The pelvic floor muscles are vital to male genitourinary health. Pelvic floor muscle training can be useful in a variety of clinical circumstances: stress urinary incontinence following prostate surgery, overactive bladder, postvoid dribbling, erectile dysfunction, ejaculation problems, including premature ejaculation, and pelvic pain.
The pelvic floor muscles have been recognized as a very important structural and functional area. For a long time, pelvic floor training has been defined as “any program of repeated voluntary contractions of the pelvic floor muscles.”
Really, it’s not a new conceptHippocrates and Galen already described it in ancient Greece and Rome, where it was performed in baths and gyms. Strengthening these muscles was thought to promote general health and sexualspirituality and longevity.
Uses of Kegel exercises
Arnold Kegel popularized pelvic floor muscle exercises for improve sexual and urinary health after Birth. In addition, Kegel employed the principle of functional restoration of a segregated group of muscles, established in orthopedics, neuromuscular surgery, plastic surgery, and physical medicine and rehabilitation.
Furthermore, Kegel recognized that for correct lack of vaginal, urethral and rectal strength by surgery, could be facilitated by pelvic floor muscle training preoperative and postoperative to improve the tone and function of the perineal muscles.
Men have similar muscles to women and an equivalent ability to exert force with them, with the potential for parallel benefits for urinary and sexual health. However, most men are not familiar with this type of exercise.
Muscles involved in the pelvic floor
The pelvic floor muscles, like all skeletal muscles, are subject to adaptation. These muscles have, between their muscle fibers, 70% slow twitch or type I (fatigue-resistant fibers that maintain static pitch) and 30% are fast twitch or type II (fatigue-prone fibers).
Even so, a decrease in the proportion of fast-twitch fibers can occur with the aging, inactivity and nerve innervation damage.
Applied exercise can improve the strength, tone, and responsiveness of these musclesas they increase your strength in direct relation to the demands, so kegel exercises they are excellent for the problems that we are going to discuss next.
The pelvic floor muscles can be differentiated into deep or levator ani muscles, which is made up of the muscles pubococcygeus, iliococcygeus, and puborectalis. These muscles, along with the urethral and anal sphincters, play an important role in urinary and bowel continence.
On the other hand, we have the superficial ones, which are the bulbocavernosus, ischiocavernosus and transverse perinealwhich function to maintain erectile rigidity and expulsion of the contents of the urethra.
Benefits of kegel exercises in men
urinary incontinence
incontinence is caused by activities including sneezing, coughing, bending over, lifting objects, exercising, and changing position. The most common is usually after a prostatectomy or after surgery performed for benign prostate conditions.
Several studies have shown the benefit of training the pelvic floor muscles with kegel exercises after a post-prostatectomy to facilitate the return of urinary continence.
Erectile dysfunction
The Massachusetts Male Aging Study showed that erectile dysfunction is present in about 40% of men by the age of 40 with an increase in prevalence of approximately 10% for each decade thereafter.
Many authors have observed a decline in all aspects of sexuality in the aging male, with the exception of libido.
Although there are many potential causes of erectile dysfunction, the common denominator is insufficient blood flow to fill the bodies, or alternatively, sufficient arterial blood flow but poor venous entrapment.
The bulbocavernosus and ischiocavernosus muscles are of particular importance during the erection process. These muscles contract during penile erections, and their contractions help prevent the exodus of blood from the penis, improving penile rigidity.
Overactive bladder
Overactive bladder is the presence of frequency and nocturia with or without incontinence., in the absence of a urinary tract infection or other pathology. Although it often occurs without provocation, it can be triggered by changes in position, exposure to running water, approaching a bathroom, and putting the key in the door.
During urine storage, the detrusor muscle relaxes and the sphincters are activated. During emptying, the detrusor muscle contracts and the sphincter muscles relax synchronously.
This “antagonistic” relationship between the detrusor and pelvic floor muscles can be exploited causing patients to recognize these contractions and respond by contracting their sphincters to inhibit it.
Post-micturition drip
Post micturition dribbling occurs immediately or shortly after urinating, when the urine that remains accumulated in the urethra drips, helped by gravity and movement.
This is more annoying than serious, and although it occurs more commonly after the age of 40, It can happen to men of any age.
The contractions of the pelvic floor muscles are the body’s natural mechanism to facilitate the expulsion of the urethral contents.. When contracted, the bulbocavernosus muscle, the urethral “spreader” of the body, compresses the bulbar urethra, displacing urine distally for emptying.
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