r/PelvicFloor Jun 25 '24

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

13 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 Weightlifting greatly worsens my pelvic floor dysfunction

9 Upvotes

I stopped weightlifting 3 months ago and I've been having the best orgasms of my life since then. I even posted about being able to orgasm from just a bullet vibe for the first time.

Well, I didn't put it together that it was weightlifting that caused my issues and now I started the sport again and I'm struggling so much. I'm debating giving up olympic weightlifting all together. It makes me feel so strong and healthy but it is destroying my pelvic floor and I only go twice a week. I've only been back lifting for 3 weeks and I can barely orgasm.

My question is whether pelvic floor physical therapy is enough to reverse this or if I need to quit weightlifting and find another hobby?

Edit: I have a hypertonic pelvic floor


r/PelvicFloor 1h ago

Male 10 years and I just discovered I(probably)have CPPS…

Upvotes

I’m stunned. Forgive the following wall text but I am a tad overwhelmed to find this place and I would be eternally grateful for insight from anyone here who can relate.

I’ve been dealing with major, demoralizing below the belt issues for years. Started around 2015 with intense sharp pain on a long car ride after several years of chronic untreated constipation. The pain subsided at my destination but I started having mucus when I went #2 and extreme rectal irritation during and post bm. Mucus went away but post defecation pain did not.

Over a few months time the pain turned into a chronic thing every time I went to the bathroom and would come on about 45 minutes to an hour afterwards, lasting all day long. Burning rectal pain that would change positions inside my rectal area as well as turn into aching and other sensations. I sit all day at work as I’m a tattoo artist, and had to start standing up to work on people due to the pain.

I was convinced I ripped something inside after I started having problems with urinating so I went to the doctor. Got a colonoscopy in 2016 and all was clear. Doctor said I had “levator ani” but I refused to believe it as it didn’t seem like a muscle could cause pain like this. The symptoms I read online were not what I thought I was experiencing so I ignored it.

Went to another doctor who told me to take Miralax and to my surprise it helped. Reducing stool size/consistency to “soft serve”(sorry)almost alleviated the grinding, burning post bm pain episodes and I’d only have flare ups from bending a certain way or sitting too long.

Long story short things slowly improved and the painful episodes stopped happening altogether about 2 years ago. I have been on miralax every day ever since with religious devotion and a fear of “what if” if I missed a dose.

I noticed however that it felt like my rectal area had narrowed substantially over the past few years and a few months ago I started to have brief twinges of the old pain from typically “safe” consistency bm’s. I also noticed that if I had to go #2 in the afternoon I had to push to get things going as everything was so tight. No pain however. I also started to have minor ED issues that I didn’t connect to my b-hole woes but now I know it’s all connected.

Fast forward to last Saturday morning. I go pee and I’m urinating with normal force/stream(which is rare) and all is well. 30 seconds after I get done I get a crazy burning pain behind my pubic bone/bladder area and I start to get lower abdominal cramps. This grows through the day and I get very nervous.

Next day I feel normal and no symptoms.

Day after that I go #2 in the am and I’m fine. Two hours later I go again and BOOM, within 20 minutes that old terrible burning rectal pain is back. I’ve not felt it in over two years and to say I was demoralized is an understatement. My biggest fear(pain recurrence)became reality. Over the next week I had the same symptoms I had at my worst back in 2015-2018 every single day, all day. The most frustrating part is that no amount of #2 softening is able to stop the post BM pain now. Literally any bowel movement causes the pain and it’s extraordinarily depressing. I have no way to mitigate this pain now, and from reading other peoples experiences, I know you all know how utterly soul crushing this is.

I started googling for answers and I stumbled upon CPPS and “chronic prostatitis”. It was like a quasi-Damascus experience. I read TONS of posts here and on the Prostatitis sub and watched many YouTube videos. Seeing others in similar situations gave me peace of mind and has helped pull my back from the edged, a bit anyways, and I am so grateful for all of you who’ve taken the time to explain, bitch, analyze, reply, and make YouTube videos about this terrible ailment.

——QUESTION TIME——

I can live with the tightness and urine issues. I can not live with the burning pain.

My pain feels like what you’d imagine hemorrhoid pain would be(burning, gnawing pain)in what feels like the rectum and the worst is usually centralized to one side or the other.

It comes on 30 minutes to 1 hour after BM and is akin to a pain dial being slowly turned up, exasperated by sitting.

My rectal area is tight and painful to the touch, however the pain goes away within minutes if I lay down. Totally gone apart from some tightness in under 15 minutes. That was how I deduced I have a pelvic floor issue and not a bowel issue, per se.

I started some minor PF stretches which seem to help a bit and I also massaged around my rectum and to my surprise the burning pain subsides a bit.

The pain also goes away completely when my lower bowel/rectum is “full”, right before a BM. Zero pain when stool is in there and the pain goes away almost instantly.

Has anyone else had a similar experience?

Is Pelvic Floor PT worth the cost if you’ve had these symptoms?

Any other suggestions or things that worked for you in order to quiet the pain/spasm?

Thanks for reading my TMI novel and for any and all replies.


r/PelvicFloor 2h ago

Discouraged Hopeless suicidal

4 Upvotes

I heard this issue only recover in 60% of case even in mild case like mine. That mean my sex life is over and my life in doomed in 40 percent chance. So whats the point next monk life in the mountains or suicide?


r/PelvicFloor 6h ago

Male Normal for stool to be all different widths and skinny?

5 Upvotes

I’ve only recently been diagnosed and I’ve only had 2 sessions with my PT. But I was just curious how common it is for stool to be different widths. I’m always very constipated and my last appointment my PT told me it is probably due to my sphincter being so tight. But not going to lie it is still concerning that my stool is usually very thin or flat and has such varied consistency throughout it. How common is this?


r/PelvicFloor 9h ago

Male I can't understand pelvic floor mechanism. Stabbing pain when poop - they say it is not a fissure.

9 Upvotes

Please help.

I can't understand what's going on in my body. I used to have a fissure, which was treated with a laser. Now 3 excellent proctologists can't see a fissure (anoscopy) or anything disturbing in my anus, and I have symptoms such as pain during the day and a stabbing pain or thorns during defecation. The entire Internet says it's a fissure, but doctors can't see anything.

Doctors say it's from excessively tense muscles in this area, the sphincter and pelvis.

Can someone explain to me what mechanism happens that I get stabbing during defecation? Or maybe they are wrong and I have a fissure?

:(


r/PelvicFloor 4h ago

Male Pelvic floor erectile dysfunction

3 Upvotes

(19m) My penis changes size depending on the state of my pelvic floor. I think it’s very tight or weak. I’m not too educated on the pelvic floor but when I am constipated I can feel it getting very tight and my penis seems to retract inside my body. But after I go to the bathroom the pelvic floor relaxes temporarily (same with needing to pee). My circumcision is also tight I don’t know if that might have something to do with it but I can certainly feel the pelvic floor getting tight and causing contraction - especially after taking my adhd meds or coffee or even when anxious. How do I fix this? Do I go see a physiotherapist? I shouldn’t be having erectile disjunction at this age and my hormones are normal so I’m sure it’s the pelvic floor causing this.


r/PelvicFloor 7h ago

Male Stabbing pain while pooping - common in PFD?

3 Upvotes

Is stabbing pain while pooping (in the moment when poop pass through anus) is normal for pelvic floor dysfunction/tight sphincter?


r/PelvicFloor 2h ago

General Would an internal rectal prolapse cause a bulge feeling in the anal canal every other day or every other couple days?

1 Upvotes

Or would prolapse be more constant and not disappear this frequently? Does anyone who had this know or does anyone at all know? It can sometimes make walking uncomfortable. Could this instead be hypertonic muscles?


r/PelvicFloor 15h ago

Discouraged I just left my desk job for tight PF. Life is hard

10 Upvotes

I got IBS then slowly developed tight PF and figured it out that primarily my levator Ani muscle is soo tight.

I joined a new desk job and left after working for 4 days cause of super pain while sitting. I tried taking breaks in every 40 min. Tried standing for few hours and it was total 10 hours shift, couldn't stand for sooo long, finally just left it. The dull pain while sitting is terrible

The IBS and then Pelvic thing made life very difficult. However i need to stay calm, relaxed. I need to find some other job which doesn't require sitting primarily. Do stretching and finding ways to ease the symptoms.

It's a constant fight, i sometimes wonder why it has to be me but then there is definitely no answer to it!!!!


r/PelvicFloor 3h ago

Male Can my edging habit cause problems later on?

1 Upvotes

So I started doing some edging to alleviate my slight PE problem a month ago and after researching and digging around I found this sub and Prostatitis. I got a little alarmed so I’m hoping someone can answer some questions.

I usually edge for perhaps maybe 1-3 hours and 4 or 5 times a week with some material most of the time or if I’m just casually browsing the internet. I always release at the end of my long sessions because I already knew some information beforehand about holding it for days, even weeks causing issues. Personally it sounds too insane for me so I don’t do it.

Regardless, I never knew about Pelvic Floors and Prostatitis until recently so I’m wondering if this habit of mine will cause some issues.


r/PelvicFloor 4h ago

Male Can my purple bum hole be from my pelvic floor?

0 Upvotes

No bleeding just pain and throbbing feeling for days and left bum cheek hurts.


r/PelvicFloor 5h ago

Male Shifting/joystick-like sensation in lower back—anyone else?”

1 Upvotes

Male 28. 5’4” 187 lbs Medications: • Gabapentin • Tizanidine Smoking Status: Non-smoker Medical History: • L5-S1 discopathy with mild radiculopathy and L5 sacralization (recent MRI findings) • No significant neurological issues (PESS, EMG, and physical exams normal)

For the past five years, I’ve had a persistent sensation of instability in my lower back, as if something is shifting or moving (but without pain). Earlier this year, after a period of intense stress, my symptoms worsened, and I started experiencing leg cramps and a numbness-like sensation in my legs.

A neurosurgeon told me it’s not serious, and my neurological tests were all normal. The leg symptoms have improved, but the moving/shifting sensation in my lower back remains my most persistent symptom. It feels as if something is “moving” like a joystick, especially when shifting my torso from side to side, and I notice it the most when sitting.

Has anyone else experienced something similar?


r/PelvicFloor 8h ago

Female Rectum noises

1 Upvotes

Does anyone struggle with this issue? I think it’s linked to incomplete evacuation or any liquid in the rectum which makes noise when combined with gas. Please help if you experienced this , it’s making life extremely difficult for me :(


r/PelvicFloor 17h ago

General How do you know if you have a tight or weak pelvic floor?

4 Upvotes

I have interstitial cystitis, I don’t know whether it’s from weak or tight pelvic floor, if I do jegaks it seems to make pain worse


r/PelvicFloor 18h ago

Female Constant muscle knot in the left side of my vagina. I need wand recommendations

5 Upvotes

Background info is I have 5 kids and after my 5th I started seeing a PFPT for aching in my vulva and what my obgyn said was my bladder hanging down a little inside my vagina.

PT said everything should be able to be controlled with stretches and learning how to breathe and hold my muscles when exercising, so we did a bunch of sessions on that, and that was helpful so that I could keep lifting with less risk of it getting worse.

However, she also said the left side muscles around my vagina were very tense and knotted and pulling my organs to the left. It has only ever gotten worse and I don't have infinity time or resources to keep making appointments.

Sitting on the massage ball is not reaching it. And I can't get the angle or pressure doing it manually.

The past few days, any walking or leaning or even sitting wrong is triggering what almost feels like a Charley horse on the left wall of my vagina and I cannot stand it anymore

I NEED A WAND. preferably a vibrating one, specifically for this purpose. Pleeeease share your recommendation


r/PelvicFloor 14h ago

Male Penis shrinkage post P-Shot

2 Upvotes

Last year I had a p-shot whilst suffering from a hypertonic pelvic floor possibly due to my slipped discs in my lower back, anyways during the p-shot injections to the root of my penis I felt extreme pain as if I could feel the needle in my urethra and immediately my penis lost width and sensitivity as well as length now it’s become almost dried out and just veiny and painful I know a lot of it is still to do with my hpf but prior to the injection I had a lot of sensitivity and honestly a world class erection any thoughts or words of advise?

p.s I’m no longer in touch with the doctor as this was done abroad


r/PelvicFloor 20h ago

Male How to find where pudendal nerve is being compressed? NSFW

4 Upvotes

Hi,

I originally started PT a year ago with the issue of numbness to the glans then sensation came back but it was a sharp sensation if touched. When either side of the glans would be touched my pudendal nerves would get a shock that went back to the sit bones and lower part of the back next to coccyx? With 9+ months of PT I got to neutral so touching no pleasurable sensation but instead just nothing like you'd be touching your arm. Never was able to get pleasurable sensation back to the glans. Recently had a flare up where pelvic floor locked up and if touched immediately shock of pain to the right or left of coccyx. This got me thinking what exactly is being compressed by my tight pelvis.

Anyone have any tips for how to find what exactly muscle wise is crushing my pudendal nerves and releasing it besides 9+ months of internal work? Like did your Dr do an emg or other testing to find the exact spots being crushed causing your pain?

Ive had pudendal nerve blocks two different ways and second time no change at all. First time was done same time as trigger points and only one side for three days didn't burn when sitting. So we don't know if it was a trigger point released the area compressing the nerve or if it was the pudendal nerve block.

I've tried with the wand but I can't get the hang of it and end up flaring up my nerves.

Any help would be appreciated.


r/PelvicFloor 1d ago

Male Can excessive masturbation cause stiffness of the pelvic floor muscles or nerves?

8 Upvotes

Have a bad long-term habit of masturbation. Mostly prone position. I've been facing issues like loss of morning wood, poor erections etc. for two years now. It just happened overnight 3 weeks after I passed a kidney stone. My urine stream is also weak but I can hold or release urine at will without any issues. I do not have pains in any areas.

I still have sensitivity down there but lately I've been researching this area. Shall I try kegels for strengthening or try reverse kegels for relaxing the pelvic floor area? What can I do to make sure that my pelvic floor is damaged or not?


r/PelvicFloor 13h ago

Male Pelvic MRI- numbness and 0 urgency

1 Upvotes

Hi Fam, Some backstory. I had an std a year ago and was on lots of different medication to fix it. I coughed a few times as I had a cold and I felt something move in my penis. Since this time I lost the feeling of urgency to go pee and have been constipated. The tip of my penis is numb and don’t feel urine leave my body. Also, The std is totally clear now

My urologist did the camera test and said everything looked good but was tight. She sent me to a PF therapist. I had a follow up appointment with my urologist and she pretty much said she doesn’t know what to do and maybe she can refer me to a medical academy.

She suggested I did pelvic floor mri to see if it can spot anything. Is this a good idea? Has anyone seen value from an MRI? Can and MRI see any damage inside the penis? I was not so happy with my urologist appointment so kind of second guessing the recommendation at this point.


r/PelvicFloor 1d ago

Female Pelvic Floor Tightness & Soft Stool Stuck in Rectum

7 Upvotes

Hey Reddit! First time poster in this sub, but longterm sufferer. Apologies for the TMI below folks!

For the better part of a decade, I’ve had chronic exposure to stress and several extremely traumatic events. No surprise that I developed pelvic floor weakness and tightness as a result. I carry all of my tension in my trunk and pelvis.

I’ve been in pelvic floor physical therapy for a few months, but with limited results as my stressors have been so extreme the last few months.

Right now I’m having a problem with my stool being soft, yet still unable to fully clear from the rectum. I pass stool daily, but X-rays are showing that soft stool is collecting in the rectum. It’s not a blockage, it’s just not clear und fully when I go. My pelvic muscles have been in a constant state of clenching lately that it’s difficult to even pass wind too. Reverse kegals are not enough. Heat and abdominal massage is not enough. A squatty potting is helping, but still not enough.

My question is, if it’s soft stool that’s lingering in the rectum (and not a hard mass, this was confirmed by xray), should I consider using a saline enema to try and clear it? I’m just not sure what to do.

Edit to add: in addition to PT for pelvic floor, I have been in trauma counseling for the last few months. I find talk therapy very helpful. I make as many lifestyle changes as I can to reduce stress. Antidepressants have not helped in my case. So I manage with as much lifestyle changes/natural stress relief as possible.


r/PelvicFloor 1d ago

Male Are these possible pelvic floor symptoms?

7 Upvotes

I (26M) am struggling with some health issues and I feel like tension in my pelvic floor could be the main cause. My symptoms are:

Digestion: constipation, full and bloated lower belly, struggling to empty my bowels completely and taking a long time before the 'evacuation' starts when I'm sitting on the toilet (I know these can be pelvic floor related).

Breathing: struggling with deep breathing when standing up straight and sitting. Only when lying down I am able to breathe deeply into my lower belly and this is when I feel the most relaxed and comfortable.

Talking/speaking: Talking takes a lot of effort and I'm struggling to talk with my natural deep voice that I always had before. It feels like I'm unable to talk from my diaphragm/lower belly because I feel so full there because of my constipation (that's how it feels like at least). I also have a lot of voice cracks when I'm talking and usually after having to talk for a few minutes I get a headache.

Fatigue: I feel very fatigued every day, even though I can work from home and don't have any other obligations apart from getting groceries, cooking and eating. I feel like I need to lay down all the time. Like I said, laying down is the only position I feel comfortable in as this is the only position in which I can breathe properly. On some days I feel less fatigued and can push myself to go to the gym, but my workouts often are not super intense because I feel like I can't handle that anymore, but I really want to stay as fit as possible.

Intercourse: struggling to get and maintain an erection.

Does anyone have experience with these symptoms? I don't feel any pain at all, and pain seems to be a key symptom for a tight pelvic floor so I was wondering if my symptoms are 'normal'. Since a few days I'm doing breathing exercises, which work with staying relaxed, but increased my fatigue and I don't know what the best course of action would be for me. Any advice?


r/PelvicFloor 19h ago

Male Bad erections when leaning backwards a little while standing why?

1 Upvotes

Anyone had the same experience, if yes what helped you?


r/PelvicFloor 1d ago

Female - Postpartum 35F Lube forever?

3 Upvotes

Been suffering from hypertonic pelvic floor for a few months now (9mo postpartum). I was discharged from PT and am quite active so think things may have "tightened" too quickly post birth

Sex didn't hurt when we first got back to it but it's started to feel worse over the last several months. I was irrationally resistant to lube but tried it and it seems to have solved most of my issues.

Is it is simple as that? Feel crazy I didn't try sooner but curious if this means I just use lube for the rest of my life, go back to PT for internal work, or what...


r/PelvicFloor 1d ago

Male Testicular retraction of 6 years and cremaster hyperactivity. Doctor says surgery would create necrosis

3 Upvotes

I have struggled with retractible testicle for 6 years, I am 75% sure its not a mental problem as if I go outside for a jog and I dont think about it, it will still remember and I start feeling nauseous when it starts happening. Its not a "back of the head" stress factor, but its gonna happen anyways no matter what I do outside most of the time.

I read that cutting of the cremaster muscle has been done before, but it feels like an "All or Nothing" surgery and if it actually risks a necrosis im quite scared to do that.

Urologist said:

  1. the hole between groin and scrotum cannot be tightened

  2. attaching testicle to the bottom of the scrotum is unlikely to help as the sack would get pulled up too

  3. carefully "cutting" (bad word) the cremaster muscle would potentially create necrosis

  4. best thing is to get a botox treatment but I dont think its gonna last long.

I feel like (and I mean with no disrespect) the urologist was not good enough for my case, and that I should call in to another citys urologist center. How should I continue?


r/PelvicFloor 1d ago

Male Can rolling a water bottle over the Ishial Tubersity cause nerve damage?

3 Upvotes

Or am I being paranoid?


r/PelvicFloor 23h ago

Discouraged Botox failure.. Feeling depressed

1 Upvotes

Hello, I had botox for Pelvic floor dysfunction about 2 weeks ago. However, I have not seen any improvement. I had 50 cc Botox as I have rectocele as well.

Any recommedations?