Urology

• Prostate surgery
  
  

  What is the prostate?

  The prostate gland is a small, walnut-sized gland in men. It is located below the bladder and surrounds the upper portion of the urethra . The prostate gland lies in front of the rectum , and its posterior surface can be felt during a rectal examination. The function of the prostate is to secrete a fluid that makes up part of the semen. The prostate gland may be a source of many health problems in men, the most common being benign prostatic hyperplasia ( BPH ), prostatitis and cancer.

  What is prostate cancer?

  Prostate cancer is a significant health-care problem due to its high incidence. It is the most common cancer in men . Prostate cancer is different from most cancers in that a large percentage of men may have a silent form of this cancer — it does not cause symptoms or progress beyond the prostate gland. Sometimes this cancer can be small, slow growing and present limited risk to the patient. Clinically important prostate cancers can be defined as those that threaten the well-being or life span of a man.

• Treatment of urinary stones
  
  

  Fortunately, most stones pass out of the body without any intervention. If you are not so lucky, the following information should help you and your doctor address the causes, symptoms and possible complications created by your ureteral stone disease.

  How does the urinary tract work under normal conditions?

  The urinary tract is similar to a plumbing system, with special pipes that allow water and salts to flow through them. The urinary tract includes two kidneys , two ureters and the urethra.

  The kidneys act as a filter system for the blood, cleansing it of poisonous materials and retaining valuable glucose, salts and minerals. Urine, the waste product of the filtration, is produced in the kidney and trickles down hours a day through two 10- to 12-inch long tubes called ureters, which connect the kidneys to the bladder. The ureters are about one-fourth inch in diameter and their muscular walls contract to make waves of movement to force the urine into the bladder. The bladder is expandable and stores the urine until it can be conveniently disposed of. It also closes passageways into the ureters so that urine cannot flow back into the kidneys. The tube through which the urine flows out of the body is called the urethra.

  What is a ureteral stone?

  A ureteral stone is a kidney stone that has moved down into the ureter . The stone begins as a tiny grain of undissolved material located where urine collects in the kidney. When the urine flows out of the kidney, this grain of undissolved material is left behind. The material deposited is usually a mineral called calcium oxalate. Other less common materials that may also form a kidney stone are cystine, calcium phosphate, uric acid and struvite. Over time, more undissolved material is deposited and the stone becomes larger. Most stones enter the ureter when they are still small enough to move down into the bladder. From there, they pass out of the body with urination. Some stones, however, have grown larger by the time they leave the kidney. They may become lodged in a narrow part of the ureter, causing pain and possibly blocking the flow of urine. These stones may need to be treated.

• Treatment of kidney problems

• Impotence & sterility

Male Infertility

Infertility is a common yet complex problem affecting approximately 15 percent of couples attempting to conceive a baby. In up to 50 percent of couples having difficulty getting pregnant, the problem is at least in part related to male reproductive issues. It is essential that men be assessed to pinpoint the treatable or untreatable causes of this heartbreaking health issue. Fortunately, with today's high-tech procedures and powerful drugs, a diagnosis of infertility may simply mean the road to parenthood may be challenging but not impossible. So read below to learn more about the available treatment options so you are better prepared when talking with your urologist and/or fertility specialist.

What causes male infertility?

Your doctor will be interested in any factor, including possible structural and other defects in the reproductive system, hormonal deficiencies, illness or even trauma that might be impairing your fertility. Their investigation will center on many possible combinations of factors, the most common of which are:

Sperm disorders:  Problems with the production and development of sperm are the most common problems of male infertility. Sperm may be underdeveloped, abnormally shaped or unable to move properly. Or, normal sperm may be produced in abnormally low numbers ( oligospermia ) or seemingly not at all ( azoospermia ).

Varicoceles: These dilated scrotal veins are present in 16 percent of all men but are more common in infertile men — 40 percent. They impair sperm development by preventing proper drainage of blood. Varicoceles are easily discovered on physical examination since the veins feel distinctively like a bag of worms. They may also be enlarged and twisted enough to be visible in the scrotum . This is the most common correctable cause of male infertility.

Retrograde ejaculation: Caused by the failure of nerves and muscles in the bladder neck or the opening into the urethra to close during orgasm, retrograde ejaculation occurs when semen pushes backwards into the bladder instead of out the penis. It is one of several difficulties couples may have delivering sperm to the vagina during intercourse. Retrograde ejaculation can be caused by previous surgery, medications or diseases affecting the nervous system. Signs of this condition may include cloudy urine after ejaculation and diminished or "dry" ejaculation with orgasm.

Immunologic infertility: Triggered by a man's immunologic response to his own sperm, antibodies are usually the product of injury, surgery or infection. In attacking the sperm, they prevent normal movement and function of the sperm. Although researchers do not yet understand just exactly how antibodies damage fertility, they know that these antibodies can make it more difficult for sperm to swim to the uterus and penetrate eggs.

Obstruction: Blocking sperm from its normal passage, obstructions can be caused by a number of factors, including repeated infections prior surgery, inflammation or other development problems. Any portion of the male reproductive tract, such as the vas deferens or epididymis , can be obstructed, preventing normal transport of sperm from the testes to the urethra, where it leaves the body during ejaculation.

Hormones: Responsible for stimulating the testicles to make sperm, pituitary gland hormones play a pivotal role in fertility. Therefore, when levels are severely low, poor sperm development can result.

Genetics: Genetics plays a central role in fertility, particularly since sperm carry half of the DNA mix to your partner's egg. Abnormalities in chromosomal numbers and structure as well as deletions on the important Y chromosome present in normal males can also impact fertility.

Medication: Certain medications can affect sperm production, function and ejaculation . Such medications are usually prescribed to treat conditions like arthritis, depression, digestive problems, infections, hypertension and even cancer.