Pelvic Floor Muscle Training in Males: Practical Applications

Siegel, Andrew L.

doi:10.1016/j.urology.2014.03.016

Cited by 53 publications

(26 citation statements)

References 27 publications

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“…The protocol mostly prescribed consists in 150–160 min/week of aerobic PA of moderate intensity. Vigorous intensity PA and resistance exercise could represent a valid supplement, as well as pelvic floor muscle‐specific exercise (Gerbild et al, ; Siegel, ). PA is more effective if prescribed together with PDE5i (Silva et al, ), drugs that exert little effect on physical performance (Guidetti et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic floor muscles participate in an important way in the mechanics of the penile erection. In fact, the superficial pelvic floor muscles (bulbocavernosus, ischiocavernosus and transverse perineal muscles) maintain erectile rigidity, increase pressure in corpora cavernosa, prevent the return of the venous blood from the penis and promote the expulsion of semen from the urethra during orgasm (Siegel, ). Colpi and colleagues reported that perineal floor muscle contraction, evaluated by electromyography, is significantly higher in potent men than in patients with ED matched by age and that perineal floor efficiency gets worse with age (Colpi, Negri, Nappi, Chinea, & Colpi, ).…”

Section: Effect Of Aerobic Resistance and Pelvic Floor Muscle‐specimentioning

confidence: 99%

“…Thus, it is plausible that pelvic floor muscle‐specific exercise can improve erection. There is evidence that pelvic muscles training is more effective in the subset of patients with venous‐occlusive deficit and in those with ED post‐radical prostatectomy (Siegel, ).…”

Section: Effect Of Aerobic Resistance and Pelvic Floor Muscle‐specimentioning

confidence: 99%

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Erectile dysfunction, physical activity and physical exercise: Recommendations for clinical practice

et al. 2019

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Erectile dysfunction could be an early sign of endothelial dysfunction and, therefore, of cardiovascular disease, with which it shares many risk factors. Among reversible risk factors, physical inactivity is one of the most important. Regular physical exercise has been shown to improve erectile function through different mechanisms involving glucose and lipid metabolism, regulation of arterial pressure, production of nitric oxide and hormonal modulation. Furthermore, exercise shows a synergistic effect with the drugs commonly used in the treatment of impotence. Since many patients with erectile dysfunction may have underlying cardiovascular disease, the evaluation of individual cardiovascular risk is mandatory before prescribing physical exercise. When exercise is not contraindicated, the most appropriate protocol must be chosen, considering the individual characteristics of the patient. Both aerobic and anaerobic/resistance protocols have proven effective. However, meta‐analytic studies show that aerobic exercise with moderate‐to‐vigorous intensity is the most effective in improving erection. Testosterone is an important modulator of physical performance, and its blood levels must always be evaluated in patients with erectile dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Effect Of Aerobic Resistance and Pelvic Floor Muscle‐specimentioning

confidence: 99%

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Erectile dysfunction, physical activity and physical exercise: Recommendations for clinical practice

et al. 2019

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“…A growing body of evidence suggests that the pelvic floor muscles play a crucial role in penile rigidity. Their efficient contraction prevents the return of venous blood from the penis and increases intracorporeal pressure significantly higher to that of systemic blood pressure 26. One study demonstrated via electromyography that their contractility was more efficient in men with a normal erectile function than in male patients with erectile dysfunction 27.…”

Section: Discussionmentioning

confidence: 99%

Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis

et al. 2016

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“…In men, PFMT is primarily used to treat postprostatectomy SUI. Nevertheless, PFMT has been shown to be beneficial in the treatment of both, stress and urgency urinary incontinence [4]. However, to be successful, voluntary pelvic floor sensorimotor control must be at least partly intact which can be a limiting factor in many neurological patients.…”

Section: Behavioral Therapy and Pelvic Floor Exercisesmentioning

confidence: 99%

The management of urinary incontinence in the male neurological patient

Mehnert

Kessler

2014

Current Opinion in Urology

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PURPOSE OF REVIEW: Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. RECENT FINDINGS: Intermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SUMMARY: Standard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in male neurological patients, well-designed, multicenter studies are warranted. Purpose of review Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. Recent findingsIntermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SummaryStandard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in mal...

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Pelvic Floor Muscle Training in Males: Practical Applications

Cited by 53 publications

References 27 publications

Erectile dysfunction, physical activity and physical exercise: Recommendations for clinical practice

Erectile dysfunction, physical activity and physical exercise: Recommendations for clinical practice

Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis

The management of urinary incontinence in the male neurological patient

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