Urology Conditions and Procedures
Bladder cancer is currently the sixth most common cancer in the United States. In recent decades there has been a steady increase in the incidence of bladder cancer. Medical advances continue to improve the previously dim survival rates.
A number of substances that cause bladder cancer have been identified include cigarette smoke and various industrial chemicals. Cigarette smoking alone has been estimated to cause 50 percent of all bladder cancer cases in the United States. The symptoms of bladder cancer include painless blood in the urine (hematuria) which eventually occurs in nearly all bladder cancer cases; however, the presence of hematuria can be symptomatic of other conditions outside of bladder cancer. Other bladder cancer symptoms may include frequent and painful urination.
A consultation with the urologist will include a medical history and physical examination, including urinalysis. Cystoscopy can be used to view the inside of the bladder. Treatment options include removing the tumors and chemotherapy. Your urologist can provide more information and treatment options.
Circumcision, the removal of the foreskin of the penis, is usually a rapid and safe procedure when performed by an experienced urologist. The American Urological Association believes that circumcision performed on a newborn has potential medical benefits and advantages as well as disadvantages and risks.
The immediate risks to circumcision include bleeding, infection and penile injury in addition to poor cosmetic appearance. Some of these complications could demand surgical correction, but when performed on healthy newborn infants as an elective procedure, the incidence of serious difficulties remains extremely low.
Properly performed newborn circumcision prevents urinary tract infections and is associated with a decreased incidence of cancer of the penis among males in the United States. In addition, there is a connection between the foreskin and urinary tract infections in the newborn. Circumcision should be considered in detail taking into consideration the medical benefits and risks, as well as any ethnic, cultural, religious and individual preferences to the procedure.
As a man ages, his prostate (the tube that carries urine from the bladder out through the penis) may become larger and start to cause frequent or painful urination. Benign prostatic hyperplasia (BPH) is a common urological condition caused by the non-cancerous enlargement of the prostate gland in aging men. BPH is very common, affecting fifty percent of men over the age of 50 and up to 90 percent of men age 80 or older. Men should see their urologist if blood is seen in the urine (hematuria), or if there is pain or burning with urination.
Evaluation with a qualified urologist will include a physical exam, a urinalysis test, and a thorough medical history. Cystoscopy allows the urologist to look directly in the urethra and/or bladder using a small flexible scope. Treatment options include pharmaceutical options and other possibilities, and your urologist can provide an appropriate course of action.
Erectile dysfunction (ED), which is also known as impotence, is the inability to attain or maintain a penile erection sufficient for satisfactory sexual intercourse. This disorder affects one in 10 men in the United States. Impotence is an obviously sensitive topic but it can now be treated effectively in most cases.
The causes of impotence include but are not limited to the following: Nerve disorders and injuries, blood supply abnormalities, hormone disorders, medications and psychological conditions. Aging also causes changes in sexual function with less frequent and less firm erections; aging also increases the chances for having other causes of impotence. However, age in and of itself should not cause erectile dysfunction. Getting older should not prohibit one from an active sex life!
Patients with erectile dysfunction should come to our clinic for an evaluation where a detailed patient history, physical exam and set of blood tests will be taken. Once the information has been assimilated, a variety of treatment options are available, including medications, injection therapy, vacuum pump, penile prosthesis and urethral suppositories. Many treatment options can be applied depending on the situation of the patient, and we can help our clients determine the best options.
Hematuria is the abnormal presence of blood in the urine. When the urine is visibly red or pink, it is referred to as gross hematuria. When no blood is visible in the urine, but blood can be seen under the microscope, it is called microscopic hematuria.
The causes of hematuria can stem from many sources. The most common causes of significant hematuria are infections, kidney stones, trauma and tumors. The blood that appears in the urine can come from anywhere along the urinary tract, including the kidneys, the ureters (the tubes that connect the kidneys to the bladder), the bladder, the prostate (in men), and the urethra (the tube that drains the urine out of the body).
Patients with hematuria should come to our clinic for an evaluation where a detailed patient history, physical exam, a blood sample and a urine sample will be obtained. Depending on the situation, an intravenous pyelogram or cystoscopy may be required.
Treatment for hematuria depends on the cause. A small quantity of blood can turn the urine bright red, and hematuria rarely requires a blood transfusion. Some types of hematuria will require immediate attention if clots are present in the urinary tract; however, most forms of hematuria can be evaluated in a non-life threatening manner. Hematuria from an infection can be treated with the appropriate antibiotic. If a kidney stone or tumor is the culprit, appropriate treatment options can be applied to remove the invader. However, in approximately twenty percent of all cases, no cause can be determined (the so-called "idiopathic hematuria"), so patients need to be followed for six to twelve months with a urinalysis regimen to see if the problem persists.
Hematuria is a warning signal that should not be ignored by the afflicted patient. A thorough evaluation should be administered by a qualified urologist, and prompt treatment lowers further complications.
Urinary incontinence is the involuntary loss of urine. Over 12 million Americans are estimated to have some degree of urinary incontinence. Incontinence affects all ages, including 15 - 30 percent of people over the age of 60. Women are affected twice as often as men, and because of the social stigma, many do not report their problem which can be quite troublesome for the afflicted.
There are several types of incontinence. Stress incontinence is the loss of urine during coughing, laughing, or other physical activities that increases abdominal pressure. Urge incontinence is the loss of urine with a sudden and severe desire to void the urinary tract. Overflow incontinence occurs when the bladder becomes so full that it simply overflows against the wish of the afflicted person. Transient incontinence results from something that can be easily reversed using the right methodology. Sometimes incontinence can be a mixture of more than one of the above.
Patients afflicted with incontinence should come to our clinic for an evaluation. Evaluation will include taking a detailed history and a physical exam, urinalysis, a post-void residual (PVR) analysis (which measures the amount of urine left in the bladder after urination.) Occasionally a voiding diary, cystoscopy, intravenous pyelogram and urodynamic testing may be required to fully ascertain the extent of the incontinence.
Treatment options include behavioral techniques, medications and surgery. Options and applications of each can be discussed at the time of the evaluation. For more information, see this brochure on Coaptite and this brochure on Urinary Incontinence.
Incontinence affects one's emotional, psychological and social wrathfulness, but the great majority of incontinence causes can be treated successfully.
Kidneys produce urine that drains through the ureters into the bladder. Kidney cancer stems from kidney tumors which are abnormal growths within the kidneys. Tumors can be benign (non-cancerous) or malignant (cancerous), and approximately 2 percent of all cancers are kidney cancers. It is important to realize that with timely diagnosis and treatment, kidney cancer can be cured. If found early, the survival rate for patients with kidney cancer ranges from 80 to 100 percent, and more than 100,000 survivors of kidney cancer are alive in the United States today.
Kidney tumors do not produce symptoms, but they may be discovered through routine screening or through the evaluation of an unrelated problem. Symptoms can include some pain, blood in the urine (hematuria), shortness of breath and coughing of blood. Different types of kidney cancer produce varying symptoms, and your physician can offer additional details.
A variety of treatment options exist for kidney cancer, and a consultation with a urologist will help to find a suitable treatment plan. Radiation therapy, hormone therapy, chemotherapy, surgical removal, and immunotherapy are common treatment options. Laparoscopic nephrectomy is a technique using specialized telescopes inserted into the abdominal cavity through small incisions to remove the cancerous growth. A suitable course of treatment can be found using a knowledgeable urologist as your guide.
Kidney stones form when excess unwanted material crystallizes in the kidney. Kidney stones affect about 10 percent of the population of the United States, and men are affected more often than women. Symptoms will often include back and groin pain, urination pain, and blood in the urine (hematuria). Some kidney stones can cause urinary tract infections. Rarely stones will exhibit no symptoms in the patient but will still lead to kidney damage. The best method to avoid kidney stone formation is to keep well-hydrated with water. Regrettably more than 50 percent of patients form another kidney stone within 10 years, so following up with the patient is critical.
Patients besieged by kidney stones should come to our clinic promptly for an evaluation. The evaluation will include some or all of the following: urinalysis, blood tests and X-rays.
A variety of treatment options exist which can be enacted in tandem depending on the circumstances and the patient. Often the best method is for the patient to pass the kidney stone on his/her own, but other options include Extracorporeal Shock Wave Lithotripsy (ESWL), a ureteral stent, ureteroscopy, percutaneous nephrolithotomy and even open surgery.
Male Hypogonadism is a condition in which the body doesn't produce enough testosterone — the hormone that plays a key role in masculine growth and development during puberty — or has an impaired ability to produce sperm or both.
You may be born with male hypogonadism, or it can develop later in life from injury or infection. The effects — and what you can do about them — depend on the cause and at what point in your life male hypogonadism occurs. Some types of male hypogonadism can be treated with testosterone replacement therapy.
Read more about male hypogonadism in this document.
An overactive bladder is a condition characterized by a sudden, uncomfortable need to urinate with or without urine leakage. Overactive bladder symptoms can occur with both daytime and nighttime frequency. Overactive bladder symptoms occur when the smooth muscle of the bladder squeezes or contracts more often than normal and at inappropriate times. Instead of staying at rest while urine fills the bladder, the muscles contract while the bladder is filling with urine.
The cause of an overactive bladder is unknown; however, identifiable underlying causes can include drug side effects, nerve damage or neurological diseases. Diagnosis includes keeping a urination diary; medical procedures include catherization, cytology and cystoscopy. Your urologist will give you more details regarding the appropriate diagnosis and treatment. Treatment options can include drugs, behavioral medications, Kegel exercises and other therapies. Your urologist will assist you with appropriate choices for treatment.
The prostate gland is a small gland in men located below the bladder which surrounds the upper portion of the urethra. The prostate gland secretes a fluid that makes up part of the semen.
Prostate cancer is currently being diagnosed in over 200,000 men in the United States each year, making it more common than lung cancer and the most common internal cancer in males. Prostate cancer is rarely diagnosed in males under age 50, but incidences of prostate cancer rise quickly past the age of fifty. Undiagnosed prostate cancer has been shown to be very common in postmortem autopsies of men age 50 and older. It is the second leading cause of cancer deaths among men in the United States, but when detected in the early stages, prostate cancer can be effectively treated and cured.
The symptoms of prostate cancer are wide-ranging. In the early phases, prostate cancer may cause no symptoms whatsoever in the affected male. When symptoms occur, they may include dull pain, frequent urination, problems with urination, blood in the urine or semen, and other related symptoms.
Prostate cancer can only be adequately diagnosed by analyzing tissue under a microscope; however, a digital rectal examination can assist with the determination. Treatment options include radiation therapy, radical surgery, hormonal therapy, and other methods. A trained urologist can offer appropriate suggestions in treating prostate cancer. With proper management and urologic care, prostate cancer can often be eliminated or survival increased.
A vasectomy is the surgical cutting and sealing of part of each vas deferens as a means of sterilization. The decision to proceed with a vasectomy is a very personal one and it is important that the patient has a clear understanding of what a vasectomy is and is not.
The vasectomy itself is a minor surgical procedure designed to interrupt the sperm transportation system between the testicle and the penis. Vasectomies are performed in the urologist's medical office (depending on the patient's anxiety level.) The scrotal area will be shaved and washed with an antiseptic solution. A local anesthesia will be injected to numb the area but the patient will be aware of touch, tension and movement during the procedure while eliminating sharp pain. The patient is awake during the procedure.
After the vasectomy, the patient should return home for a brief convalescence and avoid strenuous or sexual activity. Most patients can expect to recover completely in less than a week and most can return to their job as early as a day after the vasectomy. Sexual activity can often be resumed within a few days. However, patients should realize that vasectomies are not effective immediately. The effectiveness of the vasectomy must be proven by having the patient submit at least one semen analysis to prove there is no active sperm in the ejaculate. Patients can still use contraception during this period.
There is no significant change in one's ejaculate after a vasectomy since the sperm contributes a small amount to the overall ejaculate volume. Ejaculation and orgasm are generally not affected by vasectomy, and uncomplicated vasectomies cannot cause impotence. These and other concerns can be addressed in the consultation with the urologist.