Erectile dysfunction
Incontinence
Urinary tract infection
Prostatitis
Benign Prostatic hyperplasia (BPH)
Peyronie’s disease
Kidney stones
Kidney cancer
Testicular cancer
Bladder cancer
Prostate cancer
Urethral stricture
Overactive bladder
Prolapsed uterus
Vaginal dryness
Erectile dysfunction
Erectile dysfunction, aka impotence, ED, is the inability to obtain or maintain an erection during sexual activity.
Medical causes of erectile dysfunction include vascular disease, neurological problem, hormonal insufficiency and drug side effects.
In order to get an erection blood enters into a cavity within the penis and fills it up causing it to become hard and increase in size. When there is compromised blood flow in vascular disease, the blood cannot fill the penis to enlarge and harden it. Vascular disease can be caused by many things. The most common causes are diabetes, hypertension, high cholesterol, and smoking. Older patients are more likely to have vascular disease causing ED.
Side effects of medication can prevent the ability to get an erection. The most common types of medication with these side effects are antidepressants, specifically SSRI drugs. Nicotine is also a drug that can cause ED.
Neurological problems can cause ED. The most common neurological problems leading to ED include complications of chronic disease like peripheral neuropathy, trauma, and surgical injury and complication. Peripheral neuropathy due to diabetes is the most common cause of neurological impotence.
Localized disorders of the penis can also cause ED. The most common type is Peyronie’s disease.
Phycological impotence occurs when erection or penetration fail due to feelings or thoughts rather than medical reasons. Psychological erectile dysfunction is treated with psychotherapy and drug therapy.
Incontinence
Urinary incontinence is defined as any leakage of urine. There are four main types of incontinence. Urge incontinence is due to an overactive bladder. Stress incontinence is due to poor closure of the bladder. Overflow incontinence is due to poor bladder contraction or blockage of the urethra. Functional incontinence is due to underlying medical problems or side effect of medications that make it difficult to reach the bathroom in time.
Anatomy of the urinary tract includes the bladder with is a balloon like organ that stores the urine that is produced by the kidneys. The urethra is the tube that allows urine to exit the body. In order to remain continent, the sphincter muscle closes the urethra with more force than the force of the urine trying to exit the bladder, called bladder pressure. As a result, urine remains in the bladder.
In order to urinate a person relaxes the sphincter muscle and contracts the detrusor muscle squeezing the bladder such that the bladder pressure exceeds the sphincter pressure, and urine exits the body.
In incontinence, the person has the inability to maintain sphincter tightness greater than bladder pressure and urine exits the body involuntarily.
Urinary tract infection
Urinary tract infection (aka “UTI”) is a condition in which there is an infection of the anatomy that make up the urinary tract. The infection can affect the kidneys, ureter, bladder and urethra.
Symptoms of UTI include pain with urination, frequent urination, feeling the need to urinate despite having an empty bladder, fever, abdominal and pelvic pain, blood in the urine, and flank pain in the kidney.
Many different bacteria or fungi can cause UTI but the most common cause is E. Coli. Risk factors for UTI include sexual activity, diabetes, obesity, family history, immunocompromise, and poor hygiene. Bacteria or fungi can enter the urinary tract externally through the urethra or internally from a blood borne infection.
Prostatitis
Prostatitis is an inflammation of the prostate gland. There are five classifications of prostatitis including acute, chronic bacterial, asymptomatic, inflammatory and chronic pelvic pain syndrome. Acute prostatitis is caused by an infection of the prostate gland. Chronic bacterial prostatitis is caused by intermittent urinary tract infections. Asymptomatic prostatitis is classified as inflammation of the prostate gland without any symptoms. It is diagnosed by an elevated white blood cell count or pus in the semen. Chronic pelvic pain syndrome is a chronic inflammation of the prostate gland in the absence of a UTI.
Benign Prostatic hyperplasia (BPH)
A benign enlarged prostate is a noncancerous increase in the size of the prostate gland due to hyperplasia. Hyperplasia is defined as an increase in the number of cells, versus hypertrophy, which is an increase in the size of cells.
The function of the prostate gland is to secrete fluid into the ejaculate that is alkaline. It constitutes about 30% of the ejaculate volume. The alkalinity helps neutralize the acidity of the vaginal tract to protect the sperm.
The prostate gland surrounds the urethra, the tube that carries urine from the bladder to the outside of the body and also the ejaculate out of the body. When the prostate gets sufficiently large, it pushes one the urethra causing narrowing. The creates a partial obstruction and increased resistance of urine flow.
Symptoms of BPH include need to urinate frequently, urine urgency whereas you feel the need to urinate even after the bladder is empty, involuntary nocturnal urination, urine leakage, delay in urination, non-continuous urination, weak urine stream, feeling of incomplete void, leakage at the end of urination and inability to urinate.
Causes of BPH are not completely know but experts have shown that male hormones known as androgens play a permissive role in the enlargement of the prostate. Studies have also shown that diet plays a role in BPH with men that consume more animal protein are more likely to develop it. Hyperplasia is an age-related disease whereas normal cellular turnover results in enlargement over time.
Peyronie’s disease
Peyronie’s disease is a problem of the penis that is caused by scar tissue that forms inside the penis. It often makes the penis bend upward or to a side.
The exact cause of Peyronie’s disease is not exactly known, but it is commonly thought to be caused by scar tissue, called a plaque, forming after hitting or bending of the penis that may be very minor and not even noticed. The trauma causes minor bleeding within the penis tissue. Experts also speculate that it is genetically linked as well.
Symptoms of Peyronie’s disease include bending or curvature of the penis and hardening of the soft tissues when erect. The hardened plaque decreases flexibility can cause localized pain. Usually symptoms are not present in the flaccid penis, however, with severe cases hardening can be noticeable.
Kidney stones
Kidney stones (aka urolithiasis) are hard, crystalline salt and mineral deposits that accumulate within the kidney or urinary tract. They occur when a solid piece of material forms due to a decrease in urine volume and an excess of stone forming minerals within the urine.
Symptoms of kidney stones include pain that is often severe that can occur in the flank, groin, pelvis, abdomen and inner thigh. Pain can be intermittent or constant. Additional symptoms include urinary urgency, increased frequency of urination, painful urination, blood in the urine, sweating, nausea, and vomiting. Kidney stones that remain in the kidney are often asymptomatic and non-painful. They become painful when they travel through the ureters.
The most common cause of kidney stones is dehydration due to not drinking enough water. There is a congenital predisposition to get kidney stones as they tend to be hereditary. Systemic diseases such as endocrine disorders can cause an imbalance of water, salts and minerals in the kidney that leads to accumulation of stones. Diet and liquid consumption play a role in the salts and mineral in the urine as well.
Kidney cancer
Also called renal cancer, cancer of the kidney is a disease in which the normal kidney cells become malignant and grow out of control to form a tumor.
The two most common types of kidney cancer are renal cell carcinoma and transitional cell carcinoma. There are many other types of kidney cancers that are less prevalent. Almost all types of kidney cancer are renal cell carcinomas. This cancer first appears in the lining of the kidney tubules. The Tubules are the small tubes that transport the urine. Transition cell carcinoma is cancer that forms in the transitional epithelium which is the tissue that lines the inner surface of the kidney.
Symptoms of kidney cancer include a mass in the abdomen, pain in the abdomen, blood in the urine, systemic symptoms such as loss of appetite, tiredness, weight loss, fever, and sweating.
Risk factors and causes of kidney cancer include smoking, long term use of NSIADs and other medications, obesity, genetic predisposition, family history, use of dialysis, hepatitis, and other chronic kidney disease.
Testicular cancer
Testicular cancer is most often a disease of young men that originates in the testicles. It is a disease in which the normal testicular cells become malignant and grow out of control to form a tumor.
Self examination is critical for all men. This is most effective during a warm shower. Symptoms of testicular cancer include a lump in the testicle, swelling of the testicle, pain in the testicle, abdominal pain, a heavy feeling in the testicle, male breast enlargement, and low back pain.
Risk factors and causes include undescended testicle, abnormal development of the testicle, Klinefelter syndrome (multiple X chromosomes), and previous diagnosis of cancer.
The testis almost invariably needs to be removed in its entirety when cancer is present. Exam and ultrasound of scrotum are both critical in the urologist’s decision to recommend removal of the testis. Thankfully, Huge strides have been made of late in the treatment and cure of testicular cancer.
Bladder cancer
Bladder cancer is cancer that originates in the bladder. It is a disease in which the normal bladder cells become malignant and grow out of control to form a tumor.
The most common types of bladder cancer are transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma.
Symptoms of bladder cancer include blood in the urine, low back pain, frequent urination, and painful urination.
Bladder removal is sometimes necessary but most cases can be treated more conservatively where the bladder is spared. Once bladder cancer is found, patients need to be educated about the disease. Smoking must be curtailed.
Bladder cancer patients are cautioned that the entire lining of their urinary tract has an impairment. This requires periodic imaging, endoscopic exams and specialized studies of their urine, periodically.
Risk factors and causes include smoking, family history, prior radiation therapy, frequent bladder infections, obesity, and environmental exposure to certain chemicals.
Prostate cancer
Prostate cancer is cancer that originates in the prostate gland. It is a disease in which the normal prostate cells become malignant and grow out of control to form a tumor.
Usually, prostate cancer starts off with no symptoms. In the later stages, symptoms of prostate cancer include difficulty urinating, nocturnal urination, inability to urinate, blood in the urine, pelvis pain, back pain, pain with urinating, and abdominal pain.
Risk factors and causes of prostate cancer include obesity, age, family history, and congenital predisposition.
Urethral stricture
Urethral stricture is a narrowing of the urethra. The urethra is the tube that connects the bladder to the outside and allows for urination.
The most common symptom of urinary stricture is weak urine stream. Other symptoms include urinary frequency, urinary urgency, straining to urinate, pain with urination, prostatitis and inability to completely empty the bladder.
The most common cause of urethral stricture is as a result of injury. Other causes include infection, non-infectious inflammatory conditions of the urethra, prior surgery, and cancer.
Overactive bladder
Overactive bladder is condition whereas there is a frequent feeling of the need to urinate. It can occur during the day or night, or both. Often, it leads to urinary incontinence and can negatively affect one’s life.
The cause of overactive bladder is unknown. Risk factors include obesity, caffeine, constipation, diabetes, and neurological problems.
Symptoms of overactive bladder include urinary urgency, increase urinary frequency, nocturnal urination, urge incontinence, and painful urination.
Prolapsed uterus
Prolapsed uterus is a condition whereas the uterus slips down into, or protrudes out of the vagina.
Uterine prolapse occurs when the pelvic floor muscles and ligaments weaken and stretch and are unable to provide support for the uterus. As a result, the uterus falls down into the vagina.
Prolapsed uterus occurs most often in woman that are postmenopausal and have had one or more vaginal childbirths. Other risk factors include chronic increased intrabdominal pressure from lifting, coughing, straining, and damage to the pelvic muscles and connective tissues.
Mild prolapsed uterus often does not present with many symptoms, however, the more the uterus falls, the more likely there will be significant discomfort and pain.
Vaginal dryness
Vaginal dryness is often a symptom of vaginal atrophy that occurs in women after menopause. The vaginal tissues become thinner and easily irritated.
Causes of vaginal atrophy include the natural decrease in estrogen in the body after menopause. Insufficient stimulation or excitement that can occur after menopause due to hormonal changes can lead to vaginal dryness. Other causes of vaginal dryness include side effects of certain medications, pregnancy, lactation, diabetes and other systemic diseases.