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.

Addressing 7 Vasectomy Myths

Alright guys, it’s time now to talk about the big V! When you hear about different birth control methods, whether through word-of-mouth, billboards, newspapers, TV or radio, you seldom hear anything about vasectomy. We want to talk to you about vasectomy now, explain away the myths and fears around it and shift the birth control discourse from the most common approach of what women should do to what men can do.

So what’s a vasectomy?

It is a simple, 15-minute non-drug permanent sterilization procedure for men. It’s performed under localized anesthesia and involves sealing off or cutting a portion of the sperm-conveying tubes (called vas deferens) in order to stop sperm from reaching the ovum when ejaculation occurs. If you are a man who has had all the children you wanted to have or are sure that you will never want to have any children in the future, vasectomy is a safe and cost-effective way to sterilize yourself.

Lots of questions

Yet, if you are like most men, you have probably heard the horror stories associated with vasectomy and you are worried that things may go wrong for you. Will it reduce my sexual pleasure? Will it turn me into a “eunuch” — a sad miserable man looking back constantly to his youthful years with nostalgia? And what if disaster strikes late in my life, or my life plans change, and I decide to have children? Can I reverse it? These and many more questions can make you have doubts about having a vasectomy. But it turns out these fears are baseless myths that shouldn’t stop you from a vasectomy.

What are the most frequent myths about vasectomy?

1. It will be intolerably painful

Honestly, for most men, the idea of the whole procedure can seem quite awkward. And since most of us have the habit of protecting our testicles from any type of direct assaults, a vasectomy seems like a real intrusion into a protected zone. But the truth is doctors who conduct vasectomies have gone through many years of study and training. They know what they are doing. They use the latest minimally invasive techniques to perform the procedure, ensuring that you feel no pain. The procedure is done under local anesthetic, so you will probably only have to worry about the needle going in. After that, you will remain aware of the procedure as it goes on but you will feel no pain or uncomfortable sensations.

2. Your penis won’t work

That’s wrong, mate. In reality, the procedure isn’t done anywhere near your penis — except of course if it’s causing an obstruction and the urologist has to move it out of the way. The snip is entirely about your balls and affects only those little tubes inside your balls that are called the vas deferens. Remember too that when you have sex and reach orgasm, the fluid that comes out, called ejaculate, is 97 percent semen and only 3 percent sperm. After vasectomy, you will still achieve orgasm and produce this ejaculate, except it won’t contain sperm and you won’t be able make your partner pregnant. That means your erections will remain exactly the same and your penis will stay as sensitive during sex as it was before the vasectomy. Likewise, your ability to enjoy sex and achieve orgasm will remain unchanged, though now you’ll be able to do so without having to worry about making anyone pregnant.

3. You will no longer ejaculate

That’s wrong, too. If you ejaculated before the snip, you’ll continue to do so after. Semen, the main component of ejaculatory fluid, is produced in the seminal vesicles and the prostate, which aren’t cut or blocked off during a vasectomy. And since only a small portion of fluid comes from the testicles with sperm, the overall volume of your ejaculate will reduce only slightly after a vasectomy — you won’t even notice it. Likewise, because the muscle contractions that propel fluid out during ejaculation typically come from the pelvis, your ejaculations won’t be affected by a vasectomy.

4. Your sperm production will shut down

Not true. Vasectomy doesn’t block sperm production and you’ll continue to make sperm after the snip. The only difference is that sperm will no longer reach semen and form part of the ejaculate. Because the sperm will go nowhere after a vasectomy, it will live for 3-5 days and decay naturally in the body. This is the same thing that happens naturally in men if they don’t ejaculate every 5 days or so. They produce sperm continuously but the sperm goes nowhere and is reabsorbed naturally in the body.

5. You can’t reverse it once it’s done

No, you can if you want. Vasectomy can be reversed through a surgical procedure called vasovasostomy (vasectomy reversal). During the procedure, the vas deferens (tubes) are reconnected, with each tube re-joined as it was before the snip in order to create a passageway for sperm, allowing sperm to again be present in semen. A successful reversal procedure restores your fertility and you can again make your partner pregnant. But when considering a vasectomy reversal, you need to consult an experienced urologist. That will ensure that no tissues are irreparably damaged during the reversal procedure.

6. Even if it’s reversed, you’ll remain impotent

Not really. With microsurgical advances currently used in vasectomy and vasovasostomy, the reversal has become more precise and more successful. So while vasectomy reversal is still technically expensive and demanding, doctors can now successfully restore a man to his pre-vasectomy condition. Although many men think that vasectomy can make them impotent, they should know that the procedure has no effect on blood flow to the spongy veins of the penis. These veins cause an erection. A vasectomy tends to make love-making more pleasurable and fun through the exhilarating feeling accompanying the ejaculation of spermless semen and also by erasing the fear of pregnancy.

7. It’s harder than a woman getting her tubes tied

A nice try indeed, but still wrong. Tubal ligation is performed under epidural or general anesthesia and typically takes longer than the 10-20 minutes required for a vasectomy. Tying a woman’s tubes also comes with a much more serious complication rate than a vasectomy. So why not just take the simpler route to contraception and block the source of sperm in order to remove the burden of birth control from women instead of looking for excuses to pressure women with contraception? After all, vasectomy is more effective than tubal ligation, costs much less and guarantees better results. In fact, for partners and couples considering family planning, vasectomy is a great cost-saving and effective solution to consider.

What if you are just one of those men who want to have multiple sexual partners without any additional responsibilities? Well, vasectomy works for that too. If you get a vasectomy, you can enjoy your lifestyle without having to worry about the possibility of fatherhood.

Want to know more about vasectomy? Speak with your partner and assess whether you have had all the children you want. Once you are sure of your decision, visit your doctor to discuss this birth control method. For more information on vasectomy and vasectomy reversal, visit the “St Pete Urology” site.

Early Signs of an Enlarged Prostate

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

How can you know that you have an enlarged prostate?

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

If you have an enlarged prostate, you will:

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

The early warning signs of BPH include:

1. Weak or slow urination

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

2. Leaking of urine

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

3. Straining when urinating

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

4. Waking up several times at night to urinate

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

5. High PSA during a blood test

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

6. Sexual dysfunction

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

How can a urologist help?

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

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

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

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

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

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

How To Manage The Pain Of Kidney Stones?

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

What are kidney stones?

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

Symptoms of kidney stones

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

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

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

Managing Pain Due To Kidney Stones

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

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

Surgery for Kidney Stones

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

Common surgical treatments include:

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

Preventing Kidney Stones

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

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

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

What It Actually Feels Like To Get A Vasectomy

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

Ready to go?

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

Learning from others

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

What is a vasectomy?

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

How is a vasectomy done?

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

Does it hurt?

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

Can it go wrong down there?

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

What about anxiety?

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

What of post-op pain?

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

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

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

When can you begin to have sex?

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

Where can you undergo the procedure?

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

Is It Ok to Work Out After Getting A Vasectomy?

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

Scalpel-Free Open Ended Vasectomy

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

Less Strenuous Activities

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

More Strenuous Activities

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

Sexual Intercourse

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

Work With Your Urologist

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

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

What foods to avoid with kidney stones?

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

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

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

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

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

Which types of food should you avoid?

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

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

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

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

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

Dietary tips for avoiding kidney stones

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

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

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

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

What is BPH

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

Phases of prostate growth

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

Causes of BPH

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

Symptoms of BPH

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

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

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

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

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

When Should You See a Doctor?

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

Treatment for BPH

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

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

How does a penile implant pump work?

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

What is a penile implant?

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

Types of penile implants

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

1. Three-piece inflatable pump

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

2. Two-piece inflatable pump

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

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

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

Factors considered when selecting a penile implant

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

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

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

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

Prostate Enlargement BPH

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

How prostate size varies with age

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

Symptoms of prostate enlargement

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

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

Treatment of prostate enlargement

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

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

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