Actually. On a warm, summers night. It's quite easy for men like myself to be able to pull my 'tools' upward, and just leave my anus exposed. However. This course of action is not usually necessary.
Anyways, it would be hard to do that action on Le Chiffre . And even in that position, it does hurt. (I didn't actually try it but there were times where I fell in the floor on my ,hard and it does hurt. )