What is BPH

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

Phases of prostate growth

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

Causes of BPH

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

Symptoms of BPH

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

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

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

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

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

When Should You See a Doctor?

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

Treatment for BPH

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

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

How does a penile implant pump work?

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

What is a penile implant?

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

Types of penile implants

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

1. Three-piece inflatable pump

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

2. Two-piece inflatable pump

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

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

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

Factors considered when selecting a penile implant

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

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

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

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

Prostate Enlargement BPH

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

How prostate size varies with age

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

Symptoms of prostate enlargement

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

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

Treatment of prostate enlargement

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

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

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

BPH: Can Green Tea Cure It?

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

Green Tea Ingredients

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

Can Green Tea Cure BPH?

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

Factors Affecting the Efficacy of Green Tea

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

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

How Are Kidney Stones Formed?

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

Why Stones Form

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

How are kidney stones formed?

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

Processes of stone formation

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

Passing kidney stones

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

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

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

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

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

Vasectomy Animation Overview

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

Movement of Sperm

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

Sperm after vasectomy

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

Does vasectomy have complications?

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

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

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

What is the best medicine for enlarged prostate?

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

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

1. Alpha blockers

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

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

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

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

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

2. 5-Alpha reductase inhibitors

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

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

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

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

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

Side effects of 5-ARIs

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

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

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

3. Phosphodiesterase-5 inhibitors

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

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

4. Combination therapy

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

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

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

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

What happens to the sperm when you have a vasectomy?

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

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

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

Continued production of sperm

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

Fate of sperm after a vasectomy

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

Open-ended vasectomy

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

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

Bladder Control Problems in Women

While there are many types of bladder problems in women, including an overactive bladder and urinary incontinence, one of the most common problems related to the bladder is urinary tract infection (UTI).

Urinary tract infection occurs when a bacteria gets into the urethra and then moves into and multiplies in the bladder. The bacteria may even spread to other parts of the body from the bladder, resulting in complications such as blood poisoning and kidney failure.

Causes of urinary tract infections in women

The urethra is located close to the anus, making it easier for bacteria found in the large intestine (such as E. coli) to move from the anus into the urethra. Once inside the urethra, bacteria can move into the bladder and begin to multiply, resulting in inflammation of the bladder. If the infection is not treated, the bacterial infection may spread into the kidney or the blood.

Women have a higher risk of bladder infection than men because their urethra is shorter, allowing bacteria to gain quick access to the bladder. Bacteria also may be introduced into a woman’s urinary tract during sexual intercourse. Other factors that make women more susceptible to UTIs include diabetes, older age, surgery, catheterization, menopause, immobility and improper hygiene.

Symptoms of urinary tract infection in women

Women with UTIs may have the following symptoms:

  1. Cloudy, bloody, dark or strange-smelling urine.
  2. A burning sensation or feeling when urinating.
  3. An intense or frequent urge to urinate, although very little urine comes out when they do.
  4. Cramping, pressure or pain in the lower abdomen or back.
  5. Feeling shaky or tired.
  6. Low-grade fever or chills (indicating that the infection has reached the kidneys).

Seeking for medical help

Even though most urinary tract infections do resolve on their own, it is important that women seek medical help when having symptoms that are very uncomfortable or when their symptoms last for more than 5 days. Similarly, UTIs may require medical help when there is a sudden worsening of fever or of symptoms. Likewise, women who are diabetic or who are pregnant should seek medical help.

During a visit to a urologist or doctor, a urine test may be ordered to check for offending bacteria before antibiotics are given. In some instances, specialized laboratory testing may be necessary and an intravenous urogram (IVU) may be done to evaluate the urinary tract. Another diagnostic option is cystoscopy, a procedure in which a thin flexible tube is used to look into the bladder.

Treatment of UTIs in women

Generally, most cases of urinary tract infections are easy to treat as long as the diagnosis and treatment begins early. Therefore, it is important to visit a urologist as soon as your UTI symptoms worsen or last longer than expected. Treatment is usually done using antibiotics for about 5 days. However, more complicated cases of UTIs, such as those occurring during pregnancy, may call for administration of antibiotics for a longer duration. Even if you get better soon after starting to take antibiotics, make sure to continue the treatment so that all bacteria are killed and to prevent a recurrence of the infection.

The doctor also will recommend that you drink plenty of water to prevent dehydration and to relieve symptoms. Paracetamol may be prescribed for relieving UTI pain and discomfort, while methenamine hippurate (which is effective in stopping bacterial growth in the urinary tract) may be used as an alternative treatment in women who cannot use antibiotics. More severe cases of UTIs may require hospital admission, where antibiotics are administered through intravenous (IV) drips.

Prevention of urinary tract infections

Because women are at higher risk of getting UTIs than men, they should always take the necessary steps to prevent the infections. Ways of preventing UTIs include:

  1. Urinating soon after sexual activity.
  2. Drinking copious amounts of fluids.
  3. Practicing proper hygiene.
  4. Avoiding fragrant feminine products (not douching).
  5. Wearing cotton underwear.
  6. Avoiding tight-fitting-pants.
  7. Taking showers instead of baths.
  8. Avoiding bladder-irritating fluids such as alcohol and caffeine.

At St Pete Urology in St Petersburg, Fl., we have treated bladder and urinary tract problems in women for decades. Through our skilled, experienced and professional board-certified urologists, we give the most accurate diagnosis and administer the most effective treatments. If you have a bladder problem or have symptoms of UTIs, come see us for quick relief. For more information on the diagnosis, treatment and help with bladder problems, visit the “St Pete Urology” site.

Should You Screen for Prostate Cancer?

A visit to St Pete Urology to screen for prostate cancer is also an opportunity to have a variety of health issues resolved. St Pete Urology operates according to the principle that most health issues affecting men are interconnected and can only be treated effectively through a comprehensive and multidisciplinary approach. When you visit our urologists for prostate cancer information, screening, diagnosis and treatment, we extend our role to include screening for signs of mental health disorder, make efforts to influence behavior change and speak with you candidly about psychological and medical care beyond our direct involvement in treatment of urologic disease.

At St Pete Urology, we are committed to safe, holistic and effective care for all our patients. We handle diagnosis and treatment of prostate cancer using the latest technological, medical and psychosocial approaches.

Tackling mental health issues during prostate cancer screening

Helping patients with mental health problems is a familiar territory for urologists at St Pete Urology, Fl. For instance, during prostate cancer screening, the urologists also screen for signs of distress, educate patients on their diagnosis, treatment and potential side effects, and provide support through referral to psychosocial services or rehabilitation programs. For men experiencing urinary tract symptoms, the urologist may conduct a functional analysis to assess the effect of the symptoms on everyday activities, recommend practical solutions such as Kegel exercises, and provide psychosocial referrals to help deal with issues related to interpersonal relationships and self-esteem. Working with our urologists not only provides the opportunity to detect and treat urological problems like prostate cancer, but also for early detection and treatment of mental health disorders.

Should you undergo prostate cancer screening?

Prostate cancer is a very common cancer so it is very important to get checked for its presence. While screening tests will not show with certainty that you have cancer, they help to find warning signs and help to detect the cancer when it is still at an early stage, making treatment easier and more effective. If one of the screening tests gives an abnormal result, you will need a biopsy of prostate tissue to confirm whether or not you have cancer. Men who want to be checked are tested using the PSA (prostate-specific antigen) blood test and the DRE (digital rectal exam).

1. PSA (Prostate-specific antigen) blood test

PSA (Prostate-specific antigen) is an essential substance made by the cells of the prostate, typically by both normal and cancerous cells. It is predominantly found in semen. However, it also may be found in small quantities in blood. The majority of men with no prostate cancer do have PSA levels below 4 nanograms-per-milliliter [abbreviated as ng/mL] of blood. Those with higher PSA readings have a greater likelihood of developing cancer of the prostate.

While the PSA usually goes up beyond 4ng/mL as prostate cancer develops, a reading below 4 is not a guarantee that you do not have the cancer. In fact, about 15 percent of men whose PSA is under 4ng/mL are found to have the cancer upon a biopsy. Similarly, men with PSA between 4 and 10 have 25 percent chance of having the cancer, while those with PSA above 10 have a 50 percent chance of developing prostate cancer. If you have elevated PSA, your urologist may indicate that you either wait for a period of time and you repeat the test or take a prostate biopsy to confirm the cancer.

2. DRE (Digital Rectal Exam)

During a DRE (digital rectal exam), your urologist will insert a gloved and lubricated finger into your rectum in order to feel or detect any hard areas, nodules or bumps on your prostate, which may be due to cancer. Prostate cancer usually starts at the back of the prostate and this can be felt through a rectal exam. The DRE may be a bit uncomfortable, particularly for men with hemorrhoids, but it is not usually painful and often takes a very short time. Although the DRE is less accurate than PSA in screening or detecting prostate cancer, its ability to occasionally find cancer in men whose PSA values are normal makes it a vital component of prostate cancer screening.

Making screening decisions

It is important to work closely with your doctor in order to make informed screening decisions. At St Pete Urology, we recommend that men should screen for prostate cancer at:

  1. Age 50 for those men who are at average risk of getting prostate cancer and are still expected to live for more than 10 years.
  2. Age 45 for men who are at high risk of developing prostate cancer, such as African Americans and men whose first-degree relative [father, son or brother] had the cancer before the age of 65 years.
  3. Age 40 for men with even greater risk, especially those who have had more than one first-degree relative get prostate cancer at a very early age.

For more information, visit the “St Pete Urology” site.