5 Things You Should Know About Urologic Problems

By Ernst Lamothe Jr.

Physician David Gentile is an associate professor of clinical urology and chief of the division of urology at Highland Hospital.
Physician David Gentile is an associate professor of clinical urology and chief of the division of urology at Highland Hospital.

Problems with your urinary tract, reproductive system or genitals are often both physically and emotionally difficult. Urologists specialize in providing advanced, minimally invasive treatments for a wide range of urologic conditions, including prostate cancer, bladder cancer, urinary tract infection and erectile dysfunction.

“Three of the top 10 forms of cancers deal with conditions that you would see a urologist for,” said physician David Gentile, an associate professor of clinical urology and chief of the division of urology at Highland Hospital.

Urologists also are committed to preserving your urinary and sexual function, which are often affected by these disorders. Gentile, who is certified by the American Board of Urology, discusses five types of urologic issues that affect men.

1. Enlarged prostate

As a man ages, his prostate which is the tube that carries urine from the bladder out through the penis may become larger and start to cause frequent or painful urination. Benign prostatic hyperplasia is a common urological condition caused by the non-cancerous enlargement of the prostate gland in aging men. According to the Centers for Disease Control and Prevention, the condition affects 50 percent of men over the age of 50 and up to 90 percent of men age 80 or older.

“Some of the symptoms are a weak stream and having to get up and use the bathroom continuously at night,” said Gentile. “This is something that happens later in life, and there are a lot of treatments ranging from medication to non-invasive surgical procedures.”

Men should see their urologists if blood is seen in the urine or if there is pain or burning with urination. Evaluation with a qualified urologist will include a physical exam, a urinalysis test, and a thorough medical history. Cystoscopy allows the urologist to look directly in the urethra and/or bladder using a small flexible scope. Treatment options include pharmaceutical options and other possibilities, and your urologist can provide an appropriate course of action.

2. Stone disease

Stone disease is a painful and common condition that affects more than 5 percent of all adults in the US, according to the National Kidney Foundation. It’s estimated that nearly 2 million patients visit their doctors or local emergency rooms because of kidney stones every year. Stone passage produces renal colic that usually begins as a mild discomfort and progresses to a plateau of extreme severity over 30–60 minutes.

“It occurs more often in warmer climate that likely leads to increased sweating,” said Gentile. “Often the stones just pass on their own, but there is also technology using a shock wave machine where a patient lays down on the table and a device is placed against their back and waves are created from the outside to focus on particular stones.”

The procedure is performed under sedation or general anesthesia.

3. Urinary incontinence

There are different types of urinary incontinence in men, including stress incontinence, urge incontinence and overflow incontinence. Some men may have one, two or all three types of incontinence Diagnosis of urinary incontinence in men will involve a medical history and physical exam, and may include keeping a bladder diary. It may also include an ultrasound and urodynamic testing.

“Even though this condition is mostly associated with women, men can be affected as well. It can be a situation where simply laughing, coughing or picking up something heavy can cause urine to come out,” added Gentile.

4. Erectile dysfunction

Erectile dysfunction symptoms might include persistent trouble getting an erection, trouble keeping an erection or reduced sexual desire. Because male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessel, erectile dysfunction can result from a problem with any of these.

“While this can affect a very large portion of people as they get older, there are many types of solutions from oral medication that we have seen advertised in the market like Viagra or Cialis to surgical options,” he said.

5. Infertility

Ten to 15 percent of couples in the United States are infertile. Infertility is defined as not being able to get pregnant. For men, it could be a combination of hormonal balance or issues with blood vessels in the testicles.

“There are some men who have undergone treatment and surgery to repair some of the damages. If you have tried to get pregnant without success, I would recommend first talking to an urologist as well as having a semen analysis. The analysis will check for sperm count, how your sperm moves and look for possible infections.”

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