Treating Large Prostates (>80g) for BPH
Benign Prostatic Hyperplasia (BPH) or enlarged prostate is a concern that most men will experience as they age. On average, about 50% of men over 50 and 80% of men over 80 will experience the lower urinary tract symptoms associated with prostatic enlargement. Because of the nature of this condition, many novel procedures have tried to address the limitations of their predecessors. Some have succeeded, while others have fallen out of favor.
In the absence of more serious medical complications, Dr. Engel always focuses on medical therapy as a first line of treatment for most cases of an enlarged prostate. However, if initial medical therapy does not offer the relief the patient expects, if there are side effects, or if the patient simply does not want to be on chronic medication, we often move on to offering minimally invasive BPH therapies that can be quick, effective, and have minimal side effects. However, some patients will need surgical intervention such as robotic simple prostatectomy or HoLEP (Holmium laser enucleation of the prostate) as the procedure of choice when the prostatic enlargement is extreme. The prostate is measured in grams; we consider a large prostate to be anything over 80g, and Dr. Engel has treated prostates of up to 400g. Continue reading
Welcome Dr. Tobon
Dr. Engel is pleased to announce the arrival of Dr. Andrew Tobon to Urologic Surgeons of Washington. Dr. Tobon’s education and training are truly first-rate, and he has been practicing all areas of urology for nearly 29 years.
His skill set complements Dr. Engel’s perfectly, particularly in the area of complex percutaneous kidney stone management.
As Dr. Engel is based primarily in the downtown location, Dr. Tobon will be mostly in our Chevy Chase location, just as Dr. Losee was. He is the medical director of our urologic urgent care and, as such, will be available for same-day appointments alongside Ndidi Okanu, NP.
Welcome, Dr. Tobon!
Why Hydration Is So Important in Urology
As you probably know, the body is composed of 70% water. It’s one of the reasons why we can’t last more than a few days without water, but we can last for weeks without food. You can imagine. Therefore, hydration is key to a healthy body, including a healthy urinary system. But, what exactly does water do for our urinary system, and how do we know we’re getting enough of it?
First, water is critically important for every cell and structure in the body. Water makes everything work better, from bones and cartilage to tendons and muscles. Dehydration affects the brain and body at almost every level.
TUNA After a TURP
Transurethral Needle Ablation or TUNA is a safe and effective in-office therapy to treat benign prostatic hyperplasia / BPH. Dr. Engel is one of the leading users of this technology across the entire United States. One of the great benefits of using TUNA is its versatility. A TUNA can be likened to a free swing – where downtime is minimal, and the procedure does not preclude the use of other treatment options after that. But what about the other way around? For example, can a TUNA be performed after a TURP or transurethral resection of the prostate?
Dr. Engel Joined “Great Day Washington” – Discusses Erectile Dysfunction (ED)
Dr. Engel joined “Great Day Washington” on WUSA 9 to discuss erectile dysfunction (ED) and treatment options including inflatable penile prostheses. Dr. Engel told viewers about the distinction between ED caused by prostate cancer surgery and radiation, for which medication is relatively ineffective; and ED caused by other problems and/or aging. For patients recovering from prostate surgery or radiation, an inflatable penile prosthesis is often an excellent option, allowing them to have natural, relatively spontaneous erections using a device that is completely hidden within the anatomy.
Cystoscopy – A Patient’s Perspective
A cystoscopy is an important test, used by your urologist, to examine the inside of the bladder. It’s an outpatient procedure, which means you may be at your doctor’s office, a hospital, or clinic and go home the same day. This procedure lets your doctor check the complete length of your urethra and the bladder for cancerous or pre-cancerous polyps, narrow areas called strictures, abnormal growths, and other problems. Your urologist will insert a thin, lighted instrument called a cystoscope into the bladder through the urethra.The procedure generally takes about 15 to 20 minutes.
Do Kidney Stones Increase the Risk of Kidney Cancer?
The kidneys, located in the mid-upper abdomen (around the back) are our bodies’ main filtration system, eliminating excess waste products, salt and water. Beyond this filtration, the kidneys also play a role in blood pressure and red blood cell regulation. The kidneys create urine, which is pass through the ureters, to the bladder and then eventually out of the body. As such, the kidneys are an incredibly important part of our overall function. Kidney diseases that require the removal of a kidney are not a death sentence, however. Our bodies can function normally on one kidney and even those who do not have working kidneys can survive with an external filtration process, known as dialysis.
Although kidney cancer is one of the top 10 most common cancers in the United States, the number of new cases diagnosed each year (about 65,000) is less than 1/3 the number of breast cancer, prostate cancer, or lung cancer diagnoses. Much like other cancers, early detection is critical for treatment and survivability. However, even advanced forms of kidney cancer are being treated more effectively than ever before.
How Exercise and Vitamin D Can Reduce Prostate Cancer Risk
Exercise is one of the most important predictors of long-term health. Without exercise, i.e. living a sedentary lifestyle, we increase our risk for a number of problems not least of which is are certain forms of cancer. Beyond the tangible improvements in health that we see from exercise, regular cardio and strength training can even improve some mental health issues including anxiety, depression, and mood problems.
Choosing Between In-Office Procedures and Surgery for BPH
Benign prostatic hyperplasia or BPH is a non-cancerous enlargement of the prostate gland. It is extremely common with about 50% of men over 50, and 80% of men over 80, suffering from its symptoms. While BPH is very common, there is a lot of confusing information that can delay patients from receiving the most effective treatment. Many men live with the lower urinary tract symptoms associated with BPH for years before they pursue a treatment option. Many are then bombarded by advertisements telling them that herbs may shrink the prostate. Having read this website you know that these claims are questionable.
Dr. Engel Completes His First Half IronMan Triathlon
I am thrilled to announce that I have completed my first Half IronMan Triathlon. It has always been a dream of mine to train and compete in such a high-level athletic pursuit. It was even more exciting and enjoyable to have done it with my son. And, while I am proud of my achievement, it also represents advice that I would like to give all my urologic patience.
