Guys with BPH tend to have tight pelvic floor muscles. This is driven by urinary urgency and frequency. The brain interprets these pelvic sensations as a warning signal to the body and the pelvic floor muscles shorten, like a dog tucking its tail. Here is a video showing how the penis and testicles fill with blood and how having tight pelvic floor muscles alters erectile quality:
I am a pelvic floor PT who has noticed a shift in male pelvic health since COVID. So, I made a video explaining possible reasons as to why so many young men tell me about changes in erectile function most recently. Here is the video:
I treat many men after HoLEPs and aquablations and wanted to share some intel on what I encourage for the first 3 months after said procedure.
Most men maintain too much intra-abdominal pressure throughout the lifespan. Add having prostate enlargement into that, with the urinary urgency and retention, and that pressure will continue to build. This puts a lot of downward pressure on the pelvic floor muscles.
Many men begin to have increased pelvic floor tension with BPH - they are often not aware of this. And performing Kegels to address the urinary dribbling will increase intra-abdominal pressure. Which makes urinary retention more likely.
After having a procedure to make the prostate smaller, many men will still subconsciously perform Kegels or embark on a Kegel routine. The opposite is usually helpful. We need LESS pressure in the system and we need more muscle relaxation in the saddle region to promote better urinary streams and sexual arousal.
Performing reverse Kegels are indicated after a prostate procedure. For those with a HoLEP, do this on the toilet to capture the pee. For thise with an aquablation or PAE, you will be less likely to lose urine when performing this and it can be done anywhere. Here is a video on how to perform a reverse Kegel: