3 reasons to see a urologist

Men who feel healthy may think they don’t need to see a doctor. But as men get closer to their 40s, they should begin talking with a health care provider about the best ways to stay healthy. Establishing a relationship with a trusted urologist is one way men can maintain sexual health and quality of life. Urologists Dr. Mark Jackson, Dr. Robert Grand and Dr. John Brizzolara of Washington Regional’s Ozark Urology offer insight into some issues that urologists commonly diagnose and treat.

1 Frequent nighttime urination - Nocturia, or frequent waking to go to the bathroom, may have several causes, says Dr. Mark Jackson. “Your kidneys work around the clock to make urine, even when you sleep,” he explains. “Try decreasing the amount of fluid you drink in the hours before you go to bed. This can help you avoid having a full bladder in the middle of the night.”

Nocturia can also be caused by an enlarged prostate. After puberty, the prostate starts to enlarge and eventually can obstruct the urinary stream. “Fortunately, there are many ways to treat an enlarged prostate,” Jackson says. “We find that most men improve with medication alone.”

Another cause of nocturia may be sleep apnea. “This is a serious disorder that causes breathing to stop during the night. People with this condition gasp for air, which causes pressure inside the body to make their kidneys dump more urine into the bladder,” Jackson says. Individuals who snore or are overweight are more likely to have sleep apnea.

Men with frequent nighttime urination should see a health care provider to determine the cause and whether intervention is required.

2 Low testosterone - Some men may find themselves struggling with fatigue, diminished physical performance, loss of body and facial hair, weight gain, inability to concentrate and loss of sexual interest. Although these symptoms could have many causes, one possibility is testosterone deficiency.

“Testosterone is a hormone that plays a key role in the development of male reproductive organs and also promotes the growth of muscle, bones and body hair,” says Dr. Robert Grand. “As some men get older, the amount of testosterone produced by their body decreases. For men with these symptoms, a physical exam and lab tests can help to determine if their testosterone level is low.”

It is important to address low testosterone with a health care provider, as it is also associated with increased risk of cardiovascular disease and bone density loss. The management of low testosterone varies, Grand says, from simple lifestyle changes to taking supplements.

3 Prostate cancer screening - Prostate cancer is the most common cancer among men in the U.S., after skin cancer. “Most cases of prostate cancer cause no symptoms, so screening is an important tool to ensure early detection and treatment,” says Dr. John Brizzolara. Screening typically entails a simple blood test called prostate-specific antigen, or PSA. Higher PSA levels in the blood are associated with increased risk of prostate cancer. In addition to a PSA test, a prostate exam may be performed to check for any abnormalities of the prostate that may suggest cancer.

The American Cancer Society recommends that men who are at average risk of developing prostate cancer discuss screening risks and benefits with a health care provider beginning at age 50. For men with a strong family history of prostate cancer, screening as early as age 40 may be recommended.

The management of prostate cancer has made great advances in recent years, Brizzolara says, and not all prostate cancers are treated aggressively. “One common therapy for localized prostate cancer is active surveillance, or watchful waiting, which monitors the prostate cancer to ensure that it is stable and not advancing,” he says. “We follow the cancer with routine prostate biopsies, lab values and prostate imaging studies. As long as the cancer is stable, you can avoid more invasive treatments.”

Treatment can also include radiation therapy – which is delivered externally or through seeds that are implanted directly into the prostate without any incisions – or surgery. Today surgical removal of the prostate is commonly performed with assistance from the da Vinci® robotic system, which allows the surgeon to spare muscles and nerves surrounding the prostate – and offers the patient a much quicker recovery time.

“When choosing a treatment option, it is important to consult with your health care provider to personalize your treatment plan,” Dr. Brizzolara says.

To schedule an appointment at Washington Regional Ozark Urology, call 479-404-1100 or learn more at www.wregional.com/ozarkurology.