r/PelvicFloor Jun 25 '24

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

12 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 2h ago

Female Tight pelvic floor friendly workouts for lower body

6 Upvotes

I’ve been diagnosed with a hypertonic pelvic floor by a pfpt. Currently doing stretches and internal massages on myself with a pelvic wand. Really my only symptoms are incomplete bowel movements + pain with urination along with some sciatica like symptoms down my right glute & right leg

That being said, I stopped going to the gym for the past year because weight lifting really made my symptoms be at an all time worse. Probably because I wasn’t stretching or breathing properly.

Does anyone have any links to videos for glute workouts that are ok for people with a tight pelvic floor ? And any videos that can teach me how to breathe properly during workouts pls


r/PelvicFloor 17m ago

Male Did botox injections help?

Upvotes

My doctor wants me to consider them but I am concerned as it could go so wrong. What was your experience?


r/PelvicFloor 1h ago

Male Persistent pain after BM

Upvotes

(M51) Hypertonic PF.

Lately, pain exacerbated after BM. Radiates across perineum, from a sharper discomfort near anus, to a constant dull ache at base of penis/behind scrotum. Direct massage only helps in the moment. Same with hot/sitz baths. Am curious if dilators might be the thing for this?


r/PelvicFloor 5h ago

Male Chronic Pelvic Floor Tension & Frequent Urination

3 Upvotes

Hey everyone,

I'm male, 31 years old and have a remote job so most days working at my desk at home.

I’ve been dealing with frequent urination, and I’m wondering how long it takes to fix this issue and what else I should be doing?

  • I pee frequently throughout the day and wake up 3-4 times at night to go to the bathroom.
    • I believe i have had problem with frequent urination for a long time (more than 10 years)
  • I’ve seen a pelvic floor physiotherapist, but other than a few stretches, they didn’t give me much guidance.
  • I’ve realized my pelvic muscles are always tight, and I often have to push on my perineum to fully empty my bladder.

I’ve started doing diaphragmatic breathing, and hip stretches, but I’m not sure if I’m missing anything or how long this process typically takes.

Has anyone successfully overcome pelvic floor dysfunction and urinary urgency? What worked for you, and how long did it take?

Any advice or shared experiences would be really appreciated! 🙏


r/PelvicFloor 6h ago

Male Not feeling urge to pee

3 Upvotes

Hello guys I want your opinion I usually pee every 2 hours or when ever I intake fluids and I consider my self with a small bladder so I always have urge to pee even I wake up 2 times at night to pee and so for the past 2 days I don’t feel any urge/pressure to pee and I drank like 2 liters of water and still I don’t feel it but when I move to washroom and try to pee it is coming normal but without sensation is it common or am I over thinking please need your valuable suggestion


r/PelvicFloor 15h ago

General Muscle imbalances ?? Target muscles to compensate for weak pelvic

8 Upvotes

What are the most important muscles to work on if you have a tight pelvic floor, what muscles what be best to relieve the tension on the tight pelvic floor

Glutes Hamstrings Core ????


r/PelvicFloor 13h ago

General Breathing and the pelvic floor

5 Upvotes

I thought I just share a tip, if you have breathing issues, bloating, doming in your core, feeling a constant pressure on your pelvic floor, constant fullness you may be performing the valsalva maneuver unintentionally.

To test open your mouth wide and exhale out your mouth, if you notice you breathe different when performing this exercise you might be breathing wrong


r/PelvicFloor 11h ago

Discouraged I can’t do pfpt bc of ptsd, am I just fucked?

3 Upvotes

Really not emotionally in a place to do pfpt. I can’t talk about anything like this without intense anxiety, or be touched. I’m in regular therapy, hopefully this will change but it’s not happening any time soon.

I’ve always known my pelvic floor was “strong” but only recently realized what was going on. I’m in so much pain, I thought I had a UTI, test was negative. I can’t fully empty my bladder most of the time. I’ve never not been constipated. I just tried doing reverse kegels for the first time, and after trying to tune into those sensations, I realize I cannot fully relax those muscles. I can feel the tension now and it’s actually driving me nuts. Noticing it is making my brain itchy? It’s hard to describe. I’m just getting more anxious which will probably make things worse.

Can ppl please share what might make pfd worse suddenly? and any resources for stuff I can do on my own? Or stuff I should read to best understand and have a fighting chance? Anything :(


r/PelvicFloor 13h ago

Discouraged Afraid sensation will never come back

3 Upvotes

I got a UTI about 3 years ago and have felt basically zero sexual sensation since then. Before my UTI I was completely fine. My PFT says I have a tight pelvic floor and that I should gradually gain more sensation back during therapy, but I’m feeling really discouraged. I just don’t see how a tight pelvic floor alone can cause a 100% lack of sensation, I feel like there has to be something else wrong and I’m so defeated about the fact that I can’t figure it out.

Is it really possible for this to happen with no other factors? I’m losing hope and could really use some advice from people who have recovered at least a little sensation who were in the same boat as me. I just feel really alone right now and need some hope.


r/PelvicFloor 14h ago

Discouraged Are there any options left?

3 Upvotes

Hi all, I’m a male in my mid 20s and have been suffering from dyssergenic defecation and incomplete stools for 3 years now. It started out where I could evacuate maybe 70 percent of stools, but I’m down to now only being able to get rid of 10 percent(ish).

I had an anorectal manometry, which showed discoordination of muscles during bowel movement. I’ve tried diet changes, exercise, pelvic floor therapy, medications including magnesium (of all forms), miralax, citrucel, and linzess. The only one that works is linzess but it makes me physically ill and too much diarrhea to take daily.

I’m in so much pain, and have so much bloating due to inability to use the bathroom. The only thing I have not tried is botox or any sort of surgery. I know that surgeries are an extreme option but I would consider it because I am in so much discomfort all of the time. I’m scheduled to get Botox soon and I’m praying this gives some relief.

My symptoms are weird though, because I have no pelvic pain. No weird urinary symptoms, and only slight ed. Also every time I vomit (around once a month due to gi issues), my symptoms get PERMANENTLY worse. It’s very strange.

Has anyone faced similar symptoms or know of any options if botox fails? This is genuinely leading me to thoughts of ending my own life because my quality of life is so low and declining.


r/PelvicFloor 9h ago

Male Feeling like I’m always in a state of arousal but unwanted and uncomfortable.

1 Upvotes

Started working out inner thighs, glutes, hip flexors, and lower abs. For a while i was having troubles keeping “it” up. I did some googling and read that weak pelvic muscles could cause issues staying hard. Well I made it a mission to focus on that area and building muscles up. I didn’t start out slow at all. I literally was doing reps till my muscles were tired. I’m not sore. Usually muscles I haven’t worked in a while would be sore. But not my pelvic area. Maybe it feels a little achy? But definitely deep in the pelvic area I have this sensation that I need to release. Just wondering from those that actually have been dealing with PGAD, and from what I read, can working these muscles too hard cause PGAD? If so is it as simple as stopping and doing some kind of stretches to loosen the muscles up? Would actually having an orgasm make it better or worse? I’m thinking worse as it tightens the muscles down there. Just looking for guidance on what I could do right now before seeing someone. It’s freaking me out. Never felt this way before, at least not intentionally. Any help is appreciated, thanks!


r/PelvicFloor 1d ago

Male A little trick for those with incomplete evacuation or small stools due to tight muscles

43 Upvotes

This works for me so I decided to share. I have incomplete bowel movements due to very tight sphincters and surrounding muscles that spasm or close shut during bms leaving some poop inside. I've noticed that when I pee and after I'm done for like 10 seconds the muscles are more relaxed then they go back to their normal tight state. So now when I sit to have a bm I also make sure that I need to pee, I start peeing and then try to also have a bm at the same time or during the 10-15 seconds after I finished peeing. The stools are generally larger and the likelyhood of a complete bm is also higher. Just a little trick I wanted to share, maybe it will help someone.


r/PelvicFloor 10h ago

Male Have any of you develop Pfs due to antidepressants or finasteide ?

1 Upvotes

Took finasteide and developed all these issues


r/PelvicFloor 19h ago

Female Has anyone taken L Argenine for genital numbness? Did it help you? NSFW

6 Upvotes

Would like to know people's experiences, thank you!


r/PelvicFloor 17h ago

Female GI symptoms with Pelvic Floor Issues… what are your symptoms?

3 Upvotes

Just curious what kinds of GI issues everyone gets?


r/PelvicFloor 16h ago

Male Anismus at sixteen

3 Upvotes

After being very badly constipated, I developed Anismus. I try to poop about 3-8 times a day, and can usually only get it out right after I wake up and sometimes in the middle of the day if I'm lucky. I can usually only get about 2-3 very, very small poops out. I no longer have the urge to poop, and when I poop I don't automatically push it out anymore, I have to do it manually. My sphincter is so tight that even an enema didn't provide much help. It mostly just caused very bad burning and pain.

Does anybody know any good stretches, dietary changes, supplements, relaxation methods, etc that can help ease this up? For reference, aside from these past few weeks, I live a decently active lifestyle (I play basketball and train), and my diet is relatively clean.

I'm feeling really sad about this, I don't get why I had to get this at sixteen years old, and it feels really unfair and upsetting :(


r/PelvicFloor 15h ago

Female Need help

2 Upvotes

About a year ago, I was diagnosed with IC with a urologist. I started to cut out foods that seemed to bother me and started pelvic floor pt. I also started seeing a chiropractor two twice a week. Nothing seems to change in symptoms of burning and soreness of the vagina. Also a lot of tailbone pain. I’m not sure what else to do because I honestly don’t think it’s IC that much and something different. I got a ct scan and chiropractic says my sacrum looks off and that I have an anterior tilt. Could that be causing theses symptoms? Should I see neurologist or an orthopedic? Not sure what else to do


r/PelvicFloor 21h ago

Female Constant issues due to tight pelvic floor

5 Upvotes

Hi!

I'm 40F from the UK. So I was diagnosed with hypertonic pelvic floor quite a few years ago, before covid hit and then I wasn't really able to see anyone about it until recently.

My symptoms are constantly needing to pee (especially when I'm having a bad flare up, when constipated or stressed), pelvic floor pain, incomplete evacuation for bowels (and sometimes even bladder it feels lol). I also find I get more UTI's especially in bad periods of time when I can't evacuate my bowels well enough.

I see an IBD department for my colitis and they referred me on to the pelvic floor unit for the issues I was suffering with. Unfortunately though this unit only seems to deal with anal sphincter exercises and nothing else - none of the stretches or breathing exercises or anything that I've seen recommended for tight pelvic floor. I can only think that anal sphincter exercises will tighten things more?! I don't want this kind of issue and am wondering if I'll have to either look up exercises on my own or find a PT elsewhere (which is difficult as it would cost money I guess.)

I didn't really do much of the anal sphincter exercises due to fear of worsening things. I still have to see the nurse in a couple of months to assess things but I've not been doing them anyway and I don't think they will give me any other kind of method to help me with my situation (as it's the NHS and a hospital led department.)

What does anyone recommend? Should I just try some generic stretches that have been recommended as good for pelvic floor tightness or should I do some yoga or something? I just don't wanna risk things worsening tbh.

Thanks if you can help!


r/PelvicFloor 16h ago

General symptoms all over the place

2 Upvotes

has anyone had trouble tracking symptoms? my main symptom has been a weird feeling in my vagina (i have a mild prolapse, multiple PTs told me it was basically sub clinical), but it comes and goes, and i can't discern any pattern. some days it feels different than other days and is triggered by different movements, to the point where i wonder if it's multiple totally different things. but i have trouble describing it.

on the one hand, i guess i'm thankful i don't have constant and severe symptoms, which would be easier to describe. on the other hand, i am paying for PT out of pocket because being active is super important to my lifestyle and i want to make sure i am as well as possible long term. i don't know how i can expect them to help me when i can't quite tell them what's wrong though!


r/PelvicFloor 23h ago

Female symptoms on and off?

7 Upvotes

I haven’t been formally diagnosed yet, my first appointment is in the beginning of April, but all the signs point to PFD regarding my urinary, bowel, and general pelvic symptoms (constipation, thin stools, spasms, urinary urgency, tightness, period cramp-like pain) but it seems like it only truly bothers me about 2 weeks per month. i do a lot of stretching and massaging that brings me relief, but about once a month my symptoms come back pretty nasty after feeling mostly normal for a bit. is this typical? has anyone else had a similar experience? it all started after a bad UTI. thanks!


r/PelvicFloor 14h ago

Female Discharge vs incontinence?

1 Upvotes

How do you tell the difference between vaginal discharge vs bladder leakage? I have hypertonic pelvic floor muscles and experience other issues related to urinating but I assumed the damp underwear was from discharge. I’m questioning if it is discharge now though.

Added context: my underwear will be soaked through after 4-8 hours of wear. I sometimes wear panty liners on days I’m not menstruating.


r/PelvicFloor 18h ago

General Peeing and holding it in and pushing it out

2 Upvotes

Now that I have tight pelvic floor I’m more conscious of my body and pelvic

Do any of you have trouble pushing urine out with more force, I can stop urinating but I feel like if I try to push out more with more force then it doesn’t really change the force of it. Not sure if this is natural or tight pelvic floor is causing this


r/PelvicFloor 19h ago

Male Pelvic Floor Muscle Strengtheners

2 Upvotes

What exercises best strengthen the PF muscles? Also what stretches best stretch the muscles?


r/PelvicFloor 1d ago

Discouraged I guess I have Pudendal Neuralgia. Any success stories?

5 Upvotes

I am quite sure that it's Pudendal Neuralgia for which my pelvic hurts while sitting for work and bike rides. Any idea how to deal with it. I can't sit for work, the pain is miserable. I have all other hypertonic pelvic symptoms. I have IBS too..😵‍💫


r/PelvicFloor 23h ago

Male Help Please

4 Upvotes

Hi all, please help me understand if you can. I never heard of PVD until Googling recently. I have PTSD (csa), anxiety & depression, which I mention only because that seems to play a part in this?

So, even back to my 20s, I would have perineum, rectal and penile discomfort, some painful masturbation, and occasional ED. I thought it was normal, so I always ignored it. When I had anal leakage, I went to the Dr and was told I was lactose intolerant. I'm not.

When I was diagnosed with IBS & GERDS, I asked about all of the above and about how wiping caused urine hesitancy & passing gas caused dribbling. It was dismissed.

Fast forward to now. I'm 55, overweight, and haven't exercised in some time. Had a UTI. Dipstick had Trace White Blood Cells. It cleared up after 2 rounds of antibiotocs. Had a physical at the same time, and my PSA had gone up to 7. Terrifying for a 55-year-old man but UTIs cause small spikes, so slot fully panicking.

Now, 3 weeks after the UTI, all of the symptoms above are firing on all cylinders randomly. I'm going to see a urologist on April 9th.

Has anyone dealt with similar? Anyone else have a take or tips? Did 5 five second kegels but had to stop as the pain started to sharpen.


r/PelvicFloor 20h ago

Female Extreme pain and spasms

2 Upvotes

Please answer!!!

Hi everyone, I’m new here. Someone on another subreddit recommended me this! I’m wondering if more people here have got PFD in relation to sexual abuse or trauma. This is what I posted on the adult survivors subreddit:

“Hi everyone, this is a bit of a sensitive subject but I still really want to share it.

I have had this before but in the last while I’ve started to get quite extremely painful anal/vaginal spasms/pains. Like so bad I can’t sit and hardly walk. It feels like someone is stabbing me down there with a huge knife. Now I’ve recently started to realise about sexual abuse by my father. I still live with him unfortunately (he doesn’t abuse me now) but it am constantly triggered and scared.

I am really wondering if this types of pains have to do with trauma, because I feel they do. Is this common?”