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Frequent Urination, Erectile Dysfunction + Urological Cancers

Monday, August 12, 2013
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Symptoms and Treatments Men Need to Know with Dr. Daniel Canter, Einstein Medical Center Philadelphia

Urination seems like a simple thing. What don’t we understand about it?

“Frequent urination, especially when it occurs at night, isn’t recognized as the quality of life problem that it can be,” says Dr. Daniel Canter. “Part of that is because frequent urination is a gradual process that evolves as we age. It can start with getting up once a night to urinate and increases to two or three times per night. If you are getting up that many times per night, you are usually exhausted the next day. By the time many patients come see me, a lot of men are chronically sleep deprived and don’t realize it. I can give them medication and, six weeks later, they come back and tell me that they can’t believe they’ve waited so long to deal with the situation. This type of non-invasive treatment can really have a huge impact on a patient's quality of life.”

What other urination problems get overlooked? What is the norm and when should men seek a doctor’s help?

“One question I often ask men is, ‘How good is your stream?’ because a weak stream can signal a problem,” Canter says. “I also ask, ‘How well do you feel like you empty your bladder? Do you feel that you have to go again right away? Do you frequently have a feeling of urgency?’ All of those things are symptoms of an enlarged prostate that can be improved.”

Incontinence is also a warning sign, Canter says. Women often experience urinary stress incontinence – which happens when they cough or sneeze — if their pelvic floor has been stretched during pregnancy. “But men shouldn’t have incontinence, especially if they haven't had any surgery on their prostate. So, urinary leakage in men is usually caused by bladder spasms and the underlying problem is, most often, an enlarged prostate putting pressure on the bladder.”

What are treatments for frequent urination and an enlarged prostate?

“We start with behavioral changes, like not drinking water before bed and reducing the amount of alcohol you drink at night,” Canter says. “There are oral medications that can improve urinary symptoms. On the other end of the spectrum are surgical procedures that reduce the size of the prostate. They are relatively routine procedures. Patients go home the same day or the next day.”

Erectile dysfunction obviously affects a man’s quality of life. Is treatment a matter of taking a pill?

“A lot is misunderstood about erectile dysfunction,” Canter says. “Erectile dysfunction can be one of the earliest symptoms of heart disease.” That’s because erectile dysfunction is a vascular problem where blood flow to the penis is reduced. This is of special concern in men who have risk factors like a family history of heart disease. “ED can predate any other symptoms by several years,” Canter says. “Men who have this need to be screened for underlying coronary artery disease.”

Men are at more risk than women for urological cancers. According to the American Cancer Society, one in six men will develop prostate cancer, one in 26 will have bladder cancer and one in 63 will get kidney cancer. What are symptoms to watch for?

“Urological cancers typically strike people when they are in their 60 or 70s, so age is one symptom,” Canter says. “Blood in the urine, back pain, loss of energy, bone pain — all of these signal a problem. There is a strong genetic component to some kidney cancers, so family history is important.” There are many treatments for urological cancers, Canter says, and they are effective when the cancer is caught in its early stages.

With all urologic issues, preventive measures are not to smoke cigarettes and see a doctor for urination or erectile problems. Sometimes treatment is as easy as a little blue pill.

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