For the anatomical male: What to Expect on Your First Pelvic Floor Physical Therapy Visit

There may be many reasons that you are here:
Pelvic pain
Penile pain
Bladder pain
Rectal pain
Urinary incontinence
Urinary urgency and frequency
Bowel urgency and frequency
Sexual Dysfunction
And other reasons not listed but still related to pelvic floor dysfunction whether it is due to a tight or weak pelvic floor or both

This is your session and your time, I am here to guide the assessment and help give some insight into your symptoms.

First we talk- we get to ask each other questions. I will ask about your symptoms, your urinary, bowel and sexual functioning. You are also welcome to ask questions as we go along. I like to explain about the anatomy and function of the pelvic floor muscles.

Second I like to do an orthopedic assessment of posture, strength and range of the motion of the spine and hips. Since everything in the human body is interlinked, it is essential to look at the physical structures that attach directly into the pelvis and in this case the pelvic floor musculature.

Third, with your permission and at your comfort level, we will do an assessment of the superficial muscles of the pelvic floor muscles which includes the muscles under the testicles.
To do this, you will have to undress and I will leave the room so you can have a moment to disrobe from the waist down and lay down on the treatment table with a sheet to drape over yourself. I will first touch the pelvic floor muscles and assess for pain and tightness, then I will ask you to contract the pelvic floor muscles.

Fourth, if appropriate and if necessary for your particular symptoms, we can do an internal assessment of the pelvic floor muscles. You can be side lying or laying on your stomach for this. I only go as far as you can tolerate and at any time you need me to stop you are always welcome to tell me to stop.

Fifth and final, I leave the room for you to get dressed and then I reenter when you are ready. We will review the findings of the evaluation and assessment and come up with a strategy to address your symptoms with behavior modification suggestions and therapeutic exercises.

Contributed by Dr. Ilene Schulman
January 2024