Frequently asked questions

Roscoe Nelson, MD, a board-certified urologist and Fellow of the American College of Surgeons. He has spent more than 30 years in urology, a specialty where hormones and the endocrine pathways run through everything, from the adrenal gland and parathyroid to the hypothalamus, pituitary and gonads.

PeeDoc is an education site. The goal is straight answers about hormones, sexual health, urinary health, weight, and aging, written by a physician rather than a marketing department. Here is what we know, here is what we do not, here are the reasonable options.

Undergraduate at Brigham Young University, where he graduated in 1989 as valedictorian of his college. Medical degree at the University of California San Diego, and general surgery and urology training at the University of California Davis. He is board-certified in urology and a Fellow of the American College of Surgeons.

Yes. He sees patients in Utah through Peri Health & Hormones. He also serves as Chief Medical Officer of Options Medical Weight Loss. National medical leadership reaches a lot of people, but it does not replace sitting down with one patient and seeing their life improve, which is why he continues direct patient care.

After about 26 years practicing in Arizona, he moved to Utah in 2024 to be closer to his children and grandchildren. Family was the reason. The move also opened the door to a new chapter of direct patient care.

Hormone care, including HRT, perimenopause and menopause, and testosterone. Sexual health. Medical weight management. Hair restoration. Complex and recurrent urinary tract infections. Vasectomy. Complex urologic second opinions, which are welcome. Complex voiding dysfunction. Kidney stones, including stone prevention. And minimally invasive treatment for an enlarged prostate.

Kidney stones, yes, including the prevention side, which is where a lot of the value is and where most patients never get a real workup. Enlarged prostate, yes, with the minimally invasive treatments. Complex voiding dysfunction and complex urologic second opinions, also yes. What he does not do is general full-service urology, and prostate cancer treatment is not part of his current practice. The Urology Library on this site covers those topics because the education is still useful.

PeeDoc is the education site and Dr. Nelson's personal physician brand. Peri Health & Hormones is the clinical practice where he actually sees patients. If you are reading, you are on PeeDoc. If you want to become a patient, you are looking for Peri.

The usual definition is two or more infections in six months, or three or more in a year. If that describes you, the goal is not just treating the next infection. It is understanding why they keep happening.

No. It means nothing grew in a dish, using a method designed in the 1950s, and that is a much narrower fact than you have been led to believe. Low counts, slow growers and bacteria embedded in biofilm routinely slip past a standard culture. Better tools exist now, molecular tests like PCR and next generation sequencing, and I order them routinely. A negative culture with real symptoms is a reason to look harder, not a verdict that nothing is wrong. You were never imagining it.

The honest answer is that it depends on why yours keep coming back, which is why the evaluation matters more than any single product. But a few things carry real weight.

One step I have seen pay off again and again: make sure the urine is actually sterile first, with PCR or next generation sequencing, before stepping down to the gentler preventive options. Prevention layered over an infection that never cleared is set up to fail.

For postmenopausal women, vaginal estrogen is the most effective preventive option we have and the most consistently overlooked. Falling estrogen thins the tissue of the vagina and urethra, raises vaginal pH and lets the protective bacteria decline. Restoring it treats the reason the infections started rather than the infection in front of you.

Methenamine hippurate, usually taken with vitamin C, is a real alternative to daily antibiotics. Cranberry helps in selected patients, but only when it is standardized to around 36 mg of proanthocyanidins, since the word cranberry on a label tells you almost nothing. Some people have success with D-mannose, particularly against E. coli, though the evidence there is thinner than the enthusiasm.

The unglamorous things matter as much as any of that: drinking enough, emptying the bladder regularly and completely, treating constipation, and pelvic floor physical therapy where it is indicated.

Preventive antibiotics do have a place, but they should be a deliberate choice rather than the default. Every repeated course makes the next infection a little harder to treat.

Because the tissue changes that come with declining estrogen directly affect the vagina, urethra, and bladder. That is a large part of why urinary infections become more common after menopause, and it is why hormone-directed treatment is often part of prevention rather than an afterthought.

Yes. Vasectomy remains an active part of his practice and he performs the procedure personally.

It is an office procedure with laughing gas from start to finish. The gas keeps you relaxed, and the no-needle local does the numbing: the anesthetic goes in with a jet injector rather than a syringe, and most men describe it as the snap of a rubber band on the skin. Instead of cutting, a small instrument makes a single opening a few millimeters across, so there is no scalpel and nothing to stitch.

The whole thing takes under fifteen minutes, you go home the same day, and most men are back to a desk job in a day or two. Bring a jock strap and arrange a driver. Most men say the same thing when we finish: was that it?

Plan for it rather than improvising, because the men who take the first two days seriously do considerably better.

For the first two days: jock strap, ice and minimal activity. Frozen corn or peas work better than an ice pack because they mold to the right shape. Ice matters more than men expect and it is the single thing that most changes how the first forty eight hours feel.

For the first week: light duty with the jock strap staying on. No lifting, no workouts, no long days on your feet.

After that most men are back to normal activity.

No. A vasectomy divides or blocks the vas deferens. It does not remove the testicles, it does not stop testosterone production, it does not normally change erections, and it does not stop ejaculation. What changes is that sperm are no longer part of the fluid.

No, and this is the single most important thing to understand.

It takes two to three months for the sperm still downstream of the vasectomy to clear out. You must keep using contraception until a semen analysis confirms that has happened. Not until you feel recovered, and not until a certain number of weeks have passed. Until the test comes back.

It is intended to be permanent. Reversal procedures exist, but they are a separate operation, they are not always successful, and no one should have a vasectomy while counting on being able to undo it. Make the decision as a permanent one.

Yes, through Peri Health & Hormones. That is where hormone evaluation and treatment, perimenopause and menopause care, testosterone therapy, sexual health, and metabolic and weight care are provided.

Understanding hormones and many of the other endocrine pathways is a cornerstone of urology training. Urologists deal with the adrenal gland, the parathyroid, the hypothalamus, the pituitary and the gonads, which are all endocrine organs. Men and women share the same major hormonal systems. What differs is the amounts, the ratios, the timing, and how tissues respond.

Beyond the training, it has been an area of particular interest to me for a long time. I have been treating perimenopausal and postmenopausal problems in my practice since 2009.

No. A single lab value taken out of context is one of the most common reasons symptomatic men get dismissed. Symptoms, timing of the draw, repeat testing, and the rest of the hormonal picture all matter, as does whether you may want to father children in the future. Read together, they usually point to something treatable.

Care is provided through Peri Health & Hormones in Draper, Utah. You can reach the practice at perihealthcare.com.

Dr. Nelson does not bill insurance for his care. There are two places that still works in your favor. If you need a procedure done in an outpatient surgery center, he can work with your insurance for that portion. And for medications, the practice will work with you to find the best available pricing. Because of his national connections he can frequently get medications for less than you would pay locally.

Yes, for a focused set of problems. Dr. Nelson is licensed in Utah, Arizona, Florida, Georgia, Illinois, Indiana, Michigan, North Carolina, Ohio and Pennsylvania, and telehealth visits in those states are mainly for recurrent urinary tract infections and complex urologic second opinions. He also continues to care for his established patients in Arizona.

The move to Peri Health & Hormones was about having real face time and real relationships with patients, so the in-person practice is where most care happens.

If you live out of state and want to follow his weight and metabolic protocols, he will most likely refer you to Options Medical Weight Loss, where he serves as Chief Medical Officer.

Peri Health & Hormones, 807 East Pioneer Road, Suite 105, Draper, Utah 84020. Online at perihealthcare.com.

No. Everything here is general education. It is not a substitute for an evaluation by your own physician, it does not create a doctor-patient relationship, and it cannot account for your individual history. If something here raises a question about your health, bring it to a clinician who can actually examine you.