Enlarged prostate or benign prostatic hyperplasia (BPH) is a non-cancerous (benign) growth process (hyperplasia) of the prostate. These symptoms may begin around the age of 40 — 45 years of age. The prostate’s main role is to make fluid for semen. The prostate is found just below a man’s bladder, and surrounds the urethra that carries both urine and semen out of the body through the penis. As the prostate grows, there are some symptoms you may notice when you pass urine which consist of any or all of the following:

• Slow stream
• Small stream
• Urgency
• Frequency
• Getting up at night to urinate
• A feeling of not emptying the bladder

Check out our Urolift and Rezum treatment options.

Non-bacterial: Chronic nonbacterial prostatitis causes long-term pain and urinary symptoms. Involving the prostate gland or other parts of a man’s lower urinary tract or genital area, this condition is not caused by an infection with bacteria. Symptoms:

• Blood in semen
• Blood in urine
• Pain that is located:
  • Above the pubic bone (suprapubic)
  • Urethra
  • In between the scrotum and anus (perineal)
  • Lower back
  • Testicles
  • Head of the penis
• Bowel movement pain
• Ejaculation pain
• Frequently urinating
• Burning or pain when urinating
• Feeling of incomplete urination
• Small urine stream

Bacterial: Bacterial prostatitis is an infection with bacteria. Prostatitis causes swelling and irritation (inflammation or infection) of the prostate gland.

• Acute bacterial prostatitis starts quickly
• While chronic bacterial prostatitis’ onset is slow and the infection lasts for 3 months or longer

As a bacterial infection of the prostate gland, any bacteria that can cause a urinary tract infection can also cause acute bacterial prostatitis. Symptoms of acute prostatitis can start quickly, and can include:

• Flushed skin
• Chills
• Fever
• Severe urgency
• Frequency
• Bearing an infection
• Perineal and low back pain
• Hematuria

Men

Many men will experience problems with erections some time in their life. These problems can happen once in a while or can be ongoing. There are many things that can cause problems with erections. These include many medications, smoking tobacco or marijuana, excessive alcohol use, injury to nerve or blood vessels, low testosterone levels, certain illnesses, and even stress. There are treatments available no matter what the underlying cause or causes may be. There is no reason to put up with the inability to have suitable erections.

Erectile dysfunction is not a disease, but is a symptom of another disease process or processes. There are several systems that must be healthy in order to produce a good erection. They include a good hormone balance, especially testosterone, adequate blood flow into the penis and minimal blood leakage out of the penis. A man’s nervous system and muscular function must also be in good shape for erections to occur. The emotional health is also of great importance for sexual function.

If you are having any difficulties with erections, your physician will first ask a series of questions to see if medication use or lifestyle choices may be affecting your sexual health. Your blood will be drawn to check on hormone levels.

Diagnosis:

You may be scheduled for some or all of the following tests to check the other systems as mentioned above:

• Duplex Doppler: A medicine will be given to cause you to have a partial erection. An ultrasound has been used to test the blood flow into the penis and any leakage through the veins.
• Electromyelogram (EMG): Sensors will be placed in the perineal area to test the activities in the muscles.
• Biothesiometry: Vibratory pulses are applied to the upper extremities, the lower extremities, and the genitals to test nerve function.
• Psychological questionnaire: A set of questions will be asked to evaluate your psychological health.
• Penile ultrasound: An ultrasound of the penis will be performed to evaluate for any scar tissue which may be interfering with sexual function.

Other tests may be ordered to evaluate the prostate health as this may also affect the quality of erections. These tests are necessary to determine the underlying cause of erectile dysfunction. When the test results are all available, you will follow up with your physician to go over the results. You may be advised to follow up with other specialists if necessary because of the test findings

 Treatment

Phase 1:

• Hormone replacement: If you have been found to have low testosterone, your physician may recommend hormone replacement therapy as this affects any treatments for erectile function.
• Lifestyle or medication changes: Your physician will discuss with you any possible lifestyle or medication choices that are affecting your erections and may recommend changes.
• Oral medications: Oral medications work by opening the blood vessels in the body. Because of the way they work, they may cause mild side effects, the most common of which are headache, facial flushing, and nasal congestion. These medications cannot be used at the same time as any nitrates or your blood pressure may drop to a dangerously low level.
• Vacuum device: A mechanical device that is placed over the penis and pumped to create a vacuum. This produces a suction effect that draws blood into the penis. A constricting ring is placed around the penis to hold the blood in place until intercourse is completed.

The patient will be reevaluated after 4 or more weeks of therapy. If improvement is satisfactory, the provider will continue to see the patient every 3-6 months. If improvement is unsatisfactory there may be changes in the medications or the patient will progress to phase 2, only after completing an ED workup which is described in the diagnosis section.

Phase 2:

Penile injections: These medications increase the blood flow in the penis. Because these medications work locally there are no systemic side effects and they can be used safely by someone who uses nitrates.

GAINSWave Treatment GAINSWave utilizes high frequency, low intensity sound waves to improve blood flow to the penis. The sound waves repair aged blood vessels, stimulate growth of new blood vessels and remove decades of micro-plaque.

The patient will be reevaluated after 4 or more weeks of therapy. If the treatment is satisfactory, the provider will continue to see the patient every 3-6 months. If improvement is unsatisfactory the patient may progress to phase 3.

Phase 3:  

• Penile prosthetics: Several types of implants are available for patients who do not get good results from other treatments.  This is a surgical treatment option which is very well tolerated and is very nearly 100% effective.

Women

Persistent, recurrent problems with sexual response or desire is known medically as female sexual dysfunction. You may experience more than one type of female sexual dysfunction. Types include:

• Diminished sex drive
• Unable to maintain arousal during sexual activity
• Difficulty in achieving an orgasm
• Painful intercourse

Sexuality involves a combination of physiology, emotions, experiences and relationships. Disruption of any of these components can affect sexual drive, arousal or satisfaction. More often than not, female sexual dysfunction is treatable.

Treatment Options Available:

• Hormone Replacement Therapy
• Morpheus8V
• FormaV
• PT-141 Injections
• PRP Injections

Hormone Replacement Therapy involves taking hormones to replace those that your body has stopped making or doesn’t make enough of. For women, this is usually estrogen and progesterone. For men, it’s testosterone. If you don’t feel as energetic, vital, or happy as you used to be, hormone replacement therapy may be what you need. Symptoms can be:

• Decreased libido (sex drive and desire)
• Fatigue and lethargy
• Problems achieving an erection
• Osteoporosis
• Muscle weakness
• Hot flashes
• Insomnia
• Depression
• Decrease in muscle mass
• Irritability and/or mood swings
• Decrease in energy
• Weight gain

Hematuria is when there is blood in the urine, and two types of blood in the urine exist. Blood that can be seen in the urine is referred to as gross hematuria, but blood that cannot be seen in the urine is called microscopic hematuria. Although most people with microscopic hematuria do not exhibit symptoms, people with gross hematuria have a urine color that is pink, red or cola-colored. People with gross hematuria with blood clots in the urine may have mild to severe pain.

A urinary tract infection (UTI) is an infection that exists anywhere within the urinary tract. Depending on where the infection exists, dictates the condition. The symptoms of a bladder infection include:

• Cloudy urine
• Blood within the urine
• Mild fever
• Urinary pain or burning sensation
• Lower abdomen cramping
• Insatiable need to urinate

If the infection spreads to your kidneys, symptoms may include:

• Fever, chills, shaking or night sweats
• Fatigue and a general ill feeling
• Flank pain
• Mental changes
• Nausea and/or vomiting

A vasectomy is a minor surgical operation to sterilize a male by disconnecting the spermatic cords that move sperm from the testicles to the penis. Things to consider:

1. Most of the time, a vasectomy is irreversible. Although a reversal procedure exists, one should accept in advance that sterilization is permanent.
2. In rare cases, the cut ends of the spermatic cords will reattach; this is why it is necessary for two sperm samples to be collected and assessed in the 1st and 2nd months after surgery.

Infertility means you cannot conceive a baby. The two categories of infertility are:

• Primary infertility which refers to couples who have not become pregnant after at least 1 year of unprotected intercourse.
• Secondary infertility is a classification for couples who have gotten pregnant at least once, but haven’t since then.

Causes: A wide range of physical and emotional factors can cause infertility. Female infertility may occur when:

• A fertilized egg or embryo dies once it attaches to the lining of the uterus
• The fertilized egg fails to attach to uterine lining
• The eggs have trouble moving from the ovaries to the uterus
• The ovaries have issues producing eggs

Male infertility may be due to:

• Low sperm count
• A blockage stopping sperm from being released
• Dysfunctional sperm

Peyronie’s disease is the existence of scar tissue inside the penis that causes curved, painful erections. Having a curved erection isn’t necessarily a cause for concern, however, in some men, a significant bend can cause severe pain. In most cases, this causes erectile dysfunction. In mild cases, medications can help. GAINSWave® treatment has been shown to be an effective procedure to breakdown the scar tissue and reduce the curvature of the penis for someone suffering from typical Peyronie’s disease. Surgery to treat Peyronie’s disease is only recommended if the curvature and pain are so severe it prevents healthy sex. Another option to treat peyronie’s plaque is an injectable medicine called Xiaflex.

Prostate cancer occurs in a man’s prostate — a small walnut-shaped gland that produces seminal fluid that helps transport sperm. As one of the most common types of cancer in men, prostate cancer usually grows slowly and initially located in the prostate gland. If you detect prostate cancer early, while it’s still located in the prostate gland, there is a better chance of success with treatment.

Testicular cancer is rare and occurs in the testicles, inside the scrotum. But testicular cancer is the most common cancer with American males between the ages of 15 and 34. Testicular cancer is extremely treatable, regardless of whether the cancer has spread beyond the testicle. Depending on stage of testicular cancer, you can have one or several treatments. Regular testicular self-examinations can help identify problems early on.

Overactive bladder (OAB) is a condition where frequent urination exists with sudden urgency. Although OAB is not life-threatening, it can significantly affect the quality of life of any person. Often times, patients with OAB have to limit their social life and sexual activity due to a disruption from OAB. Sometimes, people assume that OAB is a natural part of aging and is something that is just to be tolerated. But, on the contrary, OAB occurs when abnormal messages are sent from the brain to the bladder muscle. The bladder may even make urine leak out before you can make it to the bathroom, which is referred to as “urge incontinence.”

Urinary incontinence is the involuntary loss of urine. Not only a medical problem, this also affects patients emotionally, psychologically and socially. Daily activities may be compromised because incontinence. The causes of urinary incontinence:

• Constipation
• Weak pelvic floor muscles
• Blocked urethra due to an enlarge prostate
• Chronic urinary tract infections (UTI)
• Medications
• Post-menopause vaginal issues
• Diabetes
• Pregnancy and childbirth
• Pelvic surgery
• Neurological disorders (i.e. Parkinson’s disease, Multiple Sclerosis, Stroke, etc.)

Chronic interstitial cystitis (IC) is severe, inflammation of the bladder wall. And, while there is much research, the cause is still unknown. Affecting both men and women, interstitial cystitis is more common in women. People with a history of migraines, fibromyalgia, and allergies seem to be more prone to IC, and symptoms of the condition may start as early as teenage or young adult years. Without treatment, it can manifest into unrelenting pain and urinary frequency. Early treatment is often much more effective than later treatment in terms of this condition.

Fecal incontinence is the inability to control your bowels. More than 5.5 million Americans have fecal incontinence. It affects people of all ages. Fecal incontinence is more common in women and older adults, but it is not a normal part of aging. People who have fecal incontinence may feel ashamed or embarrassed. For these people there is good news. Pelvic Floor Therapy can produce dramatic improvement when the cause of the problem is a loss of sphincter control or sensation.

Kidney cancer is cancer that originates in the kidneys. Your kidneys are two bean-shaped organs, each about the size of your fist. They’re located behind your abdominal organs, with one kidney on each side of your spine. In adults, the most common type of kidney cancer is renal cell carcinoma. Other less common types of kidney cancer can occur. Young children are more likely to develop a kind of kidney cancer called Wilms’ tumor. The incidence of kidney cancer seems to be increasing. One reason for this may be the fact that imaging techniques such as computerized tomography (CT) are being used more often. These tests may lead to the accidental discovery of more kidney cancers.

Bladder cancer is a type of cancer that begins in your bladder — a balloon-shaped organ in your pelvic area that stores urine. Bladder cancer begins most often in the cells that line the inside of the bladder. Bladder cancer typically affects older adults, though it can occur at any age. The great majority of bladder cancers are diagnosed at an early stage — when bladder cancer is highly treatable. However, even early-stage bladder cancer is likely to recur. For this reason, bladder cancer survivors often undergo follow-up tests to look for bladder cancer recurrence for years after treatment.

Kidney stones affect about 2 of every 1000 Americans each year. About half of people who experience kidney stones will have repeat episodes unless they seek treatment. Your doctor can do a simple urine and blood test to help you make lifestyle changes to help prevent recurrences. Kidney stones are crystal-like masses that form in the kidney. The formation of stones depends on chemicals present in your urine. If you do not drink enough water, your urine will have more concentrated levels of the chemicals that form stones. Drinking water is essential to preventing the chemicals from clumping together and forming a stone. There are several types of stones each of which may have more than one cause. Diet, fluid intake, metabolic disorders and heredity can all influence stone formation. The main symptoms of stone presence are abdominal and/or back pain and blood in the urine.

The symptoms you might notice include:

• Severe pain in the back, side, abdomen, and groin (depending on the stones location)
• You may also experience nausea and vomiting
• Urinary frequency
• Burning sensation when urinating

Diagnosis:

• History and physical exam
• Urine and blood tests
• Ultrasound and/or CT scan (to confirm presence of the kidney stone)

Treatment:

Not all kidney stones require treatment. Stones that do not cause symptoms and are not at risk for damaging the urinary tract may pass on their own. In fact, 80% of kidney stones will pass through the tract when you urinate. If a stone is too large to pass, the following treatments are available:

• Lithotripsy: the break up of  kidney stones using shock waves. No surgery or incision is required.
• Ureteroscopy: placing a scope into the urethra, the bladder, and up into the ureter, to remove the kidney stone.
• Percutaneous Nephrostolithotomy (PCNL): placing a scope directly into through the skin, in your back, into the kidney to remove the kidney stone. (Used for very large kidney stones).

Prevention:

• The most important thing you can do to prevent future kidney stones is to drink lots of water. You want to produce 2 liters of urine a day.
• Smoking cessation
• Reduce caffeine intake
• Daily exercise program
• A kidney stone metabolic work up can help your doctor determine the reason your body is prone to producing kidney stones. Through this workup, he may be able to give you dietary suggestions or daily medications to prevent future kidney stones.

Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine. Bone is living tissue, which is constantly being absorbed and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the removal of old bone. Osteoporosis affects men and women of all races. But white and Asian women — especially those who are past menopause — are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.