By Dr. Hagop Sarkissian, MD, SMGOR Urologist – Eastside and Redmond Clinics
In my experience, most men ignore their health. There is a myriad of complex psychological, societal/cultural, and individual reasons for this— whether due to society’s definition of a “man” and his expected behavior, or just simply believing “this is what happens” when men get old. Whatever the reasoning is, men need to pay attention to their health. Male health, from my perspective, includes all the urologic changes or issues that young and old men may experience: from infertility to desire for vasectomy, from urinary symptoms of a large prostate to prostate cancer, from low libido to erectile dysfunction, from metabolic syndrome to weight loss, and even the process of quitting smoking. Not surprisingly, the last two can have profound positive effects on male urologic health. (hint, hint!)
I would like this article to be used as a roadmap, one that inspires you to take inventory of your urologic health. I also hope this information helps you realize that if you have one or more of these issues, you are not alone, and there are remedies to correct and improve your quality of life.
Let’s begin with a brief overview:
Erectile dysfunction (ED) is defined by most professional societies as the inability to get and/or maintain sufficient erection for sexual satisfaction. We know ED can be an early warning sign for cardiovascular disease or diabetes. ED can negatively impact the individual’s psyche, relationships and diminish one’s quality of life. If you have ED, talk to your primary care doctor or see a urologist for appropriate treatment options and evaluation for underlying disease processes. ED is more common than you think, but as men, we just don’t share or talk about it.
2. PSA and prostate cancer
For the past several years screening for prostate cancer with prostate-specific antigen (PSA), which is a biochemical marker produced by prostate cancer or by benign prostate cells, has been controversial to say the least. Just like any other tool, the way it is intended to be used is very important. The decision to get screened for prostate cancer should be discussed with your provider, including the risks and the limitations of PSA testing. If you decide to get screened and have an elevated PSA it does not always mean that it’s due to prostate cancer. But in the off chance that it is, or if you have recently been diagnosed with prostate cancer, we live in an era where we have numerous treatment options customized to each individual’s disease stage. One such option is using the DaVinci Robotic System. As a robotic surgeon I’ve seen first-hand the positive impact this minimally invasive approach has had on my patients. Robotic prostate removal has become the standard of care in our country. If your PSA is elevated, take a breath, take a step back and keep the big picture in mind. Then allow your primary care doctor and urologist to help you navigate through the process.
3. Low Testosterone
We have started to ask better questions about the lifestyles of our patients, and our patients have become better at asking us about symptoms of tow testosterone. Low T, as it’s known, can be due to medical reasons such as chronic opioid use/addiction but mostly it is idiopathic (no direct reason). If you suffer from fatigue, low libido, ED, or a decrease in mental acuity, decreased testosterone may be the culprit. We have new and innovative means of replacing and normalizing T levels such as nasal sprays, patches, testosterone pellet implants, gels and injections.
4. Benign prostatic hyperplasia (BPH)
By far, the largest issue that guys complain about as they get older is benign prostatic hyperplasia (BPH) or enlarged prostate, or related lower urinary tract symptoms such as frequency, urgency, hesitancy, waking up at night, etc. Most men think this is due to old age and they are partially correct. As we age our prostate grows which will cause bladder outlet obstruction causing urinary symptoms. Today, aside from the tried and true methods of medical management and traditional prostate surgery, we have new and innovating ways of tackling this issue such as Greenlight™ Laser Surgery, Aquablation and Urolift procedures. Just because BPH and urinary symptoms occur in most men, it does not have to stay that way.
Talk to your PCP or see a urologist. Your future self will thank you.
Hagop Sarkissian, MD
Dr. Sarkissian is a board-certified urologist with a primary focus and interest in diagnosis, treatment and follow-up of prostate, kidney, and bladder cancers. He uses the da Vinci Robotic System and advanced laparoscopy to offer minimally invasive ways to treat disease. Dr. Sarkissian works closely with Primary Care Physicians, Medical Oncologists and Radiation Oncologists to offer treatments uniquely tailored to each individual patient’s disease and circumstance.