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Male urination is controlled by the pelvic floor muscles and the urethral sphincter muscles. The pelvic floor muscles support the bladder and bowel, and wrap around the urethra to help keep it shut. The urethral sphincter muscles, innervated by the somatic and autonomic nervous systems, also control the exit of urine through the urethra. Weakened pelvic floor muscles can lead to urinary incontinence, which can be treated with Kegel exercises that strengthen the pelvic floor muscles and improve bladder control.
| Characteristics | Values |
|---|---|
| Muscles controlling male urination | Pelvic floor muscles, urethral sphincter muscles |
| Urethral sphincter innervation | Somatic and autonomic nervous systems |
| Pudendal nerve | S2 to S4 nerve roots |
| Neurons that innervate the urethral sphincter | Onuf's nucleus |
| Autonomic nervous system control | IUS muscle |
| Pelvic floor muscle function | Support bladder and bowel, assist with sexual function |
| Pelvic floor problems | Stretched, weakened, too tight |
| Treatment for pelvic floor problems | Pelvic floor muscle exercises, pelvic floor physical therapy |
| Kegel exercises | Squeezing pelvic floor muscles for a count of five, releasing for a count of five, repeating 10 times, three times a day |
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What You'll Learn
Pelvic floor muscles support the bladder and bowel
Pelvic floor muscles are a group of muscles and connective tissues that support the pelvic organs, including the bladder and bowel. These muscles span the bottom of the pelvis, stretching from the pubic bone at the front to the coccyx (tailbone) at the back, and from one ischial tuberosity (sitting bone) to the other. The pelvic floor muscles support the bladder and bowel by wrapping firmly around the urethra and rectum, helping to keep these passages shut.
When the pelvic floor muscles are strong, they help prevent the leaking of urine and faeces. They also play a role in sexual sensation and function, with evidence suggesting that pelvic floor exercises can improve sexual function, arousal, and orgasm intensity. Pelvic floor muscles are essential for erectile function and ejaculation in men.
However, pelvic floor problems can occur when these muscles become stretched, weakened, or too tight. Weakened pelvic floor muscles can create problems with bladder and bowel control, leading to conditions such as urinary and faecal incontinence. A common cause of weakened pelvic floor muscles is pregnancy, especially multiple births, assisted births, and perineal tearing. Other factors include heavy lifting, chronic coughing, constipation, hormone changes during menopause, ageing, and diabetes.
On the other hand, a hypertonic pelvic floor occurs when the muscles become too tense and unable to relax, causing the bladder and bowel not to empty properly. This condition can lead to constipation, painful sex, urgency, and pelvic pain. Pelvic floor muscles can also tighten protectively due to pain, and the hidden nature of the pelvic floor can make diagnosis challenging.
It is important to maintain strong and healthy pelvic floor muscles through specific exercises. These exercises can help individuals gain control over their pelvic floor muscles and improve their function. Before starting a pelvic floor exercise program, it is crucial to correctly identify the muscles and consult with a healthcare professional.
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Urethral sphincter muscles control the exit of urine
Urethral sphincter muscles play a crucial role in controlling the exit of urine from the body. In males, the urethra is used for both urination and ejaculation. The urethral sphincter muscles work in conjunction with the pelvic floor muscles to regulate urination.
The pelvic floor muscles wrap around the urethra, providing support and helping to keep it closed. When these muscles are strong, they effectively prevent urine leakage. However, when they are weak, it becomes difficult to control the flow of urine, leading to urinary incontinence.
The urethral sphincter itself consists of two muscles that work together to control the exit of urine from the urinary bladder through the urethra. One of these muscles is the internal urethral sphincter (IUS), which is composed of smooth muscle fibres and regulated by the autonomic nervous system. The other muscle is the external urethral sphincter (EUS), a striated muscle that controls voluntary urination.
The innervation of the urethral sphincter is facilitated by both the somatic and autonomic nervous systems. The EUS muscle, innervated by the pudendal nerve, prevents urination through voluntary motor innervation. On the other hand, the IUS muscle is controlled by the autonomic nervous system due to its smooth muscle fibre composition.
To maintain urinary control and strengthen the pelvic floor muscles, men can perform Kegel exercises. These exercises target the pelvic floor muscles, improving their strength and ability to support the bladder. By performing Kegel exercises consistently, men can enhance their ability to control the exit of urine.
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The somatic and autonomic nervous systems innervate the urethral sphincter
The urethra in males is used for both urination and ejaculation. The urethral sphincter, a group of muscle fibres that surround the urethra, controls the exit of urine from the bladder through the urethra. The somatic and autonomic nervous systems innervate the urethral sphincter.
The somatic nervous system enables voluntary control of the pelvic floor and external urethral sphincter. This allows for pelvic floor exercises. The autonomic nervous system (ANS), on the other hand, regulates the function of internal organs like the bladder and acts subconsciously. It is composed of the sympathetic nervous system, which is activated during the "fight or flight" response, and the parasympathetic nervous system, which is activated during rest. These two systems have opposing effects on the bladder.
The sympathetic innervation of the bladder originates in the lower thoracic and upper lumbar spinal cord segments (T10 to L2). The preganglionic axons connect to sympathetic neurons in the inferior mesenteric ganglion and the ganglia of the pelvic plexus. Postganglionic fibres from these ganglia pass through the hypogastric and pelvic nerves to the bladder, causing the internal urethral sphincter to close. Sympathetic activity prevents retrograde ejaculation in men by stimulating the smooth muscle of the internal sphincter.
The parasympathetic nerves, also known as pelvic splanchnic nerves, originate from the S2-4 nerve roots and pass through the pelvic plexus. These nerves trigger bladder contraction during voiding. When the bladder is full, parasympathetic activity increases, causing the internal sphincter muscle to relax and the bladder to contract, allowing for urination. The pelvic nerves, which are the main parasympathetic nerves, cause contraction of the detrusor muscle and relaxation of the internal sphincter, facilitating urine elimination.
The interplay between the somatic and autonomic nervous systems, along with the voluntary motor system, regulates urination. The urethral sphincter is innervated by the pudendal nerve, which arises from Onuf's nucleus at the S2-4 spinal level. The neurons that innervate the urethral sphincter originate in the spinal cord in the area of Onuf's nucleus. The voluntary motor innervation of the external urethral sphincter muscle prevents urination.
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Kegel exercises help strengthen pelvic floor muscles
The pelvic floor muscles in males support the bladder and bowel. The pelvic floor muscles wrap around the urethra and rectum to help keep them shut. Weakened pelvic floor muscles can cause urine and fecal leakage. Pelvic floor muscles can weaken with age, obesity, excessive straining, or chronic coughing.
Kegel exercises help strengthen the pelvic floor muscles. These exercises involve tightening and releasing the pelvic floor muscles to strengthen them. To perform Kegel exercises, one must lift, hold, and then relax the pelvic floor muscles. It is recommended to start with a few Kegels at a time and gradually increase the number of repetitions and duration of each session.
Kegel exercises can help prevent urine and fecal leakage by strengthening the pelvic floor muscles. These exercises can also improve bladder and bowel control. Additionally, Kegel exercises can be beneficial during pregnancy, as they may provide greater control over the pelvic muscles during labor and delivery.
It is important to note that Kegel exercises should be performed correctly and in moderation. Doing too many Kegels or doing them when they are not necessary can cause the pelvic floor muscles to become too tense or tight.
Other exercises that can help strengthen the pelvic floor include pelvic tilts and the bird-dog exercise. Pelvic tilts involve lying on the back with bent knees and tightening the abdominal muscles while pressing the lower back into the floor. The bird-dog exercise starts with a hands-and-knees position and involves engaging the core muscles while extending and raising the left leg and right arm simultaneously.
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Urinary incontinence can be caused by weak pelvic floor muscles
The pelvic floor muscles support the bladder, bowel, and, in women, the uterus. Pelvic floor muscles in men help control their bladder and bowel and assist with sexual function. They wrap firmly around the urethra, vagina, and anus, helping to keep them shut. When the pelvic floor muscles are contracted, the internal organs are lifted, and the sphincters tighten the openings of the vagina, anus, and urethra. Relaxing the pelvic floor allows for the passage of urine and faeces.
Weak pelvic floor muscles can create problems with bladder and bowel control, leading to urinary incontinence. Pelvic floor dysfunction is the inability to relax and coordinate the pelvic floor muscles to pee or poop, and its symptoms include leaking urine, painful urination, unexplained low back pain, and ongoing pain in the pelvic region, genitals, or rectum.
There are several factors that can lead to weak pelvic floor muscles, including traumatic injuries to the pelvic area, overuse of pelvic muscles, prior pelvic surgery, pregnancy and childbirth, aging, stress and anxiety, and connective tissue disorders. Additionally, ongoing or repeated straining on the toilet due to constipation can weaken the pelvic floor muscles and increase the risk of urinary incontinence. Heavy lifting and participating in high-impact exercises can also put extra stress on the pelvic floor.
Pelvic floor exercises can help strengthen the muscles and improve muscle tone and brain connection. These exercises can be done lying down, sitting, or standing, and it is important to be properly assessed to address the specific causes of weak pelvic floor muscles.
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Frequently asked questions
The pelvic floor muscles control male urination.
The pelvic floor muscles support the bladder and bowel. They help keep the urethra shut and prevent urine leakage.
When the pelvic floor muscles are weak, it becomes difficult to control the flow of urine. This can lead to urinary incontinence.
Kegel exercises are an effective way to strengthen the pelvic floor muscles. These exercises involve contracting and relaxing the pelvic floor muscles for a set duration.
It is important to focus on the correct muscles during Kegel exercises. Men should not tense their buttocks, legs, or stomach muscles. Consistency is key, and it is recommended to perform the exercises at the same time each day.
