BPH results from the natural, noncancerous growth of the prostate. This growth leads to obstruction to the flow of urine and brings about urinary symptoms which include: • slow starting and interrupted stream • decreased strength of stream • straining to urinate • incomplete bladder emptying • daytime and nighttime urinary frequency • urinary urgency • occasional urinary incontinence Treatments range from medical management, minimally invasive therapies and surgical intervention.
Smoking is the #1 risk factor for the development of bladder cancer. Some symptoms of bladder cancer include: • painless blood in your urine • frequent urination • painful urination • recurrent urinary tract infections • abdominal pain • back pain Diagnosis is based up on inserting a scope into the urethra to see inside the bladder (cystoscopy) as well as CT scans which allows doctors to see the urinary tract. Treatments for bladder cancer can include a transurethral resection of bladder tumor (TURBT).
Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Erectile Dysfunction is more often caused by physical problems than psychological ones. Treatments for ED include: • oral medications • vacuum erection devices • injection therapies • surgical implantation of a penile prosthesis
Hematuria is the presence of blood in the urine. It can be visible to the naked eye, known as gross hematuria. The urine may also appear normal but have red blood cells under microscope which is known as microscopic hematuria. Hematuria can be painless or painful depending on the etiology. Some known causes of hematuria include: • medical renal disease • benign prostatic bleeding • strenuous physical exertion • kidney, ureteral or bladder cancer • kidney, bladder or prostate infection • stone passage • trauma There are various types of evaluations for hematuria some of which include urine cytology, CT scan, intravenous pyelogram, renal ultrasound or cystoscopy.
Incontinence is the involuntary loss of urine. This occurs with maneuvers that increase abdominal pressure such as coughing, bending or exercising. This is known as stress urinary incontinence. Others may feel a strong urge to urinate just before losing a large amount of urine. This is known as urge incontinence. Many may experience a combination of each. This is known as mixed urinary incontinence. Treatment for incontinence depends on the type. Some types of treatments may include: • periurethral collagen injection • sling procedures • behavioral modification • medication
Infertility is defined as being unable to conceive despite having frequent, unprotected intercourse for at least one year. Infertility can result from male factors, female factors or combinations of each. Male factors include defects in sperm production or delivery, environmental and lifestyle factors such as excessive alcohol intake or stress, health status, age and genetic issues. Treatment depends on the cause and duration of infertility as well as the age and personal preferences of the partners. Options vary from medical management to increase sperm production to surgical interventions that relieve obstruction or treat anatomic abnormalities such as varicocele.
Many kidney cancers are detected incidentally with imaging techniques such as CT scans or ultrasounds during evaluation for other diseases. It rarely causes signs or symptoms early on but can present with the following: • blood in the urine • persistent pain in the upper back just below the ribs • weight loss • fatigue • intermittent fever Treatment options for kidney cancer involve removing either the entire kidney or if possible, removing the tumor from the kidney.
Kidney stones are one of the most painful of the urologic disorders. Stones form in the kidney and sometimes travel down the ureter which can cause obstruction of the flow of urine from the kidney, thereby putting pressure on the kidney, leading to pain, nausea and vomiting. Most kidney stones pass out of the body without intervention. Stones that cause lasting symptoms may be treated by various techniques. Treatment options for kidney stones include: • extracorporeal shock wave lithotripsy (ESWL) • ureteroscopy to remove the stone • medically treated (specifically uric acid stones) Dietary and lifestyle modifications can be made so as to decrease your risk for developing kidney stones. These include increasing your daily water intake, decreasing sale intake and decreasing red meat intake.
Testosterone is a principal male sex hormone mainly produced by the testicles. Low testosterone is also known as hypogonadism. As men age, most will begin to experience a gradual decline in testosterone. Often the most noticeable side effect is a decrease in sex drive. There are both sexual and non-sexual symptoms of low testosterone. Some sexual sign include: • poor erectile function • low libido • weaker erections. Non-sexual symptoms related to low testosterone include: • reduced muscle mass • decreased energy • fatigue • depression Men with high blood pressure and high cholesterol levels can also have low testosterone levels. Other diseases that can contribute to low testosterone are diabetes and obesity. Low testosterone can be treated by hormone replacement therapy.
Chronic pelvic pain refers to any pain in the pelvic region which lasts six months or longer. Diagnosing the etiology of your chronic pelvic pain often involves a process of elimination. Urologic evaluation can include a thorough history and physical examination, laboratory tests, cystoscopy, radiologic imaging, and bladder function tests. If the doctor can determine the source of your pain, then treatment can focus on eliminating that cause. Interstitial Cystitis (IC) is a chronic condition characterized by a combination of uncomfortable bladder pressure, urinary urgency, urinary frequency, bladder pain and sometimes pelvic pain. The severity of symptoms caused by IC often fluctuates and can be affected by diet, exercise and stress. Some people may experience periods of remission. Although no treatment reliably eliminates IC, a variety of medications, lifestyle modifications and other therapies offer relief.
Prostatitis is an infection or inflammation of the prostate which can be classified as acute or chronic, bacterial or nonbacterial. Most cases of prostatitis are diagnosed as nonbacterial. If it continues to reoccur, it is considered chronic. Acute bacterial prostatitis presents with sudden fever, pelvic or low back pain, burning or frequency of urination and at times inability to urinate. Treatment includes pain relievers and several weeks of antibiotics.
One out of six men will be diagnosed with prostate cancer in their lifetime. Prostate cancer is the second leading cancer diagnosis in men. Screening for prostate cancer includes a simple blood test called a PSA as well as a digital rectal exam (DRE). A prostate biopsy, an office procedure, is performed for abnormalities found in the PSA test or on the DRE. If prostate cancer is detected, treatment options include: • active surveillance • medical management • surgical removal • radiation therapy
Many processes can present as masses in the scrotum; fortunately, most are noncancerous. Most common of these are noncancerous types are: hydrocele, varicocele and spermatocele. A hydrocele is a fluid filled sac that develops around the testicle. A varicocele is pooling of blood in the veins that drain the testicle and is often described as a “bag of worms” in the scrotum. A spermatocele is an out-pouching of the epididymis.
While testicular cancer is rare, it is the most common in men aged 15-34 years. Presenting signs and symptoms include: lump or enlargement of the testicle, a feeling of heaviness, dull ache in the scrotum/testicle, sudden collection of fluid around the testicle and rarely, breast tenderness or enlargement. Evaluation includes an exam, scrotal ultrasound and blood tests. If a mass is detected, then surgery is performed to remove the testicle.
A urinary tract infection is an infection which is localized to the genito-urinary system. Symptoms of a urinary tract infection include: • burning with urination • frequency and urgency of urination with small volume voids • pelvic/suprapubic pressure • at times, blood in the urine • confusion or altered mentation Diagnosis is based on performing a microscopic analysis in the office as well as a urine culture which can confirm the diagnosis. A short course of oral antibiotics are the typical treatment. A urinary tract infection involving the kidneys can be quite serious, causing high fevers, chills, and upper back pain. This type of infection may require hospitalization and IV antibiotics to resolve.