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Urology  (Expert Forum)
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Role of pubococcygeus muscle in urination?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Role of pubococcygeus muscle in urination?

by jaredxp, May 01, 2007 12:00AM
I'm 37 yo male.  I had abdominal pain 2 wks ago I thought was a workout muscle strain but my doc said its Epidytimitus and gave me Cipro. A few days after,when still working out lightly, the pain got worse and moved from my abdomen to both sides of my lower back and I also had a pain shooting up to my abdomen from both sides of my testicles. Pain occured randomly. After a week plus of no improvement went to a Urologist for new opinion and also to have frequent urination, weak stream, and dripping checked out again since it was 8 years ago I saw a urologist about this issue. At that time doc did prostate milkings, scope up my urethra but couldn't come up with an explanation and I was told to just live with it.   The new urologist said my prostate was normal and my epidytimus were no longer tender, no explanation for pain.  He said urination issues maybe due to bladder hood thickness.  I was in hottub Sunday and  suddenly felt a mild muscle strain going across my entire abdomen and pelvis down to either side of my testicles.  I thought this might be cause of unexplicable pain I was experiencing on and off in my lower back and testicles.   Can a muscle strain mask itself for several weeks like this or is this unusual??? Out of hottub I started to massage abdomen and pelvis to ease strain.  I also started to massage my perenium because throughout this 2 week period of pain I felt like it was very tight/immobile.  I felt my bladder relax and kegal muscle.  Later I had sex with wife and after my pubococcygeus muscle felt incredibly limber all of a sudden. I can't recall when it felt so loose b4.  For the last few days I've noticed my stream is pretty strong. I'm also able to hold my urine for longer periods.  I feel like I am on to something big but I want to know if this is plausible, that a tight pubococcygeus has somehow been responsible for urinary probs? What role does the pubococcygeus muscle serve in urination?  
  

by Kevin Pho, MD, May 02, 2007 12:00AM
It can take several weeks of a muscle strain to fully heal.  It seems that a comprehensive evaluation has already been done by the urologist, including the cystoscopy and prostate massage.

You can consider a mass or abscess leading to the symptoms.  A transrectal ultrasound can image the prostate, and a pelvic CT can provide further imaging of the area.  

If the tests remain negative, perhaps strengthening the pelvic floor muscles can be considered.  The pubococcygeus muscle can be found within the pelvic floor and influence orgasm and urination.  Any weakening can certainly affect urinary stream.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
Member Comments

by jimbo21, Mar 25, 2008 09:29PM
A related discussion, Role of pubococcygeus muscle in urination was started.
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