[ARCHIVED THREAD] - November is "Men's health awareness month" - ask a urologist (almost) anything (Page 1 of 6)
Posted: 11/11/2019 10:20:04 AM EDT
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We may have more urologists on here, and I welcome them to chime in.
The month of November allows us to promote awareness of men's health issues through campaigns like Movember or "No Shave November." These are usually focused on promoting awareness of prostate cancer and PSA testing. Sometimes we talk about ED, but it's mainly prostate cancer. In general, the American Urological Association recommends a discussion about PSA screening "average risk" men between the ages of 55 and 70. Average risk means you're white with no significant family (first degree relative) history of prostate cancer. PSA is a simple blood test. The results of the blood test can give us an idea of your risk of harboring significant prostate cancer. There are several reasons why PSA may be elevated, including an enlarged prostate, infection, recent sexual activity, riding a bike, etc. The most worrisome is cancer. There are other tests such as MRIs, 4K scores, PSA3s, etc, but none of these tell you if you actually have cancer or what type of cancer you have. You can only be diagnosed with cancer through a prostate biopsy. The treatment of prostate cancer varies widely because there are a number of different factors to consider when discussing the treatment of prostate cancer. Options include doing nothing (watchful waiting), repeating biopsies (active surveillance), surgery, and radiation. Your cancer type and overall health will determine what's best for you. I welcome any questions you have on the subject. I'll answer to the best of my abilities. |
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Why didn’t my doctor tell me that I have a 15% chance of post vasectomy pain for the rest of my life? I’ve been in constant 24/7 pain since my vasectomy 10 months ago. The doctor says well...we can try to get you a reversal but it probably won’t help. THANKS OBAMA. The only benefit is I’m shooting blanks but I’m already hurting so bad I rarely feel like trying to have sex so that benefit is...minimal.  This may not be the thread for me. I do appreciate what you are doing.
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Why didn’t my doctor tell me that I have a 15% chance of post vasectomy pain for the rest of my life? I’ve been in constant 24/7 pain since my vasectomy 10 months ago. The doctor says well...we can try to get you a reversal but it probably won’t help. THANKS OBAMA. The only benefit is I’m shooting blanks but I’m already hurting so bad I rarely feel like trying to have sex so that benefit is...minimal. This may not be the thread for me. I do appreciate what you are doing.As far as I know, nothing can get rid of the pain. I wouldn't try to reverse it. If you can find someone who will do a cord denervation, that might help. |
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What are your thoughts on the various online services offering "virtual" doctor consultations for ED evaluation and prescription of ED medication. For Hims, Roman, etc...
Are the drugs prescribed by these services relatively safe considering it's such a simple screening done by someone who hasn't seen you in person? I believe they mostly offer viagra, cialis, and the generic versions if available. |
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My Urologist in Michigan saved my life...had laparoscopic surgery last year to remove a grade 4 renal clear cell carcinoma tumor (partial nephrectomy, 3 cm exophytic cyst)
I go back every six months or so for another CT scan, but if my primary doctor and urologist weren't as thorough as they were, I'd likely be looking at dealing with metastatic cancer this year. Thanks for all that you do, doc! |
| I currently take Dutastirde (.5) and Tamsulosin (.4) for enlarged prostrate and to promote urinary flow. I still have many nights that I'm up 3 or four times to urinate and good flow can be hit or miss. Is there a better combination that I should be considering. I prefer to stay away from having a roto rooter job. |
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What causes one of the "boys" to be considered heterogeneous? What does it mean?
Have had pain for 6+ months in the left testicle and seen a urologist. Had ultrasound done, been through several rounds of antibiotics, and basically told nothing can be done. All test results come back normal(besides heterogeneous), but slight pain persists. Might go see someone else but discouraged. Thanks in advance Op. |
| My urologist put me on 200mg Test Cyp injection every other week. According to some in the testosterone thread this is a very bad regimen. What are your thoughts? I feel mostly good except for the couple days before my next shot. I inject myself in my thigh and rotate thighs every shot. |
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My urologist put me on 200mg Test Cyp injection every other week. According to some in the testosterone thread this is a very bad regimen. What are your thoughts? I feel mostly good except for the couple days before my next shot. I inject myself in my thigh and rotate thighs every shot. |
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I currently take Dutastirde (.5) and Tamsulosin (.4) for enlarged prostrate and to promote urinary flow. I still have many nights that I'm up 3 or four times to urinate and good flow can be hit or miss. Is there a better combination that I should be considering. I prefer to stay away from having a roto rooter job. What does the OP think of those two options? |
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So half a vial every week? Quoted:
Quoted: It’s bad because of the half life of cypionate. You need to be injecting every 7 days. Or you can split the injections. I shoot twice a week. - Not a doctor but have been on TRT for years and I occasionally dabble in gynecology. |
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Flomax causes something called ' Intraoperative Floppy Iris Syndrome" IFIS. during surgery the iris can constrict making cataract surgery extremely difficult. If the patient tells you in advance I can prepare and use medications or special hooks to keep the iris open. When the patient forgets to tell you,, it can be a real PITA getting the cataract out. As for Demodex, lid scrubbing is really the best , for severve infex, then Neo Poly Dex ointment along with lid scrubs |
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this from an Ophthalmologist, please don't over prescribe Flomax. My life is hard enough without three or four Flomax patients every surgery day. :) Not sure about the MOA of flomax... ETA, nope, I was wrong. Alpha blocker causing iris problems. |
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I currently take Dutastirde (.5) and Tamsulosin (.4) for enlarged prostrate and to promote urinary flow. I still have many nights that I'm up 3 or four times to urinate and good flow can be hit or miss. Is there a better combination that I should be considering. I prefer to stay away from having a roto rooter job. You might look into Laser therapy, either ablative or enucleative procedure. I opted for TURP. Beats midnight runs to the ER but it is life changing for some months. Had to have a couple of cystoscopy procedures to clean things up and the whole deal took about 6 months to play out. |
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I had prostate cancer, and I'm concerned that it is "coming back"
I had Da Vinci surgery 10-16. After surgery my PSA was 0.01. I get a blood test every 6 months and in the last year and a half it has started to rise. From 0.01 to 0.07 to 0.12 last month. My Urologist says it's ok to monitor but in the next breath asks if I want to see a radiation specialist. This confuses me. No I didn't ask for clarification (head in the sand mode). Is this a sign that they didn't get all the cancer? I'm 69 years old. Thanks for any info |
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What advice would you give a guy that isn't quite 40? Things to do? Things to avoid? We haven't had prostate cancer in my family, but my father has a weak one now and has had one bout of prostatitis that seemed kind of miserable. Quoted:
Why does it burn when you pee after not drinking lots of water? Quoted:
My last PSA was .6, 45 year old white male with a dad that had to have the laser roto-rooter to fix an enlarged prostate. What should my concern level be based on family history and what do you recommend for health? Thanks for doing this. |
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So half a vial every week? Injecting twice a month gets worse the longer you do it, it'll increase your estrogen too much and you'll rarely have your test where want it so you're more likely to have negative side effects like high HCT, mood swings, acne,hair loss, ED, etc. I felt amazing when I got that first shot though. I inject more often than that so I can get my test higher without using an AI or having sides, but everyone is different and twice/wk. is a good regimen for most. |
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What are your thoughts on the various online services offering "virtual" doctor consultations for ED evaluation and prescription of ED medication. For Hims, Roman, etc... Are the drugs prescribed by these services relatively safe considering it's such a simple screening done by someone who hasn't seen you in person? I believe they mostly offer viagra, cialis, and the generic versions if available. Quoted:
What is your call schedule like? How many emergent urological cases do you see a year? When not on call, we will have maybe 3 or 4 add on cases a week (at the VA). Quoted:
What do you think of pellet therapy for testosterone in men (60's). I know there's an enormous thread here addressing this, but it's overwhelming. Thanks. |
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What about PSA testing on men who have a family history of prostate issues? What’s the recommendation there?
Also, what’s the TRUE percentage of men who test positive for some sort of prostate cancer when they’re in their 70’s? I’ve heard it’s quite high, even if it’s slow moving. |
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My Urologist in Michigan saved my life...had laparoscopic surgery last year to remove a grade 4 renal clear cell carcinoma tumor (partial nephrectomy, 3 cm exophytic cyst) I go back every six months or so for another CT scan, but if my primary doctor and urologist weren't as thorough as they were, I'd likely be looking at dealing with metastatic cancer this year. Thanks for all that you do, doc! Quoted:
I currently take Dutastirde (.5) and Tamsulosin (.4) for enlarged prostrate and to promote urinary flow. I still have many nights that I'm up 3 or four times to urinate and good flow can be hit or miss. Is there a better combination that I should be considering. I prefer to stay away from having a roto rooter job. Nocturia is a really difficult thing to talk about, because it's not always (and, in my opinion, rarely ever) caused by the prostate itself. Do you have sleep apnea? Do you get swelling in your feet after a long day? Usually it's an issue with production of urine at night and not so much not being able to empty your bladder well. Quoted:
What causes one of the "boys" to be considered heterogeneous? What does it mean? Have had pain for 6+ months in the left testicle and seen a urologist. Had ultrasound done, been through several rounds of antibiotics, and basically told nothing can be done. All test results come back normal(besides heterogeneous), but slight pain persists. Might go see someone else but discouraged. Thanks in advance Op. Unfortunately ball pain is really, really hard to treat and is frustrating for the patient as well as the urologist. Have they put a camera in you or scanned your bladder to see if you empty your bladder well? |
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Had my vas about age 45. Shortly after that, climax went from volcanic eruption to, "I might be able to drain the hose if I squeeze it out like an empty tube of toothpaste." Is this vasectomy related, or just old age? It's almost like a spasm instead of being able to control the muscles now. I've tried the kegel exercises, vitamins, prayer, etc... Large doses of Pygeum and Zinc seemed to help with about a week or two of abstinence. But I miss the old days.  
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What's polyoma virus? As far as I know it's self-limiting and just causes uncomfortable urination for a while. Quoted:
Is there a do-it-yourself way to make your dick bigger? Asking for a friend. Thanks. Quoted:
My urologist put me on 200mg Test Cyp injection every other week. According to some in the testosterone thread this is a very bad regimen. What are your thoughts? I feel mostly good except for the couple days before my next shot. I inject myself in my thigh and rotate thighs every shot. |
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Should I be concerned that I have the sudden urge to pee often for as long as I can remember? Like from age 9-10 to now age 36. When I drink I have to pee every half hour. It's ridiculous. Quoted:
this from an Ophthalmologist, please don't over prescribe Flomax. My life is hard enough without three or four Flomax patients every surgery day. :) Honestly, we don't give enough consideration to cataracts when we prescribe Flomax. Everybody at the VA gets Flomax, and I imagine a lot will end up with eye surgery in the future. Quoted: Have you looked into the UroLift or ReZum proceedures? What does the OP think of those two options? They're both fairly new. UroLift has about 6 years of data right now, showing a decently durable result. Rezum is newer and also seems to be promising. For men who don't like meds or who are failing meds and don't want to pursue a TURP, I would ask your urologist about these options. I personally perform TURPs and I think there's a good reason why it's still the gold standard. You have to convince me why TURP is not the best option for you before we start talking about alternative procedures. |
| If my sinuses plug, my face completely flushes, and I have a hard time breathing because my lungs feel clogged after the first time of taking 20mg of viagra, should I take the advice of some guy on the internet to go ahead and up the dose to 100mg to see if my Johnson will stand at attention? |
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Does eating spicy peppers really ward off prostate cancer? I eat lots of jalapeños in hopes that I don't get anything. Quoted:
My son had Stage 1 Seminoma in 2016. Glad it was caught early. My beard is in full bloom this month. Check your balls guys. Or have somebody do it for you. Quoted:
Reported. OP posting a thread to drum up business without site staff approval  . |
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Why didn’t my doctor tell me that I have a 15% chance of post vasectomy pain for the rest of my life? I’ve been in constant 24/7 pain since my vasectomy 10 months ago. The doctor says well...we can try to get you a reversal but it probably won’t help. THANKS OBAMA. The only benefit is I’m shooting blanks but I’m already hurting so bad I rarely feel like trying to have sex so that benefit is...minimal. This may not be the thread for me. I do appreciate what you are doing. |
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Surely you’re aware they have female patients. I have kidney stones and have been seeing one for years. Quoted:
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Do you get tired of looking at women's vaginas? oh wait... I have kidney stones and have been seeing one for years. |
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I had prostate cancer, and I'm concerned that it is "coming back" I had Da Vinci surgery 10-16. After surgery my PSA was 0.01. I get a blood test every 6 months and in the last year and a half it has started to rise. From 0.01 to 0.07 to 0.12 last month. My Urologist says it's ok to monitor but in the next breath asks if I want to see a radiation specialist. This confuses me. No I didn't ask for clarification (head in the sand mode). Is this a sign that they didn't get all the cancer? I'm 69 years old. Thanks for any info It's possible that the PSA is coming from benign prostate tissue left behind. It's possible that it's from cancer that is either in the prostate bed (where the prostate used to be) or in lymph nodes in the pelvis. It's hard to say. You have the option of pursuing radiation therapy right now if you want. Technically you haven't had a "recurrence" of prostate cancer until your PSA is 0.2. Radiation can cause side effects like worsening incontinence and ED. There are also long-term consequences of radiation. Some people want it sooner rather than later, some guys want to wait until they clearly need it. Right now all they're treating is a number. Nothing HAS to be done, but can be done if the PSA is stressing you out. You could also ask your urologist about obtaining something like an Axumin PET scan if that's available to you. Quoted:
What about PSA testing on men who have a family history of prostate issues? What’s the recommendation there? Also, what’s the TRUE percentage of men who test positive for some sort of prostate cancer when they’re in their 70’s? I’ve heard it’s quite high, even if it’s slow moving. Basically if you live long enough, you'll end up with prostate cancer. But yes, the vast majority of prostate cancer is slow growing and will never spread or cause any issues. What we're trying to do is figure out who has the bad cancer and actually needs to be treated, while not over-treating guys with low grade prostate cancer. Quoted:
Had my vas about age 45. Shortly after that, climax went from volcanic eruption to, "I might be able to drain the hose if I squeeze it out like an empty tube of toothpaste." Is this vasectomy related, or just old age? It's almost like a spasm instead of being able to control the muscles now. I've tried the kegel exercises, vitamins, prayer, etc... Large doses of Pygeum and Zinc seemed to help with about a week or two of abstinence. But I miss the old days. It should have nothing at all to do with the vasectomy. |