Bottom line: 'I found that ‘prostate pain’ may be caused by pelvic floor problems--not just infections'
Put those Kegel muscles to work
(Editor’s note: Richard Maye is a good friend of TheActiveSurveillor.com. He is a business executive who is a thorough researcher and stays on top of the trends relating to active surveillance and prostate cancer, especially favorable intermediate-risk prostate cancer. If you have been coping with some of the symptoms of prostate cancer, prostatitis, and benign prostatic hyperplasia, it may be worthwhile to check out Richard’s article and Kegel exercises. . He recommends YouTube videos by Rena Malik, MD, urologist and pelvic surgeon; Michelle Kenway, PT, and Connect Physical Therapy.)
By Richard Maye
Like me, you may not have been familiar with the term “pelvic floor muscles,” nor the important role they play in the health of women and men. Women may be more familiar with this term than us guys from their experience of having children.
Here is a brief explanation of how the pelvic floor muscles apply to men with prostate cancer.
What do we mean by the term pelvic floor muscles? This is a group of muscles that lay below the pelvic region, sort of like a hammock underneath the bladder and prostate gland. If you are reading this article sitting down, you are resting your bottom on the pelvic floor.
Over time, these muscles lose strength due to aging, or perhaps trauma in that region. Trauma may include prostate surgery or treatment. Here are some examples of symptoms that could be related to the condition of pelvic floor muscles.
1: Frequent urination
2: Urine retention
3: Poor blood flow, which may cause erectile dysfunction
4: Pelvic, lower back, or abdominal pain.
5: Incontinence
(Richard Maye)
I have experienced lower abdominal and back pain for years, which my primary care physician often attributed to chronic prostatitis, and, as result, have taken a mountain of antibiotics.
During this time of pain, my PSA would rise, and then after taking medication, the pain would decline, only to have it rise again.
This went on for decades. However, as I became aware of non-bacterial chronic prostatitis and the fact that if the antibiotics worked it was only for a short period of time, I started pursuing a solution.
After a recent bout of pain and antibiotics, it seemed that the pain was becoming more persistent regardless of what I did.
After a urinalysis that showed no bacteria, I asked my urologist for his opinion. He mentioned that a physical therapist (PT) could assess the state of my pelvic floor muscles. A PT told me that this area of care is a specialized course of study for the PT profession. Before they begin a course of treatment, an assessment of the patient’s condition is performed to determine if there is a pelvic floor muscle issue and what type.
After some research on YouTube, I learned quite a bit about the function of pelvic floor muscles and what can be done about it. There are certain exercises involved generally referred to as Kegels used to strengthen the pelvic floor.
You may recall your wife doing Kegels while you sat idly by eating bonbons.
For men, Kegels amount to contracting the rectum and retracting the penis while sitting, standing, or lying on the floor for about the count of one second at a time using various techniques.
I am using specific techniques sitting and lying on the floor experimenting with exercises that do not cause discomfort. While it is too early to claim victory over my pain, there is some evidence that it is helping my condition. The amount of time required to notice any improvement varies for each person.
You may want to seek an assessment from a physical therapist specializing in this area as these muscles can be too weak or too strong. Or, like me, I preferred to educate myself first and try the exercises to see if it works.
Bottom line? Your pelvic floor may be the source of your symptoms.
Bio: Richard Maye was almost 71 when had a 12-core transrectal biopsy in late October 2018 and received the diagnosis in November of three cores with a Gleason Score of 3+3 = 6 and one core that was 3+4 = 7. The 4 core was less than 5% involved with cancer. He underwent a Oncotype DX, a genomic test that indicated there was less 1% chance that the cancer would lead to death in 10 years and less than 4% of metastasis within 10 years.
Richard’s urologist suggested that he go Active Surveillance with a follow-up confirmatory biopsy in one year and a PSA every six months.
Richard has had 50 years of senior-level management and administration experience, primarily in the healthcare and human services industries, including behavioral health, acute care hospitals, and outpatient rehabilitation. His career experience includes serving as Chief Financial Officer, Chief Operating Officer, and Chief Executive Officer.
He is the Founder & President of Strategic Integration Solutions, Ltd., a healthcare consulting firm that focuses on providing organizations with the Strategic Solution that forms a Clinically Integrated Patient Care System, which includes the Integration of Behavioral Health and other clinical service lines with Primary Care.
Prior to forming his consulting practice, Richard served as Senior Vice President of Physician Integration for Mary Rutan Hospital in Bellefontaine Ohio. He led the effort to have all employed physician practices achieve accreditation recognition.
Richard has a Bachelor’s degree in Business Administration from Tiffin University in Tiffin, Ohio, and a Master’s degree in Business Administration from the University of Dayton in Dayton, Ohio. Richard served as an adjunct faculty member for Tiffin University, instructing a variety of business courses at the undergraduate and graduate levels.
Richard and his wife Monica have two adult children and currently reside in Elida, Ohio just outside of Lima.
Please take TheActiveSurveillor.com survey on transperineal v. transrectal biopsies. Go to https://bit.ly/35mD6OY
Some interesting trends are emerging. Hope to see if they hold up with more data.