Nicole Fournier, BHKin, MSc (PT), CAFCI, Physiotherapist, discusses rehabilitative ultrasound imaging with your physiotherapist.
Dr. Dean Elterman MD, MSc, FRCSC Urologist discusses Contino®, a new technology to deal with Male incontinence
Whether you are managing a chronic condition such as arthritis, have a condition such as Achilles tendonitis, are recovering from surgery or want to improve your flexibility, you may work with a local physiotherapist. From spinal adjustment and manual therapy techniques to rehabilitative ultrasound imaging, a local physiotherapist can help patients of all ages improve mobility and balance and reduce pain such as sciatica pain. A local physiotherapist can help patients develop a safe and effective fitness program, whether it’s shoulder exercises after surgery or isometric back exercises to reduce lower back pain. Some people need to work with a local physiotherapist and local urologist at some point in their life.
A local urologist is a physician who diagnoses and treats conditions that affect men’s, women’s and children’s urinary tract, which consists of the bladder, kidneys and ureters. They also treat patients who have issues affecting the male reproductive system, including infertility and erectile dysfunction. 1 in 6 Canadian men suffer from urinary incontinence. Unfortunately, only 1 in 5 will seek treatment. According to the Wall Street Journal 1 in 4 American men over 40 lives with distressing urinary symptoms. More than an inconvenience, UI is a chronic and complex medical condition that is usually the result of some other underlying medical condition, which should be identified and treated. Often seeing a local urologist in Toronto can help.
If you’re experiencing symptoms of male incontinence, a local urologist can help. A local urologist can ask about your symptoms and recommend further testing or male incontinence treatment. Male incontinence can be a result of an enlarged prostate, prostate surgery, Parkinson's disease and diabetes. There are a number of treatments for male incontinence, including medication, pelvic floor muscle exercises (your local physiotherapist can teach you how to do these), Contino® (a simple device that blocks the flow of urine) and electrical stimulation. Contino is a urethral catheter that a man inserts. It stops the flow of urine, and the man with male incontinence can release his urine when it's convenient for him. Men who use Contino also get a trainer and nurse to support them as they use this male incontinence product. There needs to be better tests out there and that’s for sure. We are looking at identifying better bio-markers, we are looking at genetic testing, but what is available now is expensive and only gives you a probability – they don’t say yes or no. And, there probably is a role for MRI we just don’t know what that is as of yet.
Sometimes, incontinence in men can be treated by avoiding caffeine, soda and alcohol, especially before bed. Doing Kegel exercises may also help prevent incontinence in men. Ask your local urologist for more information on male incontinence treatments including Contino®, an alternative to diapers or surgery.
You or someone you know may have recently been started on Androgen Deprivation Therapy, also known as ADT or Hormone Therapy, for prostate cancer treatment. ADT essentially lowers testosterone in your body to almost zero, so that your prostate cancer is essentially “put to sleep”. Most of the side effects of ADT are related to this low testosterone.
Your “Heart Health” is very important while on ADT, as this treatment may increase the risk of cardiovascular side effects, especially in patients with a previous history of cardiac disease or previous cardiac events, such as a previous heart attack. For this reason, it’s very important that lifestyle modifications are implemented, for example, smoking cessation, getting regular exercise and maintaining a healthy diet. If you need help trying to stop smoking, don’t hesitate to reach out to your family doctor for help.
Some patients benefit from seeing a local nutritionist in addition to a local urologist. A local nutritionist can give you advice on healthy food choices that are geared towards heart health and weight management. Enrolling in a local supervised exercise program can be beneficial, to formally ensure you are meeting exercise targets for optimal heart health. We recommend 150 minutes of moderate intensity aerobic exercise spread over 3-5 days. Weight gain while on ADT may heighten your cardiac risk, so diet and exercise are crucial!
Your blood pressure should be well controlled with a target of less than 130/80. Your weight should be optimized as much as possible. Controlling blood glucose and cholesterol levels are important for heart health, especially on ADT. You should engage your family doctor or cardiologist to ensure that your blood work for glucose and cholesterol are on target, and if not, the addition of dietary and/or medical therapy may be beneficial to achieve these targets. Patients with a cardiac history, who have been started on ADT, would benefit from being followed by a cardiologist in addition to their urologist/oncologist. By following these recommendations, including eating heart-healthy food, your cardiac health can be optimized, and you will be working towards making your heart as strong as it can be.
If you'd like more information on local urologists, start by talking to your family physician.