Interviewer: Three reasons guys should go see their urologist immediately. Dr. John Smith is a urologist at University of Utah Health, and today wanted to talk about three different things from your perspective, Dr. Smith, that if a man is experiencing, they should probably go see their urologist sooner than later. Let's go ahead and start with number one.
Dr. Smith: As men age, they tend to have a little bit of a decrease in their urinary stream, and sometimes this can be a sign that something may be going on that long term could be damaging to their urinary tract.
Interviewer: All right. So if you are experiencing any sort of urinary problems like the stream isn't as strong, are there other symptoms that would indicate that that might be an issue to get to your urologist?
Dr. Smith: Absolutely. I tend to be very frank with my patients, and I ask them, "How's your stream? Do you hit the back of the bowl, the middle, the front, or your shoes?" And if they're hitting their shoes, then they probably needed to be here a little bit sooner than they are.
Other things that I generally ask is are they going to the bathroom more frequently. If they're on the golf course with their buddies and they golf 18 holes, do they go to the bathroom way more than their friends, or do they have an urgency, the gotta-gos?
Another thing that I'll ask them is, "How much are you waking up at night to go to the bathroom?" Those are good indications that there is likely something going on, and it's usually an enlarged prostate causing an outlet obstruction.
Interviewer: I always thought that was just part of getting older, but it's not, huh?
Dr. Smith: Well, to an extent. So if we lined up 100 people, both male and female, over the age of 60, all of them will get up to go to the bathroom once, possibly twice, and that's within the normal limits. But the gentlemen who come in and I say, "How much are you getting up?" and they're like, "I'm up five or six times a night," that's abnormal and doesn't normally happen.
Interviewer: All right. And if you don't take care of that right away, what's the detriment?
Dr. Smith: So the detriment is your urinary system is a low-pressure system. Your bladder likes to fill. It likes to empty. It likes to be like Maxwell House, good to the last drop. And when you have this outlet obstruction, generally you hold a little bit of urine back and your bladder has to push harder to empty. And that, long term, can cause damage to the bladder. It makes it so it's not as elastic, meaning that it can't fill and empty the way that it would like to, and it can cause an issue. And long term, with higher urine leftover, kind of a glass half full kind of guy, you can have damage long term to the bladder as well as to the kidneys.
Interviewer: All right. So three reasons guys should see the urologist right away, number two.
Dr. Smith: So number two is guys with a family history of prostate cancer. I've seen quite a few guys who kind of put that off coming in and having a PSA test done.
Prostate cancer is a slow-growing disease that we can treat very well these days. We're very good at it. And there are also some new technologies for identifying possible prostate cancer to make sure we get early treatment.
So starting early, getting a PSA at age 50, 55, depending on your family history, and having that discussion with a urologist can really be beneficial to make sure that we get you in the loop, and take care of you, and make sure that there's not a problem down the road.
Interviewer: So to you, as a clinician, that family history is a pretty good indicator that a man is likely going to have prostate cancer issues in their future?
Dr. Smith: Absolutely, especially men who have a family history of their father or a first-degree relative, like a brother, who has had prostate cancer at an early age. Those are the ones that we definitely want to watch a little bit closer.
Interviewer: Getting in sooner than later is definitely a good plan. All right. Three reasons guys should see their urologist sooner than later. What is number three?
Dr. Smith: Number three is one that everybody wants to talk about all the time -- erectile dysfunction. And I'm joking.
Interviewer: Yeah. I was going to say I don't think we want to talk about that all the time.
Dr. Smith: And that's one where we have great treatments. We can generally treat men rather easily with few side effects. Seven out of 10 men generally do very well on medication to help their erections. And so there's no reason to have a subpar sexual life when there is great treatment out there and all you have to do is come in and say the word, "Hey, I need a little help."
Interviewer: Yeah, and it's okay to think about it as a health issue because having a satisfying sex life is very much a part of emotional and mental health, something that us guys don't normally think about, right? We think about the physical part of it more than the emotional part.
Dr. Smith: That's true. Another thing too that we keep in mind is sudden onset erectile dysfunction can sometimes kind of clue us into something that could be going on, underlying vascular problem that may need some attention that you just thought was an erectile issue. So, again, there are some other things there that can really be beneficial.
Interviewer: It's a symptom of maybe something else going wrong in your body that's just manifesting itself through your ED?
Dr. Smith: Absolutely. One of the most common is a cardiovascular problem for men who kind of have a sudden onset of erectile dysfunction and are otherwise healthy that may not think . . . Maybe they have a few extra pounds and they just thought, "Oh, well, I just figured with age my erection would go away." Well, when it was there on Saturday and it's not there on Monday, that's not usually something that is normal and may need a closer look by your primary doctor.
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