- Emergency CareTesticular torsion is one of the emergencies encountered in Urology. With testicular torsion the cord bringing blood to and from the testicle is twisted, the blood supply to the testicle is interrupted and it will eventually die. How long that takes depends on the circumstances and the person, but most urologists consider four hours the maximum time of torsion to prevent injury. The more time torsed, the more injury will be incurred. A torsed testicle is usually very tender, and doesn’t retract normally with cremasteric muscle stimulus. It usually swells as well. Some people have intermittent torsion – the testicle rotates into a problematic position, but can be returned to normal anatomic position without treatment. If you suspect torsion, go to the emergency room for evaluation. If you have intermittent pain but no lasting torsion, make an appointment to be seen by your urologist for evaluation – sometimes surgery is done to ensure the testicle cannot torse. The opposite testicle is usually fixed in place when a surgery is done to prevent a torsion on the other side.
- Erectile Dysfunction
- Bladder CancerUreteroscopy is done to inspect the ureter, which is the tube that drains the bladder to the kidney. This is done using either a rigid or a flexible scope, depending on what the purpose of the procedure is and how far up the ureter the work is done. Most ureteroscopies are done for removing stones from the ureter or kidney. Others are done for diagnostic purposes such as biopsies. Some are done just to monitor a patient with ureteral or bladder cancer.
- UrologyThe information on this website is solely intended to educate and inform persons interested in Urology. It does not offer any individual advice and is not intended to provide treatment recommendations. Anyone wishing advice or treatment should make an appointment with their urologist for individualized care.
- Kidney StonesI’ve been reading papers about kidney stones around the country. It turns out that people in Colorado have the same number of kidney stones as anyone in another state. According to an article by Grant published in the Journal of Endourology, calcium stones were the most common, with only 12% of stones made [ read more… ]
- Testicular CancerIf you think there is a lump on your testicle, it could be cancer. Testicular cancer grows slowly at times, and quickly at others. Some lesions are benign, meaning that they are bothersome, but won’t spread. Others are malignant and have potential for great harm. There are many examples of a person having a problem and not noticing it until they have an “event” like falling off of a bike. The best way to be sure is to visit your urologist. They will be able to examine it and see what it is all about. They might even order an ultrasound of your scrotum to see what it looks like inside and help make the decision easier. Hopefully it will turn out to be a cyst or fibrotic mass and not cancer at all.
- Urinary Tract InfectionThis question is answered simply: to whichever antibiotics they are sensitive. The problem is knowing that sensitivity. A lot of people are diagnosed with a UTI based on incomplete information. Sometimes symptoms are indicative of a UTI, but the urine is sterile. Sometimes urine is tested with a dipstick, and the doctor sees a hint that a UTI is present. Antibiotics are often dispensed for either symptoms of a UTI, or an dipstick test. But unless the urine is sent for culture, there is no information that the antibiotic given is actually the right one, nor is there confirmation that the person actually had a UTI. And the more times a person receives an antibiotic, the more their bacterial flora adapt and change to resist what has been given. A negative dipstick test proves that there is no UTI, but a slightly positive test can be caused by contamination of the specimen or the dipsticks themselves. The more UTI’s a person is treated for, the more difficult the treatment when a UTI comes along. So if a treatment is given for a UTI, a culture should be sent as well so that the treatment can be evaluated in detail.
- Prostate CancerResearchers at Boston University School of Medicine have found a protein that is related to the growth of prostate cancer, BRD4. By inhibiting this protein cancer growth was slowed, opening a new potential avenue to new medicines that can target this protein. The work has been done under the supervision of Gerald Denis, PhD. Similar findings in other cancers have led to ground-breaking new drug therapies. It will be many years before this work evolves to therapeutic alternatives, but it is promising.
- Diabetes Care
- UltrasoundScrotal varicoceles occur when the veins that drain a testicle are enlarged. There are four grades of varicocele. Subclinical grade is a varicocele which is detectable with ultrasound. Grade 1 is detectable by touch only with valsalva, as when coughing or bearing down. Grade 2 is detectable by touch without valsalva, as when lying down or at rest. Grade 3 can be seen with the eye, and obvious without feeling them. They are more common on the left, since the left spermatic vein drains to the left renal vein which has more pressure than where the right drains; the inferior vena cava. Varicoceles can affect fertility by lowering sperm count and motlity. Rarely varicoceles can occur due to masses in the abdomen or vascular problems. Other than that, they are benign and wouldn’t require treatment unless fertility is an issue or they are bothersome in some way.
- VasectomyA vasectomy is a procedure that interrupts the vas deferens, which is the tube that carries sperm from the testicles to the prostate where they are mixed with the semen. It is usually done with small scrotal incisions with local anesthetic. The vas deferens is lifted out of the incision and freed from the tissue layers covering it. Once isolated, a small length of vas deferens is cut away, and oversewn to minimize the chance of the tube repairing itself. The ends of the vas deferens are then allowed to drop back into the scrotum and the skin wound is closed. Once the vas deferens is divided in this way there is less than a 1 in 4500 chance of conceiving a child.
- Acne Treatment
- Cyst
- FungusThe foreskin on the end of the penis will trap old sloughed skin and will remain moist if the foreskin is not retracted and cleaned periodically. The white material that collects under the foreskin is called smegma. Fungal infection due to chronic moisture there is a problem for some men. Either or both can have an odor. An infection of the foreskin from bacteria or from fungus is called “balanitis”.
- Lesions