fully clued in on why their symptoms are happening, they feel ten times better about their ability to overcome them.

Zoë will initially listen very carefully to your complaint and background history. She will then perform a physical examination, which may in some cases, involve a digital rectal examination (of course only with your consent and only if indicted) and/or use real time ultrasound to image your pelvic floor muscles. She may also give you a bladder or bowel diary, or even a pain diary to take home and fill out prior to the next consultation, depending upon your specific problem.

Next, we collaborate with you on a pelvic floor recovery program that’s customized to your situation. Where are you now? Are there activities you’re afraid to perform because of your pelvic floor dysfunction? Is this detracting from your work and family life? We’ll build an entire program around improving your situation.

For instance, if you’re suffering from an overactive bladder, we’ll not only teach you about good bladder habits; we’ll show you how to cultivate them. In some cases, overactive bladder may be curable.

We use the same techniques to help you mitigate or eliminate other symptoms of pelvic floor dysfunction. If you have prostate cancer and are about to undergo a prostatectomy – either open, laparoscopic or robotic, Zoë will start you on a pre-op pelvic floor muscle training program to ease the complications that can result. Similarly, if you have already undergone a prostatectomy and are finding it difficult to cope with incontinence or erectile dysfunction, pelvic floor physiotherapy can help you get back on track.

Frankly, pelvic floor dysfunction is no fun; it can impact on your private relationships. It’s frustrating, annoying, embarrassing, and debilitating. But when you come to RehWork, we will formulate a specific plan for you and you can look forward to steady improvement, which will give back the quality of life that you have been striving for.