Frank's Story*
Step 1
Frank discovered what mattered
Frank (he/him) is a 65-year-old semi-retired engineer referred by his Urologist. He was waking 4-5 times every night to urinate and was rushing to the toilet during the day. Frank was also experiencing erectile dysfunction that was affecting his marriage and self-confidence. He'd been putting up with his symptoms for years, assuming they were just "part of getting older." He was exhausted from broken sleep and had stopped initiating intimacy with his wife entirely, feeling like less of a man. Working together, we discovered that Frank's pelvic floor muscles were weak with poor control. His bladder habits and evening fluid intake patterns were contributing to his nocturia and worry about having to rush to the toilet and performance anxiety contributed to his erectile issues. His poor sleep was affecting everything - his energy, his mood, and his libido.
Frank's Pelvic Health Goals:
- Wake only once a night - I'm so tired I can barely function.
- Stop worrying about rushing to the toilet and wondering where all the toilets in Melbourne are.
- Have the energy to enjoy life - play golf and travel with my wife
- Feel confident about getting and maintaining an erection and enjoy intimacy with my wife again without worrying or making excuses.
- Return to feeling like myself - not like a tired old man.
Step 2
Frank restored what mattered
Frank committed to pelvic floor and abdominal muscle training daily, using transperineal ultrasound biofeedback to see his muscles working for the first time. He embraced bladder retraining strategies, reduced his evening fluids and ensured he drank adequately during the day. Learning how to ride the wave of urgency was helped by breathing exercises and relaxation techniques that calmed his nervous system and reduced anxiety around bathroom use and intimacy. Sleep optimisation improved his rest quality – but his reduced nighttime urination had the biggest impact. Education about male sexual function helped Frank understand that his weak pelvic floor, performance anxiety, and fatigue were major contributors to his erectile dysfunction - not just aging.
Step 3
Frank enjoyed what mattered
After 6 months, and 5 consultations, Frank was waking only once per night, his bladder emptying had improved dramatically and his energy returned. Most significantly, his sexual function improved substantially - his erections were stronger and he felt confident initiating intimacy again. He and his wife reconnected, and Frank said it felt like they were "dating again." Three months later, they went on their long-postponed trip to Europe.