Vasectomy Recovery Guidelines

Immediately after your vasectomy, everything you do or don’t do can mean the difference between a simple, painless recovery and a sore, miserable experience that lasts for days, weeks, or even longer. Here are six easy-to-follow suggestions to give you the best probability for a quick recovery.

1. Most importantly, stay off your feet for several days. The delicate tissues will swell up and hurt if you spend time standing for the first days of recovery. This means you cannot go out to dinner somewhere in St. Louis, a movie, or any activity where you're standing a lot. It's best if you sit around for several days, taking it easy.

2. Avoid lifting of heavy items or straining for around a week or two. If it’s heavier than a gallon of milk, then don’t pick it up. Needless to say, everyone knows you can move that fridge or pick up that keg but immediately after a vasectomy is not necessarily the time to prove it.  And this means if you work out, no squats, crunches, or leg presses for a couple weeks. Your core and muscles will be just fine without the heavy lifting and exercises.

3. You should ice up down there (20 to 30 minutes on, 10 off) for a couple of days following the vasectomy.  You can use frozen peas. This will reduce inflammation and swelling, and give you a more comfortable recovery. And be sure to put the ice outside of your underwear, never right against the skin.

4. Wear an athletic supporter or bike compression shorts, outside your underwear, to offer support during the first week or two following the vasectomy. Gravity and movement aren't best for recently traumatized tissues within your scrotum.

5. Take anti-inflammatory medications like naproxen or ibuprofen, as directed by your physician, for the first few days to minimize swelling, inflammation, and discomfort. Of course, don’t take these if you have had issues with upset stomach or stomach ulcers.

6. No sex (all definitions) for one week to let the area heal. And then, after one week, just with birth control until you are told it's safe to go without. The vasectomy doesn't immediately sterilize you! It only blocks the resupply of fresh sperm into the pipes, so it will take two months or more to flush out the sperm in your system. That's why you have to check and make sure you are cleared out with a sperm check at eight weeks. Don't ever assume you're sterile, as sometimes it takes a lot longer and so you could still be fertile.

The good thing is that for most men, recovery following a vasectomy is relatively easy and painless, especially when you follow these simple guidelines. If you think that you might want to get a vasectomy or want to know more about the procedure, visit Metropolitan Urological Specialists. They help men all around St. Louis, Creve Coeur, Florissant, and Kirkwood, MO with these procedures.

Vasectomy Reversal (Vasovasostomy)

A vasectomy is recognized as a permanent approach to birth control. Vasectomy reversal (vasovasostomy) reconnects the tubes (vas deferens) that were cut in a vasectomy. If you are considering a vasovasostomy, you'll want to read this information given by Metropolitan Urological Specialists in St. Louis, MO.

Vasectomy reversal is usually an outpatient procedure (without an overnight stay in the hospital). Spinal or general anesthesia is typically utilized to ensure that you stay entirely still throughout the surgery.

The odds of vasectomy reversal success depend on just how much time has passed between your vasectomy and the reversal. With time, additional blockages can develop, and some men create antibodies to their own sperm.

The surgery is much more complicated and takes more time when blockage between the vas deferens and the epididymis requires correction (vasoepididymostomy).

What To Expect After Surgery

Vasectomy reversal normally takes from two to four hours, followed by a few more hours for recovery from the anesthetic. You will probably go home the same day.

Pain can be mild to moderate. You should be able to resume normal activities, like sex, within three weeks.

Why It Is Done

Vasectomy reversal is done when you've  had a vasectomy and would now like to be fertile.

How Well It Works

Probability of a successful vasectomy reversal decline over time. Reversals are more successful in the first decade after vasectomy.

Generally, vasectomy reversal:
•   Brings about overall pregnancy rates of higher than 50%.
•   Has the greatest chance of success within three years of the vasectomy.
•   Causes pregnancy only about 30% of the time if the reversal is done ten years following vasectomy.

Risks

Risks of vasectomy reversal include:
•   Infection at the site of surgery.
•   Fluid buildup in the scrotum (hydrocele) that might require draining.
•   Injury to the arteries or nerves within the scrotum.

What To Consider

Before a vasectomy reversal is carried out, your doctor will want to make sure you were fertile before your vasectomy.

You can have tests to find whether you have sperm antibodies in your semen before and after vasectomy reversal. If there are sperm antibodies inside your semen after surgery, your partner is unlikely to become pregnant. In this case, you may decide to try in vitro fertilization with intracytoplasmic sperm injection.

If you have any questions concerning reverse vasectomy or any of the other services provided by Metropolitan Urological Specialists, set up a meeting with them and they’ll give you the answers you need. Metropolitan Urological Specialists is a good place to go for urological knowledge in St. Louis, Creve Coeur, Florissant, and Kirkwood, Missouri.

Kidney Stones And What Causes Them

Kidney stones many times have no particular, single trigger, although a number of factors might increase your chances. Here’s some information from Metropolitan Urological Specialists in St. Louis, MO about some of those factors.

Kidney stones form whenever your urine contains more crystal-forming substances -- such as calcium, oxalate, and uric acid -- than the fluid in your urine can dilute. At the same time, your urine might lack substances that prevent crystals from sticking together, creating a perfect environment for kidney stones to form.

Knowing the kind of kidney stone helps identify the cause and may also give clues on exactly how to lower your risk of getting more kidney stones. Varieties of kidney stones include:

•   Calcium stones. Most kidney stones are calcium stones, normally as calcium oxalate. Oxalate is a natural substance found in food. Some fruits and veggies, and nuts and chocolate, have high oxalate levels. Your liver also generates oxalate. Dietary factors, high doses of vitamin D, intestinal bypass surgery, and numerous metabolic disorders can increase the concentration of calcium or oxalate in urine. Calcium stones might also show up in the form of calcium phosphate.
•   Struvite stones. Struvite stones form in response to an infection, like a urinary tract infection. These stones can grow quickly and get quite large, sometimes with very few symptoms or little warning.
•   Uric acid stones. Uric acid stones can develop in individuals who don't drink enough fluids or who lose too much fluid, those who have a high-protein diet, and those who have gout. Certain genetic factors can also boost your risk of uric acid stones.
•   Cystine stones. These stones form in individuals with a hereditary disorder that causes the kidneys to excrete too much of certain amino acids (cystinuria).
•   Other stones. Other, rarer types of kidney stones also can occur.

Factors which increase kidney stone risk for people in St. Louis, Creve Coeur, Florissant, and Kirkwood, MO include:

•   Family or personal history. If somebody in your family has kidney stones, you're more likely to develop stones, as well. And if you have already had one or more kidney stones, you are at increased risk of developing another.
•   Dehydration. Not drinking enough water each day increases your chance of kidney stones. People who live in warm environments and those who sweat a good deal might be at greater risk than other people.
•   Certain diets. Eating a diet that is loaded with protein, sodium, and sugar may raise your risk of some types of kidney stones. This is especially true with a high-sodium diet. Too much sodium in what you eat raises the amount of calcium your kidneys must filter and substantially increases your risk of kidney stones.
•   Obesity. High body mass index (BMI), large waist size, and gaining weight have been connected to a greater risk of kidney stones.
•   Digestive diseases and surgery. Gastric bypass surgery, inflammatory bowel disease, or chronic diarrhea can cause changes in the digestive process which affect your absorption of calcium and water, increasing the levels of stone-forming substances within urine.
•   Other medical conditions. Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism, specific medications, and some urinary tract infections.

If you think that you might have a kidney stone, the best thing you can do is see a doctor. The experts at Metropolitan Urological Specialists have many years of combined experience helping patients with kidney stones and a number of other urological health problems.

Tips for Talking to Your Doctor about OAB

If you've got urinary symptoms, make bladder worries the main target of your next doctor appointment.

Overactive bladder is a common problem. Generally, people wait seven years prior to seeking treatment for urinary control problems, according to a recently available survey by the National Association For Continence. If you've got OAB, these basic steps from Metropolitan Urological Specialists in St. Louis, Missouri will help you get the best results from your next doctor's appointment.

1. See an expert. Your primary care physician could be a good place to start. Nevertheless, not all doctors are well-trained in diagnosing and treating incontinence. If your family doctor or gynecologist isn't, consider going to Metropolitan Urological Specialists if you live in St. Louis, Creve Coeur, Florissant, Kirkwood, Crestwood, Chesterfield, or Washington, Missouri.

2. Take note. One of the most important things to do is log your bathroom habits. This gives your physician an extensive picture of the symptoms you're experiencing and can help her get right to the source of the problem. Keep a bladder diary for two or three days prior to your visit. In it, note:

•   when you urinate,
•   whether you urinate a lot or a little every time,
•   what you eat and drink throughout each day,
•   the number of accidents you experience,
•   activities that seem to lead to leakages, and
•   whether each leak is small, moderate, or large.
In addition to a bladder diary, give your doctor a list of all medications you take, including over-the-counter and herbal products. Also, list medical procedures you have had (including vaginal births).

3. Know yourself. Create a list of the 3 to 5 most annoying problems related to your bladder problems and share it during your appointment. Maybe you do not leave home without knowing the precise location of every toilet along your route or you no longer get involved in activities that you enjoy, like tennis or golf.

4. Set goals. Come into your appointment with a couple of very clear goals in mind. Maybe you want to be taken seriously or you want to leave the office with a game plan, or you have a very personal goal, like being able to wear white pants without fear of leakage. Remember, you and your doctor are a team, so be open with her about your wishes.

5. Train your bladder with an expert. If you've had little success with the pelvic floor exercises known as Kegels, tell the doctor. Many times, women who are self-taught have been doing them incorrectly. Your physician can make it easier to find out how to do them properly and can teach you proper technique and how to hone in on the right muscle groups.

If you've got overactive bladder, take the first step and visit a doctor. Metropolitan Urological Specialists in St. Louis, MO is a group of dedicated and experienced doctors ready to help you stop thinking about your overactive bladder and get back to thinking about living your life.

Overactive Bladder Diagnosis

Diagnosis of overactive bladder is step one to finding the right treatment for it. Here are some of the tests that will be considered if you visit Metropolitan Urological Specialists. They serve patients in St. Louis, Creve Coeur, Florissant, and Kirkwood, Missouri.

A complete health history, including a voiding diary; a physical assessment; and one or more diagnostic procedures can help your health care provider diagnose any underlying condition and devise a suitable treatment plan for overactive bladder.

Medical History

The medical history includes information regarding bowel habits, patterns of urination and leakage (when, how often, how severe), and whether there is pain, discomfort, or straining when voiding. A history of health complications, pelvic surgeries, pregnancies, and list of medications (prescription and over-the-counter) also can supply information relevant to creating a diagnosis. In seniors, a mental status evaluation and evaluation of social and environmental factors also may be performed.

Physical Examination

A physical examination includes a neurologic status evaluation and examination of the abdomen, rectum, genitals, and pelvic area. The cough stress test, where the patient coughs forcefully while the physician observes the urethra, enables observation of urine loss. Immediate leakage with coughing indicates a diagnosis of stress incontinence. Leakage which is delayed or persistent after the cough indicates urge incontinence.

The physical examination also helps the physician identify health problems which can be the cause of overactive bladder. For example, poor reflexes or sensory responses may suggest a neurological disorder.

Urinalysis

Examination of the urine might identify health problems connected with overactive bladder, including the following:

•   Bacteriuria-presence of bacteria in urine; indicates infection
•   Glycosuria-excess glucose within urine; may indicate diabetes
•   Hematuria-blood in urine; may indicate kidney disease
•   Proteinuria-excess protein within urine; might point to kidney disease, cardiac disease, blood disease
•   Pyuria-presence of pus in urine; suggests infection

Specialized Testing

If overactive bladder continues on after diagnosis and treatment, further testing may be required. Urologists perform urodynamic, endoscopic, and imaging tests to obtain a more extensive evaluation of the lower urinary tract to figure out a new treatment plan.

Postvoid Residual Volume (PRV)

This procedure requires catheterization or pelvic ultrasound. The patient voids right before the PRV is measured. This initial void is observed for hesitancy, straining, or interrupted flow. A PRV lower than 50 mL indicates adequate bladder emptying. Recurring measurements of 100 to 200 mL or higher represent inadequate bladder emptying. The clinical setting and the individual's readiness to void might affect the test result; therefore, repeated measurements may be necessary.

Urodynamic Testing

Cystometry might be used to appraise the anatomic and functional status of the bladder and urethra. The cystometer is an instrument that measures the pressure and capacity of the bladder; thus evaluating the function of the detrusor muscle. Simple cystometry detects unusual detrusor compliance, but abdominal pressure isn't included and the results need to be evaluated with caution.

The multichannel, or subtracted, cystometrogram concurrently measures intra-abdominal, total bladder, and true detrusor pressures. This allows involuntary detrusor contractions to be differentiated from increased intra-abdominal pressure. The voiding cystometrogram registers outlet obstruction in patients who are able to void.

Uroflowmetry identifies unusual voiding patterns. Urethral pressure profilometry measures the resting and dynamic pressures within the urethra.

Endoscopic Tests

Cystoscopy may be carried out when urodynamic testing fails to duplicate symptoms, when the patient encounters new symptoms (e.g., cystitis, pain), or whenever urinalysis reveals a disease process (e.g., henaturia, pyuria). Cystoscopy identifies the presence of bladder lesions (e.g., cysts) and foreign bodies (e.g., stones).

Imaging Tests

X-rays and ultrasound can be used to evaluate anatomic conditions connected with overactive bladder. Imaging of the lower urinary tract before, during, and after voiding is useful in examining the anatomy of the urinary bladder and urethra.

If you think that you may have overactive bladder and want answers, visit Metropolitan Urological Specialists in St. Louis, MO and schedule an appointment.

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.