Whenever we broach the topic of testosterone therapy, many will assume we are referring to the abuse of anabolic steroids to create beefcakes and musclemen.

Testosterone therapy is a legitimate medical therapy. Men who have testosterone deficiency may also have Diabetes and even Metabolic Syndrome.

Our andrologist was recently invited on the Big Show 91.3 FM to talk about these issues.

Testosterone Deficiency and Cardiovascular Disease

Testosterone Deficiency and Diabetes

The prostate gland is often referred to as a walnut-sized gland.

Most men do not know that this gland exists till it gives them problems.

The prostate gland together with a pair of seminal vesicles would produce semen which provides the nutrients for the sperms to survive once they are “deployed” in the female genital tract in search of the egg.

In a way, the prostate is associated with pleasurable activity. 🙂

The prostate is also associated with an often overlooked function. Something we take for granted.

Passing urine.

The prostate gland enlarges in size as a man ages. Unlike most male reproductive organs, this is one organ that a man should not wish to be well endowed in. Due to its location, being at the bladder neck, the sheer size of the prostate can make urination more difficult.

When men present to the urologist, the attention is always on the prostate.

1. To rule out prostate cancer
2. To shrink the prostate
3. To open up the channel within the prostate

The truth of the matter is, once we have ruled out prostate cancer, we should actually focus on the urinary bladder.

The urinary bladder bears the brunt of an enlarged obstructing prostate gland.

The urinary bladder has 2 roles:

1. storage of urine
2. emptying of urine

When the prostate is large enough to cause obstruction to the flow of urine, the bladder works harder to squeeze the urine out of the body. Just like any stressful events, prolonged stress would result in fatigue and failure!

Unfortunately, we are unable to save the bladder once it fails.

A person’s quality of life really plummets when there is bladder failure. It affects not just himself but also his significant other as well as the loved ones around him.

Early treatment of an enlarged prostate is advisable. By treating the prostate, the bladder is spared from long-term irreversible damage.

Treatment ranges from oral medications to surgical procedures eg TURP, Greenlight Laser.

Novel minimally invasive surgical options would include UroLift.

Improving a man’s urinary issues can now be done without causing sexual dysfunction.

Should you have any concerns that there are problems with urination, see a urologist early.

Be kind to your bladder. Bladder health is often neglected.

Sexual dysfunction was a topic not taught in depth when I was a medical student. This could well be the reason why many healthcare professionals are uncomfortable with discussing these issues when a male patient surfaces this during the follow up of his chronic medical conditions.

With better understanding of this previously ignored “taboo” topic, urologists fellowship-trained in andrology and sexual medicine are able to offer proper medical and surgical treatment to men who are afflicted with these conditions.

3 common sexual issues I see in my practice include:

1. erectile dysfunction
2. premature ejaculation
3. penile curvature

Men who find it difficult to broach this topic with their regular family doctor seek the internet for “medications” and advice, in the hope of restoring their manhood. There have been potentially avoidable tragedies from the consumption of counterfeit medication, back alley bogus drugs, unsafe injections and exercises to modify the dimensions of the penis.

I encourage men facing these bedroom issues to seek proper professional help. As with all clinical encounters with a healthcare professional, physical examination is as important as history taking.  A specialist with proper training would be able to recommend investigations that help to pinpoint the cause and rule out any other worrisome causes that may require immediate attention.

Proper prescriptive medication can also be given on the spot. Adequate counselling regarding how to use these medication, what to expect and what are the red flags to look out for.

To the men out there who are struggling with these issues, make a trip down to the clinic for proper assessment and treatment.

To the significant other of these men, encourage them to seek proper assessment and treatment.

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.

Keen to find out more?

Contact our Andrologist and Prosthetic Urologist today.

More and more men are benefitting from the placement of Urolift implants. They are enjoying improvement in terms of urinary flow and symptoms without compromising on sexual performance.

Our andrologist discusses BPH and Urolift on radio.

1st Urolift in Singapore 16 October 2019

Urolift 16 October 2019

Urolift is currently available for suitable men with enlarged prostates to get them off medications, improve their urinary flow and not compromise on their sexual function.

Placement of urolift implants can be performed under sedation as a day procedure with no requirement of urinary catheter for most men in the recovery period.

Contact our urologist if you feel you would benefit from urolift or if you know a loved one who would.

Urolift

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.

See our urologist today to discuss the treatment options for BPH.

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.

Check out this article from someone who has the experience of the penile implant.

Erectile dysfunction is treatable. Do consult a prosthetic urologist today.