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What is a PSA Test and Should All Men Have One?

PSA stands for prostate specific antigen – a protein produced by the male prostate gland which plays a role in nourishing the sperm. A PSA test is a blood test to determine if PSA levels in the blood are elevated – which may indicate prostate cancer or alternately another problem with the prostate gland.

Prostate diseases

While prostate cancer may be the disease of the prostate that we tend to hear the most about, other non-cancerous prostate problems can also occur. These include:
•    Prostatitis – acute or chronic bacterial infection of the prostate.
•    Chronic non-bacterial prostatitis.
•    Sterile pyuria – elevated white cells in the urine.
•    Non-cancerous enlargement of the prostate.

So as you can see, prostate cancer is not the only concern. However, when having a PSA test done, the aim is usually to detect if cancer might be present.

How common is prostate cancer?

This cancer is rare in the under-50s, even though it is the commonest type of cancer in Australian men apart from certain skin cancers. According to the federal government, approximately 20,000 men are diagnosed with the disease each year in Australia, and this is expected to rise over time. The most common risk factors are advancing age and genetic predisposition. Around 60% of men with the disease are older than 65.

What can a PSA test show?

Normally, only small amounts of PSA enter the bloodstream. Where the PSA reading is higher than 4ng/ml, a follow-up might be recommended.

A PSA test is not enough on its own to determine if prostate cancer is present – often a digital rectal examination (DRE) is performed as well for confirmation. Other tests may include a biopsy, MRI, and / or a CT scan.

For older men – those over 70 – testing and treatment is not always recommended, especially if it is considered they are likely to die of other causes within a few years. Prostate cancer treatments can have a number of side effects – including damaged nerves and muscles, urinary incontinence, erectile dysfunction and reduced libido. For an older man who is asymptomatic, it may not be worth the risk involved.

What treatments are available?

The type of treatment recommended will depend on the age and health of the patient and how advanced the cancer is. Treatments include surveillance, radiotherapy, surgery, androgen-deprivation therapy, chemotherapy, brachytherapy, and high-intensity focused ultrasound. With some patients, surveillance or watchful waiting may well be the main course of action recommended – especially for older men or where the cancer is low-grade and do not appear to be advancing.

Should all men have a regular PSA test?

As indicated earlier, PSA levels can become elevated for any number of reasons. In addition, testing can sometimes result in false positives, which can lead to undue anxiety and even unnecessary treatments or procedures that do not necessarily improve the patient’s quality of life.

The current guidelines for men without symptoms recommend testing every two years for men aged 50-69, and only for those that genuinely want the test and who understand all the risks and benefits involved. PSA testing is not recommended for men who are likely to die from any cause within seven years.

So in a nutshell, broad-based PSA for men is not recommended. However men with symptoms such as an increased need to urinate especially during the night, difficulty urinating, or a feeling of the bladder not being completely emptied after going to the toilet, should speak to their medical practitioner about their symptoms and about the options that are available to them.

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Effective Non-Surgical Treatments for Erectile Dysfunction

The best and most effective long-term treatment for erectile dysfunction is to find the underlying cause of the problem, and treat that. This applies whether the cause is physical, psychological, emotional, or all of the above.

In the majority of cases, the cause is physical and frequently relates to conditions that affect the blood vessels and blood flow, such as diabetes or heart disease. Many sufferers of erectile dysfunction may benefit from lifestyle changes including weight loss, quitting smoking, reducing alcohol consumption, and improving overall health through diet, exercise and reduction of stress.

In some cases of erectile dysfunction, the condition is temporary and may resolve itself over time. For instance, temporary illness, anxiety or tiredness can cause short-term erectile dysfunction that goes away when the cause is treated through medication, therapy or rest.

Surgical or non-surgical treatments?

In more serious cases of erectile dysfunction, following prostate cancer treatments for example, surgery involving penile implants may provide an effective and successful long-term solution. Surgery is not for everyone however – some sufferers do not need surgery, and some prefer to choose non-surgical treatments.

Effective non-surgical treatments

Fortunately, there are some very effective non-surgical treatments available. These include:


Medications such as Viagra, Levitra or Cialis are known as PDE-5 inhibitors, and work by increasing blood flow to the penile tissue in order to create an erection. It’s important to note that these drugs are not a hormonal treatment, nor are they designed to increase libido.

Some drug treatments need to be taken just prior to intercourse, while others should be taken on a daily basis. They are generally safe, but should not be used without medical supervision, especially by men who are taking nitrate drug treatments for heart disease.

Injection therapy

Penile injections open the blood vessels and increase blood flow to the penis, creating an erection within minutes which lasts for up to 30 minutes. Side effects may include penile scarring, or prolonged erections – especially if the dose is too high. Injection therapy must be done under medical supervision, and when proper care is taken this treatment can be very effective.

Vacuum constriction device

This device – also sometimes called a vacuum pump – can be used to produce an erection within a few minutes. The erection can last for up to 30 minutes.

The device is made up of a cylinder and pump, either hand or battery-operated, with the vacuum effect being created through pumping air out of the cylinder.

As for the other treatments mentioned, vacuum pumps are designed to increase blood flow to the penis. It can be a very effective treatment for men who have a physical erectile dysfunction problem, and who do not wish to take the surgical option. It is also relatively inexpensive.

Some men report a cold feeling and a loss of sensation in the penis, or a loss of spontaneity. Some bruising may also occur, although it is usually not painful.

Linear shockwave therapy

This is a new treatment that uses low-intensity shockwaves to reverse vascular dysfunction in the penis. It involves having four or five treatments over several weeks in a day clinic. Treatment is usually pain-free.

This treatment may suit men who cannot take PDE-5 drugs or those who have undergone prostate cancer treatment.

Psychological treatments

Psychotherapy and counselling may be helpful on their own where the cause of erectile dysfunction is psychological. They may also be used in conjunction with physical treatments, particularly for men who are struggling with anxiety and loss of self-confidence as a result of erectile function problems.

Contact us if you would like information on erectile dysfunction treatment in Sydney.

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Erectile Dysfunction: The Causes and Solutions

Erectile dysfunction is defined as the inability to attain an erection or to sustain one long enough for sexual intercourse. As you might imagine, this can seriously affect a sufferer’s self-esteem and interfere with his intimate relationships.

Occasional erectile dysfunction is not something to worry about. If a man is tired from working long hours, has just had a bout of the flu, or been to hospital for surgery, for instance, he may experience some temporary dysfunction while his body recovers. It could also happen when he’s just had too much of a good time and a few too many beers!

Isn’t it really just psychological?

It’s often thought that erectile dysfunction is mostly a psychological condition, perhaps caused by factors such as anxiety, overwork, or emotional distress. While these can certainly be contributing factors in some cases, as a rule, the more serious cases of erectile dysfunction have a physical cause.

Causes include:   

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Rehabilitation After Prostate Cancer Treatment


Prostate cancer treatment may lead to urinary continence and / or erectile function problems in some patients. Good post-operative care and rehabilitation can help patients to manage these conditions, and greatly improve their quality of life.

Prostate cancer treatments

Prostate treatment is likely to differ from one patient to the next, depending on the severity of the cancer as well as symptoms and the age of the patient. Treatments include active surveillance and regular testing (for lower-grade cancers and possibly for men of more advanced age), brachytherapy (radioactive pellet implantation), radiotherapy, and surgery.

Prostate surgery

Prostate cancer surgery – known as radical prostatectomy – is performed to remove any cancer in the prostate and the surrounding tissues, and involves complete removal of the prostate, the seminal vesicles, and the associated lymph nodes.

Fortunately, modern surgical techniques involve what is known as nerve sparing – which basically refers to preserving the nerves involved in erectile function. Nerve sparing helps to reduce the risk of erectile problems after surgery, and may also help to make erectile dysfunction treatments more effective.

Post-operative rehabilitation options

For men who undergo surgery and who do experience urinary incontinence and / or erectile function problems there are various treatment options available.

Urinary incontinence post prostatectomy

This may occur as a result of a weakness in the urinary sphincter valve which forms part of the pelvic floor group of muscles. It can be treated by:

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Lab-Grown Penis Transplants May Only Be A Few Years Away!


Believe it or not, scientists in North Carolina have managed to grow human penises in the lab, and may only be a few years away from testing them by transplanting them onto men.

This could prove to be a very positive breakthrough for men suffering from penile congenital abnormalities, injury from trauma, damage from disease, or for those who have undergone penile surgery or removal.

While it might sound like the stuff of science fiction, transplants of lab-grown rabbit penises have already proved a success, with all of the male rabbits involved in the experiment attempting to mate and with some even successfully reproducing.

There have also been successful transplants of other bio-engineered human organs in recent years, which was no doubt very encouraging for the scientists involved in this research and development.

Why the delay?

Because they are a very complex organ in terms of structure, cell density and the uniqueness of the erectile tissue, growing penises in the lab has been a rather slow process. The scientists involved also need to be sure of safety and effectiveness before performing the first transplant. They are presently putting the lab-grown penises through their paces – so to speak! – to test for the ability to withstand wear and tear and to work as anticipated.

Also, while there has been success with the rabbit experiments, human penises are much larger, and growing them successfully has been a much more involved process.

Why not just transplant from donors?

At the present time, donor penises can be transplanted onto patients but the risk of rejection warrants drug treatment – complete with the potential for unpleasant side effects. Direct penile transplants like this can also have a psychological effect on patients, because of the rather intimate nature of the organ itself.

Other current treatments for men with penile damage include penis reconstruction using tissue taken from the forearm or thigh, along with prosthetic implants for producing erections.

How does this differ from donor transplants?

Growing penises in a laboratory is done using cells from the intended recipient. It involves taking a donor penis and washing it in a detergent of enzymes to remove donor cells, leaving the collagen ‘scaffolding’ or basic structure remaining. Cells from the live patient which have been grown in cultures are then seeded onto the penile structure to rebuild the organ. It is hoped that this method will overcome the problem of donor organ rejection.

What is the next step?

Approval from the US FDA will need to be sought before any transplants can commence. The lead scientist involved in this work, Professor Anthony Atala, expects this to occur within five years, but anticipates that the initial stages will likely involve growing smaller lengths for treating damaged penises and performing only the partial replacement of organs.

Either way, the future for urology procedures for men suffering from severe penile injury, disease or erectile dysfunction may just be very positive indeed as a result of all the work done by Dr Atala and his team.

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Get Your Sex Life Back with a Penile Prosthesis


When erectile dysfunction is a problem the good news is that there are a number of treatment options that may help a man reclaim his sex life. In this post, we discuss penile prosthetic surgery and how it compares to other treatments for erectile dysfunction.

What is erectile dysfunction?

Erectile dysfunction is the inability to attain and / or sustain an erection long enough to engage in sexual intercourse. Causes include conditions that affect the blood vessels such as cardiovascular disease, diabetes, and high blood pressure, as well as prostate surgery, trauma, injury, kidney or liver failure. Sometimes the cause may be psychological but it is more likely to be physical or have a physical component.

If the condition is temporary or mild non-surgical treatments may be the best option. However, if it is ongoing, an implant could be an option for getting back into action!

How prosthetic implants work

Prosthetic implants are made from biocompatible silica and they have an antibiotic coating to reduce the risk of infection. There are a few different  types of implant:

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A Guide to Peyronie’s Disease


Peyronie’s disease is a condition in which plaques form in the erectile tissue of the penis. Over time this causes penile curvature, indentation, inflammation and shortening, and / or narrowing.

The plaques usually form on the top or upper side of the penis causing it to curve upwards. The condition occurs in approximately 3% of adult men, mostly in older men aged 50-plus.

Peyronie’s disease (PD) can cause sufferers some pretty unpleasant symptoms – from pain, discomfort and erectile problems to psychological symptoms such as anxiety.

Causes, symptoms and diagnosis

The causes are not always known or understood, but the following may have an impact in the development of the disease:

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What is Stress Incontinence?


Urinary incontinence is an issue that some sufferers may feel embarrassed about, but might be relieved to hear is more common than they realise. It is also usually very treatable – with treatments ranging from exercises, to various surgery options or medication, depending on the nature of the condition and its cause.

Urinary incontinence refers to involuntary leakage of urine, and is a condition that may affect around 15% of men and 37% of women at some stage of their lives. In a healthy bladder, urine passes from the kidneys to the bladder via the two ureters, and then is passed out of the body through the urethra. In a normal situation, the person is able to tighten the urinary sphincter muscle that surrounds the urethra – therefore having some control over the flow of urine out of the body. When this muscle is weakened, incontinence may happen. In some cases, incontinence can occur when the pelvic floor muscles have become weakened.

There are a number of different types of urinary incontinence, including what is known as stress incontinence.

Stress incontinence

Contrary to what you might think, the term stress incontinence does not refer to emotional stress (although it may well cause emotional stress for some people!). It is a condition where urine leaks out when the sufferer sneezes, coughs, laughs, lifts something, plays sport or does exercise. These activities create an increase in pressure in the abdomen, which then pushes down on the bladder causing the leakage.

It is more common in women and is often caused by pregnancy and childbirth, due to the weakening of the pelvic floor muscles that support the urethra. The condition can also occur in menopausal women due to a drop in the hormone oestrogen (which helps to maintain the thickness of the lining in the urethra), and in men after prostate surgery.

Treating stress incontinence

Treatment of stress incontinence may not necessarily involve surgery. Post-childbirth women may benefit greatly from pelvic floor strengthening exercises, enabling them to manage the condition. If the condition occurs due to a urinary tract infection, it can often be successfully treated with antibiotics.

For weakness in the sphincter muscle, there are a number of surgical treatment options:

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