Plumbing Problems? They say age is just a state of mind. Sometimes, however, our lower anatomy doesn’t get the memo. he truth is, as we get older, our “pipes” often begin to cause problems for both men and women. For men, conditions related to their prostate gland are often the center of attention. In this article, urologist Simon Kim, MD, MPH discusses two urologic conditions that are frequently seen in men over 50. Urinary Retention: Why can’t I go? Do you frequently feel a strong urge to urinate but when you get to the restroom, the results are, well….disappointing? Do you feel as though your bladder has not been fully emptied and return to the bathroom again only to experience the same weak, low volume stream? If you said yes, you are more than likely one of the almost 50% of men in the 50+ age group who have benign prostatic hyperplasia (BPH). It is more commonly known as an enlarged prostate gland. As the gland gets bigger, it may narrow or partially block the urethra – the tube that carries urine from the bladder out of the body. BPH is a normal part of aging in men, caused by changes in hormone balance and cell-growth factors. “Some men may have more severe symptoms than others. And, while the condition is not life threatening, there are many treatment options ranging from medication to surgery that can significantly improve a patient’s quality of life,” states Dr. Simon Kim, assistant professor of Urologic Oncology and Urology. In some cases, however, BPH can be a real health threat. In its most severe, untreated form, BPH can lead to kidney failure, recurrent urinary infections, bladder stones or blood in the urine. Usually medicine can delay or halt the progression of the benign prostate growth but occasionally surgery is necessary. If you are experiencing symptoms of BPH, it is always recommended that you see your physician. Your doctor will take a complete medical history and perform a physical exam that will likely include urinalysis, a digital rectal exam (DRE) and possibly a prostate-specific antigen test (PSA) to rule out prostate cancer. What if it is prostate cancer? If tests show that you have prostate cancer, your doctor will work with you to develop a management and treatment plan based on several factors – your age, the stage of the cancer and your overall health. In some men, the first step is simple surveillance. While most prostate cancers tend to grow slowly, some forms can be quite aggressive. If intervention is necessary, treatment options may include radiation therapy or surgery, which typically involves removal of the entire prostate gland and any surrounding tissues that may contain cancer cells. Advanced disease will be managed using a team approach with colleagues at the UH Seidman Cancer Center and the UH Urology Institute, where patients have access to emerging techniques, including the robotic radical prostatectomy. At UH Ahuja Medical Center, our urology specialists can help you choose the right course of medical treatment! Call 216-844-3009 for more information or to schedule a consultation. Or, email Dr. Kim directly at simon.kim@uhhospitals.org. T “Many men don’t even know how bad their BPH symptoms are until they are seen by a doctor who specializes in this area. The medicines usually prescribed for this condition are very safe and the surgery can often be performed in a minimally invasive way, usually not requiring hospital admission.” Simon Kim, MD, MPH Assistant Professor of Urology Case Western Reserve University School of Medicine 46 Beachwood Buzz n July 2015