HealthMatters 2010
the body and acts like a heart pacemaker to
control urges. Botox to numb nerve fibers in
the bladder is also being tested as a way to
control the urge to urinate.
Male Call
erecTIle dysfuncTIon: Causes in-
clude other medical conditions, such as dia-
betes. Walsh says men may come into the
office for one urology issue but end up dis-
cussing a number of others, such as eD. The
For the various urologic conditions men face,
problem “has become much less stigmatized
than in the past,” Butler says, “so people are
the sooner you seek treatment, the better off
more likely to come in earlier, and early
treatment leads to better outcomes.”
you’ll be. By Scott R. WeinBeRgeR
KIdney sTones and cancer: The
treatment for kidney stones depends on
size and location, but it’s often done with
shockwaves that pulverize the stone into
tiny pieces. also, a scope may be navigated
through the urethra to deploy tiny lasers
and basketlike instruments to blast and re-
move stones. for very large stones, a tube
can be inserted through the back. Cancer-
ous kidneys can be removed laparoscopical-
ly, sometimes with robot-assisted surgery, or
treated with the CyberKnife.
VasecToMy and ferTIlITy: Walsh per-
forms 300 to 400 vasectomies a year, each
taking about 10 minutes in an office setting.
While urologists may help diagnose fertility
T
he message for men is simple: get an annual physical exam from problems and can treat a few of them, they
your primary care doctor, and make sure it includes screening for prostate cancer are more likely to refer infertile couples to
– blood and urine analysis, and an exam of the lower abdomen and genitals – as other specialists for advanced options, such
well as a digital rectal exam. as in vitro fertilization. ✚
“The biggest concern is prostate cancer,” says Dr. Chris Walsh, a urologist at metropoli-
tan Urology group who is on staff at prohealth Care, Wheaton franciscan healthcare
and aurora health Care. Walsh estimates that 50 percent of a urologist’s time is spent
RoBotic SuRgeRy
diagnosing or treating this one condition.
Robot-assisted suRgeRy for pros-
Key Issues for Men
tate, bladder and kidney cancers is relatively
common in Milwaukee. The surgeon still
ProsTaTe cancer: “We’re beginning to understand who needs to be treated [quickly]
performs the operation – a form of laparos-
for prostate cancer and who can be followed” without immediate treatment, says Dr. Brian
copy with small incisions instead of one
Butler, a urologist who practices at Urology associates ltd. and is also on staff at Wheaton large open one – but the robotic assistance
franciscan healthcare, aurora health Care and prohealth Care. extremely slow-growing
allows for finer movements than the human
cancers, for example, may bear careful watching rather than immediate treatment.
hand alone can achieve. Tiny cameras
one new method of treatment – using ultrasound energy to heat up and shrink tumors
inserted into the site also mean excellent
– is up for fDa approval. another treatment option, the CyberKnife, shoots a couple hun-
3-D visualization of the surgery area.
The surgeon doesn’t touch the patient,
dred rays of carefully targeted radiation. high doses of finasteride, the active ingredient in
but instead sits at a video and control con-
the hair-loss product propecia, may prevent prostate cancer.
sole a few feet away.
enlarged ProsTaTe: also known as benign prostatic hyperplasia (Bph), it can cause “Standard laparoscopic instruments
urinary symptoms that include frequent or difficult urination. medications may help. la- didn’t provide the dexterity needed to do a
ser ablation, needle ablation or microwave thermal treatment may be used to shrink the
more complex surgery,” such as removing
enlarged prostate. a greenlight laser is being considered as a way to “trim” the pros-
the prostate, says Dr. Brian Butler. Robotic
tate gland in an office-based procedure that is less invasive than the typical transurethral
prostate cancer surgery offers advantages
over open surgery with an equal cancer
electro-resection of the prostate.
cure rate.
InconTInence: in some people, frequent or uncontrollable urination can be devastating.
“The real advantage,” says Butler, “is that
sometimes medications, biofeedback or minor surgery may help. a small percentage of pa-
you can do complex operations in a much
tients with severe incontinence may benefit from a nerve stimulator that is implanted into more delicate way.” ✚
32 › Milwaukee Magazine › HealthMatters 2010 ›
milwaukeemagazine.com
1109_HM_Urology.indd 32 9/21/09 11:54:03 AM
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96