How Does Prostatitis Impact My Pelvic Floor?

By Dr. Christine Martirez PT, DPT on 10/23/2024

Prostatitis is a condition that can cause significant pain and discomfort in men, often affecting their quality of life. While it primarily involves inflammation or infection of the prostate gland, it’s closely linked to the health and function of the pelvic floor muscles. Understanding the anatomy of the prostate in relation to the pelvic floor and how pelvic floor physical therapy can provide relief is essential for anyone experiencing symptoms of prostatitis.

Anatomy of the Prostate and Its Relationship to the Pelvic Floor

The prostate gland is a small, walnut-sized organ located just below the bladder and surrounding the urethra, which is the tube that carries urine and semen out of the body. The prostate plays an important role in the male reproductive system by producing a fluid that nourishes and protects sperm.

The pelvic floor muscles, which include the pubococcygeus, iliococcygeus, and puborectalis, form a sling-like structure that supports the pelvic organs, including the bladder, rectum, and prostate. These muscles are responsible for functions such as urinary control, sexual function, and bowel regulation. When these muscles are tight or dysfunctional, they can contribute to pain and other symptoms associated with prostatitis.

What is Prostatitis?

Prostatitis is a broad term used to describe inflammation of the prostate gland. It can be caused by bacterial infections or, more commonly, nonbacterial factors such as muscle tension or stress. There are four main types of prostatitis:

1. Acute bacterial prostatitis

   A sudden bacterial infection that causes severe symptoms such as fever, chills, and intense pelvic pain.

2. Chronic bacterial prostatitis

   A recurrent bacterial infection that leads to long-lasting inflammation of the prostate.

3. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

   The most common form of prostatitis, which is often nonbacterial and related to muscle dysfunction or nerve irritation in the pelvic region.

4. Asymptomatic inflammatory prostatitis

   Inflammation of the prostate without noticeable symptoms, often discovered during routine medical exams.

Symptoms of Prostatitis

The symptoms of prostatitis can vary depending on the type, but common signs include:

• Pelvic pain

  Pain in the lower abdomen, perineum (the area between the scrotum and anus), or lower back.

• Painful urination

  A burning sensation when urinating, frequent urination, or difficulty starting and maintaining urine flow.

• Sexual dysfunction

  Pain during ejaculation, erectile dysfunction, or reduced libido.

• Urinary symptoms

  Urgency, frequency, or a feeling of incomplete bladder emptying.

• Discomfort in sitting

  Pain or pressure that worsens when sitting, particularly for extended periods.

In many cases, prostatitis can persist for months or even years, leading to chronic pain and frustration for those affected.

How Pelvic Floor Physical Therapy Can Help with Prostatitis

While medications and other treatments may address the bacterial causes of prostatitis, pelvic floor physical therapy is particularly beneficial for those experiencing chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) or nonbacterial prostatitis, where muscle tension, pelvic floor dysfunction, and nerve irritation play a significant role.

Here’s how pelvic floor physical therapy can help:

1.

Pelvic Floor Muscle Relaxation and Retraining

In cases of nonbacterial prostatitis, the pelvic floor muscles are often tight or overactive, contributing to the pain and discomfort. A pelvic floor physical therapist can assess the tone of these muscles and guide you through relaxation techniques to release tension. This may include:

• Manual therapy

  Hands-on techniques to gently release tight pelvic floor muscles, improve circulation, and reduce tension.

• Breathing exercises

  Diaphragmatic breathing to promote relaxation, reduce pelvic floor overactivity, and stimulate the vagus nerve for "rest and digest" nervous system activity.

• Pelvic floor muscle coordination

  Exercises to retrain the muscles, improving their ability to contract and relax properly, which is essential for urinary and sexual function.

2.

Trigger Point Release

Trigger points are small, tight knots in the muscles that can cause referred pain to other areas of the body. In prostatitis, trigger points in the pelvic floor muscles or surrounding areas like the hips and lower back can lead to pelvic pain. A pelvic floor physical therapist can use trigger point release techniques to alleviate this pain, either manually or with the help of tools like dry needling.

3.

Postural Training

Poor posture, particularly when sitting for long periods, can put excessive pressure on the pelvic floor muscles and exacerbate prostatitis symptoms. A pelvic floor physical therapist can work with you on postural correction to alleviate pressure on the pelvic floor and prevent further irritation. This may include:

• Ergonomic adjustments

  Modifications to your workstation or seating position to reduce strain on the pelvic floor.

• Strengthening exercises

  Strengthening the muscles of the core and lower back to improve overall posture and reduce pressure on the pelvic area.

4.

Improving Bladder and Bowel Function

Prostatitis often leads to urinary symptoms such as urgency, frequency, and incomplete bladder emptying. Pelvic floor physical therapy can help retrain the pelvic floor muscles to function optimally during urination, reducing these symptoms. Similarly, if constipation or bowel dysfunction is contributing to pelvic pain, a therapist can guide you through strategies to improve bowel function and reduce strain during bowel movements.

5.

Lifestyle Modifications and Stress Management

Stress and anxiety can lead to increased pelvic floor muscle tension, exacerbating prostatitis symptoms. A pelvic floor physical therapist may also incorporate stress management techniques, such as mindfulness, relaxation exercises, and strategies to reduce overall muscle tension. These holistic approaches help to calm the nervous system and reduce chronic pain associated with prostatitis.

Prostatitis is a challenging condition that can significantly affect men’s lives, particularly when it becomes chronic and is not well-managed. While traditional medical treatments can address infections and inflammation, pelvic floor physical therapy plays a crucial role in treating the muscle and nerve-related aspects of the condition. By addressing muscle tension, improving bladder and bowel function, and providing strategies for postural and lifestyle modifications, pelvic floor physical therapy offers a comprehensive approach to managing prostatitis and improving overall pelvic health. If you're struggling with prostatitis or chronic pelvic pain, consider seeking the help of one of our pelvic floor therapists who can create an individualized treatment plan to alleviate your symptoms and help you regain control of your pelvic health.

Suffering from prostatitis or similar symptoms? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.

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