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Article Category: Highlights

Urology and You: A Doctor Answers Sensitive Questions

Published on February 24, 2025

Last updated 10:52 AM February 24, 2025

Woman and man drinking water

The Weekly Check-up Atlanta


Dr. Scott Miller, a Wellstar urologist and expert in robotic and laparoscopic surgery, joined Dr. Bruce Feinberg on 95.5 WSB’s The Weekly Checkup. Together, they tackled common questions about urology, prostate health, incontinence and more.

Does dark urine mean I have a medical problem?

There’s no normal color for urine, Dr. Miller explained. Most of the time, expect urine to be “fairly diluted, almost like water or very pale yellow.”

Urine color may be different in the morning after a night’s sleep without hydration. Some prescription and over-the-counter medicines, like multivitamins, can also affect urine color. Any red in urine could indicate the presence of blood. That’s a sign to call your primary care provider or urologist.

Should I be worried about bubbles in my urine?

That depends, according to Dr. Miller.

“If bubbles form simply because of the way your urine stream hits the water—causing a little turbulence—there’s no need for concern,” he said. “But if you actually feel the bubbles or air passing as you urinate, that’s different. It could indicate a bladder infection or an abnormal connection between the urinary and GI (gastrointestinal) tract.”

In that case, Dr. Miller said a doctor would likely order tests to determine the cause and recommend appropriate treatment.

Do women need urologists?

Yes. Urologists specialize in treating the kidneys and the bladder in both women and men, in addition to addressing prostate health in men.

“Anyone with a urologic issue should see a urologist,” Dr. Miller said. He noted that women are more likely than men to experience conditions like kidney stones and urinary tract infections, making specialized care essential.

Is bladder leakage inevitable with aging?

Dr. Miller noted that bladder control issues are common, but they can be an avoidable part of aging.

“Some females assume bladder control is a natural consequence of childbirth or aging,” he said. “But in reality, these are all treatable issues and sometimes very simple fixes.”

Dr. Miller said that both women and men can benefit from treatments that may include medications, lifestyle changes and minimally invasive procedures. He encourages those experiencing bladder control concerns to talk with their primary care doctor or urologist rather than assume it’s something they must live with.

What about erectile dysfunction? Is it unavoidable with aging?

Erectile dysfunction (ED) can occur at any age, Dr. Miller said. But it is more common as men get older.

“ED isn’t necessarily a direct result of aging. … For instance, testosterone levels naturally decline with age, which can contribute to ED. But that’s not necessarily the cause of the erectile function,” he said.

Underlying health conditions, such as heart disease, are sometimes related to ED and are more common as people age.

People with other diseases, such as diabetes, may also experience erectile dysfunction, he explained.

At any age, patients should see a doctor as soon as they start having erectile dysfunction, Dr. Miller said. Doctors can test and rule out other causes. Early treatment for erectile dysfunction is often more successful than when patients delay seeing a doctor.

Is vasectomy safe? Is it reversible?

Not only is vasectomy safe, but it’s also the “most effective form of permanent birth control,” Dr. Miller assured listeners. The outpatient procedure is performed in a doctor’s office, and recovery is quick.

Some men worry that a vasectomy might affect their sexual function or desire, but that’s not true, Dr. Miller added. Vasectomy doesn’t affect the testicles, where testosterone, the male hormone, is produced or the delivery of the hormone to the bloodstream.

Dr. Miller said that when patients ask if vasectomy is reversible, he cautions that while vasectomy reversal is possible, it is a complex procedure with no guarantees. The patient’s age, how much time has passed since the vasectomy and the partner’s fertility all influence the chances of achieving pregnancy.

“So, never count on it,” he said. “But there are other ways to achieve pregnancy, even in someone who has had a vasectomy, including retrieving sperm directly from the testicle” then attempting in-vitro fertilization.

If I have prostate cancer, does that mean I need surgery?

Advances in prostate cancer detection and treatment have changed considerably in how doctors treat the disease, Dr. Miller said.

“Up to 40% of all prostate cancers we diagnose are at least initially candidates for active surveillance,” he said. Of those, 40 to 50% will, over three to five years, require treatment. Even in those cases, he added doctors “have a lot of ‘runway.’”

“It’s like landing a commuter jet on a 747 runway. We don’t need to start at the very beginning of the runway to safely land before the runway runs out,” he said.

For some patients, that may eventually mean they are candidates for laparoscopic surgery to remove the prostate gland or parts of it that are cancerous.

Advances in diagnostic tools, such as MRIs, genetic testing and genomic testing, have also revolutionized the detection and treatment of prostate cancer, according to Dr. Miller. Genetic testing can help determine a person’s risk of developing prostate cancer, while genomic testing reveals the molecular makeup of tumors and helps guide treatment decisions between doctors and patients.

Can I change my diet to prevent kidney stones?

Dr. Miller recommends two dietary habits to help prevent kidney stones: drinking plenty of fluids and limiting sodium intake—not only table salt, but also foods high in sodium, including diet and snack foods. He advised that when you have a meal high in sodium, counter its effects by drinking extra water.

In general, “most of the things in your diet will have very little effect on your chance of having kidney stones,” Dr. Miller said.

Because calcium is one of the chemicals that makes up kidney stones, Dr. Miller said many people ask if they should avoid calcium to prevent kidney stones. In most cases, the answer is no. Women especially need adequate calcium in their diets to support bone health and reduce their risk of osteoporosis.

Find a urologist at Wellstar

Do you have questions or concerns about your urinary health? Wellstar’s expert urologists are ready to help. Visit wellstar.org/urology to learn more or schedule an appointment.

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Dr. Kathryn Potter, a dermatologist at Wellstar MCG Health Medical Center, said she had not seen the social media trend but was intrigued.

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If people are paying attention to moles, though, that’s a good thing. May is Skin Cancer Awareness Month, and while most moles are harmless, it’s good to notice them from time to time to make sure they aren’t changing, which could be an indicator of skin cancer.

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Moles are caused by melanocytes—cells that contain a dark pigment that protects your skin from UV radiation—that cluster together. But it can be confusing sometimes.

“Not all brown things are moles,” Potter said. “There can be freckles, sunspots or benign lesions called seborrheic keratosis.”

Whichever it is, if it is growing, changing shape or color, or developing irregular borders, it should be evaluated by a dermatologist.

“As far as skin cancer goes, we worry that a mole can become a melanoma—although most melanomas arise de novo, meaning they come up on their own and not through existing moles,” Potter said. “But for moles, we watch to see if they start to evolve or change.”

Potter also said most people who develop true moles will develop them before the age of 40. Moles that arise later in adulthood should be checked by a dermatologist.

You should also perform skin checks at home periodically. There are no hard and fast rules for when you should perform a skin check, but taking a few minutes to scan them is always a good idea.

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Paula Greaves, MD, chief of women’s health at Wellstar, emphasized the importance of addressing a wide range of women's health issues in the workplace.

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Other speakers included Jannine Versi, CEO of Elektra Health, and Kali Beyah, chief people officer at Spanx. They highlighted that employers need to do more than just offer health insurance. Creating wellness programs, offering mental health resources, and offering flexible work arrangements can help employees maintain a healthy work-life balance, they said.

The summit also featured insights from Dean Burke, MD, chief medical officer at the Georgia Department of Community Health; Jemea Dorsey, CEO of the Center for Black Women's Wellness, and Chadburn B. Ray, MD, professor of obstetrics and gynecology at Augusta University’s Medical College of Georgia. They discussed the challenges and solutions related to maternal health in the state and how employers can make a difference by prioritizing health and wellness.

"I want employers to understand that healthier employees are more productive," said Dr. Ray. "They take fewer sick days, experience greater happiness, and positively impact everyone they interact with throughout their day."

One of the summit's highlights was the keynote address by Lovewell, a best-selling author and Peloton instructor. Her inspiring speech resonated with the audience, emphasizing the importance of holistic health and wellness.

The event concluded with a VIP meet-and-greet and book signing with Lovewell, where attendees had the opportunity to connect with her and learn more about her wellness journey.

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There’s an undesirable side to Georgia’s natural beauty. Just ask any allergy sufferer.

In the state’s warm climate, pollen from grasses, trees and ragweed causes itching, sneezing and wheezing almost year-round.

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Seasonal allergies in Georgia

Dr. Ryan treats children and adults for various head and throat conditions, and allergies are a chief complaint.

The Asthma and Allergy Foundation of America ranked the 100 most challenging places for allergy sufferers. In 2025, Augusta ranked 12th and metro Atlanta 40th.

“When you talk about allergies and how they lead to sinus issues, this area is one of the hotbeds in the entire country,” Dr. Ryan said.

Common-sense ways to prevent and treat seasonal allergy symptoms

Dr. Ryan recommends that if you have allergies, start preventive medicines two to four weeks before the season when pollen kicks up, using:

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  • Oral antihistamines, such as Claritin (loratadine), Zyrtec (cetirizine HCl) and Allegra (fexofenadine)

“Being consistent with these things is most important,” Dr. Ryan said. “You need to do them every day for the maximum benefit.”

Even then, allergy symptoms can break through. In those cases, Dr. Ryan recommends adding:

  • Antihistamine eyedrops such as Pataday
  • Saline sprays and rinses to wash irritants from your nose and sinuses

Aside from medications, Dr. Ryan described extra steps allergy sufferers can take to reduce their discomfort:

  • Check pollen counts daily and limit your time outside when they are high.
  • Use HEPA air filters in every room inside your home.
  • Service heating and air-conditioning units and change out filters regularly.
  • Take off your shoes and possibly change clothing when coming indoors from outside.
  • Shower before bedtime to prevent pollen from getting into your bed.

Indoor allergens also stir up symptoms

Another culprit causing allergy symptoms is dust mites. These microscopic, insect-like pests feed on flakes of dead skin or dander shed by humans or pets. A caller on The Weekly Check-Up described having itchy ears at night, which Dr. Ryan said could be caused by an allergy to dust mites.

“We call these year-long or perennial allergies,” he said. “And patients need year-round treatment. Changing your pillows, wrapping your mattress, washing bedding frequently and putting HEPA filters in the room can help.”

Even Dr. Ryan has a routine to prevent discomfort from particles or pollutants that might have crept into his nose. “Before bed, I spray my nose with normal saline to get a moisturizing coating. You can also flush out your nose using a neti pot or other irrigation system,” he said.

“As soon as you lie flat (in bed), all the blood flows to your head, and you’ll get a little more swelling in your nose. We call that nasal cycling. If you’ve already picked up all those irritants over the day, you’re just putting gasoline on a fire.”

Is it allergies, a virus or a bacterial infection?

In peak allergy season, Dr. Ryan’s schedule is full of patients with nasal congestion, runny noses and facial pain and pressure. But not all are suffering from allergies. Some may have a cold or another virus. In rarer cases, they may have a bacterial sinus infection.

“The thing that separates viral infections from allergies is usually fevers and a feeling of malaise,” he said. “Typically, a patient with a bacterial sinus infection has those symptoms plus a heavy yellow or brown nasal drainage.”

Dr. Ryan noted that even in the last case, a provider won’t jump quickly to prescribe antibiotics. “Those symptoms need to last for seven straight days, or you need to get worse over those five to seven days before we start to worry that you need an antibiotic.”

OTC medicines for congestion, cough and pain usually relieve symptoms of viral and bacterial infections. Patients should also drink plenty of fluids and use a saline spray to prevent infection from the buildup of fluids caused by a cold or allergies.

“We have to be very smart about when we give antibiotics,” Dr. Ryan said. Healthcare experts have concerns about the mounting evidence that overuse of antibiotics is breeding “antibiotic resistance.” Bacteria can adapt and evolve, becoming immune to antibiotics. That can become life-threatening if someone has an infection that antibiotics can’t treat.

Find a Wellstar ENT specialist

Allergies are just one of many ear, nose and throat conditions that Dr. Ryan diagnoses and treats. Others include:

  • Acid reflux
  • Cancers of the head and neck
  • Hearing loss
  • Sleep apnea

Learn about our ENT services and find a Wellstar doctor near you.

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