Participants: Nick Evenson (Host), Dr. James Marcum
Series Code: UP
Program Code: UP000088B
00:01 Welcome back to the programme, I'm your host Nick Evenson,
00:02 and on the Ultimate Prescription today,
00:04 we're discussing pain
00:06 that happens in the urogenital areas,
00:08 which is a difficult topic.
00:10 And if you want to get some information
00:13 or ask us questions,
00:14 we want you to visit our website
00:15 at HeartwiseMinistries.org.
00:17 There's a lot of health resources there,
00:19 and it also links back to previous radio
00:21 and television programs
00:23 and they're just a lot of good health resources there.
00:24 So reach out to us through the website
00:25 if you have questions and, Dr. Marcum, thank you
00:29 for discussing this with us, it's not an easy topic.
00:31 Yeah, yeah, no.
00:32 And gynecological specialists are the ones
00:35 that really have this knowledge.
00:36 And we have several of them work with us.
00:38 And if they send their questions to the website,
00:40 we'll make sure we get it answered.
00:43 But I find it very difficult for men.
00:45 Men don't like to talk about these things
00:47 'cause they're proud,
00:48 they have a lot of reasons that they avoid it.
00:52 And usually these problems are not life threatening,
00:55 but they can be incapacitating in other ways.
00:58 And so it's important that we talk about it today,
01:00 and there's been quite a few questions,
01:01 so let's try to answer them the best we can.
01:04 All right.
01:05 Well, our first viewer writes in and asks,
01:07 "Why is pelvic inflammatory disease so serious?"
01:10 And what is pelvic inflammatory disease?
01:12 Let's describe that a little bit, it's, you know,
01:15 really not the pelvis that's inflamed,
01:17 but you have tubes,
01:19 a female has tubes that connect with the ovaries, okay,
01:22 where they make an egg, it travels down that ovary,
01:25 it leaves the ovaries and it travels down a tube
01:27 called the fallopian tube.
01:30 And then it heads out towards the uterus, okay.
01:32 Well, different pelvic inflammatory,
01:36 different conditions can cause inflammation of this area.
01:39 Okay. Okay?
01:40 And inflammation is as we've learned
01:42 in other parts of the body, inflammation can cause pain.
01:46 Inflammation immune cells come to this area
01:48 can cause pain and also can cause
01:51 disruption in normal function.
01:53 Okay. Okay.
01:54 And there's certain things
01:55 can cause inflammation in this part of the body.
01:59 Some women, as a reproductive, for pregnancies,
02:03 they use IUDs and sometimes IUDs
02:06 can cause inflammation, of course, infections.
02:09 Especially the sexually transmitted
02:11 diseases of Gonorrhea, Chlamydia,
02:13 those can cause that.
02:15 There's conditions we have
02:16 chronic inflammation endometriosis,
02:18 some people have heard of that.
02:20 Some chronic infections can cause this.
02:22 It has a lot of pelvic pain.
02:25 You might diagnose this
02:26 because when they examine this area,
02:28 there's lot of tenderness in this area.
02:30 It might hurt when you have relations
02:32 in this area.
02:33 And one of the big reasons
02:35 why I think we need to bring it up is
02:36 'cause people with pelvic inflammatory disease,
02:39 they have increased risk of Ectopic Pregnancies.
02:44 Okay, because when the egg is fertilized,
02:45 you know, it can't move through the tubes as well.
02:49 So it can't get to the,
02:50 so they have ectopic pregnancies,
02:51 that can be very dangerous.
02:53 And so, that's, you know,
02:55 they say if you have pelvic inflammatory disease,
02:57 the chance of an ectopic pregnancy
03:00 increases 10 times.
03:01 Oh, wow.
03:03 And that's, you know,
03:04 we have fertilization in the tube,
03:06 and then it doesn't move and then the tube
03:08 can have something serious happen...
03:11 In that, so this is a big problem.
03:14 Another situation that happens,
03:17 if you have pelvic inflammatory disease,
03:19 it makes it harder to have a baby later on,
03:22 because, of course,
03:23 the tubes aren't working as well,
03:25 it's harder to work through those tubes
03:27 to get what needs to be accomplished.
03:30 So those are two things that we need to talk about
03:33 pelvic inflammatory disease.
03:35 If you're having lots of tenderness in that area,
03:38 see your doctor, they wonder if they can do some examination
03:41 to see if you might have pelvic inflammatory disease
03:43 if it's due to infection,
03:45 of course, they would treat that.
03:46 And they might want to be very sensitive to you
03:49 if you ever were to get pregnant,
03:51 so watch out for ectopic pregnancies.
03:54 We've got another viewer who writes in and asks,
03:55 "What is Peyronie's disease
03:57 and what's the treatment for it?"
04:00 Peyronie's disease is a disease that affects about 1 in 20 men.
04:03 Okay. Okay.
04:05 That's a fair number of 5%. Yeah, mm-hm.
04:08 And this is really a simple way
04:09 to think of it as arthritis of the penis, okay?
04:12 Inflammation of the penis and specifically
04:14 you have connective tissue that's very painful.
04:18 And it can lead to a lot of scar tissue.
04:21 And when the scar tissue develops,
04:23 it can cause lots of pain.
04:25 Now the good news,
04:27 the good news is even though lots of people have it,
04:30 20% of those that have it spontaneously improve,
04:34 so a lot of them just get better on their own
04:36 and it goes away.
04:39 However, if it progresses and is very painful,
04:41 some might need surgery
04:43 or some might even need a prosthesis if it progresses.
04:46 Now those are the most serious cases.
04:48 The doctors that specialize in that are urologists.
04:51 Mm-hm. Okay?
04:53 And they would know the questions to ask,
04:55 the detailed questions that would go into that,
04:58 a lot of men don't like to mention that,
05:02 you know, they won't even mention that things hurt.
05:03 Right, sure, sure.
05:04 But when a man has his penis that hurts,
05:06 there's some serious things that it can be.
05:08 It can be an infection, it can be Peyronie's,
05:11 and they want to look and make sure
05:12 all the parts are working well.
05:14 They're doing what they should do
05:15 and make sure there's nothing more serious going on.
05:18 So the urologist is the person to go to
05:21 when you have this type of symptom.
05:22 Now, I generally think, for some reason,
05:24 I think of arthritis being more in the hands or places
05:27 where there's bone structures, but really you're saying
05:29 it's in soft tissue?
05:30 Yes, soft tissue, the connective tissue.
05:31 The connective tissue?
05:33 The connective tissue and that's throughout the body,
05:36 You know, you have connective tissue
05:38 in the ear, unfortunately,
05:39 it doesn't cause too many problems in the ear,
05:40 but yes, you can have inflammation that's abnormal,
05:43 it's plaques.
05:45 You know, there's connective tissue plaques
05:46 and it pushes on things it shouldn't put on.
05:48 And when the normal function's disrupted, guess what,
05:52 the nerves say, "Oh, I'm not happy here."
05:54 There's lots of nerves in this parts of the body,
05:57 and they're used to being very sensitive to things.
05:59 And when things aren't right, the nerves go,
06:00 "Oh, this plaque is disrupting my normal function,
06:03 I'm going to cause pain.
06:05 I'm going to tell the host that something's not wrong."
06:08 So, our duty when we have pain, we should say,
06:10 "Well, something's not wrong, let me find out what it is."
06:13 Because chronic pain is not good.
06:15 So if something's not feeling well,
06:17 get it checked out.
06:18 Exactly, exactly. Yeah. All right.
06:19 We've got another question, also again referring to men.
06:23 "What causes pain in the scrotum?"
06:25 Yeah and...
06:26 Is this a common thing that people experience or...
06:28 Actually, actually, I'm not a urologist,
06:30 so I don't know,
06:31 but when I was preparing for this program,
06:35 it's one of the most common questions
06:37 that's not asked.
06:38 Oh, really?
06:40 So I said, "Well, we're gonna ask this,
06:41 you know, that we're gonna ask this question today and see."
06:43 Not talked about a lot.
06:45 Talk about it, but there's many different causes,
06:47 and the number one cause of scrotal pain is trauma, okay.
06:55 Trauma, you know, we talked about it,
06:57 you know, bicycles,
06:59 you know, constant repetitious pain on this area.
07:02 Some people get inadvertently hit in this area,
07:05 causes lots of pain.
07:07 Whenever the body has trauma to it,
07:10 it starts to swell, inflammation,
07:13 lots of nerves are activated, the body tries to fix itself.
07:16 Sometimes, the pain increases pressure in an organ,
07:19 swelling in an organ that causes major problems.
07:23 So trauma is probably the number one
07:25 cause of scrotal pain.
07:26 I tend to think of trauma in that area
07:29 usually goes away on its own.
07:30 Yes, usually, it does.
07:31 Now if it's prolonged for a period of time, what's next?
07:36 That's right, sometimes you can actually have
07:38 damage to the testis, and the other tissue in there,
07:42 epididymis, etcetera.
07:44 And if it's damaged, then you really sometimes things
07:46 can get torsed, turned around, and doesn't move as well.
07:49 Sometimes the tubes can get obstructed, okay.
07:53 And that causes lot of pain as well.
07:55 And what would happen if the pain continues?
07:58 You would probably see a urologist
08:00 and they would do a complete physical,
08:02 they'd also do an ultrasound
08:05 to see if there's been serious damage,
08:07 to see if the testes or the tubes have been damaged.
08:10 Sometimes, they actually find
08:13 that the scrotum has been damaged,
08:15 not by trauma, but it's damaged by cancer.
08:20 Testicular cancer is rare but it does exist,
08:23 and testicular cancer is another cause of pain
08:27 to the scrotal area.
08:28 And if it's diagnosed early, it can be very well treated.
08:32 There's some famous athletes that have had that in the past,
08:35 and it's been Very well publicized.
08:37 But I'd say, you know, if you're having pain
08:39 in the scrotal area, see if it's trauma,
08:42 if the pain doesn't go away, it needs help right away.
08:44 And then a man can examine this area themselves.
08:47 If you feel anything that's hard,
08:49 that's like a rock,
08:50 that would be consistent with something that shouldn't be,
08:53 and you need to get it checked in to right away.
08:54 Right, right.
08:56 So those are some of the more common causes
08:57 on trauma, torsion, obstruction of the tube,
09:00 see a urologist.
09:02 He'd do some ultrasound, make the diagnosis,
09:04 and in severe cases, they have lots of modern medicine
09:07 that they can do to take care of the problems.
09:09 I was gonna ask, is it often surgery
09:11 that they use or...
09:12 Well, sometimes, they have to do,
09:14 rarely they have to do an orchiectomy, okay,
09:16 and that's where they, you know, take the testes out,
09:18 and that can be done.
09:21 And that would be the most extreme case.
09:23 And sometimes, they can manipulate
09:24 and relieve the pressure as well,
09:26 but you don't want it to,
09:28 especially if you're young and want to have a family,
09:31 you'd want to get it evaluated because a chronic problem
09:34 could hurt your fertility down the road as well.
09:36 Sure. Right.
09:37 So that's why it's something to have evaluated soon,
09:40 and a lot of men don't like to talk about problems
09:43 in their reproductive organs you know.
09:44 Yeah, right.
09:45 They'll talk about stones, they'll talk about the pain
09:47 that they got, playing ball with junior, you know,
09:49 "I got hit in the mouth, and now I can't breathe anymore
09:51 and my shoulder's hurting" and you know...
09:54 They like those type of pains
09:56 but when it gets personal pains, they don't,
09:57 but I'm telling them that it's okay.
10:01 Don't let a little problem become a big problem.
10:03 Now you mentioned cancer a minute ago,
10:05 and we've got another question.
10:06 Someone writes in, "how is bladder cancer diagnosed?"
10:09 Yeah. well, that's a good question
10:10 'cause cancer can occur anywhere in the body, right?
10:14 It can occur in the urogenital tract,
10:16 it can happen in the kidneys, it can happen through
10:18 in the bladder cancer,
10:19 it can happen in the reproductive organs
10:21 as well.
10:23 Bladder cancer is usually diagnosed
10:25 by someone having a symptom that they don't feel right.
10:29 It's something out of the ordinary.
10:30 When they go to their doctor, they might have something,
10:32 they usually have blood in the urine, you know,
10:34 something like that will show up,
10:36 they might have some pain or some presenting symptoms.
10:39 And the doctor would go
10:40 and they do a test where they can actually go
10:42 into the bladder, they can look in the bladder,
10:44 and they can see if there are cells
10:46 that shouldn't be there,
10:47 a growth that shouldn't be there.
10:49 They will take that growth out, okay,
10:51 and look at it under the microscope.
10:53 Now other cancers that are, you know,
10:55 bladder cancer happens in the bladder, of course,
10:57 but we've heard a lot about prostate cancer, okay and...
11:02 Men can, when they get their prostate examined,
11:03 you can feel nodules on the prostate,
11:05 feels like marbles,
11:07 and the doctor can go up and biopsy that
11:09 and see if there's a cancer there.
11:11 But, of course, cancer in the testes
11:12 feels like a marble,
11:16 in the female tract, uterine cancer, ovarian cancer,
11:20 those are cancers that can press on organs
11:22 and have pain as well.
11:25 So whenever you have pain in the urogenital system,
11:26 you know, they would say,
11:27 "Well, where's the pain coming from?"
11:29 And you say, "Well, it's coming from here."
11:30 So your doc will say, "Well, let me see if I can find out
11:32 what's causing the pain."
11:34 They would think infection but on the list,
11:36 they'd say, "Well, could they have
11:37 a possibility of a cancer?"
11:39 And they would evaluate that with ultra-sounds, CAT scans.
11:43 If they thought it was a cancer,
11:44 the next step would be to biopsy it
11:46 and see exactly what it is.
11:47 Right, right.
11:49 You know, we're just about out of time today,
11:51 but what would you say is the most important
11:53 take home point that we've discussed today?
11:56 Well, like we've talked about in pain,
11:57 when you have pain, that's your warning system
11:59 that something's not right, get it evaluated,
12:02 and try to get back to doing the things
12:04 to stay healthy
12:06 so we don't have chronic pain
12:07 and don't be embarrassed, you know, go and get help.
12:10 That's right.
12:11 We have professional people,
12:12 and the professionals that help with this type of pain
12:14 are the urologists, okay, the gynecologists,
12:18 those are the ones that really do the best job
12:20 with this type of pain.
12:22 And if you might have a question
12:23 that we can help you with
12:24 or get you to the right person,
12:26 go to our website HeartwiseMinistries.org.
12:29 Okay, Marcum, thank you for sharing your thoughts,
12:30 and thank you for at home for viewing our program today.
12:32 We hope that it's been beneficial
12:34 and helped you through maybe some issues
12:36 that you're experiencing.
12:37 Stay with us and there's more to come
12:39 on the Ultimate Prescription.
12:48 Let's take a moment together as we pray.
12:51 Let's bow our heads.
12:54 Heavenly father, there are many out there
12:55 that suffer from pain.
12:58 We pray that you be especially close to them
13:00 and lead them in the path
13:02 that they should go to deal with these pains, Father.
13:05 We thank you for being our ultimate physician
13:08 and for your saving grace.
13:10 We thank you for your love and kindness.
13:14 Well, we covered a lot of topics today,
13:18 if you like more information, please go to our website,
13:20 that's HeartwiseMinistries.org.