Erectile dysfunction is often linked to treatments that are used to target prostate cancer. So, a lot of people might be asking where are the pelvic floor muscles and what they look like in men. Let’s consider the purpose of these muscles. One of them wraps around the penis and assists in hosting it up into the erect position. The surrounding muscles are there because once blood is forced into the testicles and penis, it needs to remain there.
Those surrounding muscles that keep the blood inside this area and allow for a nice erection. What do we need for good pelvic floor control? You need good nerve supply, but we also need the muscles to respond to the nurse command. What happens after removal of the prostate, also known as a prostatectomy, is that even when the nerves that allow an erection to take place are spared, these nerves are very shy, and they really don’t like to be fiddled with.
Even under the surgeon’s glaring lights on the operating room or even just touching the surrounding tissues with a scalpel will cause these nerves to go into a little bit of a retraction, and they won’t want to fire as well as they once did. Luckily for the men who received prostate removal with the nerve bearing, these nerves can regrow and rebound to their past glory.
So what would we want to tell a man before he goes in for either a prostate removal or radiation for prostate cancer?
We’d want to tell this man to come to physical therapy for the pelvic floor at least a couple of times to get in touch with these muscles and know what they’re doing. The other thing we would ask this gentleman is to attempt sex, erections, ejaculations, whether that be men or with a partner, three times a week.
We want to keep these tissues working well to prepare them for what’s going to happen with this prostate cancer treatment. Following your treatment or prostate cancer, which is either going to be surgery to remove the prostate or it’s going to be radiation in several different forms, what we’re going to recommend to get you back to erectile function is we want you to attempt sex when you are cleared by your physician.
Now a lot of men are terrified of this because they feel that they’re going to leak urine out of the tip of their penis, and this is extremely common and normal. If you’re at all concerned about it, you can simply wear a condom which will contain the urine during the sexual act. If you do not want to engage in sex with a partner, though, it is highly recommended we still recommend solo manual stimulation and what’s the reason why. We want to promote blood flow.
If we don’t do that, how will these tissues ever remember what normal direction is? What are the methods that we can use to get more blood flow in the area and restore this male to his previous sexual function?
Number one is a class with pharmaceuticals known as PDE-5 medications, and they include Viagra, Cialis, and Levitra. These medications will improve blood flow to the perineum to the testicles and the penis. Remember, when we talked about the thought that floor muscles and how they assist the penis to get hard and erect and they prevent the blood from leaving the penis? Well, after prostate surgery, which is the prostatectomy or radiation to the area, those muscles are not working in the same fashion.
So how do we achieve the rigid erection and keep the blood from leaving the area? This is a very simple technique, and you can utilize a penis ring. These come in many different forms, and they are placed around the base of the penis, and it’s going to allow the blood to get into the penis but not a stay back because we don’t want that.
There is another model of one, so you could use one compartment for the penis, the other for the testicles. And one of the popular ones involves a cinching mechanism so you could put the penis or the testicles in the one tighten around it to whatever feels right for you or put the penis in the top portion and the testicles in the bottom.
Next, we’re going to talk about penile pumps. These are a vacuum suction type mechanism, and what they’re going to do is elongate the tissues of the penis. They’re extremely safe, and there are many of them on the market, so they range from very inexpensive to very expensive.
The bottom line is you want to be able to get some suctioning and lengthen your penis. You can do that with your hands, but this is a simpler mechanism to use this penis pump and use it several times weekly. When a man has a traditional erection, there are red blood cells in the blood that are going to induce penis and testicles, making for a very pink firm erection. The penile pump is a very different mechanism of an erection. So what we’re pulling into the penis is pay up left from the venous system, so there is a dearth of red blood cells in this blood.
However, the penile pump will still serve the purpose of a long getting the tissues keeping the penis nice and elastic so that when the sexual function returns, the teachers can respond in kind, and it won’t be hard and ironic.
Finally, there’s a wonderful new technology out there. It’s been around for women for a while, and now you men can enjoy it as well.
There are called vibrators, in other words, guybrators. There are many different types of guybrators out of the market. THEY wrap around the base of the penis, and inside is a vibratory mechanism. There’s not a lot of research that suggests the vibration is going to improve sexual function. It is going to bring blood flow back to the area, and it’s going to keep the tissues moving, and that is the goal of all of these things that we’ve just discussed. You have to use these tissues. If not, you’re setting yourself up for never returning to erectile function.
Our final suggestion for what to do after prostate cancer treatment would be to come to pelvic floor physical therapy. That’s the purpose of this article in the first place so that you can learn how to isolate your pelvic floor muscles. These are the muscles that are responsible for erection and ejaculation.
In a study performed in 2004, 40% of men who underwent pelvic floor physical therapy demonstrated an improved sexual response to almost prior to what they had been surgery or treatment. Keep in mind if you’ve had treatment for prostate cancer, your erections and ejaculation may not be the same as it once was, and that’s perfectly okay. When you’re in the healing process, you want to aim for ejaculation, you might not have a full erection, but that’s perfectly okay.
Also, if you experience pain at any moment during this rehabilitative process – stop, return to your urologist, and get clearance before returning because your body might simply not be ready for these techniques. There is a two-year window for recovery, and that’s extremely exciting, so get into physical therapy clinics as soon as you’re diagnosed.
Your doctors will get a nice explanation of why urinary leakage and incontinence occur following prostate cancer treatment. So now, you’re learning about how pelvic or physical therapy can help with erectile dysfunction. The takeaway message is to come and find a pelvic floor physical therapist before diagnosis, and after that, we can help you with both of these issues.
We want to let you know that prostate cancer is the second most commonly diagnosed cancer in the United States. One in three men will typically acquire this disease at some point in their lives. You are not alone, and you were surrounded by so many other men were going through exactly the same thing. They feel they have nowhere to turn, but they do.
So find pelvic floor physical therapy, try these other techniques that we’ve discussed, reach out to people, find a urologist that you trust, talk to people, talk to your partners, talk to your friends, open up about it.