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Many men suffer from incontinence, rectal pain, erectile dysfunction, and more symptoms as a result of pelvic floor dysfunction. We specialize in pelvic floor therapy, a type of physical therapy that strengthens the pelvic floor muscles to improve its function. Visit our NYC office or give us a call to learn more about how our professionals can help you.

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Pelvic floor dysfunction is often associated with women and typically flagged with pelvic discomfort issues stemming from vaginal intercourse or pregnancy. However, many men suffer from pelvic floor dysfunction as well. Men can suffer from incontinence, rectal pain, erectile dysfunction, and more symptoms caused by issues with the pelvic floor. Unfortunately, many physicians do not know how to treat male pelvic floor dysfunction. That is where pelvic floor physical therapy services at Bespoke Surgical come into play. Bespoke Surgical is an elite anal surgery practice with pelvic floor specialists in NYC. Our focus on wellness underlines our mission for proactive healthcare. Learn more about pelvic floor massage therapy for men from the experts at Bespoke Surgical.

What is Male Pelvic Floor Therapy?

Male Pelvic Floor Therapy is a type of physical therapy that reconditions the pelvic floor muscles to improve strength and function. It refers to not just one, but a number of therapeutic assessment and treatment techniques intended to decrease pain and increase your control of your pelvic floor muscles. Achieving and maintaining pelvic floor health is essential to lifelong sexual enjoyment by minimizing or preventing injury and increasing arousal and sexual intensity. Pelvic floor therapy can be used in the prevention of pelvic floor issues (such as urinary or anal incontinence) or the rehabilitation of existing issues and post-surgical recovery. Many members of our community who bottom or want to bottom don’t know how to achieve success. We are experts in prevention and rehabilitation of the pelvic floor and will help you achieve your bottoming goals.

You can check out our guide to bottoming, How to Be a Better Bottom in 8 Steps, if you’re curious about what we recommend.

What Is the Pelvic Floor?

pelvic floor musclesThe Pelvic Floor consists of the muscles, nerves, connective tissues, tendons, and ligaments that lay like ahammock between your tailbone and your pubic bone. This hammock supports you penis, bladder, rectum, and anus. It is important to keep these muscles strong, flexible, controlled, responsive, and alive, especially because these muscles are crucial for sexual function.


What Is Male Pelvic Floor Dysfunction?

Male Pelvic Floor Dysfunction refers to the inability to control the muscles of the pelvic floor. To simplify things, there are two main issues that cause most of the issues with the pelvic floor: the muscles are either too weak or the muscles are too tight. Pelvic floor dysfunction in men can be caused by a variety of factors, which are outlined below along with symptoms.

What Are the Symptoms of Male Pelvic Floor Dysfunction?

There are many symptoms that can accompany pelvic floor dysfunction. Many of these symptoms are similar to those that would be seen in patients with prostatitis. This can occasionally lead to patients being incorrectly diagnosed with prostatitis and prescribed ineffective antibiotics. If you are suffering from any of the following symptoms, we recommend booking an appointment with our physical therapists to see if pelvic floor therapy may be right for you.

The symptoms of Pelvic Floor Dysfunction vary and can include, but may not be limited to:

  • Pain or spasming in the anus, deeper into the pelvis, penis, and/or scrotum
  • Difficulty urinating, including urge and stress incontinence, mixed incontinence, and hesitancy
  • Frequency of urination
  • Pain while urinating
  • Anxiety about sex before, during, or after the act, causing a dissatisfactory experience
  • Pain with receptive anal sex
  • Inability to experience receptive anal sex
  • Fecal constipation or incontinence
  • Painful bowel movements
  • Sharp, stabbing cramps, such as pelvic pain
  • Weak ejaculation contraction
  • Erectile dysfunction
  • Post-ejaculatory pain

What Are the Causes of Male Pelvic Floor Dysfunction?

Loose or weak pelvic floor male muscles can be caused by:

  • Too much sex
  • Engaging in fisting and/or double penetration
  • Playing with large toys
  • Bladder or bowel surgery
  • Radical prostatectomy (surgical prostate removal)
  • Constipation
  • Being overweight
  • Heavy lifting
  • Coughing that is ongoing, like smokers cough or chronic bronchitis
  • Being physically unfit

Weak muscles are responsible for leakage of urine and fecal matter and can cause a person to become socially isolated.

Tight muscles are caused by a number of factors:

  • Stress
  • Learned behavior or habits over time
  • Inability to relax
  • Anticipation of pain during sex
  • Misunderstandings and overcorrection of core stability training
  • Extended edging sessions

Tightness can make bottoming difficult and painful, which can lead to bleeding and/or physical damage to the anus. It can also cause the inability to completely empty your bowel and/or bladder, as well as create intermittent or constant pain due to muscle tension.

Is Pelvic Floor Rehabilitation Right for Me?

If you are a gay male and think you have issues related to being too tight or too loose in or around your anus, causing pain, any problems with sex, aesthetic issues, bowel or bladder issues, constipation, or leakage, you will benefit from Pelvic Floor assessment and physical therapy treatment.

If you want more information about pelvic floor therapy for men or would like to book a consultation to see if this physical therapy could be right for you, please book an appointment with Bespoke Surgical.

What Are the Benefits of Pelvic Floor Therapy for Men?

Pelvic Floor Therapy is designed to give you control of your pelvic muscles and thereby give you control over your life by preventing injuries from happening or reoccurring in the future.

What Are the Procedures Used for Pelvic Floor Evaluation?

Evaluating a pelvic floor involves looking at a person holistically and completely. The comprehensive assessment is vital so we know how to help you in the best way possible and includes:

  • Postural assessment
  • Muscle strength and length testing
  • Internal and external palpation for tenderness and restrictions
  • Surface Electromyography testing to assess the electrical activity in your pelvic region
  • Real-Time Ultrasound Imaging of your pelvic floor position and excursion during contraction, relaxation, and symmetry
  • Anal Manometry: a test of anal pressures and responses

Male Pelvic Floor Therapy: What To Expect At Bespoke Surgical

There are a number of techniques designed to help with pelvic floor disorders. The main aim of treatment, no matter what the issues are, is to relax the muscles to an acceptable baseline level. After achieving an appropriate baseline of muscle activity and resting tone, the goal of pelvic floor physical therapy is to create control through the range of muscle activation. So, to put it another way, pelvic floor muscle action controlled by you, from relaxation to contraction and back again.

At the initial consultation, you will be able to discuss in detail your issues and your goals, no matter what they are, in a judgment-free environment. A comprehensive pelvic assessment will determine a treatment plan and appropriate therapeutic options. Your pelvic assessment may include ultrasound imaging, anorectal manometry pressure testing, external and internal pelvic muscle strength testing, anal sphincter compliance testing and dilation. No assessment procedure or treatment option will be painful or uncomfortable, no matter what your condition or goal.

At Bespoke Surgical, we typically treat men who are either too tight or too loose, both of which interfere with function including sexual function and satisfaction. Treatment options vary depending on your symptoms and goals.

Treatment Techniques:

  • Education about your condition, treatment, and home program (including Kegel exercises)
  • Postural realignment and re-education
  • Manual therapy to tighten external and internal pelvic muscles
  • External muscle strengthening and lengthening as needed
  • EMG Biofeedback
  • Ultrasound imaging Biofeedback
  • Manometric Biofeedback
  • Manual therapy to mobilize restricted skin and pelvic floor structures, including the anus
  • Manual scar mobilization to ease anal stricture
  • Pelvic floor massages for men-specific techniques that will strengthen the skin
  • Home program of anal dilatation activities and control through range exercises

Biofeedback is a technique used for several health conditions where electrical monitoring is used to help a patient gain control over their body’s functions. Recent studies show that 80% of patients who undergo biofeedback training have major improvements in their pelvic floor dyssynergia.

The home program often includes stretches and exercises that you don’t need supervision for. Check out our Guide to Kegel Exercises for Men to see how you can start strengthening your pelvic floor.

We use a variety of treatments to assist our patients as fully as possible. From a specialized pelvic floor massage for men to electronic monitoring, Bespoke Surgical is prepared with years of experience to help you. If you live in NYC and are looking for a male pelvic floor therapist near you, we can help.

How Long Does a Course of Pelvic Floor Therapy Usually Take to Work?

It takes between 6 to 8 weeks to see a physiological change in a muscle or skin after therapy has started. However, is it not uncommon to see changes in coordination and muscle control well before this time due to a reinforcement of the existing neural pathways.

Is Special Preparation Needed Before Having a Pelvic Floor Evaluation or Treatment?

The answer depends on how well you know your bowels and at what time of the day your appointment is. Most likely, if you have had your normal bowel movement for the day before arriving for assessment or treatment, you should be fine. If you want a little more reassurance, please use a Fleet Enema, being mindful to follow the directions provided on the box, two hours before your appointment.

Schedule a Pelvic Floor Evaluation Today

If you are interested in having your pelvic floor muscles evaluated by the experts at Bespoke Surgical in NYC, schedule a pelvic floor therapy appointment today.

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Pelvic Floor Therapist


Steven Lavender is an Australian trained physiotherapist and has extensive post-graduate education and advanced training and worked in all levels of hospital and private healthcare. He is passionate about all aspects of men’s health, especially concerns affecting those within the gay male community, and is one of a very few men who specializes in Men’s Pelvic Health. Pelvic floor dysfunction includes many symptoms that can be embarrassing and stressful. Steven will take the stress and embarrassment out of your experience and help you achieve the best possible outcomes. He understands that for those specifically who engage in receptive anal sex, issues related to being too tight or too loose in the pelvic area can cause pain, any problems with anal sex, bowel or bladder issues, constipation, or leakage can directly affect quality of life. That’s why proper assessment and treatment by a skilled professional who knows what they are doing and understands you is key.

Read More    Click to send an email to steven@theptpractice.nyc



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