What is sex like with a penile prosthesis

There is no such thing as “normal” when it comes to sex. What you like isn’t necessarily what another person likes. How important it is to you and how often you want it is also a personal preference, but what is common for everyone is the desire to have a pleasurable sexual encounter.

Men with erectile dysfunction who intend to have a penile implant inserted into their penis often want to know how it would impact their sexual pleasure.

Strong, reliable erection

A penile prosthesis enables you to have an erection that is strong enough for satisfactory sex. You will have an erection similar to a natural erection and will not have problems keeping it throughout sexual intercourse.

At St Pete Urology, we offer both inflatable and non-inflatable penile implants. An inflatable implant has two rods filled with fluid from a reservoir near the bladder. As the rods fill, the penis becomes erect. When there is no fluid in the rods, the penis is fully deflated and unnoticeable.

With the non-inflatable implant, a single rod is surgically implanted within the erection chamber of your penis. The rod keeps the penis in a semi-rigid state so that you merely need to lift it into position or adjust it by hand for sexual intercourse.

Regardless of whether the implant is inflatable or in a semi-rigid state, it will support your penis without making it larger or affecting the shape of its head. Expect your penis to be erect to about the same size as before you got the implant, and provide enough hardness for penetration and satisfying sex.

Unhindered sensitivity

A penile prosthesis does not affect the sensitivity of the penis, its glans, or its skin. You will not lose sensitivity and will generally respond to sexual stimulation. You will also have no limitations such as axial effort, traction, or your partner tightening the penis during sexual intercourse.

You can still enjoy different positions and enjoy normal orgasm and ejaculation—deriving maximum pleasure from your sexual encounters. The penis stays rigid even after orgasm, and it is up to you to choose to release the valve to remove the fluid from the rods and end the erection. You should also make sure to have good lubrication during intercourse.

Once you have a penile prosthesis, it may destroy your natural erection reflex. You should have the implant only when recommended by your urologist.

Hidden and unnoticeable

Due to the small incision made for the procedure, the healed scar after penile implant surgery is subtle and hidden to casual observers. The implant will be fully concealed and remain private. You can freely enjoy sex without worrying about your partner knowing you have an implant.

No one will be able to tell that you have a penile prosthesis until they see the small scar at the bottom of your penis. Even in the shower or locker room, it will remain undetectable.

Do you have erectile dysfunction? Would you like to restore your sexual function? At St Pete Urology, we understand that erectile dysfunction can severely impact your relationships and your quality of life. We offer various solutions that can help you with this predicament.

We typically recommend a penile prosthesis for patients who have not found the other ED treatments effective. After the implant surgery, patients can expect to enjoy healthy sex lives, enhanced self-esteem, and more satisfying relationships.

Schedule a consultation with one of our skilled and experienced surgeons at St Pete Urology to find out if a penile implant could be an excellent option for you




Phone: (727) 822–9208
Fax: (727) 822–9211



The New FDA Approved InterStim™ Micro is the Smallest and Fastest Rechargeable Bladder and Bowel Control System with Conditional Full-Body MRI

Full-Body MRI Conditional InterStim™ II and InterStim™ Micro Systems Give Patients a Choice Between Sacral Neuromodulation Devices to Suit Their Lifestyle

ST PETERSBURG, FL – JUNE 28, 2021 –  St Pete Urology is one of the only medical providers in St. Petersburg, FL to offer new solutions to the millions  of people who suffer from incontinence thanks to technology advancements from Medtronic — the world’s leading provider of therapy for bladder and bowel control issues. 

More than 37 million adults in the United States – almost one in six – suffer from overactive bladder (OAB) and nearly 18 million Americans – about one in 12 – have fecal incontinence (FI).1-4 It is life-altering because many sufferers limit their lives socially, professionally, and personally,5 but it is  treatable. The new InterStim™ II and InterStim Micro systems provide patients with safe, effective relief from OAB and FI. The InterStim™ II recharge-free system offers patients freedom from a recharging routine, the hassle of recharging components, and a reminder they have a disease. The rechargeable InterStim™ Micro system, the smallest device available in the sacral neuromodulation (SNM) market, benefits patients who want a smaller, longer lasting device. Both systems are full-body* conditional MRI and deliver the same therapy with long-term relief.

“Effective long-term bladder and bowel control is an unmet medical need by many in the St. Petersburg area who experience regular accidents and/or frequency issues associated with OAB and FI. It can significantly impact all aspects of a person’s quality of life – self-confidence, exercise, activities and even intimacy,” said Adam Oppenheim, DO. “By partnering with Medtronic, the trusted leader in SNM therapy, my goal is to help give patients a life without limits.” 

Known as sacral neuromodulation (SNM), the therapy is delivered by the InterStim™ system – an implanted medical device that provides gentle stimulation to the sacral nerve and is thought to normalize the brain-bladder connection to alleviate symptoms. Medtronic developed SNM therapy more than 25 years ago in partnership with physicians who specialize in treating incontinence. Recent technology advancements from Medtronic now gives patients lifestyle-friendly choices in the type of InterStim system they choose; improved battery technology; conditional full-body MRI; and the smallest and fastest charging device on the SNM market.

“I must say, I was very impressed with EVERY aspect of my visit with Dr. Oppenheim. His knowledge goes without saying. Top notch. I was taken aback, though, by his patience and kindness. He took the time to listen patiently to the questions I had. I didn’t feel rushed. He answered those questions in a way that was very easy for me to understand. The staff that I encountered were friendly and assistive. I was also glad that any procedures/tests that he recommended I need are done right there at the office, not a hospital. His office and the building in which it’s in is very easy to find. Overall, a great experience. Should the need arise for anyone I know to need a urologist, I’m definitely recommending Dr. Oppenheim and his staff.”

“For much too long, my life revolved around where I would find the next bathroom,” said Wes Linkovich. “I’m so glad I finally sought help and was open-minded about sacral neuromodulation. My therapy fits well with my lifestyle and, finally, I can focus on the things I love. To anyone suffering in silence, please ask your doctor or urologist about the InterStim™ system from Medtronic. I wish I done this sooner.”  

Not every patient receives the same benefit, and there are potential risks, which may include surgical, device and stimulation risks.6   St Pete Urology will explain the benefits and risks and help each patient find their best treatment. 

About St Pete Urology

Drs. Reid Graves, Nicholas Laryngakis and Adam Oppenheim are dedicated to serving the urological needs of the Tampa Bay and surrounding communities. We strive to provide state-of-the-art diagnosis and treatment and believe in rendering the least invasive, most efficacious treatment of urological disorders in a kind, empathetic, manner. We treat each patient as a partner in his or her medical care and make patient education a central component of our care. Because many urological conditions are accompanied by social discomfort or embarrassment, we emphasize sensitivity and discretion when dealing with all of our patients’ concern


*Under certain conditions; see approved labeling for details. Patients with InterStim™ SureScan™ MRI leads only

  1. Stewart WF, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003 May;20(6):327-336.
  2. United Nations, Department of Economic and Social A airs, Population Division (2011). World Population Prospects: The 2010 Revision, CD-ROM Edition.
  3. United States Quick Facts. United States Census Bureau Web site. Available at: https:// www.census.gov/quickfacts/table/ PST045215/00. Accessed July 19, 2016.
  4. Whitehead WE, Borrud L, Goode PS, et al. Fecal Incontinence in US adults: epidemiology and risk factors. Gastroenterology. 2009;137(2):512- 517.
  5. Dmochowski RR, Newman DK. Impact of overactive bladder on women in the United States: results of a national survey. Current Medical Research and Opinion. 2007;23:65-76.
  6. Link to Important Safety Information

What is the fastest way to cure erectile dysfunction

For a man, erectile dysfunction can be a serious issue. When sex stops, your relationship problems may begin or worsen.The occasional inability to have an erection that is firm enough for sexual intercourse is normal. However, when the problem persists for a while, it points to a deeper issue that should be addressed immediately. Without treatment, ED can make sexual intercourse impossible.

So what is the fastest way to cure erectile dysfunction?

1. Make lifestyle changes
If you have erectile dysfunction, you can get quick results by making a few lifestyle changes that ensure enhanced blood flow to the penis and help achieve harder erections.

For example, if you quit smoking, lose weight, or exercise regularly, you may see an improvement in your sexual function. You may also need to speak with your doctor if you suspect that a medication you are taking contributes to your ED. Your doctor may change or withdraw the medication.

2. Using oral medication
You can get quick results through oral medications such as Viagra, Cialis, Levitra, Staxyn, or Stendra. These pills boost blood flow to the penis during sexual arousal, making it possible to achieve an erection that is firm enough for satisfactory sexual intercourse.

These pills require a doctor’s prescription to guarantee safety and should not be taken more than once per day. They are taken 30-60 minutes before sexual activity. Cialis can be taken up to 36 hours before sexual activity and comes with a lower daily dose.

3. Injectable drugs
If you don’t like pills, injectable medications for ED can help you achieve a stronger erection. They are injected directly into the penis and work by widening the blood vessels, making the penis engorged with blood.

Alternatively, you can use a medicated pellet that you insert into your urethra to trigger an erection within a few minutes.

If you are considering injectable drugs as an option, please make sure to discuss the details with your urologist.

4. Vacuum devices
Also called pumps, vacuum devices provide an alternative to medication. To use the pumps, you place your penis inside a cylinder connected to the pump. The pump draws out air from the cylinder to create a partial vacuum around the penis. As a result, blood rushes into and fills your penis, causing an erection.

You will have an elastic band around the base of your penis to maintain the erection during intercourse. But if you are considering using a vacuum device, it is important to discuss its proper use with your urologist because the elastic band must be used correctly to avoid potential penile damage.

5. Penile implant surgery
If you have tried pills and other less invasive options without success, you may need to undergo penile implant surgery. This option is ideal if your penile blood vessels have been damaged by severe diabetes or during radical prostatectomy. You may also need to undergo penile implant surgery if you have structural problems that make erections difficult or impossible.

There are two basic types of penile implants: inflatable and non-inflatable. The non-inflatable (malleable) implant is a single rod that can be shaped by hand to create an erection. The inflatable implant has two rods filled with fluid from a reservoir located near the bladder.

When you desire an erection, you use the pump to fill the rods with pressurized fluid. As the rods fill, the penis becomes erect and broader. The prosthesis leaves the penis completely deflated when there is no fluid in the rods, making the penis implant unnoticeable.

Want to overcome erectile dysfunction fast?

At St Pete Urology, we offer various safe, effective treatments for erectile dysfunction, including medications, injections, vacuum devices, and penile implants.

We are proud of what we have been able to achieve for our patients. In most cases, our patients have the same level of sexual satisfaction and ability to ejaculate that they had before the erectile dysfunction.

If you have trouble with erections, speak with our skilled urologists and begin your journey to a life of renewed self-esteem, confidence, and optimum sexual function. For more information about effective treatments for erectile dysfunction, visit the St Pete Urology website.

What Foods Are Good For Kidneys?

Kidneys play a significant role in the overall health of the body. They filter out waste products from blood and send them out of the body as waste through urine. The kidneys also balance fluid and electrolyte levels in the body while making hormones that regulate the function of other organs of your body. But to keep your kidneys healthy, you need to watch what you eat and drink because some foods boost the performance of the kidneys while others stress, degrade and damage them.

What foods support healthy kidneys?

Kidney-friendly foods are those that enhance kidney function and protect them from damage. Generally, a good balance of quality protein, calories, vitamins, and minerals are great for the kidneys. Very high dietary levels of some mineral ions such as sodium, potassium, phosphorus and calcium may in the long run endanger your kidneys. Foods linked to heart problems and high blood pressure may put additional pressure on the kidneys.

For healthy kidneys, consider the following:

1. Stay Hydrated

Water helps to flush out toxins from the body. In fact, the body relies on water to assist transporting toxic wastes into the bloodstream, then to the kidneys where they are filtered and removed through urine. This process helps reduce the risk of bacterial infection, kidney stones, and kidney disease, which is why water is crucial for the critical salt-fluid balance in the body.

Ideally, you should drink 6-8 glasses of water per day, but of course you can drink more if you are active during the day. In addition to the many other benefits of staying hydrated, drinking water when thirsty helps to support your kidneys.

2. Apples and mushrooms

Apples are rich in fiber. One of the fibers, called pectin, helps to reduce various risk factors for kidney disease, such as high blood sugar and cholesterol levels. Apples also have anti-inflammatory constituents, prevent constipation, protect against heart disease, and lower the risk of cancer. You might also consider eating mushrooms for their high levels of vitamin D, which boosts kidney function.

3. Sweet potatoes

Sweet potatoes have a robust fiber profile. They break down very slowly in the body which helps to support low insulin levels. Sweet potatoes also have a healthy amount of vitamins and minerals, such as potassium which helps to balance sodium levels in the body and reduce the effect of sodium on the kidneys. However, since they contain high levels of potassium, sweet potatoes are not ideal for those with chronic kidney disease (CKD).

4. Berries

Dark berries, such as strawberries, raspberries and blueberries are a great source of nutrients and antioxidants and for most people protective for the kidneys.

5. Dark leafy vegetables

Leafy vegetables such as kale, spinach and chard contain a wide variety of vitamins, fibers, and minerals that support kidney function. While they do supply a number of protective compounds, dark leafy vegetables are highly rich in potassium and therefore less suitable for those with chronic kidney disease (CKD), restricted diet, or patients on dialysis.

6. Kale and cauliflowers

Kale is a terrific source of vitamins A and C which reduce inflammation, boost the immune system and protect the kidneys. Kale is also lower in potassium compared to other greens, and contains lots of iron. Like kale, cauliflower is rich in vitamin C and also has plenty of fiber and folate that are crucial for kidney function. Likewise, cauliflower contains compounds that improve the liver’s ability to neutralize toxic substances and reduce the stress on the kidneys.

7. Fatty fish and egg whites

Tuna, salmon and other cold-water, fatty fish have high omega-3 fatty acids. The omega-3 fatty acids in these fish are heart protective and also healthy for the kidneys. Since high blood pressure is a risk factor for kidney disease, fatty fish is a great way to improve your cholesterol profile and protect your kidneys.

Foods to avoid include:

1. High salt

Elevated salt levels raise blood pressure making the heart and kidneys work extremely hard. You can control your salt intake by cooking at home and avoiding most fast foods which are sky high in sodium.

You can also try substituting new spices and herbs in place of salt and by avoiding packaged and pre-cooked foods, such as soups, frozen dinners, and boxed meals that usually have extra salt. Similarly, you should avoid table salt and high-sodium seasonings like soy sauce, garlic salt and sea salt.

2. Foods rich in potassium

While potassium helps your nerves and muscles to work properly, too much of it can lead to serious heart problems and eventually to kidney issues. Potassium is found in most fruits and vegetables, such as bananas, oranges, avocadoes, raw carrots, cooked broccoli, potatoes, greens, tomatoes, and melons.

Instead of these high potassium foods, try alternatives such as apples, cranberries, blueberries, raspberries, and strawberries. Other good options are pineapples, peaches, plums, asparagus, cabbage, cucumber, and beans (green and white).

3. Limit phosphorus and calcium

Phosphorus and calcium are great minerals for keeping your bones healthy and strong. But high levels of phosphorus may increase the risk of long-term kidney disease. Since most foods that contain phosphorus are also equally rich in calcium, the body’s levels of the two minerals can be controlled by similar mechanisms.

If your doctor suggests limiting phosphorus, avoid foods such as red meat, dairy products, nuts, fish, most grains, and legumes. Consider replacing these foods with healthy foods that are lower in phosphorus, such as fresh fruits and veggies, rice, corn and fish.

At St Pete Urology, we encourage our patients to take care of their kidneys through healthy behaviors—exercise, drinking plenty of water and eating a balanced diet. We also perform surgeries and treat urination problems such as incontinence, tumors, cysts, growth and stones of the urinary system, as well as problems of the male reproductive system. For more information on kidney disorders and their treatment, visit the St Pete Urology website.

Overcoming an Overactive Bladder

Overactive bladder (OAB) is an uncomfortable and stressful condition. Characterized by a sudden involuntary bladder contraction that triggers a compelling urge to pass urine, OAB may lead to urine leakage or the need to pass urine several times during the day or night. As a result, having an overactive bladder makes it difficult to go through the day without several visits to the bathroom.

Bothersome Symptoms

While the symptoms of OAB may be less troublesome when you are at home, they can be a problem in a public or unfamiliar place. No one wants to rush out of meetings with important clients or friends for fear of not making it to the restroom in time.

The fear instilled by overactive bladder can interfere with your ability to go out with friends, work, exercise, and even sleep. It can also disrupt your sex life, leave you tired and short-tempered, or cause rashes or infection due to the leaks. And the whole experience may leave you feeling unhappy and hopeless.

Strategies for Overcoming Overactive Bladder

The good news is that overactive bladder can be controlled. In fact, many patients overcome OAB without the need for invasive medical and surgical procedures. The key to successful treatment is seeing a urologist early to assess your condition and identify steps to help you manage the symptoms and regain control over your bladder.

Lifestyle measures may include changing what you eat or drink, pelvic floor exercises, and pre-planned bathroom visits. When lifestyle changes are unsuccessful, medical and surgical interventions may be necessary.

Behavioral Changes

1. Reducing fluid intake

Restricting fluid intake reduces your urinary output and helps control OAB symptoms. Since the symptoms of overactive bladder usually occur after a certain critical urinary volume is reached in the bladder, limiting fluid intake ensures it takes longer to reach this critical volume.

By consuming most of your fluid before 7 PM, you can lessen your nocturnal frequency. If you are on diuretic medications, you can check with your urologist to see whether they can be changed.

2. Limiting foods and drinks that trouble your bladder

Alcohol and caffeine (present in coffee, tea, colas, chocolate and some energy drinks) irritate the bladder and increase urinary output. By reducing the intake of these beverages and foods, you can improve your bladder control.

Foods such as fruits and vegetables have hidden water content, so you can limit additional beverages when eating healthy fresh produce. You might also want to reduce or abstain from spicy foods, citrus fruits, and artificial sweeteners, foods made with tomatoes, soda, and other fizzy drinks.

Because the chemical constituents of tobacco constrict blood vessels, impair blood flow, decrease oxygenation, and promote inflammation—affecting the bladder, urethra and pelvic floor muscles—quitting cigarette smoking will improve your OAB symptoms.

3. Keep a bladder diary

Writing down the time and triggers for your trips to the bathroom can help you understand your body better. After a few days, your diary will show you the things that make your symptoms worse. For instance, you may realize that your symptoms get worse after you eat or drink a certain food. This helps you to decide what changes to make in your diet.

4. Weight loss and regular exercise

Excess weight puts pressure on the urinary bladder and worsens overactive bladder. Even modest weight loss may improve your overactive bladder symptoms.

Lower impact exercises, such as yoga, cycling, Pilates, and swimming, can help to alleviate pressure on the urinary bladder by boosting core muscle strength and tone. As a result, OAB symptoms improve.

Due to the proximity of the rectum to the bladder, a full rectum can put pressure on your bladder, resulting in worsening of urgency, frequency and incontinence. Taking steps to avoid constipation will improve bladder control.

Voiding Measures and Bladder Retraining

You can overcome overactive bladder by managing how and when you void. Ways to manage voiding include delayed (inhibited) voiding, timed voiding, and double voiding. Bladder retraining gradually imposes increased intervals between voids and establishes a more normal pattern of urination.

Delayed voiding means you practice waiting before you can go into the bathroom, even when you feel the urge. At the beginning, you may try waiting a few minutes, then gradually increase your waiting time to achieve a delay of up to 2-3 hours.

By timed voiding, you follow a daily pre-planned bathroom schedule. That is, instead of going to the bathroom every time you feel the urge, you go at set times during the day. For example, you may try to pass urine every 2-4 hours regardless of whether you have the urge to go or not. The goal of doing this is to prevent an urgent uncontrollable feeling and to regain control over your bladder.

Double voiding (emptying your bladder twice) helps if you have trouble emptying your bladder. After you go to the bathroom, try again a minute later.

Pelvic Floor Muscle Training

Pelvic floor muscle exercises, also called Kegel exercises, help to stimulate inhibitory reflexes between the bladder and the pelvic floor muscles. By exercising your pelvic floor muscles rhythmically, you can inhibit involuntary contraction before and after it begins.

Kegel exercises target muscles that relax the bladder. To perform the exercises, you should begin by mastering the presence, location, and nature of the pelvic floor muscles. A simple means of identifying the muscles is to start urinating and then, when about halfway completed, to abruptly stop the urine stream.

Once you locate the muscles, squeeze them just before and during the trigger for urgency or incontinence. This will diminish the urgency and help avoid the incontinence. When performing Kegel exercises, always squeeze and relax the muscles repeatedly when you feel the urge to pass urine.


Bladder relaxant medications can help you suppress overactive bladder symptoms, although you may need several trials of different medications or combinations of medications to achieve optimal results.

Your urologist will prescribe medication either in conjunction with behavioral modification or after behavior modification has been tried unsuccessfully. The drugs prevent involuntary contractions of the bladder muscles by relaxing and stabilizing them.

Biofeedback and Botox injections

Biofeedback is an adjunct to training pelvic floor muscles in which electronic instrumentation is used to transmit feedback information about pelvic floor muscle contractions. It enhances awareness and strength of pelvic floor muscles.

In other cases, your urologist may opt for Botox—a simple procedure usually done in the doctor’s office—where it is injected directly into the bladder muscle to help reduce OAB symptoms. Once injected, Botox helps to relax areas of the bladder where it is injected. Botox injections generally last 6-9 months and are covered by Medicare and most insurance companies.

Percutaneous Tibial Nerve Stimulation (PTNS) and Interstim

PTNS is a minimally invasive form of neuro-modulation. A tiny acupuncture-style needle is inserted near the tibial nerve in the ankle and a hand-held stimulator used to generate electrical stimulation with the intent of improving OAB symptoms. The procedure is performed once every week for 12 weeks.

In some cases, your urologist may opt for the more invasive form of neuro-modulation, called interstim. During the interstim procedure, electrical impulses are used to stimulate and modulate the sacral nerves in the effort to relieve OAB symptoms. A battery-powered neuro-stimulator (bladder “pacemaker”) is used to provide the mild electrical impulses that are carried by a small lead wire to the stimulated sacral nerves affecting bladder function.

Surgery for Overactive Bladder

Treating OAB with surgery is not common and is usually reserved for cases where other treatment plans have failed. Surgery may increase the physical size of the bladder by using portions of the bowel to replace and expand a section of the bladder.

At St Pete Urology, our approach to helping you overcome overactive bladder includes lifestyle changes and medical treatments such as prescription drugs, bladder Botox treatment, nerve stimulation, and surgery. Our specialist team of urologists is experienced at dealing with overactive bladder through proper diagnosis and treatment. You can be sure your consultation will lead to a recommendation of the best possible treatment options for you. Schedule your appointment with us and begin your journey to freedom from overactive bladder. For more information on overcoming overactive bladder and other urologic conditions, visit the St Pete Urology website.

What Causes Low Sperm Count?

Low sperm count, which means having fewer than normal sperm in the ejaculate, decreases the likelihood that your sperm will fertilize your partner’s ovum and result in pregnancy. But it may also be related to your overall health, as it is often characterized by symptoms such as pain, swelling or a lump in the testicle area, low sex drive, erectile dysfunction, or decreased facial or body hair. Your sperm count is lower than normal if you have fewer than 15 million sperm per milliliter of semen.

What are the causes of low sperm count?

1. Emotional stress and inadequate sleep

Prolonged or severe emotional stress may interfere with the hormones needed to produce sperm, while depression lowers sperm concentration. Inadequate sleep makes it difficult to maintain a healthy weight and may lead to obesity. Obesity impairs fertility by directly impacting sperm and causing changes in the hormones that promote sperm production.

2. Overexposure to harmful chemicals

Chronic exposure to pesticides and other harmful chemicals can lead to low sperm count. For instance, prolonged exposure to industrial chemicals, such as xylene, toluene, benzene, herbicides, pesticides, organic solvents, BPA, perfluorinated chemicals, lead, and painting materials may lead to low sperm count. Likewise, when exposure to radiation or x-rays lowers sperm production, it can take years for sperm production to normalize.

3. Lack of exercise

Exercise plays a huge role in the health of your sperm. Men who sit for longer periods tend to have a lower sperm count than those who are active in their daily life. This means you can improve your numbers through moderate routine exercise every day, such as a daily walk for lunch or daily yoga in the evenings. Frequent exercise will increase your circulation, boost your mood, and increase your sperm count.

4. Overheating of the testicles

Exposure to high temperatures impairs sperm production and function. This is why frequent use of hot tubs or saunas temporarily lowers sperm count. Similarly, wearing tight clothing, sitting for long periods or working on a laptop for a long period of time may raise the temperature around the scrotum and reduce sperm production.

5. Drug and alcohol use

Anabolic steroids that are taken to stimulate muscle growth and can cause testicular shrinkage and decreased sperm production. Use of cocaine or marijuana also lowers sperm number and quality, while excessive drinking of alcohol lowers testosterone levels and hampers sperm production. Men who smoke tend to have a lower sperm count than those who do not.

6. Infection, medications and prior surgery

Some infections interfere with sperm production and sperm health. They include epididymitis (inflammation of epididymis), orchitis (inflammation of testicles), sexually transmitted infections (like gonorrhea, Chlamydia and HIV), and mumps infection. Also, long-term anabolic steroid use, cancer medications, testosterone replacement therapy, some ulcer medications, some antifungal and antibiotic medications, and other medications can hinder sperm production and lower sperm count.

Prior surgeries such as a vasectomy, scrotal or testicular surgery, inguinal hernia repair, prostate surgery, and large abdominal surgery for testicular or rectal cancer may affect sperm production. Similarly, tubes that carry sperm may be blocked by injury from surgery, trauma, prior infections, or abnormal development such as cystic fibrosis. Spinal cord injuries, diabetes and surgeries can block the normal flow of sperm and lead to retrograde (backward) ejaculation.

7. Certain medical conditions

A varicocele, the swelling of veins that drain the testicle, impairs testicular temperature regulation and causes low sperm count. Anti-sperm antibodies, which are immune cells that mistakenly identify sperm as harmful invaders, may destroy sperm and lead to low sperm count.

Undescended testicles, Peyronie’s disease, sperm duct problems, vas deferens blockages, unhealthy prostate, high blood pressure, diabetes, peripheral vascular disease, tumors that affect male reproductive organs directly, and hormonal imbalances may impair sperm production and lower sperm count.

What should you do to improve your sperm count?

  1. Eat healthy
  2. Exercise regularly and minimize your sitting time
  3. Don’t smoke
  4. Reduce or abstain from alcohol
  5. Avoid illicit drugs
  6. Use protection (condoms) during sexual intercourse
  7. Manage stress
  8. Get enough sleep
  9. Maintain a healthy weight
  10. Avoid exposure to pesticides, heavy metals, and other toxins
  11. Keep your laptop away from your lap
  12. Speak with your doctor about medications that can affect your sperm count
  13. Avoid frequent hot showers or hot tubs.
  14. Avoid tight pants

Maintaining a high sperm count is not necessarily difficult. All you need is some good habits such as healthy eating, regular exercise, comfortable clothes, and avoiding toxins. You should also speak with your urologist about possible remedies.

At St Pete Urology, we offer a variety of treatments for low sperm count, including lifestyle changes and minimally invasive procedures. We make sure to conduct thorough physical exams, medical history, and diagnostic tests to establish the underlying cause of the low sperm count before we recommend treatment. Meet with one of our urologists and start your journey to healthy fertility. For more information on male fertility, erectile dysfunction and other urologic issues, visit the St Pete Urology website.

How and Why Should I Do Kegels?

Kegel exercises are for strengthening pelvic floor muscles. They involve contracting and relaxing, clenching and releasing those muscles. Also called pelvic floor exercises, Kegels strengthen and coordinate the muscles that support the bladder, rectum, uterus and small intestines. The strengthening, in turn, helps to prevent the accidental passing of stool or gas, stops bladder leaks, and improves orgasm.

What are the benefits of Kegel exercises?

1. Prevent pelvic organ prolapse

Pelvic floor muscles support abdominal organs such as the stomach, bladder, intestines and uterus. With age, the weakening and slowing down of these muscles may lead to pelvic organ prolapse (POP).

A prolapse means the pelvic organs are displaced, drooping and fallen out of their normal position. In women, the pelvic organs may fall into the vagina or cause vaginal tissues to protrude from the body, particularly if the prolapse occurs after a hysterectomy.

Through regular Kegel exercises, pelvic floor muscles become stronger and more coordinated, reducing the risk of prolapse.

2. Avert incontinence

Pelvic floor exercises not only contribute to good posture and spinal stability, they also strengthen the muscular support for bladder and bowel function and help to maintain urinary and fecal continence. If you already have bowel or bladder incontinence, or drip after peeing, the exercises can help to relieve your symptoms.

3. Enhance sexual function

Kegel exercises improve sexual function. In men, they increase control over ejaculation and enhance the feeling experienced during orgasm. In women, the exercises improve flexibility and ease penetration. In addition, they provide the muscular strength to achieve orgasm while also making pregnancy and childbirth easier.

How should you do Kegel exercises?

1. Begin by identifying pelvic floor muscles

Kegel exercises do not require a lot of time, but targeting the right muscles is necessary. One of the easiest ways to identify the muscles is to stop urinating midstream by squeezing your muscles to hold the urine in. Another way of locating the muscles is to stop the passage of gas.

The muscles that help you to stop the passage of urine or gas are the ones you will need to work on. You only need to stop passing urine once or twice in order to identify the right muscles. After that, it is not advisable to perform Kegel exercises while urinating as that can lead to incomplete emptying of the bladder and increased risk of urinary tract infections.

2. Start slowly and improve with practice

Like other exercises, Kegels become easier with practice. Plan to begin slowly and build on your gains over time. For instance, you can start by squeezing your pelvic floor muscles for 3 seconds, releasing for another 3 seconds, and then repeating 10 times in a row. If you are not able to do 10 at time, begin with a lower number and increase with time.

3. Keep the focus

As you do these exercises, you will be tempted to flex the buttocks, thighs or abdomen. You may also find it difficult to increase the number of repetitions. Always target and exercise your pelvic floor muscles, pushing your body to complete at least one set of 10 Kegel exercises two to three times a day.

As you do the exercises, make sure to relax your pelvic floor muscles completely and to avoid holding your breath.

4. Perform Kegels anytime, anywhere

Kegel exercises are quite convenient. You can make them part of your routine and do them anywhere, whether brushing your teeth, driving to work, shopping for groceries or watching TV. Combining the exercise with another activity is a good way to remember your routine and see quick results.

Can Kegel exercises cause complications?

While the exercises are completely safe, you still need to do them the right way. For instance, you should not overdo Kegels as this may lead to straining when you visit the bathroom. You should also not do them as you urinate because that could increase your risk of urinary tract infections.

Kegel exercises are not for everyone. If your muscles are already tired, they will not respond if you try to contract them. Also, if your muscles are already tight, exercising them may cause more harm. Speak with your urologist to determine if you can benefit.

Are the exercises effective?

For those who do Kegel exercises regularly, the results are excellent. For example, urine leaks become less frequent within a few weeks of starting the exercises. Keep in mind that they have more impact when performed regularly over an extended period of time, such as doing them every day for at least 15 weeks. If you do not feel your symptoms are improving, you should speak with your doctor about alternative treatments.

At St Pete Urology, we offer personalized treatments for patients with urological problems. We will only recommend you do Kegel exercises after a thorough assessment of your condition. For more information on pelvic floor exercises and other treatment options for urologic disorders, visit the St Pete Urology website.

The 5 Best Ways to Prevent Kidney Stones

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

Growing concern

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

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

What are the 5 best ways to prevent kidney stones?

1. Drink plenty of fluids.

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

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

2. Increase your calcium intake.

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

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

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

3. Eat fewer oxalate-rich foods.

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

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

4. Reduce your sodium intake.

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

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

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

5. Limit intake of animal proteins.

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

Need help dealing with kidney stones?

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

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

Continue reading

Symptoms of Low Testosterone

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

What is low testosterone?

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

What are the symptoms of low testosterone?

  1. Diminished sexual function

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

  1. Adverse physical changes

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

  1. Mental and emotional problems

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

Why should you see a urologist?

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

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

What color is urine when kidneys are failing?

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

Clues from urine color

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

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

What urine colors are abnormal?

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

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

What is the color of urine when kidneys are failing?

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

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

Treatment of kidney failure

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

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

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