Vasectomy Information

A vasectomy is a permanent method for birth control. A vasectomy prevents the release of sperm whenever a man ejaculates. Metropolitan Urological Specialists in St. Louis, Missouri would like to give you the following information so that you can make the right decision for you and your partner.

During a vasectomy, the vas deferens from each testicle is clamped, cut, or otherwise sealed. This prevents sperm from mixing with the semen that is ejaculated from the penis. An egg cannot be fertilized when there aren't any sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed by the body. (This also happens to sperm that are not ejaculated after a while, no matter if you've had a vasectomy.) Because the tubes are obstructed before the seminal vesicles and prostate, you will still ejaculate about the same amount of fluid.

It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. You have to use another method of birth control until you have a semen sample analyzed and it shows a zero sperm count. Otherwise, it is possible to still get your partner pregnant.

What Happens

In a vasectomy:

•   Your testicles and scrotum are cleaned with an antiseptic and probably shaved.
•   You may be given an oral or intravenous (IV) medication to reduce anxiety and make you sleepy. If you do take this medication, you may not remember much about the procedure.
•   Each vas deferens is located by touch.
•   A local anesthetic is injected into the area.
•   Your doctor makes one or two small openings within your scrotum. Through an opening, both vas deferens tubes are cut. The 2 ends of the vas deferens are tied, stitched, or sealed. Electrocautery can be utilized to seal the ends with heat. Scar tissue from the procedure helps block the tubes.
•   The vas deferens is then replaced inside the scrotum and the skin is closed with stitches that dissolve and don't have to be removed.

The treatment takes about 20 to 30 minutes and can be carried out in an office or clinic such as Metropolitan Urological Services in St. Louis, MO. It may be done by a family medicine doctor, a urologist, or a general surgeon.

No-scalpel vasectomy is a method that utilizes a small clamp with pointed ends. Instead of using a scalpel to cut the skin, the clamp is poked through the skin of the scrotum and subsequently opened. The benefits of this procedure include less bleeding, a smaller sized hole in the skin, and fewer complications. No-scalpel vasectomy is as effective as regular vasectomy.

In the Vasclip implant procedure, the vas deferens is locked shut with a device known as a Vasclip. The vas deferens is not cut, sutured, or cauterized (sealed by burning), which possibly reduces the potential for pain and complications. Some research shows that clipping isn't as effective as other ways of sealing off the vas deferens.

What You Should Expect After Surgery

Your scrotum will be numb for 1 to 2 hours after a vasectomy. Apply cold packs to the area and lie face up as much as possible for the rest of the day. Wearing snug undergarments or a jockstrap will help ease discomfort and protect the area.

You may possibly have some swelling and minor pain in your scrotum for a number of days following the surgery. Unless of course your work is strenuous, you'll be able to return to work in one or two days. Avoid heavy lifting for a week.

You can go back to sexual activity when you are comfortable, normally in about a week. But you can still get your partner pregnant until your sperm count is zero. You should use another method of birth control until you have a follow-up sperm count test 2 months after the vasectomy (or after 10 to 20 ejaculations over a shorter period of time). When your sperm count is zero, no other birth control method is needed.

Most men go back to the physician's office to get their sperm count checked. But there is also a home test available.

A vasectomy will not affect your sex drive, capacity to have erections, feeling of orgasm, or capability to ejaculate. You may have occasional mild aching in your testicles in sexual arousal for just a few months following your surgery. If you think that a vasectomy may be something worth exploring for you or your partner, get a hold of Metropolitan Urological Specialists and set up an appointment. Metropolitan Urological Specialists serves St. Louis, Creve Coeur, Florissant, and Kirkwood, MO with the latest in non-invasive surgical and nonsurgical urological solutions.

Causes Of Male Infertility

Male fertility is a complicated process, which is why the professionals at Metro Urological Specialists in St. Louis, MO have this important information for your use. In order to get your partner pregnant, the following need to occur:

•   You need to make healthy sperm. At first, this requires the growth and formation of the male reproductive organs during puberty. One or both of your testicles need to be working properly, and your body needs to produce testosterone and other hormones to trigger and maintain sperm production.

•   Sperm need to be carried into the semen. When sperm are made in the testicles, delicate tubes transport them until they combine with semen and are ejaculated from the penis.

•   There needs to be enough sperm in the semen. If the number of sperm in your semen (sperm count) is low, it reduces the chances that one of the sperm will fertilize your partner's egg. A low sperm count is under 15 million sperm per milliliter of semen or fewer than thirty-nine million per discharge.

•   Sperm have to be functional and able to move. If the movement (motility) or function of your sperm is unusual, the sperm might not be able to reach or penetrate your partner's egg.

Medical Causes

Problems with male fertility may be the result of a number of health issues and medical treatments. Metro Urological Specialists, serving the folks of St Louis, Creve Coeur, Florissant, and Kirkwood, has the ability and experience to deal with all of these issues, including:

•   Varicocele. A varicocele is a swelling of the veins which drain the testicle. It's the most common correctable cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it might be related to irregular testicular temperature regulation. Varicoceles lead to reduced quality of the sperm. Treating the varicocele can improve sperm numbers and function, and may possibly improve outcomes when using assisted reproductive techniques such as in vitro fertilization.

•   Infection. Some infections can interfere with sperm production or sperm health or can cause scarring that hinders the passing of sperm. These include irritation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transferred infections, including gonorrhea or HIV. Although some infections can bring about lasting testicular damage, usually sperm may still be retrieved.

•   Ejaculation issues. Retrograde ejaculation occurs when semen goes into the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can lead to retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of the bladder, prostate, or urethra. Some men with spinal cord injuries or certain diseases can't ejaculate semen, even though they still generate seminal fluid. Often in these instances sperm can still be retrieved for use in assisted reproductive techniques.

•   Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that mistakenly identify sperm as dangerous invaders and attempt to eliminate them.

•   Tumors. Cancers and nonmalignant tumors could affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. In many cases, surgery, radiation, or chemotherapy to handle tumors can affect male fertility.

•   Undescended testicles. In some males, during fetal development one or both testicles fail to come down from the abdomen into the sac that usually contains the testicles (scrotum). Lowered fertility is much more probable in men who've had this problem.

•   Hormone imbalances. Infertility can be a consequence of disorders of the testicles themselves or an irregularity affecting other hormonal systems including the hypothalamus, pituitary, thyroid, and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of potential root causes.

•   Defects of tubules that transport sperm. A variety of tubes carry sperm. They can be obstructed due to various causes, including accidental injury from surgery, previous infections, trauma, or abnormal development, such as with cystic fibrosis or similar inherited conditions. Blockage can occur at any level, including within the testicle, within the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts, or within the urethra.

•   Chromosome defects. Inherited disorders like Klinefelter's syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause unusual development of the male reproductive organs. Other genetic syndromes related to infertility include cystic fibrosis, Kallmann's syndrome, and Kartagener's syndrome.

•   Difficulties with sexual intercourse. These can include difficulty keeping or maintaining an erection adequate for sex (erectile dysfunction), early ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship issues that affect sex.

•   Celiac disease. A digestive disorder triggered by sensitivity to gluten, celiac disease can result in male infertility. Fertility might improve after implementing a gluten-free diet.

•   Certain medications. Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medicines can impair sperm production and decrease male fertility.

•   Previous surgeries. Some surgeries may prevent you from having sperm in your semen, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries done for testicular and rectal cancers, among others. Usually, surgery can be performed to either reverse these obstructions or to retrieve sperm directly from the epididymis and testicles.

Environmental Causes

Overexposure to certain environmental elements like heat, toxins, and chemicals can reduce sperm production or sperm function. Specific causes include:

•   Industrial chemicals. Extensive exposure to benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials, and lead may contribute to low sperm counts.

•   Heavy metal exposure. Exposure to lead or other heavy metals also may result in infertility.

•   Radiation or X-rays. Exposure to radiation can lessen sperm production, although it will often eventually return to normal. With high doses of radiation, sperm production may be permanently decreased.

•   Overheating the testicles. Elevated temperatures hinder sperm production and function. Even though research is limited and inconclusive, recurring utilization of saunas or hot tubs may briefly reduce your sperm count. Sitting for extended periods, wearing tight clothing, or working on a laptop for long periods of time also may increase the temperature in your scrotum and may somewhat lessen sperm production.

Health, Lifestyle, and Other Causes

Some other causes of male infertility include:

•   Illicit drug use. Anabolic steroids taken to provoke muscle strength and growth might cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana may temporarily reduce the number and quality of your sperm as well.

•   Alcohol use. Consuming alcohol can lower testosterone levels, trigger erectile dysfunction, and decrease sperm production. Liver disease as a result of excessive drinking may also lead to fertility problems.

•   Smoking cigarettes. Men who smoke may have a lower sperm count than do those that don't smoke. Secondhand smoke also may influence male fertility.

•   Emotional stress. Stress can interfere with certain hormones needed to produce sperm. Severe or prolonged emotional stress, including difficulties with fertility, can impact your sperm count.

•   Weight. Obesity can impair fertility in many ways, including directly impacting sperm themselves and by causing hormone changes that reduce male fertility.

•   Some occupations including welding or those involving extended sitting, such as truck driving, may be associated with a risk of infertility. Nevertheless, the research to support these links is mixed.

As you can see, there are numerous factors that can play a role in infertility. If you feel that you are infertile or you've got any questions relating to infertility, Metro Urological Specialists in Washington, Florissant, and St. Louis, Missouri is the perfect place to go to get the help you need.

Basic Facts About Prostate Cancer

Prostate cancer is an unusual growth of cells in a man's prostate gland that many older men in the St. Louis area are afflicted with. The prostate rests just below the bladder. It produces a portion of the liquid for semen. In young men, the prostate is about the size of a walnut. As men age, the prostate generally grows larger.

Prostate cancer is normal in men older than 65. It normally grows slowly and can take many years to grow big enough to bring about any problems. As with other cancers, treatment for prostate cancer works best when the cancer can be found early. Often, prostate cancer which has spread responds to treatment. Older men who've prostate cancer typically die from other causes.

Experts do not know what causes prostate cancer, but they believe that your age, family history (genetics), and ethnicity determine your chances of getting it. What you eat, such as foods loaded with fats, can also play a role.

Prostate cancer normally does not lead to symptoms in its early stages. Most men do not know they've got it until it's found during a regular medical exam.

When problems are noticed, they are most often problems urinating. But these same symptoms can also be attributed to an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men who live in St. Louis, Creve Couer, Florissant, and Kirkwood, Missouri.

See your physician for a checkup if:
•   You have urinary problems, such as:
      o   Not being able to urinate at all.
      o   Having difficulty starting or halting the flow of urine.
      o   Having to urinate many times, particularly at night.
      o   Having pain or burning during the course of urination.
•   You have difficulties having an erection.
•   You have blood in your urine or semen.
•   You have deep and recurring pain in your lower back, stomach, hip, or pelvis.

The most common way to test for prostate cancer is to have a prostate-specific antigen (PSA) blood test. An increased level of PSA could mean that you've got prostate cancer. But it could also mean that you've got an enlargement or infection of the prostate.

If your PSA is high, you might need a prostate biopsy to figure out the cause. A biopsy means that your physician takes tissue samples from your prostate gland and sends them to a lab for evaluation. Your treatment depends on what sort of cancer cells you've got, how far they have spread, your age and general health, and your preferences.

You and your doctor might choose to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or if you have cancer that's low-risk and has not spread (early stage), you might be able to wait and watch with active monitoring to discover what happens. Throughout active surveillance, you will have regular checkups with your doctor to see if your cancer has changed.

Choosing treatment for prostate cancer can be complicated. Speak with a medical professional like those at Metropolitan Urological Specialists to determine the treatment that is right for you.

Your age and general health will make a big difference in how treatment may affect your quality of life. Any health issues you've got before you are treated, specifically urinary, bowel, or sexual function problems, will determine how you recover.

Both surgery and radiation may cause urinary incontinence (leaking urine) or impotence (being unable to have an erection). The level of urinary incontinence and the length of time it lasts and the quality of the erections a man has following procedures will depend on whether or not the tumor has spread. These also depend upon what treatment solutions are utilized.

Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer could damage these nerves. Many times a special type of surgery, known as nerve-sparing surgery, can preserve the nerves. But if the cancer has spread to the nerves, they may need to be taken out during surgery. These same nerves can also be damaged by the X-rays that are used in radiation therapy.

Medicines and mechanical aids may help men who're impotent as a result of treatment. Some men recover a portion or a majority of their capability to have an erection months or even years after surgery.

If you live in St. Louis, Washington, Creve Couer, Crestwood, or Chesterfield, Missouri and you believe that you may be experiencing any of the symptoms of prostate cancer, contact Metropolitan Urological Specialists today and schedule an appointment.

Bladder Incontinence and the Percutaneous Nerve Evaluation

There's a lot of important matters that you need to think about prior to having a permanent bowel implant operation. Metropolitan Urological Specialists in St. Louis, Missouri wants to furnish you with an introduction to some of the symptoms that could lead to this kind of procedure and then let you know about a very important test that your physician may advise that you take before the procedure.

What are “bothersome” bladder symptoms?

•   Leakage of large or small amount of urine
•   Urinating often
•   Urinating urgently
•   Waking up at night to urinate
•   Inability to completely empty the bladder, or may be not able to urinate at all

What are “bothersome” bowel symptoms?

•   Fecal leakage
•   Fecal smearing
•   Diarrhea
•   Constipation

How common are bladder control problems?

•   Over thirty-three million people (1 in 6 adults) suffer from urinary control issues in the United States alone.
•   These issues may affect both males and females.
•   It may affect people of all ages; it isn't just a normal part of the aging process.
How common are bowel control issues?
•   Over 18 million individuals or 8.3% of adults suffer from symptoms of bowel control.
•   Likely more prevalent than reported due to the embarrassing nature of condition.

What are the causes of “bothersome” bladder and bowel symptoms?

•   There could be multiple causes; including, injury, side effects from particular medications, neurologic diseases, infection, bearing children, pelvic pain, and others.
•   Dr. Naughton, one of Metropolitan Urological Specialists’ top doctors makes it a priority to rule out medical causes of “bothersome” bladder and bowel symptoms.  Then, based on how these symptoms affect quality-of-life of the person, she will make suggestions on treatments.

Before placement of the permanent implant, your doctor may recommend a Percutaneous Nerve Evaluation. A Percutaneous Nerve Evaluation (PNE) is a simple office test which allows you a chance to test two temporary leads (or wires) into the pelvic nerves.  Under local anesthesia in an office setting, two temporary leads are positioned on each side of the pelvic nerves.  The leads are fixed to the back and connected to an external battery the size of a beeper.  The patient will have the opportunity to test both leads over the next 3-5 days to determine if there are any changes to the bladder and/or bowel symptoms.  We look at a fifty percent improvement in symptoms a positive test, which makes the patient a prospect for implantation of the permanent device.

What to know about the Percutaneous Nerve Evaluation (PNE) Procedure

1.   Please show up thirty minutes before your scheduled appointment time.
2.   You might drive yourself to the procedure; however, it is considerably better to have somebody drive you both to and from the procedure.
3.   This procedure is completed in the office under local anesthesia.
4.   Don't eat 2 hours prior to your procedure.  A light snack or meal is acceptable 2 hours before your procedure.
5.   Give up aspirin and ibupfren products (Motrin, Alleve, etc.) no less than five days before your procedure.
6.   Let our scheduler know whether you're taking blood thinners, such as Coumadin (warfarin), Xaralto, etc.
7.   No baths or showers during the test period.
8.   Abstain from heavy lifting or excessive bending during the trial.

What you should expect on the day of the PNE procedure:

1.   You will meet a medical assistant and agent(s) from Medtronic; the product company.
2.   You're going to be told to lie on your stomach.  The medical assistant will wash off your back and buttocks.
3.   Dr. Naughton will perform the procedure with the help of the Medtronic agent.
4.   The Medtronic agent and the medical assistant will secure the leads to your back, wipe off the cleaning solution on your back and buttocks before you get dressed.
5.   Following the process, you will talk with the Medtronic representative to review voiding and bowel diary instructions and set up contact plans with the representative to go over changes in your urinary and bowel function during the trial period.
6.   You will make an appointment to see Dr. Naughton in 3 to 5 days in the office before you leave to remove the leads and talk about the results of your trial.

If you have any questions before the procedure, call the procedure scheduler at the offices of Metropolitan Urological Specialists at 314-315-9933 during regular business hours. If you have questions about this procedure or anything else associated with bladder problems, schedule an appointment with one of our offices in the St. Louis area, including Washington, Florissant, and Creve Couer, Missouri.

More Info On Impotency (Erectile Dysfunction)

Impotence is the lack of ability to have and maintain an erection adequate for sexual activity. As a result of the unfavorable associations and misunderstandings surrounding the term impotence, the issue is usually referred to as erectile dysfunction, or just ED.

According to many specialists, erectile dysfunction is the most common sexual problem among American men. Nearly all males suffer from occasional short episodes of ED due to routine or short-term causes such as tiredness, emotional stress, or illness. For some erectile problems become chronic. While ED might be associated with decreased sexual interest, typically it isn't connected to libido (the emotional or psychic element of sexual interest), nor does it impact the capacity to experience an orgasm.

Male impotence can take place at any age, but it’s more common as men grow older. An estimated five percent of American men are impotent at age forty; among those over age sixty-five, the percentage rises to 15 to 25 percent. However, the issue is not an inevitable result of aging. The causes are complex, combining physical and psychological factors. While the the vast majority of men with erectile dysfunction can be helped, many experts feel that as many as 90 percent don't look for medical help due to fear of embarrassment and a belief that nothing can be done medically. This is unfortunate, because once underlying medical conditions and psychological factors are addressed, the regularity and duration of erections usually improves. Most males with erection problems don’t need to settle for them.

Signs and Symptoms of Male Impotence

• Chronic difficulty getting and sustaining an erection for a period of time long enough to take part in sexual intercourse
• Fewer nighttime erections

What Can Cause Erectile Dysfunction?

In the past, over 90 percent of all cases of ED were associated with emotional factors. However, experts currently calculate that only about ten percent of cases are strictly psychological in origin.
An erection depends upon many physical factors, such as the blood flow and nerve tissue within the penis, as well as hormones. Circulatory problems, nerve disorders, cardiovascular disease, diabetes, and the negative side effects of specific medications (tranquilizers, blood pressure medications, antidepressants, and anti-inflammatory medications) can contribute to impotence. Smoking, unnecessary use of alcohol, and lower levels of the hormone testosterone may also come into play. Impotence may also be caused by prostate surgery or radiation treatment for cancer.

Psychological factors, such as stress, depression, and performance anxiety, believed to play a limited role in cases of erectile dysfunction. When such factors are involved, it's mainly in males under age forty. However even in older men, emotions and sexual history could complicate physical factors.

What If You Do Nothing?

Frequent or chronic erectile troubles are not going to improve without some kind of intervention, particularly among men over the age of fifty. There are proven treatments for ED, but out of embarrassment or a lack of knowledge about medical solutions, a lot of men choose to do absolutely nothing about their ED, which often leads to emotional distress.

Home Remedies for Impotence Problems

If you're having erectile problems, it’s a great idea to seek a medical assessment. If you've got an underlying illness, early treatment may restore sexual potency.

Getting more informed about sexual matters, undergoing treatment for physical problems, giving up tobacco use, and reducing excessive alcohol consumption can all contribute to restoring potency. If erectile dysfunction takes place only from time to time, some of the below measures may help address—and solve—the issue.

•   Exercise regularly. Along with increasing blood circulation, regular moderate exercise—for example, walking, swimming, jogging, bicycling, or resistance training—helps raise energy levels, increases physical awareness, and stimulates sexuality. Don't forget that bicycle riding has with it a threat of seat or crossbar injuries to the perineal nerves (situated just behind the scrotum) that may lead to ED.
•   Consume a healthy balanced diet.
•   Restrict alcohol ingestion. ED among men in their late 40s and 50s is associated more regularly with excessive alcohol consumption than with any other single factor. There are numerous other health-related reasons to avoid excessive drinking, so if it appears to be dampening your sex life, scale back or avoid alcohol completely.
•   Minimize stress in your life. Stress and other emotional problems can affect the brain and thus reduce libido and the ability to achieve or maintain a suitable erection.
•   Give up smoking. Smoking has not been found to be an immediate cause for ED. Nevertheless, studies have found that when smoking is coupled with other risk factors, such as heart disease, high blood pressure, and untreated arthritis, erectile dysfunction levels are constant and very high.
•   Lose weight. Obesity is not necessarily a direct cause of erectile dysfunction, but researchers know that being obese is associated with the onset of diabetes and the buildup of fatty deposits on the interior walls of arteries, and these two problems are certainly related to erectile dysfunction.
•   Relieve your anxieties. Don't assume each sexual experience has to end with orgasm. Thinking that you need to have a climax can make you nervous, which might lead to erectile dysfunction. As an alternative, your partner and you can agree to focus on caressing and kissing instead of having an orgasm. This might alleviate performance anxiety.

Medical Treatments for Erectile Dysfunction

A number of methods have been designed to treat erectile dysfunction that's caused chiefly by physical factors. If you decide to try any, speak to your doctor from a trustworthy office like Metropolitan Urological Specialist in St. Louis, Missouri about beginning with the least invasive—the oral prescription drug Viagra (sildenafil citrate). Viagra improves the flow of blood to your penis to allow for an erection, and it is effective for the majority of men: In one study, it alleviated impotence in nearly 70 percent of males. It might not be safe for some adult males with cardiovascular disease.

For these males, there are some other treatment options for erectile dysfunction, though they're more invasive or cumbersome. One choice is a penile suppository, which is placed into the urethra 10 to 30 minutes before intercourse; a drug is dispensed that widens arteries in the penis, causing an erection which lasts 30 to 60 minutes in about two thirds of men in most cases. The drug, known as alprostadil, can also be administered by injection with an ultrathin needle into the base of the penis (which could produce infection or scarring as side effects).

A third option is a vacuum erection device (VED)—a pump that draws blood into the penis. It may seem awkward, but it has a really low failure rate and no significant side effects.

By comparison, a penile implant, consisting of a bendable rod or an inflatable cylinder connected to a little pump, has downsides that make it the very least popular option. Not only does an implant necessitate surgery, but implants may fail or become infected, and then need to be eliminated. Be sure to get a second, or even third, opinion before getting an implant.

Beyond Home Remedies: When You Should Contact Your Doctor

Contact your health care provider if you are consistently unable to achieve or maintain an erection. Also get hold of your doctor if new medications you are taking have caused a change in erectile function, or if work-related stress or other psychological factors are impacting your sexual abilities. (The side effect of numerous prescription drugs for depression, allergies, and cardiovascular disease is erectile dysfunction.) Over 200 medications currently on the market can significantly affect sexual performance. Physicians at the Center For Sexual Health in St. Louis, MO including Dr. Cathy Naughton have a lot of experience helping men with their ED issues.

What Your Doctor Will Do

The first thing your doctor should do is take a comprehensive medical and sexual history. If mild to moderate erectile dysfunction is identified, your doctor might suggest an experienced urology specialist, who can perform tests to find out if blood flow to the penis is adequate. The medical specialist might also find out whether spinal cord problems may be involved or if blood testosterone levels are low.

If your issue is basically psychological, a physician should give you advice or refer you and your partner to a therapist. (If you're waking up at night or in the morning with a full, firm erection, then the cause of the dysfunction is most likely psychological.) Sex therapy delivers a cure rate of 60 to 80 percent for erectile problems brought on by psychological causes. If counseling is needed, a referral from your physician or from a psychologist is probably the best way to find a properly certified sex therapist, however some family practitioners might have training in sexual therapy.

If the problem is associated with medicine you're taking, your doctor will discuss with you about alternative medicines that will not impact your ability to have an erection.

For impotence that can't be treated by some other means, some medical solutions are available. Be certain to try all nonsurgical choices before thinking about a penile implant. If you've got any other queries, contact Metropolitan Urological Specialists at 314-315-9911.

The Many Effects of Male Impotence

Regardless of whether the reason behind your erectile dysfunction is physiological or psychological, both the patient and his partner commonly experience a variety of intense feelings and emotions. Any of these feelings can result in a sense of hopelessness and reduced self-esteem. Men in St. Louis, Florissant, Creve Couer, and Kirkwood can go to the Center For Sexual Health, a location of Metropolitan Urological Services, to obtain answers pertaining to their impotence problems.
Naturally, feelings of sexual anxiety can reinforce any performance anxiety a man experiences and produce a vicious cycle of repeated failures and increasingly negative feelings.

Step one to surmounting these feelings is to recognize the issue and speak truthfully and freely with each other.

ED Effect on Self-confidence

Because sexual performance is generally a big part of a person's self-confidence, experiencing erectile dysfunction (ED) can be damaging not only to a man's sexual life, but to his whole sense of being. Men with erectile dysfunction can become uncertain of themselves and avoid intimate situations with their partners; this just escalates the pressure and anxiety associated with a condition that is often treatable.

Additionally, erectile dysfunction may cause men to feel inadequate in their roles. Men suffering from male impotence commonly isolate themselves from their relationships and withdraw from their partners.

The psychological results of erectile dysfunction can interfere with every aspect of a man's everyday life, from his relationship with his partner, to his communications on a social level, to his job performance. Therefore, it is crucial for a man who is experiencing ED to feel as secure as possible speaking about his condition with his companion, and with his physician, in order to discover the treatment strategy that can best help get over this condition.

Male Erectile Dysfunction Effect on Sexual Partners

Erectile dysfunction can be awkward to discuss not just with a doctor but also with a partner. It often causes men to withdraw from those people that care about them, which places a significant stress on relationships.

Partners of men with erectile dysfunction assume that starting a conversation regarding the situation will cause embarrassment and humiliation. They also may develop a sense of inadequacy, thinking the reason for male impotence is their fault and that they are not physically attractive to their partner.

In most cases, erectile dysfunction is a result of physical causes (though it could easily be worsened by psychological factors), and can often be addressed. Nevertheless, silence, embarrassment, and feelings of inadequacy and humiliation only result in additional withdrawal on the part of both partners, boosting the distance and tension within the relationship. The stress and anxiety which results can easily make a case of ED worse, resulting in a vicious cycle of failure and anxiety about failure.

Both partners and males with erectile dysfunction should try to keep in mind that erectile dysfunction is often times a treatable physical condition. The first step to treatment, however, is trust and a readiness on the part of both people to go over the situation with each other, and with a health care provider. Physicians at the Center For Sexual Health like Dr. Cathy Naughton have many years of experience helping men feel relaxed about finding the answer to their erectile dysfunction. Give them a call today and set up an appointment.

An Overview Of Erectile Dysfunction

The Center For Sexual Health, a division of Metropolitan Urological Specialists in St. Louis, MO, and Dr. Cathy Naughton, head of the Center, are pleased to provide you with some of the basic information regarding one of the most prevalent sexual problems facing men today. Erectile dysfunction (ED) is the inability of a guy to attain or maintain an erection sufficient for his sexual needs or the needs of his partner. Many men suffer from this at some point in their lives, in most cases by age 40, and aren't mentally affected by it.

A few men, nevertheless, experience persistent, complete male impotence, and others experience partial or brief erections. Frequent erectile dysfunction causes emotional and relationship problems, and often results in decreased self-esteem. Male impotence has several causes,—most of which are treatable. Impotence is not an inevitable outcome of the aging process.

Incidence of ED

The phrase "erectile dysfunction" could mean the inability to get an erection, an inconsistent ability to do this, or the ability to reach only brief erections. These various definitions make estimating the frequency of male impotence tough.

According to the National Institutes of Health (NIH), around 30 million men across the nation encounter chronic erectile dysfunction and incidence of the condition increases with age.

Chronic erectile dysfunction affects around 4 percent of men in their 50s, almost 17 percent of males in their 60s, and about 47 percent of men older than 75. Transient erectile dysfunction and inadequate erection affect up to half of men between the ages of 40 and 70.

Ailments (for example., diabetes, kidney disease, alcoholism, atherosclerosis) account for up to seventy percent of persistent ED cases and psychological factors (e.g., stress, anxiety, depression) may account for 10–20 percent of cases. Between 35 and 50 percent of males with diabetes experience ED.

If you believe you've got chronic or partial erectile dysfunction, it is vital that you contact a physician at the earliest opportunity. The Center For Sexual Health and Metropolitan Urological Services in St. Louis, Creve Couer, Florissant, and Kirkwood, Missouri would be pleased to meet with you anytime you like to help you to find a solution.

Risk Factors for Stress Incontinence

Risk factors that Metropolitan Urological Specialists in St. Louis, Missouri specialize in include childbirth, menopause, and pelvic surgery (such as a prostatectomy or hysterectomy).

Having A Baby

Pregnancy and childbirth can flatten, stretch, and weaken the pelvic floor muscles which support the bladder neck and urethra. The position of the bladder and urethra might change, bladder control nerves can be damaged, or an episiotomy (incision of the perineum and vagina) may be performed to prevent tearing during vaginal delivery. These kinds of issues will damage the pelvic floor muscle groups.

If urinary control is lost right after giving birth, the pelvic floor muscles may recover within about 6 weeks. If continency isn't restored, treatment may be required. Sometimes incontinency develops months or years after the birth. Ladies who work out the pelvic floor muscle groups (Kegel exercises) are less likely to develop incontinence.
 
Menopause

At menopause, the ovaries quit producing estrogen. Insufficient estrogen brings about thinned tissues that line the urethra, a weakened sphincter mechanism that opens up and closes the urethra, and weak bladder muscles. These factors can cause the urethral sphincter to open during physical exercise.

Pelvic surgery

Pelvic surgery can weaken and damage the pelvic floor muscles, causing the bladder neck and urethra to drop when abdominal pressure is applied (hypermobility) during the course of physical exercise.

Surgical operations which can affect the pelvic floor muscles include the following:
Abdominal resection for colorectal cancer
Total or partial hysterectomy (removal of the uterus)
Failed surgery to correct stress incontinence

Causes of Stress Incontinence

Stress incontinence is a result of the following:
Thinning of the urethral lining
Vaginal prolapse (e.g., cystocele, enterocele, rectocele, uterine prolapse, vaginal vault prolapse)
Weakened bladder and/or pelvic floor muscle groups
Damaged urethral sphincter

Sign and Symptom of Stress Incontinence

Urine leaks throughout strenuous physical activity are a symptom of stress incontinence.

If you are living in St. Louis, Washington, Creve Couer, Florissant, or Kirkwood, Missouri and think that you may have stress urinary incontinence, give a call to Metropolitan Urological Specialists at 314-315-9911.

What are Bladder Stones?

Metropolitan Urological Specialists, serving Washington, Creve Couer, Florissant, and St. Louis, MO want to offer a couple of tips on identifying and treating bladder stones. Bladder stones develop whenever substances (like calcium oxalate) in the urine concentrate and coalesce into hard, solid lumps that lodge in the bladder. Often, several stones form at once. Generally, they're pretty small and are excreted in the urine without complications, but on occasion stones become trapped in the neck of the bladder and—as residues in the urine continue to accumulate—grow large enough to cause discomfort, urinary blockage, or infections, thus necessitating surgical intervention. Bladder stones almost exclusively impact middle-aged and older men, but, for unknown reasons, are becoming progressively more rare.

What Causes Bladder Stones?

Most commonly, stones come to be problematic whenever the neck of the bladder is hindered due to prostate growth, a benign growth (adenoma) inside the prostate, or unnatural contraction or stricture of the bladder neck. Stones often arise elsewhere in the urinary tract (such as the kidneys), or perhaps in the bladder itself. Hereditary factors may be involved.

Other causes include the long-term usage of a urinary catheter, chronic urinary tract infections, or a nerve injury that impairs bladder function.

Moderate, chronic dehydration concentrates the urine, which could promote stone formation.
A diet high in oxalic acid (found in rhubarb, leafy vegetables, and coffee) may lead to stones.
Weakened area of the bladder caused by a bulging pouch within the organ (called bladder diverticulum)

Damage to the nerves that carry signals to the bladder muscles from the brain (known as neurogenic bladder)

Symptoms of Bladder Stones

• Disruption of the urine stream, lack of ability to urinate except in specific positions, frequent urge to urinate but with only small amounts of urine passed
• Blood in the urine, often only apparent within the last few drops
• Dark urine
• Pain—sometimes severe—in the pelvic region, genitals, lower abdomen, or lower back
• Low-grade fever (under 102°F)

Bladder Stones Avoidance

• Drink no less than eight glasses of water a day.
• Get prompt treatment for urinary tract infections.
• Potassium citrate can increase urine levels of citrate, which is a substance that suppresses calcium stone formation.
• Avoid meat, eggs, and animal fats, as well as processed and fried foods.
• Dietary changes and treatment for any underlying condition may be helpful.

Bladder Stones Diagnosis

• A thorough medical record and physical examination (including a rectal exam) and lower abdominal check to look for bladder distention are performed.
• Urine samples are taken and analyzed (urinalysis).
• Stones can be found with x-rays or ultrasound.
• Bladder stones diagnosis may be confirmed with x-rays, ultrasound, computerized tomography (CT) scan, cystoscopy (inspection of the inside of the bladder using a scope) and intravenous pyelogram (x-rays are taken after dye is used to highlight the urinary organs).

How to Deal with Bladder Stones

Your physician may prescribe narcotic analgesics to relieve pain and antibiotics to treat an infection.
Smaller stones can be removed with a cystoscope, a tube inserted through the urethra that allows the physician to view the stones. The scope can also be outfitted with a device that crushes the stones, after which the fragments are washed away.

Larger stones are treatable with extracorporeal shock-wave lithotripsy, which aims focused bursts of sound waves that powderize the stones.

In rare occasions, very large stones may necessitate surgical removal (suprapubic lithotomy).
The root problem (such as prostate enlargement) causing stones to be caught in the bladder must be identified and treated to avoid recurrence.

For additional information about identifying and treating bladder stones, contact Metropolitan Urological Specialists in St. Louis, Missouri.

Keep Your Kidneys Healthy!

The following strategies can help keep acute kidney injury and other risks to your kidneys at bay. Common-sense steps that shield against heart disease, diabetes, and other major health risks can safeguard your kidneys, too.

• Get some exercise regularly.
• Reduce your consumption of high sodium foods; take in at the most one thousand five hundred milligrams of sodium each day.
• Keep a healthy weight.
• If you've got high cholesterol or diabetes, take all medicines as advised.
• Don't smoke cigarettes.
• Get your blood pressure tested regularly. If you are administered blood pressure–lowering medications, take them as instructed.
• Speak with your physician about your usage of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve).
• Consume alcohol only in moderate amounts or not at all.
• Visit your physician for routine physical exams.

Metropolitan Urological Specialists hopes that you recognize the necessity of healthy kidneys. If you feel you are having kidney-related trouble, visit one of their offices in St. Louis, Washington, or Florissant, MO.

Bladder Control Problems? Great Tips on Getting Yourself Ready For Your Doctor Visit

If urinary urgency is curbing your regular activities, talk to your physician. Speaking up can change your life.

Your bladder needs your kidneys, nerve signals, and muscles to all be in sync with one another. When they're not, you might experience overactive bladder and incontinence, leaving you with symptoms that can lessen quality of life.

Your primary physician (or gynecologist, urologist or urogynecologist) like those at Metropolitan Urological Specialists in St. Louis, MO should be able to pinpoint the root of your condition and determine a treatment plan. Here's what you need to get the dialogue started.

Before Your Doctor Visit

Your physician may have asked you to maintain a bladder diary for several days prior to your appointment. In it, you'd detail fluids you ingest and when you urinate, feel an urge, and experience leakages.

Right Now

No bladder diary? Not a problem. Take a couple of minutes and make a mental list of the times and situations whenever you felt urgency or experienced leakage. It will give your doctor hints about factors that might be bringing about your condition.

During the Visit

Your physician will ask questions regarding your urinary control issues, take your medical history and provide you with a physical evaluation. During or in the days after the visit, you'll also have diagnostic tests.

If You Need More

Some OAB symptoms, such as urgency to urinate, might be caused by other medical issues. So you may initially be diagnosed with another urinary disorder, like the bladder condition interstitial cystitis. A thorough exam and tests should determine the exact cause of symptoms. Yet, if your doctor seems stumped, you might want to see a urologist or a urogynecologist who specializes in urinary tract disorders. The doctors at Metropolitan Urological Specialists have years of experience and are well-equipped to diagnose you correctly the first time.

7 Questions The Doctor May Ask You

1.   What meds are you taking? Some prescription and non-prescription drugs can dull the nerves and muscles involved.
2.   What fluids do you consume regularly? Alcohol, for example, interferes with signals from your brain to your bladder about when to release.
3.   How much fluid do you consume on a typical day? Drinking too much water before going to bed may cause overnight accidents.
4.   What recent surgeries or illnesses have you had? Trauma coming from pelvic or back surgery, for example, can spur leakage problems.
5.   How many kids have you had? Pregnancy and childbirth can deteriorate pelvic muscles.
6.   Can you recall when you began to first notice bladder symptoms? Even if it was years ago, you can find some relief.
7.   How many times per day are you feeling the need to urinate? Going more than eight times a day may mean OAB.

Your Health Background

A number of health conditions send nerve signals to the bladder at the incorrect time, which may cause urine leakages.

Take a glance at this list of diseases and conditions and check off all that apply to you. This often helps your physician better identify the source of your bladder problem and create the very best treatment plan.

•   Bladder tumors or polyps
•   Brain or spinal cord tumor
•   Diabetes
•   Herniated disc
•   Lead, mercury, or arsenic poisoning
•   Multiple sclerosis (MS)
•   Myelodysplasia
•   Parkinson's disease
•   Radiation treatment for cancer
•   Spinal cord injury
•   Stroke

Some study also indicates that individuals with particular conditions might be susceptible to OAB, especially these below. Check all that apply.
 
•   Attention deficit disorder (ADD)
•   Depression or anxiety
•   Fibromyalgia
•   Irritable bowel syndrome (IBS)

Are there any other medical situations that you find could be influencing your bladder function? If that's the case, tell your doctor. The doctors at Metropolitan Urological Specialists, serving individuals living in St. Louis, Creve Couer, Florissant, and Kirkwood, would love the opportunity to have an appointment with you so that you can find solutions to your bladder control problems.

Male Urinary Incontinence

Male urinary incontinence is often the consequence of a damaged sphincter; the circular muscle that controls the flow of urine out from the bladder. When damaged, usually the inevitable consequence of prostate cancer surgery, the muscle cannot squeeze and shut off the urethra. This causes urine to leak.

Managing Incontinence And Recovering Your Quality Of Life

Persistent incontinence can limit your activities, keep you homebound in really expensive, messy pads, dealing with the frustration and embarrassment, and the continual anxiety about leaking and odor. But the truth is, you don’t have to put up with bladder control problems anymore. Today you can find real solutions in the St. Louis, Missouri area that can fix incontinence forever, so you're able to go back to the things you love, with confidence and control.

In men, the urinary sphincter muscle is found below the prostate. The sphincter muscle surrounds the urethra. Whenever the sphincter muscle contracts, it holds urine in the bladder. When it relaxes, the bladder contracts and the urethra opens, allowing urine to flow outside the body. Whenever the sphincter muscle is damaged, it cannot close up the urethra.

Forms Of Incontinence

•   Stress Urinary Incontinence (SUI)-The most typical type of incontinence following prostate cancer surgery, SUI occurs when you leak urine during a physical activity such as lifting, exercising, sneezing, and coughing.
•   Urge Incontinence-Occurs when you have an overwhelming need to urinate and aren't able to hold urine long enough to reach a toilet.
•   Overflow Incontinence-When your bladder never entirely empties, which causes urine to leak.
•   Total Incontinence-When the urinary sphincter muscle is entirely deficient, the result is continuous leakage of urine without control.

Stress Urinary Incontinence Responses To Prepare For Your Doctor Visit

1.   Do you ever experience unforeseen, abrupt urine loss either while sleeping or throughout the day?
2.   Do you have leakage while laughing, sneezing, jumping, or performing other movements that put pressure on the bladder?
3.   Do you have trouble holding urine as you hurry to the bathroom?
4.   Do you frequently experience a sudden and immediate urge to urinate?
5.   Have you detected a change in your regularity of urination?
6.   Do you go to the bathroom to urinate more than 8 times each day?
7.   Do you currently wear pads or liners to safeguard against unplanned leakages?
8.   When planning a trip, outing, or event, does the availability or location of the restroom facilities impact your decision?

Treatment Options

There are a selection of ways to manage incontinence, ranging from continuous management to long-term surgical solutions.
•   Absorbent Products-Pads, diapers, and absorbable garments are frequently used to handle incontinence.
•   Internal Collection Devices-Catheterization on a regular basis may be used for certain men to make sure that the bladder is emptied on a consistent schedule.
•   External Devices-Condom catheters can be used to collect urine, and clamps may be used to block the flow of urine.
•   Biofeedback/Electrical Stimulation-Can help patients get awareness and control of their urinary tract muscles.
•   Collagen Injections-Injections of bulk-producing agents, like collagen, into the urinary sphincter.
•   Surgical Options-These cover anything from implantable “male sling” treatments designed to support the muscles surrounding the urethra, to implanting a synthetic urinary sphincter which mimics the function of a normal, healthy sphincter.

Lots of men seek a permanent solution rather than deal with continuously having to wear pads, restrict their activities, and worry about leakage. You and your physician may find out that the ideal way to address your incontinence is using these effective surgical options. Metropolitan Urological Specialists in St. Louis, Florissant, and Washington, MO specialize in that very question. If you would like to find out more about how to treat your male urinary incontinency, give them a call today.

Information About Your Bladder Control Problems

If you have got incontinence, you're not alone. Urinary control trouble impact millions of Americans, making it rank right up there with numerous well-known diseases like asthma, diabetes, and osteoporosis. It is not just a female problem, nor a typical part of aging for the people of Washington, Florissant, and St. Louis, MO.

Urinary control difficulties can be devastating – You may leak small or large volumes of urine, use the restroom really often, or be unable to completely empty your bladder. These conditions affect your life and make simple daily activities an issue and social life quite hard. You may have to scale back on your hobbies or stop working. You may feel confined by a fear of leaking accidents, the need to be near the restroom at all times, and a general preoccupation with your bladder.

How Come I Have Urinary Control Difficulties?

Nerves carry information back and forth from your brain. Some nerves control the bladder and muscle groups that relate to urination. Whenever the communication system between these nerves and your brain isn't working properly, a person may have bladder problems like urinary retention and over active bladder including urgency urinary incontinence and urgency-frequency.

Different Kinds Of Bladder Control Difficulties

With urgency urinary incontinence, you may:
•   Lose urine whenever you feel a strong need to go to the washroom
•   Leak urine when you can't get to the bathroom fast enough
•   Leak urine whenever you drink even a small amount of liquid, or when you hear or touch flowing water

With urgency-frequency, you may:
•   Have frequent, uncontrollable impulses to urinate
•   Visit the washroom more frequently than normal (over 7 times a day)
•   Often sense your bladder is not entirely empty even after using the restroom

With urgency-retention, you may:
•   Spend a long time at the toilet but emit just a weak, dribbling stream of urine
•   Leak urine (often called overflow incontinence)
•   Not have a sensation when your bladder is full
•   Have to use a catheter to empty your bladder

Now that you've an idea just what problem is, the next task is discovering a solution. If you are living in the St. Louis, Missouri area, get a hold of Metropolitan Urological Specialists and schedule an appointment with one of their doctors. They'd be happy to go through each available option with you to find what’s right for you.

Treatments for Female Stress Urinary Incontinence

Metropolitan Urological Specialists of St. Louis, Washington, and Florissant, Missouri, is focused upon delivering innovative solutions for common women’s medical problems. Their aim is to offer worthwhile, easy-to-understand information so ladies, with their health professionals, can consider their options and make well informed decisions.

What Exactly Is Stress Urinary Incontinence?

Stress Urinary Incontinence, or SUI, is the unexpected, accidental release of urine during normal, everyday activities. You may have SUI if you lose urine when you:
•   Cough, sneeze, or laugh
•   Walk, work out, or lift something
•   Rise from a sitting or lying position

You may also visit the restroom often during the day to prevent accidents. If you are suffering from stress urinary incontinence, this means your urethra (the tube from the bladder through which urine exits your body) doesn't stay closed until it’s time for you to urinate. This issue can occur as a result of:
•   Pregnancy and childbirth
•   Prolonged heavy-lifting or straining
•   Menopause
•   Obesity
•   Cigarette smoking

Typical Signs And Symptoms Of Stress Urinary Incontinence

If you are suffering from urine leakage, take the time to ask yourself:
•   Do you experience urine leakage while laughing, sneezing, coughing, or working out?
•   Do you wear pantiliners or pads to soak up urine leaks?
•   Do you limit or eliminate activities to prevent leakage?
•   When organizing a trip, outing, or event, does the accessibility of washroom facilities impact your choice?

If you said “yes” to even one of these questions, take the next step and speak with a physician or some other healthcare professional like those at Metropolitan Urological Specialists in St. Louis, Washington, and Florissant, MO. Talking about it is the most important thing you can do to start taking control. But for quite a few ladies, it's often the hardest step. It should not be embarrassing, urinary incontinence is a medical problem which can be treated, after all.

Consider asking your doctor the subsequent questions in order to make that discussion a little easier:
•   What kind of urinary incontinence do I have?
•   What remedies are there to help me regain urinary control? Which one is ideal for me?
•   Can you take care of this problem, or can you send me to a doctor specializing in female urinary incontinence?

Treatments

Stress urinary incontinence is treatable at any age. But not all methods work for every person or for every type of incontinence. For SUI, your physician may encourage one or more of the following:
1.   Behavioral/Muscle Therapy: Therapy often starts off with Kegel exercises to help strengthen the pelvic floor muscles. Depending on the severity of your condition, however, Kegels may not give adequate relief.
2.   Biofeedback: In this method, the patient exercises the pelvic floor muscles while attached to an electric sensing device. The device provides “feedback” to help you understand how to better control these muscles. With time, biofeedback can help you utilize your pelvic muscles to reduce sudden urges to urinate and lessen some kinds of pelvic pain.
3.   Electrical stimulation: This method helps pelvic floor exercises by separating the muscle groups involved.
4.   Medication: Some forms of urinary incontinence, such as urge incontinence, can be treated with medications; however there is currently no medication approved to treat SUI in the United States.

This article is brought to you by Metropolitan Urological Specialists. If you've any further questions about stress urinary incontinence for women or any other issues that they provide treatment for, come by one of their practices in St. Louis, Washington, or Florissant, Missouri and make an appointment.

Important, Practical Varicocele Information

When To Contact Your Physician 

Contact your doctor if you've any of the following problems following treatment:

•   Recurring soreness not reduced by pain medicine
•   Black and blue across the cut, bleeding through the incision, or puffiness in the scrotum
•   A fever over 100.2 degrees Fahrenheit, or chills

Blood vessels Within The Scrotum

The scrotum is a sac of skin that covers the testicles—the male sex organs that produce sperm and the male hormones. Blood vessels in the scrotum carry blood to and from the testicles. The vessels that carry blood out from the testicles are called veins.

When There Is An Issue In The Veins

The veins that take blood from your testicles extend up into the groin. This means the blood will have to move upward a long way. Valves within the veins behave like gates to keep the blood from flowing back to the testicles. In many males, these valves do not shut completely. Or the muscles in the walls of the veins might be weak. Then some blood moves back into the scrotum. The blood gathers in the veins above the testicles. This will make the veins expand.

With or Without Treatment

A varicocele is rarely a severe condition. Should you have pain, treatment is likely to relieve your symptoms. If a varicocele is causing infertility, treatment can improve your sperm count. Regardless of whether you have treatment, you can lead a typical, active life.

If you've got any other questions relating to urological services provided by Metropolitan Urological Specialists, head over to one of their offices in St. Louis, Washington,  or Florissant, Missouri.

What Is A Varicocele?

A varicocele is a swelling in the blood vessels over the testicles. It really is similar to having varicose veins within the legs. The swelling develops when too much blood collects within the veins. A varicocele oftentimes takes place around the left testicle.

Exactly what are the symptoms?

A varicocele in many cases causes no symptoms whatsoever. Or it might create an achy or heavy feel in the scrotum. The pain could be more intense later on during the day or after standing for a long time. You may even observe inflamed veins underneath the skin within the scrotum.

How Is it recognized?

Commonly a varicocele is clinically diagnosed during a physical exam. A testicle with enlarged veins may be more sensitive. A varicocele may also be clinically determined during the course of evaluation for fertility concerns. If you have got soreness but your physician cannot feel any enlarged veins, an ultrasound could be done.

A varicocele can decrease sperm count.

Whenever blood accumulates in the veins over the testicles, changes occur that can lessen the amount and the quality of the sperm. For men who're infertile, about forty percent to fifty percent may have a varicocele. Oftentimes, sperm count heightens after treatment.

Treatments

About 1 in 6 guys have a varicocele. In most situations, a varicocele is not serious. Your doctor might wait and watch the problem. If you have pain, if the veins become unsightly, or should you and your partner are having trouble conceiving a child, your physician may recommend surgical procedures or another procedure to shut off the enlarged blood vessels.

Watchful waiting

If you don’t have any discomfort and your partner and you aren't wanting to have a baby, your doctor might advise just observing the problem for a time. Make sure to keep all of your appointments. If the veins don’t get bigger and they don’t bother you, you possibly will not need additional treatment.

Surgery (Varicocelectomy)

The doctor might advise that you get surgery somewhere in the St. Louis, Missouri area to take care of enlarged veins near the testicles. In some cases, surgery is carried out with a laparoscope (a lengthy, thin, telescope-like device).

•   First you are offered anesthesia to keep you relaxed. You might be asleep.
•   One or more tiny lacerations are made in the groin or mid-section.
•   The blood vessels are then tied up or sealed off.
•   The incision is closed with sutures, staples, or surgical tape.

Varicocele Embolization

Instead of surgery, your doctor may advocate varicocele embolization.
•   Firstly you are given anesthesia so you remain comfortable.
•   Then a tiny incision is made in the groin or side of the neck.
•   A small tube is moved through the incision.
•   Led by x-rays, the physician passes the tube into the varicocele.
•   A tiny coil is sent through the tube. This is to block blood flow to the varicocele.
•   The tube is completely removed. In most cases, stitches are not necessary.

Metropolitan Urological Specialists is proud to offer this and other informational materials about urological health. If you have any more questions for them, stop by one of their offices in St. Louis, Washington, or Florissant, Missouri.

What Else Can You Tell Me About Percutaneous Nephrolithotomies?

What is a ureteral stent? 

A ureteral stent is a small plastic tube which is put in your urinary tract to help reduce swelling and allow the kidney to drain urine. The stent ordinarily remains in the body for four to fourteen days and is then removed in a follow-up appointment.

What is a nephrostomy tube?

A nephrostomy tube is a catheter placed into your kidney that links to a drainage bag to accumulate urine outside of your body. The nephrostomy tube is generally gotten rid of prior to hospital discharge. At times patients return home with the nephrostomy tube and it is taken out several days afterwards during a follow-up appointment.

What can I do to deter additional stones?

There are steps you can follow to keep stones from coming back:
•   Consume lots of liquids.
•   Control your sodium ingestion.
•   Keep a healthy weight.
•   Take medicine. Some patients need medication to help decrease their risk of developing another kidney stone.
•   Make dietary changes,  like reducing your intake of soft drinks, animal protein, and salt.
Your doctor will discuss a prevention plan with you following your procedure.

To find out more, contact Metropolitan Urological Services.

What Should I Expect After A Percutaneous Nephrolithotomy Procedure?

Lots of individuals in cities like St. Louis, Chesterfield, Florissant, Washington, Creve Couer, Kirkwood, and Chesterfield, Missouri have percutaneous nephrolithotomies each year. We have looked into some of the more frequent questions about recovery below.

Prevalent side effects include:

•   Nausea and occasional vomiting.
•   Pain frequently occurs for the first 24 to forty-eight hours in your kidneys, abdomen, lower back, and sides. Hurting might increase whenever you urinate. Take medicine as prescribed by doctors.

If you go home with a nephrostomy tube and drainage bag:

•   Bloody urine is typical. However, if the bleeding grows significantly, speak to your health care provider right away or return to the hospital for additional assessment.
•   Empty the drainage bag before it gets full. If the bag no longer drains urine and you experience back pain, call your doctor immediately. The tube may be clogged or loose.
•   You may see leakage of urine around the tube and might need to change the dressing.
•   It’s fine to shower with the bag. It may become damp. However, you should keep your incision site covered with a watertight dressing.
•   A few days after release from the hospital, you need to go to your doctor’s office for removal of the tube.

If you go back home with a ureteral stent, your health care provider will remove it in a follow-up appointment four to fourteen days following your procedure.

Should you go back home with a stent, typical side effects include:

•   Blood in the urine. Drinking fluids minimizes blood clots from forming within your urine.
•   A feeling of fullness and a continual need to urinate (urgency and frequency).
•   A burning sensation during urination or whenever you move around.
•   Bladder muscle spasms.

In a follow-up appointment, typically 4 to 14 days following the procedure, your physician takes out the stent. Patients are usually conscious whenever a stent is removed. Your physician may apply a local anesthetic jelly to the opening of your urinary tract (urethra) before the procedure. If it has a string affixed, the physician pulls on the string to take out the stent. Or, your doctor may use a little scope placed within your bladder to pull out the stent.

When should I call my physician?

Call if you:
•   Have a temperature greater than 100 degrees or chills
•   Realize that the pain medicine is not relieving your pain.
•   Can't tolerate food or fluids.
•   If you've got excessive blood within the urine, which is typically red, thick, and cannot see through it (like ketchup), or if you have blood clots within your urine which render it challenging to urinate, please get hold of your physician straight away.

A little blood in the urine is common after a PCNL procedure. Urine colors can vary from light pink to reddish and sometimes can even have a brownish hue – but you can for the most part see through it. Medications to help with the burning feel can occasionally turn the urine into an orange or blue color.

Metropolitan Urological Specialists in St. Louis, Florissant, and Washington, Missouri are ready and willing to answer your questions regarding percutaneous nephrolithotomy.

What Is A Percutaneous Nephrolithotomy?

A percutaneous nephrolithotomy, or PCNL, is a kidney stone surgery for large or multiple stones. The doctor carries out the operation in a medical center operating room. It customarily calls for a hospital stay of one or two nights.

What takes place during the procedure?

A PCNL customarily lasts 1 to 3 hours. Once you are under anesthesia, your doctor will make a small surgical incision in your back. The doctor places a protective sleeve called a sheath through your back and into your kidney. Your doctor then passes a video scope referred to as a nephroscope through the sheath to locate and remove the kidney stones.

To help your kidney heal and drain urine while in the recovery process, your doctor may place a nephrostomy tube or a ureteral stent at the conclusion of the process.

A number of patients require a second procedure to remove all of the stone. In that case, the nephrostomy tube and stent could be left in position until the next operation.

What do I have to do before the operation?

There are actually 3 significant things to do prior to your procedure:

Consult with your personal doctor. 

Let your doctor know:
•   All of your prescription medications, vitamins, and supplemental herbs and natural remedies, and over-the-counter medications.
•   Any known allergies you have got to medicines and the contra agent found in some x-rays.
•   If you may be pregnant.

Review the pre-operative information.

Make time to analyze these instructions offered by your doctor. For instance, you might need to:
•   Go to appointments for medical tests before the procedure like an electrocardiogram (EKG), x-rays, and blood and urine tests.
•   Discuss with your doctor medication that might raise your danger of bleeding, for instance: aspirin, ibuprofen, warfarin, clopidrogel, and non-steroidal anti-inflammatory drugs. You may have to stop taking a lot of these medicines before the procedure.
•   Take antibiotics, if prescribed, to help you avoid infection.
•   Check with your physician on which of your regular drugs to take the morning of surgical procedure. On that day, take these drugs with just a sip of water.
•   Do not have anything to eat or drink after midnight the night prior to operation (except for the drink of water with the morning medicine).

Plan for a ride home.

After the operation, you cannot drive yourself home. Before the procedure, ask a relative or a dependable friend to pick you up and get you home. Most hospitals and surgery centers in the St. Louis, MO area won't permit you to take a taxi home following your operation.

Should you have any additional queries about Percutaneous Nephrolithotomy, Metropolitan Urological Services would love the opportunity to assist you. Their offices have locations at St. Louis, Washington, and Florissant, Missouri.