Mar 20, 2026
3 min read
Prevention and early diagnosis can make the difference, especially when it comes to very common pathologies such as benign prostatic hypertrophy or prostate cancer.We talked about it with an expert
Why do many men still neglect examinations?Men's urological health continues to be one of those topics that is too often postponed, underestimated or addressed only when the first warning signs appear.However, prevention and early diagnosis can make a difference, especially when dealing with very common pathologies such as benign prostatic hypertrophy or prostate cancer.
Shining the light on the importance of prevention is an initiative sponsored on the occasion of Father's Day by the Friends of the URI ETS Foundation, a non-profit organization created to promote research in urology and oncology, both male and female, supporting the work of the Urological Research Institute (URI) at the IRCCS San Raffaele Hospital in Milan.Together with the historic fashion house E. Marinella, it has announced a special fund for search, which works until March 19, to support research on urological diseases, which can be supported by purchasing a special hardback edition.
To shed light on some of the most important issues in men's urological health, we spoke to Giorgio Gandaglia, chief assistant urologist at the Department of Urology at the IRCCS San Raffaele Hospital and associate professor of urology at Vita-Salut San Raffaele University.
Men often tend to postpone medical examinations: how much is this attitude towards late examination of urological pathologies?
«Men tend to postpone or avoid medical and urological examinations due to cultural factors: compared to women, who usually undergo examinations at the same time as annual gynecological visits, people turn to specialists only when clear symptoms are detected.Oncology like prostate cancer increases with age.That's why it's important to carry out urological evaluations every time to consider the risk factors, the impact of the symptoms on the quality of life and special visits.
What are the basic tests that a man should do regularly to maintain his urinary health?And at what age is it appropriate to start?
"It is important for men to pay attention to the prevention of urological diseases, which means adopting a healthy diet and lifestyle and getting tests to diagnose these problems early. A basic urological examination at age 40, periodic check-ups, allows you to monitor any symptoms and risk factors. When considering cancer risk, prostate cancer is the most common form in men in Western countries. Monitoring this biomarker can detect prostate cancer at an early stage, allowing for less aggressive treatment until full recovery.And a favorable clinical outcome is achieved Individual follow-up based on the individual patient's characteristics does not require annual PSA testing in those with prostate cancer and gene mutations such as BRCA2.
What are the signs or symptoms that should never be underestimated?
"As mentioned, many kidney pathologies are initially bad and secret symptoms. After a while, some patients consider "normal" conditions such as difficulty urinating, waking up at night or not completely emptying the bladder and the need to urinate. In some cases, these conditions can continue with urinary retention and require the use of a bladder catheter to perform kidney function. It is emphasized because it is an early symptom of tumor disease, especially of the bladder and kidneys and should always be investigated."
What are the most common urological diseases in clinical practice today?
The development of prostate hypertrophy is common in men, which occurs with urinary disorders from the age of 50-60.It is a rare problem that, however, can significantly affect quality of life and often requires drug treatment or, in some cases, surgical treatment aimed at relieving symptoms and preventing long-term complications.This condition must be differentiated from prostate cancer, which in men in Western countries is the most common solid neoplasm, both in terms of incidence (number of new cases per year) and prevalence (number of affected people).Fortunately, this is a form of cancer that is often treatable with excellent results.In recent years we have also seen a significant increase in the incidence of kidney cancer, for example cases identified during tests for other reasons.It's often a small kidney mass that can be seen or treated surgically with better results."
Prostate cancer remains one of the biggest concerns in men's health: where are we today in terms of early diagnosis and treatment options?
"Recently, we have seen significant advances in the diagnosis and treatment of prostate cancer. In most cases, it is an asymptomatic type of cancer that is detected after an increase in the PSA level in the blood test. In the past, patients with an elevated PSA level were almost automatically tested for prostate cancer. Today, we have more modern tools, such as prostate MRI and new biomarkers, that allow us toto identify patients with high clinical cancer types and in need of treatment.Over time, these tools allow us to avoid unnecessary biopsies in almost half of the cases, in terms of treatment possibilities, we have seen important innovations in the field of surgery and radiology.These methods are shown in patients with tumors and allow to obtain good long-term results and the possibility of obtaining good oncological results and maintaining quality of life.unique has also become widespread, which allows removal of the prostate through a single incision as small as 3 cm below the navel facilitates postoperative recovery.
In recent years, there has been much discussion about issues related to male fertility and erectile dysfunction.Are these phenomena increasing?Which factors have the greatest impact?
"These are problems that are often seen today because there is a great awareness and patients often ask for help from professionals. There are also factors related to health and social changes, such as the increase in the age at which men are wanted, smoking, metabolic diseases, obesity, sedentary lifestyle and stress, which can affect the production of men and the appearance of sexual diseases. For these reasons, the causes of urological examination and the necessary methods of obtaining treatment and the necessary methods of obtaining treatment.
How much lifestyle (diet, sedentary lifestyle, smoking, stress) leads to the development of urological pathology?
"Lifestyle plays a very important role in the development of various urological pathologies. Smoking is the main risk factor for urinary tract tumors, especially bladder, upper urinary tract and kidney tumors. However, it is not yet clearly linked to prostate cancer. Therefore, it is important to raise awareness in this area. Other factors, such as diet, inactive lifestyle and stress, can affect the risk of neoplastic diseases and their development, as well as benign conditionssuch as erectile dysfunction and benign prostatic hypertrophy.It is generally recommended to have a healthy lifestyle, to avoid smoking, to maintain an adequate body weight, to exercise regularly and to follow a balanced diet: habits that not only improve the general state of health, but also reduce the risk of developing urological diseases, as well as their progression.
How is research changing today's diagnosis of urinary tract disease?What are the most promising advances in innovative therapy?
"Over the years, research has introduced many discoveries that change the diagnosis and treatment of urological diseases. New indicators are available that help to identify patients who are at high risk of cancer and therefore need to undergo further diagnostic tests. At the same time, new tracks have been developed for molecular imaging, for example in PET, which provides a more accurate diagnosis with various types of urological tumors. The same molecular targets, allowing more and more targeted treatments. In addition, the concept of precision medicine, based on the analysis of genetic changes, ismore and more widespread in urology In some patients with prostate cancer, for example, today we can learn the presence of genetic mutations such as BRCA1 and BRCA2 (especially with breast cancer) which allows us to choose breast cancer telemedicine platforms, i.e. the possibility of implementing remote interventions, represents a new frontier in the field of urology Finally, the role of artificial intelligence should be emphasized, which can help us in diagnosis and planning treatment There is already a program capable of interpreting images ofradiology, improving diagnostic accuracy and providing traditional functional models, allowing treatment customization.
What are the main problems in the management of urinary tract infections?Late diagnosis, access to screening, lack of information?
"At the moment, there is no national screening program for urological cancers. However, there are several studies and initiatives underway in Europe and Italy to assess the effectiveness of screening programs, especially for prostate cancer. Another important aspect concerns patient information and awareness. In many cases, reluctance or discomfort to undergo a urological examination can delay the diagnosis of the condition, which is often detected early and treated."
From your clinical and scientific observatory, are there any new trends or epidemiological changes that particularly concern you?
"Despite the availability of increasingly accurate diagnostic methods and effective therapies, in some cases there are still obstacles to accessing care which can lead to delays in the diagnosis or treatment of potentially curable pathologies. It should also be considered that, with the progressive aging of the population, the prevalence of urological pathologies, both benign and malignant, is destined to increase in the coming years, making the role of prevention and early diagnosis increasingly important. Finally, it is essential to develop studies that evaluate the impact of the therapies available even outside ofborders clinical studies, where the patient population is often very selected and free of comorbidities typical of the "real world".This field, defined as Real World Evidence based on the use of big data, represents one of the most interesting aspects of current research and will allow us to further improve clinical practice in urology.
