Scott Webb: Male pelvic health is not as commonly discussed as women's pelvic health, but in both cases, physical therapists can help. And I'm joined today by Dr. Willie Kwok. He's a physical therapist with Eisenhower Health, and he specializes in male pelvic health.

Scott Webb (Host): This is Living Well with Eisenhower Health. I'm Scott Webb.

Scott Webb: Willie, it's nice to have you here today. I was mentioning to you that I've done a lot of podcasts on women's pelvic health, but this is the first one on male pelvic health. So let's just start there. What is male pelvic health and why is it important?

Willy Quach: Hi, yes, thank you for having me today. I'm Willie, a male pelvic floor physical therapist here at Eisenhower. Male pelvic health refers to the proper functioning of the muscles, ligaments, tissues, and other structures in the pelvic region. It's an important topic to me because male pelvic health is underserved compared to women's health.

Everyone thinks about pelvic floor therapy being a women's type of thing, that they face, postpartum or just like incontinence is something that they think is related to age or just women have to deal with. But, , men also have pelvic floors and so the pelvic floor is structurally important because it functions in bowel, and sexual function.

So having good pelvic health means that you're optimizing your sexual performance. your continence, , as well as dealing with your comfort and quality of life. And if these things are neglected, it can lead to issues like incontinence, chronic pain, erectile dysfunction, and other conditions.

Scott Webb: Right. Yeah. I was going to ask you, you say underserved and absolutely like your point, I've never actually hosted in the thousands, perhaps of podcasts I've hosted. I've never hosted one on male pelvic health. We always think of women, which is good, but also as you say, men have pelvic floors too. So let's just go through the common conditions.

You kind of ran through them there, but the common conditions related, you know, that men may experience. Okay.

Willy Quach: some of the more common male pelvic health issues can include urinary incontinence, fecal incontinence, chronic pelvic pain, erectile dysfunctions, ejaculatory dysfunctions. and prostatitis. They can also face things like urinary hesitancy, usually related to BPH or benign prostatic hyperplasia, urinary frequency, constipation, rectal prolapses, hemorrhoids, anal fissures, and, you know, pain in the perineal or genital region.

Scott Webb: Yeah, as you say, so there's a whole bunch of things, , signs, symptoms, things that men could experience. And you were talking about women there and the association with childbirth and pelvic floor and all of that. What are some of the causes cause male pelvic floor issues or male pelvic floor dysfunction?

Willy Quach: Some of the more common ones might include surgery or any kind of prostate procedure, whether it be for prostate cancer or to help mitigate The symptoms of BPH, and so that's one of the major populations I see is, pre and post prostatectomy. The male anatomy or the length of the urethra allows men to not really have to usually deal with urinary leakage the way, women can be more prone to that.

However, with any, procedure in that area, that may lead likely lead to urinary leakage. So, we want to make sure we're able to help these men, who probably would never have imagined they would be leaking.

Scott Webb: Yeah, let's talk about how you help, you say you specialize really in this, so how can pelvic floor therapy help in treating some of these issues?

Willy Quach: pelvic floor therapy is helpful in that we want to improve muscle function. We want to alleviate tension and promote proper the muscles. Now, For men with issues like incontinence, pelvic pain, or erectile dysfunction, physical therapy can help target specific muscle weaknesses, tightness, utilizing exercises.

biofeedback, and manual therapy techniques. So, we work on both strengthening and relaxation techniques to address the root cause of dysfunction, , aiming to improve symptoms and overall quality of life.

Scott Webb: Yeah, I feel like that's probably like the top of the list really, is the quality of life issue. You know, I drink a lot of coffee, which causes me to have to Run to the bathroom a lot because of the natural diuretic quality or properties of coffee. I, it's sort of a self inflicted wound. I just love coffee so much.

And anyway, let's talk about the benefits then, whether it's quality of life and otherwise, what are some of the benefits to meeting with and working with a physical therapist like yourself?

Willy Quach: being able to seek treatment early can prevent issues from worsening and also can, you know, lead to significant improvements in daily life. So men who undergo pelvic floor therapy often experience less pain, better bladder and bowel control, and improvements in sexual function, whether it be ability to obtain, maintain an erection, or being able to ejaculate properly.

Scott Webb: Yeah. So a lot of benefits and just. Making life easier and perhaps more pleasant and pleasurable, for men. so what are some of the misconceptions, Willie? I'm sure there are a lot of misconceptions or maybe even stigmas surrounding male pelvic health. Maybe you can sort of dispel some of them.

Willy Quach: Yeah, so we touched a bit on , a little bit of that earlier, but A common misconception is that pelvic floor dysfunction only affects women, or that men only really need treatment after like a prostate surgery or procedure. However, you know, everyone has a pelvic floor, and so I think anyone could benefit from seeking treatment for these conditions, and there's also a lot of stigma around discussing issues like incontinence or sexual dysfunction, um, in men because it's seen as embarrassing, a sign of weakness, , But, you know, these conditions are very common and very treatable.

 Seeking help doesn't mean there's anything wrong with you. It's just a part of health that should be normalized. Just like going to a cardiologist or a dentist.

Scott Webb: Yeah. I was thinking about breaking it down like physical therapist and thinking about sometimes you're probably a physical therapist, sometimes maybe just a therapist. Do you find, or maybe what are some of the techniques you use? Cause. You know, I sort of picture myself in the room and trying to explain what I might be experiencing.

And do you find that there's just a certain way that you have or the many physical therapists have that maybe it's easier to talk to you or talk to physical therapists in general about some of these things, these male, you know, pelvic floor, pelvic health issues that maybe they might, you know, have with their primaries.

Like what's your secret, I guess.

Willy Quach: I think therapists in general are really good at being able to refer the patient's needs. in the right direction. So even if you're just at a regular physical therapy appointment for your knee, if you mention you're having some bowel or bladder sexual issues, therapists are good at referring the patient to seek pelvic floor therapy.

 And you know, within seeing a pelvic floor therapist, we're very trauma informed with our care. We're very aware. That this is a sensitive topic, an area, very private, , heavily stigmatized, so we provide a safe environment for the patient, we meet them where they're at, everything is consensual we usually do evaluation at the beginning of a patient.

Your visit, which might include an external or internal exam, depending on patient comfort, consent, and appropriateness. from there we can use other techniques such as biofeedback, manual therapy. and likely, well, all the time, exercises to strengthen or relax the muscles.

Scott Webb: for sure. Right. the word I can think of as kegels, right? I sort of know what kegels are popular. It seems to come up on television and films and things like that, but I'm sure there's some other physical things that men can do to help themselves.

Right.

Willy Quach: Yeah, thank you for bringing that up. Another misconception is physical therapy or pelvic floor therapy is all about doing kegels. And while that is a good exercise that is appropriate for some patient populations, it's not, you know, for everyone. Sometimes doing kegels can worsen conditions.

So we need to Guide the patient in the correct direction, and maybe they would benefit more from lengthening the muscles, relaxing the muscles, and that usually can help a patient more with pelvic pain or difficulty voiding, , things like that.

Scott Webb: Yeah. Yeah. That's such a good point. Right. I'm glad just sort of came up and I'm glad it came up because, , we don't want folks to, you know, self diagnosing, right? So if they have to speak with their primary and then be referred to a physical therapist, we don't want them diagnosing themselves and everybody's sitting around doing kegels when they, may be doing more harm than good, right?

Willy Quach: Yeah, absolutely. So we want to be able to properly assess the muscle functioning, the coordination, and give you the appropriate exercises to meet your goals.

Scott Webb: Let's just finish up here, and this has been really educational as I knew that it was going to be. But I'm wondering, are there any lifestyle changes? You know, so many topics that I do, a lot of times comes down to sure, genetics, family history, but I don't think that's the case, you know, generally with male pelvic health.

So is there anything we can do, behavior, lifestyle, Willie, that can help ourselves , either, you know, not have to go to the office to see you or limit those trips?

Willy Quach: Absolutely. I think prevention is key. And lifestyle choices can really have a big impact on pelvic health. So doing things like staying hydrated, eating a fiber rich diet. Staying physically active and maintaining regular bowel movements can prevent issues from arising, such as constipation, , that may lead to pelvic floor dysfunction.

Also being mindful of how you lift heavy objects, avoid prolonged sitting, and managing stress overall can help maintain the strength and flexibility of your pelvic floor muscles. And to add, regarding coffee, sometimes reducing the intake of coffee,

Scott Webb: don't say that. Don't, don't say that out loud.

Willy Quach: I know, I'll whisper, um, alcohol, caffeine, you know, other bladder irritants can, also help with bladder control and comfort.

Scott Webb: yeah, it is one of those, I guess I'd sort of self inflicted wounds. I'm just like, you know, I know this third cup of coffee is going to send me to the bathroom a number of times, but I just love it. So, and it's my little will be here when I'm hosting podcasts. So, good stuff today, Willie, really helpful.

I think important to point out as we've done here today, that. public floor issues, are indiscriminate in that , men experience them, women experience them and physical therapists like yourself can help. So thank you so much.

Willy Quach: Of course, thank you so much for having me.

Scott Webb: And for more information go to EisenhowerHealth. org and search Pelvic Health Program.

Host: And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics of interest. I'm Scott Webb. And this has been Living Well with Eisenhower Health. Thanks for listening.