Patient Care

Taking a multi-specialty approach to men’s health and wellness

Dec. 20, 2022

Providing patients with the best urological care at the University of Rochester Medical Center (URMC) means implementing a multi-disciplinary approach to men’s health and wellness.

URMC’s Department of Urology explores problems with various organ systems to address men’s health more broadly – with the overall goal of improving overall health and quality of life. The Department engages health practitioners from a variety of disciplines within URMC to work as a team to implement this approach, ranging from urology to gerontology, cardiology, dermatology, nutrition and ophthalmology.

This interdisciplinary team takes its message about the importance of healthy aging out into the community. One example is the Urology Department’s annual Men’s Health Day conference. The 2022 event was held in June and featured presentations on such topics as skin cancer treatment and prevention, eye health, healthy aging, spine rehab, management of low testosterone and erectile dysfunction, and healthy eating.

“We held this year’s event close to Father’s Day, but we view every day as Father’s Day,” said Jean Joseph, M.D., M.B.A., chair of URMC’s Department of Urology. “Our core mission is community education to inform men what they need to do to promote their health as they age.”

“This interactive event has been invaluable for hundreds of men in our area, many of whom have attended for several years,” Joseph added. “We will continue to hold this important event for years to come, thanks to the generous support of a valued donor.”

Optimizing erectile function and testosterone levels

Scott Gabrielsen
Scott Gabrielsen, M.D., Ph.D.

During his presentation on erectile dysfunction and low testosterone, J. Scott Gabrielsen, M.D., Ph.D., assistant professor - Department of Urology, focused as much on prevention of problems as on treatment. He highlighted that the best thing men can do to prevent these issues is to take care of their overall health.

The Department’s holistic approach recognizes that individual issues are not always independent of one another – and, in fact, they may be fully tied together. “What’s good for a man’s heart is good for their health, for their erections, for their testosterone and for their sperm quality,” Gabrielsen said. “For ED, lifestyle modification and medications changes can help men maintain and improve baseline function, whereas other treatments like sildenafil (Viagra) or tadalafil (Cialis) are Band-Aids to compensate for decreased function.”

According to Gabrielsen, ED and low testosterone are two issues that lead younger men to seek medical attention. This presents a unique opportunity to intervene and reinforce the importance of prevention, such as getting screened for diabetes.

“It’s important for men to understand that testosterone levels decrease with age, but most symptoms of low testosterone are due to other causes,” he added. “Improving overall health will have benefits not only for sexual function but will also help prevent a myriad of other health problems down the road.”

Urologists play a key role in healthy aging

Timothy Holahan, M.D.

While aging impacts everyone, there are specific health issues that arise that affect men physically, mentally and emotionally. Learning how to stay healthy longer was a large part of the Men’s Health Day discussion.

“We can’t stop aging, of course, but we can help men stay functional as long as possible,” said Timothy Holahan, DO, CMD, University of Rochester, Division of Geriatrics, Assistant Professor of Medicine, during his presentation on steps toward healthy aging. “Part of that effort is educating patients on such things as the impact of high cholesterol and high blood pressure on heart health.”

Helping men age healthier may not seem like the role of a urologist. Yet, because urologists care for male patient many times throughout their lives, they have more opportunities to engage with their patients.

“Urologists have a unique role in men’s health, and they have a greater impact on healthy aging than they probably realize,” Holahan said. “Following a man’s health for many years, a urologist may be able to pick up on other issues, such as memory loss or cognitive decline, which can be immensely helpful in overall patient care.”

“When looking at dementia, people think about how to prevent it or how to slow its progression. How you do that is by looking at a man’s health across the board – and that involves a urologist,” he added.

Food as more than fuel

April Ho, R.D., C.P.T.

When it comes to healthy eating, men often receive societal pressures to “achieve,” similar to many other areas of life, according to April Ho, R.D., C.P.T., a registered dietitian and certified personal trainer with URMC’s Center for Community Health & Prevention. Whether it is the pressure to achieve career status, financial success, or a diet that fuels the body and builds muscle, the cultural messaging often promotes productivity and black and white thinking.

“Seeing food as fuel and as a means of simply building muscle or losing weight misses the fact that for as long as the human race has been alive food has been part of ritual, social gathering and holidays as well,” Ho said. “Reducing food to solely its physical health benefits promotes an incomplete perspective that ultimately is often demotivating for patients.”

During the Men’s Health Day presentation, Ho covered the basics on healthy eating for retired men. This includes the need to eat from a portion plate that is equal parts fruit, vegetable, protein and starch, getting more calcium and vitamin D, and eating three servings of dairy and 30 grams of fiber and more each day.

While important to educate men about healthy eating, central to that is explaining the meaning of balance. Dietitians help patients understand tradeoffs they can make in their diets to make room for all their favorite foods.

“It is extremely valuable that we get to collaborate with urologists in an effort to reframe the all-or-nothing approach to healthy eating,” Ho added. “Dietitians can help men overcome the barriers to healthy eating – and to social and emotional health - because we get a good amount of time with our patients.”

As part of the inter-specialty approach, dieticians also work in tandem with the Department’s Comprehensive Kidney Stone Treatment Center on stone prevention.

“Our health care system is overtaxed, and patients demand and expect a lot from their providers,” Ho said. “Through our interdisciplinary approach, we are increasing collaboration among URMC departments and divisions, but, most importantly, we are improving patient outcomes immensely.”