man wearing a sweatshirt and jeans sitting in a green chair

Did you know the penis is just a muscle?

Did you know Viagra works just by relaxing this muscle?

How the penis and its supporting muscles contract and relax can affect erectile function, orgasm, ejaculation, and urination.

We’ve all experienced how it feels when muscles are too tight or too weak and become sore and painful. If you’ve ever received a shoulder massage, you have “felt the burn” when a tense muscle gets pressed on.

Breaking this down a bit more, the penis is a type of muscle called smooth muscle, which means it’s under the influence of the fight or flight system called the autonomic nervous system.  For example, if you are running away from a tiger in the jungle, it would probably be pretty hard to get an erection. Unfortunately, we don’t have complete control of the penis muscle itself.

However, the muscles that surround the penis and the pelvis are skeletal muscle, the type of muscle we have control over. These skeletal muscles can be trained, strengthened, and assessed just like if you needed rehab on your shoulder or hip.

Did you know there are physical therapists who specialize in the muscles of the penis and pelvic floor? Seriously! Your pelvis is a bowl full of muscles and problems with these muscles are very common.

These pelvic floor physical therapists can help with urinary incontinence, urinary frequency, urgency, constipation, and pelvic pain.

There is even evidence out there that says pelvic floor physical therapy helps men with erectile function, ejaculatory function, and other sexual issues.

But not all pelvic floor physical therapists are trained in these specialized techniques.

So I set out to change that, along with Dr. Jessica Probst, an incredibly talented, evidence-based and cutting-edge pelvic floor physical therapist and owner of Thrive Again Physical Therapy in Washington, DC. Dr. Probst and I hosted an advanced course for physical therapists to help them develop a better understanding of treating the pelvic floor to help men with erectile dysfunction and pelvic pain.

Physical therapists came from all over—including Richmond, Baltimore and as far away as Massachusetts—for this advanced training. To provide hands-on experience for our physical therapists, we brought in male patients who have had incredible success with pelvic floor physical therapy.

Many doctors know how to treat the symptoms of erectile dysfunction. We use pills, injections, vacuum erection aids, and surgically implanted penile prostheses. I prescribe these treatments often, but I also believe strongly in diagnosing the underlying cause of sexual dysfunction and working in a multidisciplinary fashion to find ways that we can fix the underlying problem.

After all, the penis is just a muscle.

Course Directors

Rachel S. Rubin MD Urologist and Sexual Medicine Specialist

Jessica Probst PT, DPT, MTC, PRPC  Thrive Again Physical Therapy & Wellness

Male Pelvic Pain and Erectile Dysfunction Course on September 28, 2019


9:00-9:15       Introduction to male pelvic pain/ED (Dr. Jessica Probst)

9:15-9:45       Physiology and pathophysiology of erections and erectile dysfunction, treatment of erectile dysfunction (Dr. Rachel Rubin)

9:45-10:15     Male pelvic pain (Dr. Rachel Rubin)

10:15-10:30   Male pelvic floor anatomy and the role of the pelvic floor in male sexual function (Dr. Jessica Probst)

10:45- 11:00   Lab 1:  Palpation and manual technique warm-up (therapists will practice on each other to warm up)

11:00-11:30    Lab 2: Locate the bulbospongiosus, ischiocavernosus, superficial transverse perineal muscle, obturator internus externally and feel for contractions

11:30-11:45    Lab 3: Treatment techniques for OI (externally), ischiocavernosus and  bulbospongeosus in basic and alternate positions

11:45-12:15    Lab 4: Internal rectal assessment in supine with focus on anterior portion of puborectalis and OI

12:15- 12:45   Lab 5: Advanced manual treatment techniques and strategies

1:00-1:30        Case studies and Q&A with Dr. Jessica Probst and Dr. Rachel Rubin

1:30-1:45        Post-test and course evaluations

African American couple smiling with beverages and soft pretzels

If you or a loved one has an enlarged prostate known as benign prostatic hyperplasia (BPH), you are well aware of the negative effects it can have on your life, such as difficult or frequent urination. Maybe you’ve considered surgery, but the risks–including potentially worsening erectile or ejaculatory dysfunction, which you may already be experiencing due to BPH or the medications you’re taking in the first place–kept you from choosing that option.

We know living with BPH, which affects 12 times as many men as prostate cancer, can be a struggle. Men with BPH are more likely to suffer from depression, decreased productivity, a diminished quality of life, and interrupted sleep. Not treating BPH can cause symptoms to worsen and even lead to permanent damage to your bladder. What is one to do with these scary statistics and no good answers?

That’s where we come in! We are excited to share that the American Urological Association (AUA) now recommends on the UroLift® System “as a standard of care treatment for lower urinary tract symptoms due to benign prostatic hyperplasia (BPH),” and our very own Dr. Rachel Rubin, a urologic surgeon, and sexual medicine specialist, is one of the early adopters of this new treatment option for men with BPH. The UroLift System is a “proven, minimally invasive treatment that fills the gap between prescription medications and more invasive surgical procedures.”

“The Urolift System is one of the few sex-friendly treatment options we have for BPH,” Says Dr. Rubin. “It is shown to improve flow, urinary frequency, and urgency, all while allowing men to maintain their ability to ejaculate normally and not increase the chances of erectile dysfunction.”

The UroLift System consists of a UroLift Delivery Device and small UroLift Implants. The implants widen the urethra within the enlarged prostate, alleviating the irritating symptoms related to BPH. Men who have received UroLift Implants report “rapid and durable symptomatic and urinary flow rate improvement without compromising sexual function,” according to clinical data collected in a study by the manufacturer of UroLift. You can learn more about some of the men UroLift has helped on the company’s website.

So what are you waiting for? Make an appointment with Dr. Rachel Rubin here in Washington, D.C. today to discuss the UroLift System and get relief for BPH now!

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