Male pelvic pain

Male pelvic pain can be caused by various conditions such as prostatitis (inflammation of the prostate), urinary tract infections, or chronic pelvic pain syndrome. Symptoms can include pain which varies in intensity and type. The pain may be localised to the lower abdomen, hips, buttocks, back passage, perineum, scrotum or penis. 

Urinary symptoms may include urgency and frequency, changes to urinary flow, hesitation to start the flow of urine, pain on urination and urinary incontinence. Patients may have trouble with bowel function, including pain on bowel opening, constipation or difficulty emptying the bowel. 

Symptoms can also impact sexual function and may include erectile dysfunction and pain associated with erections or ejaculation. 

An important stage in improving many symptoms is recognising when the pelvic floor muscles are tight, knowing how to enable them to release and to acknowledge when they are relaxed. 

Like other muscle groups in the body, the pelvic floor muscle has a scale of activity. When we contract, or tighten the pelvic floor, it should lift and when we let go of the contraction, the muscles should return to their resting position. When muscles are not able to let go, this can also lead to pain and further consequences which may affect the bladder or bowel. 

The pelvic floor muscles form a hammock underneath your pelvis to provide support and control for your bladder and bowel. The muscles attach to your pubic bone at the front, then span backwards to your coccyx (tailbone) and outwards to your sitting bones.

How to perform a pelvic floor contraction

A pelvic floor contraction is performed by drawing up your back passage and testicles. Imagine you are trying to stop wind and at the same time trying to stop your flow of urine. It should be a sensation of ‘tighten and lift’. 

You should:

• Continue to breathe normally
• Keep your buttocks and legs relaxed though you may feel a gentle tightening of your tummy
• Always let the muscles fully relax at the end of a contraction

Getting to know how it feels to contract the muscles is an important step in knowing when they are working, as well as when they are relaxed. It is easiest to practise this in a sitting or lying position.

When you understand how to contract and relax them, there are other exercises which can be useful to achieve relaxation. 

See more relaxation exercises

There are a variety of treatment options that can be tried. The response varies between individuals, so it is worth trying different things to see which will help you and often it is a combination that seems to be useful.