Dr Ronny Tan has been certified by Teleflex as a Urolift Specialist as of 13 August 2020.
Urolift (prostatic urethral lift) is a minimally invasive treatment for benign prostate enlargement or BPH (benign prostatic hypertrophy). This procedure is performed as a day surgery procedure under sedation with minimal disruption to the patient’s daily activities. Most, if not all, men would not require a urethral catheter after the procedure. Men who undergo Urolift can stop their chronic medications for BPH and there are no sexual side effects.
Solving a man’s issues with urinary symptoms should not be at the expense of his sexual function.
Nocturia. The need to wake up to pass urine at night after going to bed. It may appear to just be an issue to men afflicted by this problem. We tend to forget the significant other who is lying next to these men with nocturia.
Nocturia due to an enlarged prostate is one of the commonest symptom of BPH (Benign prostate hypertrophy). It affects the quality of sleep resulting in poor QOL (quality of life). The patient’s spouse also ends up with poor sleep quality.
Now we know. BPH can also affect women.
There is a new minimally invasive treatment for BPH that has arrived in Singapore. It is the Urolift procedure, also known as prostatic urethral lift (PUL). It involves placing implants into the prostate gland to open up the channel so allow for good flow of urine, hence relieving LUTS (lower urinary tract symptoms).
LUTS include slow urinary stream, straining at urination, sensation of incomplete emptying of the bladder, frequency and urgency, nocturia. Current treatments for BPH still carries a risk of sexual dysfunction e.g. erectile dysfunction and ejaculatory disorders. Men who wish to maintain their sex life can consider Urolift.
After this uplifting experience, the couple can have a good night’s rest and yet not compromise on their sex life.
However, when it comes to the size of a man's prostate, the reverse is true.
Men with enlarged prostates often see their doctors for lower urinary tract symptoms (LUTS). The urinary stream is weak and there is often need to strain to empty the bladder. Current treatment often results in erectile dysfunction and ejaculatory dysfunction. Most sexually active men would prefer treatments that do not affect their sexual performance.
Prostatic urethral lift with placement of implants like the Urolift has good treatment outcomes without the unwanted side effects of sexual dysfunction. For men who want to stop having to take long term medication for his problem of LUTS due to an enlarged prostate can also consider this form of treatment which can be performed as a day surgical procedure.
These implants are placed via a small scope inserted into urine tube (urethra) opening up the channel without the need to remove any tissue. It is akin to drawing open the curtains to let more light into the room. The Urolift implants draws apart the obstructing prostate tissue to enable urine to flow out from the bladder.
Do you have slow urinary stream and want to be able to improve on that without compromising your sexual function? You need to see a urologist today.
As medical science advances, we find that we are able to replace increasing parts of our anatomy as we age.
We have the cardiothoracic surgeons replacing heart valves for the longest time. The orthopaedic surgeons replacing joints with increasing advanced implants. The most well-known of implants include breast implants by our plastic surgeons. Our dental colleagues also put in permanent implants for patients with poor dentition wishing to have the million dollar smile.
Amongst the urologists, we also have a group of us prosthetic urologists.Prosthetic urologists put in urological prosthesis.
Testicular implants for men who have lost their family jewel due to cancer or trauma, artificial urinary sphincters to treat severe stress urinary incontinence and urethra slings to treat moderate stress urinary incontinence.
Erectile dysfunction that is refractory to medical therapy and other non-surgical treatment modalities can be cured with the penile prosthesis or the penile implant. This procedure is not as invasive as some imagine it to be. It is a day surgical procedure and the patient would only have to stay overnight in the hospital and 6 weeks after surgery, he would have top quality penile erections. There is a choice between the malleable non-inflatable implant versus the inflatable implant.
Men who need these implants are not necessarily older men. We have placed implants for younger men with spinal cord injury, men who had pelvic surgery and/or pelvic radiotherapy and men with early onset of diabetes with resulting severe erectile dysfunction.
These implants do not only benefit the men in terms of sexual function and self esteem, but also their partners.
Shockwave treatment is an established modality for treating urinary tract stones. The shockwaves delivered to the stones in either the kidney or the ureter cause fragmentation into small pieces. The patient would then pass the stones out in his/her urinary stream.
In the recent years, shockwave treatment has also extended to other applications. One example would be for the treatment of musculoskeletal problems by sports medicine specialists. The energy levels used in this instance is lower than that used for breaking urinary tract stones. Lower energy levels have been found to decrease inflammation (i.e. anti-inflammatory purpose) and cause growth of new blood vessels (neovascularization).
The most current use of low intensity shockwave treatment is for both erectile dysfunction as well as chronic pelvic pain syndrome and chronic prostatitis.
For erectile dysfunction, the man would have stronger erections due to improved blood flow to the penis without any complications.
With regards to CPPS and chronic prostatitis, the anti-inflammatory effects of the treatment shows good promise for this difficult to treat condition.
We have started using shockwave treatment for both conditions at our clinic.
How straight does a man’s penis need to be? Should a man be concerned if his manhood no longer points forward? Is this condition part of the normal aging process?
Peyronie’s disease, a wound healing disorder, usually afflicts men above the age of 50. The insidious bending of a man’s penis which eventually affects penetrative intercourse with his partner is not something most men would want to discuss openly. Peyronie’s disease is deemed to be less prevalent in Asian men. However, I beg to differ. The perceived lower prevalence of this disease is more likely to be due to the lack of awareness of this condition. Peyronie’s disease may not be a malignant (or cancerous) condition, but the psychological effects on these men is significant. Peyronie’s disease affects a man’s self image, his self esteem as well as his relationship with his partner.
What starts off as an off-centre organ develops into a perceiveable lump on the penis. The penile curvature results in the total inability to penetrate the partner without causing pain to either to the man or his partner and in many cases the couple. As much as everyone likes to console the man that size does not matter, for men with Peyronie’s disease, length and girth are often affected. Erectile dysfunction can also set in either due to the curvature or due to the intense psychological stress this condition afflicts on the man.
Treatment of Peyronie’s disease is not straight forward (pun intended). The presence of erectile dysfunction would make certain surgical options more applicable than others. To date, surgical intervention is still the gold standard for treatment of this condition. Other forms of treatment would help to slow down the deformation and shortening of this important male phallic symbol.
See a specialist who is trained in the treatment of Peyronie’s disease for the best outcome after a face-to-face consult to straighten things out once and for all.
Testosterone, the hormone that is often misunderstood. Many think that it is the elixir of youth which keeps a man young forever. Others picture sportsmen getting suspended for using it to enhance performance during competitive events.
Testosterone Therapy is legitimate medical treatment for men stricken with the condition of Testosterone Deficiency (TD). Studies have shown the link between Testosterone Deficiency (TD) and Metabolic Syndrome, commonly known as Syndrome X. Metabolic Syndrome consists of obesity, high blood pressure, high blood sugars or diabetes and high cholesterol. Men with TD often complain of weakened erections or erectile dysfunction, loss of morning erections, loss of sex drive or libido and generalised poor energy levels affecting their productivity at work. Some even have difficulty staying awake during important meetings or at their work desk!
The effects of TD on sexual function often results in a strain in the couple's relationship and a negative impact on a man's self esteem and confidence. TD is more common once a man reaches the age of 40 and one should never attribute these changes to normal aging. Low levels of testosterone in a man's system puts him at higher risk for heart diseases and even strokes, not to mention a decreased life expectancy.
The aim of testosterone therapy is to bring the testosterone levels of a man to the normal range so as to treat the problem that causes the symptoms above and to improve the quality of life as well as general health and well-being of the man. Initiation of testosterone therapy requires prescriptive medications from a medical doctor and there is a need for follow-up to keep the man in tip-top condition.
Do you think you or your loved one may have TD? Seek help early.