Who Do I Choose?

The potential warning signs are there. You are urinating more often, starting a urine flow is taking more effort, and there are challenges keeping that stream going. Are you having a sense of urgency to urinate, only to find you are experiencing a weak stream or just dribbling? Are you saying to yourself, "this is something I can live with?” Chances are the answer to that last question may be NO as things progress.

Unless you visit a doctor, it may be impossible to know what is going on. And that leads to the next question: do I visit with a general practitioner, or do I take a deep breath and make an appointment with a urologist? Is there a difference? For me, the answer is YES.

Seeing a urologist

For a person experiencing below-the-belt issues, I think they owe it to themselves and their family to make an appointment with the urologist for a complete examination. Is it a fun experience? The answer, to me, is NO. And YES, I think the experience can be somewhat embarrassing and a bit uncomfortable.

That said, I think it's important to know if you are facing early-stage prostate cancer, an infection, or an enlarging prostate due to aging.

Trying to get a handle on symptoms

If symptoms are new and not severe, a few things may be of help, including: trying to maintain a healthy weight, avoiding antihistamines and decongestants, and limiting the amount of caffeine and alcohol consumed (as these can irritate the bladder). While this may be helpful advice, I think many tend to forget it after a few days.

As things continue to slow down, and one finds themselves spending more and more time at the urinal, a person may be motivated to visit with an MD (hopefully a urologist), who can check things over.

Different approaches

The doctor may prescribe alpha blockers to relax the muscle around the prostate and bladder neck, allowing urine to flow more easily.1 They may also prescribe other drugs to lessen the pressure on the urethra. You might be surprised to learn that Cialis (tadalafil) can help relieve urinary flow problems and ... as a side benefit may help with erections. That must be good news to all of us as we age.2

If these approaches are not successful, a person may need a surgical procedure to remove the excess prostate tissue that is preventing or slowing urine flow. This type of surgery generally takes between one or two hours and can be performed in the MD’s office, at a local surgical center, or a hospital. While your symptoms may improve, future problems can still develop, and some may require additional procedures.3

Improving urine flow

Today urologists have many ways to improve urine flow, ranging from the removal of tissue surgically or by using some of the newer types of tissue vaporization tools such as HoLEP and Rezum. Another development is the use a UroLift, in which a series of small implants pull back tissue and in the process improve urine flow.4

While your general practitioner may have some familiarity with these procedures, it just makes sense to me to have an expert involved in care sooner than later when it becomes harder to treat.

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