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.

What foods to avoid with kidney stones?

When substances found in urine become so concentrated, they can combine to form solid masses called kidney stones. For instance, calcium in urine can combine with phosphorous or oxalate to form calcium phosphate and calcium oxalate crystals respectively. Likewise, the buildup of uric acid in urine following protein metabolism can lead to uric acid crystals. Since the urinary tract is not functionally adapted to expel solid matter, the stones become very painful to pass. Fortunately, the risk of formation of kidney stones can be reduced through dietary measures.

So what should you eat and drink to avoid getting these painful stones?

1. Drink copious amounts of water
Taking large quantities of fluid, particularly water, can significantly reduce the risk of kidney stones. Water dilutes urine and lowers its concentration, minimizing the possibility of the chemicals combining to form stones. Just make sure to drink 12 glasses or more of water every day.

2. Eat more calcium-rich foods
Calcium combines with oxalate and eliminates it. Therefore, low calcium intake allows your oxalate levels to rise while increased intake reduces the quantity of oxalate in urine. It is advisable that you get calcium from food and not from supplements (as supplements increase the risk of kidney stones). Recommended sources of calcium include cottage cheese, other types of cheeses, yogurt, milk (cow’s milk, goat’s milk, fortified soy milk and lactose-free milk), legumes, dark green vegetables, calcium-set tofu, seeds, blackstrap molasses and nuts. Intake of foods rich in vitamin D every day can ensure that the body absorbs more calcium. There are several foods fortified with vitamin D, but you also can get this vitamin from egg yolks, cheese and salmon.

3. Increase your citrus intake
Citrus provides naturally occurring citrate which is effective in stopping or reducing the formation of kidney stones. You can get citrate from citrus fruit, citrus juice, oranges, grapefruit and lemons.

Which types of food should you avoid?

1. Limit your salt intake
Increased sodium levels promote the buildup of calcium in urine. Hence, it is important to avoid adding too much salt to your food and to check all labels on processed foods to control the amount of sodium you take. Whenever possible, instruct that no salt be added in the foods you order in hotels or restaurants. Vegetable juices may contain high quantities of sodium, so check what you drink.

2. Reduce intake of animal protein
Most animal sources of protein increase the level of uric acid and reduce the level of citrate in urine. Citrate is important in preventing stone formation. Therefore, you should avoid eating large quantities of red meat, poultry, chicken, pork, eggs and fish which contain large quantities of citrate. Instead of animal proteins, you should turn to alternatives such as Greek yogurt, quinoa, hummus, tofu (bean curd) and chia seeds. Make sure to discuss what types of protein you should eat with your doctor.

3. Minimize the quantity of oxalate-rich foods
Oxalate-rich foods can increase the development of kidney stones. So if you are at greater risk or already have had stones before, then you should either eliminate or reduce the quantity of oxalates. But if you have to eat oxalate-rich foods, always follow or combine them with a calcium source to ensure the oxalate is bound to calcium during digestion and prevented from reaching the kidneys. Foods with high quantities of oxalate include beets, chocolate, nuts, tea, spinach, swiss chard, sweet potatoes and rhubarb. Speak with your doctor to determine the limits of oxalate-rich foods you should have in your diet.

4. Cut down sugar intake
High levels of added fructose and sucrose can increase the risk of stones. You should reduce or eliminate the amount of added sugar you take, particularly in processed foods, cakes, fruits, soft drinks, juices, agave nectar, honey, cane sugar, crystallized fructose, corn syrup and brown rice syrup.

5. Avoid cola drinks
Cola contains high quantities of phosphate, a chemical that promotes kidney stone formation. Avoiding colas will therefore reduce your risk of kidney stones.

Dietary tips for avoiding kidney stones

Once you have kidney stones for the first time, the risk of a recurrence increases drastically unless you take the necessary steps to prevent them. For instance, you can take medications prescribed by your doctor to prevent the stones. Likewise, you can begin to watch keenly what you drink and eat. It is also important that tests are run on the stones you currently have to determine what type they are in order to clearly define appropriate steps for preventing a recurrence. Strategies for preventing recurrence of kidney stones include:

  1. Drinking at least 12 glasses of water every day.
  2. Drinking citrus juices, like orange juice.
  3. Reducing the amount of animal protein you take.
  4. Reducing the amount of added sugar, salt and products rich in fructose corn syrup.
  5. Avoiding drinks and foods high in phosphates and oxalates.
  6. Eating a calcium-containing food at every meal, at least 3 times a day.
  7. Avoiding foods or drinks that dehydrate the body, such as alcohol.

Kidney stones can cause a lot of pain and discomfort. But with slight dietary changes, occurrence of the stones can be effectively prevented or managed. Keeping your body hydrated, pairing oxalate-rich foods with calcium and avoiding foods high in sugar and salt are crucial dietary steps for preventing kidney stones.

At St Pete Urology, we apply a range of treatments, such as lifestyle, dietary, medical and surgical interventions to ensure the best outcome possible for our patients. At our center, most patients with kidney stones are seen by specialists, taken through 24-hour urine studies and blood tests, and given the right treatment depending on the type and cause of their stones. Our urologists are experts in shock-wave lithotripsy (SWL), ureteroscopy and percutaneous nephrolithotomy, among other treatments for relieving pain and restoring a normal, pain-free life. We also develop preventive plans for our patients, giving them a clearer picture of why the stones develop and the necessary changes they should make to prevent them, including dietary, lifestyle and medications to take. For more information on the diagnosis, treatment, prevention and follow-up care for kidney stones, visit the “St Pete Urology” site.

What is BPH

Benign Prostatic Enlargement (BPH) is an age-related, non-cancerous growth of the prostate. BPH is a common condition, particularly in older men. In fact, almost every man will suffer from the symptoms of the condition at some point after the age of 40; with more than 70 percent of men over 60 having symptoms of BPH while 90 percent of men over 85 years have the condition. As the prostate gets larger, it presses hard on the urethra causing urethra blockage and bothersome urinary symptoms. However, BPH is not cancer and does not make a man more likely to get prostate cancer.

Phases of prostate growth

Located in front of the rectum and between the penis and the bladder, the prostate is a small, walnut-sized gland that secretes the prostatic fluid, one of the key components of semen. Typically, the prostate goes through two major growth phases during a man’s lifetime. The first growth phase takes place during puberty when the prostate usually doubles in size. Beyond puberty, often at around the age of 25, the prostate begins to grow again and continues to do so for the rest of life in many men. This continuous growth is what leads to BPH and makes the condition quite frequent in older men. BPH does not occur in men until the second phase of prostate growth when the gland begins to press on the urethra and causes urinary problems.

Causes of BPH

As a man gets older, the balance between self-proliferation of cells and cell-death becomes harder to maintain due to changes in hormone levels (androgens), cell-to-cell communication (cell signaling pathways) and growth factors. The cells of the prostate multiply rapidly and form microscopic nodules, which then continue to grow. The abnormal and uncontrolled increase in the number of prostate cells is called hyperplasia. The microscopic nodules increase in mass and volume, resulting in an enlarged prostate. This abnormal growth occurs in the transitional zone around the urethra and is characterized by increase in size without becoming cancerous.

Symptoms of BPH

As the prostate increases in size, it begins to squeeze more tightly on the urethra. This makes it difficult for the bladder to fully compensate for the resulting pressure and reduces its ability to empty completely. Urine flow problems may result, including:

  1. Difficulty starting urination.
  2. Dribbling of urine, often after urinating.
  3. Weak urine stream (peeing in stops and starts).

As the urethra is squeezed by the enlarged prostate, it becomes difficult for the bladder to push out urine. Over time, the bladder muscles are weakened as they push harder to empty urine. This in turn makes it more difficult for the bladder to empty, resulting in:

  1. Frequency, urinating too often, typically eight or more times per day.
  2. Incontinence, lack of control over when to pass urine.
  3. Urgency, sudden need to urinate.
  4. Nocturia, waking up several times each night to pass urine.
  5. Urinary retention, a sense that you are not fully emptying your bladder.
  6. Urine leakage.

In some cases, BPH may lead to backing up and stagnation of urine, which may in turn result in bladder stones, recurring urinary tract infections, bladder divericulae and kidney or bladder damage. The condition also may lead to a sudden inability to pass urine (acute urinary retention), a very painful medical emergency requiring urgent drainage.

When Should You See a Doctor?

Symptoms of BPH vary from person to person. Some men with the condition have few or no issues while others experience severe symptoms. Generally, treatment for BPH may be optional when the symptoms are mild and no complications exist. So if the symptoms do not bother you enough to take medications or go through a procedure for it, then you may only need to speak with your doctor to make sure that your symptoms are stable and your bladder empties well. However, if you experience complications such as a burning sensation when urinating, bladder pain when urinating, blood in urine accompanied by chills and fever or nausea and vomiting, acute urinary retention or lower back pain, then you must seek immediate medical attention.

Treatment for BPH

There are many treatment options for BPH. If you are diagnosed with this condition, talk to your doctor to find out the right treatment for you. The most common treatments include medications (such as alpha reductase inhibitors), UroLift System treatment, thermotherapies (using heat energy such as radiofrequency or microwave), laser resection and transurethral resection. The treatment recommended by your doctor will depend on the severity of your symptoms, the extent to which the symptoms affect your life and the presence of other medical disorders.

Looking for the best urology center for safe and effective treatment? At St Pete Urology, we have built a reputation for exceptional and excellent diagnosis and treatment of BPH and other urological conditions using medical and surgical interventions. Through our skillful and experienced urologists, nurses and technicians, we deliver comprehensive, compassionate and patient-centered treatment and care to all our patients. We use state-of-the-art surgical and medical techniques to deliver timely, safe and effective treatment. For more information on the diagnosis and treatment of BPH and other urological disorders, visit the “St Pete Urology” site.

How does a penile implant pump work?

Erectile dysfunction (ED) is a common problem, affecting up to 52 percent of all men at some point in their lives. Statistically, ED is found in 20 percent of men over the age of 20, 40 percent of men over 40 and 78 percent of men over 75. As a general marker of cardiovascular function, erectile dysfunction tends to occur more frequently in men with obesity, diabetes, high blood pressure, current smoking history, diabetes, heart disease or who are taking medications that impede cardiovascular function. In most men with ED, the problem can be successfully treated with prescription medications (pills) or a penis pump (a vacuum constriction device). However, in cases where pills and penile pumps prove ineffective, a penile implant surgery may be recommended as a last resort.

What is a penile implant?

A penile implant (also called penile prosthesis) is a medical or prosthetic device that is surgically placed and customized inside the penis and scrotum to help a man to achieve a natural-feeling and natural-looking erection, thereby gaining sexual function. It is an ideal treatment of erectile dysfunction in men who are not candidates for other ED treatments, have not been able to achieve an erection after other treatments, or have specific medical conditions such as peyronie’s disease ( a condition characterized by scarring inside the penis resulting in curved painful erections). Nevertheless, doctors usually prefer to start with the simpler, less invasive treatments for ED before opting for penile implant surgery.

Types of penile implants

There are three main types of penile implants: the three-piece inflatable pump, the two-piece inflatable pump and the semi-rigid, non-inflatable implant (malleable rods).

1. Three-piece inflatable pump

Also called the multi-component penile implant, the three-piece pump delivers the most natural, comfortable and rigid erection and offers the most suitable flaccidity when deflated. It is a larger and softer pump that is very easy to inflate by squeezing the pump and to deflate by pressing the release value above the pump. During the operation to implant the three-piece inflatable pump, two cylinders are placed in the penis, a fluid-filled container is implanted in the abdomen and an inflatable pump placed inside the scrotum. These three components are then connected using special tubing. To achieve an erection, the pump located in the scrotum is pressed to allow fluid to move from the abdominal container into the penile cylinders. Squeezing the release valve ensures that the fluid leaves the cylinders and moves back to the containers, making the penis flaccid.

2. Two-piece inflatable pump

For men with limited agility, such as those with trouble using their hands or with arthritis, the two-piece inflatable pump is ideal. Similar to the three-piece inflatable pump, the two-piece device works in the same way except that the fluid is kept in the pump located in the scrotum and not in a container in the abdomen (as with the three-piece pump). While the two-piece inflatable device is simpler and easier to place than the three-piece device, it is smaller, more difficult to inflate and offers a less-rigid erection than the three-piece pump.

3. Semi-rigid non-inflatable penile implant (malleable rods)

In some cases, the surgeon may insert two flexible rods into the penis to improve its rigidity. Once inserted, the rods will not change their stiffness or size and will keep the penis in a semi-rigid state. Typically, these rods are bent downward during implantation, but can be straightened upward or set in any other manner necessary for sexual intercourse. Non-inflatable implants can be inserted even by doctors with limited experience because they involve the simplest surgical procedure. They are completely concealed in the body and are a great option for men with limited dexterity, such as those with arthritis or problems using their hands. While malleable penile rods are very easy to use, their constant rigidity may make them uncomfortable.

Factors considered when selecting a penile implant

In order to achieve optimum results with penile implants, the needs and preferences of the patient must be carefully considered. So before doing an implant, the doctor will consider:

  • (a) Age of the patient and of his partner.
  • (b) Overall penile length and scrotum size.
  • (c) Patient’s body size and type.
  • (d) Ratio between the pendulous penis and crus (buried) penis.
  • (e) Size of glans penis.
  • (f) Any history of penile implant and previous pelvic or abdominal surgery.
  • (g) Whether the penis is circumcised or not.
  • (h) Presence of colostomy or previous kidney transplant.
  • (i) Overall health and well-being of the patient.
  • (j) Life expectancy of the patient.

Even though penile implants enable men to achieve an erection, they do not boost sexual sensation or desire. Most penile implants also will not make the penis larger or bigger than its natural size at the time of surgery. For some men, the penis may even be slightly smaller or shorter than it was before the procedure.

At St Pete Urology, our multi-dimensional and compassionate approach can be trusted to deliver excellent outcomes for all men with erectile dysfunction. For every man who comes to us, we identify the risk factors, assess the degree of dysfunction and recommend a safe and effective treatment. Apart from lifestyle modifications, medications and vacuum constriction devices, we also conduct safe penile implant surgery whenever necessary. We are committed to improving the sexual function and quality of life for all our patients. So do not suffer silently when we can provide effective solutions to your problem. For more information on prevention, diagnosis and treatment of ED, visit the”St Pete Urology” site.

Prostate Enlargement BPH

Prostate enlargement (Benign Prostatic Hyperplasia) is a medical condition characterized by increase in the size of the prostate gland without becoming cancerous. So the prostate grows bigger but the cells do not become cancerous. The prostate is an essential organ in the male reproductive system, secreting the prostate fluid that forms part of semen. In childhood, the prostate is a small, walnut-sized gland and maintains this size up to puberty. During early puberty, the prostate undergoes the first phase of growth which doubles its size. Later on, at about age 25, the prostate starts to undergo a second phase of growth which continues for the rest of a man’s life. It is during this second phase of growth that benign prostatic enlargement (BPH) occurs.

How prostate size varies with age

By the age of 20, average males have a walnut-sized prostate and very few prostate-related health concerns. However, around 40, many men begin to experience issues related to prostate enlargement. By the age of 50, around 50 percent of all men have health concerns related to BPH. And at 60 and beyond, the prostate continues to grow and press against the urethra, reducing the size of the urethra and obstructing the flow of urine. Men in their 60s may experience mild inconvenience or serious lifestyle disruptions such as lack of sleep due to difficult or frequent nighttime urination as pressure is applied on the bladder and urethra by the inflamed prostate. By the age of 80, around 80 percent of men experience symptoms of prostate enlargement. In fact, the symptoms are so common beyond the age of 80 that almost all men will experience them if they live long enough.

Symptoms of prostate enlargement

As the prostate increases in size, it presses against the urethra and causes the size of the urethra to reduce. The narrowing of the urethra causes the bladder to thicken, weaken and lose the ability to empty fully, resulting in urinary retention. The urinary retention in the bladder and the tightening of the urethra causes several urinary tract problems, such as:

  1. Difficulty in starting a urine stream.
  2. Difficulty emptying the bladder.
  3. Urinary urgency, being unable to delay urination.
  4. Urinary frequency, passing urine eight or more times per day.
  5. Nocturia, passing urine during periods of night sleep.
  6. Interrupted or weak urine stream.
  7. Dribbling after passing urine.
  8. Pain during urination or after ejaculation.
  9. Urinary incontinence, accidental loss of urine.
  10. Unusual smell or color of urine.

Treatment of prostate enlargement

The right treatment for benign prostate enlargement varies from patient to patient depending on the severity of the symptoms, the extent to which the symptoms affect a man’s life, presence of other medical conditions and the patient’s preferences. A man may not need treatment for a mild prostate enlargement unless he has bothersome symptoms that are affecting the quality of his life. However, in cases where no treatment is administered, regular checkups are recommended.

If the benign prostatic hyperplasia is causing severe, bothersome symptoms or presents a serious health risk, then the urologist would recommend treatment, such as medications (using alpha blockers, 5-alpha reductase inhibitors, phosphodiesterase-5 inhibitors or combination medications), minimally-invasive procedures (like transurethral needle ablation, transurethral microwave thermotherapy, high-intensity focused ultrasound, transurethral electro-vaporization, water-induced thermotherapy or prostatic stent insertion) and surgery (transurethral resection, laser surgery, transurethral incision or prostatectomy) for long-term treatment.

Are you a man age 40 or older who is worried about your risk of prostate enlargement? Would you like a session with some of the best, world-renowned urologists to help you find relief from your prostate enlargement symptoms? At St Pete Urology, we have tailored our urology services to meet the diverse needs of our patients. We have assembled a great team of urologists, nurses and technologists to help us deliver prompt, safe and effective treatment of urological disorders. We use the latest technology and techniques to guarantee utmost convenience, safety, comfort and efficacy of all our procedures. Visit us today for help with your BPH symptoms. For more information on the diagnosis, treatment and care for prostate enlargement, visit the “St Pete Urology” site.

BPH: Can Green Tea Cure It?

For men, living long enough means you are going to have problems with your prostate. While the prostate is typically a small, walnut-sized gland in young males, it undergoes two phases of growth later on in life which often result in urinary problems. The first phase of growth occurs during puberty and usually doubles the size of the gland, while the second phase of growth begins at around 25 and continues for the rest of your life leading to benign prostatic enlargement (benign prostatic hyperplasia or BPH). More than 50 percent of men have BPH by the age of 60 and experience urinary difficulties. Although prescription medications are commonly used to treat BPH, herbal supplements may provide much needed relief during the initial stages of the condition. One such herbal solution is green tea.

Green Tea Ingredients

Green tea is not only the second most popular beverage across the globe, but also a pleasant alternative to soft drinks and coffee. It contains potent polyphenols, catechins with anti-inflammatory, anti-carcinogenic and antioxidant properties. The active ingredients in green tea include gallic acid, caffeic acid, chlorogenic acid and epigallocatechin (EGC), among other polyphenols. The polyphenol known as epigallocatechin-3-gallate (EGCG) is effective in reducing the overproduction of cells common in BPH and in preventing the onset of prostatic enlargement. Other specific polyphenols found in green tea can treat the symptoms and eradicate various causes of BPH, making green tea invaluable for managing the condition alongside lifestyle changes, medications and other interventions.

Can Green Tea Cure BPH?

Green tea contains antioxidants that reduce the levels of dihydrotestosterone (DHT), the hormone that promotes the growth of the prostate. A reduction in the levels of DHT lowers the risk of developing an enlarged prostate. The catechins in green tea regulate the secretion of DHT and PSA, promoting normal prostate size and volume and reducing the risk of BPH. Likewise, the catechins in green tea have demonstrated efficacy in relieving urinary symptoms such as frequent urination, nighttime urination and problems with urinary flow. Improved urine flow, relief of annoying urinary symptoms and reduced prostatic inflammation lead to a higher quality of life. Besides, the catechins in green tea can kill certain viruses and bacteria, reducing the risk of urinary tract infections that may occur in men with enlarged prostate.

Factors Affecting the Efficacy of Green Tea

The strength and effectiveness of green tea depend on the amount of the tea consumed. Studies have shown that men who take large quantities of green tea regularly enjoy more prostate health benefits from the tea than those who take the tea occasionally or in small amounts. The amount of catechins in green tea also depends on where the plants are grown, how the tea leaves are harvested and how the leaves are processed. For instance, Japanese green teas usually have greater quantities of catechins than Chinese teas, with slight differences within specific groups. Remember that the power of green tea comes from the fact that its leaves are not oxidized and are able to retain essential substances such as the catechins that promote both general health and prostate health.

Consult with your doctor before using green tea to improve your prostatic health. Remember that taking herbal supplements without guidance from a qualified health professional may cause problems in your body. At St Pete Urology, we are committed to safe and effective treatment of BPH and other urological issues. We have assembled a team of highly trained and experienced surgeons to help us deliver leading-edge urological care for the best possible outcomes. Our comprehensive, multidisciplinary and patient-centered approach and a dedication to adopting new medical technologies as soon as they are available guarantee state-of-the-art treatment for all our patients. For more information on diagnosis and treatment of BPH, visit the “St Pete Urology” site.

How Are Kidney Stones Formed?

Kidney stones are hard mineral or salt deposits formed in the kidney when urine is concentrated. Originating as microscopic crystals or particles that develop over time into pebble-sized calculi or larger deposits as minerals crystallize and fuse together, kidney stones can affect any section of the urinary tract (the kidney, bladder, ureters and urethra). The kidneys filter and remove wastes from blood, add them in urine and concentrate the urine as it flows from the cortex into the renal pelvis. However, if the minerals and other wastes fail to dissolve completely in urine, microscopic particles may develop which may grow into larger stones.

Why Stones Form

Formation of urine crystals is a common occurrence even in those who never form stones. The natural existence of substances promoting crystal development in all urine means that everyone can have urine crystals. Substances that promote crystal development in urine include oxalate,calcium, phosphorus, uric acid, sodium and cystine (for those with cystinuria). Nevertheless, urine also has natural inhibitors of crystal formation such as magnesium, citrate, phytate, pyrophosphate, proteins, total urine volume and other byproducts of normal metabolism. These inhibitors promote elimination of crystals before they can attach to the kidney and develop into larger stones.

How are kidney stones formed?

Kidney stones typically form from soluble salts found in urine. For example, the soluble salt calcium oxalate is commonly found in urine in a dissolved or crystalline form. Soluble salts are usually formed when various chemical elements found in urine combine. When the urine concentration of these soluble salts is very high, solid crystals may be formed. While there is usually a high concentration of salts in urine, the presence of inhibitors makes it more difficult for crystals to develop.Therefore, urine must become supersaturated for the balance between stone-promoters and inhibitors to be broken and allow larger stones to form. Supersaturation of urine may be caused by low urine volume, very low quantities of inhibitors or very high concentration of stone-promoters.

Processes of stone formation

Kidney stone formation begins by the process of nucleation, an association of free ions into microscopic particles. Nucleation can occur in the kidney nephron and on the surfaces of the extracellular matrix and cells. Once tiny crystals are formed, they can undergo secondary nucleation or aggregation, the processes through which the crystals formed in solution form into bigger multi-component particles. Larger crystals then can grow into giant single crystals which can be retained in the kidney by further aggregation and attachment to specific intra-renal structures.

Passing kidney stones

Once kidney stones are formed, they move down the urinary tract from the kidneys through the ureter and to the bladder. Small stones can pass out on their own without causing problems. However, larger stones can become lodged in the ureter and cause severe, agonizing pain that starts in the lower back and spreads out to the groin. When a stone is lodged in the ureter, it can block urine flow, causing increased pressure build-up in the affected ureter or kidney and resulting in severe pain and spasms. Larger kidney stones (called starghorn stones) also may be problematic to the entire urinary tract, resulting in symptoms such as:

  1. Severe pain in the back, in the side or below the ribs.
  2. Excruciating pain radiating to the groin and lower abdomen.
  3. Red, pink or brown urine.
  4. Pain when urinating.
  5. Pain that fluctuates in intensity or comes in waves.
  6. Frequent urination, urinating small amounts or persistent urge to pass urine.
  7. Nausea and vomiting.
  8. Foul-smelling or cloudy urine.
  9. Chills and fever if an infection is present.

While kidney stones can cause severe pain and discomfort, they usually do not cause permanent damage when recognized early and treated promptly. In fact, depending on the situation, passing the stones may require nothing more than just taking pain medication and drinking plenty of water. In situations where the stones are lodged, obstructive or linked with urinary infections or complications, other removal mechanisms may be necessary, including surgery. The urologist also may recommend effective preventive measures to minimize the risk of recurrent stones.

At St Pete Urology, we have made a difference in many lives by helping patients get relief from the pain and discomfort caused by kidney stones. We have assembled a skilled and experienced team of urologists committed to the best practices in health care and delivering world-class urological care to all. We also have put together the latest diagnostic and treatment tools to ensure that our patients receive the very best care. With our patient-centered, collaborative approach to management of kidney stones and other urological problems, you can be sure that you will not leave our doors without getting the relief you seek.

For more information on prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

Vasectomy Animation Overview

Sperm production occurs in the male testis (testicle). Each testis contains seminiferous tubules, which are tiny coiled tubes lined with spermatogonia (sperm stem cells) and sertoli cells (sperm nurse cells) for sperm production. Around the tubes are testosterone-producing cells called Leydig cells, which produce hormones that stimulate the nurse cells and regulate sperm production. It takes roughly 70 days for sperm to develop in the testis and be ready for action.

Movement of Sperm

Newly formed sperm cells move into the epididymis (a tightly coiled duct located above the testis), where special proteins are added to the sperm membrane resulting in highly specialized cells capable of swimming, binding and penetrating the ovum (female egg). Since sperm cells only form a small portion of the ejaculated fluid, the cells are typically mixed with fluids from glands such as prostate, seminal vesicles and Cowper’s gland as they are pushed through the ducts. In fact, a big part of the fluid making up semen comes from the prostate gland and the seminal vesicles. From the epididymis, sperm cells move into the vas deferens and then into the urethra.

Sperm after vasectomy

During a vasectomy, the sperm duct (vas deferens) is cut and its ends sealed to prevent passage of sperm into the urethra. So sperm cells are still produced and moved into the epididymis to mature but are not able to pass into the vas deferens because of the blockage at the ends of the vas. After a vasectomy, sperm is still produced but does not get into the ejaculated fluid due to the blockage of the vas deferens. And since the sperm cells cannot move out, they naturally dissolve and are absorbed by the lining (membrane) of the epididymis. Vasectomy does not reduce a man’s ability to have orgasms. In fact, you still have the same mind-blowing experience but without the possibility of a pregnancy.

Does vasectomy have complications?

Vasectomy is one of the most effective and safest methods of birth control. However, like every other surgical procedure, a vasectomy may have complications. Therefore, it is important to discuss this with your doctor before undergoing the procedure.

Whenever complications occur after a vasectomy, they are usually minor and very easy to treat. For instance, after the procedure a man may experience a dull ache or pain due to pressure on the tiny tubes of the epididymis. This pain is treated with medication, though removal of epididymis sometimes may be recommended. Other possible complications are a risk of infection, fluid accumulation, temporary swelling, transient bruising or bleeding. Vasectomy does not increase the risk of prostate cancer.

Looking for a surgical and medical center where you can have the safest vasectomy procedure? At St Pete Urology, you can be sure of getting one of the most skilled and experienced pool of urologists, latest medical and surgical equipment, and patient-friendly, multidisciplinary services that guarantee the best outcomes. For more information, visit the “St Pete Urology” site.

What is the best medicine for enlarged prostate?

Treatment options for benign prostatic hyperplasia (BPH) have increased significantly in recent years. A few years ago, men suffering from BPH only had surgery as the main treatment option. This has changed as drug-makers have developed a number of drugs to offer more choices for alleviating the symptoms of an enlarged prostate. In fact, medicines now have become the most common treatment method for men with mild-to-moderate BPH. When administered, the drugs can calm bladder and prostate muscles, shrink the prostate, stop prostate growth or relieve symptoms of BPH, such as weak urine streams or the need to urinate several times per day.

Here are some drugs commonly used to treat BPH. Before using any drug, make sure to speak with your doctor to find out which medicine is appropriate for you.

1. Alpha blockers

When diagnosed with an enlarged prostate, your doctor may recommend that you take alpha blockers to ease your symptoms. These drugs relax bladder and prostate muscles and make it easier to pass urine. While they do not alter prostate size, they are effective in promoting urine flow and will prevent the need to urinate frequently or urgently. They work right away so you will not wait too long for the results.
Some alpha blockers that your doctor may suggest include:

  • (a) Doxazosin (Cardura)
  • (b) Alfuzosin (Uroxatral)
  • (c) Tamsulosin (Flomax)
  • (d) Silodosin (Rapaflo)
  • (e) Prazosin (Minipress)
  • (f) Terazosin (Hytrin)

Alpha blockers are very effective for men with both BPH and high blood pressure because they remedy both conditions. However, the drugs should not be taken by men planning to go for cataract surgery as they may cause problems during the surgery.
Side effects of alpha blockers include:

  1. Tiredness/fatigue
  2. Fainting
  3. Dizziness
  4. Lightheadedness
  5. Headaches
  6. Low blood pressure

Alpha blockers also can cause retrograde ejaculation, a condition in which sperm moves backward into the bladder instead of moving forward through the penis. While the condition is not harmful, it means that the fluid ejaculated may not contain sperm. Therefore, men with BPH should keep this in mind particularly if they still desire to have children.

2. 5-Alpha reductase inhibitors

In order to prevent the prostate from growing or just to shrink it, the urologist may recommend that you take a 5-alpha reductase inhibitor. Such drugs stop the body from producing one of the hormones necessary for prostate growth and enlargement. As a result, the drugs improve urine flow and relieve the symptoms of BPH. The 5-ARIs are most effective in men with very large prostates.
The two major 5-alpha reductase inhibitors recommended for BPH are:

  • Dutasteride (Avodart)
  • Finasteride (Proscar, Propecia)

Apart from shrinking or stopping the growth of the prostate and relieving BPH symptoms, the 5-ARIs have two other benefits:

  1. They reduce the chances that BPH will result in other complications, like bladder damage.
  2. They eliminate the need for surgery as treatment for BPH.

The full effects of 5-alpha reductase inhibitors may take up to 6 months to be realized. So you must continue taking the medicines for as long as necessary.

Side effects of 5-ARIs

5-alpha reductase inhibitors are not supposed to be used by women. In fact, pregnant women must never be exposed to the drugs as they can cause birth defects in male fetus. Other side effects of 5-ARIs include:

  • (a) Lower sex drive/libido
  • (b) Erectile dysfunction
  • (c) Retrograde ejaculation

Some of these side effects may improve as the body gets used to the drug.
The 5-ARI drugs also may reduce the levels of prostate-specific antigen (PSA) in the blood. PSA levels are used to screen for prostate cancer, so a drug-induced drop makes it impossible to use the PSA test. It is advisable to have the PSA test done before you start these drugs. The FDA now requires that the labels on 5-ARIs must include a warning that they may increase the risk of having aggressive (high-grade) prostate cancer.

3. Phosphodiesterase-5 inhibitors

In some cases of BPH, the urologist may recommend the use of phosphodiesterase-5 inhibitors, which are drugs that smooth the muscles of the prostate and bladder and help to relieve BPH symptoms. While there are many types of phosphodiesterase-5 inhibitors, only tadalafil (Cialis) has been approved by the FDA for treatment of BPH. Tadalafil is not prescribed as often as other drugs, but when doctors are dealing with cases in which BPH and ED occur together, then it is often a viable option.
The side effects of Tadalafil include:

  • (a) Headaches
  • (b) Muscle and back pain
  • (c) Stomach upset (after eating)
  • (d) A stuffy nose
  • (e) Vision problems
  • (f) Redness, warmth or burning on the neck, face and upper body

4. Combination therapy

When a doctor realizes that a single medication may not effectively relieve BPH symptoms, a combination of two or more drugs may be considered. The most common drug combinations for treating BPH include:

  • (a) Tamsulosin and Dutasteride, comes in one pill called Jalyn
  • (b) Doxazosin and Finasteride
  • (c) Alpha blocker and an antimuscarinic (a drug for treating overactive bladder)

Drug combinations are generally more effective than single drug treatments. However, the combinations also come with greater side effects than those of single drugs.

Are you or your loved one suffering from the symptoms of BPH? Would you like to receive accurate information and effective treatment for an enlarged prostate? Or do you want someone to to talk to about any other urological problem that you may have? If so, then St Pete Urology is the right place for you. For more information on the diagnosis, treatment and care for BPH, visit the “St Pete Urology site.

What happens to the sperm when you have a vasectomy?

Vasectomy is an effective way of sterilizing men permanently. The surgical procedure involves partially removing (cutting) or blocking both sides of the vas deferens to stop sperm from getting into the semen. A vasectomy is not intended to stop the production of sperm; it just ensures that the sperm produced in the testes does not reach the ejaculate and no longer reaches the female reproductive tract to trigger pregnancy.

So what is the fate of the sperm that is still produced after a vasectomy?

After a vasectomy, your ejaculations remain much the same as before the procedure. You will still produce as much ejaculatory fluid as before and will experience the same feeling and pleasure as before the operation. The only change is that your semen will no longer have sperm. However, since sperm is just around 2-5 percent of the ejaculate volume, there is no significant difference in ejaculate volume after a vasectomy.

Continued production of sperm

The testicles continue to produce sperm even after a vasectomy. The testicles are made up of small, coiled tubes known as seminiferous tubules, which produce sperm. In the tubules are sperm nurse cells that regulate sperm stem cells. The tubules are also surrounded by testosterone-generating cells, which promote sperm development by stimulating the nurse cells and in turn controlling the sperm stem cells. It takes around 70 days for sperm cells to develop fully and be ready for action. After sperm cells are produced, they move into the duct where some proteins are added to improve sperm performance. The sperm then gets into the vas deferens (tubes) for transportation to the ejaculation point.

Fate of sperm after a vasectomy

For sperm to mature, it is usually stored in a tube called the epididymis. The epididymis is a tightly-coiled tube measuring 15-18 feet long where sperm usually leaves to the vas deferens to take part in fertilizing an ovum (egg). After undergoing a vasectomy, the sperm cannot move out of the epididymis. Therefore, most of the sperm is absorbed by the lining (membrane) of the epididymis and dissolves naturally into the body.

Open-ended vasectomy

At St Pete Urology, we use the open-ended vasectomy procedure as part of our no-scalpel, no-needle technique to improve sperm drainage after vasectomy. We understand that a man’s testicles age and the sperm machinery may be less efficient with time. Therefore, instead of leaving our patients to rely solely on the epididymis for sperm disintegration and absorption, we apply the open-ended technique to ensure the bottom end of the tubes (vas deferens) is left open (uncauterized) while cauterizing the end leading to the penis, providing a reliable way for drainage of sperm after a vasectomy. The open-ended technique ensures that sperm is naturally reabsorbed back into the testes without any pain, discomfort or pressure.

Are you planning to have a vasectomy? At St Pete Urology, we perform the procedure using a simple, safe and effective method. Our no-scalpel, no-needle technique ensures quick recovery and a return to work in as soon as 2 days. Want an appointment with our vasectomy experts? Visit the “St Pete Urology” site.