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Happy Pride Month! Let’s Talk Treating & Examining Males
By: Nataliya Zlotnikov, HBSc, MSc

The Many Celebrations of June (In July)

June is a month in which we celebrate and pay homage to a few profoundly important subjects (even though we are publishing this blog in July).

National Indigenous History Month, Pride Month and perhaps the little less known, Men's Health Month

In today's blog, we will not be addressing Indigenous History Month. This subject deserves a complete blog and much much more, and we will not do it justice by speaking about it in brief. 

This blog will however touch on Pride Month and several issues related to men's** health.

The health content of today's blog is derived from Dr. Holly Herman's very entertaining and informative online healthcare course on Embodia, Highlights of Examining and Treating Males

**We understand that the binary terms male/female and men/women are imperfect concepts and don't accurately reflect the diversity of gender-diverse individuals' bodies or identities. In the absence of more appropriate terminology, these terms are used here when necessary.   

Brief History of Canadian Pride

2021This year Pride Toronto celebrates its 40th anniversary. Happy Anniversary, Pride!! You've come a long way. 

To all those, both present and past, who have championed this cause over the past few decades, thank you. Your unrelenting efforts have brought the LGBT2Q+ community to where it is today.

In light of this event, we decided to bring you a brief timeline of notable events in Canadian Pride history.

A more complete timeline can be found here

Male Anatomy Review

As I mentioned above, I find Dr. Herman to be a real pleasure (and riot) to listen to. I wanted to give you all the pleasure of listening to her speak (in case you have not yet had that pleasure). So whenever I could, I put in little video tidbits from her course. I had to exercise some restraint and stop at 2. 

Here is the first little snippet of Dr. Herman discussing the male anatomy. 

Click Here for the Full Course

 

About The Course:

This online physiotherapy course highlights important issues to cover when examining and treating males.

This course is a highlight course and therefore does not delve too deeply into the topics, however, it does provide an excellent overview and is an excellent place for clinicians to start.

Some specific topics in this course include:

  • Pre and post-prostatectomy
  • Erectile dysfunction
  • Premature ejaculation
  • Peyronie's disease
  • Hard/flaccid conditions
  • Testicular pain
  • Ejaculatory pain
  • Urinary frequency and retention
  • Constipation
  • Anal fissures
  • How orthopedic impairments throughout the body can influence these conditions
  • And more

 

Testicular Pain, Football, Rockclimbing & More  

Now, that you know what's in the course, let's briefly discuss a few of the above topics starting with testicular pain.

Chronic scrotal or testicular pain is found in up to 4.75% of men, yet there is little written about its impact on quality of life (Aljumaily et al., 2017) or even about the subject itself. A PubMed search for "chronic scrotal pain" yields only 318 results.  

As physiotherapists, there is so much that we can do to help persons suffering from testicular pain. 

Here is another snippet from the course in which Dr. Herman discusses football, rock climbing, testicular pain and more. 

Tucking: What Is It and How to Do It Safely

Switching our gears a little, let's discuss tucking.

What is tucking?

Tucking is defined as ways one can hide the penis and testes, such as moving the penis and scrotum between the buttocks or moving the testes up into the inguinal canals. 

Tucking can lead to some painful problems because of the suspensory ligament.  

The suspensory ligament is highlighted in the image below:


Image source: Mayo Clinic

Why? Well, you can visualize that tucking can pull on the suspensory ligament and lead to quite a bit of injury.

When palpating, you want to palpate for that and there should be no pain or discomfort.

Beyond palpating, we can also provide education and teach how to tuck safely.

Here is a wonderful resource that I stumbled upon from the Gender Clinic of the Doernbecher Children’s Hospital in Portland Oregon which discusses safe tucking and provides some local as well as online resources.  

Click Here to Continue Learning With Dr. Holly Herman

 

The Prostate, Its Really Important

Back to anatomy 101.

What does the prostate do?

"The prostate’s most important function is the production of a fluid that, together with sperm cells from the testicles and fluids from other glands, makes up semen.

The muscles of the prostate also ensure that the semen is forcefully pressed into the urethra and then expelled outwards during ejaculation." (NCBI, 2020).

Those are big roles!

Look below! It's the important gland for a refresher:

Image source: WebMD

Prostatitis: What Happens When Things Go Wrong?

Prostatitis, along with prostate cancer and non-cancerous prostate enlargement make up the three most common forms of prostate disease (Better Health Channel, 2020). 

Let's talk prostatitis, what is it?

Prostatitis refers to four different conditions that affect the prostate gland

Men with prostatitis may have infection, inflammation and/or pain. Adult men of any age can get prostatitis (Cleavland Clinic, 2021).

Classifications of Prostatitis

There are 4 classifications of prostatitis:

  • Category I: Acute bacterial 
  • Category II: Chronic bacterial
  • Category III: Chronic prostatitis/chronic pelvic pain syndrome (CPPS)
  • Category IV: Asymptomatic

Learn More About Prostatitis With Dr. Holly Herman

 

Climacturia

Let's discuss yet another prevalent yet often under-discussed issue affecting male health - climacturia. 

Climacturia is defined as orgasm-associated urinary incontinence. It often affects men following prostatectomy (partial or complete removal of the prostate).

"Reported prevalence rates of climacturia, reveal a great variability, ranging between 15.7% and 93%. This wide range could be attributed to the lack of a standardized and validated assessment method for climacturia diagnosis and also in the variability" (Mykoniatis et al., 2021).

Often, males feel very nervous and anxious about it. 

But guess what, physios can help!

Physios for Climacturia

It has been found that men who underwent a 3-month pelvic floor muscle training (PFMT) program saw greater improvements in climacturia and erectile function compared to men who received no treatment.

Additional Resources

Here is a great patient resource from the International Society for Sexual Medicine containing excellent up-to-date information on various sexual health conditions (both male and female). 

This resource is an excellent tool for clients and clinicians alike. 

More Courses & Blogs 

If you'd like to see more courses on the subject, take a look at 

CPA Congress 2021 Opening Keynote Presentation - Two-Spirit Resilience: The James Makokis Story with Dr. James Makokis 

and Cultural Competencies in Pelvic Health

You can also read our blog about this course, LGBTTIQQ2SA and Cultural and Religious Competencies in Healthcare

Thanks for Stopping By

Thank you for joining us today!

What better way to finish off today's blog than an entertaining video about what gay guys think about vaginas. 

Pride Season (not month) actually spans June-September in Canada.

Happy Pride Season, Canada!

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Date written: 23 June 2021
Last update: 1 July 2021

Pelvic Health Solutions

Pelvic Health Solutions (PHS) is an evidence-based teaching company that aims to educate and empower physiotherapists, healthcare professionals, and everyday people about pelvic health. PHS was founded in 2010 out of the need to develop pelvic health resources in Ontario at a time when it was an under-serviced health concern. PHS provides continuing education courses, mentoring, and clinical resources for a variety of practitioners with the goal of equipping them to deliver evidence-based, biopsychosocial assessment and treatment of pelvic health problems in our province and abroad. Our company also exists as a way to connect people experiencing pelvic health concerns to pelvic health physiotherapists in their area. PHS has ultimately blossomed into a community of curious people who are committed to providing hope and healing to those who suffer from pelvic health issues.
Dr. Holly Herman
DPT PT MS OCS WCS BCB-PMD IF CSC PRPC
Dr. Hollis Herman (Holly) has been a physical therapist for 43 years. Her passion is Women and Men’s Health including LGBTQAI community. Holly is board certified as an Orthopedic, Women’s Health, Biofeedback Specialist and Pelvic Rehabilitation. Holly is an AASECT certified Sexuality Counselor and an ISSWSH Sexuality Fellow. She has pioneered physical therapy evaluation and treatment of problems that involve orthopedic, urologic, colorectal, obstetric, gynecologic, reproductive and sexual medicine. She maintains a vibrant private practice, HealthyWomen HealthyMen HealthyPeople, in Cambridge, MA, seeing patients in addition to training thousands of health professionals in these areas worldwide. Holly has authored numerous books, book chapters and peer reviewed articles. She has received many grants and awards for her dedication and clinical excellence in physical therapy. Holly co-founded the Herman & Wallace Pelvic Rehabilitation Institute in 2005, though, no longer affiliated. Her present courses through HWHMeducation can be viewed on hollyherman.com and facebook.com/HWHMeducation/ Holly believes all patients deserve the right to be validated, educated and empowered so that they can live healthy, functional, active lives.

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