PERINEOLOGY

Male Perineal Rehabilitation

Male pelvic floor rehabilitation is an essential treatment for men, particularly after prostate surgery, such as a prostatectomy. It aims to treat various pelvic floor disorders, such as urinary incontinence, sexual dysfunction, and anorectal disorders.

Objectives of rehabilitation

• Urinary Incontinence: After a prostatectomy, pelvic floor rehabilitation strengthens the muscles responsible for bladder control, reducing urinary leakage. It is often performed before and after surgery, with a series of sessions tailored to each case.

• Erectile Dysfunction: This treatment can improve blood flow and pelvic muscle tone, promoting better erectile function in some cases.

• Anorectal disorders: It can help with problems of constipation, fecal incontinence or gas control.

Techniques used

• Kegel exercises: These consist of repeated contractions of the pelvic floor muscles to restore their strength and coordination.

• Biofeedback: This method uses sensors to guide the patient in real time in controlling their muscles.

• Electrostimulation: A gentle current is used to stimulate the deep muscles of the perineum, particularly useful for cases of severe incontinence.

• Pre-operative support: Preparing the perineum before an operation promotes faster recovery after the procedure.

Global approach

In addition to in-office techniques, home exercises are often used to complement rehabilitation to maximize results. These sessions may also include education on daily best practices, such as avoiding excessive pressure on the perineum and adopting positions that promote recovery.

This support is essential to regain an optimal quality of life after an operation or in the event of pelvic floor disorders in men.

Ano-rectal rehabilitation

Anorectal rehabilitation is a specific treatment that addresses disorders related to the management of anal and rectal functions, such as terminal constipation, anal incontinence, gas loss, or disorders related to rectal prolapse. It is also indicated to improve symptoms after anal or pelvic surgery.

Objectives and benefits

Anorectal rehabilitation aims to:

• Restore muscular control of the anal sphincters and rectum to effectively manage the evacuation of stool and gas.

• Improve coordination and muscle strength to better control bowel movements and reduce incontinence or leakage.

• Relieve symptoms related to terminal constipation (difficulty evacuating) by retraining the reflexes necessary for evacuation.

• Support people with rectal prolapse to limit the sensations of descent and slow the worsening of the disorder.

Rehabilitation methods

1. Personalized assessment: Evaluation of the clinical situation, symptoms, and muscular capacities via manual examinations and sometimes techniques such as manometry or biofeedback.

2. Muscle strengthening exercises: Based on the contraction of the pelvic floor muscles, these exercises help strengthen the pelvic area and restore control of the anus and rectum.

3. Biofeedback and electrostimulation: Use of sensors or stimulation devices to visualize muscle contractions and stimulate weakened muscles.

4. Abdominal massage and manual therapy: Techniques aimed at relaxing muscles and improving circulation in the pelvic area.

5. Hygiene and dietary advice: Monitoring of eating habits and lifestyle to optimize digestive function and transit.

Frequently asked questions

• Anal incontinence: Weakness of the sphincter muscles after surgery or trauma, or simply related to aging or traumatic childbirth.

• Terminal constipation: Dysfunction of the muscles of the rectum or anus that prevents normal evacuation.

• Rectal prolapse: Descent of the pelvic organs which can be relieved by specific exercises.

Pelvic pain

Physical therapy plays a crucial role in relieving pelvic pain, whether related to endometriosis or other causes.

Here are the specific approaches we offer for these disorders:

1. Comprehensive Assessment and Evaluation: The physical therapist begins with a detailed assessment, evaluating the entire body to identify painful areas, muscle tension, and imbalances. This includes work on the pelvic floor, abdominal muscles, and areas where tension is exacerbated (perineum, lower back, abdomen).

2. Tissue relaxation and mobilization: Endometriosis can cause tension in pelvic tissues and fascia, increasing pain. The physical therapist uses manual techniques to relax and release these contracted areas, improving circulation and mobility.

3. Pelvic floor muscle strengthening and rehabilitation: For pelvic pain related to muscle weakness or pelvic floor dysfunction, targeted exercises are prescribed to strengthen the muscles and restore balance.

4. Pain and tension management: For patients suffering from endometriosis, the physical therapist can offer breathing and relaxation exercises to better manage pain, reduce stress, and improve body awareness. Techniques such as biofeedback and electrical stimulation can also be used to relieve chronic pain and retrain pelvic floor muscles.

5. Hygiene and dietary advice: We will provide you with advice on diet and hydration to improve intestinal transit, which is often disrupted by endometriosis. Lifestyle habits are also taken into account to optimize pain management and avoid excessive irritation or tension in the pelvic region.

Through a personalized approach that combines manual techniques, pelvic floor rehabilitation, stress management and hygiene and dietary advice, we can help you reduce pain and improve your quality of life.