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About Stephen W. Leslie, MD
Expertise
Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.
Experience
Full time practicing urologist with 20 years experience. Assistant Clinical Professor of Urology at the Medical College of Ohio. Editor in Chief of eMedicine Urology internet textbook. Author of only book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.
Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society
Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.
Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison
Awards and Honors
Thirlby Award of the American Urological Association.
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You are here: Experts > Health/Fitness > Urology > Urology > Prostate gland
Expert: Stephen W. Leslie, MD
Date: 10/4/2008
Subject: Prostate gland
Question
My partner who is 49 has had problems with a weak urine stream, lower back pain occasionally, he gets up for the toilet on average 4 times a night and frequently goes during the day. He also gets a throbbing pain in the anus area about every 4 weeks. He also has quite alot of normal bowel movements through the day. He gets very tired through his sleepless nights, he has no problems with his sexual functions. He has been to see a consultant about this problem and they seem to think it is not his prostate that is the problem, they think he needs the neck of the bladder stretching and has a slightly small bladder. They have done all the tests on him, like PSA levels, scan, CT bladder flow tests. I am not totally sure they are right in their diagnosis...can you give me some advice, my partner just wants to get some relief from urinating all the time and accept the surgery the have offered him, is this the right thing to do. Do you think it could be something like prostatitis? I am worried because the surgery could be unnecessary and their is a risk the surgery could leave him with an erectile dysfunction. Please help!
Answer
Lynn:
With an incomplete or unreliable diagnosis, it's not possible to make much of a recommendation. Stretching the bladder neck is not likely to solve anything permanently and surgery on it could have long-lasting complications. One example would be using alpha blocker meds to see if they help his flow or a trial of antibiotics, no caffeine and hot sitz baths to see if this might help (it's a standard treatment for prostatitis). My best advice is to get a second urology opinion before getting any kind of surgery like this.
Erectile dysfunction is a very unlikely complication of this surgery, but ejaculatory problems or lack of semen due to retrograde ejaculation is likely.
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