Founder of the Man vs Prostate® campaign, Dr. Wayne Kuang urges men to drop the “I’m fine” façade and seek timely bladder and prostate care.
What is the inspiration behind Man vs Prostate, and how has it opened up conversations around the world?
It starts with one simple truth: Besides the brain, there’s only one other major organ that cannot be transplanted, and that’s the bladder. For me, it all started with a patient who was a cowboy. He was miserable: urinating all night, experiencing urgency and frequency, having pain in the lower belly, and he had been reduced to just a fraction of who he was before. We found that he had multiple urologists who kept recommending more drugs, higher doses, without doing any diagnostics. When I did his first prostate ultrasound, we were all shocked to see that his prostate was huge — about the size of a baseball. Back in 2006 in New Mexico, the only thing I could offer him was open surgery under general anesthesia. When he was faced with the choice between continuing to live that quality of life or going under the knife with all its associated morbidities and risks, he chose the one path he could control and, sadly, took his own life. Too many men with severe symptoms need our help earlier. It starts with a simple question: What about my bladder? The Man vs Prostate campaign is about raising awareness that men need to be proactive about protecting their bladders and preventing late-stage disease.
Why is there such a stigma around talking about men’s urological health?
In many cultures, too many men wake up and put on this armor of masculinity. These men suffer from “‘I’m fine’ syndrome,” when in truth they’re just living a miserable existence because of the cultural silence that we’ve instilled in this generation of men. Men around the world need to be willing to take off that armor, lower their defenses, make themself vulnerable, and avoid that “cowboy mindset.” It’s going to be a process of education, public awareness, understanding where men are, looking at the data, and making better decisions with men based on that data.
What are some of the most common urological issues in men’s health?
I think we need to take a step back as healthcare providers and think of our overall mission: to empower men with the healthcare experience to evolve fearlessly into the best version of themselves. We also have to invite men to start thinking about who they are now, who they want to be in the future, and what it’s going to take to get to that future. 60 is the new middle age, but we can’t wait until men have progressed to the very late stages of benign prostatic hyperplasia (BPH); otherwise, the burden will be too great. Already, 1 in 3 men aged 65 years and older globally will have moderate to severe symptoms. When you do the math, that’s 280 million men worldwide by 2050. We don’t have enough doctors and providers, so we need to act now before it becomes too overwhelming for healthcare systems worldwide.
What are the five stages of bladder health?
The bladder is a muscle that pumps urine through the prostate, which starts off about the size of a golf ball in the shape of a mini donut. As men get older, the prostate gets bigger and the donut hole gets tighter. As a result, there are five stages of bladder health.
- Stage one: The donut hole gets tighter, and the flow slows down.
- Stage two: Over the years, that bladder muscle is having to squeeze harder and harder, and it begins to struggle, causing symptoms of urgency, frequency, and getting up at night to pee.
- Stage three: Men start to develop leakage down their leg, causing shame and embarrassment.
- Stage four: Similar to how a heart can have a “heart attack,” the bladder can suddenly stop working, and you need an emergent catheter to drain the bladder.
- Stage five: Just like the heart can have heart failure, the bladder can go into bladder failure, and now you might need a catheter for the rest of your life.
What advice do you have for men who are potentially experiencing a problem with their urination or bladder health?
Number one: Don’t be a cowboy. Be willing to take off that armor and have an open dialogue with your doctor if you are struggling with slow flow, urgency, frequency, getting up at night to pee, or even leaking. Your non-replaceable bladder is too important to ignore. You only have one. Take care of it.
Number two: In this modern era of medicine, there are so many new diagnostic and therapeutic options. You cannot manage what you don’t measure. If you are having problems, get your data. Many diagnostics can be done in the office or even at your home. Moreover, the latest prostate surgeries to help your bladder are minimally invasive and can even be performed in the office. Talk to your urologist about which management and treatment strategies would be best for you.
Number three: Engage your doctor with one simple question: #WhatAboutMyBladder? Together, we can achieve the vision of all men living their best lives — incontinence-free and catheter-free — when we prioritize bladder health for men with BPH.
