Ask the Doctor: Brian Cohen, MD, Talks about Urology and His Medical Philosophy (Video)

Q. What attracted you to urology?
A. In medical school, I thought that I wanted to do plastic surgery. I liked the reconstruction aspect. I did a rotation in plastic surgery, and hated it. I did a rotation in urology, and it allows you to do reconstruction and be creative. For example, we do a reconstruction procedure where I take a graft from the inner lining of the cheek from inside the mouth and use that to repair the urethra. It’s not just giving someone medication. Sometimes, that works for some people and it doesn’t work for others. There’s different ways of treating the same issue that require you to think outside of the box and be creative.

Q. What kind of training to you have?
A. I did my residency in urology at the University of Miami in Florida. I did a one-year fellowship in female pelvic medicine and reconstructive surgery. I am board certified in urology, and I have a subspecialty certification in female cervical medicine reconstructive surgery.

Q. What do urologist do?
A. We take care of a lot of different problems — anything from kidney cancer, prostate cancer, bladder cancer, kidney stones, problems passing urine and enlarged prostates. About 50 percent of my practice is female pelvic medicine and reconstructive surgery. And, I do a lot of male reconstruction and incontinence reconstruction on both men and women. I also treat pelvic organ prolapse.

Q. What are some of the signs of urological problems?
A. Blood in the urine is one thing that we see that always requires a urological evaluation.

Q. When would a primary care doctor send a patient to a urologist?
A. They would send someone to me if they’ve got incontinence or a kidney stone. If they do a pelvic exam and find prolapse or there’s an abnormal PSA [prostate-specific antigen] test. If men have difficulty passing urine.

Q. Do you perform a lot of reconstructive surgeries?
A. I do a fair amount of them. In men, I do a urethral reconstruction called urethroplasty. I also do surgery for pelvic organ prolapse for women whose bladder has dropped.

Q. How has COVID-19 affected your work?
A. Since elective surgery opened up at the end of April last year, everything has been pretty much practice as normal. Everybody wears a mask. All patients go through the screening questions and get their temperature taken. We’re limiting the number of people allowed in the hospital during surgeries.

Q. Why is it important that you also have an office in Transylvania and Brevard?
A. I’m 60-40 percent in Asheville and the region. Being able to offer specialized services to people closer to home, rather than having to drive forty-five minutes to Asheville, is something that they certainly appreciate.

Q. What is your medical philosophy?
A. My philosophy is if two individuals have the same issue, there could be different solutions for each of them based on their home life, their profession and what they want to do in life. I deal with a lot of quality of life issues. Helping people restore normal function, such as when passing urine is out of whack, gives you a real appreciation for the human body and how things work. I appreciated the simplicity of it and the things that we take for granted.

Brian Cohen, MD, is a urologist with Mission Urology.

Click to learn more about Mission Urology services [1] or schedule an appointment with Dr. Cohen, call 828-254-8883 or 828-883-5858 at Mission Urology – Brevard.