Keeping It Up with Dr. Mehan

Erectile dysfunction deserves more than a prescription.

A stronger pill may not address the underlying cause.

In Episode 9 of Keeping It Up with Dr. Mehan, Dr. Rahul Mehan explains how he evaluates erectile dysfunction, from blood flow and heart health to sleep apnea, hormones, and performance anxiety. He covers the tests he orders, Viagra versus Cialis, medication safety, and lifestyle changes that may help. This is part one of a two-episode series on understanding and treating ED.

Fill out yourSHIM score sheet: https://www.rohbaltimore.com/SHIM.pdf

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Chapters

0:00 - ED Treatment Starts With the Cause

0:53 - Why Erections Fail

2:17 - What Age Can Tell Us About ED

3:08 - Nitric Oxide: How Erections Work

3:50 - ED and Heart Health

7:21 - Blood Pressure, Cholesterol, and ED Testing

8:58 - Sleep Apnea and Erectile Dysfunction

11:28 - Five Questions a Urologist Asks

13:15 - Anxiety, Depression, and Erections

15:26 - Your SHIM Score Explained

16:31 - When Penile Doppler Ultrasound Helps

18:02 - Lifestyle Changes That Can Help

18:43 - Exercise and Erectile Function

20:32 - Weight Loss and ED

22:15 - Viagra vs. Cialis

23:05 - Why ED Pills May Not Be Working

23:51 - ED Pill Safety and Drug Interactions

26:07 - Online ED Care: What to Consider

28:00 - Common Viagra Side Effects

28:54 - Daily Cialis Side Effects

29:53 - Why Dr. Mehan Often Prescribes Daily Cialis

32:18 - ED Pills and Heart Health Research

33:15 - Cialis Before the Gym: What We Know

34:19 - Your Next Steps for ED

Prostate cancer treatment does not always mean weeks of daily visits and your sex life belongs in the decision, too.

In Episode 8 of Keeping It Up with Dr. Mehan, Dr. Rahul Mehan welcomes radiation oncologist Dr. Ankit Agarwal to explain brachytherapy, a seed implant procedure that can take 20 to 30 minutes. They discuss how it compares with surgery and other radiation options, who may be a candidate, and what men should know about erections, ejaculation, urinary symptoms and hormone therapy. Treatment plans vary with cancer risk and baseline function.

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Chapters

0:00 - A Single-Day Prostate Cancer Procedure

0:23 - Prostate Cancer Treatment and Your Sex Life

3:36 - Brachytherapy, SBRT and Other Radiation Options

9:02 - SBRT vs. Brachytherapy: What the Evidence Shows

11:00 - Why Radiation Can Cause Erectile Dysfunction

13:13 - Testosterone, ADT and Sex Drive

17:35 - Orgasms, Ejaculation and Erections After Treatment

22:21 - Who Benefits Most From Brachytherapy?

24:52 - Why Is Brachytherapy Hard to Find?

25:58 - How Long Does Brachytherapy Take?

27:10 - Who Is Not a Good Brachytherapy Candidate?

32:08 - How Modern Seed Implants Have Changed

33:57 - Low-Dose vs. High-Dose Brachytherapy

36:29 - Urinary Side Effects and Recovery

39:48 - Could Brachytherapy Mean Less Hormone Therapy?

42:10 - The FLAME Study: Targeted Radiation Boosts

44:05 - Rapid Fire: Radiation and Surgery Myths

48:57 - Radiation Safety and Sex After Brachytherapy

51:10 - What If Prostate Cancer Comes Back?

53:34 - Can Radiation Cause Another Cancer?

He could handle an operating room, yet this new exercise made him nervous.

One unfamiliar workout challenged more than his fitness.

In Episode 7 of Keeping It Up with Dr. Mehan, Dr. Rahul Mehan welcomes professional ballroom dancer Gergana Slavova to explore dancing for men over 40, from balance and brain health to confidence and connection. They discuss research on mood and mobility, why men fear looking foolish, and what happens in a first dance class. Dr. Mehan shares how learning to dance changed his posture and confidence, while Gergana explains how couples can build a closer connection.

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Chapters:

0:00 - The Workout Men Are Too Embarrassed to Try

1:59 - Gergana Slavova's Ballroom Dancing Journey

5:24 - What Dancing Adds to Your Workout

8:51 - Dance Research: Balance and Fall Risk

10:00 - Dr. Mehan's Dancing With the Stars Story

12:43 - The Brain Workout Behind Dance Routines

18:28 - Dancing and Men's Mental Health

26:27 - Can You Dance Without a Partner?

28:43 - Why Men Are Afraid to Dance

32:12 - Can Anyone Learn to Dance?

32:59 - Dance Skills, Confidence and Attraction

36:44 - Ballroom Dancing for Married Couples

38:49 - Does Dancing Make You Better in Bed?

39:41 - Who Should Try Dance Lessons?

41:20 - Your First Dance Class: What to Expect

43:42 - Choosing Your First Dance Style

45:57 - Too Embarrassed to Dance? Start Here

Great sex takes more than a strong erection.

Penis size and penetration are only small, or big, part of the conversation.

In Episode 6 of Keeping It Up with Dr. Mehan, Dr. Rahul Mehan and female urologist Dr. Suelyn Hall compare perspectives on what men get wrong in bed. They discuss porn and erections, testosterone and low libido, orgasm, and why intimacy and communication matter to a partner's pleasure. The conversation also explores mismatched sex drives, stress, masturbation, pelvic floor therapy, and sexual health in your 40s, 50s, and beyond, with candid stories from their practices.

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Chapters:

0:00 - Preview: Size, Erections and Better Sex

0:26 - Male vs. Female Urologist: Who Understands Men?

4:42 - Rapid Fire: Erections vs. Intimacy

5:46 - Testosterone and Low Libido

6:44 - Does Penis Size Matter?

7:59 - Is Porn Bad for Erections?

9:22 - What Morning Erections Can Tell You

10:12 - Penetration, Orgasm and What Women Want

13:02 - Do Men Peak Sexually in Their 20s?

15:44 - When Partners Have Different Sex Drives

17:47 - Why Couples Avoid Talking About Sex

19:37 - How Often Do Couples Have Sex?

21:30 - Social Media, Body Image and Sexual Expectations

24:24 - Should Couples Schedule Sex?

24:56 - Fitness, Confidence and Sex

26:00 - GLP-1s and Libido: What They've Observed

27:32 - Dr. Hall's Career as a Female Urologist

31:09 - Writing About Male Sexual Pleasure

35:14 - Stress and Sexual Performance After 40

36:34 - Masturbation and Sexual Function

38:36 - When Sex Hurts

39:10 - Pelvic Floor Therapy for Men and Women

40:33 - Why Orgasms Can Take Longer With Age

41:43 - Great Sex in Your 60s and 70s

Prostate cancer care goes beyond a Gleason score.

Your cancer’s biology could change your treatment options.

In Episode 5 of Keeping It Up with Dr. Mehan, Dr. Rahul Mehan joins medical oncologist and hematologist Dr. Wishwdeep Dhillon to explore genetic testing, biopsy warning signs, PSMA-targeted radiation with Pluvicto, and research on hormone therapy before surgery. They discuss why some men may need a team approach earlier, where focal therapy fits, and how treatment decisions balance cancer control with sexual function, urinary health, and quality of life.

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Chapters

0:00 - A New Era of Prostate Cancer Care

0:38 - Meet Dr. Wishwdeep Dhillon

3:58 - Same Gleason Score, Different Cancer Risk

5:20 - What Your Prostate Biopsy Can Reveal

9:49 - Can AI Help Assess Prostate Cancer Risk?

12:01 - Germline vs. Somatic Genetic Testing

15:28 - PARP Inhibitors and Earlier Treatment

21:11 - Tests Your Oncologist Wants to See

21:58 - Prostatectomy: Sexual and Urinary Side Effects

24:40 - Who Needs Surgery, and Who Can Wait?

26:31 - Active Surveillance and Focal Therapy

27:47 - Focal Therapy: Evidence and Insurance Barriers

33:53 - PSMA: From Finding Cancer to Targeting It

37:25 - Combining Treatments for Advanced Prostate Cancer

41:14 - PROTEUS: Hormone Therapy Before and After Surgery

45:47 - A High-Risk Patient and Treatment Before Surgery

48:58 - Ivermectin: What These Doctors Have Seen

50:38 - Diet, Exercise, and Hormone Therapy Side Effects

52:40 - Rapid Fire: PTEN, BRCA2, and Genetic Testing

55:39 - Actinium Trials: What Could Come Next?

55:59 - Why Earlier Oncology Involvement Matters

Optilume BPH and UroLift take different paths to better urine flow.

Implants, recovery, and sexual function can shape the choice.

On episode 4 of Keeping It Up with Dr. Mehan, Dr. Rahul Mehan compares Optilume's drug-coated balloon with UroLift's permanent implants for enlarged prostate symptoms. He explains who may be a candidate, what the PINNACLE trial found, and why results from separate studies do not prove one procedure is better. The discussion covers ejaculation, paclitaxel and family planning, catheter use, bleeding, recovery, and the possibility of needing treatment again.

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Chapters:

0:00 - Optilume BPH vs UroLift

0:56 - How Optilume's Drug-Coated Balloon Works

2:53 - Paclitaxel and Family Planning

4:26 - Permanent Implants vs No Implant

5:09 - Who Is a Candidate for Optilume BPH?

6:32 - Who Should Not Have Optilume BPH?

8:06 - Optilume Results: Symptoms and Urine Flow

10:04 - Ejaculation and Erectile Function

12:05 - Why Comparing Optilume and UroLift Is Difficult

13:20 - Retreatment Rates: What the Numbers Mean

15:11 - Dr. Mehan's Ideal Optilume Candidate

16:00 - When Another BPH Procedure May Be Needed

17:18 - Office Procedure or Operating Room?

18:10 - Catheters and Bleeding After Optilume

20:25 - Recovery: Urgency, Burning, and Urine Flow

21:44 - Optilume BPH: Pros, Cons, and Evidence Gaps

24:22 - Optilume vs UroLift: Dr. Mehan's Take

Waking up to pee every night should not run your life. An enlarged prostate is only ONE possible cause.

On episode three of Keeping It Up with Dr. Mehan, Dr. Rahul Mehan breaks down nocturia, weak urine flow, and other enlarged prostate (BPH) symptoms. He walks through a first urology visit in his practice, from symptom scores to bladder and prostate tests, and explains why fluid intake, sleep apnea, and diabetes matter. The discussion covers medication benefits, sexual side effects, and when a procedure may be considered, with a focus on long-term bladder health and quality of life.

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Chapters:

0:00 - Why You're Waking Up to Pee

1:24 - What the Prostate Does

3:38 - Prostate Size, Shape, and Urine Flow

6:29 - Recognizing Enlarged Prostate Symptoms

8:11 - Nighttime Urination and Lost Sleep

8:53 - How Prostate Blockage Affects the Bladder

13:44 - Your First Urologist Visit

15:00 - What Your Urinary History Reveals

16:23 - IPSS: How Severe Are Your Symptoms?

17:51 - What a Prostate Exam Checks

19:07 - Watchful Waiting for BPH

20:52 - BPH Medications and Their Tradeoffs

23:39 - Finasteride and Sexual Side Effects

25:42 - PDE5 Inhibitors for Urinary Symptoms

27:45 - Is Your BPH Medication Working?

28:34 - When to Consider a Prostate Procedure

30:38 - Tests Before a Prostate Procedure

33:19 - Measuring Urine Flow at Home

34:12 - Cystoscopy: Looking for the Cause

36:44 - Preparing for Your Follow-Up Visit

Vanquish brings water vapor ablation into the prostate cancer treatment conversation.

Its inventor spent 26 years pursuing a more targeted approach designed to limit exposure to nearby nerves and urinary structures.

In Episode 2 of Keeping It Up with Dr. Mehan, Rahul is joined by Dr. Michael Hoey, founder and CTO of Francis Medical, to explain how Vanquish differs from Rezūm, how vapor moves through prostate tissue, and why nerve protection, urinary control, erectile function, recovery, MRI, ultrasound and AI matter when men evaluate emerging prostate cancer technology.

For more on Vanquish and Francis Medical, visit: https://www.francismedical.com/

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Chapters

0:00 - Why His Father’s Prostate Cancer Inspired Vanquish

1:11 - How a Farm Built a Medical Device Inventor

7:06 - How Was Water Vapor Ablation for the Prostate Invented?

9:26 - The Family Loss That Turned Research Into a Mission

11:35 - Why Existing Prostate Ablation Methods Fell Short

12:40 - How a Race Car Inspired Water Vapor Ablation

15:02 - How Does Water Vapor Ablate Prostate Tissue?

17:38 - What Dr. Mehan Has Seen in Early Vanquish Cases

20:07 - What Did Early Vanquish Patients Report?

22:25 - Why Did Vanquish Take 26 Years?

26:25 - Why BPH Came Before Prostate Cancer

29:16 - The Mission-Driven Team Behind Francis Medical

30:31 - Inside the Planning Behind a Vanquish Procedure

34:55 - Rezūm vs. Vanquish: What’s the Difference?

40:49 - How Is Vanquish Designed to Protect Nearby Nerves?

46:24 - How Is Vanquish Designed to Protect Urinary Control?

50:04 - Vanquish Rapid Fire: Myths, Failures, and Firsts

52:37 - Why Persistence Mattered More Than Intelligence

57:05 - What Still Amazes the Inventor of Vanquish?

59:30 - Reaching the Prostate Apex and Anterior Region

1:01:49 - What’s Next for the Vanquish System?

1:03:46 - How Could AI Shape Future Vanquish Procedures?

1:07:53 - Why Francis Medical Is Named After His Father

The biggest BPH treatment mistake may happen before a procedure is ever chosen. Most men never hear the full range of enlarged prostate treatments available to them.

In Episode 1 of Keeping It Up, urologist Dr. Rahul Mehan explains 16 treatment options, including minimally invasive procedures, TURP, HoLEP, GreenLight, Aquablation and emerging technologies. Discover how approaches differ in invasiveness, durability and potential effects on sexual function, so you can discuss your options with your urologist. Subscribe for clear, physician-led men's health education.

Chapters:

0:00 - The Biggest Mistake Men Make With BPH Treatment

0:32 - Why Dr. Mehan Created This Men’s Health Channel

1:35 - Are You Hearing All Your Enlarged Prostate Options?

2:31 - The 3 Types of Enlarged Prostate Treatments

3:10 - Can BPH Be Treated in Under 10 Minutes?

3:59 - 6 Minimally Invasive BPH Procedures

4:33 - What Are the Traditional BPH Surgeries?

5:56 - 5 Emerging Technologies for Enlarged Prostates

7:32 - What Should Dr. Mehan Explain Next?

Prostate health, testosterone, and erectile dysfunction care are entering a new era.

Welcome to Keeping It Up with Dr. Mehan. In Episode 0, Urologist Dr. Rahul Mehan explains how modern care is changing enlarged prostate treatment, prostate cancer care, ED, low testosterone, fertility, urinary leakage, and kidney stone prevention. Learn about newer procedures, focal therapies, hormone options, and the links among sexual health, sleep, fitness, heart health, and longevity so you can ask better questions about your care.

Follow Dr. Mehan:

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Chapters:

0:00 - Why Men’s Health Treatments Are Changing Fast

0:57 - Who Is Dr. Rahul Mehan?

3:00 - Inside the Clinical Trials Changing Urology

4:33 - How Are Men’s Health Problems Connected?

5:48 - Why Doctors Must Fight Medical Misinformation

6:58 - Why Men’s Health Needs More Than 60 Seconds

7:57 - What Does “Keeping It Up” Really Mean?

8:25 - Why Modern Urology Has Left Old Treatments Behind

8:56 - Can BPH Treatment Preserve Sexual Function?

9:49 - What Are the Newest Prostate Cancer Treatments?

10:46 - How Is Erectile Dysfunction Treated Beyond Viagra?

11:22 - Low Testosterone Treatment and Fertility Preservation

12:01 - What Are the New Treatments for Urinary Leakage?

12:14 - How Can You Treat and Prevent Kidney Stones?

12:48 - Why Men Ignore Their Health Until a Crisis

13:27 - How Sleep, Diet, and Exercise Shape Men’s Health

14:03 - Inside Dr. Mehan’s Personal Health Routine

15:20 - How Would a Urologist Treat His Own Prostate?

15:37 - Why Active Clinical Experience Matters

16:14 - What Can Real Patients Teach Us About Treatment?

16:35 - What Sexual Health Reveals About Your Overall Health

17:24 - Ask Dr. Mehan Your Men’s Health Questions