Archive for May, 2011

Outlawing the Prime Cut-California Tries to Ban Baby Circumcisions

May 28, 2011

It’s a question parents of baby boys have to decide but now there’s a discussion on Beacon Hill in San Francisco that would take that choice away from parents in California.

State lawmakers in California will debate a bill that would make it illegal for parents to circumcise boys, unless there’s a medical reason.  The bill, if passed, would ban the procedure on any male under the age of 18 even for religious reasons.  Under the legislation, people who disregard the ban would face a $1000 fine and possible 14-year prison sentence.  The proposal classifies male circumcision as genital mutilation and supporters of the bill say baby male infants can’t possible consent to the procedure.

Many Jewish groups are objecting to the fact that ritual circumcision of men under the age of 18 would be made illegal, despite the fact that it is, in the words of these San Francisco-area Jewish organizations, “of fundamental importance in the Jewish tradition.” Male circumcision is also an important practice in Islam, although it is not compulsory.

My opinion:  Male circumcision has actually been associated with some health benefits which includes reducing the risk of HIV acquisition by men during vaginal intercourse.  Secondly, there is a decrease in urinary tract infections in baby boys who are circumcised compared to baby boys who are not circumcised.  Also, the risk of penile cancer is less in circumcised boys compared to those who have retained their foreskins.  And finally, an ancient religious ritual for both Jewish and Muslim boys should not be criminalized by the government.  Don’t we have bigger problems in America than trying to police doctors and mohels (Jewish ritual circumcisers) who perform circumcisions?  I truly believe that after we balance the budget we might discuss the decision of parents to allow their baby boys to be circumcised!

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The Contraception Conundrum-Vasectomy vs. Tubal Ligation

May 28, 2011

Every couple whose family is complete comes to a fork in the road and asks which partner is going to get either a vasectomy or a tubal ligation.  This blog will answer a few questions that may help you make a more informed decision.

First of all both procedures should be considered a permanent form of contraception or sterilization.  A vasectomy isn’t nearly as costly and invasive as the surgery to reverse it. And the odds that you’d be able to father a child again aren’t good enough to count it as a fall-back option down the road, Shih says.

What Could Go Wrong?

A report in a medical journal pointed out that women were 20 times more likely to have a serious problem related to a tubal ligation than men who select to have a vasectomy. In addition, men tend to recover more quickly from a vasectomy.  Most men can return to all activities, including sexual intimacy, 3-4 days after the procedure.   A tubal ligation requires a general anesthesia and incisions into her abdomen.  Both of these can result in significant complications.  However, if a woman is going to have her tubes tied during a planned C-section delivery, the added risk of the tubal is less of a concern.

A vasectomy can be done in the doctor’s office using a local anesthetic and usually takes less than 15 minutes.  The most common problems related to vasectomy include bruising, infection, and inflammation in the epididymis, a sperm-holding structure near the testicle. But each of these seems to occur in less than 5% of cases.  Now that the procedure is performed without an incision but through a tiny puncture wound and does not even require a needle to provide the local anesthesia,

If you’re looking for instant results, a tubal holds the edge: It works immediately. After a vasectomy, a man can still get a woman pregnant until lingering sperm are flushed from his plumbing which usually requires 15 ejaculations.  So it’s crucial for couples to use a backup method of contraception until your doctor says you’re in the clear. And men need to provide a semen sample after a vasectomy that is examined under a microscope to be absolutely certain that no sperm are present.

The Essure and Adiana devices, which are inserted into the Fallopian tubes, also require a checkup to ensure that they’re installed properly and the woman can’t get pregnant.  If you choose these options, be sure you’re going to do the follow-up work. During the first three months after insertion of the device, another form of birth control must be used.

If you’re thinking about your bank account, In terms of cost, a vasectomy is definitely more cost-effective. In general, a tubal costs about three times as much as vasectomy.

Bottom Line:  Most couples are happy when children are planned.  When the time comes to cut off  “reproduction production”, consider either a vasectomy or a tubal ligation.

The Prime Cut-A Vasectomy For When You Are Done Having Kids

May 28, 2011

Though their circumstances vary widely, millions of men have asked themselves two questions: Do I have all the kids I want and can afford? If so, should I get a vasectomy?

Men have one successful option when they want to permanently turn off their baby-creating machine – a vasectomy. A doctor, usually a urologist, cuts and seals off the two tubes that allow sperm to travel from the testicles to vagina and ultimately to combine with an egg and produce a baby.

At the present time only 6% of couples wishing to have a sterilization procedure select a vasectomy.

Reasons that men choose to have the procedure include wanting to avoid difficult pregnancies if their partner has had previous problems during pregnancy, or if the partner had problems using hormonal contraception. Many men are now feeling that a vasectomy is their chance to contribute. 

There are nearly 400,000 vasectomies performed each year in the United States.  The procedure can now be accomplished without an incision and even without a needle to inject the local anesthetic.  The procedure takes 15 minutes and most men can resume all activities, including sexual intimacy, in 2-3 days after the procedure.

For more information, please go to my webiste, www.neilbaum.com or http://www.neilbaum.com/the-vasectomy-procedure.html for an article and a video on the subject.  

When Viagra, Levitra and Cialis Do Not Work In Diabetic Men-Other Treatment Options For Erectile Dysfunction

May 27, 2011

Diabetes is a risk factor for developing erectile dysfunction (ED).  However, the drugs that are commonly used to treat ED, Viagra, Levitra, and Cialis, are less likely to be effective in men with diabetes.  That doesn’t mean that your sex life is over.  Many of these men will find improvement in second line treatments such as injection therapy, where a drug, prostaglandin, is injected directly into the penis to increase the blood supply to the tissues that are responsible for an erection.  Also, there are vacuum devices that create a negative pressure around the penis and allows more blood to enter the penis which is then trapped with a special rubber band placed at the base of the penis.  Finally, if second line treatments do not work, there are surgical procedures where a prosthesis is placed in the penis.  This consists of two cylinders that are filled with a salt solution, a reservoir to hold the solution that is inserted behind the muscles of the lower abdomen and a pump that is placed beside the testicle in the scrotum.  By squeezing the pump in the scrotum, fluid transferred from the reservoir to the cylinders in the penis creating a natural erection.  When the man wishes the erection to subside, the pump is squeezed and the fluid returns from the cylinders back to the reservoir and the penis becomes naturally soft.  The procedure for the insertion of the prosthesis takes about 20 minutes and is done on a one-day stay basis not requiring hospitalization.  Most men can begin having intercourse 4 weeks after the insertion of the prosthesis. 

For more information please go to my website, www.neilbaum.com, or refer to the article on the “Dangling Stress Test” at http://www.neilbaum.com/erectile-dysfunction—the-dangling-stress-test.html

 

Pay attention to the color and smell of your urine

May 26, 2011
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by Neil Baum, MD

Most of us are uncomfortable talking about our waste products, urine and feces. However, changes in the color and odor may signify disease that can be treated or prevented. This article will review causes of discoloration of urine and when there is a change in the odor of urine.

For hundreds of years doctors have looked at urine as a barometer of what is happening in the body. The urine can tell what you have been eating, how much fluid you are consuming, and what diseases you may have. Early doctors even tasted the urine of their patients in order to diagnose their medical conditions. Fortunately, we have made progress and a simple urinalysis can make this determination in seconds.

Urine is an important part of the body’s regulation process. Its job is to remove the extra water and wastes that the kidneys filter out of the blood. The urine is there primarily to get rid of toxins or things that would otherwise build up in the body that would be bad for the body.

When you notice that your urine has changed color, or there’s a strange odor emanating from the toilet, the cause might be something as harmless as what you had for dinner such as asparagus. It also might be a sign of a more serious condition, such as an infection or cancer.

Color changes

Urine normally varies from pale yellow to deep amber, depending on the concentration of the urine, which is determined by the amount of fluid you consume. Darker urine is usually a sign that you’re not drinking enough water. Correction is as simple as consuming more liquids, especially water.

The opposite is also true. If your urine is very pale, it means that you’re either drinking a lot of fluid, or you’re taking a diuretic or water pill which is a drug that forces the body to eliminate excess water.

Urine can turn a rainbow of colors, and an unusual hue isn’t necessarily cause for alarm. Certain medications can turn the urine fluorescent green or blue, the carotene in carrots can tint it orange, and vitamins can give it a yellow hue. Pyridium, a medication, which is used to treat burning on urination, will turn the urine orange-red.

Seeing red is typically a sign that there is blood in the urine, but before you panic, know that a little blood can produce a dramatic color change. Just like a drop of food coloring will add color to a large volume of food or fluids, it only takes one drop of blood to turn an entire toilet bowl red.

Red urine is usually an ominous sign and can indicate an infection or maybe even cancer. Red blood is a real warning sign and should prompt you to see your doctor or urologist, a doctor who specializes in disease of the kidneys and bladder.

Odor changes

Urine normally doesn’t have a very strong smell. If your urine has a foul odor, you could have an infection or urinary stones, which can create an ammonia-like odor. Diabetics might notice that their urine smells sweet, because of excess sugar.

Some foods can also change urine odor. Asparagus is among the most notorious. What people are smelling when they eat asparagus is the breakdown of a sulfur compound called methyl mercaptan (the same compound found in garlic).

How often do you need to go?

How often you need to go can be as important an indicator of your health as the color or smell of your urine. Most people take bathroom breaks about six to eight times a day, but you might go more or less depending on how much fluid you drink. If you’re constantly feeling the urge to go and it’s not because you’re not drinking extra fluid, causes can include:

  • overactive bladder (when you gotta go, you gotta go!)
  • urinary tract infection
  • interstitial cystitis (painful urination without an infection)
  • prostate gland enlargement
  • diabetes

The opposite problem, not going to the bathroom enough, can occur when there is a blockage or infection. Or, it can be the result of bad bathroom habits. Some people — especially teachers, surgeons, and anyone else who doesn’t have time for regular bathroom breaks throughout the day — tend to hold it in.

Delaying urination can also cause problems. The bladder can develop a chronic over-distension and will not empty completely. As a result urine is left in the bladder and can be a source for developing a urinary tract infection.

Develop good bathroom habits. Drink whenever you’re thirsty, but certainly increase your fluids before going outside in the hot summer sun or before exercising.

If you’re getting up during the night to use the bathroom, stop drinking three to four hours before bedtime. Limit caffeine, which can irritate the lining of the bladder. Also watch your intake of alcohol, which can have an effect similar to a diuretic.

Finally, don’t hold it in. Don’t delay answering the call of the rest room. Your bladder will thank you.

Bottom Line: Pay attention to the color and odor of your urine. If there is a change, contact your physician.

Neil Baum is a urologist at Touro Infirmary and can be reached at his self-titled site, Neil Baum, MD, or on Facebook and Twitter.

A Walk In The Park May Keep Your Prostate Cancer In the Dark

May 25, 2011


Brisk walking may help men diagnosed with early-stage prostate cancer reduce their risk of progression of the disease, according to Harvard School of Public Health.  The study shows that survivors who walk at a pace of at least 3 miles per hour for three hours or more per week were 57% less likely to develop the biochemical markers of cancer recurrence, which is the PSA test, or to need a second round of treatment for their disease.

The walking had to be brisk for men to experience a benefit.  The study suggests a way for men who have prostate cancer to do something to improve their prognosis and stay well.

Bottom Line:  If you have prostate cancer and want to reduce your risk of recurrence, then get off of the couch and get on to the walking path and start walking briskly

Can’t Pee? It May Be Your Medications

May 25, 2011

Having the urge to urinate — and not being able to do so — is painful, as many men know.  Certain medications may make the emergency form of this condition, known as acute urinary retention, more likely.

Painful urination or difficulty urinating are listed as possible side effects of the drugs studied – sold under the names Atrovent, Combivent and Spiriva.

An article published in the prestigious Archives of Internal Medicine reported that men with chronic pulmonary or lung diseases who had just started taking inhaled anticholinergic medications, a common treatment for the breathing diseases, had 42% greater odds of developing the urinary problem than men who were not on anticholinergics.

Bottom Line: There is an association between respiratory inhaler use and urinary symptoms especially urinary retention.  This is particularly important issue in men who have enlarged prostate glands as they are at an increased risk of having the complication of urinary retention.

A Jolt of Java May Be Just What the Doctor Ordered-Coffee May Reduce The Risk of Prostate Cancer

May 22, 2011

In cases you needed one more excuse to have a cup of coffee in the morning, a study conducted at the Harvard School of Public Health demonstrated that men in a study of nearly 50,000 men who consumed the most coffee, i.e., six or more cups\day, were nearly 20% less likely to develop any form of prostate cancer.  Even more interesting, the heavy coffee drinkers were also 60% less likely to be diagnosed with a lethal prostate tumor.  Those who drank between 1-3 cups\day were 30% less likely to develop a lethal case of prostate cancer.  The risk of prostate cancer was decreased regardless of whether the men drank decaffeinated or regular coffee.

Bottom Line: Coffee may give you a boost of energy and concentration but it also can boost the health of your prostate gland and reduce your risk of prostate cancer.

Meet Doctor Fido-Dogs That Can Sniff Colon Cancer

May 1, 2011

The notion that dogs can sniff danger is not a new one, but researchers in Japan say that this ability includes the ability to detect colon cancer by sniffing it.  A Labrador retriever sniffed out the disease in stool so accurately that the dog’s diagnosis almost always matched that of a the more invasive colonoscopy.  The results are a first step toward a means of developing an early detection system for colon cancer

Dogs have been helping owners with diabetes to sense through smelling breath times when blood sugar levels are low, and encouraging owners to check their blood sugar and treat themselves.

They’ve also been used as service dogs for seizure patients, with the ability to detect subtle behavioral changes and special odors that emitted before patients have a seizure.

Dogs have so many million more sensor cells than humans in their noses that send messages to their brain.  With regard to cancer, researchers have started looking at canine sniff tests for melanoma, as well as prostate, bladder, lung, breast, and ovarian cancer.

So the researchers decided to look at dogs’ detection power in colon and rectal cancer  as well. They took breath and stool samples from colorectal cancer patients at a hospital in Japan and compared them with those of healthy controls.

The Labrador retriever, trained in scent detection of cancer, smelled each sample group and sat down in front of the sample in which it detected the scent of cancer.

Bottom Line: Dogs keen sense of smell can be huge assistance in the future for diagnosing various disease states such as colon cancer.  This gives new meaning to the word “sit”