DMC Urology experts provide diagnosis and treatment for a variety of conditions. Call 1-888-DMC-2500 with any questions or if you are looking for a treatment or procedure not listed below.
A birth defect causing the outer genitals to not have the typical appearance of either a boy or a girl, making it difficult to classify a newborn as male or female. The extent of the ambiguity varies. In very rare instances, the physical appearance may be fully developed as the opposite of the genetic sex. For example, a genetic male may have developed the appearance of a normal female.
The genetic sex of a child is determined at conception. The mother's egg cell (ovum) contains an X chromosome, while the father's sperm cell contains either an X or a Y chromosome. These X and Y chromosomes determine the child's genetic sex.
Normally, an infant inherits one pair of sex chromosomes – one X from the mother and one X or one Y from the father. This is why the father "determines" the genetic sex. A baby with two X chromosomes is a genetic female and a baby with an X and a Y chromosome is a genetic male. The male and female reproductive organs and genitals come from the same tissue in the developing fetus, so if the process causing fetal tissue to become male or female is disrupted, ambiguous genitalia can develop.
There are a number of underlying health issues that can cause ambiguous genitalia, including pseudohermaphroditism, true hermaphrodism, mixed gonadal dysgenesis (MGD), congenital adrenal hyperplasia, chromosomal abnormalities such as Klinefelter’s Syndrome (XXY) and Turner’s Syndrome (XO), maternal ingestion of certain medications, lack of production of specific hormones or a lack of testosterone cellular receptors.
In genetic females (XX):
- An enlarged clitoris that has the appearance of a small penis.
- The urethral opening (where urine comes out) is anywhere along, above, or below the surface of the clitoris.
- The labia may be fused, resembling a scrotum.
- The infant may be thought to be a male with undescended testicles.
- Sometimes a lump of tissue is felt within the fused labia, making it look like a scrotum with testicles.
In genetic males (XY):
- A small penis (less than 2-3 centimeters) resembling an enlarged clitoris.
- The urethral opening may be anywhere along, above, or below the penis; it can be placed as low as on the peritoneum, further making the infant appear to be female.
- There may be a small scrotum with any degree of separation, resembling labia.
- Undescended testicles commonly accompany ambiguous genitalia.
Ambiguous genitalia is not usually life threatening, but it can create social problems for the child and family. For this reason, a team of experienced specialists, including neonatologists, geneticists, endocrinologists, and psychiatrists or social workers will be involved.
Commonly called low testosterone, androgen deficiency can be a problem for many men as they age. Our current understanding of the causes and symptoms of low testosterone in aging men, often referred to as andropause or male menopause, is that treatment to increase testosterone levels relieves many symptoms previously believed to be part of the aging process.
- Weight gain in the wrong places
- Loss of muscle tone
- Inadequate erections and poor sexual performance
Testosterone replacement therapy is commonly prescribed. Your physician will determine if another option is available based on your specific needs. TOP
Antenatal Urologic Abnormalities
DMC Urology Specialists treat the full spectrum of Antenatal Urolgical Abnormalities, including hydronephrosis, vesicoureteral reflux (VUR), ureterovesical junction obstruction (UVJ), reterocele, ectopic ureter, posterior urethral valves (PUV), prune belly syndrome (PBS) and multicystic dysplastic kidney, (MCDK). TOP
[link prune belly syndrome]
Bladder Neck Contracture
Usually formed after surgery on the prostate, a bladder neck contracture occurs when scar tissue forms where the bladder and prostate meet. This scar tissue can cause the opening between the two organs to become partially or totally blocked.
- Difficulty starting or maintaining urination
- Slow or interrupted urine stream
- Feeling that you have not emptied your bladder, even after urinating
Treatment is provided by a non-surgical procedure, known as dilation, which uses tubing to gradually reopen the area to allow for normal function. Another option is surgical, in which your surgeon will make small incisions that allow for normal function. TOP
Also known as a hidden penis, this is a congenital condition causing the penis to be partially or totally hidden under the skin. Adult onset of buried penis can be caused by morbid obesity.
- Trouble urinating
- Soft tissue infection
- Phimosis, or the inability to retract the foreskin
Treatment is often surgical, depending on the cause of the hidden penis.
Enlarged Prostate/Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) is a condition in men in which the prostate gland is enlarged but not cancerous. Benign prostatic hyperplasia is also called benign prostatic hypertrophy or benign prostatic obstruction. As the prostate gets bigger, it presses against and pinches the urethra, causing difficulty urinating. It is common as men age, and the specific cause is unknown.
- No symptoms – some men may not have any symptoms
- Frequent urination
- Difficulty urinating or a weak urine stream
- Dribbling after urination and/or a feeling that your bladder is not completely empty
- An urge to urinate again shortly after urinating
- Pain during urination
- Waking at night to urinate
- A sudden, uncontrollable urge to urinate
Benign Prostatic Hyperplasia (BPH) cannot be cured. Treatment focuses on reducing your symptoms. Some men with mild symptoms opt for no treatment. Others use medicines such as alpha blockers, 5-alpha reductase inhibitors and combination drug therapies.
If your symptoms are more severe, there are several types of minimally invasive surgical therapies such as transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), laser therapy to remove overgrown prostate tissue, a prostate lift, embolization and prostatectomy. TOP
Epispadias is a rare congenital defect in the location of the opening of the urethra. The causes of epispadias are unknown at this time, but it is believed to be related to improper development of the pubic bone.
In boys with epispadias, the urethra generally opens on the top or side of the penis rather than the tip. However, it is possible for the urethra to be open the entire length of the penis.
In girls, the opening is usually between the clitoris and the labia, but may be in the belly area.
Epispadias can be associated with bladder exstrophy, an uncommon birth defect in which the bladder is exposed, inside out, and sticks through the abdominal wall. However, epispadias can also occur alone or with defects.
Symptoms In males:
- Abnormal opening from the joint between the pubic bones to the area above the tip of the penis
- Backward flow of urine into the kidney (reflux nephropathy)
- Short, widened penis with an abnormal curvature
- Urinary tract infections
- Widened pubic bone
- Abnormal clitoris and labia
- Abnormal opening where the from the bladder neck to the area above the normal urethral opening
- Backward flow of urine into the kidney (reflux nephropathy)
- Widened pubic bone
- Urinary incontinence
- Urinary tract infections
Surgical reconstruction is common for both males and females, and is performed soon after birth in order to return normal function. TOP
Erectile dysfunction, sometimes called impotence, is the repeated inability to get or keep an erection firm enough for sexual intercourse. Impotence may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved.
In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED.
ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED. Urologists, who specialize in problems of the urinary tract, have traditionally treated ED.
Since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.
Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of ED. Diseases, such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease account for about 70% of ED cases.
Lifestyle choices that contribute to heart disease and vascular problems also raise the risk of erectile dysfunction. Smoking, obesity and avoiding exercise can also cause ED. In addition, many common medicines can cause ED as a side effect. Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure can cause ED.
The most common is oral medication. There are several that help your penis muscles relax, allowing for increased blood flow in reaction to sexual stimulation. These drugs will not cause you to get an erection without stimulation. Your doctor may not prescribe an oral medication if you have heart disease, heart conditions, or low or high blood pressure.
Other medications include:
- A self-injection with a small needle into the side or base of your penis. Medicine used usually produces an erection that lasts about an hour.
- A urethral suppository placed inside your urethra with a tiny applicator. Erections start about 10 minutes later and last up to an hour.
- Testosterone replacement therapy if your ED is caused by low testosterone.
Other treatment options include:
- A penis pump that creates a vacuum around your penis and pulls blood into your organ. Once your penis is erect, you place a tension ring at the base to hold the blood in and keep your erection firm. The vacuum is removed before relations. After intercourse, the tension ring is removed.
- Penile implants where inflatable or bendable rods are surgically placed in your penis. This allows you to control when and how long your erection is.
- Blood vessel surgery to repair any leaking or obstructed blood vessels.
If your ED is caused by psychological reasons, your doctor may prescribe counseling or medicines. TOP
A hydrocele is a fluid-filled sac surrounding a testicle that results in swelling of the scrotum, the loose bag of skin underneath the penis. About one in 10 male infants has a hydrocele at birth, but most hydroceles disappear without treatment in the first year of life. Men older than 40 are more likely to develop a hydrocele due to inflammation or injury.
Hydroceles usually aren't painful, and since they normally do not cause harm to you, they may require no treatment. We recommend seeing your doctor if you have scrotal swelling to rule out other causes, such as testicular cancer and other conditions. TOP
A congenital condition called hypospadias can produce a penis that not only performs inefficiently but also looks different. Urologists have various surgical techniques at their disposal to repair the ill-placed urethral opening, hooded foreskin and curvature associated with this condition. There are different degrees of hypospadias, some minor and others more severe, and they are named according to their location on the body. TOP
Incontinence & Overactive Bladder
It can be a little leakage when you laugh or a strong urge to urinate that comes on so suddenly you can’t make it to the bathroom in time. Both men and women can suffer from incontinenceThere are multiple causes of incontinence, and it can be a temporary or long term issue depending on that cause. Incontinence can be embarrassing, so when it starts to interrupt your daily life you should see one of our DMC urology experts.
Bladder dysfunction caused by damage to the nerves or nervous system, a neurogenic bladder can cause incontinence and other problems, including bladder infections. Nerve damage can be caused be a variety of factors, including vaginal childbirth, infections, diabetes, stroke, traumatic accidents, multiple sclerosis, heavy metal poisoning and more.
This is the most common type of incontinence in women, especially if the woman has given birth vaginally or had some form of pelvic organ prolapse
. Leakage occurs when additional pressure or stress is placed on the bladder, such as when jumping or laughing.
More commonly known as overactive bladder, urge incontinence is the frequent need to go to the bathroom.
Medication, muscle strengthening exercises (Kegels), electrical nerve stimulation, urinary diversion, Botox as a treatment and in some cases surgery can all be used to lessen or eliminate your incontinence. TOP
An inguinal hernia is a condition in which intra-abdominal fat or part of the small intestine, also called the small bowel, bulges through a weak area in the lower abdominal muscles. An inguinal hernia occurs in the groin; the area between the abdomen and thigh. This type of hernia is called inguinal because fat or part of the intestine slides through a weak area at the inguinal ring, the opening to the inguinal canal. An inguinal hernia appears as a bulge on one or both sides of the groin. An inguinal hernia can occur any time from infancy to adulthood and is much more common in males than females. Inguinal hernias tend to become larger with time.
The two types of inguinal hernia have different causes.
- Indirect inguinal hernia. Congenital hernias that are much more common in males because of the way they develop in the womb. Sometimes the entrance of the inguinal canal at the inguinal ring does not close as it should just after birth, leaving a weakness in the abdominal wall. In females, an indirect inguinal hernia is caused by the female organs or the small intestine sliding into the groin through a weakness in the abdominal wall. Indirect hernias are the most common type of inguinal hernia. Premature infants are especially at risk for indirect inguinal hernias because there is less time for the inguinal canal to close.
- Direct inguinal hernia. Direct inguinal hernias are caused by connective tissue degeneration of the abdominal muscles, which causes weakening of the muscles during the adult years. Direct inguinal hernias occur only in males and develop gradually because of continuous stress on the muscles. Various factors can cause pressure on the abdominal muscles and may worsen the hernia, such as sudden twists, pulls, or muscle strains, lifting heavy objects, straining on the toilet because of constipation, weight gain and chronic coughing.
An incarcerated inguinal hernia is a hernia that becomes stuck in the groin or scrotum and cannot be massaged back into the abdomen. An incarcerated hernia is caused by swelling and can lead to a strangulated hernia, in which the blood supply to the incarcerated small intestine is jeopardized. A strangulated hernia is a serious condition and requires immediate medical attention. Left untreated, nausea, vomiting, and severe infection can occur. If surgery is not performed right away, the condition can become life threatening, and the affected intestine may die and need to be removed.
- A small bulge in one or both sides of the groin that may increase in size and disappear when lying down; in males, it can present as a swollen or enlarged scrotum
- Discomfort or sharp pain that goes away when resting, especially when straining, lifting, or exercising
- A feeling of weakness or pressure in the groin
- A burning, gurgling, or aching feeling at the bulge
- Strangulated hernia symptoms
- Extreme tenderness and redness in the area of the bulge
- Sudden pain that worsens in a short period of time
- Rapid heart rate
In adults, inguinal hernias that enlarge, cause symptoms, or become incarcerated are treated surgically. In infants and children, inguinal hernias are always operated on to prevent incarceration from occurring. Surgery is usually done on an outpatient basis. Recovery time varies depending on the size of the hernia, the technique used, and the age and health of the patient. The two main types of surgery for hernias are traditional hernia repair and laparoscopy. TOP
Also called hermaphroditism, intersex is a group of conditions where there is a discrepancy between the external genitals and the internal genitals (the testes and ovaries). Increasingly this group of conditions is being called disorders of sex development (DSDs). In many kids the cause of intersex may remain undetermined, even with modern diagnostic techniques.
Intersex can be divided into four categories:
- 46, XX Intersex
- 46, XY Intersex
- True Gonadal Intersex
- Complex or Undetermined Intersex
46, XX Intersex
The person has the chromosomes of a woman, the ovaries of a woman, but external (outside) genitals that appear male. This usually is the result of a female fetus having been exposed to excess male hormones before birth. The labia ("lips" or folds of skin of the external female genitals) fuse, and the clitoris enlarges to appear like a penis. Usually this person has a normal uterus and Fallopian tubes. This condition is also called 46, XX with virilization. It used to be called female pseudohermaphroditism.
Possible causes include congenital adrenal hyperplasia (the most common cause), male hormones (such as testosterone) taken or encountered by the mother during pregnancy, male hormone-producing tumors in the mother and aromatase deficiency, which may not be noticeable until puberty.
46, XY Intersex
The person has the chromosomes of a man, but the external genitals are incompletely formed, ambiguous, or clearly female. Internally, testes may be normal, malformed, or absent. This condition is also called 46, XY with undervirilization. It used to be called male pseudohermaphroditism. Forming normal male external genitals depends on the appropriate balance between male and female hormones; therefore, enough requires the adequate production and function of male hormones.
Possible causes include problems with the testes, problems with testosterone formation, problems with using testosterone, a 5-alpha-reductase deficiency and the most common cause of 46, XY intersex, androgen insensitivity syndrome (AIS).
True Gonadal Intersex
Here the person must have both ovarian and testicular tissue. This might be in the same gonad (an ovotestis), or the person might have one ovary and one testis. The person may have XX chromosomes, XY chromosomes, or both. The external genitals may be ambiguous or may appear to be female or male. This condition used to be called true hermaphroditism. In most people with true gonadal intersex, the underlying cause is unknown, although in some animal studies it has been linked to exposure to common agricultural pesticides.
Complex or Undetermined Intersex
Many chromosome configurations other than simple 46, XX or 46, XY can result in disorders of sex development. These include 45, XO (only one X chromosome), and 47, XXY, 47, XXX – both cases have an extra sex chromosome, either an X or a Y.
The symptoms associated with intersex will depend on the underlying cause, but may include:
- Ambiguous genitalia at birth
- Clitoromegaly (an enlarged clitoris)
- Partial labial fusion
- Apparently undescended testes (which may turn out to be ovaries) in boys
- Labial or inguinal (groin) masses -- which may turn out to be testes – in girls
- Hypospadias (the opening of the penis is somewhere other than at the tip; in females, the urethra [urine canal] opens into the vagina)
- Otherwise unusual appearing genitalia at birth
- Electrolyte abnormalities
- Delayed or absent puberty
- Unexpected changes at puberty
Exams and Tests
- Chromosome analysis
- Hormone levels (for example, testosterone level)
- Hormone stimulation tests
- Electrolyte tests
- Specific molecular testing
- Endoscopic examination (to verify the absence or presence of a vagina or cervix)
- Ultrasound or MRI to evaluate whether internal sex organs are present (for example, a uterus).
A painful bladder condition.
- Pain and/or pressure in the bladder or pelvis
- Difficulty urinating
- Frequent urge to urinate
- Pain during urination or sexual intercourse
Changing your diet, reducing stress and taking prescription or over the counter medications can all relieve symptoms of IC. There is no cure for IC. TOP
If you have had a kidney stone that has gone untreated, or have a history of producing kidney stones, DMC Urologists can give you answers with a full range of care. Starting with a full assessment and continuing with follow up care after your treatment to ensure you have the best outcome possible. As a DMC patient, you will receive a comprehensive plan to reduce your risk of new stones.
Crystals that form from salts, minerals and waste in the urine, kidney stones occur when the kidney is unable to flush out these substances. Once formed, a stone may stay in the kidney or move down the urinary tract to the ureter. Kidney stones can be small enough to pass without any pain, but problems occur when stones are too large and cause a backup of urine in the kidney, ureter, bladder or urethra. This causes extreme pain.
If you’ve had a kidney stone, you’re at a 50% risk of developing another one within seven years.
To help prevent new stones, we recommend drinking plenty of water, eating more fruits and vegetables and reduce your salt and sugar intake. Crash diets and weight loss diets that include high amounts of animal protein can also increase your risk.
There are several types of kidney stones:
- Calcium – most common type. Common in young men between the ages of 20 and 30.
- Uric Acid – more common in men than women. Usually occur in people suffering from gout or who are going through chemotherapy.
- Struvite – large stones usually found in women with a urinary tract infection (UTI).
- Cystine – rare, occurring in men and women with cystinuria, a genetic disorder.
- Other – medications, such as triamterene and acyclovir, can also cause stones.
- Severe back, abdominal, groin, or genital pain that comes in waves
- People often describe the pain “as the worst pain they’ve ever felt”
- Blood in your urine
- An upset stomach, nausea or vomiting
- Fever and chills
- Frequent or painful urination
- Urine that smells bad or looks cloudy
Treatment depends on the size and location of each stone. If you’re doctor thinks the stone is small enough for you to pass and you can handle the pain, they may recommend drinking plenty of fluids and taking pain or other anti-inflammatory medication. For stones that can’t be passed, the most common treatment is to break them up into smaller pieces, usually by shock wave therapy or the use of an Ureteroscope. Surgery is rare but useful for very large stones that are causing severe bleeding or blocking the flow of urine out of the kidney. TOP
Male Sexual Dysfunction
Male sexual dysfunction can be caused by a variety of things and can present as one or more issues, all dealing with sexual function. Most commonly known is erectile dysfunction, though other conditions can be present too.
Commonly caused by medication, you may be experiencing delayed ejaculation if you are noticing a delay in reaching orgasm.
Premature ejaculation occurs when a man orgasms during intercourse sooner than he or his partner wishes. A common complaint, it is rarely caused by a physical or structural problem and is most often caused by anxiety and overstimulation. Other psychological factors such as guilt may also be relevant. In general, practice and relaxation will help you deal with the problem.
Retrograde ejaculation is a condition in which part or all of a man's semen goes into the bladder instead of out the tip of the penis during ejaculation. It occurs when internal muscles, called sphincters, do not function normally. With retrograde ejaculation, semen enters the bladder, mixes with urine, and leaves the body during urination without harming the bladder. A man experiencing retrograde ejaculation may notice that little semen is discharged during ejaculation or may become aware of the condition if fertility problems arise. Analysis of a urine sample after ejaculation will reveal the presence of semen.
Poor blood glucose control and the resulting nerve damage can cause retrograde ejaculation. Other causes include prostate surgery and some medications.
Retrograde ejaculation caused by diabetes or surgery may be helped with a medication that strengthens the muscle tone of the sphincter in the bladder. A urologist experienced in infertility treatments may assist with techniques to promote fertility, such as collecting sperm from the urine and then using the sperm for artificial insemination.
Retrograde ejaculation occurs when, at the point of orgasm, your ejaculate is forced into your bladder instead of out the end of your penis. It is common in men with diabetes or other nerve damage.
Treatment depends on the cause of your sexual dysfunction. Your DMC expert will talk through any causes for your dysfunction, and may recommend counseling or other medicine if your dysfunction is caused by psychological reasons. Some helpful techniques include:
- “Stop and Start” Method – involves sexual stimulation until the man recognizes that he is about to ejaculate. Stimulation is then removed for about thirty seconds before resuming. Sequence is repeated until ejaculation is desired, the final time allowing stimulation to continue until ejaculation occurs.
- “Squeeze” Method – involves sexual stimulation until the man recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds, withholding further sexual stimulation for about 30 seconds, and then resuming stimulation. The sequence may be repeated by the person or couple until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs.
Penile Curvature, called Peyronie's disease, is characterized by a hard lump on the penis, also known as a plaque. The plaque itself is benign, or noncancerous.
Peyronie's disease can be mild or severe, with symptoms developing slowly or appearing overnight. If your Peyronie’s disease is mild, the inflammation may resolve without causing significant pain or permanent bending.
A plaque on the top of the shaft (most common) causes the penis to bend upward; a plaque on the underside causes it to bend downward. In some cases, the plaque develops on both top and bottom, leading to indentation and shortening of the penis. At times, pain, bending, and emotional distress prohibit sexual intercourse.
While trauma might explain acute cases of Peyronie's disease, it does not explain why most cases develop slowly and with no apparent traumatic event. It also does not explain why some cases disappear quickly or why similar conditions such as Dupuytren's contracture do not seem to result from severe trauma.
- Hard lump (plaque) on the penis
- Inflammation or swelling of the penis
- Reduced flexibility of the penis
- Abnormal bending or curving of the erect penis, can be painful
Most physicians recommend waiting 1 to 2 years before correcting the issue with surgery intended to remove or extend the plaque to remove the painful bend in the penis. Your physician may recommend trying experimental treatments during that time, such as oral vitamin E supplements or the oral application of para-aminobenzoate. TOP
Nonbacterial prostatitis is an inflammation of the prostate gland with no known cause.
- Pain - Perineal, Suprapubic, Scrotal, Low back, Urethral, Tip of penis
- Frequent urination
- Pain or burning with urination
- Decreased urinary stream
- Pain with ejaculation
- Pain with bowel movements
- Blood in the urine
- Blood in the semen
Treatment for nonbacterial prostatitis is difficult and is aimed at controlling the symptoms. Many patients are treated with long-term antibiotics to assure that bacteria is not the cause of their prostatitis. Common antibiotics used for chronic bacterial prostatitis include trimethoprim-sulfamethoxazole (Bactrim), ciprofloxacin (Cipro), tetracycline and penicillin. Other medications used to relieve prostatic urinary obstruction, including doxazosin, terazosin, and tamsulosin, are successful in many patients. Anti-inflammatory agents such as aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs) may relieve the symptoms in some patients.
Removal of the prostate may be done if medication is unsuccessful. Surgical treatment is usually not performed on younger men because it carries potential risks for sterility, impotence and incontinence. TOP
Prune Belly Syndrome
Occurring only in boys, Prune Belly Syndrome causes a baby to have an enlarged abdomen because the normal abdominal wall muscles are missing or very weak. The entire urinary tract is enlarged, and both testicles remain inside the body instead of descending into the scrotum. Skin over the abdomen is wrinkled, giving the appearance of a prune. Most children with Prune Belly Syndrome will have hydronephrosis and VUR. TOP
Sexually Transmitted Diseases (STDs/STIs)
A sexually transmitted disease (STD), also known as sexually transmitted infection (STI), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact. This includes sexual intercourse, oral sex and anal sex. While in the past, these illnesses have mostly been referred to as STDs or VD, in recent years the term sexually transmitted infection (STI) has been preferred, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without showing signs of disease. Some STIs can also be transmitted via use of an IV drug needle after its use by an infected person, as well as through childbirth or breastfeeding.
There are many types of STIs, and they can be caused by a bacteria, fungus, or viral agent. If you think you may have an STI, be sure to see your doctor. They will be able to identify and treat your STI as needed. Get more information on STDs and Women’s Health.
- BV-Bacterial Vaginosis
- Chlamydia and LGV
- Herpes, Genital
- HPV-Human Papillomavirus Infection
- PID-Pelvic Inflammatory Disease
- Tinea Cruris
- Yeast Infections
- Viral hepatitis (Hepatitis B virus)
- HIV/ AIDS (Human Immunodeficiency Virus)
- Herpes Simplex (Herpes simplex virus 1,2)
- Genital warts ("low risk" types of Human papillomavirus HPV)
- Cervical cancer, anal cancer ("high risk" types of Human papillomavirus HPV)
- Cytomegalovirus CMV - Herpes 5
- Epstein-Barr virus EBV - Herpes 4
- Kaposi's sarcoma (Kaposi's sarcoma-associated herpesvirus KSHV - Herpes 8)
Testicular torsion is the twisting of the spermatic cord, which cuts off the blood supply to the testicle and surrounding structures within the scrotum. Some men may be predisposed to as a result of inadequate connective tissue within the scrotum. However, the condition can result from trauma to the scrotum, particularly if significant swelling occurs.
The condition is more common during infancy (first year of life) and at the beginning of adolescence (puberty).
- Sudden onset of severe pain in one testicle, with or without a traumatic event
- Swelling within one side of the scrotum (scrotal swelling)
- Nausea or vomiting
- Testicle lump
- Blood in the semen
Surgery is usually required and should be performed as soon as possible after symptoms begin. If surgery is performed within six hours, most testicles can be saved.
During surgery, the testicle on the other (non-affected) side is usually also anchored as a preventive measure. This is because the non-affected testicle is at risk of testicular torsion in the future. TOP
Occurring when one or both testicles fail to move into the scrotum before birth, undescended testicles are fairly common in premature infants. In most cases the testicles descend by the time the child is nine months old.
Once a testicle has been discovered in the scrotum it is generally considered descended, even if it is temporarily pulled back (retracted) on a later examination. Sometimes a condition called retractile testes will develop, making it difficult for your child’s pediatrician to locate the testicles.
Testicles that do not descend by the time the child is one year old should be carefully evaluated. Studies suggest that surgery should be done by this age to confirm the diagnosis and to reduce the chances of permanent damage to the testicles. These testicles are considered abnormal and have an increased likelihood of developing cancer, regardless of whether or not they are brought down into the scrotum.
In other cases, such as vanished testis, no testicle may be found, even during a surgical procedure. This may be due to a problem that occurs while the baby was still developing in the mother. It may be present at birth (congenital).
There are usually no symptoms, except that the testicle cannot be found in the scrotum (this may be described as an empty scrotum). Adult males with an undescended testicle may have problems with infertility.
Usually the testicle will descend into the scrotum without any intervention during the first year of life. If this does not occur, the child may receive hormone injections (B-HCG or testosterone) to try to bring the testicle into the scrotum. Surgery (orchiopexy) is the main treatment. Earlier surgery may prevent irreversible damage to the testicles, which can cause infertility. TOP
Found primarily in men, urethral stricture is the narrowing of the urethra which may or may not impact the flow of urine out of the bladder.
There are a number of things that cause urethral stricture, with about half of the cases caused by medical procedures like the placement of a catheter, or surgery in and around the urethra. Other causes include trauma from an injury or accident damaging the urethra or bladder, pelvic invjury or trauma, previous prostate surgery or enlargement, prostate or other infections of the urethra, cancer of the urethra, and congenital malformations of the urethra.
- No symptoms occur in some cases
- Mild urinary discomfort
- Difficulty urinating
- Painful urination
- A urinary tract infection
- Incomplete emptying of bladder
- A strong urge to urinate
- Decreased urine stream
- Dribbling or not releasing urine
- Blood in the urine or semen
- Pelvic and lower back pain
- Discharge from the urethra
- Reduced ejaculation force
There are no medicines to correct a urethral stricture, only to minimize pain. Your doctor may recommend a cystoscopy or other procedure to widen the urethra. If this doesn’t work, you may need surgery, such as cutting or dilating the urethra. For longer strictures, surgery may remove the diseased area and rebuild the urethra. In some cases, a urinary diversion may be required to route bladder drainage through the wall of your abdomen using a catheter. TOP
More common in women between the ages of 40 and 70, urethral diverticulum is a condition in which a variably sized "pocket" or outpouching forms next to the urethra. Since it most often connects to the urethra, this pouch repeatedly gets filled with urine during the act of urination, causing symptoms. TOP
Urinary Tract Infection
Also known as a UTI, urinary tract infections are much more common in women. However, men can still develop UTIs, especially as they reach 50 years of age and older.
[link to women’s health UTI]
- Frequent urge to urinate
- Urgent need to urinate, even after emptying bladder
- Pain or difficulty urinating (dysuria)
UTIs in men are sometimes difficult to diagnose, due to sharing symptoms with other ailments. If you are diagnosed with a UTI, your physician will order a urine culture in order to determine the best medication to treat your situation. TOP
Urological Oncology (Cancer)
There are different types of cancer that can affect your urinary system. They are named for the part of the body in which they present, meaning where the cancerous cells show up and start growing.
Cancer can be caused by a number of factors, including:
- Cigarette smoking. Smoking increases the risk of developing bladder cancer nearly fivefold. As many as 50% of all bladder cancers in men and 30% in women may be caused by cigarette smoke. People who quit smoking have a gradual decline in risk.
- Chemical exposure. Exposure to cancer-causing chemicals (carcinogens), especially on the job, can increase your risk of cancer.
- Radiation and chemotherapy. Treatments for other cancers may contribute to the development of other types of cancer in the future.
- Infections. Long-term (chronic) infections or irritation may lead to the development of cancer. Infections can be by bacteria or parasites.
Bladder cancer is a cancerous tumor in the bladder -- the organ that holds urine. In the United States, bladder cancers usually start from the cells lining the bladder (transitional cells). Tumors may be classified based on the way they grow:
- Papillary tumors have a wart-like appearance and are attached to a stalk.
- Nonpapillary tumors, though much less common, are more invasive and harder to treat.
Bladder cancers are classified or staged based on their aggressiveness and how much they differ from the surrounding bladder tissue, normally using the TNM staging system. This system lists stages on a scale of 0-IV. When left undiagnosed or untreated, bladder cancer can spread into nearby organs, including the prostate, rectum, ureters, uterus, vagina, and also your bones, liver or lungs.
- Blood in the urine
- Painful urination
- Urinary frequency or urgency
- Abdominal pain
- Bone pain or tenderness
- Feeling tired (lethargy)
- Urinary incontinence
- Unexplained weight loss
The choice of treatment depends on the stage of the tumor, severity of symptoms and presence of other medical conditions. Treatment can include:
- Surgery to remove the tumor without removing the rest of the bladder
- Chemotherapy or immunotherapy directly into the bladder
- Surgery to remove the entire bladder (radical cystectomy)
- Surgery to remove only part of the bladder, followed by radiation and chemotherapy
- Chemotherapy to shrink the tumor before surgery
- A combination of chemotherapy and radiation (in patients who choose not to have surgery or who cannot have surgery)
Cancer of the penis is cancer that starts in the penis. Smegma, a cheese-like, foul-smelling substance found under the foreskin of the penis may increase the risk of penis cancer. Uncircumcised men who do not keep the area under the foreskin clean and men with a history of genital warts or human papillomavirus (HPV) are at higher risk for this rare disorder.
- Genital lesions on the penis
- Painless sore on penis (occasionally, the lesion may cause pain)
- Penis pain and bleeding from the penis (may occur with advanced disease)
Treatment depends on the location of the tumor and how much it has spread. In general, cancer treatment includes:
- Chemotherapy - uses medicines to kill cancer cells
- Radiation - using high powered x-rays to kill cancer cells
- Surgery - cuts out and removes the cancer
If the tumor is small and near the tip of the penis, surgery may be done to remove only the cancerous part of the penis. This is called a partial penectomy. For more severe tumors, total removal of the penis (total penectomy) is often necessary. A new opening will be created in the groin area to allow urine to exit the body. This procedure is called a urethrostomy.
Chemotherapy and/or radiation therapy can be prescribed in combination with surgery. A type of radiation therapy called external beam therapy is often used, which delivers radiation to the penis from outside the body.
One of the most common cancers in men, if caught early Prostate Cancer can be treated successfully. Some prostate cancers grow and spread quickly, but most grow slowly.
There are usually no early signs of prostate cancer. Symptoms are not related to the cancer itself, but blockage from the cancer or tumor. These symptoms can also be associated with non-cancerous conditions, like BPH or an enlarged prostate.
- Frequent urination, especially at night
- Difficulty starting or stopping your urine stream
- A weak urine stream or inability to urinate standing up
- Leaking urine when laughing or coughing
- A painful or burning sensation during urination or ejaculation
- Blood in your urine or semen
- Pain or stiffness in the pelvis, lower back, chest or upper thighs
- Loss of weight and appetite
- An upset stomach
- Swelling in the lower extremities
- Weakness or paralysis in the lower limbs, often with constipation
There are several treatment options available for prostate cancer. Treatment options vary by situation, but commonly include surgery, radiation therapy, chemotherapy, hormone therapy and vaccine treatments.
Since prostate cancer is often a slow growing cancer, your doctor may recommend “expectant management” or just keeping an eye on the cancer if you are over the age of 72. Research finds that older men with early stage prostate cancer are more likely to die from other causes.
There is no link between vasectomy and testicular cancer, in fact, doctors aren’t quite sure what causes this rare cancer. Testicular cancer accounts for only 1% of all cancers in men in the U.S., but is the most common form of cancer in men age 15 - 40. In rare cases, it may occur at a younger age. White men are five times more likely to develop this type of cancer than African Americans, and twice as likely as Asian-American men.
There are two multiple types of testicular cancer:
- Seminoma – this is a slow-growing form of testicular cancer usually found in men in their 30s and 40s. Though usually just in the testes, it can spread to the lymph nodes.
- Nonseminoma – this more common type of testicular cancer grows more quickly than seminomas. Nonseminoma tumors are often made up of different cell types, and are identified according to the cells in which they start to grow. Nonseminoma testicular cancers include choriocarcinomar (rare), embryonal carcinoma, teratoma and yolk sac tumor.
A stromal tumor is a rare type of testicular tumor. Stromal tumors are usually not cancerous, and fall into two main types: Leydig cell tumors and Sertoli cell tumors. Leydig cells release the hormone testosterone, and Sertoli cells are where sperm matures. Stromal tumors may be seen during childhood.
- Discomfort, pain, in the testicle or a feeling of heaviness in the scrotum
- Dull ache in the back or lower abdomen
- Enlargement of a testicle or a change in the way it feels.
- Excess development of breast tissue (gynecomastia) .
- Lump or swelling in either testicle.
- Symptoms in other parts of the body, such as the lungs, abdomen, pelvis, or brain (if the cancer has spread) .
Most patients can be cured, and treatment depends on the type and stage of the tumor, as well as if it has spread to other body parts what they are. There are three types of treatment commonly used with testicular cancer:
- Surgical treatment to remove the testicle (orchiectomy) and associated lymph nodes (lymphadenectomy).
- Radiation therapy using high-dose x-rays or other high-energy rays may be used after surgery to prevent the tumor from returning. Radiation therapy is usually only used for treating seminomas.
- Chemotherapy uses drugs such as cisplatin, bleomycin, and etoposide to kill cancer cells. This treatment has greatly improved survival for patients with both seminomas and nonseminomas.
Your urethra is the tube that carries urine from the bladder to outside the body. In women, the urethra is about 1½ inches long and is just above the vagina. In men, the urethra is about 8 inches long, and goes through the prostate gland and the penis to the outside of the body. In men, the urethra also carries semen.
Urethral cancer is a rare cancer that occurs more often in women than in men. There are different types of urethral cancer that begin in cells that line the urethra. These cancers are named for the types of cells that become malignant (cancerous):
- Squamous cell carcinoma is the most common type of urethral cancer. It forms in cells in the part of the urethra near the bladder in women, and in the lining of the urethra in the penis in men.
- Transitional cell carcinoma forms in the area near the urethral opening in women, and in the part of the urethra that goes through the prostate gland in men.
- Adenocarcinoma forms in glands near the urethra in both men and women.
Much like varicose veins of the leg, varicoceles are large, twisted veins that drain blood from the testicles. They most often occur after puberty on the left side of the scrotum. Once a varicocele appears, it will not go away on its own.
The testicle on the side with the varicocele may be smaller in size than the one on the opposite side. An affected testicle may not grow well and may not produce good sperm when it is time. The scrotum (sac) may appear swollen.
Most people with varicoceles have no symptoms. Some do feel pain. The pain can vary from a dull, heavy discomfort to a sharp pain, and may increase with sitting, standing or strenuous activity. It usually goes away when lying flat on the back.
Surgery is often used to repair a varicocele. TOP