03/26/2026
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👨⚕️ Are you a male patient seeking treatment in Central Texas?
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This week, a male patient told me he stopped seeing another therapist because she told him he simply needed to “hold it longer” when urinary urgency came on.
He already struggles with urinary leakage. When urgency hits, he feels horrified and embarrassed if leakage occurs. Being told to just push through and hold it longer felt unfeeling, frightening, and dismissive. To him, it sounded like the therapist didn’t understand what he was experiencing at all.
Urge deferment can be a game changer for some patients.
But for others, it should not be the starting point.
If a patient has elevated pelvic floor tone, poor pressure management, or a nervous system already on high alert, telling them to hold longer can increase fear, tension, and symptoms. In those cases, we need to start with downtraining, breath, safety, and coordination first.
Treatment is not one-size-fits-all.
Sequence matters.
And how we communicate matters just as much as what we prescribe.
When patients feel heard and safe, progress follows.
https://www.alcoveeducation.com/diving-into-the-male-pelvic-floor-online1705425225258