Can you still ejaculate after a vasectomy?

A vasectomy does not affect your ability to ejaculate. Neither does it have any adverse effect on the appearance of the ejaculate. You will still have normal ejaculations and enjoy orgasms after the procedure.

Why is there no change in ejaculation?

A vasectomy is a surgical procedure done on the vas deferens—the tubes that transport the sperm to the urethra, which then carries it out of the body during ejaculation. During the procedure, your doctor will cut and seal the vas deferens tubes to make it impossible for sperm to leave the body via ejaculation.

Even after a vasectomy, your body will still function normally. Your testes continue to make sperm, but the sperm cannot pass through the vas deferens and are reabsorbed back into the body. As a result, you are no longer able to get your partner pregnant. With an almost 100% success rate, this procedure is considered one of the most effective birth control methods.

You will continue to have normal ejaculations because sperm only makes up 2-5% of the semen. The rest of the semen is made in the seminal vesicles and the prostate gland. You will hardly notice any difference in its volume.

A vasectomy does not affect semen quality, texture and amount, and does not reduce the sensation during orgasm.

First ejaculation after a vasectomy

You should wait for a few days after the surgery before you have sex or masturbate. Following a vasectomy, you will feel some pain, soreness, swelling, and discomfort in your testicles, particularly around the small wounds on each testicle where the doctor made the incision.

It is advisable to avoid sex for 1-2 weeks to prevent the irritation of tissues that are already swollen and sensitive. After about two weeks, you can resume sexual activity.

The discomfort felt during the first few ejaculations should lessen with time. There may also be some blood in the semen. If you experience discomfort well into the third week, you should see your doctor as it may be a sign of a complication.

Roughly 1-2% of men who have a vasectomy experience post-vasectomy pain syndrome—a chronic testicular pain that lasts for at least three months. The condition causes constant or occasional pain and may lead to painful ejaculations.

Sexual activity after a vasectomy

With the pain and swelling gone, you can resume sexual intercourse with your partner. However, it is important to remember that sperm will still be present in the tubes for several weeks. To avoid pregnancy, you should use condoms or another form of birth control for at least the first three months after the procedure.

You will need a follow-up test after three months or about 20 ejaculates to check for sperm in the semen. If you still have sperm in your ejaculate at this point, you will need to use another form of contraception until a semen analysis confirms that your ejaculate is sperm-free.

Just like sexual intercourse, it is safe to masturbate after the vasectomy wound has healed and the swelling and pain are gone. To obtain semen for analysis, your doctor will ask you to masturbate into a cup at home or in the doctor’s office. You do not need additional precautions before masturbating after a vasectomy.

Enhanced sexual performance

A vasectomy does not have any adverse impact on bodily processes, hormones, or penile structure. Hence, it does not affect sex drive, sexual performance, ejaculation, or erectile function.

You will still have the same libido level as before, get erections, ejaculate, and have orgasms. And with the stress of unplanned pregnancy eliminated, you should find lovemaking more spontaneous, pleasurable, and satisfying.

The procedure also does not affect the secretion of the male hormone testosterone. There is usually a little testosterone boost because the hormone is no longer lost in the vas-deferens fluid when you ejaculate. And by helping you to reabsorb some testosterone into the body, it should give a slight boost to your sex drive.

Likewise, because erectile dysfunction can be triggered by stress, not worrying about unwanted pregnancy means you are freer to experiment during intercourse. Your greater confidence to engage in sexual activity can enhance the experience and improve your overall sexual performance.

Safe, effective vasectomy

Are you a man who is done having children? If so, you can have a safe, effective vasectomy procedure at St Pete Urology. At our state-of-the-art facility in St Petersburg, Florida, hundreds of vasectomies are performed every year with remarkable success. Our patients can enjoy their sex lives with more freedom to express themselves and without the fear of unplanned pregnancy.

How To Pass Kidney Stones?

Passing a kidney stone is an agonizing and traumatic experience. It’s something you wouldn’t wish for anyone, even your worst enemy. And you will want to do anything to avoid going through the ordeal again. Sadly, kidney stones are bound to recur in about 50 percent of people who have had them, often within 10-15 years if preventive measures are not taken. They occur more frequently in men than women and may lead to serious complications if not dealt with promptly, effectively and appropriately.

Triggers of kidney stones?

Kidney stones typically develop when the concentration of certain substances such as oxalate, uric acid and calcium are high enough in urine to form crystals. Once crystals are formed in the kidneys, they grow larger and solidify into “stones.” Most kidney stones (about 80-85 percent) are made of calcium while the others are uric acid stones occurring in people whose urine PH level is low.

Symptoms of kidney stones

Once they are formed, kidney stones can dislodge and move down the ureter, obstructing urine flow. As a stone moves through the ureter, it causes periods of severe, excruciating pain, including pain in the flank — pain occurring on one side of your body between the back and the stomach. In some cases, there may be nausea, vomiting and blood in urine. When the stones move beyond the ureter and toward the bladder, they are usually accompanied by bladder pressure, groin pain and frequent urination. If you have any of these symptoms, check with your primary care physician for help. The doctor most likely will do a urinalysis and an abdominal X-ray, renal ultrasound or CT scan to ascertain whether you have kidney stones and determine their number and size.

Allowing kidney stones to pass

It usually takes many weeks to a few months for kidney stones to pass spontaneously. The length of time to pass a stone depends on its size and location. As you wait for the stone to pass, you can use over-the-counter painkillers, such as acetaminophen (Tylenol), naproxen (Aleve) or ibuprofen (Motrin IB or Advil) to reduce the discomfort. Your doctor may prescribe an alpha blocker to help relax your ureter muscles and ensure the stone passes faster and with minimal pain.

For kidney stones that are too big to pass or are accompanied by very severe pain, surgical removal may be necessary. Your doctor may undertake a procedure called ureteroscopy, where a tiny endoscope (a device fitted with a small video camera and various tools fixed at the end of a long tube) is inserted into the bladder, then up the ureter to reach the stone. This is done while you’re under general anesthesia. Once the stone is reached, it’s broken down into smaller fragments and removed.

How can you prevent kidney stones?

Kidney stones are common and often recur in people who have had them. That’s why you should take the necessary steps to prevent them from forming. Some of the strategies to prevent kidney stones include:

1. Drink enough water: If you can produce 2 to 2.5 liters of urine every day, then you’re 50 percent less likely to have kidney stones than a person who produces less urine. To help you maintain such a level of urine production every day, you should drink about 8-10, eight-ounce glasses (roughly 2 liters total) of water every day.

2. Avoid high-oxalate foods: It is okay to eat foods with moderate to low quantities of oxalate, such as berries and chocolate. But you should avoid high-oxalate foods like almonds, beets and spinach, which will raise oxalate levels in your body.

3. Keep sodium in check: A diet with a lot of sodium can cause kidney stones because it increases the quantity of calcium that’s present in urine. Limit your total daily sodium intake to below 2,300 milligrams (mg). If you have had a previous incident of kidney stones due to the amount of sodium in your diet, then you need to reduce your daily sodium intake to about 1,500mg.

4. Take some lemons: Lemons provide citrate, a citric acid salt, which binds to calcium and prevents kidney stone formation. If you drink a cup of lemon juice concentrate that’s diluted in water each day, or just pure juice from two lemons, you will boost your urine citrate and reduce your risk of kidney stone.

5. Reduce your consumption of animal protein: If you’re prone to kidney stones, you should reduce your intake of animal proteins. Eating too much of eggs, meat and seafood, among other animal proteins, increases uric acid levels in the body and promotes the formation of stones. While you don’t have to avoid proteins altogether, you can opt for plant-based proteins instead.

Kidney stones are a painful and distressing condition that’s better prevented than treated. That’s why at St Pete Urology, we not only provide a variety of safe and effective kidney remedies, but also offer information to our patients so they can take action to prevent the stones from occurring. For those with stones, we offer extracorporeal shock-wave lithotripsy, ureteroscopy with either holmium or EHL Laser, ureteral stent and percutaneous nephrolithotomy, among other remedies. Don’t suffer in silence. If you suspect you have kidney stones, contact us so we can help you. For more information on the prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

What are the symptoms of infertility in males?

Defined as inability of a couple to achieve pregnancy after at least one year of frequent, unprotected sexual intercourse, infertility affects women and men equally. Up to 15 percent of couples are unable to achieve pregnancy after one year of unprotected sex while 10 percent of couples are unable to have a successful pregnancy after two years. In couples suffering from infertility, about 35 percent of the cases are caused by male factors, 35 percent are caused by female factors, 20 percent are due to both female and male factors, and the remaining 10 percent are due to unexplained causes. These figures indicate that male infertility is a significant contributor to infertility of couples. To get his female partner pregnant, a man must:

1. Produce healthy sperm: That includes proper growth and development of reproductive organs during his puberty, with the testicles functioning properly, and his body must make enough testosterone and the other hormones necessary for sperm production.

2. His sperm must reach semen: After sperm production in the testicles, they must be transported in the tubes until they get into semen for ejaculation through the penis.

3. He must have enough sperm in semen: The sperm count (numbers of sperm found in semen) must be sufficient in order to increase the odds of fertilizing the ovum (egg). A lower-than-normal sperm count is having fewer than 39 million sperm per ejaculate or less than 15 million sperm in every milliliter of semen.

4. His sperm must be both functional and motile: If the function and movement (motility) of sperm is abnormal, the sperm may not reach or penetrate his partner’s ovum (egg).

Male infertility symptoms

The most obvious sign of infertility in men is inability to make a wife pregnant. But in most cases, male infertility occurs because of an underlying problem, such as low sperm production, a blockage preventing sperm delivery, abnormal sperm function, hormonal imbalance, inherited disorder, dilated veins in the testicles, illnesses and chronic health problems, lifestyle choices, injuries, and other factors. So even though most infertile men may not notice any symptoms apart from their inability to make their female partners pregnant, other male infertility symptoms do exist.

Symptoms of infertility include:

  1. A lump, swelling or pain in the testicular region.
  2. Sexual function problems, such as reduced sperm volume, difficulty with ejaculation, difficulty achieving and maintaining erections, or reduced sexual desire.
  3. Inability to smell.
  4. Recurrent respiratory infections.
  5. Decreased body or facial hair and other signs of hormonal or chromosomal abnormality.
  6. Gynecomastia (abnormal breast growth).
  7. A lower-than-normal sperm count (total sperm count below 39 million per ejaculate or less than 15 million sperm in each milliliter of semen).

Male Infertility Causes

Male infertility may be caused by a number of medical, environmental and lifestyle issues.

1. Medical causes

a. Varicocele: Refers to the swelling of veins draining the testicles. It’s the most frequent reversible factor in male infertility and it triggers infertility by hampering testicular temperature regulation, which in turn reduces sperm quality. When varicoceles are treated, sperm function and numbers improve, and the outcomes are better than opting for assisted reproductive techniques like in vitro fertilization.

b. Infections: Infections that interfere with sperm health and production or obstruct the passage of sperm, such as epididymitis (inflammation of epididymis), orchitis (inflammation of testicles) and certain sexually transmitted infections like HIV or gonorrhea, may contribute to male infertility. Though some infections may lead to permanent testicular damage, sperm is still often retrievable in most infections.

c. Sperm-attacking antibodies: Anti-sperm antibodies are typically immune system cells which mistakenly recognize sperm cells as harmful invaders and try to eliminate them.

d. Tumors: Cancers and non-malignant tumors of the male reproductive organs and the glands releasing reproductive hormones, like the pituitary gland, may lead to male infertility. In some instances, chemotherapy, radiation or surgery used to treat these tumors may affect male fertility.

e. Undescended testicles: During fetal development, one or both testicles may fail to move from the abdomen to the scrotum (sac that usually contains the testicles). Men who have had undescended testicles have a bigger risk of infertility.

f. Hormone imbalances: Disorders of the testicles and abnormalities of hormonal systems such as pituitary, hypothalamus, adrenal and thyroid glands can contribute to male infertility. Likewise, male hypogonadism (low testosterone) and other hormonal issues can affect fertility.

g. Defects of tubules transporting sperm: Tubes that carry sperm can be blocked through inadvertent injury during surgery, trauma, prior infections or abnormal development, including cystic fibrosis and similar inherited conditions. Blockage may occur at any level, such as within the testicle, in the epididymis, tubes draining the testicle, in the urethra, near ejaculatory ducts or in the vas deferens.

h. Ejaculation problems: During ejaculation, semen may occasionally enter the bladder instead of coming out through the tip of the penis. This is called retrograde ejaculation and it can be caused by various conditions, including spinal injuries, diabetes, medications, and bladder, urethra or prostate surgery. In men with spinal cord injuries or certain diseases, sperm is produced but semen can’t be ejaculated. In these cases, sperm can be retrieved and used in assisted reproductive techniques.

i. Chromosome defects: Abnormal development of male reproductive organs can be caused by inherited disorders like Klinefelter’s syndrome — whereby a male is born with two X and one Y chromosomes instead of the normal one X and one Y chromosomes. Other genetic syndromes related to infertility include Kartagener’s syndrome, Kallmann’s syndrome and cystic fibrosis.

j. Celiac disease: This is a digestive disorder resulting from sensitivity to gluten. It can cause infertility in men, but improves with adoption of a gluten-free diet.

k. Sexual intercourse issues: Problems such as premature ejaculation, erectile dysfunction, painful intercourse, relationship or psychological problems that interfere with sex, or anatomical abnormalities like hypospadias (having a urethral opening underneath the penis) can contribute to infertility.

l. Certain medications: Drugs such as cancer medications (chemotherapy), long-term anabolic steroid use, testosterone replacement therapy, some ulcer drugs, certain antifungal medications and various other medications can impair sperm secretion and reduce male infertility.

m. Prior surgeries: Inguinal hernia repairs, vasectomy, prostate surgeries, testicular or scrotal surgeries, and large abdominal operations performed for rectal and testicular cancers, among others, can reduce the chances of having sperm in the ejaculate. In most cases, the blockage can be reversed surgically or sperm can be retrieved directly from the testicles and epididymis.

2. Environmental causes

Excessive exposure to environmental elements like heat, chemicals and toxins can reduce sperm production and function. Specific environmental factors include:

a. Exposure to heavy metals such as lead.

b. Prolonged exposure to toluene, xylene, benzenes, herbicides, pesticides, painting materials, or organic solvents, which results in lower sperm counts.

c. Overheating the testicles: Elevated temperatures can impair the production and function of sperm. For instance, frequent use of hot bath tubs or saunas may temporarily lower your sperm count. Wearing tight clothing, long periods of sitting, or working for long stretches of time on a laptop may increase scrotum temperature and slightly decrease sperm production.

d. Exposure to X-rays or radiation can lower sperm production, though eventually it will return to normal. But exposure to high doses may reduce sperm production permanently.

3. Lifestyle, health and other male infertility causes

a. Alcohol use: Excessive consumption of alcohol can reduce testosterone levels, decreasing sperm production and causing erectile dysfunction. Liver disease due to excessive drinking also may cause fertility problems.

b. Drug use: Use of marijuana or cocaine may temporarily lower sperm numbers and viability. Anabolic steroids used to stimulate muscle growth and strength can reduce testicle size and decrease sperm production.

c. Tobacco smoking: In men who smoke, sperm counts are generally lower than in non-smokers. Likewise, male infertility may occur in men frequently exposed to secondhand smoke.

d. Weight: Obesity can directly impact sperm themselves or cause hormonal changes that may reduce male fertility.

e. Depression: In men with depression, sexual dysfunction and subsequent infertility can result from erectile dysfunction, reduced libido, or inhibited or delayed ejaculation. In fact, the likelihood of pregnancy is lower in couples where the male partner suffers from severe depression.

f. Emotional stress: Prolonged or severe stress can interfere with various hormones necessary for sperm production and affect sperm count.

So what are the infertility risk factors in men:

  1. Being overweight
  2. Being severely stressed or depressed
  3. Using alcohol
  4. Smoking tobacco
  5. Using certain drugs
  6. Trauma to the testicles
  7. Overheating the testicles
  8. History of undescended testicles
  9. Exposure to certain toxins
  10. Having certain present or past infections
  11. Prior pelvic surgery, major abdominal surgery or vasectomy
  12. Family history of a fertility disorder or being born with such a disorder
  13. Certain medical disorders, including chronic illnesses (like sickle cell disease) and tumors
  14. Undergoing medical treatments (like radiation or surgery for treating cancer) or taking certain medications.

How can you prevent infertility?

You can do so by avoiding some of the known causes of infertility. For instance:

  1. You should not smoke.
  2. You should abstain from or limit alcohol consumption.
  3. You should stop using illicit drugs.
  4. You should lose some weight.
  5. You should reduce stress.
  6. You should avoid exposure to heavy metals, pesticides and other toxins.
  7. You should avoid activities that result in prolonged heat to the testicles.

When should you see a doctor?

You should see a doctor if you’ve been unable to achieve pregnancy after 1 year of frequent, unprotected sexual intercourse. But you may need to see a doctor sooner than that if:

  1. You have ejaculation or erection problems.
  2. You have low sex drive or any other issues with sexual function.
  3. You have discomfort, pain, a swelling or lump in your testicles.
  4. You have a history of prostate, testicle or sexual problems.
  5. You have previously undergone a penis, groin, scrotum or testicle surgery.

For more information on male infertility and how to deal with it, visit the “St Pete Urology” site.

How do men deal with incontinence?

While a man with urinary incontinence needs to see a urologist for proper and timely treatment, there are certain things he can do on his own to manage the symptoms. In fact, taking these actions will not only prevent and relieve symptoms, but also will help overcome incontinence.Ways of managing urinary incontinence in men include:

1. Keeping a diary

Keeping track of how much fluid you drink, how frequently you have to go to the bathroom, when and how often you leak urine, and anything that triggers your symptoms, such as drinking a lot of coffee, coughing or bending your body in a certain way is an effective way of monitoring your incontinence. Using the diary, your doctor can get a better grip of your symptoms and how they affect your life, and find the right tests necessary for correct diagnosis.

2. Regular double-voiding

Double-voiding is a great way to minimize dribbling. So when you finish urinating, you should wait for a minute or so and then try voiding again. If you succeed to pass urine in the second attempt, you’ll seldom dribble afterward.

3. Cutting down on caffeine and alcohol

Caffeine and alcohol irritate the bladder and often worsen incontinence symptoms. By cutting down the amount of tea, sodas, coffee and alcohol you drink, you’ll make a massive difference with your urinary incontinence symptoms.

4. Quitting smoking

Smoking tobacco aggravates urinary incontinence in men. So the sooner you quit tobacco the better for you.

5. Spacing apart your drinks

Staggering your fluid intake can help to ease the symptoms. For instance, if you are having a lot of trouble at night, drinking less fluid before going to bed might help. And when you have problems during the day, it might help to drink less fluid many hours before you travel or leave home for an event.

6. Avoiding foods that trigger symptoms

Certain foods trigger urinary incontinence symptoms in men. For example, spicy foods and acidic foods such as tomatoes and citrus fruits are common culprits. Likewise, artificial sweeteners and chocolate may trigger incontinence. While everyone is different, it’s wise to identify the foods that worsen your symptoms and avoid them.

7. Training the bladder

Training your bladder can help you to control urinary incontinence. You can do this by starting to take scheduled bathroom breaks whether you are feeling the urge to go or not. Then gradually extend the time you take between your bathroom trips, making a conscious effort to tame your symptoms and push yourself to only pass urine every 3 or 4 hours. Bladder training may not give immediate results, but if you persist, you’ll get positive results within a few months.

8. Flexing your bladder muscles

Exercising the right muscles will help strengthen them and improve your bladder control. Because exercising the wrong muscles may increase pressure on your bladder, you should correctly identify the ones you exercise. The right muscles to focus on are those you would use to stop yourself from passing gas.

So how do you flex them? Apply tension on the muscles for 3 seconds, then allow them to relax for another 3 seconds. Build up gradually until you’re able to do three sets of ten repetitions. You can perform these exercises anywhere — at your desk, in bed or when watching TV, but don’t do them when urinating as that can lead to infections. You should do the exercises for 15 minutes per day. While it usually takes 3-6 weeks to achieve the desired effect, positive results may be noticed soon by men who are doing the right exercises frequently.

9. Lose weight and stay hydrated

Excess weight increases pressure on the abdomen and makes urinary incontinence worse. By shedding a few pounds, you can reduce symptoms. Likewise, while it seems a good idea to drink less water in order to prevent leaks, drinking less only makes urine more concentrated and increases bladder irritation, resulting in more urinary incontinence. Therefore, if you’re thirsty, drink some water.

10. Treat constipation

Constipation, together with the strain that comes with it, can negatively affect the nerves that control bladder function. By eating a high-fiber diet and taking the necessary actions to prevent constipation, you may help your incontinence.

11. Speak with your doctor about any medication adverse effects

Some medications and supplements can cause or worsen your incontinence. For instance, sedatives, antidepressants, diuretics and various allergy and cold medicines may elicit urinary problems. So make sure your doctor is aware of the medicines and supplements you’re using and of any adverse effects you’re experiencing.

12. Planning ahead

A lot of men with urinary incontinence are anxious whenever they have to travel, fearing accidental urine leaks. To ease your anxiety when going on a road trip, make sure to map out the route and identify the places you’ll stop at regular intervals to use the bathroom. Going out with a plan will make you confident and less prone to accidental urine leaks.

13. Get support

Urinary incontinence can be both stressful and embarrassing and you may even feel lonely and hopeless. So you should make an effort to remain connected with your family and friends. Joining a support group also may be beneficial. Your doctor can help you find any support groups in your area.

Applying these techniques may help relieve urinary incontinence symptoms. But because on their own these techniques are inadequate for managing urinary incontinence, you should work closely with your doctor to find the best solutions for your condition, particularly if the symptoms are adversely affecting your life. It’s also prudent to always speak with your doctor before you try any of these techniques for managing urinary incontinence. If you’re looking for a urologist near you, then you can always see one of our urologists at Florida’s St Pete Urology in St. Petersburg. For more information on the right treatment plan for urinary incontinence in men, visit the “St. Pete Urology” site.

GreenLight PVP Laser, a Great Treatment Option for BPH

Photo-selective Vaporization of Prostate (PVP) is increasingly becoming a popular method of treating benign prostatic enlargement (enlarged prostate or BPH). Using a combination of a high-powered laser beam and fiber optics to vaporize overgrowths of cells in the prostate, PVP helps to shrink the prostate gland quickly and accurately and swiftly relieves symptoms of Benign Prostatic Hyperplasia. The GreenLight Laser PVP is an alternative to the more common TURP (Transurethral Resection of Prostate). While the PVP procedure offers equal effectiveness in improving BPH symptoms, it’s simpler, has minimal short-term side effects, and offers quicker symptom relief, comfort and ease of urine flow.

How Is The Procedure Performed?

Conducted as an outpatient procedure by a urologist trained in the technique, the GreenLight Laser PVP requires nerve-blocking, spinal or general anesthesia along with sedation. During the procedure, the urologist inserts a cystoscope (tube supplied with light) via the urethra into the prostate, then runs a thin fiber through the cystoscope and places it in the urethra just adjacent to the obstruction. The urologist directs the laser at the prostate with intense pulses of light radiating from the ends of the fiber that are absorbed by blood.

As the blood absorbs light its temperature increases rapidly, heating up and vaporizing nearby cells. The surgeon continues to apply the laser light to destroy tissue overgrowth and reduce restriction on the urethra. The tissue that’s evaporated seals the blood vessels and reduces bleeding. The procedure takes roughly 40-60 minutes and a temporary catheter is usually inserted to help drain urine from the bladder.

So what are the benefits of Laser PVP?

  1. Minimal bleeding.
  2. Patients return home the same day.
  3. Return to normal activities in 2-3 days with caution.
  4. Only about 30 percent of patients require a post-op catheter.
  5. Return to strenuous activities in 4-6 weeks.
  6. Complications are rare, but quite mild if they occur.
  7. No post-operative impotence.
  8. PVP has not been associated with erectile dysfunction.
  9. Less likely to cause retrograde ejaculation.
  10. Lasting improvement in urine flow.
  11. Urinary obstruction is less likely with PVP.

Recovery after GreenLight Laser PVP

After laser PVP, patients remain in a recovery area where they are observed and prepared for discharge, typically within a few hours. If a temporary catheter is inserted, it’s usually removed 2-3 days after treatment, but may be left for a longer period in men who have had very severe symptoms or suffered prior bladder damage. During the first week following the procedure, a slight burning and discomfort may be experienced when urinating and small amounts of blood may occur in urine. While a dramatic improvement of symptoms and urine flow occurs within 1-2 days after the procedure, patients may still experience frequency and a sudden urge to pass urine for some time after treatment since the urethra is still adjusting to changes. And those with multiple health problems may not realize improvement that quickly.

Many men resume normal activities three days or so after laser PVP, but it’s recommended that they refrain from heavy lifting, pushing, strenuous exercise and vibrating equipment for at least 2 weeks because such activities may aggravate the urogenital area and cause bleeding. Sexual activity should be avoided for 2-3 weeks and only resumed when the patient is really comfortable doing so. It’s crucial to take things slowly and realize that it’ll take a while to get everything back to normal, including sexual desire. At times, retrograde ejaculation or reduced volume may occur, but these do not affect sexual pleasure or orgasm.

Is Laser PVP Safe?

The GreenLight Laser PVP is a significant improvement on the other minimally-invasive procedures used to treat BPH. It accurately vaporizes the overgrowth of the prostate gland without damaging any surrounding tissues and vessels. High-powered energy beams are delivered through a very thin laser fiber resulting in safe and precise vaporization of the overgrown tissue that’s blocking normal urine flow. As the high-pulsed laser removes the tissue causing blockage, it coagulates blood vessels and minimizes bleeding. Compared to other options for treating BPH, the GreenLight Laser PVP is much safer, simpler, faster, more precise and more effective. And most importantly, it allows quicker recovery than the other treatment options.

How does laser PVP compare with TURP?

Previously, effective BPH treatment required open prostatectomy — a major abdominal operation that needed a longer hospital stay and several months for recovery. But with the availability of instruments for accessing the prostate via the urethra instead of through the abdomen, TURP (transurethral resection of prostate) became the preferred treatment as it offered more safety, efficiency and effectiveness. However, there was still need for a better treatment that could offer quicker results, shorter recovery times and fewer long-term side-effects. The GreenLight Laser PVP has proven an improvement on TURP by being less invasive, delivering more immediate results and providing shorter recovery periods.

At St Pete Urology, we recommend transurethral vaporization procedures, most commonly the PVP GreenLight Laser and HoLAP (Holmium Laser Ablation), as alternatives for the previous gold standard TURP (Transurethral Resection of Prostate) because they are minimally-invasive outpatient operations with lower risks, durable results, safe use on large glands and patients on blood thinners, and high patient satisfaction. We perform the PVP GreenLight Laser on patients eligible for TURP, but discuss all the treatment options with our patients before we make a choice. For more information on treatment and care for BPH, visit the “St Pete Urology” site.

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.

Early Signs of an Enlarged Prostate

As you grow older, your prostate also grows and swells. But if it becomes very large, it can lead to a condition called BPH (benign prostatic hyperplasia), which simply means your prostate has grown too large though not cancerous. Usually called an enlarged prostate, BPH is a frequent condition in men, especially those in their 50s or older. It is primarily caused by excess DHT, an extremely powerful form of testosterone which triggers aggressive multiplication of prostate cells. Recent studies also indicate that excessive estrogen in the body plays a role in the overgrowth of the prostate.

How can you know that you have an enlarged prostate?

Located right next to the bladder, the prostate is a tiny, walnut-sized gland that’s vital for the normal functioning of the male reproductive system. It is wrapped around the urethra (the tube that takes urine away from the bladder) and significantly influences how the urethra transports both sperm and semen. As the prostate grows and swells, it puts a lot of pressure on the bladder and can obstruct urine flow through the urethra, resulting in various urinary issues.

If you have an enlarged prostate, you will:

  1. Find it difficult to urinate.
  2. Experience dribbling after urinating.
  3. Feel the need to urinate frequently, often at night.

The early warning signs of BPH include:

1. Weak or slow urination

As your prostate enlarges, it puts pressure on your urethra and bladder, interrupting urine flow, resulting in either a weak flow or a prolonged stay in the bathroom. This is a very early and most common sign of BPH, and you’ve probably heard older men joke about how long they take to urinate. So when you have an enlarged prostate, urine does not exit normally and the resulting stream is quite weak.

2. Leaking of urine

Those embarrassing wet spots on your pants may just be the warning that you have an enlarged prostate. Why? Because a swollen prostate not only makes it difficult to urinate, but also makes it harder to retain urine in your bladder, resulting in urine leakage. The enlarged prostate also puts a lot of pressure both on your urethra and on your bladder and compromises your normal ability to hold urine.

3. Straining when urinating

Normal urination requires no effort. So if you find yourself groaning and suffering every time you are in the urinal, it may indicate that your prostate is clamping hard on your urethra.

4. Waking up several times at night to urinate

An enlarged prostate also puts extra pressure on the bladder, producing a sensation that the bladder is full even when it really isn’t. Thus waking up often at night to pass urine may indicate that you have BPH.

5. High PSA during a blood test

While prostate-specific antigen is produced in small quantities in men with healthy prostate glands and plays the critical role of liquefying semen by breaking down large seminal proteins, high levels of PSA may indicate that you have an enlarged prostate or prostate cancer. Make sure that you speak with a doctor if a test shows that you have high PSA in your blood.

6. Sexual dysfunction

BPH can trigger erectile dysfunction and difficulty with ejaculation by applying extreme pressure on the urethra (which transports both urine and semen) and reducing your sexual function. So if you are finding it difficult to have an erection or ejaculation, you should see your doctor for an examination to identify the problem. It may just be an enlarged prostate.

How can a urologist help?

When you experience the warning signs, you need to see your doctor to determine if you have an enlarged prostate. If an examination establishes that you have BPH, the urologist will recommend the right treatment. The most common approaches to treating BPH include:

1. Watchful waiting (active surveillance): If during assessment it is found that your symptoms are mild and not very troublesome, the urologist may recommend that you wait for a while before you commence treatment. Your symptoms will be monitored during this period to see if they are getting worse and require intervention. Your doctor will determine how frequent you need to go for checkup. The treatment can be started later if the symptoms worsen.

2. Medications: Your urologist may recommend medicines for shrinking the prostate gland or to relax the muscles around the gland in order to reduce or relieve symptoms. Make sure to speak with your doctor about possible side effects of these medicines.

3. Surgery: If medicines fail, the urologist may suggest that you undergo surgery to help improve urine flow. Different types of surgical procedures can be used, so talk to your doctor about the right option for you and about the risks involved. After surgery, regular medical checkups are very important.

4. Other treatments: To reduce the extra prostate tissue and relieve urinary problems associated with BPH, treatments such as microwaves, lasers or radio waves may be considered.

Want to know more about the health issues associated with the prostate, their diagnosis and treatment? Or you suspect that you have a prostate problem and want to speak to a knowledgeable and experienced urologist? Get all the information and help you need today by visiting the “St Pete Urology” site.

How To Manage The Pain Of Kidney Stones?

Marked by an agonizing, excruciating and intolerable pain, kidney stones account for over 1 million annual emergency room visits in the United States. The pain usually starts in the upper flank, as a sudden twinge on the side, escalates to the loins and migrates to the front of the body. The sharp stabbing pain of kidney stones is worse than childbirth pain and quickly makes it impossible to function. It is important for you to know how to prevent kidney stones and how to deal with the pain if you get the stones.

What are kidney stones?

Kidney stones are small, hard pebble-like lumps formed when there are high levels of various minerals in urine. The minerals and other substances crystallize and form hard masses before they can be flushed away. Classic stones are a blend of calcium and oxalate (an organic acid found in urine), but lumps of uric acid, calcium phosphate and other substances also may form. A stone may sit in the kidney or ureter with little or no pain. But often when the stone leaves the kidney or gets stuck in the ureter, it blocks the flow of urine and causes pain.

Symptoms of kidney stones

When a kidney stone moves around in the kidney or gets lodged in the ureter, it may block the passage of urine. Such a blockage causes:

  1. Sharp, stabbing pain on the side or in the back.
  2. Painful urination.
  3. Pain episodes that come and go.
  4. Blood in urine.
  5. Fever, nausea and vomiting in case of an infection.

Kidney stones are perhaps the most painful condition known. In fact, most patients with stones often find themselves in the hospital emergency department. In all cases of pain due to suspected kidney stones, urologists first rule out other possible causes of pain, such as bowel, gynecologic and musculoskeletal problems. The presence of kidney stones is confirmed by X-rays or CT scans. Blood and urine tests also may be used to assess the levels of various stone-forming substances in your system.

Managing Pain Due To Kidney Stones

Once it is confirmed that you have kidney stones, the urologist will give you intravenous painkillers to relieve pain. You then will be sent home with oral drugs (such as acetaminophen, aspirin, diuretics, and antibiotics) to use as you wait for the stone to pass out of your system. Drinking plenty of water, taking hot showers, sitting in a warm water tub and taking drugs that dilate the ureter will bring relief and allow the stone to pass. Eventually the agony will end when the stone passes out.

Smaller stones are more likely to pass on their own. In fact, 80 percent of kidney stones are usually less than 4 mm in diameter and typically pass on their own, though that takes up to 31 days. It is more difficult for larger stones to pass on their own. Stones of 4-6 mm in diameter tend to pass on their own 60 percent of the time while those larger than 6 mm only pass out 20 percent of the time. Therefore in most cases, a non-invasive or minimally-invasive medical procedure is necessary to remove stones larger than 4 mm and those stuck in the ureter.

Surgery for Kidney Stones

Non-obstructive stones rarely cause pain. So surgery is not necessary when kidney stones are not causing any obstruction. And even if they cause pain, medications are usually sufficient. But surgery is required when there is bothersome flank pain and imaging evidence of one or more obstructive stones.

Common surgical treatments include:

  1. Shockwave lithotripsy: A simple outpatient procedure in which sound waves are directed on kidney stones, breaking them into smaller pieces capable of passing on their own in urine.
  2. Ureteroscopy: An outpatient procedure for small-to-medium stones in which a small tube (ureteroscope) is inserted into the urinary tract and used to pull out stones or to direct laser to the stones to break them into smaller pieces.
  3. Percutaneous nephrolithotripsy: A procedure in which the urologist makes a small incision in the back and directly into the kidney, using the incision to access and remove stones. It is the most effective method for very large kidney stones.

Preventing Kidney Stones

Lifestyle changes can help you to avoid having kidney stones. For instance, drinking at least two-and-a-half liters of water every day will help you to achieve a daily urine production of two liters, which prevents stones. Fluids such as coffee and citrus juices also are very effective in preventing kidney stones. Citrus (especially from lemon and grapefruit) makes urine more alkaline and reduces the risk of almost all kinds of stones. But you must avoid sugary juices, as the sweetener in them may increase your risk of having stones and undo the good effects of the juice.

If you have had a bout of kidney stones before, you have a greater risk of getting stones. So depending on the chemical constituents of your first kidney stones, you may have to limit intake of certain foods, such as sugar, salt, proteins and dairy products. For calcium oxalate stones, you will have to cut down the amount of meat, eggs, shellfish, peanuts, spinach, chocolate, sweet potatoes, rhubarb and beetroot from your diet. For uric acid stones, taking allopurinol (a gout medication) will help prevent future episodes. Potassium citrate pills and thiazide family of diuretics (indapamide, chlorthalidone and hydrochlorothiazide) are also effective in preventing all calcium-based stones.

Looking for advice or help with kidney stones? At St Pete Urology, we offer timely and accurate advice, diagnosis and treatment of kidney stones. Our multidisciplinary, compassionate, patient-centered approach will ensure you get the best possible care. Don’t suffer the pain of kidney stones for a day more while we can help you get quick relief. For more information, visit the “St Pete Urology” site.

What It Actually Feels Like To Get A Vasectomy

You are married and got the number of kids you always wanted. You also have decided that your family is now complete, right? So, a vasectomy it is, then. For you know that three months after a vasectomy, you will be almost 100 percent sure of no pregnancy. And that it is reversible, with 40-90 percent success rate. That’s great. Now you can go for it and enjoy wonderful times together thereafter with your spouse — no more kids to worry about.

Ready to go?

Well, yes. But there is a problem. You don’t know what it feels like to have a vasectomy and that worries you. Will it hurt? What if something goes awfully wrong down there? How long will it take to get back to 100 percent? The Internet provides answers, but you can’t tell which answers are correct. You find several men saying the experience was so easy that they were able to run a marathon the day after. But others are complaining that their experience made them feel less of a man.

Learning from others

Both sound too extreme. You want to clear the gray areas; you want true, non-medical real-talk. You want to hear from a man who has had a vasectomy and can understand your concerns. Let’s talk about what you will experience, or rather what I experienced.

What is a vasectomy?

A vasectomy is a method of birth control that prevents pregnancy by stopping the supply of sperm to your semen. The tubes (vas deferens) carrying sperm from the epididymis to your ejaculatory ducts are sealed to prevent sperm from moving and getting into the semen. So you continue to ejaculate semen that doesn’t contain sperm and can’t cause pregnancy.

How is a vasectomy done?

Your doctor cuts open your scrotum to access the testicles (two balls inside your scrotum) and locate the tubes (vas deferens). Starting with one testicle, the urologist removes a tube, cuts a chunk out of it, closes the cut ends, puts the now-two tubes back into the testicle and stitches it shut. After that, the doctor turns to the other testicle and repeats the process. The entire procedure takes 10-30 minutes and you are free to go home. While you remain awake throughout the procedure, a local anesthetic applied to your scrotum makes sure you are numb down there. So you can engage in a chat with your doctor as the procedure goes on.

Does it hurt?

Yes, but not as much as you imagine. Initially, pain occurs when the anesthetic is applied. As the anesthetic is applied, you will feel as if someone is whacking your balls with a rubber band many times, resulting in deep, nauseating discomfort. But after that, everything down there becomes numb, though you may still feel the tugging, pulling and pressure during the procedure.

Can it go wrong down there?

Like any surgical procedure, a vasectomy comes with risks, such as infection and hematoma (bleeding in your balls). But overall, it is a safe and effective procedure. Your doctor will discuss with you all the risks of the procedure before you agree to it. And you will sign a waiver document for risks such as impotence, heart attack, bleed out, stroke and death. If you are worried that a vasectomy will trigger prostate cancer, this is the time to chat about it with your urologist. Of course studies have shown that there is no link between prostate cancer and vasectomy.

What about anxiety?

Anxiety can be a terrible part of a vasectomy. But many urologists prescribe medications to relieve anxiety, commonly a single Xanax prescription. If your doctor gives you this, don’t hesitate to take it. It will help you drift away mentally and relax, ensuring you are free from anxiety during the procedure. My urologist did not give me any such medication and I must confess that anxiety was the worst part of my experience.

What of post-op pain?

For a few days after the procedure, you have a dull, generalized soreness down there, accompanied by some low-grade stomachaches. With prescribed pain medication, you feel okay. I took Tylenol regularly plus rest and a couple of beers and felt fine. But the most serious post-op pain occurs when you catch one of the stitches with your underwear. It really hurts. I fell down like a potato sack, and believe you will too. Make sure you don’t catch one of these stitches.

How long will it take for you to recover 100 percent?

It’s different for each person. The doctor will tell you something like 10-14 days, but it may be longer or shorter for you. You definitely should keep off your feet for the first 24-48 hours and keep yourself on ice. You can start to shower after 48 hours, but that won’t be fun. I was able to walk around with slight problems after a couple of days, and started running again after a week with little soreness. I was able to resume my normal activities by day three, but that was because I felt pain-free and was quite bored after two days. Monitor your body well for pain and other complications before you get back to normal activities.

When can you begin to have sex?

The invasive stitches on your balls will remain tender and physically strange for a couple of days. This will make you quite anxious and less prepared for sex. My doctor said, “Go for sex when you are ready.” For me that was around 10 days after the procedure. Your case could be different. So don’t worry too much about it because you will get back to your old self pretty quickly once you and your spouse begin to ignite the flames of passion in the bedroom.

Where can you undergo the procedure?

Depends on which city you live in. But you should go for a doctor with years of experience performing the procedure. A place offering no-scalpel, open-ended vasectomy is great. Mine was done at St Pete Urology and it was great. The urologist was frank and friendly, and we explored a lot of questions before the procedure. Want more information on safe vasectomy? Visit the “St Pete Urology” site.

Is It Ok to Work Out After Getting A Vasectomy?

So you are thinking of having a vasectomy? And you fear it could disrupt your imminent project, work plan, business venture or regular workout routine? You really enjoy what you do and you can’t stand several days away from it. Your fears may be justified considering how long it often takes to recover from various medical procedures. But when it comes to a vasectomy, you really don’t need to worry. A vasectomy will keep you out for a far shorter time than you imagine. And in no time you will be back doing what you like.

Scalpel-Free Open Ended Vasectomy

Previously, vasectomy involved an incision in the scrotum using a scalpel, followed by blocking both ends of the tubes (vas deferens) with a clip, suture or diathermy. This closed-ended technique required stitching of the incision, which increased the risk of infection and complications, like congestive epididymitis (tenderness due to pressure build-up). However, things have since changed and the no-scalpel, open-ended procedure is now the norm. This technique only requires a tiny puncture in your skin using special forceps, followed by closing the upper part of your vas with a suture while leaving open the end of the tube connected to the testicle. In only 15-20 minutes, the procedure is done and you are out to begin your recovery.

Less Strenuous Activities

If all goes well, you can be back to your desk job soon after the procedure. But for a fitness routine or a more physically demanding job, you may require a few days off to recover before returning. Typically, the number of days you need depends on the type of activity you intend to undertake. For instance, you should not engage in activities requiring standing and walking all day or carrying loads greater than 10-15 kg until after one week. Likewise, for non-contact sports such as swimming, golf and tennis, you need 2 weeks before you can return. For cycling, you should take 2 weeks off before engaging in stationary cycling, at least 3 weeks before getting back to road cycling, and at least 4 weeks before you can engage in mountain biking.

More Strenuous Activities

Before you can engage in more strenuous activities, you need more time off to recover. For instance, contact sports such as soccer, rugby, martial arts, hockey or powerlifting will require at least a month off. If you fall in the powerlifting category, you may be tempted to use these four weeks off to build your one-rep max, but you must resist such temptations. In fact, you must avoid all sorts of heavy weights that come with low repetition sets, such as squats, leg press and heavy deadlifts. Such exercises can cause a massive build-up of internal pressure, which may lead to internal bleeding at the operation site and potentially result in a scrotal hematoma. A scrotal hematoma is a nasty lump that can be as big as a grapefruit in your scrotum and may take up to 2 months to resolve.

Sexual Intercourse

You can resume normal sexual intercourse one week after a vasectomy. But you should use contraception such as condoms for at least 3 months and until after your semen has been double-checked and found to be completely sperm-free. Ever heard of pregnancies after a vasectomy? Sex within 3 months after a vasectomy may still result in pregnancy because your semen may still contain sperm. So use contraceptives until your doctor confirms that your semen is sperm-free.

Work With Your Urologist

To prevent any problems and reduce the time you need to be off before resuming normal work, follow post-care instructions strictly and pay attention to your doctor’s guidance. By using a cold pack during the first 3-4 days after the procedure and avoiding strenuous activities until your body has healed properly, you will prevent potential complications (such wound reopening, pressure build-up and infection) and speed up your recovery. Fortunately, the most likely issue after a vasectomy is often just a mild ache that goes away in a few days and can be contained with Paracetamol.The other complications, such as hematoma, infection and sperm granuloma (a pea-sized lump on the cut end of your vas deferens) are quite rare.

At St Pete Urology, we offer the painless, no-scalpel open-ended vasectomy procedure. And we guarantee that you recover swiftly and get back to your most cherished activities very quickly. Have questions still? Find out more about safe, painless vasectomy by visiting the “St Pete Urology” site.