Meet Dr. Adam Oppenheim

Urology is a great blend of surgery and medicine and a specialty that provides an amazing work-life balance. It also brings profound satisfaction from the excellent outcomes with most cases. It is a wonderful opportunity to help people with embarrassing conditions and a chance to provide life-saving and life-extending treatments. Being passionate about making a difference in the lives of people, I found urology the perfect specialty for me.

Becoming a urologist

I was born and grew up in Yorktown, Va., and went to Virginia Tech for my Bachelor of Science in Biology. I went to the Nova Southeastern University, College of Osteopathic Medicine for my medical education. While a lot of factors were involved in choosing to become a doctor, my dad was a big influence. He was an ophthalmologist who spoke fondly about the joy of caring for patients — both in his office and in the operating room. My dad made medicine such a noble career that I was inspired to follow in his footsteps.

But it was when I was a third year medical student that I chose to become a urologist. My general surgery rotations allowed me to interact closely with many urologists. During those sessions I spent with them, I saw the enthusiasm the urologists brought to their work and it inspired me. They really appreciated their work and their passion and commitment translated into great care and excellent outcomes for their patients. They instilled that love for urology in me — a love that has continued to flourish ever since.

I completed my general surgery and urology residency at the Einstein Medical Center in Philadelphia. During those years in Philadelphia I also received urology oncology training at the Fox Chase Cancer Center — one of the nation’s top centers in cancer care. My urology training included working with the country’s leading doctors in penile implant surgery, enabling me to be solidly grounded in knowledge, skill and experience in penile prosthesis. Likewise, I took extra-curricular courses in mid-urethral sling insertion for stress incontinence in women, urologic prosthetics, GreenLight laser therapy and InterStim sacral neuromodulation for BPH.

What do we do as urologists?

We are specialists in treating medical problems of the urinary tract and the male reproductive system. The problems are found in organs such as kidneys, uterus, urethra, urinary bladder and male reproductive organs. When necessary, we perform surgeries to remove kidney stones, genital abnormalities present at birth, urinary tract obstructions, and other issues causing problems for patients. We diagnose and treat enlarged prostate, erectile dysfunction, urinary problems, urologic cancers, overactive bladder, urethritis, prostatitis and interstitial cystitis, among other conditions. We see patients of all ages, from babies and children to seniors.

Urology is a specialized field with a lot of things that I like. We do many procedures to improve the quality of life of our patients. For instance, we do prostate procedures to help patients pass urine, treat erectile dysfunction which is quite embarrassing to those who struggle with it, treat kidney stones that can cause agonizing pain, and tackle life-threatening conditions such as prostate cancer and kidney cancer. I practice every aspect of general urology but I have a special interest in erectile dysfunction, kidney stones, urinary problems, enlarged prostate, prosthetics and men’s health, spending the better part of each day doing exams on the male genitalia and performing a lot of surgeries on balls and penises.

Job Satisfaction

As a urologist, I always feel that I’m in a unique position. I am able to have a lasting relationship with my patients, which is something I find really gratifying. And after almost every successful diagnosis and treatment, my patients improve quickly and are able to enjoy life again — something that fills me with joy and satisfaction.

During our work, the most difficult part is usually for patients struggling with embarrassing and awkward conditions to walk in, sit down and discuss sensitive issues openly and honestly. With every encounter I try to provide a caring and compassionate environment that allows for frank and open conversations. The goal for me is to craft a personalized treatment plan that suits the goals and lifestyle of each patient. A plan may be as simple as changing medications or as complex as conducting surgery with sophisticated equipment.

Why St Pete Urology

St Pete Urology is a wonderful place with great professionals and state-of-the-art equipment. Working here always fills me with pride because of the excellent outcomes we achieve for our patients and the unwavering commitment to improving the standards of care through innovative and advanced techniques. It’s always buzzing with people sharing jokes and smiling, and that positive attitude is contagious. It also helps because we have to perform tests and procedures in an uncomfortable area of the body and there are often times we have to deliver news about diagnoses that patients may not want to hear. It has been an amazing time being here and I have only good things to say about urology — I would choose urology if I had to do so again.

For more information on our urologists and range of services, visit the “St Pete Urology” site.

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 causes the prostate to enlarge?

Although the exact trigger of BPH (Benign Prostatic Hyperplasia) is not fully known and may vary from one man to another, there are risk factors that contribute to the condition. Benign prostate enlargement means your prostate grows in size without being cancerous. As the prostate swells and becomes bigger, it presses on your urethra and bladder and may cause a number of urinary and bladder function problems. The known contributing factors to prostate enlargement are age, hormones, stress levels and diet.

1. Age

Your age is a risk factor and not a cause of BPH. Prostate growth is considered a normal part of aging. In fact, the prostate usually goes through two major periods of growth as a man ages. During early puberty, the prostate doubles in size. Then from the age of 25 the gland enters a second phase of growth and continues to increase in size for the rest of his life. It’s typically during this second growth phase that benign prostatic hyperplasia occurs. About 50 percent of men over the age of 50 have BPH, while up to 90 percent of men over 80 years old have the condition.

2. Hormones

Hormones have a major role in triggering BPH. For instance, testosterone — the male sex hormone responsible for sexual development, muscle mass, deep male voice and libido — is converted to DHT (dihydrotestosterone) when it is in excess in the body. DHT is a useful hormone in adolescents because it ensures normal growth and development of sexual organs, including the prostate. But the production of excess quantities of DHT results in problems such as aggression and acne in adolescents. In older men, excess production of DHT causes the prostate to continue to grow and enlarge. If left unchecked, this could lead to an enlarged prostate and other problems associated with the gland.

3. Diet

Prostate enlargement is a more common problem in Western countries such as the U.S. and UK, but occurs in lower rates in Asian countries like Singapore and Japan because of dietary reasons. A typical Western diet contains simple carbohydrates, refined sugar, meat, dairy and unhealthy fats, while traditional Asian and Eastern diets are often richer in complex carbohydrates, vegetables and healthy soya-based proteins. The dietary differences are therefore critical for the varied incidences of BPH in the Western and Eastern countries.

The regular consumption of red meat escalates the risk of developing BPH by 38 percent, and regular dairy intake not only contributes to joint pain and hay fever through inflammation, but also inflames the prostate and accelerates the enlargement process. On the other hand, consuming 4 or more vegetable servings a day decreases the risk of BPH by 32 percent, and regular intake of soya reduces the chances of having an enlarged prostate. Likewise, zinc, commonly found in seeds and nuts and often missing in typical Western diets, is critical for a healthy prostate.

Poor diets lacking in fiber can cause constipation, which badly affects the prostate. The prostate is located very close to the bowels. If toxins remain in the bowels for a long time they start to leak into the surrounding tissues and into the prostate. When that happens, inflammation and pain may occur in the prostate. Similarly, the pressure caused by constipated bowels on both the bladder and prostate can worsen BPH symptoms.

4. Stress levels

Prolonged repeated exposure to stress, such as men who have high-pressure jobs, who commute frequently or who are rarely relaxed, can lead to or worsen BPH. For men already suffering the symptoms of an enlarged prostate, stress leads to inflammation of the prostate and worsens the symptoms. It also causes muscular tension, which results in further restriction of bladder function. Increased exposure to stress quickly depletes the body of nutrients and one of the most frequently stress exhausted nutrients is zinc, which is vital for prostate health. Repeated high stress levels also lead to increased secretion of testosterone and DHT hormones, which contribute to the growth of the prostate.

So what’s your role in preventing BPH?

You can’t do anything about your age, but you can do something about your lifestyle and diet to boost the health of your prostate. Start by avoiding or cutting down on dairy and meat, add lots of vegetables, fruits, nuts, seeds and whole grains to your nutrition regimen, and try including soya products like miso, tofu and tempeh in your diet. Initially that may be difficult if you are used to consuming meat and dairy-heavy meals. But by incorporating tasty, plant-based substitutes such as tofu, three-bean curry, mushroom risotto and vegetable satay, you can quickly get used to meals without meat and dairy. Take steps to reduce your stress levels by dealing with the underlying causes of your stress. Take a stress remedy, practice mindfulness or see a counselor — whatever works best for you.

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

Foods That Can Cause Kidney Stones

You have a role in preventing kidney stones. By being cautious with what you eat and drink you can manage to stay free of the stones. One of the easiest ways to prevent kidney stones is to drink plenty of liquid, mainly water. In fact, unless you have trouble with your kidneys, drinking six to eight 8-ounce glasses of water every day is a proven way to prevent stones. Talk with your doctor about the quantity of liquid you should drink and begin right away. Another way to prevent kidney stones is to lose weight since being overweight increases the risk of the stones. Have your meals planned by a dietician and take the necessary steps to lose excess weight.

What if you have already had kidney stones?

You will need to talk to your doctor to find out which type of kidney stones you had. Depending on the type of stone, you’ll need to change your diet to prevent the recurrence of similar stones in the future. The most common types of kidney stones are calcium oxalate stones, calcium phosphate stones, uric acid stones and cystine stones. You can prevent them by making certain changes in how much calcium, oxalate, sodium and animal protein are in the foods you eat. Working with a dietician who is an expert in kidney stone management and prevention can help you greatly.

1. Dietary steps to prevent calcium oxalate stones

If you’ve had calcium oxalate stones, then you’ll need to reduce the amount of sodium, oxalate and animal protein in your diet while keeping your calcium consumption optimum. Speak with your doctor and also with a dietician about the food sources to avoid and how much of oxalate, sodium, calcium and animal protein you should take.

To reduce the amount of oxalate in your urine, avoid the following foods:

  • a. Spinach
  • b. Wheat bran
  • c. Nuts and nut products
  • d. Peanuts — which are legumes, but are rich in oxalate.
  • e. Rhubarb

To reduce the amount of sodium in your diet:

  • a. Reduce your salt intake
  • b. Avoid packaged, canned and fast foods, which often contain sodium
  • c. Avoid food condiments, seasonings and meats, which are often rich in sodium

To limit the amount of animal protein you eat, reduce the following in your diet:

  • a. Eggs
  • b. Chicken, beef, pork, particularly organ meats
  • c. Milk, cheese, and the other dairy products
  • d. Shellfish and fish

Remember, you’ll still need to get enough protein even as you limit the amount of animal protein. Just replace the meat and animal protein with other protein sources such as dried peas, lentils, white beans, which are plant-based and low in oxalate. Your doctor and dietician can guide you on the total protein you should eat and what portion of the protein should come from animal or plant-based sources.

Optimal calcium

To prevent calcium oxalate stones, you need to have enough calcium in your diet. While you may assume that increased calcium would increase your risk of kidney stones, that’s not true. Actually, in the right quantities, calcium combines with other substances in your digestive tract and prevents stone formation. You should check with your doctor about how much calcium you need to prevent a recurrence of calcium oxalate stones and to develop strong bones. Also find out from your dietician the best food sources of calcium for you. It’s often recommended that calcium be obtained from low-oxalate, plant-based sources like cereals, calcium-fortified juices, breads, some types of beans and some types of vegetables.

2. Dietary steps to prevent calcium phosphate stones

Just like calcium oxalate stones, the prevention of calcium phosphate stones requires that you reduce the amount of sodium and animal protein in your diet while ensuring that you get enough calcium. Talk to your doctor about the dietary changes you should make. A dietician who is expert in kidney stones can help you with exactly how much sodium, calcium and animal protein to include in your diet.

To reduce the amount of sodium in your diet:

  • a. Reduce your salt intake
  • b. Avoid packaged, canned and fast foods, which often contain sodium
  • c. Avoid food condiments, seasonings and meats, which are often rich in sodium

To limit the amount of animal protein you eat, reduce the following in your diet:

  • a. Eggs
  • b. Chicken, beef, pork, particularly organ meats
  • c. Milk, cheese, and the other dairy products
  • c. Shellfish and fish

Consider replacing the above sources of animal protein with plant-based ones such as:

  • a. Soy foods, like tofu, soy nut butter and soy milk
  • b. Legumes, such as dried peas, lentils, beans and peanuts
  • c. Sunflower seeds
  • d. Nuts and nut products, like cashews, cashew butter, almond butter, almonds, pistachios and walnuts.

Talk to your doctor and dietician about the total quantity of protein to eat and how much should be from animal foods or plant-based sources.

Optimal calcium

To prevent calcium phosphate stones, you’ll also need enough calcium in your diet. While it may seem that having calcium in your diet may cause calcium stones, taking the right amount of calcium helps eliminate various substances responsible for stone formation from your digestive tract. So talk to your doctor to find out how much calcium would help you maintain strong bones and prevent calcium phosphate stones. Also ask your doctor or dietician about the appropriate food sources for calcium. Getting calcium from plant-based sources such as cereals, breads, calcium-fortified juices, some types of beans and some types of vegetables will help you prevent the stone formation.

3. Dietary steps to prevent uric acid stones

For uric acid stones, increased intake of animal protein will increase your risk of developing the stones. The animal proteins to limit in your diet include:

  • a. Eggs
  • b. Chicken, beef, pork, especially organ meats
  • c. Shellfish and fish
  • d. Cheese, milk, and the other dairy products

In order to ensure that you get enough protein every day, replace the animal proteins with plant-based ones such as:

  • a. Legumes like beans, lentils, dried peas and peanuts
  • b. Soy foods like tofu, soy nut butter, soy milk
  • c. Sunflower seeds
  • d. Nuts and nut products like cashews, cashew butter, pistachios, walnuts, almonds, and almond butter

Speak with your doctor about how much total protein you should include in your diet every day and how much of that should come from plant-based or animal-based sources.

For uric acid stones, being overweight is also a major risk factor. So consider losing weight to prevent a recurrence of the stones.

4. Dietary steps to prevent cystine stones

The most important lifestyle change you’ll need to make to prevent cystine stones is drinking plenty of liquids, mainly water. Speak with your doctor about how much water you should drink, especially if you’ve had kidney failure.

Tips for limiting the amount of sodium in your diet

Most Americans take in too much sodium which increases their risk of kidney stones. An adult should consume not more than 2,300 mg of sodium a day — remember that one teaspoonful of table salt contains 2,325 mg of sodium. To prevent a recurrence of calcium phosphate or calcium oxalate stones, use the following guideline to limit the amount of sodium you consume:

  • a. Check the Percentage Daily Value (%DV) of sodium on the label of the food products you buy. A %DV of 20 percent or more is high while a %DV of 5 percent or less is low.
  • b. Write down the quantity of sodium you consume every day.
  • c. Always try to find out the sodium content of the food you eat.
  • d. Cook your meals from scratch — avoid canned vegetables and soups, fast and processed foods and lunch meats as they often contain a lot of sodium.
  • e. Buy foods labeled: salt free, sodium free, low sodium, very low sodium, light in sodium, less or reduced sodium, unsalted, no salt added, or lightly salted.
  • f. Check food labels for hidden sodium and sodium-rich ingredients such as sodium nitrate, sodium nitrite, sodium alginate, monosodium glutamate (MSG), disodium phosphate, sodium bicarbonate, and baking soda (contains sodium bicarbonate and other chemicals).

Looking for more information on prevention and treatment of kidney stones? At St Pete Urology, we treat ureteral and kidney stones as safely, painlessly and effectively as possible. We also equip our patients with the information they need to prevent the recurrence of the stones. Talk with us about your symptoms, fears or concerns and we can help find the best plan for you. For more information, 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.

Vasectomy Reversal – Does it REALLY work?

A vasectomy reversal is the procedure to reconnect the tubes (vas deferens) that are cut and sealed off during a vasectomy. Though still considered a permanent method of birth control, advances in microsurgery have ensured that it can be reversed even after 15 years or more. Men can choose to undergo a vasectomy reversal after a remarriage, a change of heart, loss of a child, or to treat testicular pain associated with a vasectomy. The reversal is typically an outpatient procedure performed under general or local anesthesia, taking around 3 hours and followed by a short recovery period. Nevertheless, only about 6 percent of men who undergo a vasectomy choose to have it reversed later.

Success rate of vasectomy reversal

The success rate of reconnecting the tubes severed during vasectomy is quite high, about 90 percent. After a successful reconnection of each tube, sperm is again able to pass from the testicles through the tubes and reach semen, and a man may again be able to get his partner pregnant. But the success of a vasectomy depends on a number of factors, such as the state of the tubes during the reversal and how many years have elapsed since the vasectomy was done.

If you undergo a vasectomy reversal within seven years of the vasectomy, the reversal is a simple procedure of putting the vas deferens back together. But if the tubes are too short to reconnect, if there is scarring or it’s been more than seven years since you had the vasectomy, the reversal process may be more complex. However, even with the more complex procedure, the success rate is still around 50-60 percent with no much difference in pregnancy rates — the average being 50-60 percent likelihood of pregnancy, which drops to 44 percent if time since a vasectomy is greater than 15 years.

If the time since vasectomy is less than 15 years, the reversal provides a pregnancy rate that’s higher than in vitro fertilization (IVF) and sperm aspiration with intra-cytoplasmic sperm injection (ICSI). And even after intervals greater than 15 years since a vasectomy, the reversal still gives outcomes equal or greater than IVF with ICSI.

Vasectomy reversal techniques

Vasectomy reversal is usually performed in two ways. The first technique is vasovasostomy (VV), which is basically the piecing back together of the two sides of the tubes (vas deferens) — that is vas deferens to vas deferens. The other technique is vasoepididymostomy (VE), which involves reconnecting the vas deferens to epididymis, the duct that transports sperm to the vas deferens. Generally vasovasostomy (VV) is done if sperm is present in the vas fluid. If sperm isn’t present in the fluid, vasoepididymostomy (VE) is the go-to procedure. In some cases, a combination of both techniques may be necessary, with a vasoepididymostomy done on one side and a vasovasostomy on the other.

A vasoepididymostomy is slightly more complicated and therefore chosen only when a vasovasostomy is impossible or can’t work. You won’t know the technique that the surgeon will use until the operation begins and that usually depends on whether sperm is present in the fluid found in the vas deferens at the time of surgery. Both are outpatient procedures that take less than 3 hours. A man has a successful vasectomy reversal if sperm evaluations performed several months later indicate he has the normal sperm count necessary for conception.

How should you prepare for a vasectomy reversal?

A vasectomy reversal is a complex and expensive procedure that’s often not covered by insurance. So you should find out what you’ll need and all the costs well ahead of time. The procedure is generally more successful when performed by surgeons who are trained and experienced in microsurgical techniques and who have done the procedure several times. So when choosing a doctor for the procedure, find out how many reversals the surgeon has performed, the techniques used, how often pregnancy has occurred after surgery, and the risks and complications involved.

Similarly, you’ll need to buy tight-fitting undergarments (like an athletic supporter) that you will wear after the procedure to hold bandages in place and support your scrotum. You also will need to stop taking medications that increase the risk of bleeding, including pain relievers (like ibuprofen or aspirin) and blood-thinning drugs. You should make arrangements for your travel to and from the hospital and for the length of time you will need to recover after surgery.

What should you know before a vasectomy reversal?

Vasectomy reversal is performed as an outpatient procedure that doesn’t require an overnight stay in a hospital. Before the procedure, the surgeon will take your medical history and conduct a physical examination to make sure you’re not having any health problems that may lead to complications after or during surgery. If your physical exam shows abnormal results or you’ve got sexual function issues, the doctor may consider running some blood tests. Likewise, a review of your surgical history is done to assess whether you had any previous surgeries other than the vasectomy or prior injuries that can hinder the vasectomy reversal. The doctor also will confirm whether you can produce healthy sperm. While evidence of fathering a child before is usually sufficient proof of the health of your sperm, additional testing may be necessary if there is uncertainty.

What happens during a vasectomy reversal?

Once you’re in the operating room, anesthesia is applied to minimize discomfort during the procedure. That may either be general anesthesia to keep you unconscious throughout the procedure or a local, spinal or epidural anesthesia to minimize pain but without putting you to sleep. The surgeon then makes a small incision on the underside of your scrotum to expose the tubes (vas deferens) and free them from surrounding tissues. Cutting open the vas deferens, the surgeon examines the fluid inside the tubes to establish whether sperm is present. If it’s found that sperm is present, the doctor simply reconnects the ends of the tubes to enable sperm passage. If the fluid inside the vas deferens is pasty, thick or contains partial or no sperm, that’s usually an indication that there’s a blockage of sperm flow and that vasovasostomy may not work. In that case, vasoepididymostomy is the more appropriate procedure.

What happens after the procedure?

After the procedure, the doctor applies bandages to cover the incisions. Make sure to ask your doctor when it will be OK to take the bandages off. The stitches applied should dissolve in 7-10 days. You will be required to wear tight-fitting undergarments (like athletic supporter) and apply ice to minimize swelling. The area may feel sore for many days, but the pain shouldn’t be severe and should improve within a few days to one week.

Once back at home, make sure to take it easy and avoid any activities that may move the testicles excessively or pull on the scrotum or testicles, such as heavy lifting, biking, jogging or sporting activities. For the next several weeks, wear an athletic supporter at all times, removing it only when showering. Avoid activities such as swimming and bathing for the first two days following surgery because they can make the surgery site wet. If your job requires much driving, walking or physical exertion, seek your doctor’s advice on when it’s safe to return to work. But for a desk job, you can return to work within a few days after surgery — only making sure that nothing harms the surgery site. Do not ejaculate or engage in sexual intercourse until your doctor gives you a go ahead — that is often 2-3 weeks after surgery.

What results should you expect?

To assess the success of a vasectomy reversal, the doctor will examine your semen 6-8 weeks after surgery. If the procedure is successful, sperm will be present in the semen. The appearance of sperm in semen should happen within a few months, but may take a year or more in some cases. So the doctor may have to conduct periodic semen analysis to evaluate the success of the procedure, unless your partner gets pregnant soon after the reversal. The prospect of achieving pregnancy usually depends on a number of factors, including the age of your female partner and the duration of time that has elapsed since the vasectomy.

Can the reversal fail to work?

If a blockage develops in the tubes after surgery or there is an underlying issue with your testicles that wasn’t recognized during surgery, a vasectomy reversal can fail to work and you may need a second-attempt reversal procedure. Doctors often opt to collect and freeze some sperm during a vasectomy reversal, which can then be used if the procedure doesn’t work. But if sperm isn’t frozen during the procedure or you completely lack sperm in your ejaculate, sperm can still be retrieved directly from your epididymis or testicle to help you have children via assisted reproductive techniques, like in vitro fertilization.

At St Pete Urology, we have a huge pool of urologists trained in andrology and experienced in microsurgical techniques. We conduct the procedure under very high-level magnification using incredibly small sutures. We perform several vasectomy reversals every year and boast significantly high success rates. So if you are looking for specially trained and skilled doctors to reverse a vasectomy in a way that will maximize your chances of having children, come and see one of our urologists. For more information on vasectomy and vasectomy reversal procedures, 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.

What Does A Urologist Do?

If you have never been to a urologist, you may feel uneasy about your first visit. You may be seeing the urologist about a very awkward and distressing condition. In truth, though, there is no reason really to worry or feel squeamish. Urologists make every effort to keep their patients at ease and as comfortable as possible. So you can be sure that you’ll meet warm, friendly and candid professionals in the urologist office, be handled with respect, courtesy and friendliness, and have your problem solved.

Who is a urologist?

Urologists are physicians with specialization in diseases of the genitourinary tract — urinary bladder, kidneys, urethra, male reproductive organs, adrenal glands and urethra. In men, urologists tackle disorders of the prostate, penis, epididymis, testes and seminal vesicles and help resolve male sexual dysfunction and infertility. But most routinely, they see both men and women for various reasons, including recurrent urinary tract infections, urinary incontinence, kidney disease, renal transplants, urologic cancers, bladder prolapse, enlarged prostate, urethra stricture, erectile dysfunction, Peyronie’s disease, painful bladder syndrome, ureteral and kidney stones, and prostatitis. They also may see children with urological problems that are too complex to be handled by non-specialized pediatricians.

Prostate and bladder cancer

For most men, a visit to the urologist is often associated with the prostate exam. The exam is quite a crucial part of assessing the overall prostate health and enables the urologist to plan well for treatment of any prostate problems. But the prostate exam is no longer at the heart of every urologist visit and you now can see a urologist and leave without being examined. In fact, with increased use of PSA tests to screen for prostate cancer, the exams are now just performed when very crucial. You shouldn’t avoid those necessary visits to a urologist merely because you don’t like prostate and rectal exams.

Remember also that if after testing you are diagnosed with prostate cancer, your urologist can help by offering timely, lifesaving care. Actually, because the physician can detect and help you recover from a disease that can potentially incapacitate you and reduce your joy of life and the time you spend with your family and your loved ones, it’s very important to visit a urologist whenever you are directed to do so.

Urologists use some of the best medical techniques and technologies to deliver safe, painless and effective treatment for urologic cancers. For example, if your urologist opts for robotic surgery then you will not be in the hospital for more than a week after a kidney, prostate or bladder cancer surgery. Most likely, you will take only a few days, even a single day — leaving soon after procedure. That’s fast and convenient, indeed. So you shouldn’t suffer in silence and have your prostate cancer spread to other areas of the body just because you believe the treatment will be painful, uncomfortable or inconvenient.

Prostate enlargement

If you have had to habitually wake up at night to pass urine and always find it difficult to produce a steady, quick urine stream as you once did, you probably have an enlarged prostate and a urologist can help you overcome the condition. This specialist doctor is quite similar to that neighborhood plumber you call to your home when pipes are clogged. So when you visit a urologist, are examined and found to have an enlarged prostate, the doctor will use a number of techniques such as laser therapy and steam treatment to remove the pressure on your bladder and obstruction on your urethra, relieving your urinary symptoms. And you can return home the same day you undergo treatment.

Erectile dysfunction

As men get older, they may experience erectile dysfunction. In fact, for men in their 40s or 50s, erections aren’t what they once were. So what should you do when you have issues with your erections? Well, one great option — a visit to a specialist who can identify the cause of your erectile problems and provide effective treatment. And that’s a urologist — a physician with training and experience in treating erectile dysfunction and male infertility issues. Since erectile dysfunction also may indicate that you have health problems in other areas of your body which may require more careful attention, a visit to a urologist can help detect a more serious disease and save your life.

Kidney stones

The pain and discomfort of a major kidney stone is something you may never forget. But with a visit to a urologist, kidney stones of all sizes can be broken down and removed from your system. A urologist sees such cases routinely, knows exactly what to do and will help you find quick relief from the pain and discomfort of the stones. And since kidney stones may recur, you will require the long-term care and well-coordinated follow-up provided by urologists. The urologist will recommend effective ways you can use to prevent kidney stones and manage any painful stones you may develop. That means you can rest easy before or after you have kidney stones knowing that you have an expert to help you deal with such troubles. So if you suspect that you have or are at risk of kidney stones, visit a urologist for proper examination and treatment.

What if you are a woman?

Urologists see women too and there is no discrimination in terms of sex. In fact, because kidney stones and bladder problems can occur in both men and women, the doors of all urologists are always open for both sexes. Nevertheless, about two-thirds of all patients seen by urologists are still men because of the lower awareness levels among women on how these specialist physicians can help them. Likewise, visits to urologists are generally practice-specific and vary according to a doctor’s area of specialty training.

While it doesn’t really matter whether you see a male or female urologist — as the quality of care will be the same — some women prefer to be treated by female urologists while some men prefer seeing male urologists. That’s just a matter of choice and you are encouraged to see the urologist you feel most comfortable with. But as you do so, remember that all urologists are focused on holistic care, effective treatment, superb outcomes and improved quality of life for all. So even if you are a guy who is generally bashful when around females, you shouldn’t fear seeing a female urologist, for whatever condition you have isn’t something the female urologist hasn’t seen before. Don’t suffer in silence because you are anxious about being attended to by a urologist of opposite gender.

What of pain?

Pain isn’t part of the treatment process. So every time you see a urologist for a procedure, you should expect the use of an anesthetic to prevent pain and keep you comfortable. For instance, before undergoing a bladder scope, you’ll be numbed first; while the first step during a vasectomy is the injection of a nice, healthy-sized local anesthesia. Similarly, before a prostate biopsy, a prostate block is done. Whereas you may feel things moving around or some pressure during a procedure, you should not feel pain. And the point here is that you should know urologists are there to help you deal with inconveniencing problems, such as sexual function issues, urinary problems, cancer or kidney stones. But when doing so, they endeavor to keep you as comfortable as possible, aiming to eventually improve your quality of life.

Friendly, compassionate care

Urologists are skilled and experienced in treating problems that people are often unwilling to talk about or which are found in body areas that people find difficult to discuss. So your urologist knows that you are already distressed, embarrassed and feel awkward about your condition even before you visit, and has already taken steps to make you feel as comfortable as possible. By being frank and friendly throughout the treatment process, with humor coming in handy to help lighten the mood around your discussions, the doctor will ensure that you feel at home as your problem is tackled. Hence, don’t be surprised when some “potty” humor is thrown your way during your chat with the urologist.

Well, that’s it. There is nothing to dread or feel restless about in seeing a urologist. In fact, you will find a long-term friend who will help you overcome troubling urological issues and improve your quality of life. At St Pete Urology, we have a big pool of skilled, experienced, board-certified urologists to help you find relief from embarrassing and distressing genitourinary problems, such as kidney stones, urinary incontinence, erectile dysfunction and enlarged prostate. And we have a culture of collaborative, compassionate, patient-centered care that helps us deliver the high-quality of treatment and care we promise our patients. Find out more about our services by visiting 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.