Men´s health (FS-08)

Hodges P¹, Milios J², Jones R³, Greene G⁴, Nwankwo S^5
1University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia, ²University of Western Australia, School of Sport Science, Exercise & Health, Perth, Australia, ³University of Southampton, Physiotherapy, Southampton, United Kingdom, ⁴Coventry University, Physiotherapy, Birmingham, United Kingdom, ⁵University of Nigeria, Medical Rehabilitation (Physiotherapy), Enugu, Nigeria

Learning objectives

1. To launch Men´s Health as a discipline within the global physiotherapy community to parallel the increased awareness of prostate cancer, urinary incontinence, sexual dysfunction and chronic pelvic pain in men.
2. To reconsider the biomechanics and neurophysiology of male pelvic floor function and dysfunction with emphasis on urinary incontinence, erectile dysfunction and pelvic pain syndrome including assessment and treatment.
3. To help create a world where men feel comfortable to seek guidance and treatment for male health issues by physiotherapists knowledgeable in the area through consideration of educational pathways in Men´s Health.

Description

Men´s health is a global issue. It involves diverse conditions including a variety of continence disorders, sexual dysfunction and chronic pelvic pain. There is growing awareness of the potential role of physiotherapy but there are challenges. Recent reviews have questioned the efficacy of physiotherapy for post-prostatectomy incontinence. Assessments, treatments and knowledge cannot be directly applied from Women´s to Men´s health. Individual presentations are unique and there is an urgent need for specific measures that can guide treatment. A major impediment to progress is lack of clarity of mechanisms of function/dysfunction in males.This session will draw on the latest evidence from basic to clinical science to provide guidance for progress of the physiotherapist´s role in Men´s Health.

Professor Paul Hodges will use evidence from studies using novel measurements to provide a new understanding of male pelvic floor anatomy and integrated functions. Through innovative electromyography (Stafford et al. 2012) and transperineal ultrasound imaging (Stafford et al 2012, 2013, ), this work is changing the understanding of continence in healthy men and how this changes in post-prostatectomy incontinence. Per anum examination of pelvic floor muscle function is unlikely to optimally assess and rehabilitate muscle function when urinary continence is the goal (Stafford et al. 2015). Physiotherapists can apply assessments and new understanding to targeted treatments.

Jo Milios, a PhD candidate, will introduce Men's Health Physiotherapy from both a clinical and research perspective. Her discussion on quality of life issues in men diagnosed with prostate cancer - continence (Nahon et al 2011), erectile dysfunction (Telekon 2013) and Peyronie's Disease (Chung et al 2014)- will also include novel non-invasive assessment and pelvic floor treatment options based on physiological function.

Dr Ruth Jones will draw on her advanced research, clinical expertise (Chaitow, Jones, 2011) and public health advocacy to discuss innovations in management of chronic pelvic pain, urinary and sexual dysfunction in men.The contribution of physiotherapists to these conditions has enormous potential with RCTs show promising outcomes on both pelvic pain (Dornan 2012 ) and erectile function (Dorey et al 2004).

Physiotherapist and Educator, Gerard Greene will highlight the benefits of Social Media in #globalPT education and communication, drawing from his WCPT15 experience and the establishment of Women's Health Physiotherapy Facebook group which has linked >4000 Physiotherapists globally. The Men's Health Physiotherapy Facebook group has since developed and facilitated peer support, mentoring and educational opportunities across a global network. Gerard will also discuss his experiences of establishing a Men´s Health Physiotherapy service and the challenges involved.

Physiotherapist Somto Nwanko, will share his experience working in Men's Health in Nigeria, which he describes as 'non-existent'. The lack of education in Prostate Cancer has led to late diagnosis of the disease and resulted in high mortality rates. Also home to 9% of the world's HIV patients, Nigeria lost more than 210 000 people through HIV related illness in 2013. Somto is a face of the future and aims to help improve the health of the most male-dominated and populous African nation.

Implications / Conclusions

Men´s Health is 30 years behind Women´s Health. International physiotherapy organisations are considering recognition of Men´s Health as a special interest area of the profession. Research and clinical practice is refining the understanding of function and dysfunction. This session will discuss the current state of the evidence base and new innovations that have the potential to make major impact in this emerging field of physiotherapy expertise.

Keywords

1. Men's Health
2. Physiotherapy
3. Education

Funding acknowledgements

National Health & Medical Research Council of Australia; Australian Research Council

Relevance to physical therapy globally

Men’s health is an area of global importance – >40% of men report continence issues; sexual dysfunction and pelvic pain are also prevalent. There is increasing global interest in the role of physiotherapy in this domain, to the extent that many international physiotherapy special interest groups that represent “women’s health” are considering a name change to embrace the inclusion of “men’s health”. It is critical to consider/reconsider the optimal path for physiotherapy in this domain.

Target audience

Physiotherapists who treat men’s or women’s health, managers or educators of therapists; physiotherapy researchers and policy makers keen to fill a gap in global health.

Programme subject to change