Selected Podcast
Urology and Men's Health
Dr. Jeffrey Loh-Doyle discusses the importance of Urology within men's health.
Featuring:
Born and raised in Los Angeles, Dr. Loh-Doyle completed his undergraduate and medical school education in the prestigious Baccalaureate/MD program at the Keck School of Medicine of USC, where he achieved degrees in biological sciences, international relations and doctor of medicine.
Dr. Loh-Doyle’s areas of clinical and research interest include erectile dysfunction, male urinary incontinence, Peyronie’s disease, reconstruction of the urinary tract and urologic oncology. In addition to urology, he also has a keen interest in health policy and quality improvement and participated in a two-year health care administration scholars program run by the Los Angeles County Department of Health. He was awarded a grant to improve the peri-operative patient experience at Los Angeles County+USC, and he is an active participant in several committees aimed at improving the delivery of sophisticated healthcare to the underserved.
Dr. Loh-Doyle’s other interests include entrepreneurship, cooking, traveling, music and skiing.
Jeffrey Loh-Doyle, MD
Jeffrey Loh-Doyle, MD, is a specialist in complex surgical reconstruction of the male urinary tract, male urinary incontinence, erectile dysfunction, sexual health, urethral stricture disease and Peyronie’s Disease. He joins the USC Institute of Urology after completing his urology residency at USC and further fellowship training in male genitourinary reconstructive and prosthetic surgery under Dr. Stuart Boyd, a worldrenown reconstructive cancer surgeon and authority on reconstruction of the lower urinary tract and urologic prosthetics.Born and raised in Los Angeles, Dr. Loh-Doyle completed his undergraduate and medical school education in the prestigious Baccalaureate/MD program at the Keck School of Medicine of USC, where he achieved degrees in biological sciences, international relations and doctor of medicine.
Dr. Loh-Doyle’s areas of clinical and research interest include erectile dysfunction, male urinary incontinence, Peyronie’s disease, reconstruction of the urinary tract and urologic oncology. In addition to urology, he also has a keen interest in health policy and quality improvement and participated in a two-year health care administration scholars program run by the Los Angeles County Department of Health. He was awarded a grant to improve the peri-operative patient experience at Los Angeles County+USC, and he is an active participant in several committees aimed at improving the delivery of sophisticated healthcare to the underserved.
Dr. Loh-Doyle’s other interests include entrepreneurship, cooking, traveling, music and skiing.
Transcription:
Prakash Chandran (Host): Men, urologic health may not be top of mind, but it might be time to start thinking about how to prevent diseases in your kidneys, bladder or male organs. We’re going to talk about it today, with Dr. Jeffrey Loh-Doyle, a Urology Specialist at the Ridgecrest Regional Hospital Urology Clinic and alliance with USC Urology, a part of Keck Medicine of USC.
This is a podcast from Ridgecrest Regional Hospital. I’m Prakash Chandran. So, first of all Dr. Loh-Doyle, can you tell us about urology and what kinds of conditions you treat as a urologist?
Jeffrey Loh-Doyle, MD (Guest): Yeah absolutely. So, urology it’s really an all encompassing term for a specialty that takes care of basically all issues related to the urinary tract in both men and women. So, for men specifically, we deal with issues related to the prostate, kidney, bladder, erections, and all forms of testicular and sexual health and for women, we also deal with again kidneys, bladder issues, incontinence issues as well as recurrent urinary tract infections. So, urology itself is a very broad field that has very many subspecialties but in essence, we are the masters and the plumbers of the urinary system.
Host: Got it. So, because today we’re talking about men’s health and urology; can you talk about some of the most common things that you see with your male patients?
Dr. Loh-Doyle: The male urology patients obviously the first priority is to diagnose and treat cancers. So, prostate cancer itself is the most common malignancy in men above the age of 40. And under the age of 40, testicular cancer is the most common cancer. So, as urologists, we are really at the front line of diagnosing and taking care of cancers in men but also, we take care of men starting from a young age all the way up till unfortunately they pass so well into their 80s and 90s. And we treat the gamut of issues. In men we see beside cancer, issues related to an enlarged prostate, kidney stones, erectile issues, sexual health issues as well as just other maladies that affect the urinary system such as recurrent infections.
Host: Okay so you mentioned the primary priority was to treat and diagnose cancers. So, can you talk to us a little bit about why this happens? Are there any leading causes that might attribute to prostate cancer or testicular cancer?
Dr. Loh-Doyle: So, I mean the biggest risk factors for testicular cancer and prostate cancer is being male because women obviously don’t have these parts. But there are also now we are beginning to understand that there are environmental exposures as well as genetic predispositions that make patients more susceptible to these conditions. So, really, it’s our job to number one, prevent disease but also to diagnose and treat these conditions as they arise early and fast.
Host: And for things like kidney stones, what are some of the leading contributors that causes them to occur?
Dr. Loh-Doyle: Kidney stones in general, are most commonly caused by a combination of bad luck, dehydration, poor nutrition as well as genetic predisposition. Now what we’re beginning to see now more and more are that previously women were very immune to kidney stones but now, as their rates of obesity as well as diabetes have risen, their [00:03:17] are becoming in line with men which does make us think that kidney stones are definitely related to more diet and lifestyle rather than more innate things such as genetics.
Host: Yeah, I was just going to ask you for your best advice on how men can prevent some of these urologic issues that we’re talking about here. I mean is diet and exercise enough? Is there anything else that we should be doing?
Dr. Loh-Doyle: Diet and exercise is certainly very helpful and very, very important. So, my specialty in particular is treating erectile dysfunction, but I also treat a fair amount of patients with the kidney stones. So, if you’re a male or even a female, I do recommend that you drink at least two to three liters of fluid, ideally water or non-sugary drinks per day, just to flush out the system. I also recommend just eating a heart healthy diet and making sure not to hold your urine for long periods of time. Now, as it relates to erectile dysfunction, they say that erectile dysfunction is typically the earliest indicator of cardiovascular disease. So, here’s a patient in their 40s who starts to developing erectile dysfunction that seems to come out of nowhere that’s progressive, then our national guidelines do recommend that we also refer them to a primary care physician or even a cardiologist to make sure that cardiovascular wise they are doing okay.
Host: Okay, that’s really good to know. I’m 38 years old and I get my annual physical and bloodwork done and I’m wondering if that’s enough. I guess the real question is around when should men start regularly being proactive about their urologic health?
Dr. Loh-Doyle: For a patient that has no family history of urologic issues and is otherwise healthy, I do recommend about the age of 50 where we start checking your prostate, checking some lab values but it’s never too harmful to start earlier. If you feel like you’re having any issues with your urination, or if you have concerns that you may have a kidney stone. But 50 really is my cut off for really starting to see patients on an annual basis.
Host: Okay so let’s talk a little bit about an older demographic. My dad for example, he has that enlarged prostate that really makes it difficult for him to go to the bathroom and I see this as something that’s potentially pretty common. Why do you think this is and what are some things that we can do as a younger demographic to prevent it from happening?
Dr. Loh-Doyle: I tell patients that as you get older, everything gets smaller except your prostate. So, as you get older, your prostate enlarges and as the prostate enlarges, basically what happens is that the junction between your bladder and your urethra, so it just adds resistance to the actual urine flow. Unfortunately with time, that also can cause your bladder to become overworked and for the muscle to become thicker. So, this can lead to a bunch of symptoms such as having to strain to pee, poor urine stream, frequency, urgency. So, the best way to prevent that from happening is to maintain a good diet. Now there’s a lot of luck involved in this and you can have a patient who is the healthiest guy in the world but has an enlarged prostate and isn’t very bothered by it. You can also have a patient that’s in terrible health that has no urinary symptoms and a small prostate. So, it’s hit and miss. But I do recommend that diet can definitely affect the ability to empty your bladder and diabetes in particular can definitely harm your bladder’s performance. So, avoid those issues.
Host: You mentioned diet a couple of times and having a heat healthy diet. Is that just kind of avoiding things like sugars, and carbohydrates and eating more plants?
Dr. Loh-Doyle: I’d say that everything in moderation. I’m not advocating any – eliminating meats or what you like out of your diet. But you especially should not be taking in what you really enjoy on a daily basis. You should stress eating more fruits and vegetables, healthy types of proteins as well as minimizing the fats and processed carbohydrates in your diet.
Host: that makes sense. And before we move on from the prostate, you mentioned the prostate enlarges. Is there anything or any medicine that one can take to make it smaller?
Dr. Loh-Doyle: Absolutely. So, there’s different classes of medications and there’s different treatments available. So, there are medications that are designed to both shrink the prostate as well as to relax the prostate. And those can be used in combination and that’s something that even primary care physicians can comfortably start patients on. We typically see patients after they had been started on medications if patients seemed to have plateaued and not really seeing any improvement. There’s a whole class of medications and a whole field of business that aims at treating enlarged prostate.
Host: Okay that’s definitely good to hear. What about treatment for erectile dysfunction? I imagine this is something that a lot of men have and they kind of suffer in silence. So, I don’t know if there’s a cure but maybe speak to a little bit about what’s out there for them.
Dr. Loh-Doyle: ED is definitely underdiagnosed, under acknowledged. Patients are historically reluctant to admit they have this to their primary care physician. And I mentioned it before, you know erectile dysfunction can certainly be an indicator that you have some underlying cardiovascular issues. So, you definitely want to make sure that you see your regular doctor who checks your blood pressure, and also checks your cholesterol. So, once they have eliminated bad causes of erectile dysfunction or they actively managing those issues, well how do we treat erectile dysfunction? Typically, I do recommend lifestyle modifications including improving one’s diet, increasing cardiovascular exercise as well as weightloss. All those previous strategies can all independently improve erectile function over a six month period.
I also recommend oral medications. So you’ve heard all of them before, they are heavily advertised on TV and they all definitely do work. They are all meant to improve blood flow to the area and in general, they have very minimal side effects. So, they are very good first line therapy beside lifestyle modifications. Let’s say someone is refractory, oral medications don’t necessarily work or they just feel like they are just not really achieving what they want to; there’s a whole list of other tools that we have at our disposal to make erections happen. But it really just depends on how motivated a patient is and where they are in terms of their health.
Host: Just as we close here, one thing I always like to ask is I’m sure you’ve seen a lot of patients with urologic issues over time. And for men listening to this, what’s the one piece of advice that you wish more male patients knew before they came to see you?
Dr. Loh-Doyle: Male patients in general have been very, very bad about neglecting their healthcare and in general, they will wait well beyond what is reasonable. So, the one thing that I want to stress to help those male patients out there including even myself, is that seek care when you feel like something isn’t right. Don’t wait for it to really linger and fester when it’s too late. This can relate to kidney stones, cancers, even benign issues like having an enlarged prostate. Because I’ve actually seen a fair amount of patients in Ridgecrest myself that are having significant and end-stage bladder dysfunction and end organ failure because they’ve neglected their just seemingly bothersome urinary symptoms. So, don’t wait. See your urologist. See your regular doctor to get plugged in. That way we can treat you with things that can be very easily managed.
Host: Well that’s really great advice Dr. Loh-Doyle. I really appreciate your time today. That’s Dr. Jeffrey Loh-Doyle, a Urology Specialist at the Ridgecrest Regional Hospital Urology Clinic in alliance with USC Urology, a part of Keck Medicine of USC. Thanks for checking out this episode of Ridgecrest Regional Hospital Podcast. Head to www.rrh.org for more information. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.
Prakash Chandran (Host): Men, urologic health may not be top of mind, but it might be time to start thinking about how to prevent diseases in your kidneys, bladder or male organs. We’re going to talk about it today, with Dr. Jeffrey Loh-Doyle, a Urology Specialist at the Ridgecrest Regional Hospital Urology Clinic and alliance with USC Urology, a part of Keck Medicine of USC.
This is a podcast from Ridgecrest Regional Hospital. I’m Prakash Chandran. So, first of all Dr. Loh-Doyle, can you tell us about urology and what kinds of conditions you treat as a urologist?
Jeffrey Loh-Doyle, MD (Guest): Yeah absolutely. So, urology it’s really an all encompassing term for a specialty that takes care of basically all issues related to the urinary tract in both men and women. So, for men specifically, we deal with issues related to the prostate, kidney, bladder, erections, and all forms of testicular and sexual health and for women, we also deal with again kidneys, bladder issues, incontinence issues as well as recurrent urinary tract infections. So, urology itself is a very broad field that has very many subspecialties but in essence, we are the masters and the plumbers of the urinary system.
Host: Got it. So, because today we’re talking about men’s health and urology; can you talk about some of the most common things that you see with your male patients?
Dr. Loh-Doyle: The male urology patients obviously the first priority is to diagnose and treat cancers. So, prostate cancer itself is the most common malignancy in men above the age of 40. And under the age of 40, testicular cancer is the most common cancer. So, as urologists, we are really at the front line of diagnosing and taking care of cancers in men but also, we take care of men starting from a young age all the way up till unfortunately they pass so well into their 80s and 90s. And we treat the gamut of issues. In men we see beside cancer, issues related to an enlarged prostate, kidney stones, erectile issues, sexual health issues as well as just other maladies that affect the urinary system such as recurrent infections.
Host: Okay so you mentioned the primary priority was to treat and diagnose cancers. So, can you talk to us a little bit about why this happens? Are there any leading causes that might attribute to prostate cancer or testicular cancer?
Dr. Loh-Doyle: So, I mean the biggest risk factors for testicular cancer and prostate cancer is being male because women obviously don’t have these parts. But there are also now we are beginning to understand that there are environmental exposures as well as genetic predispositions that make patients more susceptible to these conditions. So, really, it’s our job to number one, prevent disease but also to diagnose and treat these conditions as they arise early and fast.
Host: And for things like kidney stones, what are some of the leading contributors that causes them to occur?
Dr. Loh-Doyle: Kidney stones in general, are most commonly caused by a combination of bad luck, dehydration, poor nutrition as well as genetic predisposition. Now what we’re beginning to see now more and more are that previously women were very immune to kidney stones but now, as their rates of obesity as well as diabetes have risen, their [00:03:17] are becoming in line with men which does make us think that kidney stones are definitely related to more diet and lifestyle rather than more innate things such as genetics.
Host: Yeah, I was just going to ask you for your best advice on how men can prevent some of these urologic issues that we’re talking about here. I mean is diet and exercise enough? Is there anything else that we should be doing?
Dr. Loh-Doyle: Diet and exercise is certainly very helpful and very, very important. So, my specialty in particular is treating erectile dysfunction, but I also treat a fair amount of patients with the kidney stones. So, if you’re a male or even a female, I do recommend that you drink at least two to three liters of fluid, ideally water or non-sugary drinks per day, just to flush out the system. I also recommend just eating a heart healthy diet and making sure not to hold your urine for long periods of time. Now, as it relates to erectile dysfunction, they say that erectile dysfunction is typically the earliest indicator of cardiovascular disease. So, here’s a patient in their 40s who starts to developing erectile dysfunction that seems to come out of nowhere that’s progressive, then our national guidelines do recommend that we also refer them to a primary care physician or even a cardiologist to make sure that cardiovascular wise they are doing okay.
Host: Okay, that’s really good to know. I’m 38 years old and I get my annual physical and bloodwork done and I’m wondering if that’s enough. I guess the real question is around when should men start regularly being proactive about their urologic health?
Dr. Loh-Doyle: For a patient that has no family history of urologic issues and is otherwise healthy, I do recommend about the age of 50 where we start checking your prostate, checking some lab values but it’s never too harmful to start earlier. If you feel like you’re having any issues with your urination, or if you have concerns that you may have a kidney stone. But 50 really is my cut off for really starting to see patients on an annual basis.
Host: Okay so let’s talk a little bit about an older demographic. My dad for example, he has that enlarged prostate that really makes it difficult for him to go to the bathroom and I see this as something that’s potentially pretty common. Why do you think this is and what are some things that we can do as a younger demographic to prevent it from happening?
Dr. Loh-Doyle: I tell patients that as you get older, everything gets smaller except your prostate. So, as you get older, your prostate enlarges and as the prostate enlarges, basically what happens is that the junction between your bladder and your urethra, so it just adds resistance to the actual urine flow. Unfortunately with time, that also can cause your bladder to become overworked and for the muscle to become thicker. So, this can lead to a bunch of symptoms such as having to strain to pee, poor urine stream, frequency, urgency. So, the best way to prevent that from happening is to maintain a good diet. Now there’s a lot of luck involved in this and you can have a patient who is the healthiest guy in the world but has an enlarged prostate and isn’t very bothered by it. You can also have a patient that’s in terrible health that has no urinary symptoms and a small prostate. So, it’s hit and miss. But I do recommend that diet can definitely affect the ability to empty your bladder and diabetes in particular can definitely harm your bladder’s performance. So, avoid those issues.
Host: You mentioned diet a couple of times and having a heat healthy diet. Is that just kind of avoiding things like sugars, and carbohydrates and eating more plants?
Dr. Loh-Doyle: I’d say that everything in moderation. I’m not advocating any – eliminating meats or what you like out of your diet. But you especially should not be taking in what you really enjoy on a daily basis. You should stress eating more fruits and vegetables, healthy types of proteins as well as minimizing the fats and processed carbohydrates in your diet.
Host: that makes sense. And before we move on from the prostate, you mentioned the prostate enlarges. Is there anything or any medicine that one can take to make it smaller?
Dr. Loh-Doyle: Absolutely. So, there’s different classes of medications and there’s different treatments available. So, there are medications that are designed to both shrink the prostate as well as to relax the prostate. And those can be used in combination and that’s something that even primary care physicians can comfortably start patients on. We typically see patients after they had been started on medications if patients seemed to have plateaued and not really seeing any improvement. There’s a whole class of medications and a whole field of business that aims at treating enlarged prostate.
Host: Okay that’s definitely good to hear. What about treatment for erectile dysfunction? I imagine this is something that a lot of men have and they kind of suffer in silence. So, I don’t know if there’s a cure but maybe speak to a little bit about what’s out there for them.
Dr. Loh-Doyle: ED is definitely underdiagnosed, under acknowledged. Patients are historically reluctant to admit they have this to their primary care physician. And I mentioned it before, you know erectile dysfunction can certainly be an indicator that you have some underlying cardiovascular issues. So, you definitely want to make sure that you see your regular doctor who checks your blood pressure, and also checks your cholesterol. So, once they have eliminated bad causes of erectile dysfunction or they actively managing those issues, well how do we treat erectile dysfunction? Typically, I do recommend lifestyle modifications including improving one’s diet, increasing cardiovascular exercise as well as weightloss. All those previous strategies can all independently improve erectile function over a six month period.
I also recommend oral medications. So you’ve heard all of them before, they are heavily advertised on TV and they all definitely do work. They are all meant to improve blood flow to the area and in general, they have very minimal side effects. So, they are very good first line therapy beside lifestyle modifications. Let’s say someone is refractory, oral medications don’t necessarily work or they just feel like they are just not really achieving what they want to; there’s a whole list of other tools that we have at our disposal to make erections happen. But it really just depends on how motivated a patient is and where they are in terms of their health.
Host: Just as we close here, one thing I always like to ask is I’m sure you’ve seen a lot of patients with urologic issues over time. And for men listening to this, what’s the one piece of advice that you wish more male patients knew before they came to see you?
Dr. Loh-Doyle: Male patients in general have been very, very bad about neglecting their healthcare and in general, they will wait well beyond what is reasonable. So, the one thing that I want to stress to help those male patients out there including even myself, is that seek care when you feel like something isn’t right. Don’t wait for it to really linger and fester when it’s too late. This can relate to kidney stones, cancers, even benign issues like having an enlarged prostate. Because I’ve actually seen a fair amount of patients in Ridgecrest myself that are having significant and end-stage bladder dysfunction and end organ failure because they’ve neglected their just seemingly bothersome urinary symptoms. So, don’t wait. See your urologist. See your regular doctor to get plugged in. That way we can treat you with things that can be very easily managed.
Host: Well that’s really great advice Dr. Loh-Doyle. I really appreciate your time today. That’s Dr. Jeffrey Loh-Doyle, a Urology Specialist at the Ridgecrest Regional Hospital Urology Clinic in alliance with USC Urology, a part of Keck Medicine of USC. Thanks for checking out this episode of Ridgecrest Regional Hospital Podcast. Head to www.rrh.org for more information. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.