I'll begin by discussing the pathway that led to my career choices. In the summer following my first year of medical school, I chose to do a fellowship in cancer research. I spent my time observing the daily activities of radiation oncologists, surgeons and medical oncologists. I became involved with a clinical research project in prostate cancer with a radiation oncologist, and from there, my curiosity exploded sending me deeper and deeper into the field.
Admittedly, cancer treatment is a major part of my day, but two other qualities of urology attracted me. First, I was amazed by the minimally invasive (meaning less trauma to the body and less scars) ways that we dealt with most of our diseases. Historically, kidney stones were removed by making large incisions in the abdomen. This was replaced by small telescopes using the "natural" tubes and passageways the human body already has called ureteroscopy. As urologists, I feel this is one of the main tenets upon which our specialty was built. My fellowship training focused on the future of "minimally invasive surgery," robotics and laparoscopy. This technology has brought wonders to the patient with regards to less blood loss, quicker recovery, less narcotic use after major surgery and a better cosmetic result.
Lastly, I was attracted to the fact that a portion of my job was responsible for improving the quality of life of my patients. No one likes to wear pads or panty liners because they leak urine. Is this life threatening, however? No, of course not, but when you rid someone of that "crutch," new doors are opened to them and their quality of life certainly improves. Similarly, with ED, restoring someone's ability to achieve erection not only restores confidence, but may strengthen personal relations. Some may also argue that this is not just a quality of life issue but is, in fact, a "life or death" situation.
During my fellowship I had an interesting opportunity to research how we as urologists study ED. My fellowship was done in Paris, France in a center that had, at the time, the largest series of laparoscopic prostatectomies (removal of the prostate for cancer through small keyhole-sized incisions) in the world. Robotic surgery was not as popular two years ago as it is now, but they also performed that procedure as well. One of the most troubling side effects of this surgery (radical prostatectomy) is ED. This side effect can occur after any type of procedure to remove the prostate (through a large incision as well). The number of patients that leak urine after this surgery (incontinence), another troubling side effect, is much less today. The nerves that are responsible for erection lie along side of the prostate. I'll elaborate more on my next posting.
Published On: July 18, 2007