Dr. Dean Elterman
“Taking time out of our busy work and personal lives to address health concerns early as opposed to waiting for a crisis will result in improved health,” wrote Dr. Dean Elterman in a Reddit Ask Me Anything forum response. (Photo: UHN)

In his first Reddit "Ask Me Anything" session, urologic surgeon Dr. Dean Elterman addressed questions about prostate health, male and female urologic health, and the social factors that impact our readiness to seek out a doctor's advice when it comes to urology.

Here are some of the key questions that came up on the popular discussion forum.

For a link to Dr. Elterman's full 'Ask Me Anything' forum on Reddit, please click here.

On the social factors that impact men's health empowerment:

You state that you find up to 80 per cent of men refuse to see a physician until they are convinced by a spouse or partner to do so. How do you change that behaviour? What interventions or culture change might make men more likely to see doctor when necessary?

Dr. Elterman: A cultural change amongst men whereby we redefine masculinity as incorporating taking care of your health and yourself would be a good start. Taking time out of our busy work and personal lives to address health concerns early as opposed to waiting for a crisis will result in improved health for men. I think this may be a generational change that is taking place whereby younger men and their partners are more engaged in staying active and healthy, which includes regular health checkups. 

On women's urologic health:

I'm a 33-year-old healthy female and last January I started experiencing what I thought was a urinary tract infection (UTI). I have been to my regular doctor, my gynecologist, and a urologist and got negative UTI tests back at all three. My regular doctor has said it's likely nothing serious and nothing can really be done. Do you have any advice as to what I can do to get used to this?

Dr. Dean Elterman: Without speaking to your specific condition, many young women experience a urinary tract infection but end up having negative urine cultures. It is considered normal for women to have up to two urinary infections per year. I was interviewed about this topic recently which you can read here.

Some women may have a urinary tract infection which clears but the symptoms persist as a result of the development of pelvic floor dysfunction. The muscles that surround your bladder in the pelvis become hypertonic (too tight) and they result in the same symptoms as a UTI such as urinary frequency and urgency. The single best treatment that a person can seek if they have these symptoms in the absence of an infection is pelvic floor physiotherapy performed by an accredited physiotherapist.

On prostate check-ups:

When do you say a guy should check his prostate? Are there any indicators that could point out to possible prostate issues?

Dr. Elterman: Men should have a discussion with their doctor about prostate health at age 50 to determine what the best approach is to your prostate health. I recommend a baseline PSA (prostate-specific antigen test) at age 50 especially if you have a family history of prostate cancer. 

On prostate cancer:

Why is it that so many men develop prostate cancer and what types of diets/lifestyle changes can one undertake to limit the chances of that happening?

Dr. Elterman: Prostate cancer is the most common cancer in men (other than skin cancer). We're still finding out all of the causes of prostate cancer but certainly family history, and possibly inflammation earlier in life are factors in the development of the genetic mutations that cause prostate cancer. An active lifestyle and healthy eating are important in preventing many types of cancer, as is minimizing red meats and other carcinogens. 

What is the most exciting advance in prostate cancer research? What questions should a man be asking their doctor about their prostate? Is there a relationship between diet and enlarged prostate? Read the answers to these questions and more on Dr. Elterman's full 'Ask Me Anything'​ .

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