Atlantic Medical Group Urology - Bridgewater

What is PSA testing?

PSA stands for prostate-specific antigen. PSA is a blood test that helps determine the risk for prostate cancer in men. 

Why is PSA testing important?

PSA testing helps identify patients who may be at risk for having prostate cancer. 

Should I be getting a PSA test?

Generally, men in their 50's should begin screening for prostate cancer with both a PSA test and a prostate exam. Those who have a strong family history of prostate cancer or breast cancer (female relatives), or who have had a relative die from prostate cancer, should consider testing earlier. 

Are there other causes of high PSA?

Yes, there are many other causes of PSA blood tests to be elevated including having a large prostate, urinary tract infection, or sometimes a spurious lab value. A decision to pursue prostate cancer should never be based on an isolated elevation and should be evaluated by a urologist.

What is prostate cancer?

Prostate cancer is characterized by the uncontrolled growth and potential spread of abnormal cells. 

What are some of the available surgical treatments for prostate cancer?

There are three surgical options to remove the entire prostate gland. These options are the best fit for patients with early diagnosed organ-confined prostate cancer. 

1. Robotic radical prostatectomy
2. Laparoscopic radical prostatectomy
3. Traditional open radical prostatectomy

What is robotic radical prostatectomy?

Robotic prostatectomy is a minimally invasive surgical removal of the prostate involving the latest advancements in robotics and computer technology.

What is robotic prostatectomy?

Robotic prostatectomy is a robotic-assisted surgical procedure in which surgeons will remove a cancerous prostate. 

Am I a good candidate for da Vinci® robotic prostatectomy?

Men who are diagnosed with a localized prostate cancer are candidates for this procedure.

What is the recovery time after undergoing robotic prostatectomy?

Recovery times may vary from patient to patient, but robotic-assisted procedures result in shortened recovery times compared to both laparoscopic and open surgical methods. 

Is there a risk of impotence after prostatectomy?

Dr. Rahman’s unique nerve-sparing technique for prostate removal surgery is crucial to preserving sexual function. Put simply, preserving the cavernous nerves preserves sexual potency after prostate surgery. There are treatments for erectile dysfunction resulting from prostatectomy surgery, but with the right surgeon and prostate surgery technique, they are often unnecessary.

Is there a risk of incontinence after prostatectomy?

Following proper prostatectomy recovery guidelines, patients who experienced normal continence prior to surgery should regain function within 12-13 months.

What size incisions will be made with modern prostate removal surgery?

A robotic prostatectomy requires 5 small incisions, each about one-quarter of an inch in the lower abdomen, through which instruments are inserted. A sophisticated video camera is one of the instruments, which gives Dr. Rahman a three-dimensional, 10x magnified field of vision. The keyhole incisions drastically reduce blood loss and the camera provides unprecedented visual clarity. The result is a clear surgical field during the prostatectomy with nothing to obstruct Dr. Rahman’s view of the prostate and surrounding tissue.

How much control does the surgeon have during the da Vinci® robot assisted prostatectomy?

The robot is completely under the control of the surgeon. The robotic arms enable the surgeon to operate in small spaces in the abdomen with increased visualization and precision. 

What does "active surveillance" and "watchful waiting" mean?

Though slightly nuanced, both options are essentially the decision not to treat prostate cancer while staying actively engaged in frequent screenings to monitor the disease status.

Is it risky to postpone prostate cancer treatment?

Prostate cancer is called a silent killer for a reason. It can advance very quickly and without warning. On the other hand, some prostate cancer never advances. Older men may have more pressing medical conditions that require treatment before addressing the prostate cancer. The challenge is that today’s diagnostics do not allow us to say with any certainty what the speed or severity of your prostate cancer will ultimately be. Keep in mind that delaying prostate cancer treatment can also take an emotional toll on men and their families, as they can be filled with worry about the disease’s status.

What if I choose not to treat my prostate cancer?

Some men opt for active surveillance instead of taking action to treat their prostate cancer. Cancer treatment is a very complex and personal decision that should be based on individual beliefs, family support, and expert physician guidance. Your age and overall medical status should be a factor in your decision, as well.

What are kidney stones?

In simple chemistry terms, stones occur when the concentration of certain minerals such as calcium in the urine becomes high enough to crystallize into solid particles. 

What causes kidney stones to form?

There can be many reasons to develop kidney stones. Not drinking enough fluids, particularly in the hot summer months, having too much calcium or salt in your diet, and having certain metabolic abnormalities all can cause kidney stones. Obesity, diabetes, weight loss surgery, and certain medications can also cause kidney stones.

How common are kidney stones?

Kidney stones are very common. 

What are the symptoms of kidney stones?

Kidney stones can present with deep, achy pain in the flank which can migrate to the groin. Nausea and vomiting, and blood in the urine can also be signs of a kidney stone.

How are kidney stones diagnosed?

Kidney stones are usually diagnosed by imaging such as CT scan or an ultrasound of the kidneys. 

How are kidney stones treated?

Not all kidney stones need to be treated. Some are small enough and the patients are comfortable enough to allow spontaneous passage of stones. If the stone is too large or patients are having severe pain, treatment usually consists of going up with a fiberoptic scope and camera through the urinary tract and lasering the stone. If the stones are too big and the patient is comfortable, treating with shock wave therapy or making a small puncture into the kidney to remove the stones directly is an option.

How can I reduce my risk of having kidney stones?

Drinking more fluid, in particular water, will reduce the risk of kidney stones. Adding citrus to the diet such as lemons or grapefruits (often added to water), reducing salt and animal protein can also help reduce risk. Occasionally medications are prescribed if stone development persists despite these measures. 

What is a vasectomy?

Vasectomy is a surgical procedure, usually performed in the office, as a form of male elective sterilization.

Is the procedure painful?

Usually there is some mild discomfort associated with the procedure. Most often the procedure is performed with local anesthetic; however, if discomfort during the procedure is a concern, you can speak with your doctor about other measures that can be taken to reduce discomfort during the procedure.

What is the recovery timeline after the procedure?

We recommend bed rest and ice for 24 hours immediately following the procedure. We suggest very limited activity and continued icing for the next 24-48 hours. Patients also should not engage in any vigorous activity or any sexual activity for a week following the procedure. Scrotal support is also advised for the first week. Semen analysis samples will be taken at the 8-week and 12-week marks following the procedure. Until the results of the two samples are back and negative for sperm, patients should use protection with any sexual partner.

Are there any risks or side effects?

Side effects are a rare and uncommon occurrence. Some people complain of long-term ongoing testicular pain. There have been questions as to whether there is a relationship between vasectomy and prostate cancer. This direct correlation has not been made. There is a risk of bleeding and infection. We are careful to be certain there is no ongoing bleeding, and you will be receiving an antibiotic to go home. Patients typically have some bruising and swelling above their testicle for a period of time. Usually, patients return to full activity levels after approximately 2 weeks.

What does BPH stand for?

Benign prosthetic hyperplasia. This is the most common benign tumor in men.

How do I know if I have BPH?

Usually, the symptoms manifest with increased daytime or nighttime urinary frequency, diminished urinary stream, urgency to void and sometimes incontinence. In later stages this can be 1 of the causes of blood in your urine and/or recurring urinary tract infections.

Does BPH have to be treated?

Frequently, this condition does not have to be treated, and is treated only if patients are having bothersome symptoms. Sometimes, patients may not realize they have progressive symptoms of BPH or obstructive uropathy and only seek medical care when their symptoms progressed to a point of having acute urinary retention. Our goal is to initiate treatment before this progression.

If BPH is left untreated, what can happen?

A variety of symptoms can occur which can impact quality of life. Symptoms including acute urinary retention, bladder dysfunction requiring self-catheterization, recurrent urinary tract infections, kidney dysfunction secondary to obstruction and hydronephrosis may occur.

How do doctors evaluate for BPH?

We will assess voiding function by going over the patients’ health history and performing a physical exam. We often perform cystoscopy and do a functional study to establish the strength of your urinary stream and how much urine you may be retaining after voiding.

What are the treatments for BPH?

There are many surgical and non-surgical methods to treat BPH. There are several medications which we can use to help improve your urinary stream and potentially shrink your prostate. If non-surgical medical treatment is unsuccessful or cause side effects, there are a variety of surgical treatments which can be performed in the office or in an outpatient surgery center usually not requiring an overnight stay in the hospital.