MEN’S YOUROLOGY

Does robotic prostate surgery really protect your bladder and sex life?

This study followed over 2,000 men undergoing mostly robot-assisted radical prostatectomy and tracked real, patient-reported urinary and sexual outcomes over the first year using the validated EPIC-26 questionnaire. Unlike many studies, it paired scores with plain-language outcomes like pad use and erections with or without medication.

Urinary control improved for most men, but not perfectly. After a year, about 2 out of 3 men didn’t need pads anymore, which sounds reassuring. But when you look closer, only about 4 out of 10 had no leaking at all. The good news is that even among men who still leaked, most said it was mild and not very bothersome, often needing just one pad per day. Sexual recovery was much harder. Of men who had normal erections before surgery, only a small number recovered erections on their own. Some men could have sex with treatment, but pills alone helped very few. Devices like vacuum pumps or injections worked better than pills, based on what men actually reported using.

So robotic surgery helps, but it doesn’t eliminate side effects. This study is a reminder that men deserve honest expectations—and early conversations about recovery options—before surgery, not after.

WOMEN’S YOUROLOGY

Is there an overactive bladder medication that actually works without the classic side effects?

This clinical study closely examined the safety and effectiveness of mirabegron, a beta-3 agonist used to treat overactive bladder (OAB), focusing on real symptom relief and tolerability. Across the included trials, involving thousands of adults with OAB, mirabegron consistently reduced daily urgency episodes, urinary frequency, and urge incontinence compared with placebo, with improvements seen as early as the first few weeks. What stood out most was how mirabegron worked compared with older drugs. At the commonly studied dose of 50mg once daily, patients experienced meaningful symptom improvement without the high rates of dry mouth, constipation, or cognitive side effects typically seen with anticholinergic medications. Blood pressure and heart rate changes were small and clinically modest for most patients, reinforcing its overall safety profile.

The most effective approach reported was mirabegron monotherapy at 50mg, which balanced symptom control and tolerability better than lower doses. Importantly, patients were more likely to stay on treatment, a key factor in real-world success. So the takeaway is, mirabegron doesn’t just reduce OAB symptoms, it offers a more sustainable option for long-term management, especially for patients who can’t tolerate traditional therapies.

This week, someone asked me, “How does one "clean out the prostate"?” There’s really no special trick or product you need to “clean out the prostate”, your body handles that naturally. Regular ejaculation, whether through sex or masturbation, may help keep things moving and has even been linked to a lower risk of prostate cancer. Just focus on a healthy lifestyle, stay active, and don’t fall for miracle supplements that promise quick fixes—your prostate will thank you.

I love hearing from you, so if there’s a question you’ve been wanting to ask, just let me know. Who knows? Your question might be the one I dive into next!

WHAT I’VE BEEN UP TO LATELY

My parents are in town, so I’ve been spending some much-needed quality time with them.

HIGHLIGHTS FROM MY CHANNEL

I dove into the topic of “Ozempic penis” and whether weight loss medications like Ozempic can actually make your penis longer. Here’s the big takeaway “Can it help improve length? Absolutely, but not for the reasons you think.”

Here are some quick points:

• Losing weight shrinks the fat pad above the penis, making it look longer.

• Better blood flow from these meds can boost erections and confidence.

• The meds may dampen your cravings, including for sex, in some cases.

Bottom line, I explained that these medications don’t physically grow your penile tissue but can help you see more of it due to fat loss and improved health. Many men also report feeling better about themselves and noticing better sexual performance. If you want to hear all about the science behind this, check out the full episode!

HIGHLIGHTS FROM MY PODCAST

My conversation with Dr. Matthew Davenport is about those “trendy” full-body MRIs that everyone’s talking about. Dr. Davenport made it clear: most people don’t need these scans—and they might do more harm than good! He warns: “This whole body MRI idea is based on the idea that I'm going to find something and I'm going to save somebody's life early. ...if it did that, I can tell you the medical societies would be endorsing it full throated.”

Here’s what you really need to know:

• Full-body MRIs can lead to unnecessary worry and procedures.

• Medical societies don’t recommend them for healthy people.

• Invest in proven, evidence-based health habits instead!

Tune in to hear why skipping that fancy scan is a smart move! So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Dr. Davenport has provided a Treasure of information for those of us not in the medical field. Great Guest! Thank you👍”.

NEW MEDIA

Worried you’re “overdoing it” or harming your sexual health? Check out my new Substack: Can You Masturbate Too Much? Urologist Debunks 6 Myths About Sexual Health.

In this article, I separate fact from fiction—explaining why daily solo sessions are usually healthy, how masturbation can actually improve intimacy, and when it’s time to seek help.