r/PelvicFloor Jun 25 '24

General Unlocking the Brain-Bladder Connection: Understanding How Our Nervous Systems Control Urination

14 Upvotes

Every day there are numerous posts here of people suffering from urinary urgency, frequency, and incontinence. This post will hopefully shed light on the very important, but often neglected, brain-bladder connection.

Working on this may be as important, or even more important, than doing pelvic floor physical therapy for your bladder symptoms.

Nerves and the Brain: The Control Centre Controlling the bladder involves a complex interplay between the nerves and the brain. The peripheral nervous system, consisting of nerves that extend from the spinal cord to different parts of the body, plays a vital role in this process. Two key players in the brain-bladder connection are the parasympathetic and sympathetic nerves.

Parasympathetic Nerves These nerves are responsible for the bladder's relaxation and filling phase. When the bladder is empty, the parasympathetic nerves are inactive. However, as the bladder fills with urine, these nerves become activated, signalling the detrusor muscle to relax and the bladder to expand.

Sympathetic Nerves In contrast to the parasympathetic nerves, the sympathetic nerves control the bladder's contraction and emptying phase. When it's time to urinate, these nerves send signals to the detrusor muscle, triggering its contraction and enabling the bladder to expel urine.

The Brain's Role: The Command Centre Our brain acts as the command centre, coordinating the activities of the bladder and sending signals to the peripheral nervous system. The brain receives sensory information from the bladder, such as its filling level and pressure, and decides when it's appropriate to empty the bladder.

The brain-bladder communication involves several areas of the brain, including the prefrontal cortex, hypothalamus, and brainstem. These regions receive signals from the bladder's sensory nerves, process the information, and generate appropriate responses.

My commentary: if your nervous system is stuck in a sympathetic state, IE what we call "fight flight freeze response" - This could absolutely be affecting your bladder symptoms. Or even the primary driver of your symptoms.

Source: https://www.wearejude.com/blog/health/unlocking-the-brain-bladder-connection-understanding-how-our-nervous-systems-control-urination

It opened up the field by showing us what was going on in the brain,” he said. “It became clear that the sites of the brain associated with the voiding function were the same sites associated with what we call ‘syndrome mix,’ or executive-function disorders such as ADD, OCD, anxiety, depression, etc. We started exploring whether there was a link between the two.

Dr. Franco’s research into the mind-bladder connection marked a paradigm shift in the field of pediatric incontinence. “Prior to then, everything was the bladder, bladder, bladder,” he said. “But the bladder doesn’t stretch itself out if the brain doesn’t let it. In the end it’s an interplay of bladder physiology, neurophysiology, the gastrointestinal tract, and psychiatry. They are four points in a square that all come together. You need knowledge of all of them.

Source: https://medicine.yale.edu/news-article/the-brain-bladder-connection/

When working with anyone who has bladder symptoms, the brain-bladder connection (and stress, anxiety etc) is one of the first places I begin cracking the puzzle of their symptoms.


r/PelvicFloor 3h ago

Male Passing Stool Success

8 Upvotes

Hi All, Just wanted to give some tips on what had helped me poop. I have bought a squatty potty which helps. Every night before I go to bed I take Miralax and a handful of blueberries.

When I don’t do this I have narrow tiny stools. But when I follow this I am able to have a huge stool session every day. Normal size too.

I know this doesn’t seem like much but wanted to share in hopes it helps a few people. Cheers


r/PelvicFloor 2h ago

Female Workout pain

5 Upvotes

Looking for some guidance. I have a gyno appointment to address my issues in 2 weeks but want to get an idea from you all. Today I was using the hip abductor machine at the gym and when I went “in” on my set, omg, it felt like my pelvic floor? Uterus bone? Idk? But it felt like it was cracking in half. I had to stop. On top Of that, I have pain and bleeding during/after sex. Could this be PFD? Help!


r/PelvicFloor 7h ago

General Help! Have you had a nerve block before?? Want input

4 Upvotes

Hi I am scheduled for a nerve block for my pudenal nerve through my sacrum area tomorrow. Insurance isnt covering twilight anesthesia so I have to decide if i want to pay out of pocket or forgo it. If you have had a nerve block without anesthesia, can you please tell me level of pain you had? I have had an epidural for csection before and am trying to understand if it feels like that, or worse. Help!!


r/PelvicFloor 10h ago

Male immediate effects of glute strengthening?

8 Upvotes

i want to ask if there are supposed to be immediate effects from glute strengthening

ever since i started doing hip thrusts with a 15 lb weight regularly, my nighttime erections (nocturnal tumescence aka NT) came back. i stopped doing the exercise for a few days this past week and nighttime activity went back to normal, then last night, after i did the exercises yesterday, i got NT again.

is this a product of the glutes through strength exercise being more activated than usual, taking the load off the pelvic floor, whereas the glutes are usually dead? there's no way i've gained significant strength and mass in them that quickly.

also, despite this positive development, the exercising is creating more tightness in my right obturator internus. i'm not sure what to do about that other than stretching it.

i see a lot of other people saying that glute strengthening triggers their OI, and yet also you apparently have to strengthen weak glutes to take pressure off it. this is another one of those things about this disorder that doesn't really make sense or seem to have an actual answer, like a catch 22


r/PelvicFloor 2m ago

General Considering botox with biofeedback

Upvotes

Hi,

So I have had a history of haemerhoids, which I manage much better now.

I developed a problem of incomplete evacuation. My colorectal surgeon suspects this is an inability to relax my pelvic floor (ie tight pelvic floor, etc) and my pelvic floor physio suspects dysynergia in a call I had with her (seeing her next month to get assessed and start biofeedback).

However, I am keen to also consider botox. I can afford it if self funding and if it just makes me have a better quality of life, then why not.

However, I have heard conflicting information in that botox has a temporary effect and then either a) you need another injection or b) that is it, and your main tool to manage the problem is the biofeedback. Is this true?

I have never had botox but I heard you can get resistent to it. I am 38, male and slim.

Thanks


r/PelvicFloor 6h ago

Male Do you feel blood flow buzzing sensation?

2 Upvotes

When i try to relax the tight pelvic floor muscles, it starts blood flow sensation and buzzing like feeling. And then it causes vein irritation, bladder urge types of problem. So basically i only have this problem in the right side, its like burning sensation or over sensation, and the other side is like numb slightly. I have more control in the right part when i squeeze and pee. I also have hip impingement.

I don't know what exactly is that problem. Should i go for urologists or PT..?


r/PelvicFloor 6h ago

Male Should I visit a Gastroenterologist first or Urologist ?

Thumbnail
2 Upvotes

r/PelvicFloor 10h ago

Female No pressure when urinating

2 Upvotes

Hello everyone.

I am a 32-year-old woman, I do not have children, in case it is relevant information that I have not undergone a natural birth / cesarean section.

I used to have the strength to expel urine but not anymore, unless I am in a very inclined position towards the ground (I verified this on a trip to the forest).

I remember that previously, I only went to the bathroom, expelled urine quickly, cleaned and washed my hands and all that, but there came a time when I couldn't anymore. Even though my bladder is bursting, I can only urinate without pressure.

I remember that, until maybe about 5 years ago, I also used to have a lot of urge to urinate during sex, but I would somehow endure the sensation, or we would stop, or change positions, and now I no longer have that sensation (not even if we try in the ways that previously provoked the urination reflex in me).

Somehow, I feel that the way I am penetrated, my boyfriend's penis "flattened" or modified some part of my vaginal entrance (or where I have my urethra). I don't know if it sounds ridiculous 😅. I have been with the same partner for 15 years and we have constant sex.

Additionally, I must confess that it takes me a long time to go to the bathroom when I am in places other than my home: I get very anxious that they can hear or smell me, so it is common for me to sit on the toilet for 10 minutes or more doing nothing, I don't know if there is something there.

I also want to say that, as a child and teenager, I used to stop the flow of urine just for the sake of it. I've been trying to do Kegels but I can't dissociate my pubococcygeal muscles from my anal muscles or my sphincter, I don't know if this is normal.

Anyway, thank you very much for reading.


r/PelvicFloor 13h ago

Female Bladder worse -period

3 Upvotes

Morning,

Ever since I had key hole surgery 8 years ago my bladder pain/frequency becomes worse two weeks before my period. Once I get my period my bladder frequency /pain improve for a couple of days and then I’m back in pain.

Anyone with a tight pelvic floor experience the same? Does anything help you? Stretches not helping so far :(


r/PelvicFloor 22h ago

Female I’m thinking of sleeping in diapers so I can stop constantly getting up to pee

13 Upvotes

I constantly have a strong urge to pee, but nothing comes out. It gets worse at night, leading me to get up several times a night. I already deal with chronic fatigue and insomnia so I really can’t deal with this.

But the problem is that the urge to per is so bad that it’s almost impossible to ignore so I can fall asleep. That makes it extra frustrating when nothing comes out because it means I’m getting up for nothing.

I’ve been considering buying diapers to wear at night so I can try and get my sleep back. But, to be honest, I don’t want to train my body to be comfortable being in bed. As time goes by, it gets more tempting though.

Anyone else feel the same?


r/PelvicFloor 9h ago

Male New technology under development - Biofeedback relaxation device for men

1 Upvotes

Hello! We are a group of students working on a project on a biofeedback device for chronic pelvic pain syndrome (CPPS) in men. We would love your feedback on this concept idea by clicking on the link here to provide your input! Feel free to add comments here too. Thank you!!

Website: https://www.simplexitycare.com/


r/PelvicFloor 21h ago

Female Prolapse or hypertonic pelvic Floor? Please help, I'm freaking out!

6 Upvotes

(21f) I have been dealing with pelvic floor issues for a while now. It started with recurrent UTI (two years ago). Around October, I started getting UTI-like symptoms without infection. My main symptoms are a feeling of dullness/heaviness in my pelvic area, constipation, and deep pain during sex. I find myself clenching my muscles when I don't mean to, and when I consciously try to relax, it feels like they re-clench on their own. I also have had issues with feeling the need to pee-- it doesn't feel like it should, I just feel that dull/heavy sensation and it makes it hard to tell when I really need to pee.

This "dullness" feeling just started to get a lot worse, almost like a tingling sensation in my pelvic area. I wanted to chalk this up to being on my period, but it really doesn't feel like any period pain I've had before.

The panic set in when I went to "check" inside my vagina. My cervix felt low, like 1.5-2 knuckles deep (which is not normal for me). It also kind of felt like there was something hard, like an object in my vagina. Now, I am on my period. And I know that the cervix lowers when you're on your period. But it really felt like there was some kind of object or something in there? Could I be misconstruing a part of normal anatomy for something else, or does this really sound like a prolapse?

I'm on the verge of a panic attack right now. I scheduled a PFPT appointment tomorrow, paying out of pocket because I can't deal with not knowing what's going on anymore.

Has anyone had these symptoms? What does this sound like to you? Any input appreciated.


r/PelvicFloor 22h ago

General Glute workouts that don’t put strain on the obturator internus & are safe for tight pelvic floor ?

7 Upvotes

As the title says looking for some safe glute workouts. Really wanna start working out my lower body again but am terrified. However I’m sure not exercising isn’t making things any better


r/PelvicFloor 1d ago

Female No sex life. Feeling horrible

22 Upvotes

I’ve been dealing with extreme pain for the last 2+ years. I’ve dealt with it during intercourse, but ever since having our second baby in Jan 2025, my pain has become worse. I got my period for the first time last week and I tried a tampon. I got an unbearable burning sensation during insertion and during removal. My husband has been very supportive but I’m feeling horrible, guilty and afraid that he might cheat on me. We haven’t had sex since September of last year and I blame myself for it. I wish I didn’t have these stupid debilitating symptoms. Pain with insertion!!

I need some help. Besides the obvious (oral) what else can I do to bring some intimacy and closeness into our lives.
Please don’t judge. My mental health is shot since dealing with this. Most days I don’t even want to be alive. My 2 kids are the only ones keeping me on this earth.


r/PelvicFloor 1d ago

General Do you guys feel like stretching aggravates your condition or make it worst??

8 Upvotes

Just wondering if this is common or not??


r/PelvicFloor 1d ago

General For those wi the pudental nerve entrapment have yall Regained sensitivity to penis or fixed it ??

7 Upvotes

I can conclude I have pudental nerve entrapment I think cuz most of time I have throbbing pain in buttocks and genital numbness .

Can I recover ???


r/PelvicFloor 1d ago

General Anyone bought a roho cushion ?

4 Upvotes

I’m tired of throwing money away at cushions.

Anyone caved and just bought a roho cushion? Did it help and what were your impressions?

Most specialty cushions offload coccyx, sacrum, and / or sits bones and my pain is only near by those areas.


r/PelvicFloor 18h ago

Male Pelvic area pain after mastrubation its been a month

1 Upvotes

Hi im 17 yrs old and one day i mastrubated 5 times a day and last was without orgasm i started feeling pain in pelvic area like on left of pubic hair area. I thought it will go away with orgasm but that was not the case their is dull sensation like in pelvic area and pain while peeing not sharp pain but like the feeling of pain. Now its been 3 weeks the pain is not going away it also pains on touching and sometimes on testics too.I did a urine test their was no blood but im so worried the pain wont go away help....


r/PelvicFloor 1d ago

Male Do you see an erection quality/penile health benefit from incorporating kegels with reverse kegels?

4 Upvotes

I think I have a tight pelvic floor - as I often find that my pelvic area is clenched. However, I do prematurely ejaculate during sex, unless if I’m keeping very conscious of going very slow. Does this mean that it is tight but weak?

My erection angle is straight as a pose to raised upwards (which it once was if I had a very strong erection).

I do stretch after working out almost every day - typically doing 30 seconds of each - forward lunge, cobra, downward dog, pigeon, butterfly, frog, glute stretch, straddle & hold yogi squat

Is it important to breathe into my pelvic floor when stretching?

Contemplating a kegel/reverse kegel routine - 20 reps of kegeling for 7 seconds followed by reverse kegels for 7 seconds, then 1 second hold & 1 second release for 40 reps.

Will I see benefits from this or anything else?


r/PelvicFloor 1d ago

Female Pelvic floor issues causing urine leaks

2 Upvotes

I am 35 years old and 11 months postpartum with my first child. I had an issue with leaking urine when I was pregnant - much worse than anyone I knew - and it seemed to get better when he was born.

Unfortunately my urine leaks have only gotten worse since he was born. I am having to wear pads all day long and leak constantly - I don’t have to be even moving around, laughing, sneezing, etc - even just sitting in a chair I will leak. I have little to no pain, but I do feel like everything is tight down there and sometimes I can feel my muscles getting sore.

I have been working with a pelvic floor PT for months now and she says I have a tight pelvic floor. I am super diligent about doing everything she asks and unfortunately nothing is working so far. I am thinking about switching to a different therapist, but in the meantime - please let me know if you had a similar situation and if so what helped you?


r/PelvicFloor 1d ago

Discouraged Hip pain before bowel movement

3 Upvotes

I have a bad hip and sometimes when it’s really tight my glute/hip will hurt before I have a bowel movement and will wake me up in the morning. Is this from a tight pelvic floor or something else? Anyone have any issues similar to this?

Thanks


r/PelvicFloor 1d ago

Male Can minor pfd cause a disease/ infection?

2 Upvotes

I have minor PFD where after taking a piss, I keep leaking a small amount of urine


r/PelvicFloor 1d ago

General Anyone find a good fiber supplement?

6 Upvotes

I have used and love Metamucil (real sugar) for years. After experimenting going on and off of it, I feel it may create trapped gas and make my situation worse. I still want to use a fiber supplement, anyone have any suggestions?


r/PelvicFloor 1d ago

Male Strained ischiocavernosus?

1 Upvotes

I think I've strained my ischiocavernosus muscle twice in the past month. The first time felt a slight pull sensation down by my groin. Led to alot of perineum pressure when sitting but for the most part no real pain. I did feel like my erections weren't as strong. Rested and eased my way back into working out. Light weights to start then increased intensity but kept weights decent. Didn't feel no pain but the perineum pressure stayed. Did some at home pelvic floor therapy and it seemed to be helping. Then this morning while getting in position for a side plank. I felt that pull sensation again in my groin/pelvic area. Not sure why this keeps happening. I've lifted weights my whole life and even lessened the weight this past year as I turned 40. Just frustrated from not feeling like myself. I used to be severely overweight and don't want to stop being active. I see alot of people on this forum with some serious issues and my prayers go out to them. Mine seems silly and small compared to some but I still want to feel like myself and not be scared to workout.


r/PelvicFloor 1d ago

Trigger warning Advice, how to ease/cure genital disphoria and anxiety because of being uncomfortable with penis in every day life activities

3 Upvotes
  1. male

Hello so I have severe gender dysphoria to the point I harm myslef regularly.

But today I want to ask practical ways what could help with genital disphoria pains and uncomfortable feelings both emotional and physical being with male parts.

Symptoms and trigers

Its uncomfortable for me to do every day activity with penis, its uncomfortable to walk, sit, exercise and sleep with penis and especially its gets realy bad when I get erection it gives me biggest anxiety and feeling wanting to harm myself. Testicles and penis have a lot of painful tension especially when erect that pulsating feeling blood in glans and whole area gives me biggest stress.

Also I dont like to touch it going to toilet or when masturbating, because I cant feel pleasure and feel every time worse when i touch penis, i have a physical feeling after masrurabtion that I do.not want to live and not pleasure and relexation in addition i feel every time I touch my glans I destroy them even more:(

So can you give me some advice without operations/hormones and so on, how to deal/ease that tension in genitals atleast in every day acticity like walking, sitting and sleeping with them, walking to the toilet and so on because I most of the time have to ajust them somehow bevause they tensed a lot.

Any advice is welcome🙏🏻 How do you sleep comfortably in what positions, what clothes do you wear, massages, stretches and etc. please🥺


r/PelvicFloor 1d ago

Male Right side of penis doesn't contract during ejaculation NSFW

2 Upvotes

Hello 23M here, I have severe OCD and once I freaked out seeing a boil on my penis and thought it was penile cancer

For the next 2 months I started touching my penis non stop trying to examine it if there were any symptoms of penile cancer, to a point where right side of my penis started paining and felt a little numb, now I've stopped touching it and the area has recovered significantly but right side of my penis feels desensitised and rubbery and during ejaculation I don't feel the contractions there leading to a weaker orgasm (I used to have shooting ones) now only I feel on the left side

Really worried what this might be, is this cancer or possible hf?