The Prostate Gland: Man’s Center of Gravity

25 Feb 2019 Blog

Written by Dr. Andrew Siegel

The prostate gland is a mysterious male reproductive organ that can be a source of curiosity, anxiety, fear and potential trouble. Since this gland is a midline organ nestled deep within the pelvis, I like to think of it as man’s “center of gravity.”

Where exactly is the prostate gland?

The prostate gland is located behind the pubic bone and is attached to the bladder (above) and the urethra (below). The rectum is directly behind the prostate (which permits access for prostate exam). The prostate is situated at the crossroads of the urinary and reproductive tracts and completely surrounds the urethra, allowing its many ducts to drain into the urethra. The relationship between the prostate and the urethra can potentially be the source of problems for the older male. When a man ages, the prostate gland gradually enlarges. This prostate enlargement can constrict and block the urethra, giving rise to bothersome urinary symptoms.

What is the prostate, what purpose does it serve, and how does it function?

The prostate is a male reproductive gland that produces prostate fluid, a nutrient and energy vehicle for sperm. The prostate consists of glandular and fibro-muscular tissue enclosed by a capsule of collagen, elastin and smooth muscle. The glandular tissue contains the secretory cells that produce the prostate fluid.

Semen is a “cocktail” composed of prostate fluid mixed with secretions from the seminal vesicles and sperm from the epididymis. The seminal vesicle fluid forms the bulk of the semen. The seminal vesicles and vas deferens (tubes that conduct sperm from testes to prostate) unite to form the ejaculatory ducts.

At the time of sexual climax, prostate smooth muscle contractions squeeze the prostate fluid through prostate ducts at the same time as the seminal vesicles and vas deferens contractions squeeze seminal fluid and sperm through the ejaculatory ducts. These pooled secretions empty into the urethra (channel that runs from the bladder to the tip of the penis). Rhythmic contractions of the superficial pelvic floor muscles result in the ejaculation of the semen.

What are the zones of the prostate gland?

The prostate gland is comprised of different anatomical zones. Most cancers originate in the “peripheral zone” at the back of the prostate, which can be accessed via digital rectal exam. The “transition zone” surrounds the urethra and is where benign enlargement of the prostate occurs. The “central zone” surrounds the ejaculatory ducts, which run from the seminal vesicles to the urethra.

Curious facts about the prostate:

  • The prostate functions to produce a milky fluid that serves as a nutritional vehicle for sperm.
  • Prostate “massage” is sometimes done by urologists to “milk” the prostate to obtain a specimen for laboratory analysis.
  • The prostate undergoes an initial growth spurt at puberty and a second one starting at age 40 or so.
  • A young man’s prostate is about the size of a walnut, but under the influence of aging, genetics and testosterone, the prostate gland often enlarges and constricts the urethra, which can cause annoying urinary symptoms.
  • In the absence of testosterone, the prostate never develops.
  • The prostate consists of 70% glands and 30% muscle. Prostate muscle fibers contract at sexual climax to squeeze prostate fluid into the urethra. Excessive prostate muscle tone, often stress-related, can give rise to the same urinary symptoms that are caused by age-related benign enlargement of the prostate.
  • Women have a female version of the prostate, known as the Skene’s glands.

Learn more about Men’s Health at New Jersey Urology >

4 Common Causes of Urinary Incontinence in Men

18 Feb 2019 Blog

Urinary incontinence is the accidental leakage of urine that you can’t control. Anywhere from 5% to 15% of men over the age of 60 are affected.

Urinary incontinence is not just a medical problem – it often becomes an emotional and social problem that interferes with people’s everyday lives. Often targeting the cause of urinary problems can help you and your doctor find the best treatment option to reduce bladder leakage and restore daily function.

Common Causes of Urinary Incontinence in Men:

  • Prostate problems. Prostate problems, especially as men age, can result in problems with urinary incontinence. If the prostate is enlarged, it may affect the flow of urine and cause a weak stream, frequent urination, or leaking. When the prostate is removed for cancer treatment, it is common to have stress incontinence, meaning coughing or sneezing can trigger leakage.
  • Conditions that cause nerve damage. Because muscles and nerves must work together to control the bladder, any condition that damages the nerves can create urinary problems. Conditions may include Parkinson’s, a stroke, diabetes, or multiple sclerosis. Injuries of the spinal cord can also result in urinary incontinence.
  • What you drink. Certain types of beverages can put stress on the urinary system. Limiting the amount of alcohol, caffeine, or carbonated beverages that you drink can help reduce bladder leakage. Staying hydrated is important, but it is not necessary to drink a certain amount of water during the day.
  • Being overweight. Being overweight can cause or worsen male incontinence because extra weight weakens the muscles that help with bladder function. Obesity may affect female incontinence more than in men, but it can still be a factor of male incontinence.

Treating Male Urinary Incontinence

There are many ways to ease the symptoms of male urinary incontinence, including behavioral treatments, medication, and surgery. Find a urologist near you by visiting our locations page.

5 Signs of Bladder Cancer: What Women Should Know

11 Feb 2019 Blog

Written by Dr. Paul Littman:

Even if you’re vigilant about getting routine GYN care, bladder cancer may not be on your radar. After all, it’s far more common among men than women, and the majority of cases affect patients over age 65. However, don’t let those stats keep you from learning to spot the symptoms.

Many people mistakenly think bladder cancer is only a disease of older men, but there are more than 18,000 women who are diagnosed with this cancer every year in the United States. Because women may not be on the lookout for early signs of bladder cancer, the Bladder Cancer Advocacy Network reports that women are more likely to be diagnosed with bladder cancer at an advanced stage.

Knowing the signs and symptoms can help you get diagnosed sooner, which may improve your prognosis. Here are five warning signs to watch for:

  1. Blood in your urine. This is the most common early symptom of bladder cancer, and it’s an easy one for women to overlook because it’s typically painless and you can go weeks or even months between occurrences. Many women ignore this symptom because they connect it with menstruation or menopause. Women who have microscopic blood in the urine without symptoms of urgency, frequency or pain often don’t have a urinary tract infection (UTI). In fact, the blood in the urine may be due to cancer or other conditions.
  2. UTI-like symptoms. Bladder cancer can often be mistaken for a UTI because many of the symptoms overlap. Patients may experience increased frequency of urination, urgency to urinate, pain with urination, or urinary incontinence. If you’ve noticed any urinary problems—you have to go all the time, or you feel like you have to go but can’t, or you have a hard time emptying your bladder—or if antibiotics don’t seem to be helping your UTI symptoms, talk to your doctor.
  3. Unexplained pain. Pain is often associated with more advanced bladder cancers. Pain can occur in the flank area, abdomen, or pelvis. Patients can also develop pain in their bones if the cancer has spread to their bones. If you’re having aches and pains in those areas, tell your doctor—especially if you’ve also had the aforementioned spotting or UTI symptoms.
  4. Decreased appetite. Appetite loss is a common cancer symptom, and bladder cancer is no exception. If the cancer has grown or spread, you might have weight loss or feel tired and weak. Of course, there are plenty of other things that can mess with your appetite, so don’t automatically assume the worst—but do talk to your doctor about it if it persists.
  5. Smoking. According to the National Institutes of Health, about 50% of women diagnosed with bladder cancer are smokers. Smoking is the biggest risk factor for bladder cancer. If you notice any of the above symptoms and you smoke, let your doctor know as soon as possible.

Because it’s easy to chalk up symptoms to a stubborn UTI or normal vaginal spotting, bladder cancer may be overlooked in women, and they are often not diagnosed until their cancer has spread and it’s harder to treat. So if you’re worried, don’t just write off your symptoms. A urogynecologist is the perfect type of doctor to determine if it’s a minor infection or something more serious—and if it is bladder cancer, it’s easier to treat if you catch it early.

Find a doctor near you >

Male Sexual Dysfunction: A Predictor of Heart Disease

4 Feb 2019 Blog

Written by Dr. Andrew Siegel:

Having some fat on our bodies is not a bad thing, as long as it is not excessive. Fat serves a number of useful purposes: it cushions internal organs, provides insulation to conserve heat and it is a means of storing energy and fat-soluble vitamins. Fat is also part of the structure of the brain and cell membranes and is used in the manufacturing process of several hormones.

All fat is not created equal. It’s all about location, location, location.

Not all fat is the same. It’s important to distinguish between visceral fat and subcutaneous fat. Visceral fat– also referred to as a “pot belly” or “beer belly” – is internal fat located deep within the abdominal cavity. Subcutaneous fat – also known as “love handles,” “spare tires,” or “muffin top,” – is superficial fat located between the skin and the abdominal wall.

In addition to the physical distribution of the fat being different, so is the nature of the fat. Although neither type is particularly attractive, visceral fat is much more hazardous to one’s health than subcutaneous fat. Visceral fat increases the risk of heart disease, diabetes and metabolic disturbances. Subcutaneous fat is inactive, relatively harmless, and generally does not contribute to health problems.

Factoid: A beer belly is called a beer belly for good reason. One of the real culprits in creating visceral fat is drinking liquid carbs, including sweetened beverages (sodas, iced tea, sports drinks), fruit juices (such as orange or cranberry) or alcoholic beverages. These liquid carbs have no fiber and are essentially pre-digested, stimulating an insulin surge and rapid storage as fat. It’s always better to eat the fruit rather than drink the juice because fruit is loaded with fiber that fills you up, slows the absorption process, and contains abundant phytonutrients.

Visceral fat essentially is a metabolically active endocrine “organ” that does way more than just create an unsightly protrusion from our abdomens. It produces numerous hormones and other chemical mediators that have many detrimental effects on all systems of our body, including risk of diabetes, cardiovascular disease, low testosterone, erectile dysfunction (ED) and premature death.

Sexual dysfunction

Beer belly and metabolic syndrome are highly associated with low testosterone and poor erection and ejaculation function. The fatty tissue present in obese abdomens contains abundant amounts of the enzyme aromatase, which converts testosterone to estrogen —literally emasculating obese men. So, visceral fat can steal away our masculinity, male athletic form and body composition, mojo, strength, and the ability to obtain and maintain a good quality erection.

ED serves as a good proxy for cardiac and general health. The presence of ED is as much of a predictor of heart disease as is a strong family history, tobacco smoking, or elevated cholesterol.

FactoidThe penis can function as a “canary in the trousers.” Since the penile arteries are generally rather small (diameter of 1- 2 mm) and the coronary (heart) arteries larger (4 mm), it stands to reason that if vascular disease is affecting the tiny penile arteries and causing ED, it may affect the larger coronary arteries as well — if not now, then at some time in the future. In other words, the fatty plaque that compromises blood flow to the smaller vessels of the penis may also do so to the larger vessels of the heart and thus ED may be considered a genital “stress test.”

While the penis can genuinely shrink for a variety of reasons, most of the time it is a mere illusion — a sleight of penis. Obesity causes a generous pubic fat pad that will make the penis appear shorter. However, penile length is usually intact, with the penis merely hiding or buried behind the fat pad. Lose the fat and presto…the penis reappears. Yet another reason to remain lean!

Trivia: It is estimated that for every 35 lbs. of weight gain, there is a one-inch loss in apparent penile length.

What does this all mean?

  • Visceral fat is a bad, metabolically-active form of fat that is highly correlated with metabolic syndrome, diabetes, heart disease and sexual dysfunction.
  • ED often occurs in the presence of “silent” heart disease (no symptoms) and serves as a marker for increased risk for heart disease (as well as stroke, peripheral artery disease and death). ED will often occur 3-5 years before heart disease manifests. Early detection of ED provides an opportunity to decrease the risk of heart disease and the other forms of blood vessel disease. ED has a similar or greater predictive value for heart disease as do traditional factors including family history, prior heart attack, tobacco use and elevated cholesterol. The greater the severity of the ED, the greater the risk and extent of heart disease and blood vessel disease.

What can I do?

Lifestyle intervention has the potential for reversing visceral obesity, metabolic syndrome and sexual dysfunction. This lifestyle intervention involves achieving a healthy weight, losing the belly fat, eating healthy, exercising regularly, quitting smoking, limiting alcohol intake, and managing stress.

Learn more about Men’s Health services at New Jersey Urology >

Why You Should Exercise the Pelvic Floor Muscles

28 Jan 2019 Blog

Written by Dr. Andrew Siegel:

We hear much about the importance of strengthening our “core” muscles. Most core exercise programs focus on the abdominal, hip, and back muscles. However, there are deeper core muscles that form the floor of the core muscles–the pelvic floor muscles—that are often neglected. These muscles play a vital role in sexual, urinary, and bowel health and in maintaining proper form, balance and posture during virtually every form of exercise.

The Pelvic Floor Muscles

The pelvic floor muscles are not well-respected external glamour muscles. However, these often-ignored pelvic muscles are hidden gems that work diligently behind the scenes. These muscles have a role that goes way beyond the joint movement and locomotion function of the external muscles. Although concealed, the pelvic muscles have a profoundly important role in sexual, urinary, and bowel function as well as in supporting our pelvic organs.

Use Them Or Lose Them

The pelvic floor muscles, as with other muscles in the body, are subject to adaptation. Unused as intended, they can become thin, flabby and poorly functional as happens with aging, weight gain, a sedentary lifestyle, poor posture and other forms of injury and trauma, chronic straining, and surgery. Used appropriately as designed by nature, they can remain healthy in structure and function. When targeted exercise is applied to them, particularly against the forces of resistance, they can be enhanced. Diligently practiced pelvic exercises will allow one to reap tangible rewards, as having fit pelvic muscles is the essence of functional fitness.

Pelvic Floor Muscle Training: In Isolation and Integrated With Other Workouts

There are two means of working out the pelvic floor muscles: in isolation and integrated. In order to become the master of your pelvic domain, it is initially important to isolate the pelvic floor muscles. Once pelvic floor muscle competence is established, pelvic exercises can then be integrated into other exercise routines and workouts. In real life, muscles do not work in isolation but rather as part of a team, the pelvic muscles being no exception. The pelvic floor muscles often contract in conjunction with the other core muscles in a mutually supportive and synergistic fashion. In fact, many Pilates and yoga exercises emphasize consciously contracting the pelvic muscles simultaneously with the other core muscles during exercise routines.

Engaging the pelvic floor muscles while doing squats, lunges, etc., serves not only to integrate the lower regions of the core and provide optimal support and “lift” of the floor of the core, but also as a means of exercising the mind-body connection. It is important to avoid overexertion of the pelvic floor muscles and awareness directed towards this region is sufficient without the necessity for a forceful contraction.

Dynamic exercises in which complex body movements are coupled with core and pelvic stabilization—such as squats and deadlifts—enhance non-core as well as core strength and function to the maximum. The core muscles, including the pelvic floor, stabilize the trunk when our limbs are active, enabling us to put great effort into limb movements. It’s impossible to use the arm and leg muscles effectively in any athletic endeavor without engaging a solid core as a platform from which to push off (think martial arts). Normally this happens without conscious effort, but with some focus and engagement, the core and pelvic floor contraction can be optimized. The stronger the platform, the more powerful the potential push off that platform can be.

Pelvic Contractions To Counteract Intense Training Regimens

Weight training and other forms of intense exercise result in tremendous increases in abdominal pressure. This force is largely exerted downwards towards the pelvic floor, particularly when exercising in the standing position, when gravity also comes into play. Engaging the pelvic floor during such efforts will help counteract the vector of downwards forces exerted on the pelvic floor.

Knack Maneuver

Many females and certain males (particularly after radical prostatectomy) suffer with stress urinary incontinence, a spurt-like urinary leakage that occurs at times of increased abdominal pressure such as with sports and other high impact activities including jumping and kickboxing. For years, urologists and gynecologists have advocated the “knack” maneuver to counteract this, a technique in which the pelvic muscles are braced and briskly engaged at the time or just before any activity that triggers the stress incontinence. When practiced diligently, this can ultimately become an automatic behavior.

Bottom Line: The pelvic floor muscles are out of sight and therefore out of mind. However, these muscles that form the floor of the core are fundamental to many important body functions (sex, urinary and bowel). Pelvic floor muscle conditioning will not only help keep these functions in working order, but also is a vital component to the performance of complex movements that require engagement and stabilization of the core muscles.

10 Ways to Get Your Best Night’s Sleep

21 Jan 2019 Blog

Written by Dr. Andrew Siegel:

In addition to exercise and healthy eating as the key pieces to a healthy lifestyle, modern science supports quality sleep as a third piece of equal importance. According to the CDC, more than one third of Americans are not getting enough sleep on a regular basis. 

What’s obvious

Getting enough good quality sleep is important for our well-being and daily functioning. We’ve all enjoyed the joyous experience of a great night’s sleep, waking up well-rested, energetic and optimistic. On the other hand, we’ve all also experienced a poor night’s sleep, awakening feeling physically exhausted, mentally spent, and often in a disassociated “zombie” state.

The amount of sleep each person needs is biologically determined and different for everyone. Some can make do with five hours of sleep while others require ten hours. As a general rule, seven to eight hours of sleep is recommended. Regardless, sleeping has a restorative function as our brains and bodies require this important down time for peak performance.

What’s not so obvious

Good quality sleep is an important component of overall health, wellness, and fitness. Sleep deprivation can have a negative impact on numerous bodily functions, including:

  • Cognitive
  • Endocrine
  • Metabolic
  • Cardiovascular
  • Gastrointestinal
  • Immunity

While sleeping, there is an increased rate of anabolism (cellular growth and synthesis) and a decreased rate of catabolism (cellular breakdown). These processes are disrupted by sleep deprivation. Chronic sleep issues can result in making one feel ill and appearing much older than they are.

Sleep disruption results in decreased levels of leptin (a chemical appetite suppressant), increased ghrelin levels (a chemical appetite stimulant), increased corticosteroids (stress hormones) and increased glucose levels (higher amounts of sugar in the bloodstream). As a result, chronic sleep deprivation commonly gives rise to increased appetite, increased caloric intake and the disassociated “zombie” state – resulting in dysfunctional eating patterns, consumption of unhealthy foods, and weight gain. In addition, chronic fatigue impairs one’s ability to exercise properly, if at all.

Chronic sleep deprivation also results in irritability, impaired cognitive function and poor judgment. The inability to be attentive and focused interferes with work and school performance, causes increased injuries (such as falls), and motor vehicle accidents.

What to do

The good news is that sleep deprivation can be alleviated. Here are a variety of ways to get a good night’s sleep:

  1. Lead an active lifestyle with lots of exercise and stimulation.
  2. Whether you are an early riser or a night owl, try to be consistent with wake-up and bedtimes on both weekdays and weekends. If these times vary greatly, you’re setting yourself up for sleep problems by disturbing your body’s internal clock.
  3. Maintain a comfortable sleeping environment with a good quality supportive bed, comfortable pillows, a dark room, cool temperature and, if you like, “white noise” (I find that the monotonous sound of the sea produced by a sound machine, coupled with the gentle whirring of an overhead fan, is an instant relaxer).
  4. Avoid caffeine (coffee, tea, cola, etc.) particularly after 6 p.m. Herbal teas (like chamomile) can be soothing and relaxing.
  5. Avoid eating a large dinner or eating very late at night.
  6. Don’t drink too much alcohol.
  7. Avoid exercising late in the evening.
  8. Reduce the stress in your life as much as you can. Engage in a de-stressing activity immediately before sleep, such as reading, watching a movie or television show, or doing crossword puzzle.
  9. Try to minimize evening exposure to the bright light (“blue light”) of cell phones, tablets and computers that inhibits production of the sleep-promoting hormone melatonin. Under normal circumstances, melatonin levels rise with darkness. If possible, dim the light settings on electronic devices that are used at night.
  10. Supplemental melatonin seems to help some people, but is ineffective for many others (including myself), but may be worth a try.

Read more health and wellness tips on our blog >

Fluctuating Urine Color and Odor – What Does It Mean?

14 Jan 2019 Blog

Urine color can range from pale yellow to deep amber – but what does it mean? There are many factors that can affect urine color, including fluid balance, diet, medicine and disease.

Urine Color

How dark or light the color of your urine is depends on how much water you drink. Water and other fluids dilute the yellow pigments in urine, so the more you drink, the clearer your urine will be. In cases of dehydration, the urine can become a dark amber color.

Some vitamins and supplements – such as Vitamin B – can turn urine bright yellow. Some foods – such as blackberries, beets or rhubarb – can turn urine a reddish-brown. Having blood in your urine can also make it appear reddish-brown, so it’s important to observe and take note of these subtle signs and symptoms.

Urine Odor

Some foods (such as asparagus), vitamins, and antibiotics (such as penicillin) can cause urine to have a different odor. A sweet, fruity odor may be caused by uncontrolled diabetes. A urinary tract infection (UTI) can cause a foul odor.

When to See a Doctor

Sometimes, symptoms can be very vague or subtle which makes it very difficult to figure out what the problem is. If you are dehydrated your urine will be more concentrated and urinating may cause discomfort. Drink enough fluids to keep your urine light yellow or clear, this will help decrease discomfort.

Visible blood in the urine is often a sign of a urinary tract infection or kidney stone. Dark or orange urine may be a sign of liver malfunction. You should notify your doctor if you experience any of these symptoms.

Find a Urologist Near You >

10 Easy Food Substitutions for a Healthier Lifestyle

2 Jan 2019 Blog

Written by Dr. Andrew Siegel:

Today’s entry is about a healthy eating lifestyle—as opposed to a diet—that works for me and I promise will help you improve your body shape and shed excess pounds. I want to emphasize that this is not a fad diet, but a style of eating that can be easily incorporated to replace the typical calorie-rich, nutrient-poor Western diet that is overloaded with highly processed and refined foods, junk and fast foods, contributing to avoidable chronic health problems. As opposed to many weight loss programs that are gimmicky, unbalanced, unhealthy, and unsustainable, this approach is a no-nonsense, intelligent one—clean, lean, with plenty of green—that will stave off your hunger and hold caloric intake in balance with expenditure, making it effective and durable.

Bialy Diet

First I will introduce the bialy diet. It is sensible and nutritious eating, substituting less caloric and healthier foods for more caloric and unhealthier alternatives. For example, eating bialys instead of bagels. A bialy diet does not imply eating a bialy at every meal, but is simply code for substituting healthier choices for unhealthier ones!

A Few Words on Bialys

bialy | bēˈälē | noun (plural bialys) US a flat bread roll topped with chopped onions

Who doesn’t love a fresh, warm NY bagel with a smear of cream cheese? Sadly, the answer is our bodies and our health. The 360-calorie bagel with two tablespoons of cream cheese (100 calories) is 460 calories of mostly refined carbs and fat. A great alternative is a bialy (“bialystoker kuchen” from Poland where it originated), a delicious flat bread roll that contains no hole, is not over-stuffed and bulging like an overinflated tire and has a depressed middle that is flavored with cooked onions and poppy seeds. The 180-calorie toasted bialy with a teaspoon of light butter with canola oil (20 calories) is only 200 calories and smells and tastes delicious. It is crisp and chewy at the same time, totally satisfying and doesn’t leave you feeling bloated. This with a mug of strong black coffee and half a grapefruit with a few strawberries or blueberries thrown on top is my typical breakfast. Sometimes on the weekends I will have an egg white omelet on a bialy with a slices of NJ tomato and avocado, a heavenly treat.

Mediterranean Diet

Mediterranean style eating emphasizes less meat and more fish, an abundance of vegetables and fruits (rich in biologically active compounds including antioxidants, vitamins, minerals and fiber), whole (unrefined) grains, legumes and healthy vegetable fats from olives, avocados, nuts and seeds. Herbs and spices are used to flavor food, rather than salt. Dairy products are eaten in moderation.

80/20 Strategy

Another element of a healthy eating lifestyle is the 80/20 strategy. This means that 80% of the time you adhere to a healthy eating style, but 20% of the time you give yourself a break, jump off the wagon and indulge in limited amounts of whatever temptation indulgence you would like. This avoids deprivation and, in my opinion, is “an inoculation to prevent the disease.” On the limited list are sweets including cookies, cakes, donuts, candy and liquid carbohydrates such as sugary drinks including soda, ice tea, lemonade, sports drinks and fruit juices. The only liquid carbohydrate I consume is alcohol in moderation, wine being a component of the Mediterranean style eating.

Here are 10 easy substitutions that incorporate the above mentioned healthy-eating lifestyles:

  1. Bialys instead of bagels
  2. Seafood and lean poultry instead of red meat (if you do eat red meat, consume only the leanest cuts and opt for grass-fed instead of corn-fed)
  3. Vegetable protein (legumes such as peas, soybeans and lentils) instead of animal protein
  4. Olive oil instead of butter
  5. Real fruit instead of dried fruit or fruit juice
  6. Whole grains (wheat, brown rice, quinoa, couscous, barley) instead of refined grain products
  7. Flavored seltzers or sparkling water instead of soda
  8. Plain Greek yogurt instead of sour cream
  9. Soy, rice, almond or other nut-based milks instead of dairy
  10. Low-fat or non-fat dairy products instead of whole milk products

Other Nuggets of Advice:

  • The pathway to a healthy weight is slow and steady, demanding patience and time
  • Eat slowly, deliberately and mindfully
  • Get enough good quality sleep to help keep the pounds off
  • Avoid late night meals and excessive snacking
  • Stay well hydrated as it is easy to confuse hunger with thirst
  • Do not skip meals
  • Keep healthy foods accessible
  • Avoid foods that contain unfamiliar, unpronounceable, or numerous ingredients
  • Organic does not imply healthy or low-calorie
  • Let the last thing you eat before sleep be healthy, natural and wholesome (e.g., a piece of fruit)—you will feel good about yourself when you get into bed and even better in the morning

A lifestyle of healthy eating can improve your overall wellness, both physical and mental. Here’s to a happy, healthy new year!

6 Kidney Stone Symptoms and When to See a Urologist

17 Dec 2018 Blog

Kidney stones can happen to adults of any age and can be extremely inconvenient. If diagnosed early, stones can be treated more quickly. About 11% of men and 7% of women in the United States will experience a kidney stone at some point, and approximately half of those who experience kidney stones will get them again. It’s important to know what the symptoms are, and when to see a urologist.

Kidney stones can be debilitating and painful (sometimes very painful). While a stone forms in the kidney, there may be no signs or symptoms. Most people start experiencing symptoms once the stone is formed and passes into the ureter (the tube that connects the kidney to the bladder). The most common kidney stone symptoms include:

  1. Pain in the side and/or back
  2. Pain in the lower abdomen and/or groin
  3. Painful urination
  4. Discoloration of urine
  5. Nausea and vomiting
  6. Frequent urination

You may be experiencing one or more of the above symptoms and think, “Should I see a doctor? Are my symptoms that bad?” You should make an appointment with a urologist when you experience any of the above symptoms for an extended period of time. If you are worried about your symptoms and think you may have kidney stones, don’t hesitate to call and make an appointment. You should especially seek a urologist if you experience:

  • Pain so extreme that it’s hard to move or get up
  • Blood in the urine
  • Consistent nausea and vomiting in combination with urination symptoms

Your urologist will conduct an imaging test to diagnose your kidney stones if they think your symptoms warrant it. This can be done early on and can help treat the stone(s) sooner. It’s better to get an appointment early on rather than wait until the last minute.

Learn more about Kidney Stones >

How To Do a Monthly Testicular Self Exam

10 Dec 2018 Blog

Written by Dr. Andrew Siegel

Most testes lumps, bumps and growths are benign and not problematic. Although cancer of the testicles is rare (less than 9,000 cases a year in the USA), it is the most common solid cancer in young men age 15-40, with the greatest incidence in the late 20s, striking men at the peak of life.

Notable men who are members of the testicle cancer club include: Tour de France Champion Lance Armstrong, baseball player Scott Shoenweis, skater Scott Hamilton, MTV Host Tom Green, comedian Richard Belzer, sportswriter Robert Lipsyte, and Olympian Eric Shanteau.

The good news is that it is a highly curable cancer, especially so when picked up in its earliest stages, and also potentially curable even at advanced stages.

How to do a testicular self exam, a simple task that can be lifesaving

Since only 5% or so of men with testicular cancer are diagnosed by a physician during a routine physical exam, and 95% are picked up in the follow up of a testes abnormality noted by a man or his partner, it makes a lot of sense to learn how to do a good self exam.

Note: For most men, touching/manipulating/rearranging their nether parts is a natural and almost reflex activity that—supplemented with a little instruction, knowledge and direction—can be put to some practical clinical use. What follows is appropriate for the partner of the man in question. If your man is not willing to do self-exams, at a moment of intimacy do a “stealth” exam under the guise of affection—it just might be lifesaving. Several times in my career as a urologist, it was the man’s partner that was astute enough to recognize a problem that prompted the patient visit that determined the diagnosis of testicular cancer.

The goal of a testicular self-exam is to pick up an abnormality– in a very early and treatable stage–at a time when testes cancer is a localized issue that has not spread to the lymph nodes or lungs, which are common sites of metastasis.

Because sperm production requires that testes are kept cooler than core temperature, nature has conveniently designed men with testicles dangling from their mid-sections. There are no organs in the body—save female breasts—that are more external and easily accessible to examination. One of the great advantages of having one’s gonads located in such an accessible locale—conveniently “gift wrapped” in the scrotal satchel—is that it makes them so easy to examine. This is as opposed to the ovaries, which are internal and not amenable to ready inspection. This explains why early testes cancer diagnosis is a cinch as opposed to ovarian cancer, which most often presents at a more advanced stage.

The testicles can be examined anywhere, but a warm shower or bath is an ideal setting as the warm water tends to relax and thin the scrotal sac and allow the testes to descend to a position that is most accessible. Soapy skin will eliminate friction and allow the examining fingers to easily roll over the testicles.

The exam is best performed with the thumb in front and the remaining fingers behind the testicles. The four fingers immobilize and support the testicle and the thumb does the important work in examining the front, sides, top and bottom of the testicle; then the thumb immobilizes the front while the four fingers examine the back of the testes. When examining the back surface of the testicle, the index and middle fingers will do most of the work. The motion is a gentle rolling one, feeling the size, shape, and contour and checking for the presence of lumps and bumps.

Compare the two testes in terms of size, shape and consistency. Generally, the testicles feel firm, similar to the consistency of hard-boiled eggs, although this can vary between individuals and even in an individual. Lumps can vary in size from a kernel of rice to a large mass many times the size of the normal testes. The epididymis is a comet-shaped structure located above and behind the testes that is responsible for sperm storage and maturation. It has a head, a body and tail, and it is worthwhile running your fingers over this structure as well.

This exam should be done regularly—perhaps every couple of weeks or so—such that you get to know your (or your partner’s) anatomy to the extent that you will be attuned to a subtle change. Once you get in the habit of doing this on a regular basis, it will become second nature and virtually a subconscious activity that only takes a few moments.

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