Male Pelvic Health: What to Expect at Your Pelvic Floor Physical Therapy Evaluation

If you’ve been wondering what a male pelvic floor physical therapy evaluation looks like, you’re in the right place. Men come to us with a wide range of concerns—including urinary leakage, pelvic pain, erectile dysfunction, post-prostatectomy recovery, constipation, and tailbone pain. No matter what brought you here, this guide walks you through exactly what to expect at your first visit at Pelvic Health and Wellness in Milwaukee

First of all, welcome! Congratulations on taking this step for your health. 

You’ve booked (or want to book) your initial evaluation with us. We’re here to help you understand what to expect at your pelvic floor physical therapy evaluation. Our goal is to help you feel comfortable, informed, and confident about the process to ensure a positive experience.

First, we listen and chat

The first thing we do is listen to your story. Your first visit starts as a conversation so we can gain a thorough understanding of your symptoms, concerns, and the history behind them. We may ask you detailed questions about:

• Bladder and bowel health

• Sexual health and function

• General physical health and activity level

• Current or past injuries, aches/pains, and surgeries 

• Prostate health or history of urologic procedures/surgeries

• Hydration and nutrition habits

• Home, work, and exercise demands

• Sleep quality

• Stress levels and stress management 

Once we’ve gathered this information, we’ll move into the physical evaluation. The pelvic floor works together with the whole body. This means it is important to look at the pelvic floor and also understand how your whole body is moving and functioning. We will determine how other areas of your body, such as the spine, hips, abdomen, ribcage, and feet, may be related to your concerns. 

This may include assessing your:

• Posture

• Breathing patterns

• Pressure management

• Flexibility

• Muscle tension

• Muscle strength

• Functional movement patterns (ex, squat)

Internal Evaluations

Before we explain further, we want you to know this part should not feel scary. You will feel informed and in control each step of the way.

We will only perform an internal evaluation or treatment after describing the process, explaining how and why it would benefit you, and answering any questions you may have. You are NEVER required to have one. 

Deep breath in, deep breath out.

What is an internal pelvic floor evaluation, and why do we do it?

An internal pelvic floor muscle assessment allows us to directly evaluate the male pelvic floor muscles. This is performed rectally using one gloved, lubricated finger to gently assess the muscles and surrounding tissues. This is very different from a prostate exam. 

The treatment table is typically set up with a sheet under you and another sheet to pull over the top of yourself. After you have had your questions answered and decided you would like to do an assessment (either external, internal, or both), we will first step out of the room. You will then undress from the waist down and lie on your back with pillows for your comfort. We prioritize your comfort throughout the entire process. When you are ready, we will come back to the room to get started.

We will start with the external portion - checking the skin health and gently feeling (palpating) the muscles and external structures of the pelvis, including the penis, scrotum, perineal tissues, and anal tissues. We communicate with you the entire time about where we are going to apply gentle pressure and what the muscles feel like, and we ask for your feedback on what you are feeling. After the external evaluation, we will ask you to turn to your side (either side). We can help assist with holding the blanket as you turn to your side and moving the pillow between your knees for comfort. Once you are on your side, we will continue to the internal portion of the evaluation, where we will apply gentle pressure to the pelvic floor muscles internally in the rectal canal. We assess muscle restrictions, decreased or increased sensitivity, strength, ability to lengthen the muscles, and any tissue tenderness. 

This information helps us better understand how your pelvic floor muscles may be contributing to your symptoms such as pelvic pain, urinary leakage, constipation, tailbone pain, sexual dysfunction, or post-surgical concerns.

When might we skip the internal assessment?

There are times when an internal assessment may not be appropriate. That includes, but is not limited to:

• Recent surgery (usually <6 weeks post op) in the pelvic floor region (ex, prostatectomy)

• Active infection

• Significant pelvic pain or fear surrounding internal examination

• You don’t agree to one

One of the best parts of our job is that your care is completely individualized. Assessing the pelvic floor is a helpful step and one of many treatment options available to us. 

If you are only comfortable with an external assessment, that is absolutely okay! If you prefer to wait several visits before considering an internal assessment, we will wait (and it’s perfectly fine if you decide to revisit that option later). If you never wish to have an internal assessment, we fully respect that choice. 

However, if you are ready to understand the full picture of your pelvic floor symptoms and would like to jump in on day one, we are here to help connect all the dots. Then you will know exactly why you feel your symptoms and have a plan to resolve them.

Next steps

At the end of the assessment, we’ll review our findings together, discuss a treatment plan tailored to your goals, including how often we would like to see you, and provide 1-2 starting points to work on at home. 

We hope this helps you feel more comfortable and informed about what a pelvic floor evaluation looks like at Pelvic Health and Wellness. We’re honored to be part of your care and look forward to helping you get back to doing the things you enjoy with confidence.

Ready to book your evaluation? Our pelvic floor specialists in Whitefish Bay serve the greater Milwaukee area and are here to help. Request your appointment today—and let’s get you back to feeling your best.

About Pelvic Health & Wellness

Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our physical therapists specialize in treating pelvic health concerns such as pelvic floor dysfunction, men’s pelvic health, bowel and gut health, pelvic pain, pelvic organ prolapse, constipation, incontinence, fertility, and various pregnancy and postpartum-related conditions.

We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. We are here to support and encourage you on your journey back to health so you can return to doing what you love! If you are ready to take the first step in reclaiming your pelvic health and wellness, don't hesitate to get in touch with us today.