Thu 09, Jun 2016

Older couple

Male deaths outnumber female deaths across all age groups until they reach 65-plus, but that’s because so many men are already dead before they reach this age. Men visit the doctor less often than women, and only go when their condition is advanced. 

According to the 2008 Australian Bureau of Statistics, some of the most common causes of premature death among men are heart attacks, lung, colon, rectum and prostate cancers, strokes, respiratory disease and diabetes.

Perhaps an added incentive for taking better care of themselves might be the knowledge that certain habits – like those prescribed by the Continence Foundation of Australia for healthy bladders and bowels – will also lower their chances of erectile dysfunction and incontinence.

Healthy habits for warding off some of most common killer diseases are essentially the same as those for promoting good bladder and bowel health – which equates to a better chance of a life with full control over their bladder, bowel and erectile function.

The five steps to healthy bladders and bowels, as recommended by the Continence Foundation of Australia, are to:

  • Drink well
  • Eat healthy
  • Keep active
  • Tone your pelvic floor
  • Practice good toilet habits

Nurse Continence Specialist and National Continence Helpline coordinator Stephen Marburg said men were often unaware of the impact lifestyle habits had on their bladder and bowel.

“Drinking enough fluids is a big issue; particularly for men working long hours with few breaks. If the urine is darker than pale lemon colour, they’re not drinking enough,” Marburg said.

“And if they’re not drinking enough, their urine gets concentrated and irritates the bladder, which then tries to get rid of it. That causes frequency and urgency.”

He warned however, of drinking too many caffeine or sugar-based fizzy drinks, which also irritate the bladder.  “And alcohol, which is a diuretic, only in moderation,” he added.

Constipation was another significant issue, particularly if men didn’t drink or exercise enough, or ate too many refined foods, he said.

“Not many people realise that constipation has a big impact on the bladder. A full compacted bowel can push up against the bladder, risking accidental leakage – which is urge incontinence.

“And straining on the toilet when you’re constipated can stretch and weaken the pelvic floor muscles, much like overstretched elastic. These muscles are really important for continence,” Marburg said.

Pelvic floor muscles could also be stretched and damaged as the result of being overweight or by ongoing, excessive heavy lifting, he said.

Marburg described the pelvic floor muscles as trampoline-shaped and spanning the tail bone to the pubic bone, and between both sitting bones.

“They are responsible for holding up the pelvic organs and closing off the urinary and anal sphincters. They also play a role in gaining and maintaining erections,” he said.

“In the past the focus has been on women doing their pelvic floor exercises, but we now know that they have benefits for men in conditions associated with prostate disease and erectile dysfunction,” Marburg said.

“There is good research telling us they can be effective in the treatment of premature ejaculation (Pastore et al, 2014) and erectile dysfunction (Dory et al, 2005).

“Recent Australian research has found that men who perform pelvic floor exercises before prostate surgery regain their continence earlier than men who start them after surgery (Chang et al, 2015),” he said.

The final, but critical step for bladder and bowel health was the development of good toilet habits, he said.

“You should only have to go urinate four to six times a day, and perhaps once overnight.”

The normal range of bowel motion frequency, he said, is anywhere between three times a day to three times a week, and the best time to go is as soon as the urge is felt.

“This urge is the gastrocolic reflex - the mass movement of contents through the bowel, and it happens about 10 to 30 minutes after a meal, most strongly felt after breakfast. 

“The stool shouldn’t be too hard, and should come out relatively easily. If you hold on too long, the urge will pass and you risk constipation,” he said.

Marburg also recommended the use of a foot stool while on the toilet in order to adopt the correct sitting position - leaning forward with knees higher than the hips - which straightens out the colon, making it easier for the bowel to empty.

Marburg said that around 30 per cent of calls to the Helpline were from men, who were often highly embarrassed about their incontinence problems.

“Remember, you are not alone and there is a lot of help out there. While incontinence is not normal at any age, in most cases it can be improved, if not cured,” he said.

He urged men with any bladder or bowel concerns to visit their GP or speak to one of the continence nurse advisors on the free and confidential National Continence Helpline (1800 33 00 66).

Go to continence.org.au for more information. Read more about male pelvic floor exercises.

References:

Pastore A.L. et al (2014). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: A novel therapeutic approach, Abstract at the 29th Annual EAU Congress.

Dorey G1Speakman MJFeneley RCSwinkels ADunn CD. (2005), Pelvic floor exercises for erectile dysfunction. BJU Int. 2005 Sep;96(4):595-7.

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