I am going to get a little down and dirty this time, but I feel that this information could be helpful to some, this post is co-authored (he told me what to write) by the subject in question.
I have ended up with a lot of medical knowledge due to my family. My father was an Advanced Emergency Medical Technician (AEMT) and insisted that I be trained in a lot of fun things like advanced first aid, Cardiopulmonary resuscitation (CPR) for all age ranges, and more. This medical knowledge was the starting point for me looking up and expanding my knowledge with as much medical information as I could find. This knowledge combined with all of my fun experiences with doctors for personal reasons and I became the go to girl for friends asking medical advice. Most of which I follow up on “with please see a doctor.” Most of this sounds inconsequential, but it comes into play.
When a close friend of mine, in his early thirties, came to me with a medical question, I was stumped. Here is the issue as it was presented to me at the time. He was suffering with erectile dysfunction, swollen testicles, tender abdomen, prominent scrotal veins, and groin pain as well as issues with urination (not being able to). Since I had not spent a lot of time studying male issues previously, I went to the internet.
I came up with a whole bunch of issues such as Varicocele, which is swollen veins and a blood back flow, mental issues, and prostate and bladder infections. So many more options came to light when I was looking this information up, but those were the most viable options. With only that in hand, he made his appointment with an urologist. Long story short, he spent more than three months in care, including a lot of medications, such as heavy duty month long antibiotics. He was starting to think that he was crazy and the pain was in his head. In the end, the doctor sent him to a physical therapist before he was scheduled for surgery.
Men often are embarrassed by their erectile or groin issues near the ‘boys’. So much of their egos are wrapped up into that issue. They ignore the pain or try to overcome the pain only to make it worse. From listening to the physical therapists, men, and women, from all walks of life don’t talk about these issues or seek help with these issues until years later when the issue is so bad and so painful that they can hardly function. Mothers that are in so much pain that they are couch bound and can’t play with their children because if they do their groin or abdomen is killing them or they lose bladder control. Men, who can’t urinate/defecate or who do when they don’t want to, and possibly have problems in the bedroom even when they are highly aroused, don’t go to seek medical attention until the pain is debilitating. Men and women need to think of physical issues other than those seen by urologists and gynecologists. Urologists look at only physical problems with flow and structure and their specialty only, but as long as all of that is normal or within tolerance then it must need surgery or be in your head. Gynecologists only look at the ‘box’ and if it isn’t in or dealing with the vulva and cervix or related sexual organs, then it again must need surgery or be in your head. In general these specialists only look at their area of expertise, but never question or think “outside of the box” and think of the whole person. The true problem is that general practitioners, who are supposed to look at the whole person, don’t look hard enough. My friend had gone to the doctor and was tested for STDs, prostate problems or bacteria issues, but wasn’t once looked at for physical issues. Testicles were looked at, only for distention and twisting, but never was the abdominal or pelvic muscles looked at. Medicine was issued without true knowledge of what was wrong, just an educated guess. When the issue was pressed, because the patient, my friend, was still in pain, the doctor finally referred him to an urologist.
My friend at this stage was feeling lost and in pain. He had overcome embarrassment, suffered through a prostate exam, which isn’t a fun or pleasurable experience, but was still in pain. He felt, and the doctors kind of talked around the issue, that it was in his head. He then talked to an urologist and again was checked for urological issues with nuclear magnetic resonance imaging (NMRI), ultrasound, and computerized tomography (CT ‘CAT’ scan), but to no avail. The specialist was frustrated, but helpful and prescribed medicine to help with pain and erectile dysfunction, but couldn’t figure out the cause. It was alluded that this pain and sexual dysfunction may stem from mental issues or stress. My friend’s job is long and stressful, so he started thinking the urologist was right, but the one constant was that he was still in pain and it seemed to be getting worse. The urologist saw my friend again after a month, and it came down to two options, surgery or get counseling. As those two options were discussed it came to light that some patients had seen positive results seeing physical therapists. My friend was deadly afraid of surgery and didn’t truly think he was mental, even though he had questioned it a time or two, so opted to first see the suggested physical therapist.
Day one in physical therapy they discovered the issue. It wasn't his testicles, prostate, or his bladder. His hip was out and had been for a while. His hip being out of alignment messed with all of his pelvic muscles. He was so out of alignment that it interfered with his every day functions. The pain was not in his head. I went with him to his first appointment and learned a lot of horror stories. Some of those stories included men and women who ended up with surgery due to the pain and the pain didn't stop after the surgeries. A woman who had a full hysterectomy to stop the pain, it didn't help. Men who had their testicles (testes) removed, so many horror stories about what can happen when people don't look into the possibility of physical therapy first. This issue can cause incontinence in men and women as well. So many issues that people just live with that could have been fixed with a few months in physical therapy.
When I did the research, I could find nothing on using physical therapy and even less on it being a muscular issue instead of a centralized issue. So, with his permission, I decided to write this post, hopefully it can help those who are starting to have issues before those issues become worse. Women who have given birth can end up with bladder issues, some of those issues can be caused by problems with the surrounding muscles. Men, who have erectile issues before the age of 50, might need to look at old injuries that could have caused further problems. If you are experiencing any of these issues, please consult a physical therapist before you opt for the surgery, instead of ignoring the issue or thinking that the symptoms all stem from your head. Bottom line is that you need to look into seeing if physical therapy can help you before you opt for surgery or counseling.