Dr. Todd Brandt answers the question: Why Urology?
ReZum procedure for treatment of BPH: Ten Question for Dr. Spencer Hart ep 109
In this episode I welcome back Dr Spencer Hart
Dr Hart and I go through my "Ten Questions" that I think can be applied to almost any procedure or surgery to cover the main questions a patient needs to know. We apply the ten questions to talk about an in-office treatment for BPH or the enlarged prostate called the ReZUM treatment.
The ReZum procedure utilizes small blasts of steam into the enlarged prostate to destroy the tissue to create a better channel through the enlarged prostate for improved urinary flow.
Here are the ten questions. 1. What is diagnosis? 2. Describe the procedure. 3. What are the benefits? 4. What are the risks? 5. Is this a common procedure? 6. What are the alternatives to the procedure? 7. What happens if I wait to do this procedure? 8 How do I prepare? 9. How do I recover? 10. Does insurance help cover this procedure?
This is another great conversation with Dr. Spencer Hart. I hope you enjoy it. Thank you for listening.
You can find Dr. Hart at https://mnurology.com/physicians/spencer-hart/
You can find the ReZum treatment information at https://www.rezum.com or text ReZum to 73771
Connect with me at whyurologypodcast.com
I have an enlarged prostate, now what? An interview with Dr Spencer Hart
n this episode I have a conversation with Dr. Spencer Hart about the enlarged prostate, what is known as BPH.
In this conversation we try to answer the question, “I have an enlarged prostate, now what?”
Find Dr. Spencer Hart at https://mnurology.com/physicians/spencer-hart/
Find information about the ReZum procedure at https://www.rezum.com
Find information about Urolift procedure at https://www.urolift.com
Connect with me at whyurologypodcast.com
I'm Nobody, Who Are You?: Content Marketing, Podcasting and the Medical Practice ep 107
We live in a social media-driven world. Facebook, twitter, Linked In, Instagram, YouTube, TikTok and many other platforms vie for our attention, and of course the advertising dollar. Medical practices have been trying to figure out social media, medical review sites, and online marketing for years now. Sadly, it is necessary for businesses to seek out the likes, and thumbs ups, shares, subscribes, stars or whatever other rating system is out there just to keep up.
Enter content marketing as an antidote to chasing likes online.
The idea of content marketing as I understand it is this. A business and professionals in business can earn credibility and trust through online content in the form of blog posts, videos, pictures, and websites that establishes authority and expertise within a certain field. Trust is then developed with a potential new client, customer, or a patient online well before any face-to-face meeting or phone call to that business or professional.
If I am a plumber, for instance, I can make videos and post them online that show you how to troubleshoot a clogged drain. Not only am I being helpful to you when your drain is clogged, but you may end up calling me to help when it is beyond the simple do it yourself fix.
We can apply the same idea to our medical practices, at least that was my thought when I got the idea for this podcast as well as other forms of online content creation.
In this episode I share 5 principles that I think are important when we think about how to create online content marketing.
Here are the five principles:
Share information and solve problems Tell a story Choose one form of content as the foundation Reimagine content Keep a schedule Connect with me at whyurologypodcast.com.
Adrenal Gland: The Adrenal Gland for Sixth Graders ep 106
Medical education, we are told, that is aimed at our patients should be written at a sixth-grade level if we want to have a majority of our patients understand what we are trying to tell them. Many, many people do not read or understand material aimed higher than a sixth-grade level, nor do they want or have time to, so to capture our patient’s attention and ability to understand we should aim no higher.
I have heard this advice many times but, to be honest, I never knew what that meant, to write at a certain grade level, nor how to achieve it.
What does it mean to read and write at the sixth-grade level?
There are a number of ways to determine what grade level a certain piece of writing is. I am going to highlight two of them. Most of the ways to calculate the reading level is to calculate based on sentence length, word complexity, and paragraph length.
THE ADRENAL GLAND
The adrenal glands are hormone producing glands. You have two adrenal glands, one on each side of the body above each kidney. The adrenal glands are about two inches long, and inch wide and half an inch thick. The glands are a deep yellow color.
The adrenal glands are surrounded fat which also surrounds the kidneys. A thin layer of fat separates the adrenal glands from the kidneys.
Each adrenal gland is made up of two parts, an outer layer called the cortex, and an inner core called the medulla.
The adrenal glands produce several different hormones.
Adrenaline is made by the inner portion of the adrenal gland. Adrenaline is released during times of stress. During times of danger adrenaline increases blood pressure and heart rate, breathing and causes your blood vessels to narrow as a way to prepare your body to either run away from the danger or to stay and fight.
The adrenal cortex has three layers. Each layer makes its own hormone.
The first layer of the adrenal cortex produces a hormone called aldosterone that helps regulate of blood pressure and salt levels in the body.
The second layer of the adrenal cortex makes a hormone called cortisol that helps regulate metabolism and the immune system.
The innermost layer of the cortex makes a hormone that gets converted to sex hormones in other parts of the body.
The adrenal gland can be seen on CT and MRI scans. A mass or tumor as an incidental finding can be seen in up to 3-5% of CT scans. Many of those unexpected small tumors are not functional and do not need to be treated.
There are a number of diseases involve dysfunction of the adrenal gland.
Insufficient production of adrenal hormones is called Addison's disease. Symptoms of Addison’s disease include hyperpigmentation of the skin, sudden pain in the legs, lower back, or abdomen, vomiting and diarrhea, low blood pressure, low blood sugar, tiredness, confusion, low salt levels in the blood and fever. A famous patient who suffered from Addison’s disease was the late President John F. Kennedy.
Overproduction of cortisol within the body or taking prednisone for a long period of time leads to Cushing's syndrome. Cushing’s syndrome produces a wide variety of signs and symptoms which include obesity, diabetes, increased blood pressure, excessive body hair, poor bone health, depression, and stretch marks in the skin.
A variety of non-cancerous tumors are found in the adrenal gland and are commonly found on x-rays. The most common finding is a tumor that does not produce any hormones.
A common functioning tumor that produces too much aldosterone is called a hyperaldosteronoma, which causes abnormalities of blood pressure and salt levels in the blood.
A tumor that produces too much adrenaline is called a pheochromocytoma. Common signs of a pheochromocytoma include a sudden high blood pressure, sweating and a rapid heart rate.
Cancer of the adrenal gland is uncommon.
Peyronie's Disease: Nesbit Plication Ten Questions ep 105
In this episode I answer the ten question about Nesbit Plication, as surgery used to treat curvature of the erect penis caused by Peyronie's Disease.
We first discussed Peyronie's Disease in episode 72 of this podcast.
Question #1. Doctor, what is my diagnosis? Can you describe it?
Peyronie’s disease is a scarring process of the penis that creates a classic triad of symptoms: curvature, pain, and palpable deformity on the penis. It can also create erectile dysfunction.
Its incidence is estimated at around 1 in 10 men.
Peyronie’s disease can affect a man’s penis with severe symptoms of pain or curvature with erection that affects his ability to be sexually active. Most men have mild to moderate symptoms that may hinder, but not prohibit, sexual activity.
Why does the penis bend? The curvature of the penis is due to the fact that scar tissue does not stretch as well as normal tissue, so with erection that area of the penis does not expand with the blood filling the corpora. The penis is then pulled towards the scar tissue. Most men will have a bend upward.
Peyronie’s disease usually presents as a rather sudden onset of pain and curvature during erection that, like any scar tissue, changes over time. We usually think about Peyronie’s having two phases, the active and the stable phase
What we call the active phase of Peyronie’s, the sudden onset of symptoms and the changing curve afterwards, may last up to 18 months or more as the scarring continues to change the shape, size, and curve of an erection. The stable phase of Peyronie’s disease is when the scarring has stopped shaping the penis and a man is left with a stable, unchanging deformity that no longer is painful.
Determining the phase of Peyronie’s Disease is critical prior to a surgery. Surgery on the penis to correct its shape or curvature can be considered when a patient has reached the stable phase of erectile dysfunction, when there is a stable curvature--no pain, no progression.
Question #2: What is the procedure you are recommending? Describe the procedure.
The Nesbit plication “tucks” or plicates the tunica albuginea of the penis on the side opposite of the curvature. Think about putting a pleat in a pair of pants or alternatively altering a suit. The surgeon can simply place a suture in the tunica to pull it together, like a pleat or alternatively, the plication procedure can remove a piece of the tunica and sew the edges back together, like fitting a suit.
The plication pulls the penis back to straight equal and opposite to the formed Peyronie’s plaque.
The procedure is done as an outpatient, in the hospital or surgery center, under general or spinal anesthesia. While a patient is asleep the surgeon exposes the tunica albuginea of the penis, creates an artificial erection to expose and measure the curvature, places the appropriate suture to correct the curvature, and then closes and bandages the incision.
The man then wakes up and goes to the recovery area to prepare for going home the same day.
Question #3: What are the goals and benefits and what can I expect to gain from this procedure?
The goal is to create a straight and firm penis for sexual activity. The goal is not a cosmetic result. This is important. Many men are concerned about and how their erection looks, but it’s the function that the surgeon cares about. A man with a small curve of the penis that does not inhibit sexual activity should not be considering this procedure.
Question #4: What are the risks?
As with any surgical procedure bleeding, infection, and anesthetic risks exist but there are three unique risks to this procedure that should be discussed: failure to correct the curvature, penile shortening and subsequent erectile dysfunction.
Failure to correct the curvature can happen when the artificial erection created intraoperatively doesn’
Bladder Cancer: Ten Questions about Transurethral Resection of Bladder Tumor ep 104
This is episode number 104 of this podcast that I started as a personal exploration into podcasting, the field of urology, and how we can combine the two to educate a general listening audience about different topics in urology.
Today’s topic is bladder cancer, and I want to focus specifically on a procedure that is the first step for most patients in their bladder cancer journey after they are diagnosed with a suspicious bladder tumor, the transurethral resection of bladder tumor or TURBT.
The format of this episode is to walk through the ten questions to ask your surgeon about any surgery or procedure and to apply it to the transurethral resection of bladder tumor.
The ten questions is a set of questions that I have come up with that I think can apply to any surgical procedure. It is meant to be a general framework for discussing any surgery or procedure with your surgeon. You can hear that episode of this podcast at