A man came into the office one time with a rigid penis even without an erection. He wants to know what causes this and how to get rid of it. To formally address him, let’s call him John (not his real name to protect his identity). He was experiencing Hard Flaccid Syndrome, a rare condition that affects the muscles in the penis or scrotum, appearing flaccid (floppy or limp) despite being abnormally firm to the touch. He was searching for Hard Flaccid Syndrome Recovery Stories, but he didn’t find much.
Here’s what happened
John had always been confident in his sexual abilities. But one day, noticed something was off. His penis was flaccid, but it felt abnormally firm to the touch. He also had trouble getting an erection and maintaining it. There’s a sense of sponginess and rubbery in his penis. He was confused and didn’t know what was happening.
While he was finding answers online, he stumbled upon the blog How Do You Get Rid Of Hard Flaccid Syndrome? published by Doctor Adam Gvili. Upon reading, this gave him hope that there is treatment or that there is help just like this blog about hard flaccid syndrome recovery stories.
Here are the Symptoms
John decided to visit Adam, a doctor of Physical Therapy who also treats hard flaccid syndrome symptoms. Dr. Adam took the time to assess what he was feeling down there. Immediately after their conversation and initial assessment, he takes note of the following symptoms of John…
Difficulty achieving and sometimes maintaining an erection
The softness of the penis even when erect
A time of losing sensation in the penis
Pain and discomfort in the penis and pelvic area
Spasms/cramps in the muscles of the penis and pelvic area
Ejaculation problems
Because of the following reasons, Dr. Gvili explained to John that he might be experiencing a rare condition known as hard flaccid syndrome.
Possible Causes
Dr. Gvili went on to explain that the exact cause of the hard flaccid syndrome is not well understood, but it is thought to be related to nerve or muscle damage. Some of the possible causes he said are:
Spinal cord injuries: Damage to the spinal cord can result in hard flaccid syndrome, as it can disrupt the normal functioning of the nerves that control the muscles of the penis and scrotum.
Nerve damage: Nerve damage caused by diabetes or other diseases can also lead to hard flaccid syndrome.
Medications: Certain medications, such as those used to treat hypertension and depression, may cause hard flaccid syndrome as a side effect.
Idiopathic: In some cases, the cause of hard flaccid syndrome may be idiopathic, meaning, you can’t identify the underlying cause.
Other possible causes include muscle or nerve damage due to surgery, radiation therapy, or trauma to the area.
Upon mentioning the above example, he told John that it is important to take note that hard flaccid is a rare condition. So, asking for a professional is a great move for him.
The Helping Hand
It was a relief for him to finally have an explanation for his symptoms, but John was also concerned about what this meant for his future. Dr. Gvili reassured him that while hard flaccid syndrome is a rare condition, it can be treated with the help of a physiotherapist.
Dr. Gvili explained that physiotherapy has numerous benefits for the hard flaccid syndrome. First, it can help improve muscle strength and flexibility. Second, it reduces pain in the penis and pelvis area. Lastly, it improves the overall quality of life.
Dr. Adam also created a treatment plan that involves exercises to strengthen the muscles of the penis and scrotum, as well as stretches to improve flexibility. Dr. Gvili also used manual therapy techniques for John to help improve muscle function and reduce pain.
John was optimistic about his treatment plan and was grateful for Dr. Gvili’s help. He knew that it would take time and dedication, but he was willing to do whatever it took to regain control of his life. With the help of Dr. Gvili, John was able to improve his symptoms and regain his confidence.
Ready to take the first step toward relief from Hard Flaccid Syndrome? Schedule a consultation with Dr. Adam Gvili today.
Experiencing pain or discomfort during urination, medically termed dysuria, can be a distressing and inconvenient issue. It’s essential to understand the causes behind this discomfort and explore potential solutions to alleviate it. In this comprehensive guide, we delve into the reasons why it hurts when you pee and discuss how physical therapy can offer relief.
Causes of Painful Urination: Urinary Tract Infection and More
There are several potential causes of painful urination, also known as urination pain:
Urinary Tract Infection (UTI): UTIs are among the most prevalent reasons for painful urination. They occur when bacteria enter the urinary tract and multiply, leading to irritation and inflammation of the bladder and urethra. This irritation can cause discomfort or a burning sensation during urination. UTIs, often resulting from a bacterial infection, can also cause abdominal pain, indicating a possible progression to a kidney infection if left untreated.
Urethritis: Urethritis, characterized by inflammation of the urethra, often results from bacterial infections or irritation. Bacteria from sexually transmitted infections (STIs) like gonorrhea or chlamydia, and even bacterial overgrowth, can cause urethritis, leading to pain and discomfort while urinating.
Bladder Inflammation: Infections or other conditions that inflame the bladder, such as cystitis, can cause painful urination. This inflammation irritates the bladder lining, resulting in discomfort or pain during urination. Conditions like interstitial cystitis and painful bladder syndrome are also known to cause similar symptoms.
Sexually Transmitted Infections (STIs): Certain STIs can lead to urethritis, causing painful urination. STIs like gonorrhea, chlamydia, and genital herpes can infect the urethra, leading to inflammation and discomfort during urination.
Chemical Irritation: Exposure to certain chemicals or irritants can irritate the urethra and bladder, causing discomfort or pain during urination. This can occur due to contact with substances like harsh soaps, perfumes, or spermicides.
Dehydration: When the body lacks sufficient fluids, urine becomes more concentrated. This concentrated urine can irritate the lining of the bladder and urethra, leading to discomfort or pain during urination. Additionally, dehydration can reduce the body’s ability to flush out bacteria and toxins, increasing the risk of urinary tract infections (UTIs) and further exacerbating symptoms of dysuria. Therefore, maintaining adequate hydration levels is crucial for preventing urinary discomfort and promoting overall urinary health.
Prostate problems: The prostate gland, surrounding the top of the urethra, plays a crucial role in urination. Issues with the prostate, such as prostatitis, may experience painful urination due to inflammation of the prostate gland.
Kidney Infection and Kidney Stones: Kidney infections, technically called pyelonephritis, and kidney stones are significant causes of painful urination. These conditions can lead to severe abdominal pain and require immediate medical attention.
Take note that when you experience a burning sensation upon urination, it is best to see a doctor to help you find the cause of your discomfort and help with the treatment. You can also find a physical therapist who can provide you with exercises that will help achieve proper engagement of the pelvic floor muscles that regulate urine release.
Physical Therapy’s Role in Painful Urination
To treat painful urination, physical therapy emerges as a pivotal approach, addressing the discomfort associated with this condition. Physical therapists leverage targeted exercises and techniques to tackle the underlying causes, such as infections or irritants, that contribute to dysuria. They emphasize strengthening pelvic floor muscles, essential for bladder control and urinary function. By enhancing muscle tone and coordination, physical therapy can improve bladder control and relieve pressure on the urinary tract. Moreover, physical therapists may introduce relaxation techniques to diminish muscle tension and discomfort, significantly boosting urinary health and life quality for those suffering from dysuria.
How Does Physical Therapy Work?
Physical therapy for painful urination involves various techniques aimed at strengthening and relaxing specific muscles involved in bladder function. These techniques include:
Pelvic Floor Exercises: Physical therapists often prescribe targeted pelvic floor exercises to strengthen the muscles that support the bladder, urethra, and surrounding pelvic organs. These exercises, such as Kegels, help improve muscle tone and control, reducing symptoms of dysuria and enhancing bladder function.
Biofeedback Therapy: Biofeedback therapy involves using specialized equipment to monitor and provide feedback on muscle activity in real time. During sessions, patients learn to control and strengthen pelvic floor muscles by observing their muscle contractions on a screen. Biofeedback helps individuals develop better awareness and control over their pelvic muscles, leading to improved bladder function and reduced urinary discomfort.
Manual Therapy Techniques: Physical therapists may employ manual therapy techniques to address muscle tension and dysfunction in the pelvic region. This may include gentle manipulation or massage of soft tissues to release tension, improve blood flow, and enhance mobility. Manual therapy can help alleviate pelvic floor muscle spasms and reduce pain associated with dysuria, promoting overall urinary function.
Choosing the Right Physiotherapist for Your Painful Urination Due to Interstitial Cystitis
We know how hard it is to find a partner who will stay with you until you say “I am FREE from PAIN NOW” especially if you are a man. However, you don’t have to be anxious because we are here to help you live a pain-free life.
At Pelvis NYC, we are dedicated to helping men ease their symptoms and improve the quality of their lives. Our physiotherapist Dr. Adam Gvili uses a variety of techniques to relieve pain, including massage, heat and cold therapies, electrical stimulation, and exercises. His treatment is specifically tailored per individual to target the right cause of the pain and employ the right treatment.
For further inquiries, visitPelvis NYC and get aFREE 15-minute teleconsultation. Book a schedule now and let’s find the right combination of treatments to ease your pain and get you back to feeling normal again.
As men, we sometimes feel like we must put on a brave face and suffer through pain silently. But that’s not the case when it comes to sharp pain during sexual intercourse. It can be really tough to deal with, but you’re not alone. In fact, one in four men reports having experienced penis pain sometime in their lives. While the cause of the pain may vary, there are a few things you can do to help ease the discomfort. One factor that can help is pelvic floor exercises. Pelvic floor exercises help men experiencing sharp pain during sexual intercourse by improving blood flow to the pelvic floor muscles, making them more relaxed and less likely to tense up during sex.
In this post, we’ll talk about what might be causing the pain and some ways to help make intercourse more comfortable for you. So hang in there – read on for helpful tips and learn how to take care of your most important asset!
Is Sharp Pain During sexual Intercourse Normal?
The answer is no. Sex should be pleasurable, not painful. Sharp pain during sexual intercourse can indicate a medical condition to physical traits that need to be considered. If you’re experiencing pain during sex, talk to your doctor about pelvic floor exercises. Pelvic floor exercises just might be the key to pain-free sex. It has been shown that these exercises can improve blood flow to the pelvic floor muscles, making them more relaxed and less prone to tense up during sex.
What are the causes?
The following factors may be the reason why there is sharp pain during sexual intercourse:
Lack of lubricant during sex– In men, lubrication prevents friction that can cause pain during sex. It also helps to keep the penis healthy by preventing the build-up of plaque and inflammation. Lack of lubrication can also lead to premature ejaculation, as well as decreased sensation in the penis.
Sexual Position- Many men assume that all sexual positions are equally pleasurable. However, this is not always the case. In some positions, the penis can rub against the woman’s pubic bone, which can be pretty painful. In addition, some positions may put abnormal pressure on the penis, which can lead to discomfort or even pain. If you find that a particular sexual position is painful, it’s important to experiment and find a position that is more comfortable.
Foreskin Problems– Foreskin problems are more common than you might think, and they can make sex pretty painful for men. The foreskin is the skin that covers the head of the penis, and it can be prone to a variety of issues, including inflammation, infection, and even cancer. In some cases, the foreskin can become so tight that it’s difficult or impossible to retract. This can not only make sex painful, but it can also lead to serious medical problems if left untreated.
Allergy– Some men who suffer from an allergic reaction to latex condoms can make their sex life in agony. The allergic reaction can cause pain and swelling in the genitals, making sex a very unpleasant experience. In severe cases, the allergic reaction can even lead to anaphylactic shock, which can be life-threatening. If you experience pain or swelling after using latex condoms, it’s essential to see a doctor immediately.
Medical Condition Causes
Also, it can be caused by a medical condition like:
Delayed Ejaculation– For some men, sex can be a bit of a letdown-literally. Delayed ejaculation (DE) is a sexual disorder in which a man takes a longer time than usual to reach orgasm and release seminal fluid (ejaculate). In some cases, men with DE are unable to ejaculate at all. DE can be frustrating and even painful for sexual partners.
STIs (Sexually Transmitted Diseases)– Many STIs can cause inflammation of the genitals, which can lead to pain during sex. In some cases, the pain may be severe enough to make intercourse impossible. And even if the pain isn’t that bad, it can still be a big buzzkill.
Ejaculation Pain– One potential cause of pain during sex is ejaculatory pain. This can occur if the prostate or seminal vesicles are inflamed or infected. In some cases, pain may also be caused by an obstruction in the ejaculatory ducts. Treatment for this condition typically involves antibiotics to clear any infection and pain medication to relieve symptoms.
Post Orgasmic Illness Syndrome (POIS)- While the exact causes of POIS are still unknown, it’s believed that the condition is triggered by an allergic reaction to your own sperm. And while POIS is a relatively rare condition, it’s important to be aware of the potential risks before you get busy with your partner.
Curved Penis or Peyronies Disease– A curved penis can make sex painful for men, as the curvature can prevent the flow of semen during ejaculation. In addition, the curve can also cause the penis to rub against the cervix during intercourse, which can be uncomfortable for both partners.
If you think these factors are the root cause of your sharp pain during sexual intercourse, it is better to discuss it with your doctor. If the cause is still unknown, we offer a FREE 15-minute teleconsultation.
What can help with sharp pain during sexual intercourse?
If you are looking for a trusted partner who can help you overcome sharp pain during sexual intercourse, look further than Pelvis NYC. We at Pelvis NYC have someone like Doctor Adam Gvili who takes every problem seriously and comes up with a favorable result. He helps men who are experiencing sharp pain during sexual intercourse improve their symptoms through a tailored treatment plan. He also specializes in pelvic floor physical therapy which is a great treatment option.
Pelvic floor exercises are a type of exercise that strengthens the muscles around the penis and testicles. These exercises can help to improve blood flow to the pelvic floor muscles, making them more relaxed and less likely to tense up during sex. Also, this helps improve muscle tone and control, which can in turn reduce pain during sex.
Pelvic floor physical therapy can also help address any underlying issues contributing to the pain, such as muscle spasms or tightness. In addition, pelvic floor physiotherapy can help to improve sexual function and satisfaction and help prevent premature ejaculation.
For further questions or inquiries, it is wise to visit Pelvis NYC and book a consultation with us. Let us help you make your sex life pleasurable and enjoyable.
Many men experience erectile dysfunction (ED) at some point in their lives but feel too embarrassed to discuss it. This silence often leads to frustration and emotional stress — which is why only a small percentage seek professional help.
Fortunately, pelvic floor physical therapy is a safe and effective erectile dysfunction treatment that improves blood flow to the penis, strengthens pelvic muscles, and helps restore erectile function naturally.
If you’re struggling to get an erection or maintain one, stop suffering in silence. Take the first step toward recovery and let our specialists help you regain confidence, improve your sex life, and enhance your overall well-being.
Understanding Erectile Dysfunction (ED)
Erectile dysfunction, also known as impotence, is a sexual health condition where a man has difficulty achieving or maintaining an erection firm enough for sexual intercourse. Both physical and psychological factors can cause ED.
Physical causes include:
cardiovascular disease
diabetes
high blood pressure
hormonal imbalances
nerve damage
certain medications
prostate surgery
Psychological factors such as stress, anxiety, and depression can also contribute to ED. Mental health conditions, including anxiety and depression, may significantly impact erectile function, and improving mental health can help alleviate ED symptoms.
Physical Causes of Erectile Dysfunction
Aging
Sedentary lifestyle or lack of exercise
Obesity
Smoking and alcohol use
High blood pressure and heart disease
Diabetes
Prostate cancer treatments or pelvic surgery
Psychological Factors
Stress
Anxiety
Depression
Relationship problems or low self-esteem
Even if the cause isn’t immediately apparent, consulting a healthcare professional is essential. With today’s medical advancements, numerous ED treatment options can restore function and improve sexual performance.
Things You Need to Know About Erectile Dysfunction
A common misconception is that erectile dysfunction only affects older men. While the risk increases with age, many men in their 20s and 30s also experience ED due to lifestyle, emotional health, medical conditions, or too much alcohol.
Since this condition can significantly impact mental and sexual health, it deserves serious and effective treatment — and one promising method is pelvic floor physical therapy.
It’s important to review your health history with a healthcare professional to determine the most appropriate treatment for ED.
Effective Erectile Dysfunction Treatment Options
There are many ED treatments available, including both medical and natural approaches. Testosterone replacement therapy is another ED treatment option for men whose erectile dysfunction is linked to low testosterone levels. The right choice depends on the underlying cause of the dysfunction. For those who do not respond to medications, other treatments such as penis pumps and surgical options like penile implants may be considered.
1. Oral Medications and ED Pills
The most common ED drugs include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). These ED pills work by relaxing blood vessels to improve blood flow and increase blood flow to the penis, making it easier to achieve and maintain an erection. These medications require sexual stimulation to be effective.
Men taking nitrate drugs to treat chest pain should not use ED pills, as this combination can cause dangerous drops in blood pressure. Men with low blood pressure or a history of chest pain should consult their doctor before using ED medications.
Prescription drugs for ED are FDA-approved and should not be substituted with over-the-counter drugs or supplements, which may be unsafe and lack quality control.
Pelvic floor therapy targets the muscles that support erectile function. Strengthening these muscles enhances blood circulation, improves muscle control, and can help restore natural erections. This is one of the most effective erectile dysfunction treatments with long-term benefits and minimal side effects.
3. Lifestyle Changes
Adopting a healthy lifestyle can significantly improve ED:
Maintain a balanced diet
Exercise regularly
Manage blood pressure and cholesterol
Quit smoking and reduce alcohol consumption
Get enough sleep
4. Managing Emotional Health
Your emotional health plays a major role in sexual performance. Counseling or therapy can help address anxiety, depression, or stress that might be contributing to ED. A holistic approach that supports both the body and mind is often the most effective.
5. Alternative Medicine
Some men explore alternative medicine such as acupuncture, herbal supplements, or yoga. While these can improve relaxation and blood flow, it’s crucial to consult your doctor before starting any alternative ED treatments.
6. Clinical Trials and New Therapies
Researchers are continually developing new ED treatments through clinical trials. These may include regenerative therapies like stem cell therapy or shockwave treatment aimed at improving long-term erectile function. Future treatment options for ED are being explored in clinical trials, including therapies that use sound waves to stimulate blood flow.
Surgery and Implants
For men who have not found success with other erectile dysfunction treatments, surgery and penile implants offer a reliable solution. A penile implant, or penile prosthesis, is a device surgically placed inside the penis to help achieve and maintain an erection suitable for sexual intercourse.
There are two main types of penile implants: inflatable implants, which allow you to control when and how long you have an erection, and semirigid rod implants, which keep the penis firm but can be positioned as needed. Penile implants are typically considered only after other ED treatments have failed, but many men who choose this option report high satisfaction rates. As with any surgery, there are risks, including infection, and the procedure may be postponed if you have a urinary tract or other infection. If you are considering a penile implant, consult with a specialist to determine if this is the best treatment for your erectile dysfunction.
Testosterone Replacement Therapy
Low testosterone is a common but often overlooked contributor to erectile dysfunction. Testosterone replacement therapy (TRT) can help men with confirmed low testosterone levels improve their erectile function and overall health. TRT involves supplementing the body’s natural testosterone, which may help reduce ED symptoms and boost sexual health. However, testosterone therapy is not usually the first-line treatment for ED and is most effective when tailored to your specific needs, sometimes in combination with other ED treatment options. Your doctor can perform blood tests to check your testosterone levels and help decide if TRT is right for you. Always consult a healthcare professional before starting testosterone replacement, as it’s important to address all underlying health conditions and choose the most appropriate treatment option for your situation.
Urethral Suppository and Penile Injections
For men who cannot take oral medications or prefer not to use a vacuum erection device, urethral suppositories and penile injections offer alternative ways to treat erectile dysfunction. Intraurethral therapy involves placing a tiny medicated pellet into the tip of the penis, which usually produces an erection within 10 minutes. Penile injections use a very fine needle to deliver medication directly into the base of the penis, rapidly increasing penile blood flow and often resulting in a firmer erection than oral medications can provide. Patients are taught how to self-administer these injections safely, with the first dose typically given in a clinical setting. While these methods are effective for many, possible side effects include mild bruising, bleeding, or, with repeated use, the risk of scar tissue formation. Discuss these ED treatment options with your doctor to determine if they are right for you.
Low-Intensity Shockwave Therapy
Low-intensity shockwave therapy (LISWT) is an innovative, non-invasive treatment for erectile dysfunction that uses gentle pulses of energy to stimulate the natural healing process in penile tissues. This therapy works by increasing blood flow and encouraging the growth of new blood vessels, which can significantly improve erectile function over time. Most men undergo a series of about six treatments, spaced over several weeks, with the best results appearing after a few months. LISWT is generally well-tolerated, causing only mild tingling during the procedure and minimal side effects when performed by a qualified provider. It’s important to note that not all sound wave therapies are the same—radial wave therapy (RWT), for example, lacks scientific support and is not recommended for treating erectile dysfunction. Always seek out FDA-approved, evidence-based treatments for the best outcomes.
Why Choose Pelvic Floor Physical Therapy for ED Treatment
Unlike medications that provide temporary relief, pelvic floor physical therapy focuses on addressing the root cause of erectile dysfunction. It improves blood flow, strengthens pelvic muscles, and enhances erectile function naturally. This approach can help restore normal erections, improve erection function, and enhance overall sexual function.
A trained physical therapist can design a personalized program with exercises and lifestyle adjustments tailored to your needs. Many men report noticeable improvements in erection quality and sexual confidence after consistent therapy.
Finding a Qualified Healthcare Provider
Choosing the right healthcare provider is a crucial step in effectively treating erectile dysfunction. Primary care doctors and urologists are experienced in diagnosing and managing ED, and can help identify any underlying health conditions that may be contributing to your symptoms. During your first visit, your provider will ask about your medical and sexual history, lifestyle habits, and any medications you are taking. A thorough physical exam and blood tests may be performed to check blood flow, blood pressure, and overall health. Being open and honest about your symptoms and sexual history will help your provider recommend the most effective treatment option for you. Bringing your partner to the appointment can also offer valuable support and insight. By working closely with a qualified healthcare provider, you can address ED symptoms, improve your sexual health, and enhance your quality of life.
Your Trusted Health Partner — Pelvis NYC
At Pelvis NYC, we understand how debilitating erectile dysfunction can be. Under the guidance of Dr. Adam Gvili, our clinic specializes in helping men restore function, relieve discomfort, and live a pain-free, confident life.
We provide individualized treatment plans that target the underlying causes of ED, whether physical or psychological. Our holistic approach focuses on strengthening the body, improving blood circulation, supporting mental wellness, and carefully considering each patient’s medical history and heart health to ensure the most effective care.
Erectile dysfunction is a common yet treatable condition. With modern ED treatment options — from medications and lifestyle changes to pelvic floor physical therapy — men can overcome ED and reclaim control over their sexual health.
Take action today. With the right support, you can achieve lasting results and rediscover the joy of intimacy.
Male pelvic health still carries a stigma. Raising awareness about men’s pelvic health is crucial, as it addresses unique challenges and the need for targeted treatment for men. Men’s needs are often overlooked, leading to a lack of understanding and treatments specifically tailored for men. Thus, Pelvis NYC was born out of necessity. When Dr. Adam Gvili, founder of Pelvis NYC – a male pelvic floor therapist, experienced pelvic floor dysfunction and did not get all the help he deserved, he decided to treat men’s pelvic floor as a male.
Male pelvic floor therapists are specially trained to focus on male health concerns, providing the specialized care and attention that men deserve. They can also help address specific issues such as male pelvic pain and pelvic floor issues, which can impact everyday activities and require specialized treatment.
Pelvic Health
The pelvic floor is a group of muscles and connective tissues that support the bladder and sexual organs. The pelvic floor muscle function is crucial for supporting these organs and maintaining their proper function. It is also part of the core muscles, which work together to provide stability and support for the pelvis and lower back.
Additionally, pelvic floor muscle function is essential for maintaining bowel and bladder control, helping to prevent incontinence. The pelvic floor plays a key role in supporting organ function and overall pelvic health. These muscles can become weak or damaged due to many factors. As a result, men may experience problems with urinary or bowel incontinence, sexual dysfunction, or pain in the pelvis or lower back.
Male pelvic floor therapists are an essential part of pelvic health because they can provide care specifically tailored for male patients. Pelvic health therapy is a specialized approach for men, addressing a wide range of pelvic floor dysfunctions and restoring function, control, and confidence. The male pelvis is different from the female pelvis, so it’s important to have someone who understands the male anatomy. Male pelvic floor therapists specialize in treating male-specific conditions, such as erectile dysfunction.
During the first visit, the therapist will conduct a comprehensive assessment, including a review of your health history and medical history. This initial consultation helps identify underlying causes and allows the therapist to develop a personalized treatment plan aimed at addressing your specific pelvic health concerns and restoring balance.
They can help men to strengthen their pelvic floor muscles, which can improve urinary control and sexual function. Pelvic floor muscle exercises, also known as Kegel exercises, can help improve bladder control, prevent incontinence, and potentially enhance sexual performance and pleasure.
Pelvic Floor Dysfunction
Dysfunction of the pelvic floor occurs when there is difficulty coordinating the pelvic floor muscles, resulting in issues like urinary or bowel incontinence, difficulty emptying, urinary frequency, chronic pain, hip pain, and other related problems. Weakened pelvic floor muscles can also be a significant concern, and male pelvic floor therapists can help treat this condition through daily routine exercises, education, and building helpful habits.
Male pelvic floor therapists can provide education and support to men who are dealing with prostate issues, have undergone radical prostatectomy, or are experiencing other chronic health conditions. It is important to note that without proper assessment and individualized treatment, some exercises may make symptoms worse, such as increasing bladder urgency or pelvic pain. By working with a male pelvic floor therapist, men can take steps to improve their overall health and well-being.
Common Conditions and Treatment
Pelvic floor physical therapy is a highly effective approach for addressing a wide range of male pelvic health conditions. Many men experience pelvic floor dysfunction, erectile dysfunction, chronic pelvic pain, or urinary incontinence at some point in their lives, and these issues can have a significant impact on daily activities and overall well-being. With the expertise of physical therapists specializing in pelvic health physical therapy, men can receive personalized treatment plans designed to target their specific symptoms and needs.
Some of the most common conditions treated with pelvic floor physical therapy include:
Erectile dysfunction: The pelvic floor muscles play a crucial role in erectile function. Weakness or poor coordination in these muscles can contribute to erectile dysfunction, but targeted exercises and manual therapy can help restore strength and improve sexual health.
Chronic pelvic pain: Persistent pain in the pelvic region can be debilitating and affect quality of life. Pelvic floor physical therapy addresses muscle tightness, connective tissue restrictions, and nervous system imbalances to reduce pain and discomfort.
Urinary incontinence: Issues with bladder control, often following prostate surgery or due to pelvic floor muscle weakness, are common in men. Pelvic floor physical therapy can help improve bladder control and reduce symptoms of urinary incontinence.
Bowel dysfunction: The pelvic floor muscles are also essential for healthy bowel movements. Problems such as constipation or fecal incontinence can be managed through pelvic floor physical therapy, which focuses on strengthening and coordinating the pelvic floor muscles for better bowel control.
Treatment plans are tailored to each patient and may include:
Targeted exercises: Customized exercises to strengthen or relax the pelvic floor muscles, helping to restore normal function and reduce symptoms.
Manual therapy: Hands-on techniques such as massage, joint mobilization, and myofascial release to address muscle tightness and improve tissue mobility in the pelvic region.
Education: Guidance on understanding your condition, managing symptoms, and adopting healthy habits for long-term pelvic health, including proper techniques for bowel and bladder habits.
Behavioral modifications: Recommendations for lifestyle changes, such as avoiding heavy lifting, minimizing prolonged sitting, and improving posture, to support pelvic health and prevent symptoms from getting worse.
By addressing the underlying causes of male pelvic health issues and providing a comprehensive, personalized treatment plan, pelvic floor physical therapy can help reduce pain, improve bladder and bowel control, and enhance sexual function. If you are experiencing symptoms related to pelvic floor dysfunction, chronic pelvic pain, or other male pelvic health conditions, consulting with a healthcare provider or a physical therapist specializing in pelvic health can help you find relief and improve your quality of life.
Pelvic Floor Physical Therapy
Male pelvic floor therapists undergo special training to assess and treat pelvic floor dysfunction, making them highly skilled pelvic floor physical therapists. They can provide customized exercises and treatments to help improve the strength and function of the pelvic muscles. These treatments can include exercises to strengthen, relax, and stretch the pelvic floor muscles, addressing specific issues such as bladder control, incontinence, constipation, erectile dysfunction, and chronic pain. Therefore, men can enjoy improved bladder control, better sexual performance, and reduced pain.
Why Choose Us?
Dr. Adam Gvili is a physical therapist specializing in male health concerns who wants to end the gap in who should treat men. Since no one wants to go next with male genitalia, he specializes in male health concerns. He offers treatments for pelvic floor dysfunction, incontinence, and pain. He is also a certified Pilates instructor, which allows him to offer tailored Pilates programs to his patients. His unique combination of skills and experience makes him uniquely qualified to treat men’s pelvic floor problems.
Our clinic is a thriving one to makes every client feel at home as we help them improve their symptoms. For a consultation with Dr. Adam Gvili, contact Pelvis NYC today to schedule an appointment with a medical professional who listens to you, identifies the root of your symptoms, and designs the best treatment plan.
Living with persistent pelvic pain can be frustrating, confusing, and sometimes even life-altering. For some people, the source of this discomfort isn’t well known or often misunderstood. One such condition is pudendal neuralgia—a type of nerve-related pelvic pain that’s frequently underdiagnosed yet has a major impact on quality of life.
Pain is the main symptom of pudendal neuralgia. The good news? Pudendal neuralgia is treatable. With approaches like physical therapy, pain management strategies, nerve blocks, and lifestyle changes, many people can reduce their symptoms and regain control of their lives.
This comprehensive guide will walk you through everything you need to know: what pudendal neuralgia is, why it happens, how to recognize it, and how specialists like the team at Pelvis NYC can help.
What is Pudendal Neuralgia?
The pudendal nerve is one of the most important nerves in your pelvic region. It runs through the pelvic floor and carries both sensation and motor function to areas including the anus, perineum, genitals, clitoris, and penis. The perineal branch of the pudendal nerve provides sensory innervation to the perineal region. It plays a vital role in urinary control, bowel function, and sexual health. The pudendal nerve also controls the sphincter muscles responsible for opening and closing the urethra and anus.
Pudendal neuralgia occurs when this nerve becomes irritated, compressed, or damaged. This can lead to nerve pain described as burning, stabbing, tingling, or shooting sensations. Because the nerve supplies such sensitive areas, including the rectum as part of its sensory distribution, the pain can be intense and disruptive.
Unlike muscle pain, pudendal neuralgia often worsens with sitting and may improve when standing or lying down. Many patients report that the discomfort feels worse throughout the day, especially after long periods of sitting.
Unfortunately, pudendal neuralgia is often misdiagnosed as a bladder problem, prostatitis, or gynecological condition, which delays proper treatment. That’s why awareness is crucial.
Pelvic Floor Muscles and Pudendal Neuralgia
The pelvic floor muscles form a supportive sling across the base of your pelvis. They hold your bladder, bowel, and reproductive organs in place. The pudendal nerve runs directly through this muscular region, making it vulnerable to compression.
When these muscles are too tight, weak, or imbalanced, they can place extra pressure on the pudendal nerve. This is why pelvic floor dysfunction and pudendal neuralgia often go hand in hand.
For example:
Overly tight pelvic floor muscles may trap or irritate the nerve.
Weak or imbalanced muscles may cause structural shifts that increase nerve compression.
The obturator internus muscle, which is located on the lateral wall of the pelvis, can also contribute to pelvic and perineal pain when it is tight or in spasm. Entrapment or spasms of this muscle may cause tenderness and should be considered during physical examination to help differentiate pelvic pain syndromes.
Understanding the relationship between muscles and nerves is key to finding the right treatment—especially since many people assume pelvic pain is purely muscular when in fact the nerve is involved.
Recognizing Nerve Pain and Chronic Pain
Not all pain feels the same. Muscle soreness after a workout is very different from nerve pain. With pudendal neuralgia, people often describe sensations like:
Burning or stinging
Electric shock–like jolts
Numbness or tingling
Stabbing pain deep in the pelvis
These are typical symptoms of pudendal neuralgia, which may affect the sensory distribution of the pudendal nerve and significantly impact quality of life.
Pudendal neuralgia is a form of neuropathic pain, and if untreated, this pain can become chronic neuropathic pain, meaning it lasts for months or even years. Chronic pudendal neuralgia can interfere with sitting at work, driving, using the restroom, and sexual activity. Patients suffering from chronic neuropathic pain may also experience emotional distress, such as depression and frustration, especially when earlier interventions have failed to provide relief.
The longer nerve pain persists, the harder it can be to treat, which is why early pain management strategies are so important.
Pelvic Pain Symptoms
Pudendal neuralgia symptoms can vary, but some of the most common include:
Pain in the genitals, anus, or perineum
Perineal pain, often chronic and neuropathic in nature
Discomfort that worsens when in the sitting position but improves when standing or lying down
Burning or tingling sensations in the pelvic region
Changes in skin sensation, such as numbness or sensitivity, in the pelvic area between the genitals and anus
Numbness or sensitivity in the buttocks or thighs
Sexual dysfunction and sexual problems, including pain during sex, erectile dysfunction, or difficulty reaching orgasm
Both men and women can experience pudendal neuralgia, though the triggers may differ. For example, men may notice symptoms after cycling or prolonged sitting, while women may develop it after childbirth or pelvic surgery.
Why is Pudendal Neuralgia Underdiagnosed?
One of the biggest challenges with pudendal neuralgia is that it’s often mistaken for other conditions. Because the symptoms overlap with urinary tract infections, prostatitis, gynecological problems, or even lower back issues, many patients see multiple doctors before receiving a proper diagnosis. Clinicians must consider other causes of pelvic pain and review all possible diagnoses to ensure accurate assessment and treatment.
The lack of awareness among healthcare providers contributes to delays in treatment. The diagnostic process involves ruling out other diagnoses and applying specific diagnostic criteria, such as the Nantes criteria, to confirm pudendal neuralgia. Patients often feel frustrated, unheard, or dismissed, which can worsen their overall mental health. Raising awareness about pudendal neuralgia helps ensure that more people get the care they deserve.
Physical Examination for Pudendal Neuralgia
Diagnosing pudendal neuralgia usually involves a thorough physical examination and medical history review. A pelvic health specialist may check for:
Tenderness along the pudendal nerve pathway
Muscle tension in the pelvic floor
Postural or structural issues contributing to nerve irritation
Rectal and vaginal examinations to assess for nerve involvement and exclude other diagnoses
During the anatomical assessment, the examiner may trace the path where the pudendal nerve travels through the pelvis, noting areas where the nerve travels through tight anatomical spaces that could lead to irritation or compression.
In some cases, imaging tests (like MRI) or a diagnostic nerve block are used to confirm the diagnosis. Early and accurate diagnosis can make treatment more effective and prevent chronic pain from worsening.
How Can Physical Therapy Help Pudendal Neuralgia?
One of the most effective conservative approaches to treating pudendal neuralgia is physical therapy. At Pelvis NYC, we specialize in pelvic floor physical therapy, which focuses on restoring balance, mobility, and function to the pelvic region.
Here’s how physical therapy can help:
Pelvic Floor Muscle Release Tight pelvic floor muscles can compress the pudendal nerve. Through manual therapy and targeted relaxation techniques, a therapist can release tension and reduce nerve pressure.
Posture and Alignment Correction Poor posture, especially when sitting, can worsen pudendal nerve pain. Physical therapy includes strategies to improve spinal and pelvic alignment, which reduces daily stress on the nerve.
Tailored Exercises Gentle strengthening and stretching exercises help rebalance the pelvic floor and surrounding muscles. Over time, this improves circulation, reduces inflammation, and prevents recurring pain.
Nerve Mobilization Techniques Some therapists use techniques designed to “free up” nerves that may be restricted by tight tissues. This helps restore natural nerve mobility.
Education and Self-Management Patients learn strategies for sitting more comfortably, modifying activities like cycling, and avoiding positions that trigger pain.
The beauty of physical therapy is that it’s non-invasive and focuses on long-term healing rather than temporary fixes. Many patients find significant relief within weeks of starting treatment.
Nerve Block for Pudendal Neuralgia
When pain is severe or persistent, a pudendal nerve block may be recommended. This is a specific type of injection used for both diagnosis and treatment of pudendal neuralgia. The procedure involves injecting an anesthetic (sometimes combined with steroids) around the pudendal nerve, often using image-guided techniques. Injections are frequently performed in anatomical areas such as Alcock’s canal to accurately target the nerve.
Benefits of a pudendal nerve block include:
Immediate pain relief in many cases
Diagnostic value (if the pain disappears temporarily, pudendal neuralgia is confirmed)
Breaking the cycle of chronic pain, making physical therapy more effective
Potential for repeated pudendal nerve blocks to provide ongoing pain relief
While pudendal nerve blocks aren’t a cure, they can provide a window of relief that allows other treatments to work better.
Pain Management Options
Managing pudendal neuralgia often requires a multifaceted approach. Beyond physical therapy and nerve blocks, other pain management strategies may include:
Medications such as nerve pain drugs (gabapentin or pregabalin), muscle relaxants to help relax pelvic floor muscles, and topical creams for localized relief and to calm nervous system sensitivity
Nerve stimulation (such as TENS or neuromodulation) as a non-invasive treatment option
Acupuncture or biofeedback for relaxation and pain reduction
Counseling or therapy to address the emotional toll of chronic pain
The goal is to reduce pain to a manageable level while improving quality of life.
Management of Pudendal Neuralgia
The best management of pudendal neuralgia is a personalized, step-by-step plan. Treatment usually begins with conservative approaches like physical therapy and lifestyle changes. If these don’t fully relieve symptoms, nerve blocks or medications may be added.
For the small percentage of people who don’t improve with non-invasive methods, surgical decompression of the pudendal nerve may be considered—but this is rare and reserved for severe cases. In such situations, decompression surgery, specifically pudendal nerve decompression, is an important option. Various surgeries may be considered to relieve nerve compression, especially when scarring, congenital issues, or trauma are involved.
Lifestyle Changes
Certain lifestyle changes can make daily life easier and reduce flare-ups:
Use cushions designed to reduce pressure on the perineum when sitting.
Take breaks from sitting to stand, stretch, or walk.
Modify activities like cycling or horseback riding that increase nerve irritation.
Stay hydrated and eat a fiber-rich diet to avoid constipation, which can worsen symptoms.
Practice relaxation techniques like yoga or meditation to reduce pelvic floor tension.
These small changes can add up to major improvements over time.
Other Conditions to Rule Out
Because pudendal neuralgia symptoms mimic other issues, it’s important to rule out other conditions, including:
Interstitial cystitis (bladder pain syndrome)
Prostatitis (inflammation of the prostate in men)
Endometriosis (in women)
Sciatica or herniated discs
Infections or hernias
A thorough evaluation ensures the right treatment is chosen.
Prognosis and Outlook for Pudendal Neuralgia
Living with pudendal neuralgia can be challenging, but the outlook is not the same for everyone. The prognosis largely depends on how early the condition is diagnosed, the underlying cause, and how well the treatment plan is tailored to the individual’s needs. With a proactive approach—including physical therapy, lifestyle changes, and other targeted treatments—many people experience significant pain relief and a noticeable improvement in their symptoms.
Early diagnosis is key. When pudendal neuralgia is identified and managed promptly, there’s a much better chance of reducing nerve pressure and preventing chronic pain from becoming a long-term issue. A comprehensive treatment plan that addresses all aspects of the condition—such as muscle imbalances, nerve irritation, and daily habits—can make a real difference in quality of life.
For some, symptoms may persist despite best efforts, and in rare cases, severe pain can lead to ongoing discomfort or disability. In these situations, more advanced interventions like surgical decompression of the pudendal nerve may be considered to relieve pressure and restore function.
Ultimately, working closely with your healthcare provider to develop a personalized treatment plan is essential. With the right combination of therapies and support, it’s possible to manage symptoms, regain comfort, and improve overall well-being—even with a chronic condition like pudendal neuralgia.
Deterrence and Patient Education
Education is a powerful tool in both managing and preventing pudendal neuralgia. Understanding how everyday activities and habits can affect the pudendal nerve is the first step toward reducing the risk of severe pain and long-term complications.
Patients should be aware that certain activities—like prolonged sitting, horse riding, or anything that puts direct pressure on the pelvic floor—can aggravate symptoms or even contribute to the development of pudendal neuralgia. Making simple lifestyle changes, such as taking regular breaks from sitting, using supportive cushions, and modifying exercise routines, can help protect the nerve and minimize discomfort.
Maintaining strong and flexible pelvic floor muscles is also crucial. Regular stretching and gentle exercises can reduce muscle tension, improve nerve function, and support overall pelvic health. Avoiding habits that increase pelvic pressure, such as straining during bowel movements or lifting heavy objects improperly, can further decrease the risk of nerve irritation.
Healthcare providers play a vital role in patient education by offering resources, guidance, and support. Educational materials—whether brochures, online articles, or support groups—can empower individuals to recognize symptoms early, seek timely treatment, and make informed decisions about their care.
By staying informed and proactive, patients can take control of their condition, reduce the likelihood of severe pain, and improve their quality of life. Together, patients and providers can develop effective strategies for managing symptoms, preventing flare-ups, and ensuring the best possible outcomes for those living with pudendal neuralgia.
Living with Pudendal Neuralgia: Patient Tips
Living with pudendal neuralgia can be overwhelming, but small strategies help:
Keep a pain journal to track triggers and flare-ups.
Join support groups where you can share experiences and coping tips.
Pace your activities—alternate sitting, standing, and lying down to avoid prolonged pressure.
Don’t hesitate to seek mental health support—chronic pain can affect mood and outlook.
When to Seek Medical Help
You should seek medical attention if you have:
Persistent pelvic pain lasting more than a few weeks
Pain that interferes with sitting, sex, or daily activities
Symptoms that worsen over time despite home care
Early treatment prevents complications and helps avoid long-term nerve damage.
Book Your Appointment at Pelvis NYC
At Pelvis NYC, we specialize in diagnosing and treating conditions like pudendal neuralgia. Our team uses advanced pelvic floor physical therapy, personalized treatment plans, and holistic pain management strategies to help patients regain control of their lives.
👉 Don’t let pudendal neuralgia control your day-to-day life. Book your appointment at Pelvis NYC today and get a FREE 15-minute teleconsultation to start your path toward relief.
FAQs About Pudendal Neuralgia
1. Can pudendal neuralgia go away on its own? In some cases, mild nerve irritation may improve with rest and lifestyle changes. However, persistent symptoms usually require medical intervention.
2. Is pudendal neuralgia permanent? Not necessarily. With the right treatment—including physical therapy, nerve blocks, and lifestyle modifications—many patients experience significant improvement or even full recovery.
3. How do I sit with pudendal neuralgia? Using a special cushion (such as a U-shaped or donut cushion) reduces pressure on the perineum. Taking frequent standing breaks also helps.
4. Who is at risk for pudendal neuralgia? Anyone can develop it, but risks are higher in people who cycle often, sit for long periods, or have a history of pelvic surgery, trauma, or childbirth.
5. How is pudendal neuralgia diagnosed? Diagnosis typically includes a physical examination, review of symptoms, imaging if needed, and sometimes a diagnostic nerve block.
6. Does pudendal neuralgia affect life expectancy? No, pudendal neuralgia does not impact overall life expectancy. While it can significantly affect quality of life, it is not a life-threatening condition.
Final Thoughts
Pudendal neuralgia is a challenging condition, but it doesn’t have to control your life. With early diagnosis, comprehensive management, and the right blend of physical therapy, pain management, and lifestyle changes, many people find real relief.
If you’re struggling with ongoing pelvic pain and suspect pudendal neuralgia, the team at Pelvis NYC is here to help with compassionate, expert care.
If you’re a man silently struggling with chronic pelvic pain, urinary problems, constipation, or sexual dysfunction, you’re not alone—and you’re not imagining things. These frustrating symptoms are often linked topelvic floor dysfunction (PFD), a condition that affects the muscles deep within your pelvis. The good news? There’s effective, evidence-based help available. Treatment for pelvic floor dysfunction—especially through pelvic floor physical therapy—is helping more men finally get relief, restore confidence, and reclaim their quality of life.
What Is Pelvic Floor Dysfunction?
Your pelvic floor is a group of muscles at the base of your pelvis that support vital organs like your bladder, bowel, and prostate. These muscles play a critical role in urination, bowel movements, and sexual performance.
When those muscles are too tight, too weak, or not coordinating properly, you may experience pelvic floor dysfunction. In men, this often goes undiagnosed for years, as the symptoms are easily mistaken for other conditions—or dismissed altogether.
Knowing what to look for is the first step toward getting the right treatment for pelvic floor dysfunction. Symptoms may vary from person to person, but common signs include:
Pain or discomfort in the pelvis, perineum, lower abdomen, or genitals
Feeling of tightness, pressure, or heaviness in the pelvic region
If any of these sound familiar, it’s worth speaking to a pelvic health expert.
What Causes Pelvic Floor Dysfunction?
While the exact causes aren’t always clear, several factors may contribute to pelvic floor dysfunction in men, including:
Chronic constipation or excessive straining
Prostate surgery or pelvic trauma
Heavy lifting or poor body mechanics
Stress, anxiety, or trauma (which can cause muscle tension)
Aging and natural muscle weakening
Sports injuries or high-impact activities
Understanding the cause helps guide the best course of treatment for pelvic floor dysfunction, especially when it comes to restoring proper muscle function.
Pelvic Floor Muscle Dysfunction: Causes and Risk Factors
Men can develop pelvic floor muscle dysfunction from a variety of sources. Chronic constipation and straining are common contributors, along with physical trauma, prostate surgery, or high-impact sports. Emotional stress and anxiety can also lead to muscle tension in the pelvic area, exacerbating symptoms. Even poor posture or weak core muscles can contribute to long-term pelvic floor imbalance.
How Pelvic Floor Exercises Help
One of the most effective, non-invasive ways to treat PFD is through pelvic floor exercises. These include targeted movements designed to strengthen weak muscles and relax tight ones.
You might be guided through Kegel exercises (adapted for men), posture alignment, breathing coordination, and core-strengthening routines. Over time, these exercises improve muscle awareness, bladder and bowel control, and sexual function.
Nonsurgical Treatments for Pelvic Floor Dysfunction
Before considering surgery, many men find success with nonsurgical treatments. These can include pelvic floor physical therapy, manual therapy for muscle knots, biofeedback training, and pain management techniques. For some, cognitive or behavioral therapy may also be recommended to reduce anxiety-related muscle tension. Together, these approaches form the first line of treatment for pelvic floor dysfunction.
Lifestyle Changes to Support Recovery
Daily habits can significantly impact your pelvic health. Incorporating lifestyle changes such as staying hydrated, eating a fiber-rich diet, and avoiding straining during bowel movements can ease symptoms. Reducing heavy lifting, managing stress through mindfulness practices, and maintaining good posture also support pelvic muscle recovery.
Surgical Treatments: When Are They Necessary?
Doctors rarely recommend surgical treatments for pelvic floor dysfunction in men, but they may consider them in severe cases when non-invasive methods fail.
Treatment of severe pelvic organ prolapse (rare in men)
Surgery is typically a last resort, and most men improve significantly with nonsurgical treatments and therapy.
Floor Dysfunction Is Treatable—You’re Not Alone
Living with floor dysfunction can be frustrating and isolating—but it’s also highly treatable. The key is getting the right diagnosis and care from someone who understands male pelvic health.
Why Choose Pelvis NYC?
At Pelvis NYC, we specialize in treating men with pelvic floor dysfunction. Our lead therapist has not only studied this condition extensively but has personally experienced it—bringing empathy and expertise to your care.
We offer one-on-one therapy sessions in a private, respectful setting. Every treatment plan is tailored to your symptoms and lifestyle, with continued support throughout your recovery.
Get Started with a Free 15-Minute Teleconsultation
You don’t have to live with pelvic pain, urinary issues, or sexual dysfunction. Treatment for pelvic floor dysfunction is available—and it works.
Did you know that chronic constipation is often linked to a weak pelvic floor? Strengthening your pelvic floor muscles through targeted exercises can help restore normal bowel movements and significantly reduce the symptoms of constipation.
The management of chronic constipation involves a range of approaches, including dietary changes, lifestyle modifications, and medical treatments, in addition to pelvic floor exercises.
In this guide, we’ll explore how pelvic floor exercises can improve chronic constipation in adults, how to recognize constipation symptoms, and what treatment options—like biofeedback therapy—can help you regain control of your digestive health.
Understanding Bowel Movements: What’s Normal?
Bowel movements are a critical marker of digestive health. The frequency, consistency, and ease of your bowel movements can reveal much about your gastrointestinal system. In clinical practice, both stool frequency and stool form are important markers used to assess bowel health.
Healthy Bowel Movements Typically Involve:
1–3 movements per day or every other day (individual variations are normal)
Smooth, soft stools (like a sausage or snake)
Minimal straining or urgency
A sense of full evacuation
Disruptions in this routine—especially infrequent or difficult bowel movements—may indicate chronic constipation or underlying bowel disease.
What Is Chronic Constipation in Adults?
Chronic constipation in adults is a long-term condition marked by difficulty passing stool, hard or dry stools, and a sense of incomplete evacuation. It affects millions and becomes more common with age, especially in women and people with sedentary lifestyles. The prevalence and risk factors of chronic constipation include demographic factors such as age and gender, as well as lifestyle factors like low physical activity and poor dietary habits. Functional constipation is a primary form of constipation that occurs without secondary medical causes, while idiopathic constipation and chronic idiopathic constipation refer to cases where no clear underlying cause can be identified.
Common Chronic Constipation Symptoms Include:
Fewer than three bowel movements per week
Hard, dry, or lumpy stools
Painful defecation
A feeling of blockage in the rectum
A sense that you can’t completely empty your bowels
Causes and Risk Factors for Chronic Constipation
Chronic constipation doesn’t have a single cause—it’s often the result of several overlapping factors. One of the most common risk factors is a low-fiber diet, which can slow down the movement of stool through the digestive tract. Not drinking enough fluids and leading a sedentary lifestyle can also contribute to sluggish bowel habits.
Certain medical conditions, such as irritable bowel syndrome (IBS), diabetes, and hypothyroidism, are known to increase the risk of developing chronic constipation. Medications are another important consideration; blood pressure medications, opioid painkillers, and some antihistamines can all slow colonic motility and worsen constipation symptoms.
Other risk factors include being over the age of 65, female gender, and a personal or family history of constipation, especially if it began in childhood. Recognizing these risk factors is key to identifying patients who may benefit from early intervention and targeted strategies to treat constipation before it becomes severe.
Diagnosis and Testing: How Is Chronic Constipation Identified?
Diagnosing chronic constipation starts with a thorough review of your symptoms and medical history. Patients with chronic constipation often report infrequent bowel movements, hard or lumpy stools, and difficulty passing stool. Your healthcare provider will likely perform a physical examination, which may include a digital rectal examination. This can help to check for issues like rectal prolapse or faecal impaction.
To rule out more serious conditions such as colon cancer or inflammatory bowel disease, your doctor may recommend diagnostic tests like colonoscopy, sigmoidoscopy, or imaging studies. Specialized tests, such as anorectal manometry or the balloon expulsion test, can help assess how well your pelvic floor muscles and rectum are functioning and identify problems like dyssynergic defecation.
A diagnosis of chronic constipation is typically made when you experience two or more of the following:
Straining during bowel movements
Hard or lumpy stools
A sensation of incomplete evacuation
Fewer than three bowel movements per week.
These diagnostic steps help ensure that any underlying bowel disease is identified and that your treatment plan is tailored to your specific needs.
The Link Between Constipation and the Pelvic Floor
When you strain repeatedly to pass stool, you may unknowingly damage your pelvic floor muscles. These muscles support your bowel, bladder, and reproductive organs. Over time, excessive pressure can lead to pelvic floor dysfunction, which worsens constipation instead of relieving it. Pelvic floor dysfunction can result in evacuation disorders, where impaired coordination of the rectal and pelvic floor muscles makes it difficult to evacuate stool. It is also often associated with anorectal disorders—structural or functional problems in the anorectal region—that further impair normal stool passage.
How Pelvic Floor Dysfunction Affects Bowel Health:
Impairs coordination needed for proper colonic transit (movement of stool through the colon)
Disrupts the relaxation and contraction of anal and rectal muscles
Increases risk of faecal impaction, a severe form of blockage where hardened stool becomes stuck in the rectum
Pelvic Floor Exercises for Chronic Constipation Relief
Pelvic floor exercises, often called Kegels, involve clenching and releasing the muscles that control urination and defecation. When done correctly, they help restore proper function and coordination of the pelvic muscles, improving chronic constipation over time.
However, identifying the correct muscle group is key. Without proper guidance, these exercises may be ineffective.
Biofeedback Therapy for Chronic Constipation
While pelvic floor exercises are a powerful first step, many patients achieve even greater success when combining them with biofeedback therapy—a highly effective, evidence-based approach that helps retrain the muscles for smooth, coordinated bowel movements. The effectiveness of biofeedback therapy is often measured by clinical response, which includes improvements in symptoms and increased bowel movement frequency.
What Is Biofeedback Therapy?
Biofeedback uses sensors and computer-guided visual or auditory feedback to help patients retrain pelvic muscles. During the session:
You’ll learn to identify and relax the appropriate muscles
You’ll receive real-time feedback on how well you’re performing the exercises
Therapists will guide you to improve coordination for smoother bowel movements
This therapy has shown significant success in treating chronic constipation in adults, especially when linked to pelvic floor dysfunction.
When to Seek Professional Help:
If you’re unsure how to activate your pelvic floor muscles or aren’t experiencing relief, it’s essential to consult a trained physical therapist. At PELVIS.NYC, Dr. Adam Gvili PT, DPT, customizes treatment plans for each patient, using evidence-based techniques including biofeedback therapy, manual therapy, and behavioral training.
Other Causes of Constipation to Consider
Irritable Bowel Syndrome (IBS) Irritable bowel syndrome, particularly IBS-C (constipation-dominant), is a common functional gastrointestinal disorder that leads to abdominal pain, bloating, and irregular bowel habits.
Inflammatory Bowel Disease (IBD) Unlike IBS, inflammatory bowel disease involves structural inflammation of the digestive tract and includes conditions like Crohn’s disease and ulcerative colitis. Though more commonly associated with diarrhea, some forms can cause chronic constipation.
Bowel Disease and Colonic Transit Slow colonic transit is a key factor in many forms of bowel disease. A sluggish colon may prevent the movement of stool, leading to constipation that’s unresponsive to diet or fiber alone.
Diet and Lifestyle Tips for Constipation in Adults
A well-balanced diet rich in dietary fiber plays a significant role in managing constipation. Aim for 25–30 grams of fiber daily from whole grains, fruits, and vegetables. Adequate fluid intake is also essential for maintaining normal bowel movements and preventing chronic constipation.
A high fiber diet and dietary fiber treatment are considered first-line strategies for managing chronic constipation, with soluble fiber (such as psyllium) being particularly effective in improving symptoms. Hydration and regular physical activity are also crucial.
Use stimulant laxatives only as directed by a healthcare provider and never for weight loss, as they do not promote actual weight reduction.
If you experience unintentional weight loss or fecal incontinence, these may indicate more serious underlying conditions and should prompt medical evaluation.
Additional Tips:
Avoid over-reliance on laxatives
Stay hydrated with at least 8 glasses of water per day
Schedule time for daily, unhurried bowel movements
Use a footstool to elevate your knees while on the toilet for optimal alignment
Preventing Complications of Chronic Constipation
Taking steps to prevent complications from chronic constipation is essential for long-term digestive health. Simple lifestyle changes, such as increasing your intake of high fiber foods, drinking plenty of water, and staying physically active, can help relieve constipation and reduce the risk of more serious problems. Avoiding foods that can worsen constipation—like processed foods and excessive dairy—while focusing on dietary fiber can make a significant difference.
Medical treatments, including stool softeners, over the counter laxatives, or pelvic floor therapy, may be recommended if lifestyle changes alone aren’t enough. Addressing underlying health issues, such as diabetes or thyroid disorders, and managing stress through relaxation techniques can also help prevent complications.
By staying proactive, you can lower your risk of developing issues like rectal prolapse, faecal impaction, or even colorectal cancer. Regular check-ins with your healthcare provider ensure that your symptoms are monitored and your treatment plan is adjusted as needed, helping you maintain healthy bowel habits and overall well-being.
When to Worry: Faecal Impaction and Severe Cases
In severe or untreated cases of chronic constipation, faecal impaction may occur, requiring urgent medical intervention. Symptoms may include nausea, vomiting, rectal bleeding, and inability to pass gas or stool. If you suspect this condition, seek professional care immediately.
In cases of severe or persistent constipation, colorectal cancer screening may be recommended to rule out serious underlying conditions.
Let Us Help You Break the Cycle
At PELVIS.NYC, we understand that no two cases of constipation are alike. Whether your symptoms stem from a weak pelvic floor, slow colonic transit, or a functional bowel disease, our approach is personalized and effective. We evaluate and treat conditions affecting the colon and rectum, including subtypes such as normal transit constipation and slow transit constipation.
Ready to Start Healing?
Book a free 15-minute teleconsultation with Dr. Adam Gvili today and begin your journey toward digestive health.
Chronic constipation in adults is more than just an inconvenience—it’s a signal that something in your digestive or pelvic system may be off-balance. With the right diagnosis, a tailored therapy plan, and consistent support, you can restore normal bowel movements and take back your quality of life.
A man may opt for a vasectomy if he does not want to impregnate someone in his lifetime. However, most of them experience lower abdominal pain after vasectomy as a response to their body’s fast healing, resulting in inflammation and secondary pain. But what is it really like after a vasectomy procedure? Is the pain bearable? Is there relief?
Continue reading to find out.
Overview of Post-Vasectomy Pain Syndrome
Post-vasectomy pain syndrome (PVPS) is a continuous or intermittent testicular pain lasting more than three months. About 1–2% of men who undergo a vasectomy experience this discomfort, which leads to some form of medical treatment.
In some cases, the pain may begin within one month following the procedure and continue for years following the surgery. Pain can be ongoing and short-lived and resolved with anti-inflammatory tablets, but can also become chronic. It can be mild to moderate chronic pain, and in rare cases, patients may experience debilitating pain. But do not worry because there are treatments used for PVPS.
The experience of lower abdominal pain after a vasectomy is only indicative of your body’s response to the healing process, which includes some inflammation and secondary pain. Typically, it is mild discomfort for 5-10 days and occurs in the scrotum area, but can also affect the groin or lower abdomen.
What Symptoms Should You Watch for After a Vasectomy?
If you’ve had a vasectomy and you’re still dealing with pain months later, you might be wondering what’s going on. You could be experiencing something called Post-Vasectomy Pain Syndrome (PVPS)—and while it’s rare, it’s real. The symptoms can range from mildly annoying to seriously disruptive, so it’s important to pay attention to what your body’s telling you.
Here are some common PVPS symptoms to look out for:
Ongoing testicular or scrotal pain: If the ache just won’t go away and it’s been more than a few months, it’s worth getting checked.
Lower abdominal pain: That dull, nagging pain in your lower belly or groin area could be related.
Pain during physical activity: Whether you’re working out, lifting something heavy, or just on your feet for too long—if it hurts, take note.
Discomfort during sex: Painful erections or discomfort during intimacy are common red flags.
Pain after ejaculation: Some men describe a sharp or lingering pain after climax, which can affect their quality of life.
Erectile dysfunction: Chronic pain can take both a physical and mental toll, making it harder to get or maintain an erection.
If any of these sound familiar, you’re not alone—and you’re not imagining things. It’s a good idea to reach out to a urologist who understands PVPS and can help you explore your treatment options. Catching it early can make a big difference.
Factors causing PVPS
In terms of the symptoms exhibited and the treatment required, there are a few main causes for testicular pain following vasectomy:
Neurogenic: Some chronic pain is caused by sperm build-up in the vas deferens, trapped in fibrous tissue. This can cause intense pain during activities that agitate your scrotum, such as running or cycling.
Granuloma: Sometimes sperm leakage occurs during or shortly after a vasectomy, causing a lump and swelling.
Epididymitis: Epididymitis results from an increase in pressure inside the epididymis, which is a tube that transports sperm from the testes to the urethra. Normally, men continue to produce sperm after a vasectomy, and the cells are reabsorbed by the body. However, they can develop a buildup of sperm in their vas deferen,s which can cause the epididymis to burst under pressure.
Testicular Torsion: If left untreated, PVPS can twist the spermatic cord that carries blood to the scrotum and cut off the blood supply.
Why Do Men Experience Lower Abdominal Pain After a Vasectomy?
It’s not uncommon for men to experience lower abdominal pain after a vasectomy, and there are a few reasons why this can happen. In most cases, the discomfort is temporary and part of the normal healing process—but for some, it may signal a more persistent issue like Post-Vasectomy Pain Syndrome (PVPS).
Common Causes of Lower Abdominal Pain After Vasectomy:
Post-surgical inflammation: After a vasectomy, your body initiates a healing response. Mild swelling or irritation can sometimes radiate to the lower abdomen or groin area, causing discomfort.
Nerve irritation or injury: Small nerves in the spermatic cord or pelvic region can become irritated during the procedure. It can lead to pain that may be felt higher up in the lower abdomen.
Congestion pain: After the vas deferens is sealed, sperm may continue to build up, causing pressure or congestion in the epididymis. This can lead to a dull ache that radiates to the abdominal area.
Referred pain: Sometimes, pain originating in the testicles or scrotum is “referred” or felt in the lower abdomen due to how nerves are interconnected in that area of the body.
Infection or hematoma (rare): In some cases, post-operative complications like infection or internal bleeding (hematoma) can lead to localized pain that spreads toward the lower belly.
When to Seek Help
If the pain is sharp, increasing, or lasts more than a few weeks, it’s a good idea to check in with your urologist. Especially if it’s affecting your daily life, sex drive, or causing concern—early intervention can prevent chronic issues.
Diagnosis of PVPS
PVPS is different from acute postoperative pain. Most PVPS patients suffer from persistent orchalgia for greater than three months after surgery. However, some patients experience pain while ejaculating, having intercourse, or erection.
The diagnosis of PVPS must be an exclusion diagnosis. A three-month follow-up history and physical are recommended after surgery. A scrotal ultrasound using color-flow Doppler is administered to every patient suffering from chronic testicular pain. It is recommended to obtain a routine urinalysis, a urine culture, and a semen culture to determine whether there is an infection.
Treatment Options for Post-Vasectomy Pain Syndrome (PVPS)
Post-Vasectomy Pain Syndrome (PVPS) is a long-term complication that affects a small percentage of men following a vasectomy. Characterized by chronic testicular pain lasting longer than three months, PVPS can significantly impact quality of life. The good news is that there are several effective treatment options for PVPS, ranging from conservative approaches to advanced surgical procedures.
1. Non-Surgical and Conservative Treatments
Many men with mild to moderate PVPS find relief through conservative, non-invasive methods:
Over-the-counter pain relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen help reduce swelling and manage pain.
Scrotal support: Wearing supportive underwear minimizes movement and pressure, which can ease discomfort.
Physical therapy: Specialized pelvic floor physical therapy can address muscle tension and nerve irritation.
Nerve blocks: Local anesthetic or corticosteroid injections into the spermatic cord can reduce nerve-related pain and serve as a diagnostic tool.
These methods are often the first line of treatment for chronic testicular pain after vasectomy.
2. Medication-Based Treatments
When conservative measures aren’t sufficient, doctors may prescribe medications targeted at nerve-related pain:
Neuropathic pain medications: Drugs like gabapentin, pregabalin, or tricyclic antidepressants (e.g., amitriptyline) help manage chronic nerve pain.
Hormonal therapy: In select cases, medications that reduce testosterone may be used to decrease testicular activity and reduce pain.
These treatments are particularly useful when pain is thought to be neuropathic or hormonal in nature.
3. Surgical Treatment for PVPS
For persistent, severe pain, surgical intervention may be necessary:
Microsurgical denervation of the spermatic cord (MDSC): A precise procedure that targets and severs specific nerves to stop the pain signal.
Vasectomy reversal: In cases where pressure buildup or sperm congestion is suspected, reversing the vasectomy may relieve symptoms.
Epididymectomy or orchiectomy: As a last resort, surgical removal of the epididymis or testicle may be considered, especially when all other options have failed.
Surgical options are typically recommended only after conservative and medication-based therapies have been exhausted.
4. Mental Health and Supportive Care
Living with chronic post-vasectomy pain can take a toll on mental health. Psychological counseling, pain management therapy, and support groups can be essential parts of a holistic treatment plan.
Physical Therapy as a non-surgical treatment for PVPS
Pelvic floor physical therapy can also be beneficial in the treatment of PVPS. People who undergo a vasectomy may experience significant pelvic pain. Due to the abnormal testicular pain they are experiencing, their pelvic muscles tend to tighten up. A physical therapist can teach them pelvic floor exercises to relax those muscles and take the strain off of other areas, such as the scrotum and testicles.
Pelvic floor therapy relieves pelvic pain and discomfort associated with testicular pain by relaxing the scrotum and testicle muscles. By using this therapy, you may be able to increase blood flow and relieve some symptoms.
At PELVIS NYC, we have successful treatments for post-vasectomy pain. By alleviating their symptoms, we enable them to carry on with their daily lives. We listened carefully to identify the source of their pain and formulate the best possible treatment.
The male reproductive system is a sophisticated network designed for the production, storage, and transport of sperm. Key components include the testes, epididymis, vas deferens, prostate gland, urethra, and bladder. The epididymis, a tightly coiled tube located at the back of each testicle, is essential for storing and maturing sperm before they travel through the vas deferens during ejaculation.
This system is closely linked to the urinary tract, making it susceptible to various infections. Urinary tract infections and sexually transmitted infections are among the most common causes of inflammation in the male reproductive system, including epididymitis. Because the epididymis connects directly to both the urinary tract and the vas deferens, infections can easily spread, leading to symptoms such as pain, swelling, and discomfort. Understanding how these organs work together is crucial for diagnosing and effectively treating conditions like epididymitis.
Understanding Epididymitis
Epididymitis is a common condition involving inflammation of the epididymis—the coiled tube located behind each testicle that stores and transports sperm. Epididymitis is characterized by an inflammatory process affecting the epididymis, which leads to pain and swelling.
It’s one of the leading causes of testicular pain in men under 50, yet it often goes undiagnosed or misdiagnosed.
According to a 2023 study published in the Journal of Urology, approximately 600,000 cases of epididymitis are reported annually in the U.S. Early detection and treatment are key to avoiding complications like epididymo-orchitis, infertility, and chronic pelvic pain.
Epididymitis Symptoms
Recognizing the symptoms early helps prevent progression and complications. Common signs include:
Pain in the scrotum
One-sided scrotal pain or swelling
Redness or warmth in the scrotum
Painful urination or frequent urge to urinate
Penile discharge (white, yellow, or green)
Fever and chills (in acute cases)
Discomfort during intercourse or ejaculation
Fluid buildup around the testicle (hydrocele)
In some cases, pain may radiate to the lower abdomen, which can help differentiate between various acute scrotal conditions.
In chronic epididymitis, symptoms may persist for over six weeks, usually as dull, aching pain in the testicle or groin.
⚠️ Testicular torsion may mimic epididymitis but is a medical emergency. Immediate evaluation is essential for sudden, severe testicle pain.
Types of Epididymitis
Acute Epididymitis
Lasts < 6 weeks
Often caused by bacterial infections, including those caused by sexually transmitted pathogens such as Chlamydia trachomatis and gonococcal infection (Neisseria gonorrhoeae), or by urinary tract infections (UTIs)
May present with fever, scrotal tenderness, and swelling
Presumptive treatment is often initiated based on the most likely causative organisms before laboratory confirmation.
Chronic Epididymitis
Lasts >6 weeks
May result from prior infections, trauma, or autoimmune reactions
Symptoms are less intense but persistent
📌 A 2024 study in European Urology Open Science found that chronic cases respond better to anti-inflammatories, pelvic floor therapy, and lifestyle adjustments than antibiotics alone.
Causes and Risk Factors
Common Causes of Epididymitis
Understanding the underlying causes of epididymitis is key to preventing recurrence and tailoring effective treatment. While the causes can vary by age, lifestyle, and health history, here are the most common culprits:
1. Sexually Transmitted Infections (STIs)
In sexually active men under 35, Chlamydia trachomatis and Neisseria gonorrhoeae are the most frequent infectious agents. These bacteria ascend through the urethra, prostate, and vas deferens to infect the epididymis.
Often linked to unprotected sex or multiple sexual partners.
STIs may be asymptomatic, so routine screening is essential.
2. Urinary Tract Infections (UTIs)
Escherichia coli (E. coli) and other non-sexually transmitted bacteria can cause epididymitis, particularly in older men or those with urinary tract problems.
These bacteria can migrate from the bladder or urethra, especially when urination is obstructed or incomplete.
3. Tuberculosis (TB)
Though rare, tuberculous epididymitis can occur when Mycobacterium tuberculosis spreads from another site of infection (commonly the lungs).
Often seen in individuals with weakened immune systems or from TB-endemic areas.
Can cause chronic inflammation and granuloma formation in the epididymis.
4. Epididymo-Orchitis
In more severe infections, the inflammation can spread from the epididymis to the testicle, a condition known as epididymo-orchitis.
Often presents with more intense scrotal pain, swelling, and fever.
Can lead to testicular damage or infertility if untreated.
5. Chemical Epididymitis
This non-infectious form occurs when urine flows backward into the epididymis, often due to heavy lifting, straining, or trauma.
Associated with conditions like reflux of sterile urine from the bladder into the vas deferens.
Risk Factors of Epididymitis
Several factors can increase a man’s risk of developing epididymitis. Awareness and prevention can significantly reduce the chances of infection or recurrence.
1. Unprotected Sex or Multiple Partners
Engaging in unprotected sexual activity increases exposure to STIs like chlamydia and gonorrhea, which are leading causes of epididymitis in younger men.
Regular STI screening and condom use significantly reduce this risk.
2. Use of Urinary Catheters or Medical Devices
Indwelling catheters or intermittent self-catheterization can introduce bacteria into the urinary tract, especially in hospitalized or elderly patients.
Any foreign object in the urinary system increases infection risk.
3. Recent Pelvic or Urological Surgery
Procedures such as prostate surgery, vasectomy, or cystoscopy may disrupt normal urinary flow or introduce pathogens.
Post-operative inflammation can also mimic or trigger epididymitis.
4. Urinary Tract Structural Abnormalities
Conditions like urethral strictures, prostatic hypertrophy, or congenital malformations may impair urine flow and increase the chance of retrograde bacterial ascent.
Chronic retention or incomplete bladder emptying compounds the risk.
5. Use of Certain Medications (e.g., Amiodarone)
The antiarrhythmic drug amiodarone has been associated with a rare side effect of chemical epididymitis, especially at doses >200 mg/day.
Typically non-infectious and resolves upon discontinuation.
6. History of Prostatitis or Tuberculosis
Chronic or recurrent prostatitis (inflammation of the prostate) can serve as a reservoir for bacteria that spread to the epididymis.
Past or latent tuberculosis infections should raise suspicion in persistent or unusual cases.
7. High-Impact Physical Activities
Activities like long-distance cycling, heavy lifting, or motorcycling can irritate or traumatize the perineal and scrotal area, leading to inflammation or increased susceptibility to infection.
Wearing protective gear and taking regular breaks can help reduce the risk.
Diagnosing Epididymitis: How Is It Identified
Physical Examination
Your doctor may assess:
Swelling, tenderness, or lumps in the scrotum
Penile discharge
Enlarged or tender prostate (via rectal exam)
Diagnostic Tests
Urinalysis and urine culture: To identify bacterial causes
STI screening: To test for chlamydia or gonorrhea
Scrotal ultrasound: To distinguish epididymitis from testicular torsion or tumors
Blood tests: To assess for infection or inflammation
Differential Diagnosis: Ruling Out Other Conditions
Diagnosing epididymitis requires careful consideration, as its symptoms can overlap with several other serious conditions. One of the most critical distinctions is between epididymitis and testicular torsion—a surgical emergency that can threaten testicular viability if not treated promptly. Both conditions can present with acute scrotal pain, but testicular torsion typically involves sudden, severe pain and requires immediate intervention.
Other conditions that may mimic the symptoms of epididymitis include orchitis (inflammation of the testicle), testicular cancer, testicular infarction (loss of blood supply to the testicle), and mumps orchitis, especially in younger males. A thorough medical history, including recent sexual activity, number of sexual partners, and any previous urinary tract infections, helps identify risk factors and guide the diagnostic process.
A comprehensive physical examination is essential, often followed by diagnostic tests such as urinalysis, urine culture, and scrotal ultrasound. These steps help rule out other causes of scrotal pain and confirm the diagnosis of epididymitis. Considering all possible differential diagnoses ensures that patients receive the correct treatment and avoid complications from missed or delayed diagnoses.
Epididymitis Diagnosed: What to Expect Next
Once epididymitis is diagnosed, the primary goal is to treat the underlying bacterial infection and manage symptoms. Most patients will begin a course of antibiotic treatment tailored to the specific bacteria identified, which is crucial for resolving the infection and preventing complications. In addition to antibiotics, doctors often recommend supportive measures to relieve discomfort, such as resting, applying ice packs to the scrotum, and elevating the scrotum to reduce swelling.
For those experiencing severe pain, pain medications or anti-inflammatory drugs may be prescribed. It’s important to complete the entire course of antibiotics, even if symptoms improve, to ensure the infection is fully eradicated. Patients should also monitor for signs of complications, such as epididymo-orchitis, and seek medical attention if symptoms worsen or fail to improve. Regular follow-up appointments help ensure that the infection has cleared and that no further treatment is needed.
Bacterial Epididymitis: Treating the Root Cause
When caused by bacteria, especially in younger men, prompt antibiotic treatment is essential to prevent progression to severe infection and to support overall disease control. Supportive measures such as scrotal elevation, cold packs, and activity limitation are also recommended to reduce pain and swelling.
Standard Treatment Includes:
Antibiotics: Ciprofloxacin, doxycycline, or ceftriaxone depending on the pathogen
NSAIDs: To reduce inflammation and pain
Scrotal support: Elevation and cold packs for symptom relief
Sexual partner treatment: To prevent reinfection if STI is confirmed
The Role of Pelvic Floor Physical Therapy
While antibiotics remain the first line of treatment, pelvic floor physical therapy has shown promise in speeding up recovery, particularly in chronic or treatment-resistant cases.
Benefits of Physical Therapy:
Improves pelvic blood flow
Relieves pressure and muscular tension in the groin
Helps with urination and ejaculation-related pain
Reduces inflammation without side effects
💡 Clinical evidence suggests pelvic floor therapy improves outcomes when combined with medication for both acute and chronic cases.
How to Maintain a Healthy Male Reproductive System
Preventing epididymitis starts with proactive care of the male reproductive and urinary systems:
Practice safe sex and limit sexual partners
Stay hydrated and urinate regularly
Avoid prolonged sitting or repetitive groin trauma
Seek care for urinary symptoms early
Incorporate pelvic floor exercises under professional supervision
Maintaining a healthy male genitourinary tract is essential to reduce the risk of infections and inflammation that can lead to conditions like epididymitis.
Complications of Untreated Epididymitis
If not addressed, epididymitis can lead to:
Testicular torsion
Infertility: Due to scarring or blocked sperm flow
Chronic pain
Abscess formation
Increased risk of testicular cancer (in rare cases)
Severe or untreated cases may also result in complications involving the spermatic cord, such as abscess formation or impaired blood flow.
Prognosis: What’s the Outlook?
The outlook for most men diagnosed with epididymitis is positive, especially when treatment is started early. With appropriate antibiotic therapy and supportive care, symptoms typically resolve within a few weeks. However, if left untreated, epididymitis can lead to more serious complications, including epididymo-orchitis, testicular infarction, and even infertility due to scarring or damage to the reproductive tract.
Certain individuals, such as those with chronic epididymitis or underlying conditions like human immunodeficiency virus (HIV), may be at increased risk for persistent symptoms or complications. In these cases, ongoing management and lifestyle modifications may be necessary to control symptoms and prevent recurrence. Regular follow-up with a healthcare provider is essential to monitor recovery, address any lingering issues, and reduce the risk of long-term damage to the male reproductive system. Practicing safe sex and seeking prompt medical care for urinary or reproductive symptoms are key steps in maintaining reproductive health and preventing future episodes.
When to Seek Medical Help
Seek immediate care if you experience:
Sudden, severe testicular pain
Fever, chills, or nausea with groin pain
Discharge from the penis
Swelling that doesn’t improve in 48 hours
Difficulty urinating
Your Next Step: Expert Help Is Available
At Pelvis NYC, we specialize in helping men manage and recover from epididymitis through science-backed pelvic floor therapy. We’ve helped countless patients ease their symptoms, restore function, and prevent recurrence.
