MDNews - Southern Indiana

procedure and would do it again. It's the highest satisfaction rate of any treatment we o•er." W h i l e t h e r e i s a c o n c e r n w i t h i mpla nt i n fection, Dr. Gi lson of fers a p r o s t h e s i s w i t h a n a n t i b i o t i c - impregnated layer, lowering infection rates to fewer than 1 percent, he says. In fact, he's seen only one infection in more than 1,000 implants performed over 16 years. Of these patients, most are still satis- fied, even after having their devices for close to two decades, he says. Revision surgeries are almost never required. A SOLUTION FOR A VEXING PROBLEM Dr. Gilson also o•ers treatment for a male urinary incontinence, a condition that is especially challenging for patients. " The most common cause by fa r is radical prostatectomy for prostate can- cer," he says. "Approximately 5 percent of men will have stress incontinence following the procedure." Some of those patients are helped with dietary and behavioral changes, while others can find relief through medication. However, Dr. Gi lson says, some men continue to experience stress inconti- n e n c e a n d a p p r o a c h a u r o l o g i s t for¦assistance. Common treatments include a peri- urethral implant, in which the physician injects a substance to add bulk to the urethra and increase resistance, holding back the flow of urine. These implants a re ef fective a nd requi re a lmost no recovery time, but they are e•ective only for minimal incontinence and must be repeated from time to time. A sling, or mesh device, may be inserted to elevate t he u ret h ra , but t hese dev ices have problematic side e•ects and are ine•ec- tive for severe incontinence. "The gold standard for male urinary incontinence treatment is the artificial urinary sphincter," Dr. Gilson says. "This device is placed around the urethra to mimic the body's natural sphincter action by closing o• the urethra and holding urine in the bladder. To empty it, the patient activates a pump in the scrotum, draining the bladder. It does require some dexterity and mental awareness to oper- a t e , b u t i t i s t h e b e s t t r e a t m e n t o p t i o n ¦ f o r ¦ m e n w i t h b o t h e r s o m e stress¦incontinence." Again, Dr. Gilson o•ers this treatment as an outpatient surgery, with the proce- dure ta king about an hour and a ha lf. Infection rates are low. After six weeks of recovery time, patients may begin to use the device, which ta kes only f ive to 10 seconds to operate. " I h a v e o f f e r e d t h i s o p t i o n s t o patients¦for the past 20 years," Dr. Gilson s a y s . " T h e v a s t m ajor it y a r e s t i l l extremely satisfied." WHEN TO CONSIDER REFERRAL Most men who experience incontinence are a lready under the care of a urolo- gist, Dr. Gilson says, but patients with ED may never discuss their concern with a physicia n. The ma n's distress may tra nslate to unhappiness in his personal relationships. "When ED is addressed, it's a gain for everyone," Dr. Gilson says. "Not just the sex portion — it's everything about their lives. The men are more confident after surgery. Everyone is happier they have received treatment." Primary care physicians and endocri- nologists caring for men with diseases that cause vascula r or ner ve da mage should initiate a conversation about erectile function when necessary. "Primar y care physicians may pre- scribe oral medications for ED without reservation," Dr. Gilson says. "However, if a patient is not successful taking oral medication and is highly motivated to open that part of his life up again, the provider should refer him to a specialist. Look for an experienced, high-volume surgeon w it h ex per tise i n t he f ield, one who ta kes a n interest in helping these patients." If you would like patient information about erectile dysfunction or male urinary incontinence, please contact Dr. Gilson at St Vincent Medical G roup Urology, 920 S Hebron Ave, Evansville, IN 47714 (812) 473-1111 Experience Equals Success Phillip Gilson, MD, urologic surgeon and male infertility expert with St. Vincent Medical Group, combines training with the expertise developed over years treating patients in a high- volume practice. Education: Dr. Gilson received his Doctor of Medicine degree from the Medical College of Wisconsin. Residency: He served a residency at the St. Louis University School of Medicine, a school ranked in the top 100 for both research and primary care by U.S. News & World Report. Board certifications: Dr. Gilson is board-certified in urology and in female pelvic medicine and recon- structive surgery by the American Board of Urology. Experience: With more than two decades of experience in urology, Dr. Gilson has performed thousands of surgeries for patients with ED and urinary incontinence. ■ M D N E W S .C O M /// M D N E W S S O U T H E R N I N D I A N A ■ 2 017 0 5

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