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Urology and Men’s Health

In a recent national survey, 72% of men said they’d rather do household chores – like cleaning the bathroom or mowing the lawn – than visit the doctor. And according to data collected by the CDC, men in the United States are less likely than women to visit a doctor, have a wellness visit, or have a place they usually go when they’re sick or in need of health care.

Some health issues men experience, like bladder control or erectile dysfunction, might be difficult or embarrassing to talk about, which can add another barrier to seeing a doctor – even though their conditions can significantly impact their everyday activities. But with the right treatment, a urologist can help patients get back to normal lives.

What Is Urology?

“Urology is a surgical specialty that covers anything that urine touches,” says Dr. Brendan Browne, an Assistant Professor of Urology at Emory University and urology specialist at Emory Healthcare. Urologists treat a variety of conditions that affect your kidneys, bladder, urethra, and ureters – the tubes that drain the kidneys into the bladder – as well as men’s reproductive conditions.

There are a variety of conditions that are treated by urologists, from benign and routine quality-of-life issues to life-threatening cancers. “Blood in the urine is often a reason people come to a urologist,” Dr. Browne explains. “For visible blood, patients will often show up on their own,” he says, “and their primary care doctors refer them if the blood is microscopic.”

When To Visit a Urologist

Emory Urology provides diagnoses and treatments for many urologic conditions that affect everyone, and some that affect only men or women. Some common conditions include:

  • Urinary symptoms, including incontinence, slow streams, incomplete emptying, or frequent urinary tract infections.
  • Kidney stones
  • Bladder and kidney cancer

Urologists also address men’s reproductive and sexual health, including conditions like:

“Urologists have a range of clinical and surgical expertise that is relatively unique to our part of the human body,” Browne says. “Patients can have small procedures, from vasectomies or clinic-based scope evaluations through major surgery – removing kidneys or bladders, dealing with cancers, or complex reconstruction from trauma.”

Often, patients are referred by their primary care doctor at the age when they begin prostate cancer screening. He explains, “A PSA is a blood test that screens patients for prostate cancer. It’s often drawn by a primary care doctor and can lead to a urology referral for further investigation.” Other patients may be referred from the emergency department for reasons like flank pain that could indicate kidney stones, or a CT scan showing something unexpected in their kidney, or the inability to urinate.

Sometimes, patients seek out urologists on their own. “People will come to us to discuss medical or surgical treatments for urinary symptoms, or to talk about erectile dysfunction and infertility,” he says, “and we have many options for helping these patients”.

Common Treatments

“Removing kidney stones is one of our most common procedures,” says Browne. “People with a family history often have kidney stones, and especially in the summer, dehydration is one of the biggest causes of formation.” Often, patients with kidney stones arrive at the emergency department or their primary care physician’s office with symptoms that include flank pain, nausea, vomiting, and blood in their urine.

There are a few ways to treat kidney stones. “Some may pass on their own,” Browne says. “It’s not always pleasant, but it’s very possible, especially with smaller stones.” In select cases, a patient may have a shockwave treatment that fragments the stone from the outside. “For large stones, the better option is to remove them with small scopes in an operating room. While this is more invasive, it has a much higher success of getting rid of the stone.”

Kidney stones are just another reason to avoid dehydration in these hot Georgia summers.

Men’s Health and Urology

Many of the procedures that urologists perform are related to men’s health, such as vasectomies, prostate cancer screenings, management of conditions that arise after cancer treatment, and treatment of infertility.

  • Vasectomy is a highly effective form of contraception that is performed in about 20 minutes and generally requires only a few days of light activity for recovery. This procedure carries a much lower risk than female-contraception procedures while providing 99.5% effectiveness for contraception.
  • Screening for prostate cancer is done mostly in men 50-70 years old. This can take several forms, usually starting with a prostate exam and PSA blood test, which are able to identify most men at risk for prostate cancer. If there are any suspicious findings, then additional testing is available, including the traditional prostate biopsy as well as non-invasive methods like an MRI, which Browne says is about 90% effective for identifying clinically significant prostate cancer.

“There are plenty of prostate cancers that are low risk that we feel comfortable safely monitoring with an active surveillance program,” Browne explains. “This surveillance process includes additional blood tests as well as MRIs and biopsies over a period of time. More than half of men with low-risk prostate cancer are able to avoid further surgery or radiation over 10 years, which means they avoid the side effects of these treatments.”

In cases that require treatment of prostate cancer, Browne says that Emory’s urologists have the full spectrum of options for treatment including minimally invasive robotic surgery to remove the prostate or multiple types of radiation treatment. Our urologists are part of a multidisciplinary genitourinary cancer care team at Winship Cancer Institute of Emory University that also includes medical oncologists, radiation oncologists, pathologists, nuclear medicine specialists, advanced practice nurses and social workers.

After having prostate cancer, Browne says some men experience issues with urinary incontinence or erectile dysfunction. “But just because you were treated for prostate cancer doesn’t mean that your life is over,” he remarks, “many of these men live for decades after treatment and we want to make sure that they enjoy those years”. With a variety of options – from medications to surgeries with prosthetics – he says that urologists can help men reclaim their sense of normalcy, “whether by eliminating urinary incontinence after years of leakage or returning to sexual intimacy with their partners that may have been lost after cancer treatment.”

Urologists at Emory also work with the range of infertility issues men may experience. This can be very challenging for a patient and his partner, but Emory Urology offers cutting-edge treatments including microscopic testicular sperm extraction and in vitro fertilization in collaboration with the Emory Fertility Center.

Helping the Most Complex Patients

“Quality is our strength at Emory,” says Browne. “What sets us apart is quality of care and being at the forefront of technology and clinical trials – we are capable of helping even the most complex of patients from all over the country, which we do regularly.”

“The Emory Department of Urology is a leader in clinical care for advanced kidney cancer, especially if they spread into the large blood vessels draining the kidney, as well as bladder cancer, minimally invasive surgery, and complex reconstruction, having patients come from all over the southeast and even across the country,” says Dr. Browne. Many of these patients have rare conditions and come to Emory for the expertise that comes from being a center of excellence. “We are happy that we can offer treatments that some smaller practices cannot access due to limited supply, such as BCG a medication that goes into the bladder for superficial bladder cancer. But also for more advanced conditions, Emory has experts in every field that frequently and seamlessly work as a team to make sure every part of a patient’s complex medical condition is optimized while they go through treatment.”

Additionally, at Emory we continue to explore the best treatments for patients (especially for those with highly complex conditions) through a variety of research programs and clinical trials that help drive the science and practice of urology forward toward ideal patient outcomes.

Dr. Browne adds, “not only do we offer the gold-standard established treatments for all urologic conditions, we are also continually evaluating new opportunities for patient care. Whether with new medications or new technologies, Emory Urology wants to evaluate these new treatments and decide what works best for our patients. Not every new treatment works as well as the established standards and we make sure that at Emory we only offer the best options for our patients.”

Some of the new technologies that have continued to grow in the department include MRI fusion prostate biopsy, single-port robotic surgery and Holmium Laser Enucleation of Prostate (HoLEP) a laser treatment for severe prostate enlargement.

In 2019, Emory Urology was the first department in the state of Georgia to offer HoLEP, a minimally invasive procedure for men with urinary symptoms related to prostate enlargement. “These patients are usually told they don’t have many options, or might need an open abdominal surgery,” he explains, “but this approach is a laser-based surgery that can manage very large prostates with just a scope.” HoLEP is safe and effective, and Browne says that the procedure has the shortest hospital stay, shortest catheter stay, and least blood loss of options available to patients with complex conditions. “That was a great thing we were able to start here and have had great success with as it’s grown,” he says.

Total Urology Care

During his career at Emory Urology, Browne says he’s watched the department grow. “We continue to add new providers who all do unique and highly-trained things,” he remarks. “I’m happy to see there aren’t any gaps in the service we have to offer.”

Emory Urology offers total urology care and uses research-based innovation in all areas of specialized care, including robotic surgery, reconstructive urology, men’s urology health & infertility, women’s urology health, kidney stones, and urologic oncology.

But foremost, Browne says, “We want to select the treatment that’s best for the patient in the short and long-term and gives them the best success to get back to living their life.”

Request an Appointment

Our caring team of urology experts can help you with your urology concerns. To learn more or schedule an appointment, please call 404-778-4898, Mon–Fri 8:00 a.m.–5:00 p.m.

 

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