FAQ Answers

I once received an anonymous letter at my office which changed my practice.  As a urologist for 30 years, I have spent much of my career devoted to helping men with erectile dysfunction.  It was after helping a man that I received the “anonymous” letter.  Like a frightening ransom note, the letters were cut and pasted from magazines.  The author was pleading with me to stop helping because, as a wife with her own difficulties, she was unable to participate in sex. She went on to question: what could I possibly offer to help her?

Well, what could I do?  I immediately started to educate myself about the often ignored subject of female sexual dysfunction.  Because half of my patients are women, I began to include an open-ended question about sexual health as part of a routine medical history.  Suddenly, I was listening to multiple stories from women about their desires and concerns that had gone unmentioned for years or decades.  More importantly, they were relieved and excited that a doctor should actually ask and be interested in their sexual health. The origins of the problems were varied, but the common goal was to restore a wonderful but missing part of their life.

Sexual health is a vital part of overall wellness. Here are Frequently Asked Questions concerning Men’s Sexual Health and Wellness.

FAQs for Votiva by InMode

Q: Why is my vagina dry and painful during intercourse?

A: The main reason for vaginal dryness lies in a lack or reduction in estrogen. Estrogen is the hormone which stimulates vaginal tissues to thicken, and to secrete fluids to moisten the lining of the vagina. In menopause, estrogen levels drop dramatically, and the vagina loses elasticity, thickness, sensation, and moisture.

High Intensity Focused Ultrasound, or HIFU, is a well established and accepted method for treatment of localized prostate cancer. It has been in continuous use in Europe since 1994, and now has been employed world-wide, including the United States, where the Food and Drug Administration (FDA) approved HIFU in October of 2015. To date, tens of thousands of patients around the world have been successfully treated.

HIFU, or High Intensity Focused Ultrasound, is a non-invasive treatment using sound wave energy to eliminate cancer.  It has been in continuous use in Europe and around the world since 1996.  It was approved in October 2015, here in the USA, by the FDA for prostate use.

Bob, a 53-year-old executive, realized he was waking up two or three times a night to go to the bathroom. During the day, he frequently ran to the men’s room, to avoid embarrassing accidents. Bob was diagnosed with benign prostatic hyperplasia (BPH), an enlarged prostate condition, which was now obstructing the urine flow from his bladder. Initially, his doctor prescribed a medication to relax the prostate, with only minimal success. Further testing confirmed that his prostate enlargement had caused the bladder to become overactive, giving him the frequent urges to urinate.

A frequent question I am asked is: “What does blood in my semen mean?” Men are not used to seeing anything but clear, whitish, or slightly yellow/green color in their semen, all normal. But when the semen is suddenly red or brown, their first thought is often times “cancer.” The good news is that, almost always, blood in the semen, or “hematospermia,” is a benign finding. Getting confirmation from a urologist is a good idea.

If you have been diagnosed with prostate cancer, has your doctor discussed all the options for treatment? If they haven’t mentioned HIFU, or if they have dismissed it as an option, please seek another opinion. HIFU remains the least invasive form of prostate cancer treatment, and has the least chance of side effects while retaining an excellent record for cancer control. After HIFU, return to normal activity is usually very rapid, and there are no restrictions against exercise, lifting, or travel.

Do you go to the bathroom too much? Are you experiencing frequent urinary tract infections (UTIs)? Does your bladder hurt, or are you feeling discomfort in the low abdomen/pelvis (lower belly) or the perineum (bicycle seat area)? You may be suffering from Interstitial Cystitis (IC). This benign but annoying inflammatory condition affects the bladders of both men and women. The symptoms are often written off to “recurrent prostatitis” in men, and to “frequent UTIs” in women. If you have had these problems, and haven’t discussed the possibility of IC with your doctor, then it is time for another visit.

One in seven men will be diagnosed with prostate cancer. Hopefully, it will be diagnosed at an early stage, when it is curable. Hopefully, a yearly PSA (the blood test for prostate specific antigen) and a DRE (digital rectal exam, also known as a “finger wave”) are being followed. When the DRE is suspicious, or the PSA is elevated, or rises more than 0.75 per year, then a prostate biopsy must be discussed with that man. There are no symptoms of early prostate cancer. By the time a man develops symptoms from the cancer, it is usually at an advanced stage. That is why a yearly check up is so critical.