Men’s health: top solutions for common concerns. Dr. Lance Walsh on the treatment of enlarged prostate, low testosterone levels, sexual dysfunction and more.
BY VICTOR MELAMED
Dr. Lance Walsh, the founder of Walsh Urology Associates in Rancho Mirage, specializes in treatment of enlarged prostate (benign prostatic hypertrophy, or BPH), prostate cancer, as well as sexual dysfunction.
In an interview with THE FIGHT Dr. Walsh talks about various health concerns facing older men, treating erectile dysfunction and the benefits of the UroLift (r) System Procedure for patients with enlarged prostates.
Dr. Walsh—what are the most common health issues men face when growing older?
Common urologic issues men have as they age include Benign Prostatic Hypertrophy (BPH), prostate cancer, erectile dysfunction (ED), and hypogonadism (Low T). The most common problem is BPH, a non-cancerous enlargement of the prostate that occurs as men age. The enlarged prostate presses on and blocks the urethra, causing bothersome urinary symptoms. It is a common condition—affecting approximately 37 million men in the United States alone. Approximately one in four men experience BPH-related symptoms by age 55, with 90 percent of men over 70 symptomatic. BPH is much more common than prostate cancer. BPH significantly impacts quality of life. Symptoms include sleepless nights and urinary problems. BPH can cause loss of productivity, depression and decreased quality of life. Early treatment is important. The sooner it is treated, the sooner patients can increase their quality of life. In addition, if BPH is left untreated, the condition can worsen over time and cause permanent bladder damage.
Do you find that men are reluctant to seek treatment when their issues relate to sexual health?
Most men want to have an active sexual life. However, when they have difficulty achieving an erection, they become anxious about their sexual performance and may avoid sexual activity. Often times, men just aren’t aware of the treatment options that are available. I tell my patients that they will be able to achieve an erection with treatment. The treatment options include oral medications like Viagra, Levitra, Stendra, Cialis, and Staxyn. There is also a vacuum erection device. Trimix is a medication that is injected into the erectile bodies of the penis. Finally, when all else fails, there is an inflatable penile prosthesis. The penile prosthesis has been available for 40 years and patient and partner satisfaction are over 95%. The prosthesis is inserted through a small incision in the scrotum. They procedure is done in the operating room at the hospital and typically takes less than an hour. Fortunately, it is covered by most insurance companies, including Medicare.
While erectile dysfunction and decreased libido is more common with age, it is a condition that is treatable and is not something older men should just accept.
How would you define erectile dysfunction? Is it “healthy” for a man to expect the same sexual stamina he had in his twenties? More specifically—is a less active libido something older men should just accept?
Although erectile dysfunction suggests a total inability to achieve an erection, it also includes problems achieving or maintaining a firm erection, or the tendency to only have brief erections. While erectile dysfunction and decreased libido is more common with age, it is a condition that is treatable and is not something older men should just accept.
How common is testosterone deficiency in older men?
Hypogonadism, or “Low T” as it is called, is more common in men as they age. It is a syndrome that is associated with low testosterone levels that are measured as part of a blood test. If a man has low testosterone, and sexual, psychological and physical symptoms, he may have “Low T.” Sexual side effects include low libido, erectile dysfunction, difficulty achieving an orgasm, and decreased spontaneous erections. Non-sexual/psychological symptoms include diminished energy, fatigue, depressed mood, impaired cognition, and reduced motivation. Physical signs include osteoporosis, decreased muscle mass, increased body fat, anemia, and insulin resistance.
Many men suffer from sexual health problems and can benefit from treatment. There are several different ways to provide testosterone supplementation, including gels, shots, and an implant. The Testopel implant is covered by most insurances, including Medicare. It is placed by a simple office procedure through a 4mm incision in the hip area. It provides for 3-4 months of steady testosterone replacement.
What is the UroLift System procedure? Who is it suitable for? What are the side effects, if any?
The UroLift System is a breakthrough treatment for patients with an enlarged prostate. It is an outpatient procedure, performed in office setting or outpatient surgery center under local anesthesia. The procedure typically takes one hour or less. It is the only FDA cleared treatment with clinical data demonstrating preservation of sexual function — 0% ejaculatory or erectile dysfunction. No instances of new, sustained erectile or ejaculatory dysfunction were observed in the study. It is a first line treatment that gets men off of their medications and allows them to avoid major surgery. It involves no cutting, heating, or removal of prostate tissue. Patients experience immediate results, rapid symptom relief, recover from the procedure quickly, and return to their normal routines with minimal down time (patients can return to normal activity within days).
Is there anything we haven’t asked you that you would like to share with our readers?
Don’t wait to seek treatment. There are solutions to these problems. Please call our office to schedule an appointment 760-346-7191. You can find out more information about our services at www.walshurology.com and request an appointment online. We look forward to meeting with you!