Maintaining Virility with Dr. Michael Esposito

Urologists at Holy Name Medical Center provide comprehensive care for male wellness, spanning from diet and exercise education to robot-assisted surgery to treat prostate cancer.

Michael Esposito, MD, FACS, urologist at Holy Name Medical Center, explains that the key to the urology program is maintaining men’s general health and well-being by educating them about healthy diets, exercise regimens and vitamin supplementation — all of which combine to promote healthy living — and screening to prevent cancer and maintain healthy testosterone levels.

Yearly checkups examine patients’ testosterone levels as well as the health of male organs and also provide important opportunities to screen for potentially life-threatening conditions.

Restoring Testosterone Levels

Testosterone levels naturally begin decreasing after men turn 40, but exercising moderately, with an aerobic-oriented regimen, at least three times per week for 30 to 45 minutes can sometimes restore testosterone to normal levels, according to Dr. Esposito. Patients suffering from side effects of low testosterone, such as decreased muscle mass, diminished sex drive and generalized fatigue, may require more advanced intervention and benefit from medical therapy. Dr. Esposito can deliver testosterone therapy through the skin via gels or patches, injections or supplements the body utilizes to generate male hormones.

Identifying Prostate Cancer Early

Guidelines set forth by the American Urologic Association and United States Preventive Services Task Force recommend men between 55 and 69 years old begin discussions with their physciains about yearly prostate-specific antigen (PSA) and digital rectal exams for prostate cancer. Additionally, men identified as being at high risk due to family history of primary or secondary relatives who have had prostate cancer, who are symptomatic of the disease or who are African-American should be similarly screened beginning at age 40, according to Dr. Esposito.

Physicians must pay careful attention to factors detailed in the patient’s recent history — including caffeine or chocolate consumption, motorcycle or horseback riding, sexual activity, flu, and other febrile illnesses or inflammatory illnesses of the prostate and urinary tract — that can cause PSA levels to rise. If patients have no history of close family members who’ve had prostate cancers, and artificial factors are ruled out, then Dr. Esposito combines results from PSA and digital rectal exams to determine if biopsy is appropriate.

If test results warrant biopsy, Dr. Esposito explains that urologists at Holy Name Medical Center proceed with caution, particularly for those patients whose initial biopsy comes back with negative or suspicious results but who definitely present prostate cancer risk factors.

“In cases such as these, we try not to repeat the biopsy unless we have imaging tests to guide us to the biopsy location,” Dr. Esposito says. “We don’t randomly perform ultrasound biopsy. We look for the area of the prostate emitting an abnormal signal on MRI scans, and then we specifically biopsy that site under MRI guidance.”

Dr. Esposito acknowledges that PSA testing is non-specific, but he notes the benefits of identifying cancer make it worthwhile.

“Deciding not to screen because of false positives would be at the cost of missing potential cancers,” Dr. Esposito says. “We actively surveil appropriate patients without treating them, but we don’t want to miss intermediate or aggressive cancers that can become clinically significant and shorten someone’s life.”

A Full Panel of Treatment Options

When biopsies confirm prostate cancer, physicians at Holy Name Medical Center can choose the most appropriate treatment modality from a wide array of treatment options. Taking into account the cancer’s stage, as well as the patient’s age, health and social conditions, physicians may choose from state-of-the-art minimally invasive surgical techniques or focused radiation therapies for the most effective and beneficial treatments. Although not FDA-approved for prostate cancer, high intensity focused ultrasound (HIFU) may become a viable treatment that targets prostate cancer cells with radiation-free sound waves, according to Dr. Esposito.

Robot-assisted surgical techniques significantly reduce bleeding, hospital stays and recovery times compared to open surgery, and experienced urologists at Holy Name Medical Center deftly operate so as not to impair erectile function.

“Using the robot, we perform meticulous nerve and blood vessel sparing to maximally preserve potency and erectile function,” Dr. Esposito says. “We achieve high rates of postoperative erectile function — up to 90 percent, when preoperative function was normal. We also achieve high continence rates, so men have a 97 percent chance of full continence following robot-assisted surgery. Cancer cure is always the foremost part of treatment.”

The original article is available here.

By |April 27th, 2015|news|0 Comments

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