Bladder & bowel problems
Urgency, leaks, a poor urine stream, constipation or difficulty emptying your bladder or bowels — common, rarely talked about, and often very treatable with specialist pelvic floor rehabilitation.
What it is
Bladder and bowel problems are far more common than many men realise, yet they are often accepted as something you simply have to live with. Whether you’re experiencing urinary frequency, urgency, leakage, difficulty emptying your bladder, constipation or bowel control problems, specialist physiotherapy may be able to help.
At Birmingham Men’s Health Physiotherapy, Gerard Greene and his specialist team regularly assess and treat men with a wide range of bladder and bowel conditions. Every assessment is tailored to identify the underlying factors contributing to your symptoms, allowing us to develop an individualised treatment programme designed to improve control, confidence and quality of life.
You don’t have to accept bladder or bowel symptoms as a normal part of ageing. With the right assessment and treatment, many men experience significant improvements and regain the confidence to get back to everyday life.
You're in the right place if…
You’re in the right place if you recognise any of these — and you don’t need to have all of them.
- A sudden, urgent need to pee that’s hard to defer
- Leaking urine — on the way to the toilet, when you cough, or after finishing
- Going to the toilet very frequently, day or night
- A weak, hesitant or stop-start urine stream
- A feeling of not emptying your bladder fully
- Incomplete bowel emptying
- Constipation, straining, or difficulty controlling wind or bowels
- Planning your day around where the nearest toilet is
Why does it happen?
Healthy bladder and bowel control depends on a pelvic floor that can both tighten and fully relax at the right moments, working in coordination with the bladder and bowel. When those muscles are weak, overactive or poorly coordinated, control suffers — which is why symptoms as different as leaking and difficulty emptying can share the same underlying cause.
It can follow prostate treatment, surgery, long-term straining or constipation, or simply years of habits that trained the system unhelpfully. The good news is that coordination and control can be relearned — which is exactly what treatment sets out to do.
How we help
We start with a careful, respectful assessment of how your pelvic floor, bladder and bowel habits are working, so we can explain clearly what’s behind your symptoms rather than leaving you guessing. For many men, simply understanding the cause is a turning point.
From there we build a practical retraining plan: strengthening or, just as often, learning to relax the pelvic floor properly; bladder and bowel retraining to calm urgency and improve emptying; and the everyday adjustments — fluids, habits, toileting technique — that make a surprising difference. It’s structured, achievable, and reviewed as you improve.
What your journey looks like
Most men see meaningful improvement with a clear, consistent plan — and knowing the steps makes it feel manageable from the start:
- An honest, private assessment. We map out exactly what’s happening with your bladder, bowel and pelvic floor — no embarrassment, no rush.
- A plan that makes sense. We explain the cause and set out a practical retraining programme tailored to your symptoms.
- Steady progress. Simple, achievable steps in clinic and at home, reviewed and adjusted until you’re back in control.
The questions men actually ask
How do you examine the Pelvic floor and Is this going to involve an internal examination?
Ultrasound Imaging of the Male Pelvic Floor
Initially we examine your pelvic floor externally with ultrasound imaging. This is done on the lower abdomen and also the perineum . It allows us to look inside but stay outside. It also in the words of my brilliant Ultrasound Colleague Dr Alime Buyuk, "Makes the invisible visible". We always start with ultrasound imaging to explore the pelvic floor and this is included in the appointment cost.
Perineal Assessment
We also examine the pelvic floor through outer perineal palpation or gentle pressure .
Internal Pelvic Floor Assessment
With many patients it may also be necessary to examine the pelvic floor because it’s the most direct way to assess the pelvic floor . Gerard and his team are very skilled at this and we can do it gently and sensitively in a way that involves you and is well explained to you. It is only ever done with your explicit consent, fully explained first, and never forced.
Is it embarrassing to talk about?
Not here. We help men with exactly these issues every day, in a private one-to-one setting, and treat them as the ordinary medical matters they are. There’s nothing you can tell us we haven’t heard before.
How long until I notice a difference?
Many men notice change within a few weeks of consistent work, though it depends on the cause and how long symptoms have been present. We’ll give you a realistic timeframe after assessing you.
You don’t have to live with this
If any of the above sounds like you, the next step is simple. Ask us anything in confidence — no pressure, and no obligation to book.
Ask Gerard a question in confidence