Source: Business World TV
Video Transcript:
I’m Dr. Ronny Tan; I’m a consultant urologist and andrologist from Singapore Mount Elizabeth Hospital.
Patients who are men who come to us for urological issues, a lot of the time, are because of urinary issues. So, in terms of urinary issues, a lot of them will present with either a slow stream or waking up at night to pass urine, which is affecting either their sleep quality or even their partner’s sleep quality.
In terms of sexual dysfunction, some patients come to us because of erectile dysfunction, premature ejaculation, and in some cases even penile deformities.
Like curvatures that affect their sexual function.
So a lot of times, for men, in terms of the slow urination, as we aged, this is due to prostate enlargement, and of course, patients who have read up online about prostate enlargement, they also worry about things like prostate cancer, so there are concerns when they come to us. What would be” Oh, Dr, if I’m not able to pee properly, is it because I have prostate cancer or is it because my prostate is enlarged?” So, I would then explain to them that with age, our prostate does increase in size cause it’s called benign prostate hypertrophy, which is a non-cancerous growth on the prostate. At the same time, as a man grows older, his chance of having prostate cancer also increases.
And when we talk about sexual dysfunction, for example, the most common erectile dysfunction, is when a man is unable to sustain his erection for a satisfactory sex life. A lot of times, with age, we find it the incidents of that happening also increase. And we also want to find out whether he has any hormonal issues like testosterone deficiency.
A lot of times, men find that everything is okay, and they don’t come to us. But when he hits them in the bedroom, they find that it affects them and their partner; that’s when they start coming to us. And of course, the other problem, like I mentioned, will be urinary dysfunction, where they wake up and to pass urine, they find it taking longer to pass urine. So, I would suggest that any patients who have any urinary symptoms seek the attention of the urologist, because other than the causes that I mentioned previously, like an enlarged prostate, we also work on things like prostate cancer and even bladder cancer, especially if the patient presents with blood in their urine.
Talking about benign enlargement prostate or BPH, treatment always starts with lifestyle modification. We have medications that help the patients; other than medications, we have surgeries. And in recent years, there have also been minimally invasive treatment techniques. So, surgeries will include things like TURP, which is transurethral resection of the prostate, or even using the green light to vaporise the prostate. For the minimally invasive techniques, these will be treatments, day surgical procedures, and they are less involved as compared to TURP. So examples will be the UroLift, treatment or the resume treatment. And in terms of the treatment of erectile dysfunction, we simply start with some medications to improve erection for the patients.
Another kind of adjunctive treatment, like injectables. We have vacuum erection device to help patients and lately we also do things like low intensity shower therapy to improve the circulation to the penis as well as the regeneration of nerves to improve the patient’s erections at the end of the day, the treatment that will help the patients to get back the erections will still be surgery, of course, before considering surgery, all the other treatments will still be given to the patient before.
Let’s start with benign enlargement of the prostate. So, medical treatment with oral tablets is always the first line. Of course, some of the medications do have their side effects. And I will look at the age of the patient and whether the patient still wants to be sexually active and whether he’s susceptible to the possible side effects of the oral medications, because sometimes the oral medications can cause either erectile dysfunction or even ejaculation dysfunction. And also they are so young men.
In their 50s, who feel that they are not ready to be on this medication for the long term. So in those cases, I will then approach the use of minimally invasive treatment methods.
The normal surgical technique, like TURP, is still suitable, but the problem is that it will result in retrograde ejaculation, with some sexually active men may not be acceptable to.
And we know that the prostate continues to increase in size even after the resection. So, for younger patients, we would then ask if the ability to ejaculate is important.
If he feels that sexual function is important to him, we would then discuss treatments like UroLift or Rezum treatment. Other than medications that we give to our patients,
We also perform minimally invasive surgical techniques, like I mentioned,
UroLift surgery and Rezum surgery can be done in our hospital.
Well, at Mount Elizabeth Hospital, we do have other specialities that we can work with
Because some patients, when they come to us for sexual function, you find that it is due to a psychogenic cause. We may even get our psychiatrist or psychologist to counsel the couple in need. Then, if you do find some organic cause, for example, very complicated hormonal issues, we have other subspecialties that we will get involved in. So they will get a wholesome treatment for the patient.
We can’t prevent the prostate from getting enlarged because as we grow older,
It is known that the prostate will enlarge in size. I think the important thing will be for men to step forward and get themselves checked, if, for example, there are difficulties in the bathroom, but they have difficulty passing urine. So get it checked earlier so that the kidneys will not be involved, because we know that if a prostate problem is not treated,
You can affect the bladder and even the healthy kidney.
In terms of sexual function, there’s no need to be embarrassed because there are always treatments available. So, we also encourage patients to have a healthy lifestyle. If smoking, try to quit smoking, because we know that smokers are always at higher risk of having erectile dysfunction and stay active, exercise, and then should there are any issues, just come and see the friendly urologist.
We will take care of you!
我是陈万伟医生；我是新加坡伊丽莎白山医院的泌尿科及男科疾病顾问医生。
因为泌尿系统问题来找我们的男性患者，很多时候是因为泌尿系统问题。所以，在排尿方面，他们中的很多人面对尿流慢，以及晚上排尿的问题，这影响了他们的睡眠质量，甚至他们伴侣的睡眠质量。
在性功能障碍方面，有些患者因为勃起功能障碍、早泄，甚至阴茎畸形来找我们。
比如影响他们性功能的弧度。
所以很多时候，对于男性来说，随着年龄的增长，这是由于前列腺增大，当然，那些在网上读过前列腺增大的患者，他们也担心像前列腺癌这样的事情，所以当他们来找我们的时候，会有一些担心。“医生，如果我不能正常排尿，是因为我得了前列腺癌还是因为我的前列腺增大了？ ”所以，我会向他们解释随着年龄的增长，我们的前列腺确实会增大，但它被称为良性前列腺肥大，这是前列腺上的一种非癌性生长。与此同时，随着年龄的增长，男性患前列腺癌的几率也会增加。
举个例子，当我们谈论性功能障碍时，最常见的勃起功能障碍，是当一个男人无法维持他的勃起硬度，并且无法满足他的性生活需求。很多时候，随着年龄的增长，我们发现这种情况也会增加。我们还想知道他是否有荷尔蒙问题，比如睾酮缺乏。
很多时候，男人发现一切都很好，他们就不来找我们了。但当他在卧室里遇见如此等情况时，他们发现这影响了他和他们的伴侣；才会开始来找我们。当然，另一个问题，就像我提到的，是排尿功能障碍，当他们醒来排尿时，他们发现排尿需要更长的时间。所以，我建议任何有泌尿系统症状的患者寻求泌尿科医生的关注，因为除了我之前所提到的原因，比如前列腺增大，我们还治疗前列腺癌甚至膀胱癌，尤其是当患者出现尿血时。
谈到良性前列腺肥大或BPH，治疗总是从改变生活方式开始。我们以药物帮助病人；除此之外，我们还有手术。近年来，也出现了微创治疗技术。手术包括TURP，即经尿道前列腺切除术，或者甚至使用绿光激光前列腺切除术前列腺。对于微创技术，这些将是治疗，日间手术，他们比TURP更少涉及。例如尿提术，治疗或恢复治疗。在勃起功能障碍的治疗方面，我们只是从一些改善患者勃起的药物开始。
另一种辅助治疗，比如注射。我们有真空勃起装置来帮助病人最近我们也做一些事情，比如低强度的淋浴疗法来改善阴茎的循环以及神经的再生来改善病人的勃起在一天结束的时候，帮助病人恢复勃起的治疗仍然是手术，当然，在考虑手术之前，所有其他的治疗仍然会给病人。
我们先从良性前列腺肿大说起。所以，口服药片的药物治疗总是第一线。当然，有些药物也有副作用。我会观察病人的年龄病人是否还想有性生活他是否容易受到口服药物的副作用的影响，因为有时口服药物会导致勃起功能障碍甚至射精功能障碍。而且他们都很年轻。
在他们50多岁的时候，他们觉得自己还没有准备好长期服用这种药物。在这些情况下，我会使用微创治疗方法。正常的手术技术，如TURP，仍然是合适的，但问题是它会导致逆行射精，与一些性活跃的男性可能无法接受。我们知道前列腺在切除后还会继续增大。所以，对于年轻的患者，我们会问射精的能力是否重要。如果他觉得性功能对他很重要，我们就会讨论像经尿道前列腺悬吊术或水蒸气疗法。除了我们给病人的药物，我们也进行微创手术，就像我提到的，我们医院可以做UroLift手术和Rezum手术。
在伊丽莎白山医院，我们有其他的专科医生可以相互协作。因为有些病人，当他们来找我们寻求性功能时，你会发现这是由心理原因引起的。我们甚至可以请心理医生或心理学家为有需要的夫妇提供咨询。然后，如果你确实发现了一些器质性的原因，例如，非常复杂的激素问题，我们会涉及到其他的专科。这样就能得到对病人有益的治疗。
我们无法阻止前列腺增大，因为随着年龄的增长，众所周知，前列腺会变大。我认为重要的是，如果男性排尿时遇到困难，他们应该站出来检查一下自己。所以要尽早检查，这样肾脏就不会受累，因为我们知道如果前列腺问题得不到治疗，你可能会影响膀胱甚至健康的肾脏。
在性功能方面，没有必要感到尴尬，因为总有治疗方法可用。因此，我们也鼓励患者拥有健康的生活方式。如果吸烟，试着戒烟，因为我们知道吸烟者总是有更高的风险有勃起功能障碍，保持活跃，锻炼，然后如果有任何问题，就来看看我们亲切的泌尿科医生。
你的健康是我们的首要任务！