Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
In this segment, Donna Lee is joined by NAU Urology Specialists' wonderful pelvic floor physical therapist, Dr. Kendel Lipe for another installment of our "That's What She Said" series. Dr. Lipe explains what a pelvic floor physical therapist does and some of the many benefits urology patients can gain from PT, including relief from incontinence; pain with penetration, erection, and/or ejaculation; premature ejaculation; erectile dysfunction; and myofascial pain. Dr. Lipe uses biofeedback to help patients take back control of their nervous system, which regulates so many of the bodily functions we take for granted...until they don't work! Importantly, Dr. Lipe emphasizes that pelvic floor PT doesn't have to be uncomfortable or embarrassing. In an average of 4-6 sessions, patients can learn to tune into their bodies and reduce or eliminate the symptoms that brought them in. If you or someone you love is suffering from any of the issues discussed in this segment, or if you think you might benefit from consulting a pelvic floor physical therapist, please give us a call today!
If you enjoyed today’s episode, don’t forget to like, subscribe, and share us with a friend! As always, be well!
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Speaker 1:
Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Donna Lee:
Welcome to the Armor Men's Health Hour today. We have our fabulous Dr. Kendel Lipe. Welcome Dr. Lipe.
Dr. Lipe:
Thanks.
Donna Lee:
Dr. Mistry stepped away so I'm going to take the reins on this one, but you can reach out to us(512) 238-0762 during the week. Our email address is armormenshealth@gmail.com. You can send Dr. Lipe all the questions you'd like. She's our pelvic floor physical therapist, along with Dr. Angela Treadway. And you can also visit our website at armormenshealth.com. We have two amazing pelvic floor physical therapists: Dr. Lipe, who's here today. Dr. Treadway, you can also Google her podcasts and other podcasts that we've done with her. We like to continue a series that we call"That's What She Said," and so we'd like to feature our special guests, surgeons in town and specialists and primary care physicians, but also our own providers within NAU Urology Specialists. This is the Armor Men's Health Hour, probably listening to a podcast. And if you're on the other side of the world, that is really cool and please reach out to me at armormenshealth@gmail.com. We have locations in round rock in North Austin, South Austin, and Dripping Springs, Texas Dr. Kendel Lipe, thank you for coming in today!
Dr. Lipe:
It's great to be here again.
Donna Lee:
You know, I was thinking about you earlier. I, until I started with this group, I had never even heard of pelvic floor physical therapy. Like I didn't know until I started, when I started here, I was like,"Oh, well, that's kind of cool. What do y'all do?" So I thought it'd be kind of fun to talk about what you do, especially for new patients, how you treat patients, what an initial evaluation looks like, how much time you spend with the patients, what diagnoses are that patients have when they come in to see you welcome...let's start talking. What is pelvic floor physical therapy?
Dr. Lipe:
I actually get that question from pretty much everybody, including a lot of healthcare professionals. I feel like a lot of people just don't know we exist. But you know, first and foremost, we're physical therapists. So we're trained in everything that your traditional physical therapist is. And then we have to go to a lot of specialized training to learn more about how to work with the muscles of the pelvic floor, which are the muscles that kind of form the sling across your hip bones. And they hold all of your organs, including your bowels, your bladder, all sorts of organs. They form a really important part of your core. And so the pelvic floor muscles specifically can really affect a lot of bowel, bladder, sexual dysfunction, low back pain, to name a few. I'm sure we'll get into more in a minute, but...
Donna Lee:
So you're saying it's kind of important?
Dr. Lipe:
It's just a little important. I always say, I love to do this because if you help someone in this field, you're really helping them like a really core important part of them.
Donna Lee:
That's really intense. I can't imagine one thing holding that many things. So your body is such a magical place. Anyway, keep going.
Dr. Lipe:
It really is. And it's all interconnected. I always remind patients, yes, I'm a pelvic floor PT, but like I said, I'm also a PT and I really combine all the different trainings. I have actually an undergrad in engineering. So I'm always looking at the mechanics of the whole human body and how it impacts each other. I have some training in myofascial release and scar tissue release, which I'll use a lot.
Donna Lee:
What's what's myofascial for the people who don't know?
Dr. Lipe:
Yeah. So myofascial release is addressing specifically the connective tissue in the body. So it's using slightly different pressures and techniques to address your fascia, which is also just a tissue that surrounds literally every organ, every artery and nerve passes through it. It's like this living cobweb and your body. If it has the adhesions in it, it can exert up to 2000 pounds of tensile force on any force on any structure going through it. And a lot of people don't think about it really impactful.
Donna Lee:
Wow. Never thought about it. That's kind of important too. Anyway, continue. Sorry.
Dr. Lipe:
I'll use techniques called a microcurrent point stimulator. So it's this pain-free little current device that can help to free up adhesions and scar tissue. We use biofeedback to actually tell us how the pelvic floor muscles are working in conjunction with things like your diaphragm--another muscle people don't really think about that helps you breathe, but has to be coordinated with your abdominals and also with your pelvic floor. So there's a whole lot of things that we can look at and kind of tailor to each patient, what they need and what they're comfortable with, too.
Donna Lee:
Gotcha. And how many years training do you have to become a pelvic floor physical therapist? Like a hundred?
Dr. Lipe:
It feels like that sometimes. So my engineering degree was five years after high school. And then my doctorate degree was three years of physical therapy. And then since then, then just a lot of specializing under, under some really expert PTs in the country and then taking a whole lot of continuing education courses to understand this very complex system a little bit more.
Donna Lee:
Right. Well, I know you and Dr. Treadway are always taking those extra courses and to stay on top of new ways of doing things. Let's talk about, for the, especially the newer patients who are learning more about pelvic floor, physical therapy, what are common things that you treat? You treat a lot of men in our clinic and a lot of women. I think when people think of pelvic floor physical therapy, they think of women. So...
Dr. Lipe:
Yeah, pre/postpartum is where a lot of people's brain go, which is very important and a big part of what I do, but definitely not all of it.
Donna Lee:
Gotcha. Well yeah, let's talk about that. What do you treat in men and women more commonly.
Dr. Lipe:
Okay. In both genders or all genders, I treat incontinence often and pain with sex. And so those can look a little bit different between male anatomy and female anatomy, but I treat them very similarly often, so that can look like for females, it can look like pain with penetration or pain with deep penetration or right at the insertion. It can just be fear associated with sex. It can be difficulty orgasming. For men or male anatomy, it can often be painful or pain with erection. Sometimes it's just a discomfort. Also treating for those with male anatomy, a lot of premature ejaculation and erectile dysfunction. A lot of people don't know that we can help quite a bit with that the end of the day.
Donna Lee:
Yeah. I haven't really, I don't think we talk about that enough. So say that again. You can help premature ejaculation and erectile dysfunction. Okay. Well, that's why it makes sense that you're in the urology clinic.
Dr. Lipe:
Exactly.
Donna Lee:
Along with those other things.
Dr. Lipe:
Yeah. It's just a blood flow issue at the end of the day, right? And the nervous system control. So I do a whole lot of things with pretty much all my patients about controlling the nervous system, how that interplays with everything.
Donna Lee:
Gotcha. And I know you treated a lot of patients with trauma, like car accidents or sexual tragedies in their past from 10, 20 years ago.
Dr. Lipe:
I do. You know, trauma as much as it's a psychological issue is also a physiological issue. And our bodies do a really great job of holding on to things for us that we can't handle or escape at the time. That can look like big huge traumas, like a car accident, sexual trauma, physical trauma. It can also look like microtraumas over a lot of time. And I have done a lot of extra training in that too, to try to understand really how the body holds onto that and using different techniques to, whether it's breathing or mindfulness or specific types of massage techniques that can kind of help the patient and their body to release that trauma and truly heal from the source of it. Because that trauma, what I've found is patients will come to me with something totally unrelated that they don't think has anything to do with that trauma. And oftentimes that ends up being kind of the last little thing that we need to get to the root of to treat it.
Donna Lee:
Gotcha. That's interesting. So, and then tell us more about more things that you treated men and women.
Dr. Lipe:
Okay. Let's see. So I mentioned pain, um, sometimes just difficulty penetration for those with vaginas and rectums can be something that I'm treating. So you can use dilators and get you set up on a program there, use some gentle stretching techniques. Let's see, low back pain and sacroiliac joint pain, tailbone pain--those are all things that I often see and can help treat. Actually infertility is one that a lot of people don't know about that pelvic floor PT has been proven to help with women, and there's some new studies that are showing that we can help with men, I personally have seen that we can help with men at times with fertility. It can be a pretty affordable treatment to, to try for those really important issues.
Donna Lee:
That's awesome. I didn't think of that either.
Dr. Lipe:
Again, it's kind of flow...
Donna Lee:
I need to talk to you more often.
Dr. Lipe:
...and blood flow and muscle tension. If those muscles are tight, things don't get through, like they should. And that connective tissue again is hugely important. Also just reconnecting patients with that part of their body and making them feel like it's part of them and it's whole and important and loved again, as weird as that sounds is really important.
Donna Lee:
Right? And it's not some foreign place it's just attached to them. You're connecting all of their, their parts back together.
Dr. Lipe:
Exactly. Exactly.
Donna Lee:
We'll have to do a whole segment based on fertility. But anyway, well, let's talk about the initial evaluation. How many times people typically come to see you?
Dr. Lipe:
Yeah. So I think a lot of the fear people have is just around what is the initial eval hold and what are these sessions going to look like? So first thing I always say is we don't need to do anything that you're uncomfortable with. In the first session, I often just spend getting to know you and what, you know, what do you think has caused this? What are your different symptoms? How is this impacting your life? And so we just talk and get to know each other for a long time. And then I'll do a whole body postural assessment. It'll look a lot like other PT if you've gone to it. Looking at your hips, your back, how you breathe, general levels, neck and headache--all of that, that all ties in. And then, if the patient's comfortable, I will do an assessment of the genital region. So on those with female anatomy, you know, looking a little bit at the external genitalia and actually looking at the muscles through the vagina. It's a really amazing way to access those internal pelvic floor muscles on those with vaginas, and it is not uncomfortable, it does not need to be uncomfortable, and it's also not necessary at the first visit or even ever. And then for men at the first assessment, it's almost always external. So, and I always tell men, I think they come in assuming everything's going to be internal, and that can be very, very helpful. But I actually rarely ended up needing to go there with men because I find once we tie them in with their body and get them controlling and relaxing the muscles, and I use some external techniques to just get everything, to relax, they don't actually need that.
Donna Lee:
Awesome. So typically you'll see a patient several times?
Dr. Lipe:
Yeah. So...
Donna Lee:
Four to six maybe?
Dr. Lipe:
Four to six is average, but I really always hesitate to give that. Some patients are okay to, and for those that have had longer, more chronic pain and trauma, or just may have a little bit more going on, it can take a little bit longer.
Donna Lee:
Awesome. Well, thank you so much for sharing all that. I think especially our new patients will benefit from that. I certainly did. I didn't know some of that. So, like I said, I will be talking to Kendel in the hallways more often to learn more about our amazing services. You can call us at(512) 238-0762. And our website is armormenshealth.com. And thank you so much again, Kendel. We appreciate it.
Dr. Lipe:
Thanks, Donna.
Donna Lee:
Alright, bye bye.
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The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at farmer men's health, ed gmail.com.