External Prostatic massage.

External prostatic massage
I was fortunate to do my chiropractic education in Oregon. Oregon has a very broad scope of practice for chiropractors. In addition to learning chiropractic manipulation and physical diagnosis they also were trained in laboratory diagnosis, minor surgery, obstetrics and gynecology, and proctology. Our training was basically that of a primary care physician.
In our proctology training, we were trained in the use of the Proctoscope, digital prostate examination and internal prostatic massage for benign prostatic hypertrophy. We initially practiced on fellow students and then once in the student outpatient clinic on patients from the general public. My personal experience of doing internal prostatic was that it was quite effective in reducing the frequency of nighttime urination in older men. I treated one older gentleman when I was an intern in the outpatient clinic who was waking five times a night to urinate and also complained of impotence. After two treatments utilizing internal prostatic massage his waking frequency reduced to one time night and his impotence was corrected. Although my experience with internal prostatic massage is that it is quite effective it can be quite difficult to do depending upon practice laws and privacy concerns. At some point I discovered an alternative technique which I call external prostatic massage. This technique can be done by any manual therapist and does not conflict with any practice laws because it is applied at the lower abdomen.
This technique is quite simple to do. Have your client lay supine on the treatment table. All of my clients are fully clothed. Have them touch the top of the pubic bone so that you can easily locate it. Once you have located the pubic bone find the rectus abdominis muscle just superior to the pubic bone. Once you’ve found the rectus abdominis muscle slide your fingers slightly lateral to the lateral edge of the rectus abdominis muscle. Slide your fingers just slightly lateral to the lateral border of the rectus abdominis and slightly above the pubic bone. The tissue there will feel softer. With two or three fingers push into the soft area directing your pressure to the opposite ischial tuberosity until you reach moderate tissue resistance. Once there, you will begin a pumping motion by releasing about 10 to 20% of the pressure and then increasing the pressure to moderate tissue resistance about two times a second. Often your client will report that they feel rectal pressure if you asked them. Continue this motion for about one minute and then locate and treat the other side. The treatment principle is to increase circulation in and around the prostate. The pumping motion facilitates circulatory exchange. Once I have finished the treatment, I instruct the client how to do it on themselves. Daily treatment is beneficial. Often client’s fingers are not able to maintain the pumping motion without fatigue. So I instruct them to use a tool like a small vitamin bottle, hairbrush handle or anything that can be held with two hands which would reduce their fatigue.
I have done this technique on people who have had the internal prostatic massage and often they report that the internal sensation while receiving the external prostatic massage is similar to an internal prostatic massage.
As an adjunct to this therapy nutritional supplements can be helpful such as saw palmetto, pygeum, and rye grass pollen (Cernilton).