10 FAQs to Urologists

Urologists tackle a variety of distressing and embarrassing conditions, improving the quality of life of their patients. From awkward urine leaks, agonizing kidney stones and humiliating failures to have an erection to life-threatening urologic cancers, urologists resolve issues that many people would rather not discuss. And because some of these issues are shrouded in secrecy, myths and untruths have developed around them which, if not tackled, may keep patients from getting treatment. There are also questions that people often seek answers for from the wrong people and which can only be properly answered by urologists. Here are 10 common, questions that urologists respond to quite frequently.

1. I feel something in my scrotum or testicle. Is that normal?

Well, there are lots of normal structures in the scrotum, particularly outside the testicle. But there are also a number of abnormal structures that may occur in the scrotum. For instance, a hydrocele is a collection of fluid around the testicle while a spermatocele is a cyst or excess fluid in the epididymis. A varicocele is a collection of unusually large blood vessels that feels like a bag of worms in the scrotum and often occurs on the left side. When a varicocele occurs, it can reduce the size of the testicle and lead to infertility. A man also may feel an actual lump in the testicle, which could indicate testicular cancer.

Whether you have a hydrocele, spermatocele, varicocele or lump in your scrotum, you should know that these are abnormal. To detect these abnormalities earlier and treat them before they advance, you should examine your testicles at least once a month. You will need to check when showering by supporting your testicle with one hand and using the other hand to feel them. If you feel anything hard or irregular inside your testicle, contact your doctor for diagnosis and treatment.

2. Can I break my penis?

Yes. While the penis is boneless, it’s made of a strong layer of tissue called tunica albuginea, which gives it rigidity during an erection. When blood flows at high pressure through these erectile bodies in the penis, this strong layer of tissue retains the blood inside and allows for erection. However, during intercourse, the fibrous connective tissue of the penis may “break” resulting in a penile fracture. When this occurs, usually in a loud, painful snap, you will bleed through the break and the erection will subside (detumescence). You also may experience swelling and bruising of the penis, which usually requires emergency surgery.

3. Should I be worried when there is blood in my semen?

Semen is typically white and thick, but may come in different consistencies. Should you have persistent blood in your semen (hematospermia), then you should definitely be worried as this may indicate a prostate problem. Likewise, you should visit your doctor for a check-up if you have painful ejaculations or a foul-smelling ejaculate as this could indicate an infection.

4. Can a young man fail to get an erection?

Only about 5 percent of men under the age of 50 have severe erectile dysfunction. So you need to speak with your doctor if you are young and can’t get an erection. Erectile dysfunction in young men may be due to a past trauma, vascular problem, disease affecting blood vessels or nerves, such as hypertension or diabetes, or some illegal drugs, prescription drugs and smoking. While this occurs only in a small proportion of young men, it should worry you if it occurs frequently.

5. How long is a normal penis? Can my small penis be made bigger?

A normal penis is 3.5-7.5 inches, with the average being about 5.5 inches. If you have a normal-size penis, just be contented with it as there is no safe way of increasing penis size.

6. Should I be concerned when my penis or scrotum has acne? Which spots are abnormal?

The hair follicles on your scrotum or penis can be infected or irritated. This is quite common and should not worry you. However, you should see your doctor if you have something that appears like the head of a cauliflower (probably a wart), an ulcerous wound or skin breakdown with a weeping wound, or something that begins as a red area then expands and produces pus (probably a signal of a serious infection).

7. Are urinary tract infections sexually transmitted? Can a toilet seat spread sexually transmitted diseases?

While some urinary tract infections have similar symptoms to sexually transmitted diseases, UTIs are generally not considered STDs. In fact, a standard UTI, such as E. coli (the most common type) is not transmitted sexually and is often caused by bacteria that’s abundant in the affected area. While a woman who is prone to UTIs may have an infection after sexual intercourse, this doesn’t mean the partner carried an STD. The woman also can not transmit a UTI to the male partner. Similarly, although it’s possible to get an infection from a contaminated toilet seat, it is quite rare for infections to be transmitted this way.

8. Should I be circumcised?

The health or medical benefits of circumcision are still debated and no doctor can make this decision on behalf of a patient. But you can choose to undergo circumcision for personal reasons. While the AAP (American Academy of Pediatrics) has reported that the health benefits of circumcision outweigh the risks involved, it does not endorse routine circumcision of newborn males. But the procedure may be valuable for treating infections of the penis and phimosis (foreskin that fails to retract) in older boys and men.

9. Should I be worried about my curved penis?

Curving of the penis is called Peyronie’s disease. Generally, curvatures of 30 degrees or less cause no functional problems and should not worry you. But if the curvature is greater than 30 degrees, it can affect intercourse and should be fixed. There are various ways of treating Peyronie’s disease. For instance, collagenase injection into the scar tissue can reduce the curvature. Likewise, a surgical removal of the scar tissue with a penile prosthesis or graft can help. Or your doctor can perform a surgical unbending (plication) of the penis.

10. I struggle to start urinating and take a long time to complete, should I be worried?

That’s probably an enlarged prostate. Also called BPH (benign prostatic hyperplasia), the condition puts pressure on the bladder and urethra and makes it difficult to start a urine stream or empty the bladder completely. There are medicines that can help relieve most cases of BPH, but if your urinary problems are very severe to the extent you can’t empty your bladder, then surgery may be necessary. If you’ve just started experiencing urinary symptoms, then you shouldn’t be worried about prostate cancer as such urinary problems occur only at a very late stage of the cancer.

Need answers for other urology-related questions? Visit the “St Pete Urology” site to find the answers to your questions.