Urological physiotherapy – when, for whom, what does it involve?

The most common complaints that men report to physiotherapists include:

Urinary incontinence

According to data from the World Health Organisation (WHO), approximately 50% of men over the age of 70 struggle with urinary incontinence. This problem may occur earlier, but many men only see a doctor when they experience pain. Urinary incontinence in men is divided into three main types: stress incontinence, urge incontinence and overflow incontinence.

Stress urinary incontinence manifests itself as involuntary leakage of urine when coughing, sneezing, laughing or during intense physical exertion. It is the result of weakened pelvic floor muscles or urethral sphincter insufficiency. It also often occurs after prostate surgery.

Urge incontinence is characterised by a sudden, strong urge to urinate, leading to uncontrolled leakage. It is usually the result of bladder overactivity, which can be caused by neurological disorders or inflammation.

Overflow incontinence is a consequence of incomplete bladder emptying and is usually associated with small amounts of urine leakage, especially at night. This is due to weakened bladder contractions or blockage in the flow of urine, e.g. due to prostate enlargement.

Overactive bladder

Overactive bladder (OAB) in men is a condition in which the bladder reacts excessively, leading to frequent, sudden and uncontrollable urges to urinate. Causes of this condition may include problems with the nervous system, urinary tract infections, enlarged prostate and other diseases such as diabetes or neurological disorders.

Treatment for overactive bladder involves exercising the pelvic floor muscles, which helps improve bladder function. Biofeedback is also often used to give the patient better control over their muscles, as well as electrostimulation to support their function. Relaxation techniques, such as breathing exercises or meditation, can reduce symptoms, especially when overactive bladder is the result of excessive stress. Setting regular breaks for urination may also be helpful.

Tension in the perineum

A feeling of constant tension in the perineum is a common problem in men. It is caused by impaired function of the perineal muscles, including the tendinous body, which leads to increased tension in the penis and anus. This tension intensifies after prolonged sitting, chronic stress, colds, and frequent coughing and sneezing. It is often accompanied by limited hip mobility, especially in terms of abduction and rotation. Treatment involves the use of biofeedback and electrotherapy to help relax the muscles, as well as working with a psychologist to reduce stress.

Urological physiotherapy is also a form of prevention and preparation for urological surgery (known as prehabilitation).

Radical prostatectomy, or surgical removal of the prostate gland, is a common form of treatment for prostate cancer. After prostatectomy, problems such as urinary incontinence or erectile dysfunction may occur, and the main cause of these conditions is the weakening or damage of the pelvic floor muscles, which play an important role in maintaining the function of the bladder and genitals. Urological physiotherapy helps to strengthen them and restore their proper functioning.

Rehabilitation begins with a detailed interview and assessment of the patient’s condition. On this basis, the physiotherapist develops an individual therapy plan, which may include:

• pelvic floor muscle exercises, also known as Kegel exercises, aimed at improving the function of the muscles supporting the bladder and rectum,
• manual techniques to help reduce muscle tension and improve tissue elasticity,
• breathing and postural training to support proper respiratory function and improve posture,
• patient education on proper toilet habits and a lifestyle that supports pelvic health.

The duration of rehabilitation depends on the individual needs of the patient and can range from 6 weeks to several months. The first effects are usually noticeable after just a few weeks of regular exercise.

Radical prostatectomy, or surgical removal of the prostate gland, is a common form of treatment for prostate cancer. After prostatectomy, problems such as urinary incontinence or erectile dysfunction may occur, and the main cause of these conditions is the weakening or damage of the pelvic floor muscles, which play an important role in maintaining the function of the bladder and genitals. Urological physiotherapy helps to strengthen them and restore their proper functioning.

Rehabilitation begins with a detailed interview and assessment of the patient’s condition. On this basis, the physiotherapist develops an individual therapy plan, which may include:

• pelvic floor muscle exercises, also known as Kegel exercises, aimed at improving the function of the muscles supporting the bladder and rectum,
• manual techniques to help reduce muscle tension and improve tissue elasticity,
• breathing and postural training to support proper respiratory function and improve posture,
• patient education on proper toilet habits and a lifestyle that supports pelvic health.

The duration of rehabilitation depends on the individual needs of the patient and can range from 6 weeks to several months. The first effects are usually noticeable after just a few weeks of regular exercise.

Several effective methods are used in urological therapy, such as:

• Pelvic floor muscle exercises – aimed at strengthening the muscles and teaching their correct activation.
• Biofeedback – a technique that allows you to visualise the work of your muscles on a screen, helping you to control them.
• Electrostimulation – stimulates weakened muscles, restoring their efficiency.
• Shock wave therapy (LI-ESWT) – improves blood circulation in tissues, supporting sexual function.
• Manual therapy – helps to relax overly tense structures within the pelvis.
• Breathing exercises and posture correction – support stabilisation and improve deep muscle function.
• Education – includes advice on lifestyle, hydration and ergonomics.

At NAMI, we know that urological problems affect not only physical health, but also emotional well-being and intimate life. That is why we offer an individual approach, modern treatment methods and accurate diagnostics to improve the quality of life of our patients. The sooner you start therapy, the faster you will regain your fitness and well-being. Do not put off your visit to a specialist – urological physiotherapy is effective support for men of all ages.

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