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3 Urological Concerns

These conditions are unique to men and cause much anxiety.

Am I losing control of my bladder?

The inability to take charge of one’s bladder is a big concern for men at all ages.

For a younger man, the inability to control the urge to go to the toilet too often has a great impact on his work. It is embarrassing to repeatedly excuse oneself from meetings and discussions to go to the bathroom, or to wake up in the morning in a wet bed. This is easily explained by excessive coffee and tea consumption, but other medical reasons such as an overactive bladder or an untreated urinary infection could be present. It is crucial to see an urologist when the urinary urge is worsening and/or a single episode of urinary incontinence or infection occurs as these are rare in males.

For older men, the inability to have a completely satisfying urination is one of the greatest fears. Finding that one can no longer sleep through the night and needs a much longer time to empty one’s bladder means a loss of control over one’s bladder. The prostate gland which guards the door of the bladder gets larger when one gets older and prevents a good and strong stream when obstruction arises. Twenty years ago, surger was the way to tackle a large obstructing prostate. Today we have far superior oral medication and only a minority require surgery, which has also improved, with newer devices and minimal bleeding and discomfort. One need no longer hide with fear from one’s large prostate.

Do I have cancer?

For a man, finding a hard lump in the testes during a bath is very distressing and there is always a need to see a urologist for assessment to rule out testicular cancer. Treatment for testicular cancer has made leaps and bounds over the years, resulting in a very good prognosis. Blood in the urine does trigger a big concern as one has to consider cancer of the bladder or kidney, especially in men.

Advancements in endoscopy, laparoscopy and robotics translate into less pain and faster recovery in the treatment of urinary cancers.

At times, blood in the urine is due to kidney stones. No matter how big or hard the stone, we have the tools not only to remove them safety but to prevent them from re-occurring.

Evidence points to an increased incidence in urinary stones arising from multiple factors like biochemistry changes in the urine as we get older, obesity associated with increased uric acid levels, and a dropping urine PH. Thankfully, technology and techniques have improved and offer minimally invasive ways to remove them.

PSA is considered a blood cancer marker for the prostate. When mildly raised, the concern is prostate cancer even though non-cancer causes like prostatitis are not uncommon. Early prostate cancer can be observated and closely monitored, if the cancer is small and slow-growing. When it is deemed to be large and more aggressive, it is treated with procedures such as robotic prostatectomy, a well-established and safe procedure for the management of select early prostate cancer with minimal downtime.

Am I infertile?

With the general reduction in the quality of sperm over the last three decades, one of the greatest fears for a man is the inability to procreate. With the trend of starting families later, it is no surprise that fertility rates are dropping. With food, water, air pollution and substance abuse like smoking capped with a much more stressful lifestyle, we have a much higher incidence of infertility factors compared with previous generations. This has resulted in poorer production of sperm and an increase in delivery issues like erectile dysfunction and premature ejaculation.

Male infertility has seen an upswing in recent years especially as data shows there can be a male factor more than 50% of the time when a couple is unable to conceive after trying for about a year. Seeking early advice from an urologist with a special interest in fertility would help minimise the distressing problem of male fertility.

Dr Michael Wong

Medical Director & Senior Consultant Urologist
FAMS (Urology), FICS (USA), FRCS (Edinburgh),
M Med (Surgery), MBBS (S’pore)

Dr Michael Wong is a Senior Consultant Urologist who is internationally recognized for his surgical expertise and academic contribution to the field of Urology, in particular the subspecialized field of minimally invasive Endourology.

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