Dr. Anika Ackerman discusses advancements in urology and how men and women of all ages can take control of their urological health.
Dr. Anika Ackerman
Board-Certified Urologist
What are some common misconceptions or myths about urological health that you encounter in your practice, and how do you address them with patients?
I’ve noticed that some patients believe if they “feel fine” then there is no cause for concern. In urology, we routinely screen urine or check PSA (prostate-specific antigen). Blood in the urine can often be microscopic and invisible to the patient, but it can also be a clue to urologic pathology, such as kidney stones or bladder tumors. These conditions may be asymptomatic, but they’re still dangerous. Additionally, most men with prostate cancer will not show any signs or symptoms. We use the PSA blood test to screen for prostate cancer. I encourage patients to screen for prostate cancer starting at age 50 or sooner if they have a family history. The bottom line is that just because there are no symptoms, urologic disease may still exist.
Can you discuss recent advancements or breakthroughs in urology that have significantly improved patient outcomes or treatment options?
Technology and techniques that we use in urology have come a long way — robots, scopes, advanced diagnostic tools, sophisticated blood and urine tests, and surgeries that only remove partial organs (kidneys and prostates). These are all being utilized to make the experience of both the surgeon and patient much easier and more precise. For instance, just two years ago, a man with prostate cancer who needed surgery would have his entire prostate gland removed. This risks both erectile dysfunction (ED) and incontinence, as well as other common risks associated with major surgery (i.e. bleeding and infection). Although robotic surgery and talented roboticists have made the incidence of these side effects much lower, we now have the ability to localize prostate cancer to one area and ablate just that tissue. This leads to less insult to the patient and a faster recovery.
In your experience, what are the most effective strategies for promoting urological health and preventing common conditions such as urinary tract infections, kidney stones, or prostate issues?
For benign conditions like UTI, kidney stones, and BPH, education is key. These are very common problems, and recognizing signs or symptoms is crucial to early detection and treatment. Many of these patients will start in the primary care office and be referred to urology as needed. Primary care physicians can often treat these benign conditions, but knowing when to refer for specialty management is also important. Judicious use of antibiotics is important to reduce resistance patterns and also adverse reactions in patients with UTIs. Urine cultures should always be utilized when UTI is suspected. Men should be educated about BPH because we have great medicines in addition to minimally invasive procedures that can significantly improve their quality of life. Education about the cause of kidney stones, especially the importance of drinking enough water, could significantly reduce the incidence of painful and sometimes dangerous stone episodes.
How do you approach discussing sensitive topics related to sexual health or incontinence with your patients, and what advice do you typically offer to individuals experiencing these issues?
As a female urologist, I do recognize that some patients, especially males, feel uncomfortable discussing sensitive topics like sexual dysfunction or incontinence. That is why I routinely ask about these issues directly and attempt (to the best of my ability) to normalize the problem at hand to get a good history. We have great medications for erectile dysfunction and incontinence related to overactive bladder and BPH. On the female side, I offer hormone replacement to women who struggle with perimenopause and menopause. We can also offer procedures like Bulkamid and Botox to women with stress and urge incontinence. Female sexual dysfunction treatments have come a long way in the last decade. We now have two FDA-approved medications for low libido in women — Addyi and Vyleesi. Additionally, testosterone use, while off-label, has been shown to help with dyspareunia (painful intercourse) and low libido in women. I prescribe testosterone to females in my practice routinely despite the lack (and lag) of FDA approval.
What are some consumer products and resources you advise for your patients to maintain and take control of their urological health?
I recommend over-the-counter products like D-mannose and cranberry for UTI prevention. Bonafide is a company that makes many women’s health products, including suppositories for vaginal dryness and probiotics specific for females. For patients with painful bladder syndrome, I recommend aloe supplements (I like the brand Desert Harvest). Men’s supplements containing nitric oxide and amino acids like L-arginine and L-citrulline are helpful for men with mild ED.
