Taking a humanistic approach to treating patients with urological diseases
UH Innovations in Urology - Fall 2018
ADAM KLEIN, MD
Urologist, UH St. John Medical Center
Adam Klein, MD, is acutely aware that talking about urologic problems can be very uncomfortable for most people, and he approaches patient care accordingly. That’s good news for patients at University Hospitals St. John Medical Center, a Catholic hospital, where Dr. Klein recently began practicing.
A native Philadelphian, Dr. Klein attended Penn State University and completed his medical training at Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania. He fulfilled his urologic residency at Buffalo General Medical Center.
During his residency, Dr. Klein’s fiancé was doing her medical training in Cleveland, Ohio.
“We were apart during our residencies, and the position at UH was a great opportunity to join forces and plant roots together,” he says.
WORDS AND RELATIONSHIPS MATTER
Dr. Klein says he likes urology, in part, because of the delicate nature of the topic. “I get to talk about sensitive things all day and make people feel more comfortable than they might otherwise,” he says. “It takes the right blend of levity and gravity, I think.”
Relationships matter, too, whether they span years or just long enough to address a patient’s problem successfully. “There’s a broad spectrum in terms of the relationships I can form,” Dr. Klein explains. “I get to treat men, women and even some children. I’m not sure there are many fields that offer the sort of breadth that urology does.”
Dr. Klein adds that he takes “a very humanistic approach” to medicine.
“I have to remember that what’s routine and daily business for me is very dramatic for people who’ve not experienced things like blood in their urine, a kidney stone or a new cancer diagnosis,” he says. “It’s important not to forget those things as we move through our busy days. These experiences resonate with people.
“I read that people only remember, on average, about 20 percent of what they heard in a doctor’s office, so it’s important to make that a meaningful 20 percent.”
TREATING BENIGN PROSTATIC HYPERPLASIA (BPH)
Although Dr. Klein is a general urologist and treats the full gamut of urologic conditions — including voiding problems, erectile dysfunction, hypogonadism and cancer — he’s especially interested in BPH and kidney stones.
Dr. Klein jokes that BPH problems are a privilege of reaching a certain age, as all men experience it to some extent. He is fascinated by the diversity in how BPH presents itself. “I’ve seen prostates the size of a grapefruit and prostates the size of a walnut,” he says. “The size of the prostate does not correlate to urinary symptoms. It depends on how much obstruction there is at the bladder outlet.”
Although BPH is benign, left untreated, it can lead to bladder failure and kidney damage. “It’s not just a peeing problem,” Dr. Klein notes.
The UroLift procedure is one of the more recent additions to the BPH treatment armamentarium, and one in which Dr. Klein is trained. UroLift is a minimally invasive treatment for an enlarged prostate. “We use a few small sutures to pull obstructing growths of the prostate apart, like curtains, to open the aperture from the bladder neck, so the lumen is wider and there’s less pressure,” he says. “It makes it easier for the bladder to empty.”
This is both a remarkable and novel approach, Dr. Klein explains, adding that new outcomes data about UroLift are extremely favorable.
“The nice thing about UroLift is that people are not laid up for very long and it’s minimal in terms of irritating symptoms afterward,” he says. “Part of what makes it so unique is that there’s no tissue destruction. Patients get back to their daily lives rapidly and get off their medications, which can be intolerable for some people in terms of side effects, inconvenience and cost. It’s a rapid, effective and durable solution.” Furthermore, says Dr. Klein, UroLift does not take other potential BPH treatments off the table if someone’s symptoms devolve over time.
Dr. Klein is also interested in treating patients with kidney stones, and helping improve their quality of life.
“I enjoy surgically removing stones and getting patients stone free,” he says. “But the metabolic aspects of recurring stone formers are fascinating in terms of treating them and trying to find what predisposing factors patients have. There are all types of stones and metabolic environments we can alter through diet and medicine. It’s rewarding to modulate that combination of factors to get achievable, durable results.”
To make an appointment or discuss a patient case with Dr. Klein, call UH St. John Medical Center Urology at 440-617-4726.