Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
The following is a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed.
Speaker 2 (00:09):
The following program is brought to you by NYU Land
Gone Health. It's Kats's Corner with doctor Aaron Katz. You're
trusted expert in men's health, providing straight talk on a
wide range of men's health topics and advice on how
to live your healthiest life. Now on seventy ten woor
It's the Chairman of Urology at NYU Land Gone Hospital,
(00:32):
Long Island. Here is doctor Aaron Katz.
Speaker 3 (00:37):
Well here he is doctor Aaron Katz, and we're live
on Katz's Corner here this morning on a rather chilly
December morning. Everyone. Yeah, winter is here, little snow on
the ground yesterday that was nice December twenty second. Here,
I've got two shows left on war and my history
(00:59):
on a radio will be ending. Oh you never know
the future, right, I mean, we don't know what we
know is now today. If you'd like to give me
a call, we are live here on this what is
this the This is the fourth actually Sunday of the month.
There's five Sundays this month. This is the fourth. We
have one more next week, a big holiday week this week,
(01:23):
Christmas and Hanukkah coinciding. That's nice. If you want to
give me a call numbers eight hundred three two one
zero seven ten one eight hundred three two one zero
seven ten and you can get to chat with me
and give you me your your questions, your thoughts, any
concerns you may be having terms of your PSA or
(01:46):
your you had a biopsy, or you have an MRI
coming up, or you have issues with sexual issues or
testosterone deficiency. These are the things that urologists such as
myself feel very comfortable to discussing because this is what
we deal with every single day. And I have been
in this field for thirty some odd years and still
(02:10):
very passionate about men's health and taking care of men.
I'm actually passionate about all health. And if you've listened
to the show and avid listener you can, you can
get a sense of that. I've had lots and lots
of wonderful guests here over the years. In the last
fourteen years from NYU and I've had just terrific cardiologists,
(02:34):
orthopedic doctors, endocrine doctors, cancer doctors, people with weight loss
experts here, nutritionists, a whole host of all kinds of
people here that have been really delivering what I think
is the greatest for your overall health. One eight hundred
and three to two one zero seven ten is the
(02:56):
number I love to hear from you. And yes, unfortunately
I will be going to a different venue. I'm not
allowed to say what that venue is, but I am
allowed to announce an email that you can email me,
and then I can tell you personally what that venue
will be and you can continue to listen to me.
(03:20):
That email is Men's Health at nyuland going dot org,
Men's Health at nyuland going dot org. And this way
you can, you know, kind of send me an email
and we can continue our conversations over the years.
Speaker 4 (03:41):
You know, I.
Speaker 3 (03:44):
Do firmly believe in diet, of course, exercise and sleep.
Those are the main three pillars that I think are
key to anyone's longevity in life, which is getting enough rest,
which none of us really do these days. Everybody's so busy, busy, busy.
I get it, We're all busy. How you doing, Oh,
I'm so busy. I'm busy I'm doing this, I'm running
(04:06):
around especially the holiday season. Wow. I mean, the roads
are jammed up here on Long Island where I live
out near the mall. I don't know why anyone would
go to the mall anymore. I mean, I mean, God
bless the stores, you know. I mean, and I give
these people an incredible amount of credit to keep stores
open during this you know, world of online shopping. But
(04:33):
the streets are just kind of crazy. The cars are
jammed up, the malls are jammed up, and you know,
people are stressed, and it's a stressful time. It should
be a happy time, yes, I get it, but it
can also be very stressful time. And what that means
is you don't eat right, and you don't sleep well,
and you probably are running around and probably not you're
(04:54):
running around in the car or wherever your subways or
mode of transportation, but probably not doing a lot of
exercise and eating a lot. So keep those three things
in mind. Please get enough sleep, eat properly, and exercise
as much as you can. We have a couple of
(05:16):
phone calls. Well we actually have David on the line,
and if you want to reach me, it's three two one,
it's eight hundred eight hundred three two one zero seven ten,
Doctor Aaron Katz here on Katz's corner, just for two
more weeks. Well, we'll continue the show on another venue.
But anyway, David, good morning, how are you?
Speaker 5 (05:35):
I have like an issue that maybe needs to be addressed.
I mean, I have a typical syndrome of frequent urination
and complete emptying of the bladder weak flow urgencies. But
I also have Pironi's disease, and so I am my
PSA is four. I mean, but I've been going back
(05:56):
and forth as to who to see. A urologist is
a Peroni's specialist, and so I've created a mindset of inaction.
I mean, I'm actually paralyzed in not doing anything about it.
Do you sense this happens more often than we than
we know?
Speaker 6 (06:16):
David?
Speaker 7 (06:17):
How old are you?
Speaker 5 (06:18):
Seventy four?
Speaker 3 (06:19):
All right, sound pretty young there, David good Let me
let me just tell you one thing. A Pironi's specialist
is actually a urologist, Okay, yeah, And we have one
in our department here on Long Island. There's one in
the city at NYU. And these peroni specialists are also
(06:43):
urologists that can also take care of and help you
with your urinary issues. And if these.
Speaker 5 (06:54):
I did ask a friend for a suggestion and he
recommended you, So okay, he's one of your patients, it
turns out. So so when I hear that, then I
think that's overkilled to my situation. So it creates more
in action. What do you mean what you're saying is logical?
I just I did see urologists and he said there
(07:17):
was a person in his department that the specialized in paronis.
But you know, then then I got cold feet again
as to needing a urologist as well as a Paroni's specialists.
But but you think I can do it all?
Speaker 6 (07:37):
You could? You think you could?
Speaker 3 (07:40):
And then the peronis today is certainly managed a lot differently.
And of course it depends upon the degree of curvature.
And if you're just listening, what is Peroni's. It's a
curvature of the penis, usually due to a plaque, could
have been done to trauma during sex, or maybe it
just developed for reasons that we are unclear. Maybe there
(08:04):
are some genetic predispositions that people have with this curvature,
but it can be sometimes painful, and it can also
prevent people from having a proper sexual relations. As you
can imagine, the degree of curvature can be sometimes ninety degrees,
which is rare. But sometimes a degree of curvature can
(08:25):
you know, prevent people from having normal sexual relations. And
sometimes it's just coming down to the office and having
a series of injections called ZIOPHILEX, which can be done.
And then also, David, you can have the urinary issues
addressed at the same time with either having a medication
(08:46):
or perhaps even an in office procedure like a eurolift
or resume or you know, depending upon the size of
your prostate and the degree of your urinary issues. But
let's do this, David, let's have you know, people talk
about New Year's resolution. I don't. I don't do new
Year's resolution. I do New Year's intention. The intention and
(09:10):
your intention, my friend, is to get your penis fixed
and your prostate fixed and improve your sexual function and
improve your urinary function. That's your New Year's intention for you.
And where do you live, my friend, I'm in Brooklyn.
I mean, okay, so fine, I just yeah, you could
you could go to Manhattan.
Speaker 5 (09:30):
I guess it's specific to get me, uh get me going.
Speaker 3 (09:34):
You know, you could see me at the Men's Center
if you want it. I'm on fifty fifth in Madison.
We have other great urologists in the city at NYU
on forty first Street. You could just go on to
the NYU website and see all the physicians that we have.
But don't, don't, don't be paralyzed. You got to just
get yourself in motion.
Speaker 5 (09:52):
And once sure, thanks for your time.
Speaker 3 (09:56):
Well, thank you, and I hope that that helps you,
and I hope that that is something that we can
go on to your New Year's attention. Okay, the number
is eight hundred and three two one zero seven ten.
We're live here at Kats's Corner on a rather chilly
Sunday morning. I've already been up and out and I
don't know if you have, but Max is on the line.
(10:18):
Good morning, Max, how are you?
Speaker 7 (10:20):
Good morning, doctor Katz. It's an honor to speak to you,
listening to thank you for a number of years.
Speaker 3 (10:26):
Thank you, man.
Speaker 7 (10:28):
Can you hear me?
Speaker 3 (10:29):
Yes, I hear you? Great?
Speaker 7 (10:31):
Oh, okay, great, well, I am all the way on
the other side of the country, but.
Speaker 3 (10:37):
Really, wow, well where are you.
Speaker 7 (10:41):
I'm in Oakland, California?
Speaker 3 (10:44):
Now, Oh, Oakland California. Wow, so it's four thirteen in
the morning there. Thanks for coming up, getting up dedicated listen.
Speaker 7 (10:51):
I love it.
Speaker 3 (10:52):
How can I help you?
Speaker 7 (10:55):
Okay, I've been listening to you for a number of years,
and about five years ago you recommended when I had
an elevated p s A that I get a guided
m r A, a guided biopsy m RI. I guided
biopsy did okay, and so we were doing watchful waiting
for a number of years, and eventually my year all
(11:19):
just thought I needed to do something. So I ended
up doing the high intensity vocal ultrasound treatment with doctor
Son out at Stanford.
Speaker 3 (11:31):
I don't know if you know him, probably yeah, okay, yeah.
Speaker 7 (11:39):
So the results were really good, and that was about
a year and a half ago. And actually I just
had another MRI and they didn't find any dark areas
like they did before the ultrasound treatment, and so I'm
going for a regular biopsy UH and a couple of weeks.
(12:00):
But what I was calling about was after I had
the ultrasound, UH, the only side effect I seemed to have,
because I already had had some ed issues with directions,
which I still do, was a retrograde ejaculation which I'm
(12:21):
still experiencing. I was just wondering if you have any suggestions,
because they tried me on some medication to try to
deal with that, which was in im im a prame mindment.
Yes and maybe yeah, yeah, Well here's the deal.
Speaker 3 (12:46):
And how old are you.
Speaker 7 (12:47):
Max, I'm seventy one.
Speaker 3 (12:50):
Seventy one, all right, So, uh, just for the listeners
out there, I'm just going to recap your case. You're
seventy one, that you had a biopsy. It was the
bio just I wasn't clear. Was the biopsy showing both
sides of the prostate had cancer and you had a
full HIPHU, a full ultrasound treatment of the prostate, or
(13:11):
was it just one specific region.
Speaker 7 (13:14):
I think it was two regions that two regions that
were close enough that they could do the HIFU.
Speaker 3 (13:22):
Well, if you could do you know, some people do
a whole gland higphoo, which is high intensity focused ultrasound,
which are ultrasound waves going into the prostate and heat
up the area of the cancer. So you may have
had it in one area, or one lobe of a
prostate or two lobes. It's unclear to me. But what
is clear to me is two things. One that you
(13:44):
had this treatment, that you may have had low grade
prostate cancer because the HIPHU the ultrasound is not really
for high grade prostate cancer, so it was usually for
lower grade prostate cancer. You had it, and then subsequently
you're following it by PSA, which sounds like your PSA
is doing pretty good, I guess, and your MRI, which
(14:04):
looks sounds to me like that's doing pretty good. And
now they want to do another confirmatory biopsy even though
the MRI looks okay, they want to do another biopsy,
which I think is reasonable. Which is reasonable considering that
you know, this HIPHU is not one of the standard
(14:27):
treatments let's say. I mean it has been used more
and more like cryotherapy and HYPHU and laser therapies for
focal therapy of the prosty. But I think it is
a good idea that your doctors are doing this biopsy.
In terms of your erections, you're saying that your your
erections are still okay. Is but you don't have a
(14:47):
proper ejaculation.
Speaker 7 (14:48):
Is that right? Well, the erections are no. The erections.
I'm still having some problems with the elections. You know, Okay,
I I had that before the high as well.
Speaker 3 (15:02):
Right, I understand what what medicine are you taking for
the erections? Has anything helped you?
Speaker 7 (15:09):
Yeah, let's see what's helped me? Is some I can't
remember the biagra. I take biagre sometimes, okay. And also
a little cannabis can help as well.
Speaker 3 (15:25):
Okay, that's not part of the guidelines. But yes, I've
heard that, all right.
Speaker 7 (15:30):
But the retrograde I get it. I get it.
Speaker 3 (15:35):
Ejaculation is back.
Speaker 7 (15:37):
I was hoping I could overcome that.
Speaker 6 (15:40):
You know.
Speaker 3 (15:40):
Let me tell you something, Max, there are certain things
in life that we have to you know, you're gonna
have to move on with. Okay. I do not think
that any medication or anything at this point in your
life after a haiphu and being seventy one is going
to help you this emit remin. I don't think that
you have retrograde ejaculation. I think you have no ejaculation
(16:03):
from the haiphu. And I say that based upon my experience.
Retrograde ejaculation can occur where the ejaculation goes back into
the bladder with some medications, specifically flomax, tam solos and
very common with that but I would say to you that, unfortunately,
my friend, I don't think it's going to get better.
(16:24):
That you're not going to have a normal ejaculation, but
I think that your erections can improve. One of the
things that I found to be helpful is a daily
cialis pill five milligrams. You could take that, which will
help urinary issues and well, and then on the days
that you want to have sexual relations on the weekend,
maybe you can bump it up from five to twenty milligrams.
(16:45):
If that doesn't work, you can try a self injection
program that's been very helpful, especially if you have some
erections that can be very helpful. Yes, you have to
kind of train yourself to do the injection every time
you want to have sex, but it'll give you the
best direction that you've ever had, well, not ever, let's say,
in their twenties, but best direction you've had in years,
(17:06):
let's say, and better than the pills. But I'm sorry
to say that these doctors can throw all kinds of
medication at you. But the ejaculation, I think is it's done.
But the good news is the cancers that the cancer
seems great and so you're going to live. You can
improve on your erections. You can have normal sexual function.
(17:29):
It's just that you're going to have what we call
a dry orgasm, a dry ejaculate, and that's part of
the deal. And I see that time and time again,
especially with patients that have had radical prostotectomy, patients that
have had HIPU, patients that have had radiation therapy. And
I think us as urologists need to do a better
(17:51):
job at managing patients expectations and telling people, Look, before
you have this procedure, you're in your late sixties, you're
in your seventies, you might not ejaculate again. Okay, we
want you to know that that's going to be part
of the deal. And I don't think that a lot
of doctors do that, especially in patients they need radical surgery,
whether patients that are going to need even radiation, or
(18:12):
patient's ticket hormones and radiation, that is part of the deal. Okay,
I hope I don't ban me out too much. Yeah,
on this holiday season, I'm just trying to be.
Speaker 7 (18:24):
Real with you. No, no, well, you're not trying to
be You maye focus on the fact that that you
know the prostate cancer is under control, so exactly and
I can.
Speaker 3 (18:36):
I can live, you know exactly, you can live.
Speaker 7 (18:42):
On top.
Speaker 3 (18:43):
You know, I understand, I understand. We you know, we
used to say there's no free lunch, you know. I mean, yeah,
I get it. But focus on the good things. Focus
on what's positive that this doctor did. It sounds like
you did a great job. And it sounds like you know,
you're not going to be on hormone therapy and it's
a prostate cancer not gonna affect your life, and you're
going to live, and you know your sexual function can
(19:04):
improve and you can do all the wonderful things in life.
All Right, you got a whole bunch, Thank you, thank you,
and thanks for tuning in. We have a whole bunch
of calls here, which is wonderful. Go ahead, Alan, you're
on with Aaron Katz. Good morning. How are you?
Speaker 6 (19:19):
Good morning, doctor? This is Alan. I'm a patient of yours. Okay, okay,
I've been out of town for quite a bit. I
haven't Harley in your Carrea, I've seen doctor has I
think and okay, yes, but I have basically one problem
I have. In consequence, I still leak and I was
(19:41):
doing the tiggles, but nothing seems to help anymore.
Speaker 3 (19:44):
Okay, And you had radiation, I take it.
Speaker 6 (19:48):
I had radiation three years ago with.
Speaker 3 (19:51):
N y U. And when did you start leaking?
Speaker 6 (19:55):
I had a terp about two years ago. And then
you told me when I saw you that that wasn't
a good idea.
Speaker 3 (20:04):
No, that's not a good idea. No, a turf after
radiation can cause incontinence, that's not a good idea.
Speaker 6 (20:11):
Yeah, that's what happens.
Speaker 3 (20:13):
Okay, that's what happened. Well, we can't go back in time, right,
we can only go forward. So what I think you
need to do is see our doctor bad Kashan. Where
do you live, Sir?
Speaker 6 (20:23):
I live in Brooklyn, but I'm gonna be going to
Florida and I'm gonna go out of the country. I'm
not around that too much.
Speaker 3 (20:28):
Because if the urinary leakage is bad and you are
you wearing pads?
Speaker 6 (20:33):
I changed about one or two times a day.
Speaker 3 (20:36):
Okay. So if you can live with it, you live
with it. Maybe we can try a little medication. If
it's really bad, you're gonna need a procedure called an
artificial sphincter. Okay, you want to look that up. An
artificial urinary sphincter. There are only a few types of
doctors that really can do that well. They usually reconstructive urologists, okay,
(20:56):
and you want to go to eurologists that does a
lot of them because there can be implications with them.
But if the leakage is bad and you've tried some medication,
you could try a little you know, some of these
medications that calm the bladder down. If you're running to
the bathroom frequently, you can even try little botox in
the bladder, or a medication called Vessicare or did trepan,
one of these medications to calm bladder function down if
(21:19):
it's an overactive bladder. But if it's really leaking quite
a bit after a terp, you might need to have
an artificial sphincter. I would have you see one of
our doctors at n YU for that.
Speaker 6 (21:30):
Anybody in Brooklyn or New York City.
Speaker 3 (21:32):
Not in Brooklyn, but in New York City, Yes, and
there there there is, and I would see either somebody
named Lee zou z h Ao. He's terrific at that.
Uh he's he's a master surgeon. Lie zou z h Ao,
(21:54):
extraordinarily busy guy. You could also see a doctor Seth Cohen.
I believe that he's doing them, and that out on
Long Island we have a doctor Shervin bad Kashan who
does them specifically. So there are doctors that can do it.
I don't know about in Florida. You'd have to check.
But again, if you're are going to consider having a
sphincter placed, you do need to see it by someone
(22:15):
who is considered to be a you know, a specialist
in that area, not just a general urologist, but somebody
that really has had a Fellowship training I believe in
if it were me, I would do that with it
with a guy that's Fellowship trained in reconstructive urology. Okay,
sorry to hear that, but certainly you could try the
(22:36):
medication first that that that can probably help.
Speaker 6 (22:38):
So and what was the name of the medication again?
Speaker 3 (22:40):
Someone write, Well that there's a couple. One is called
vesicare v is in victor E s I C A
R E. The other is called ditrepan. All right, and
those are certainly medications that you can try.
Speaker 6 (22:58):
Okay, when I when I come back from Florida, I'm
gonna okay, you're out of the country. But yeah, I'll
make an appointment with you.
Speaker 3 (23:08):
Sure thing, Allan, Thank you, Thank you Alan. Okay, I
wish you well. I hope your PSA is okay after
the radiation.
Speaker 6 (23:15):
Thanks. I think it is okay.
Speaker 3 (23:17):
Okay, Well get in get it checked. You know, don't
think you got to know your numbers. Thank you Allan. Okay,
you know I tell people this all the time. You know,
you need to be the empowered patient and know your numbers.
And not only just your PSA, but clearly you need
to know your blood pressure or your heart rate. You
should know your hemoglobin A one C, which is a
measurement of whether or not you're entering a pre diabetic state.
(23:39):
You need to know your creating level. You need to
know your kidney function. Yes, you should know your PSA.
You should know your b M. I you know you're
hight divided by weight. You really want to know that.
You know which is You know, if you're one hundred
and seventy pounds, well that sounds good, but if you're
four foot five, it's not good, you know, I mean
(24:00):
you're too short for your weight. So you know you
need to There are calculators that you can look up
online and you put in how much you weigh and
how much how tall you are. You know, you really
want your BMI to be around you know, twenty five,
twenty six. Maybe once you start going above thirty thirty five,
you're entering an area of obesity and putting yourself at
(24:24):
serious risk of other medical conditions. So you know, these
are the numbers that we need to know in our lives,
besides our phone number, which you know, I used to
know everybody's phone number when I was a kid. You know,
I could recite phone numbers off the top of my head.
I don't know anybody's phone number. Now we have another
caller on the line.
Speaker 4 (24:43):
This is John. I have a problem with UTI that's
not responding to antibiotics. I've had three rounds of antibiotics,
two macrobid, one sip ro, just finish the szip row
and continuing to have the UTI symptoms.
Speaker 3 (25:02):
What would be done in that case tough situation. First
of all, I would probably get have a discussion with
an infectious disease doctor to see why you have such
resistant organisms and why you're having persistence of these jenery
tract infections. How old are you, my friend seventy one?
(25:24):
So have you had a cat scan of the abdomen
and pelvis. Have you had a cat scan?
Speaker 6 (25:30):
No?
Speaker 4 (25:31):
Quick history. I've been self catheterizing for about a year
and I recently had a procedure done which was successful.
But because of the UTI that I had right before
the procedure and it's persistent after the procedure, it may
be all related to that.
Speaker 3 (25:51):
Oh, it's not. Not definitely. Maybe it's definitely all related
to that. Yeah, I only have thirty seconds left, but
I would say that A. Make sure you're emptying your
bladder well. And B if you're not symptomatic at this point,
are you're having fevers or chills or pain. If you're not,
you might not want to treat it. I know it
(26:12):
sounds crazy, but especially someone like you that's had intermittent cathterizations,
you might not want to treat it because you're just
going to breed more resistance. Unfortunately, that's the end of
the show. I'll be back next week, though, Guys Live
Show be back next week. Tune in if you want
to send me an email, it's Men's Health at NYU
Leandgone dot org. I'm sorry, that's the end of the show.
Have a great day. Everyone's stay warm, it's rather chilly.
(26:35):
Have a great day. I'll be back next week. This
is doctor Aaronkats.
Speaker 2 (26:39):
You've been listening to Katzer's Corner. Come back every week
to hear more straight talk on a wide range of
men's health topics and advice on how to live your
healthiest life.
Speaker 1 (26:50):
The proceeding was a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed.
The following is a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed.
Speaker 2 (00:09):
The following program is brought to you by NYU Land
Gone Health. It's Kats's Corner with doctor Aaron Katz. You're
trusted expert in men's health, providing straight talk on a
wide range of men's health topics and advice on how
to live your healthiest life. Now on seventy ten woor
It's the Chairman of Urology at NYU Land Gone Hospital,
(00:32):
Long Island. Here is doctor Aaron Katz.
Speaker 3 (00:37):
Well here he is doctor Aaron Katz, and we're live
on Katz's Corner here this morning on a rather chilly
December morning. Everyone. Yeah, winter is here, little snow on
the ground yesterday that was nice December twenty second. Here,
I've got two shows left on war and my history
(00:59):
on a radio will be ending. Oh you never know
the future, right, I mean, we don't know what we
know is now today. If you'd like to give me
a call, we are live here on this what is
this the This is the fourth actually Sunday of the month.
There's five Sundays this month. This is the fourth. We
have one more next week, a big holiday week this week,
(01:23):
Christmas and Hanukkah coinciding. That's nice. If you want to
give me a call numbers eight hundred three two one
zero seven ten one eight hundred three two one zero
seven ten and you can get to chat with me
and give you me your your questions, your thoughts, any
concerns you may be having terms of your PSA or
(01:46):
your you had a biopsy, or you have an MRI
coming up, or you have issues with sexual issues or
testosterone deficiency. These are the things that urologists such as
myself feel very comfortable to discussing because this is what
we deal with every single day. And I have been
in this field for thirty some odd years and still
(02:10):
very passionate about men's health and taking care of men.
I'm actually passionate about all health. And if you've listened
to the show and avid listener you can, you can
get a sense of that. I've had lots and lots
of wonderful guests here over the years. In the last
fourteen years from NYU and I've had just terrific cardiologists,
(02:34):
orthopedic doctors, endocrine doctors, cancer doctors, people with weight loss
experts here, nutritionists, a whole host of all kinds of
people here that have been really delivering what I think
is the greatest for your overall health. One eight hundred
and three to two one zero seven ten is the
(02:56):
number I love to hear from you. And yes, unfortunately
I will be going to a different venue. I'm not
allowed to say what that venue is, but I am
allowed to announce an email that you can email me,
and then I can tell you personally what that venue
will be and you can continue to listen to me.
(03:20):
That email is Men's Health at nyuland going dot org,
Men's Health at nyuland going dot org. And this way
you can, you know, kind of send me an email
and we can continue our conversations over the years.
Speaker 4 (03:41):
You know, I.
Speaker 3 (03:44):
Do firmly believe in diet, of course, exercise and sleep.
Those are the main three pillars that I think are
key to anyone's longevity in life, which is getting enough rest,
which none of us really do these days. Everybody's so busy, busy, busy.
I get it, We're all busy. How you doing, Oh,
I'm so busy. I'm busy I'm doing this, I'm running
(04:06):
around especially the holiday season. Wow. I mean, the roads
are jammed up here on Long Island where I live
out near the mall. I don't know why anyone would
go to the mall anymore. I mean, I mean, God
bless the stores, you know. I mean, and I give
these people an incredible amount of credit to keep stores
open during this you know, world of online shopping. But
(04:33):
the streets are just kind of crazy. The cars are
jammed up, the malls are jammed up, and you know,
people are stressed, and it's a stressful time. It should
be a happy time, yes, I get it, but it
can also be very stressful time. And what that means
is you don't eat right, and you don't sleep well,
and you probably are running around and probably not you're
(04:54):
running around in the car or wherever your subways or
mode of transportation, but probably not doing a lot of
exercise and eating a lot. So keep those three things
in mind. Please get enough sleep, eat properly, and exercise
as much as you can. We have a couple of
(05:16):
phone calls. Well we actually have David on the line,
and if you want to reach me, it's three two one,
it's eight hundred eight hundred three two one zero seven ten,
Doctor Aaron Katz here on Katz's corner, just for two
more weeks. Well, we'll continue the show on another venue.
But anyway, David, good morning, how are you?
Speaker 5 (05:35):
I have like an issue that maybe needs to be addressed.
I mean, I have a typical syndrome of frequent urination
and complete emptying of the bladder weak flow urgencies. But
I also have Pironi's disease, and so I am my
PSA is four. I mean, but I've been going back
(05:56):
and forth as to who to see. A urologist is
a Peroni's specialist, and so I've created a mindset of inaction.
I mean, I'm actually paralyzed in not doing anything about it.
Do you sense this happens more often than we than
we know?
Speaker 6 (06:16):
David?
Speaker 7 (06:17):
How old are you?
Speaker 5 (06:18):
Seventy four?
Speaker 3 (06:19):
All right, sound pretty young there, David good Let me
let me just tell you one thing. A Pironi's specialist
is actually a urologist, Okay, yeah, And we have one
in our department here on Long Island. There's one in
the city at NYU. And these peroni specialists are also
(06:43):
urologists that can also take care of and help you
with your urinary issues. And if these.
Speaker 5 (06:54):
I did ask a friend for a suggestion and he
recommended you, So okay, he's one of your patients, it
turns out. So so when I hear that, then I
think that's overkilled to my situation. So it creates more
in action. What do you mean what you're saying is logical?
I just I did see urologists and he said there
(07:17):
was a person in his department that the specialized in paronis.
But you know, then then I got cold feet again
as to needing a urologist as well as a Paroni's specialists.
But but you think I can do it all?
Speaker 6 (07:37):
You could? You think you could?
Speaker 3 (07:40):
And then the peronis today is certainly managed a lot differently.
And of course it depends upon the degree of curvature.
And if you're just listening, what is Peroni's. It's a
curvature of the penis, usually due to a plaque, could
have been done to trauma during sex, or maybe it
just developed for reasons that we are unclear. Maybe there
(08:04):
are some genetic predispositions that people have with this curvature,
but it can be sometimes painful, and it can also
prevent people from having a proper sexual relations. As you
can imagine, the degree of curvature can be sometimes ninety degrees,
which is rare. But sometimes a degree of curvature can
(08:25):
you know, prevent people from having normal sexual relations. And
sometimes it's just coming down to the office and having
a series of injections called ZIOPHILEX, which can be done.
And then also, David, you can have the urinary issues
addressed at the same time with either having a medication
(08:46):
or perhaps even an in office procedure like a eurolift
or resume or you know, depending upon the size of
your prostate and the degree of your urinary issues. But
let's do this, David, let's have you know, people talk
about New Year's resolution. I don't. I don't do new
Year's resolution. I do New Year's intention. The intention and
(09:10):
your intention, my friend, is to get your penis fixed
and your prostate fixed and improve your sexual function and
improve your urinary function. That's your New Year's intention for you.
And where do you live, my friend, I'm in Brooklyn.
I mean, okay, so fine, I just yeah, you could
you could go to Manhattan.
Speaker 5 (09:30):
I guess it's specific to get me, uh get me going.
Speaker 3 (09:34):
You know, you could see me at the Men's Center
if you want it. I'm on fifty fifth in Madison.
We have other great urologists in the city at NYU
on forty first Street. You could just go on to
the NYU website and see all the physicians that we have.
But don't, don't, don't be paralyzed. You got to just
get yourself in motion.
Speaker 5 (09:52):
And once sure, thanks for your time.
Speaker 3 (09:56):
Well, thank you, and I hope that that helps you,
and I hope that that is something that we can
go on to your New Year's attention. Okay, the number
is eight hundred and three two one zero seven ten.
We're live here at Kats's Corner on a rather chilly
Sunday morning. I've already been up and out and I
don't know if you have, but Max is on the line.
(10:18):
Good morning, Max, how are you?
Speaker 7 (10:20):
Good morning, doctor Katz. It's an honor to speak to you,
listening to thank you for a number of years.
Speaker 3 (10:26):
Thank you, man.
Speaker 7 (10:28):
Can you hear me?
Speaker 3 (10:29):
Yes, I hear you? Great?
Speaker 7 (10:31):
Oh, okay, great, well, I am all the way on
the other side of the country, but.
Speaker 3 (10:37):
Really, wow, well where are you.
Speaker 7 (10:41):
I'm in Oakland, California?
Speaker 3 (10:44):
Now, Oh, Oakland California. Wow, so it's four thirteen in
the morning there. Thanks for coming up, getting up dedicated listen.
Speaker 7 (10:51):
I love it.
Speaker 3 (10:52):
How can I help you?
Speaker 7 (10:55):
Okay, I've been listening to you for a number of years,
and about five years ago you recommended when I had
an elevated p s A that I get a guided
m r A, a guided biopsy m RI. I guided
biopsy did okay, and so we were doing watchful waiting
for a number of years, and eventually my year all
(11:19):
just thought I needed to do something. So I ended
up doing the high intensity vocal ultrasound treatment with doctor
Son out at Stanford.
Speaker 3 (11:31):
I don't know if you know him, probably yeah, okay, yeah.
Speaker 7 (11:39):
So the results were really good, and that was about
a year and a half ago. And actually I just
had another MRI and they didn't find any dark areas
like they did before the ultrasound treatment, and so I'm
going for a regular biopsy UH and a couple of weeks.
(12:00):
But what I was calling about was after I had
the ultrasound, UH, the only side effect I seemed to have,
because I already had had some ed issues with directions,
which I still do, was a retrograde ejaculation which I'm
(12:21):
still experiencing. I was just wondering if you have any suggestions,
because they tried me on some medication to try to
deal with that, which was in im im a prame mindment.
Yes and maybe yeah, yeah, Well here's the deal.
Speaker 3 (12:46):
And how old are you.
Speaker 7 (12:47):
Max, I'm seventy one.
Speaker 3 (12:50):
Seventy one, all right, So, uh, just for the listeners
out there, I'm just going to recap your case. You're
seventy one, that you had a biopsy. It was the
bio just I wasn't clear. Was the biopsy showing both
sides of the prostate had cancer and you had a
full HIPHU, a full ultrasound treatment of the prostate, or
(13:11):
was it just one specific region.
Speaker 7 (13:14):
I think it was two regions that two regions that
were close enough that they could do the HIFU.
Speaker 3 (13:22):
Well, if you could do you know, some people do
a whole gland higphoo, which is high intensity focused ultrasound,
which are ultrasound waves going into the prostate and heat
up the area of the cancer. So you may have
had it in one area, or one lobe of a
prostate or two lobes. It's unclear to me. But what
is clear to me is two things. One that you
(13:44):
had this treatment, that you may have had low grade
prostate cancer because the HIPHU the ultrasound is not really
for high grade prostate cancer, so it was usually for
lower grade prostate cancer. You had it, and then subsequently
you're following it by PSA, which sounds like your PSA
is doing pretty good, I guess, and your MRI, which
(14:04):
looks sounds to me like that's doing pretty good. And
now they want to do another confirmatory biopsy even though
the MRI looks okay, they want to do another biopsy,
which I think is reasonable. Which is reasonable considering that
you know, this HIPHU is not one of the standard
(14:27):
treatments let's say. I mean it has been used more
and more like cryotherapy and HYPHU and laser therapies for
focal therapy of the prosty. But I think it is
a good idea that your doctors are doing this biopsy.
In terms of your erections, you're saying that your your
erections are still okay. Is but you don't have a
(14:47):
proper ejaculation.
Speaker 7 (14:48):
Is that right? Well, the erections are no. The erections.
I'm still having some problems with the elections. You know, Okay,
I I had that before the high as well.
Speaker 3 (15:02):
Right, I understand what what medicine are you taking for
the erections? Has anything helped you?
Speaker 7 (15:09):
Yeah, let's see what's helped me? Is some I can't
remember the biagra. I take biagre sometimes, okay. And also
a little cannabis can help as well.
Speaker 3 (15:25):
Okay, that's not part of the guidelines. But yes, I've
heard that, all right.
Speaker 7 (15:30):
But the retrograde I get it. I get it.
Speaker 3 (15:35):
Ejaculation is back.
Speaker 7 (15:37):
I was hoping I could overcome that.
Speaker 6 (15:40):
You know.
Speaker 3 (15:40):
Let me tell you something, Max, there are certain things
in life that we have to you know, you're gonna
have to move on with. Okay. I do not think
that any medication or anything at this point in your
life after a haiphu and being seventy one is going
to help you this emit remin. I don't think that
you have retrograde ejaculation. I think you have no ejaculation
(16:03):
from the haiphu. And I say that based upon my experience.
Retrograde ejaculation can occur where the ejaculation goes back into
the bladder with some medications, specifically flomax, tam solos and
very common with that but I would say to you that, unfortunately,
my friend, I don't think it's going to get better.
(16:24):
That you're not going to have a normal ejaculation, but
I think that your erections can improve. One of the
things that I found to be helpful is a daily
cialis pill five milligrams. You could take that, which will
help urinary issues and well, and then on the days
that you want to have sexual relations on the weekend,
maybe you can bump it up from five to twenty milligrams.
(16:45):
If that doesn't work, you can try a self injection
program that's been very helpful, especially if you have some
erections that can be very helpful. Yes, you have to
kind of train yourself to do the injection every time
you want to have sex, but it'll give you the
best direction that you've ever had, well, not ever, let's say,
in their twenties, but best direction you've had in years,
(17:06):
let's say, and better than the pills. But I'm sorry
to say that these doctors can throw all kinds of
medication at you. But the ejaculation, I think is it's done.
But the good news is the cancers that the cancer
seems great and so you're going to live. You can
improve on your erections. You can have normal sexual function.
(17:29):
It's just that you're going to have what we call
a dry orgasm, a dry ejaculate, and that's part of
the deal. And I see that time and time again,
especially with patients that have had radical prostotectomy, patients that
have had HIPU, patients that have had radiation therapy. And
I think us as urologists need to do a better
(17:51):
job at managing patients expectations and telling people, Look, before
you have this procedure, you're in your late sixties, you're
in your seventies, you might not ejaculate again. Okay, we
want you to know that that's going to be part
of the deal. And I don't think that a lot
of doctors do that, especially in patients they need radical surgery,
whether patients that are going to need even radiation, or
(18:12):
patient's ticket hormones and radiation, that is part of the deal. Okay,
I hope I don't ban me out too much. Yeah,
on this holiday season, I'm just trying to be.
Speaker 7 (18:24):
Real with you. No, no, well, you're not trying to
be You maye focus on the fact that that you
know the prostate cancer is under control, so exactly and
I can.
Speaker 3 (18:36):
I can live, you know exactly, you can live.
Speaker 7 (18:42):
On top.
Speaker 3 (18:43):
You know, I understand, I understand. We you know, we
used to say there's no free lunch, you know. I mean, yeah,
I get it. But focus on the good things. Focus
on what's positive that this doctor did. It sounds like
you did a great job. And it sounds like you know,
you're not going to be on hormone therapy and it's
a prostate cancer not gonna affect your life, and you're
going to live, and you know your sexual function can
(19:04):
improve and you can do all the wonderful things in life.
All Right, you got a whole bunch, Thank you, thank you,
and thanks for tuning in. We have a whole bunch
of calls here, which is wonderful. Go ahead, Alan, you're
on with Aaron Katz. Good morning. How are you?
Speaker 6 (19:19):
Good morning, doctor? This is Alan. I'm a patient of yours. Okay, okay,
I've been out of town for quite a bit. I
haven't Harley in your Carrea, I've seen doctor has I
think and okay, yes, but I have basically one problem
I have. In consequence, I still leak and I was
(19:41):
doing the tiggles, but nothing seems to help anymore.
Speaker 3 (19:44):
Okay, And you had radiation, I take it.
Speaker 6 (19:48):
I had radiation three years ago with.
Speaker 3 (19:51):
N y U. And when did you start leaking?
Speaker 6 (19:55):
I had a terp about two years ago. And then
you told me when I saw you that that wasn't
a good idea.
Speaker 3 (20:04):
No, that's not a good idea. No, a turf after
radiation can cause incontinence, that's not a good idea.
Speaker 6 (20:11):
Yeah, that's what happens.
Speaker 3 (20:13):
Okay, that's what happened. Well, we can't go back in time, right,
we can only go forward. So what I think you
need to do is see our doctor bad Kashan. Where
do you live, Sir?
Speaker 6 (20:23):
I live in Brooklyn, but I'm gonna be going to
Florida and I'm gonna go out of the country. I'm
not around that too much.
Speaker 3 (20:28):
Because if the urinary leakage is bad and you are
you wearing pads?
Speaker 6 (20:33):
I changed about one or two times a day.
Speaker 3 (20:36):
Okay. So if you can live with it, you live
with it. Maybe we can try a little medication. If
it's really bad, you're gonna need a procedure called an
artificial sphincter. Okay, you want to look that up. An
artificial urinary sphincter. There are only a few types of
doctors that really can do that well. They usually reconstructive urologists, okay,
(20:56):
and you want to go to eurologists that does a
lot of them because there can be implications with them.
But if the leakage is bad and you've tried some medication,
you could try a little you know, some of these
medications that calm the bladder down. If you're running to
the bathroom frequently, you can even try little botox in
the bladder, or a medication called Vessicare or did trepan,
one of these medications to calm bladder function down if
(21:19):
it's an overactive bladder. But if it's really leaking quite
a bit after a terp, you might need to have
an artificial sphincter. I would have you see one of
our doctors at n YU for that.
Speaker 6 (21:30):
Anybody in Brooklyn or New York City.
Speaker 3 (21:32):
Not in Brooklyn, but in New York City, Yes, and
there there there is, and I would see either somebody
named Lee zou z h Ao. He's terrific at that.
Uh he's he's a master surgeon. Lie zou z h Ao,
(21:54):
extraordinarily busy guy. You could also see a doctor Seth Cohen.
I believe that he's doing them, and that out on
Long Island we have a doctor Shervin bad Kashan who
does them specifically. So there are doctors that can do it.
I don't know about in Florida. You'd have to check.
But again, if you're are going to consider having a
sphincter placed, you do need to see it by someone
(22:15):
who is considered to be a you know, a specialist
in that area, not just a general urologist, but somebody
that really has had a Fellowship training I believe in
if it were me, I would do that with it
with a guy that's Fellowship trained in reconstructive urology. Okay,
sorry to hear that, but certainly you could try the
(22:36):
medication first that that that can probably help.
Speaker 6 (22:38):
So and what was the name of the medication again?
Speaker 3 (22:40):
Someone write, Well that there's a couple. One is called
vesicare v is in victor E s I C A
R E. The other is called ditrepan. All right, and
those are certainly medications that you can try.
Speaker 6 (22:58):
Okay, when I when I come back from Florida, I'm
gonna okay, you're out of the country. But yeah, I'll
make an appointment with you.
Speaker 3 (23:08):
Sure thing, Allan, Thank you, Thank you Alan. Okay, I
wish you well. I hope your PSA is okay after
the radiation.
Speaker 6 (23:15):
Thanks. I think it is okay.
Speaker 3 (23:17):
Okay, Well get in get it checked. You know, don't
think you got to know your numbers. Thank you Allan. Okay,
you know I tell people this all the time. You know,
you need to be the empowered patient and know your numbers.
And not only just your PSA, but clearly you need
to know your blood pressure or your heart rate. You
should know your hemoglobin A one C, which is a
measurement of whether or not you're entering a pre diabetic state.
(23:39):
You need to know your creating level. You need to
know your kidney function. Yes, you should know your PSA.
You should know your b M. I you know you're
hight divided by weight. You really want to know that.
You know which is You know, if you're one hundred
and seventy pounds, well that sounds good, but if you're
four foot five, it's not good, you know, I mean
(24:00):
you're too short for your weight. So you know you
need to There are calculators that you can look up
online and you put in how much you weigh and
how much how tall you are. You know, you really
want your BMI to be around you know, twenty five,
twenty six. Maybe once you start going above thirty thirty five,
you're entering an area of obesity and putting yourself at
(24:24):
serious risk of other medical conditions. So you know, these
are the numbers that we need to know in our lives,
besides our phone number, which you know, I used to
know everybody's phone number when I was a kid. You know,
I could recite phone numbers off the top of my head.
I don't know anybody's phone number. Now we have another
caller on the line.
Speaker 4 (24:43):
This is John. I have a problem with UTI that's
not responding to antibiotics. I've had three rounds of antibiotics,
two macrobid, one sip ro, just finish the szip row
and continuing to have the UTI symptoms.
Speaker 3 (25:02):
What would be done in that case tough situation. First
of all, I would probably get have a discussion with
an infectious disease doctor to see why you have such
resistant organisms and why you're having persistence of these jenery
tract infections. How old are you, my friend seventy one?
(25:24):
So have you had a cat scan of the abdomen
and pelvis. Have you had a cat scan?
Speaker 6 (25:30):
No?
Speaker 4 (25:31):
Quick history. I've been self catheterizing for about a year
and I recently had a procedure done which was successful.
But because of the UTI that I had right before
the procedure and it's persistent after the procedure, it may
be all related to that.
Speaker 3 (25:51):
Oh, it's not. Not definitely. Maybe it's definitely all related
to that. Yeah, I only have thirty seconds left, but
I would say that A. Make sure you're emptying your
bladder well. And B if you're not symptomatic at this point,
are you're having fevers or chills or pain. If you're not,
you might not want to treat it. I know it
(26:12):
sounds crazy, but especially someone like you that's had intermittent cathterizations,
you might not want to treat it because you're just
going to breed more resistance. Unfortunately, that's the end of
the show. I'll be back next week, though, Guys Live
Show be back next week. Tune in if you want
to send me an email, it's Men's Health at NYU
Leandgone dot org. I'm sorry, that's the end of the show.
Have a great day. Everyone's stay warm, it's rather chilly.
(26:35):
Have a great day. I'll be back next week. This
is doctor Aaronkats.
Speaker 2 (26:39):
You've been listening to Katzer's Corner. Come back every week
to hear more straight talk on a wide range of
men's health topics and advice on how to live your
healthiest life.
Speaker 1 (26:50):
The proceeding was a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!