What to Expect at Your First Urology Appointment

Frequent urination, incontinence, sexual dysfunction, and other chronic issues can be embarrassing, painful, or even signs of a more serious condition. By seeing a urologist, you can ensure that these issues do not unnecessarily disrupt your life.

At St Pete Urology, we provide life-changing solutions for men and women with urinary tract problems and for men with issues affecting their reproductive organs. Our urologists diagnose and treat these conditions every day, so there is no need to be embarrassed about seeking help.

You should see a urologist if you have:

  • Blood in your urine
  • Painful urination
  • Poor bladder control
  • Urine leakage or flow issues
  • Sudden change in the color or smell of your urine
  • Pain in your groin, lower back or abdominal area
  • Hernia
  • Fallen bladder protrusion
  • Overactive bladder (OAB)
  • Low sex drive
  • Recurrent urinary tract infections
  • Hormone imbalance, such as low testosterone
  • Kidney pain or kidney stones
  • Concerns with testicles, penis or prostate
  • Cancer of the bladder, penis, testicles, prostate or kidney

What should you expect during your first visit?

Whether you are referred by another doctor or find a urologist on your own, your first visit will be similar to seeing your primary care physician. The urologist will begin by reviewing your full medical history, particularly in relation to previous urological issues. The doctor will then run diagnostic tests and use the results to determine the cause and likely treatment for your condition.

Paperwork

When you arrive for your first appointment, you should expect to fill out paperwork. Depending on the reason for your visit, you may be required to complete a questionnaire. Because the questionnaire helps to evaluate your symptoms, it is advisable to track them beforehand and arrive at your appointment with specific information. Give as much detail as possible, rate the severity of your symptoms, and make a note of their timing.

Urine Sample

You will probably be asked for a urine sample during your first visit. The urine sample is analyzed in order to give the urologist an inside look at your urinary system. It helps to go to your appointment with a full bladder by drinking 16 ounces of water an hour before the appointment. If you feel the urge to empty your bladder as soon as you arrive at the urologist’s office, inform the receptionist that you are ready to provide your urine sample before you see the doctor.

Medical History

Once you are taken into the exam room, you will be asked questions about your medical history. State your symptoms clearly. Describe when they started, their timing and their severity. Be prepared with a written list of your current medications and their actual dosages, prior imaging studies, plus any over-the-counter supplements you are taking.

Physical Exam and Diagnostic Tests

Your urologist will conduct a physical examination and run diagnostic tests to determine the cause of your problem. For men, a digital rectal exam is the standard procedure to check the prostate. Other tests, such as a urethral swab, rule out sexually transmitted diseases and blood work can check the Prostate Specific Antigen (PSA) level.

If you are a woman dealing with recurring urinary tract infections (UTI), the urologist may order a urinalysis and a pelvic exam. A blood panel can determine hormone levels in women with low sex drive, and a cough stress test may indicate the cause of urinary incontinence. Computed tomography (CT) scan, magnetic resonance imaging (MRI), ultrasound, and sonography are also frequently relied on by urologists for testing.

Making an Informed Treatment Decision

After exams and diagnostic tests, the urologist will discuss with you the findings, help you understand your condition, and recommend possible solutions. At this stage, you should ask questions to be fully informed about your treatment options and their benefits and potential risks. Possible treatment options include physical therapy, medication or surgical procedures.

At St Pete Urology, we treat a full spectrum of urological conditions to help our patients overcome medical challenges and enjoy a better quality of life. Our compassionate, patient-friendly approach ensures that patients have a great experience with us from the very first visit.

No need to feel intimated or embarrassed when seeing a urologist. We see these issues every day and we are ready to help you. For more information about the diagnosis and treatment of urological problems, visit the St Pete Urology website.

Robotic Surgery is the Future of Urology

The medical field of urology has long embraced technology by adopting innovative equipment and techniques soon after they are developed. One technical innovation that has been at the forefront of medical treatment is robotic surgery. Presently, robot-assisted techniques account for up to 50% of urologic surgeries. And in several types of procedures, particularly in cancer therapy, robotic surgery has become the standard approach.

Growing dominance

In recent years, urology training programs have increasingly emphasized instruction in robotic systems. In fact, more than 70% of existing urology training and subspecialty fellowships focus on teaching minimally invasive laparoscopic and robotic procedures. With this continued emphasis during medical training, robotic systems are likely to become the leading method of urology surgeries.

Standard approach

Robotic surgical systems have become the standard approach in performing radical prostatectomy. When used properly, they result in reduced blood loss and scarring, decreased risk of nerve damage and preserved erectile function. Robot-assisted surgery is also the standard technique for partial and total nephrectomy (removal of the kidney). Robotic nephrectomy has a significantly shorter operating time, minimizes blood loss, and requires a shorter hospital stay than traditional open surgery.

In addition, robotic approaches have ensured that even the more technically challenging procedures are standardized, as with intra-corporeal urinary diversion and radical cystectomy. Urologists can now perform robotic cystectomy with intracorporeal diversions resulting in reduced complications.

Increased efficiency

Since urologic laparoscopic procedures are technically quite challenging, robotic systems have increasingly become the more efficient alternative. For instance, the da Vinci robotic system has finer surgical instruments that allow for smaller keyhole incisions. This gives urologists a high degree of freedom when working with very small spaces and ensures precise tissue dissection and surgical manipulations.

With da Vinci robotic surgery, the 10x magnification and high-definition imaging of internal structures ensures that nerves and tissue are unharmed. By facilitating the identification of key anatomic structures, the robotic system makes complex surgeries more successful.

Greater patient satisfaction

Robotic surgical systems have established minimally-invasive procedures as the centerpiece of urologic surgery. Urologists can now perform bladder, kidney, and prostate removal with superior pre-operative and post-operative outcomes compared to open surgery.

The benefits of the da Vinci robotic surgery have triggered a rising patient demand for robotic surgery. Most patients want a reduced risk of bleeding and shorter recovery time. With increased patient demand, robotic surgery will become even more in demand.

Revolutionized cancer therapy

Robot-assisted surgery has changed the way urological cancers are treated, allowing for the removal of bladder and kidney tumors using minimally invasive techniques. In younger patients with testicular cancer that has already spread to the lymph nodes, robotic surgery can now be used as an alternative to radiotherapy.

The da Vinci surgical procedure provides a superior prostate cancer survival rate and ensures that the prostate cancer is treated without postoperative urinary or erectile problems. It also enables urologists to conduct salvage operations on patients with recurrent cancer, helping to avoid or delay the need for chemotherapy.

At St Pete Urology, we believe robotic surgery is the future of urology. We are continually investing in cutting-edge robotic equipment and procedures that enable us to do a wide array of minimally invasive surgeries that achieve optimal outcomes for our patients. For more information on urologic disorders and surgical procedures, visit the St Pete Urology website.

9 Tips to Keep Your Bladder Healthy

The bladder’s function is to store urine and allow urination to be infrequent and controlled. Bladder problems may lead to bothersome issues such as incontinence, infections and overactive bladder. While you may not be able to prevent every possible bladder problem, taking appropriate measures can help to lessen many of them.

What should you do to keep your bladder healthy?

1. Drink plenty of fluid

Drinking plenty of fluid increases the volume and frequency of urination, which in turn helps to flush out bacteria from your bladder. Water is the best fluid for your bladder and should be at least half of your daily fluid intake.

Ideally, you should drink 6-8 eight-ounce glasses of water every day. But if you engage in intense exercise or activity, you may need to drink more to compensate for fluid loss. On the other hand, if you have a condition such as heart disease or kidney failure, you may need to drink less. Speak with your doctor about how much fluid is right for you.

2. Avoid smoking

Smokers are more likely to develop bladder control issues than non-smokers. Cigarette smokers also tend to have more severe bladder symptoms. For heavy smokers, there is a tendency to develop a chronic cough, which exerts added pressure on the bladder and worsens urinary incontinence. Plus, tobacco smokers are three times more prone to bladder cancer than non-smokers. Avoiding cigarette smoking is good for your bladder health.

3. Get active

Physical activity not only relieves bladder problems but also prevents fluid buildup in the legs. Fluid retention in the legs—usually due to heart disease or a sedentary lifestyle—can lead to bladder control issues. You can reduce fluid retention through low-impact moderate activity such as biking, swimming or walking briskly for at least 30 minutes at least 5 days a week.

4. Do Kegel exercises

Weak pelvic floor muscles are a common cause of urine leakage (incontinence). Kegel exercises target and strengthen pelvic floor muscles and keep urine from leaking when you sneeze, laugh, lift or have a sudden urge to urinate. Speak with your urologist about what kind of exercise will benefit you the most.

5. Avoid bladder irritants

Certain foods and beverages can irritate the bladder and trigger bladder problems. Known bladder irritants include alcoholic beverages, apples, apple juice, bananas, brewer’s yeast and carbonated drinks. Others are chilies, chocolate, citrus fruits, coffee, cranberries, grapes, nuts, raw onions, raisins, soy sauce, tomatoes and vinegar.

While you don’t have to stop eating your favorite foods and drinks entirely, reducing the amounts can improve your bladder symptoms.

6. Maintain a healthy weight

Being overweight is a risk factor for incontinence, particularly stress incontinence. The excess weight exerts more pressure on the abdomen and bladder and weakens pelvic floor muscles. In fact, nearly 50-percent of older people who are overweight struggle with bladder incontinence.
By losing weight in the abdominal area, you can reduce pressure on the bladder and pelvic muscles and improve bladder control. In many cases, weight loss improves incontinence symptoms or gets rid of them completely. Make healthy food choices and engage in regular exercise to achieve and maintain a healthy weight.

7. Prevent constipation

Bladder problems are quite common in people with constipation because a full rectum presses the bladder wall causing either outflow obstruction or increased spasm. Also, constipation makes pelvic muscles overactive, which causes dysfunction in stool and urine elimination and leads to an overactive bladder. You can reduce constipation by drinking enough water, eating high-fiber foods (like whole grains, fruits, and fresh vegetables), and being physically active.

8. Manage medications

Some medications can trigger bladder control problems. For example, high blood pressure prescriptions tend to increase urine output and relax bladder muscles resulting in urine leakage. Drugs such as antidepressants, muscle relaxants, antihistamines, sedatives, and tranquilizers may hinder bladder contraction and reduce awareness of the need to urinate.

You should not stop taking your medications just because you suspect they are responsible for your bladder issues. Instead, and before making any change, speak with your doctor about your concerns. The doctor may adjust the dosage or offer a different medication. In cases where the benefits of the medications far outweigh the related bladder issues, your doctor will work with you on alternative ways to ease symptoms.

9. Flush out bacteria

Proper cleaning of the genital area before and after sexual intercourse helps to reduce bacteria and prevents bladder infections. Passing urine before and after sex helps to flush out bacteria and stops their entry into the urethra during sex.

Since holding urine in the bladder for too long increases the risk of infection and can weaken bladder muscles, make sure to pass urine as often as possible. Use the bathroom at least every 3 to 4 hours, and when urinating, don’t rush. Take your time to fully empty your bladder.

At St Pete Urology, we provide expertise in the diagnosis and treatment of urinary disorders. Our urology specialists will work with you to develop an individualized treatment plan for your problems. We value our multidisciplinary and compassionate approach to caring for our patients. For more information on the prevention, diagnosis and treatment of urinary disorders, visit the St Pete Urology website.

The 5 Best Ways to Prevent Kidney Stones

When certain chemicals become concentrated in urine, they coalesce into crystals. The crystals then grow into larger mineral deposits called kidney stones. Most kidney stones form when calcium combines with either phosphorous or oxalate, but some form from uric acid, a byproduct of protein metabolism. Once formed, kidney stones can make their way through the urinary tract and pass from the body without problems. At other times, a stone will get stuck somewhere, block urine flow and cause intense pain.

Growing concern

Kidney stones are a rising concern. In fact, one in ten people will have kidney stones during their lifetime. Currently, up to 12% of Americans have stones and those who have had one are 50% more likely to get another within the next 10 years if no preventive measures are taken.

The passing of kidney stones is often characterized by agonizing and intolerable pain that comes in waves as the stones move through the urinary tract and out of the body. The pain may occur on one side of your back or abdomen, or it may radiate to your groin and belly area. While the severity of the pain does not necessarily relate to the size of the stone, larger stones tend to be more painful than smaller ones.

What are the 5 best ways to prevent kidney stones?

1. Drink plenty of fluids.

When you pass a lot of urine every day, you have a lower risk of developing kidney stones. The more you urinate, the lower the chance of stone-causing minerals settling and combining in your kidneys and urinary tract. Drink plenty of water to ensure you urinate up to 2 liters of urine daily. You will need roughly eight 8-ounce cups of water to achieve that. Orange juice and lemonade are also good because the citrate they contain helps prevent stone formation.

If have a history of cystine stones, engage in heavy exercise or just sweat a lot, you should drink even more water. Demanding workouts increase water loss through sweating and reduce urine output, so keep your body hydrated during and after exercise. You can tell if you are properly hydrated by the color of your urine. A clear to pale yellow urine means proper hydration while a dark color indicates a need for more fluids.

2. Increase your calcium intake.

Calcium oxalate stones are the most common kidney stones. But that does not mean you should avoid calcium-rich foods—actually the opposite is true. A low-calcium diet increases the risk of stones and osteoporosis. A calcium deficiency allows oxalate levels in urine to rise, triggering the formation of stones.

A good approach is to enhance your daily intake of calcium according your age. For instance, if you are a man 50 years or older, you need 1,000 milligrams (mg) of calcium per day, together with 800 to 1,000 international units (IU) of vitamin D to help with calcium absorption.

Calcium-rich foods include cheese, milk, and yogurt. Avoid calcium supplements as they may increase your risk of kidney stones; however, you can reduce that risk by taking supplements with your meals. It is always a good idea to speak with your doctor when considering supplements and dietary changes.

3. Eat fewer oxalate-rich foods.

Oxalate is a natural compound found in some foods. Since it binds with calcium in urine to form kidney stones, reducing oxalate-rich foods helps prevent stones from forming. Examples of foods rich in oxalate are chocolate, spinach, coffee, peanuts, beets, rhubarb, sweet potatoes, beets and wheat bran. Colas should also be avoided because they are rich in phosphate.

If you have suffered from kidney stones, your doctor may recommend you avoid these foods or consume them in smaller quantities. However, you can also eat oxalate-rich foods alongside calcium-rich foods as an alternative to avoiding them. Calcium and oxalate can bind together to actually reduce the risk of kidney stones.

4. Reduce your sodium intake.

When your diet is high in sodium, the amount of calcium in your urine increases. Sodium prevents calcium re-absorption from urine to blood, which in turn leads to high calcium in urine that may cause kidney stones. Reducing sodium intake lowers the amount of calcium in your urine.

The recommended daily limit of total sodium intake is 2,300 mg. But if sodium has contributed to your kidney stones in the past, you should reduce intake to 1,500 mg per day. Your doctor may advise that lowering sodium benefits your blood pressure as well. It is easier to lower sodium intake by avoiding foods such as:

  • Processed foods, like crackers and chips
  • Canned vegetables
  • Canned soups
  • Condiments
  • Lunch meat
  • Foods containing sodium nitrate, monosodium glutamate, or sodium bicarbonate (baking soda)

5. Limit intake of animal proteins.

Animal proteins not only raise the amount of uric acid in your body, they also increase body acid levels. Increased urine acidity promotes the formation of both uric acid and calcium oxalate stones.

Need help dealing with kidney stones?

St Pete Urology brings together a multidisciplinary team of experts in urology, nephrology and nutrition to offer a single point of care for patients with acute or recurrent kidney stones. We treat kidney stones using the latest minimally-invasive and nonsurgical procedures, including ureteroscopy, extracorporeal shockwave lithotripsy and percutaneous nephrolithotomy. We also have advanced tools such as Holmium lasers and specialized ultrasound and ultrasonic equipment.

At St Pete Urology, we don’t just treat kidney stones. We aim to prevent their recurrence. Our focus is on the overall health of our patients with the goal of making their first kidney stone incident their last. For more information on the prevention, diagnosis and treatment of kidney stones, visit the St Pete Urology website.

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7 Tips for Keeping a Healthy Prostate

Prostate problems are common in men over 40. The prostate, a tiny walnut-sized gland found only in males, surrounds the urethra and produces a thick, white fluid that mixes with sperm to form semen. Though smaller early in life, the gland grows bigger with age and can sometimes become enlarged or swollen by conditions such as prostate enlargement, prostatitis or prostate cancer.

All men, no matter their age, can find themselves dealing with a prostate issue, which is why every man should be concerned about his prostate health. Fortunately, there are easy ways to prevent or reduce the risk of developing prostate health problems.

Here are 7 tips for keeping your prostate healthy:

1. Eat more fruits and vegetables

Fruits and vegetables are great sources of anti-inflammatory and anticancer compounds, such as polyphenols, antioxidants, minerals, vitamins and fiber. Plants that boost prostate health are plentiful and include favorites such as tomatoes, broccoli, cauliflower, bok choy, cabbage, Brussels sprouts, pink grapefruits, watermelons, papaya and guava. Equally powerful are green leafy vegetables like spinach, lettuce, spring mix and kale which contain cancer-killing ingredients such as folic acid, vitamin D, turmeric and curcumin. Be sure to add fruits and vegetables to your everyday meals to boost your prostate health!

2. Eat more plant proteins and cut down on animal fat

You should avoid diets that are high in animal fat, including dairy products and red meat. Heavy consumption of red meat increases your risk of prostate cancer. So go for lean proteins, such as fish and chicken, but avoid grilled meat since grilling produces carcinogens that can inflame your prostate. Instead try baking, steaming, or broiling your meat.

High animal fat intake reduces antioxidant production in the body. And since it is the antioxidants that help to maintain a healthy prostate, excess fat diminishes prostate health. A good option for a healthy prostate is fish, which contains omega-3 acids that minimize the risk of prostate problems. Fish such as tuna, herring or salmon are good choices, but if fish is not your thing, then walnuts and flaxseed can be great sources of omega-3 acids.

Ideally, you should go for whole, natural foods that provide a lot of fiber. Soy is also good for your prostate and you can get it through sources like soy nuts, soy flour or tofu. Likewise, you should eat foods rich in selenium such as wheat germ, tuna, beef liver, eggs, sunflower, cashews, sesame seeds, mushrooms, onions, garlic and kidneys. Selenium boosts prostate health and minimizes the risk of prostate cancer.

3. Achieve a healthy weight

Obesity has been associated with various prostate health issues, including prostate cancer. If you are overweight, cutting back your weight, particularly abdominal fat, reduces the risk of BPH. In fact, if you desire to shrink your prostate size and get relief from annoying urinary symptoms, weight loss is valuable. Weight loss also helps reduce the risk of prostate cancer and relieves prostatitis.

4. Regular exercise

Moderate or vigorous activity minimizes the risk of BPH, urinary tract symptoms and prostatitis. Regular exercise also decreases stress, releases tension, improves immune function and maintains healthy hormone levels, all of which are important for a healthy prostate.

Aim for at least 30 minutes of moderate or intense physical activity every day. Try walking, swimming, running or bicycling, and make sure your exercise routine is not boring by varying your activities and even inviting friends to join you.

5. Drink tea

Both green tea and hibiscus tea contain potent antioxidants. Studies show that regular intake of tea helps with prostatitis, BPH and prostate cancer. Green tea also slows down the growth of aggressive prostate cancer.

Make sure to choose caffeine free sources of tea since caffeine irritates both the prostate and bladder and worsens symptoms of prostatitis. As a measure to cut down on caffeine intake, make sure to reduce energy drinks, coffee and soda.

Like tea, water is also great for the prostate. Drinking plenty of water will help you remain hydrated and enjoy normal prostate function. Make sure to drink at least 8 glasses of water every day, and to increase water intake during and after exercise.

6. Avoid smoking

Smoking affects every cell in your body. In fact, when cigarettes are burned, they are complete carcinogens. While smoking has less effect on low-grade or benign prostate cancer, it increases the risk of fatal prostate cancer. The heaviest smokers have 24-30 percent higher risk of death from prostate cancer than non-smokers. Smoking also increases the risk of prostate cancer progress after diagnosis.

Studies also show that smoking indirectly promotes benign prostatic hyperplasia (BPH) and increases prostate inflammation. Apart from smoking, alcohol use and inadequate sleep may adversely affect your prostate health. Also, a healthy sex life is good for your prostate.

7. Talk to your doctor

Do you have family history of prostate cancer? Let your doctor know. Remember that having a father or brother who has had prostate cancer more than doubles your risk of developing the disease. Speak with your doctor about your risk of prostate issues and explore the medical screening tests you should undergo as you age, follow dietary recommendations and be alert to any risk factors.
If you intend to begin a new exercise program, make sure to inform your urologist about it. Your doctor should know if you are experiencing symptoms such as:

  • Discomfort or pain anywhere in your rectal or pelvic area
  • Blood in your urine or semen
  • Difficulty or pain when urinating

Are you or your loved one suffering from a prostate problem? St Pete Urology offers specialty urology services in a state-of-the-art facility and surgery center in St. Petersburg, Florida. We provide the latest innovations in surgical techniques and medical technology, delivering comprehensive care to those with urologic conditions. For more information about the prostate gland, BPH and prostate cancer, visit the St Pete Urology website.

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Long Term Risks of Vasectomy

Vasectomy is a one-time male contraception procedure that provides 99.9 percent efficacy in preventing pregnancies. It offers permanent contraception and, compared to the female procedure of tubal ligation, vasectomy is:

  • Simpler.
  • More effective.
  • Safer, with fewer complications to patients.
  • Much less expensive.
  • Conveniently performed on an outpatient basis.

Following a vasectomy, you will find sex with your partner more spontaneous and enjoyable. After all, you will no longer have to worry about a potential pregnancy or need to interrupt pleasure to apply contraception.

So what are the long-term benefits and risks of a vasectomy?

Vasectomy is typically performed on younger men in their thirties and forties. These men still have many years of their lives during which long-term health effects might appear.

Luckily, medical studies have examined the long-term health impact of vasectomy and the evidence suggests there are no significant risks. In fact, men who have undergone vasectomy have basically the same risk of developing heart disease, cancer, or other health problems as those who have not.

Let us now consider the specific issues.

1. Vasectomy and testosterone levels

Vasectomy does not affect the secretion and release of testosterone—the male hormone responsible for facial hair, sex drive, deep voice and other masculine traits. Hormonal tests in those who have had a vasectomy show that there is no significant change in both free and total testosterone. Hormone levels in the body remain within normal range. There is also no significant difference in testicular or epididymal size after a vasectomy.

2. Vasectomy and sexual function

Can a vasectomy affect your sexuality negatively? Studies indicate there is no such effect. Apart from changing your fertility, a vasectomy will not influence your sexual and reproductive physiology. The nerves that are critical for erectile function and ejaculation remain intact and you will still achieve normal erections, climax and produce the same amount of ejaculate—only that your semen will not have sperm.

The procedure will not diminish your libido, which is related to various hormones in the body that are not altered by the surgery. Even your sperm production remains normal except that they are reabsorbed in the body. So the only change you are likely to have is ability to enjoy yourself without the worry of pregnancy.

3. Pain, discomfort and abscesses

The cause of post-vasectomy pain syndrome is unclear, but on rare occasions when it occurs, it can be a challenging urological problem. An estimated 1-2 percent of men experience chronic scrotal pain after a vasectomy that ranges from a dull, aching sensation to a sharp, biting pain. There is no single treatment for the pain, but your urology will tailor a solution for you should it occur, and it will rarely require further surgery to reduce or correct.

Abscesses are quite rare after a vasectomy, but they may occur. In typical cases, they result from post-operation infection at the surgical site. Fortunately, most respond to treatment with antibiotics and eventually resolve. However, when left untreated, the abscesses can fill with fluid and may need to be drained. So if you suspect you have an abscess after a vasectomy, you should see your urologist immediately to stop the condition from getting worse.

4. Epididymitis

In 1-3 percent of men who undergo vasectomy, inflammation of the epididymis may occur—a condition called epididymitis. The epididymis is a duct found behind the testicles that allows flow of sperm to the vas deferens. It is highly coiled and very narrow; since sperm still flows through the epididymis to the vas deferens after a vasectomy, the duct may get inflamed when the sperm get backed up as the vas deferens is already severed.

Inflammation of the gland is rare, but is often characterized by tenderness, pain and swelling. Some urologists recommend anti-inflammatory drugs to help with epididymitis, though the swelling should be gone within a week or so after surgery. If it gets worse after the first week, speak with your urologist about it.

5. Sperm granulomas

Cutting the vas deferens during a vasectomy ensures sperm is stopped from reaching scrotal tissues. In some cases, however, the sperm may leak through the cut vas deferens into scrotal tissues. When this occurs, the sperm may form a hard, occasionally painful lump or mass, the size of a pea, called granuloma in the scrotal tissue.

Once formed, a lump can cause small bumps or cysts, which range in size from 1 millimeter to 1 centimeter. Lumps may also produce multiple lesions that tend not to produce symptoms, though some men may experience pain at the granuloma areas. Studies estimate that 15-40 percent of men undergoing vasectomy have sperm granulomas.

While sperm granulomas are not usually dangerous and often gets absorbed by the body, some cause pain and swelling in the genital region. Actually, the entire area may become sensitive to temperature and pressure changes. Most granulomas respond to anti-inflammatory drugs and the sensitivity and swelling subsides within a week after treatment. But in some extremely rare cases, reverse vasectomy may be necessary if the leakage does not stop and the swelling becomes increasingly worse.

6. Vasovenous fistula

This is another rare risk of vasectomy. It occurs when several blood vessels adhere to the vas deferens injured when vasectomy is done. It can cause pooling of blood vessels leading to development of a fistula, or abnormal association between the vas deferens and close by blood vessels. The symptoms of vasovenous fistula may include blood in ejaculate or urine. Although the risk is quite rare, you need to seek immediate medical attention should these symptoms occur.

7. Immune based illnesses

Some men may have immune reactions to the sperm that gets absorbed in their bodies after a vasectomy. The effect is the possibility of immune reactions that may lead to heart disease and other immune-based illnesses. However, many extensive studies have concluded that a vasectomy does not lead to immune-based illnesses or heart disease later in life. In fact, studies show that the risk of immune-based illnesses is so insignificant that it should not concern either the urologist or the patient.

8. Vasectomy and cancer

One serious concern has been the possibility of a vasectomy increasing the risk of having prostate or testicular cancer. A study published in the Journal of the American Medical Association in 1993 suggested that 20 years or more after a vasectomy, men who have undergone the procedure are twice as likely to develop prostate cancer compared to men of the same age group who have not undergone the procedure.

However, reviews of the study by the medical community have since demonstrated that the study did not include enough participants and the findings are therefore not statistically significant. In fact, compared to other studies that have used PSA tests to establish the possible risk of prostate cancer, the general consensus is that vasectomy comes with no increased risk of the cancer.

The risk of prostate cancer among men who have and those who have not undergone the procedure is the same when PSA tests are combined with digital rectal exam, ultrasound or prostate biopsy. Therefore, as a rule, men should undergo prostate cancer screening whether or not they have had a vasectomy. Likewise, there have been no reports of increased risk of testicular cancer after a vasectomy.

At St Pete Urology, we have offered vasectomy services for decades and we are proud of the results. The procedure has minimal long-term risks compared to other surgical procedures and provides men the freedom to enjoy sex without having to worry about a possible pregnancy. And the risk of prostate cancer, testicular cancer, heart disease, immune-based illnesses and other conditions are too insignificant to stop you from having a vasectomy.

We are ready to answer all your vasectomy related questions and concerns during your consultation. For more information, schedule a consultation or visit the St Pete Urology website.

5 Things You Need to Know About Men’s Sexual Health

5 Things You Need To Know About Men's Sexual Health Image

Sex is a critical part of life. It helps in the perpetuation of species and provides an amazing source of pleasure. It ensures intimacy between partners while making bonds stronger and unions enduring. It is also a wonderful form of exercise that releases stress, gets rid of anxiety, boosts prostate health and improves overall health.

What is sexual health?

It is the state of wellbeing that enables a man to engage in and derive pleasure from sexual activity. You are sexually healthy if you have sexual desire (libido), can get and sustain an erection, and can participate in satisfactory sexual intercourse. Sex is a hormone-driven activity that begins at puberty and lasts your entire life.

On average, couples have sex once a week. Each sexual encounter typically lasts 15-30 minutes, though the actual penetration time averages 2 minutes. If you are in a relationship, you may be having less sex than you want due to a lack of intimacy or time. But by working on communication and spending quality time together, you and your partner can improve your intimacy and have a more gratifying sex life.

What should you know about men’s sexual health?

Sexual health in men is affected by a number of physical, psychological, social and interpersonal factors. For example, physiological changes can impact both the desire and the ability to have sex, while emotional and mental factors can determine the satisfaction achieved during sexual intercourse.

As a man, the knowledge of the following male sexual health issues can enable you to achieve better sexual and overall health.

Aging and sexual health

With increasing age, changes are bound to occur in your sexual function, most of which are normal. But even in your 80’s, you should still be able to enjoy sex and intimacy in your relationship. Nevertheless, one frequent effect of aging on sexual health is loss of libido (sex drive)—often due to decreasing testosterone levels. Loss of libido means you have reduced interest in sexual activity or diminished sexual thoughts. You can also lose your libido because of stress, anxiety, relationship issues, side effects of medication or some medical conditions.

If you are experiencing a reduced drive for sex, look out for the symptoms so you can describe them correctly when you speak with your urologist. One way to deal with reduced sexual urge is to take more time in direct stimulation or foreplay. For changes that occur drastically or refuse to go away after sex therapy, work with your urologist to differentiate normal from abnormal changes and receive proper treatment.

As a rule, do not assume that every change that occurs in your sexual function is because you are growing older. After age 40, make sure you are aware of the following health indicators:

  • Cholesterol levels
  • Blood pressure
  • Blood sugar levels
  • Testosterone levels
  • PSA (Prostate-specific antigen) levels

Erectile dysfunction (Impotence)

Erectile dysfunction (ED) means you are not able to get and maintain an erection that is firm enough for satisfactory sexual intercourse. It is a common sexual health issue affecting up to 50% of men above the age of 40. You may experience erectile dysfunction because of blood flow problems such as vascular disease or blood pressure, which are quite common among aging men. But other factors such as certain medications, use of alcohol and drugs, smoking and surgeries involving prostate cancer may also cause impotence.

Fortunately, medications treat 50-70% of ED cases effectively. However, if your condition does not improve with medication, your urologist can apply various non-surgical techniques to promote blood flow. There are also surgical options such as penile prostheses or implants. Surgery is not advisable as initial treatment; but when done as a last resort it usually delivers satisfactory results.

In some cases, erectile dysfunction is not due to a detectable physiological problem. Your urologist will evaluate your condition in terms of emotional or mental well-being and may recommend you work with a sex therapist. Stress, anxiety, depression or other emotional or psychological problems can often be alleviated by therapist who encourages a comfortable, honest and confidential discussion of the problem.

Peyronie’s disease

Peyronie’s disease develops when scar tissue or plaque occurs inside the erectile tissue of the penis. Though the actual cause of scar tissue formation is unknown, many men have suffered the condition following a minor trauma that elicited bleeding inside the penis. The resulting plaque is usually benign and noncancerous, but it tends to cause the bending of the penis downward or upward depending on its location.

Men with Peyronie’s disease usually experience pain during an erection and find it difficult to have sex. If you have this problem, you need to see a urologist for a timely diagnosis and treatment. The condition is diagnosed using an ultrasound exam which gives a clear picture of the erectile anatomy and function. Most cases of the disease are mild and the initial pain disappears within 6-12 months, allowing patients to return to normal sexual activity. Urologists treat remaining plaques using personalized treatment plans.

Ejaculation disorders

Ejaculation issues in men include premature ejaculation, inhibited (delayed) ejaculation and retrograde ejaculation. When you have premature ejaculation it means you are not able to delay ejaculation until the point when it is mutually desirable for you and your sex partner. It is the most frequent ejaculation issue, particularly among younger men.

Inhibited ejaculation means your ejaculation occurs slowly or never happens at all. Both premature and inhibited ejaculations have psychological causes, such as anxiety about sex, performance or trauma. But there are techniques that can be used to overcome these issues and a qualified therapist can help you. Speak with your urologist for treatment and referral to a sex therapist when necessary.
Retrograde ejaculation means the ejaculate is forced back into your bladder instead of through the urethra and out of the end of the penis at orgasm. It can be due to nerve damage, side effects of medication or surgery for bladder or prostate.

When you experience retrograde ejaculation, your urologist will change your existing medications or prescribe new ones to treat the issue. However, if the problem is caused by surgery, it might not be correctable. But that should not worry you as treatment is not usually medically necessary with retrograde ejaculation unless pregnancy is your goal.

Vasectomy is permanent contraception

Vasectomy is a simple, effective and minimally invasive surgical procedure offered as a permanent method of birth control. The 30-minute procedure involves cutting tubes that transport sperm within the male reproductive system.

The procedure does not affect the sexual health of a man and is very effective in preventing pregnancy. While vasectomy can be undone, the reversal is quite complex and comes with a lower chance of success. The time to undergo a vasectomy is when you are sure you no longer need to make your partner pregnant, for whatever reason, and consider it as a permanent method of birth control.

At St Pete Urology, we offer timely help to men with sexual health issues. We believe that speaking about these issues with a skilled and experienced urologist will help you resolve them. We also remind our clients that any sexual health issue that lasts several months may be an indicator of a more serious underlying medical issue that needs to be treated.

For instance, premature ejaculation may be due to nerve damage, medication or underlying urinary conditions. Problems with libido or erection may be the first indicator of diabetes or hormonal imbalance; while problems with erection may be due to underlying prostate cancer or cardiovascular issues. Hence, seeing a urologist for your sexual health may help uncover a potentially life-threatening condition.

Of course, there is also a connection between your overall health and your sexual health. In fact, hormonal, cardiovascular, neurological and psychological systems all contribute to your sexual performance. A healthy lifestyle that includes a good diet, healthy weight and regular exercise will promote your overall health while enhancing your sexual health and performance. For more information on men’s sexual health issues, visit the St Pete Urology website.

Symptoms of Low Testosterone

Testosterone is a sex hormone found in humans, with men having much higher levels than women. Production of the hormone usually increases during puberty in order to help with the development of adult male physical features. Testosterone also helps maintain various critical bodily functions in men, including muscle strength and mass, body and facial hair, mood, deeper voice, red cell production, bone density, fat distribution, sperm production, erections and sex drive. In fact, due to the role of the hormone in various bodily functions, a decline in its levels can cause significant undesirable changes.

What is low testosterone?

When men have low testosterone levels, the condition is called “low-T” or hypogonadism. The bottom limit of normal testosterone in men is around 300 nanograms per deciliter (ng/dL) while the upper limit is about 900ng/dL depending on the lab. Low testosterone results in a lower-than-normal score from a blood test. Although testosterone production increases sharply during puberty, it usually decreases after age 30 at an estimated rate of 1% per year. This decrease results in low testosterone levels in about 4 out of 10 men above the age of 45, 2 out of 10 men over 60, 3 in 10 men over 70, and 3 in 10 men over 80 years of age. Nevertheless, the age at which testosterone deficiency first appears varies widely. Some men feeling great into their 70’s while a minority requires testosterone replacement therapy in their 20’s or even in their teens.

What are the symptoms of low testosterone?

  1. Diminished sexual function

Since testosterone is responsible for sex drive and high libido in men, a drop in hormone levels may result in a decreased desire for sex, a slightly lower sperm count, infertility, fewer and weaker spontaneous erections, increased refractory period after ejaculation and decreased sexual performance. Although erectile dysfunction (inability to achieve or maintain an erection) may not necessarily be caused by insufficient testosterone, if it accompanies low-T then hormone replacement therapy can help to treat the condition. The adverse effects of low-T should not occur suddenly. If they do, other underlying issues should be investigated and treated by a urologist or physician.

  1. Adverse physical changes

Since testosterone is responsible for increasing muscle mass, maintaining body and facial hair and contributing to the overall masculine form, a man with low testosterone will gradually experience physical changes. Such changes may include fragile bones, decreased strength and endurance, reduced muscle mass, increased fatigue, decreased body hair, hot flashes, tenderness or swelling in the breast tissue, frequent back pain, increased body fat, increased build-up of bad cholesterol, development of male breasts (gynecomastia) and increased risk of heart attack.

  1. Mental and emotional problems

Low-T can affect a man mentally and emotionally. For instance, a man with low testosterone may experience memory problems, difficulty concentrating (brain fog), sleep disturbances, frequent feelings of sadness and depression, irritability, mood swings, diminished self-confidence and reduced motivation. An accumulation of these mental and emotional challenges may degrade a man’s overall sense of well-being and adversely affect his quality of life.

Why should you see a urologist?

Men experiencing these symptoms should see a doctor for advice and treatment. The symptoms described above are not unique to low testosterone levels and could also be the normal side effects of aging or the effects of another serious condition such as thyroid malfunction, injury to testicles, testicular cancer, infection, HIV, type II diabetes, alcohol use, pituitary gland problems, genetic abnormalities affecting the testicles, or side effects of certain medications. By visiting a urologist, you will be examined, tested and treated for the correct condition causing the symptoms.

At St Pete Urology, we have skilled and experienced board-certified urologists who can give you proper advice on managing the symptoms of low-T. We will determine your testosterone level through a blood test and effectively treat the symptoms, allowing you to feel your best throughout your life. For more information on treatment of low-T, visit the St Pete Urology website.

What color is urine when kidneys are failing?

Kidney failure is a condition in which one or both kidneys can no longer work on their own. It may be due to an acute injury to the kidneys or a chronic disease that gradually causes them to stop functioning. When kidneys are healthy, they clean the blood by removing excess fluid, minerals and wastes. But when they are failing, harmful wastes build up in the body and excess fluid is retained, changing the appearance, amount and number of times urine is passed.

Clues from urine color

Urine can provide a lot of information about what is going on in the body, including kidney failure. It can be all sorts of colors, from pale yellow to amber, and even pink, orange or green. For healthy urine, the color ranges from pale yellow to amber-colored, depending on the body’s hydration level. Pale yellow urine means high hydration while dark amber means more concentrated urine, indicating dehydration.

The pigment called urobilin (urochrome) causes the yellow color in urine. The kidney filters out this byproduct from the bloodstream and removes it from the body in urine. The more fluids you drink, the lighter the color of this pigment in urine. The less you drink, the stronger the color. For example, during pregnancy there is 50% increase in blood volume, so urine tends to be clearer and more diluted during pregnancy.

What urine colors are abnormal?

Paying attention to the color of urine can make you aware of your kidney health and alert you to the need for a medical checkup. Clear to yellow urine is normal and indicates normal kidney function, while odd colors such as orange or blue may be due to certain medications such as laxatives, antidepressants and antibiotics. But there are two colors that you must take seriously: red and dark brown.

Pink or red urine means red blood cells are present in urine. These colors may be a sign of infection, kidney stones or even cancer. Dark brown urine could mean you are extremely dehydrated, but if you drink plenty of fluid and the urine is still brown then you may have muscle breakdown, kidney disease or kidney failure.

What is the color of urine when kidneys are failing?

When kidneys are failing, the increased concentration and accumulation of substances in urine lead to a darker color which may be brown, red or purple. The color change is due to abnormal protein or sugar, high levels of red and white blood cells, and high numbers of tube-shaped particles called cellular casts. The presence of blood in urine may make urine appear red or the color of tea or cola. Dark brown urine occurs in kidney failure due to the buildup of waste products in urine or urinating less often and in smaller amounts than usual.

Foaming or fizzing urine may also be a sign of kidney failure, though foam is not a color and usually occurs due to increased protein in urine or kidney disease. Foamy urine indicates a diminished ability of the kidney to filter and clean the blood.

Treatment of kidney failure

Kidney failure can be a debilitating and life threatening condition with symptoms such as lethargy, weakness, generalized swelling, shortness of breath, congestive heart failure and fatal heart rhythm disturbances. If your kidney is failing, treatment of the underlying disease may be the first step in correcting the problem.

Many causes of kidney failure are treatable and visiting a urologist will ensure the underlying condition is diagnosed and treated to restore normal function. The urologist may also plan for control of blood pressure, diabetes or other underlying conditions as a way of preventing chronic kidney disease. But in some situations, kidney failure is progressive and irreversible. When that happens, the only treatment options are dialysis or transplant, each with benefits and drawbacks.

Whatever treatment your urologist recommends, you will need to make some changes in your life, including how you eat and plan your activities. With the help of your urologist, family and friends, you can continue to lead a full and active life. For more information on symptoms, diagnosis, treatment and management of kidney failure, visit the St Pete Urology website.

Benefits of Testosterone Therapy

Low testosterone can diminish a man’s sex drive, energy, motivation and performance. This is why testosterone replacement therapy (TRT) is recommended for men whose blood levels of the hormone testosterone have fallen below the normal range. Additional symptoms of low testosterone may include facial and body hair loss, decreased muscle mass and fatigue or irritability and anger. Supplemental testosterone administered by gel, injection or skin patches can restore hormone levels back to normal and enhance both physical and mental health.

What is a normal testosterone level?

The normal levels of testosterone for men range from 300 to 900 nanograms per deciliter (ng/dL). When levels fall within this range, there is little to be gained from testosterone therapy. However, this range is only for total amount of testosterone and does not present the whole picture.

Urologists will also measure what is called free testosterone, the amount of testosterone that is active in a man’s body at a given time. A man with a normal range of total testosterone may still experience classic symptoms of low testosterone if his free testosterone level is low. Free testosterone level is the better indicator of whether treatment will be beneficial.

Benefits of testosterone therapy

Low free testosterone is a major factor in sex difficulties for men which is why testosterone replacement therapy can be an effective way to renew interest in sex and boost the ability to achieve and maintain an erection and orgasm. In addition, restoring normal testosterone through treatment has several benefits beyond sexual performance.

According to several medical studies, testosterone therapy can reduce the health problems related to diabetes, osteoporosis, metabolic syndrome and even obesity. Treating low testosterone helps to strengthen bones and prevent osteoporosis. There is also evidence that testosterone boosts blood sugar control and aids in preventing diabetes. Likewise, testosterone therapy can improve anemia and reduce the risk of cardiovascular disorders.

Testosterone also plays a critical role in how long a man lives. Studies have shown that there is a link between low free testosterone and shorter life expectancy in men. This link may be due to the role testosterone plays in reducing fat in the body while increasing muscle mass, indicating that the therapy is good for overall health.

Should you try testosterone replacement therapy?

If you are experiencing problems associated with low testosterone and considering this treatment, it is important to see your urologist or physician first to discuss whether the therapy will benefit you. A urologist will review your medical history, perform an examination and order tests for both total and free testosterone before suggesting a treatment that can dramatically improve your quality of life. For more information, visit the St Pete Urology website.