Here you will find a list of common Urologic Treatments.  Click the Tabs to find out more.

Prostate Cancer

Prostate Cancer

The prostate is the gland below a man’s bladder that produces fluid for semen. Prostate cancer is common among older men. It is rare in men younger than 40. Risk factors for developing prostate cancer include being over 65 years of age, family history, being African-American, and some genetic changes.

Symptoms of prostate cancer may include

Problems passing urine, such as pain, difficulty starting or stopping the stream, or dribbling
Low back pain
Pain with ejaculation
Your doctor will diagnose prostate cancer by feeling the prostate through the wall of the rectum or doing a blood test for prostate-specific antigen (PSA). Other tests include ultrasound, x-rays, or a biopsy.

Treatment often depends on the stage of the cancer. How fast the cancer grows and how different it is from surrounding tissue helps determine the stage. Men with prostate cancer have many treatment options. The treatment that’s best for one man may not be best for another. The options include watchful waiting, surgery, radiation therapy, hormone therapy, and chemotherapy. You may have a combination of treatments.

Bladder Cancer

Bladder Cancer

The bladder is a hollow organ in your lower abdomen that stores urine. Bladder cancer occurs in the lining of the bladder. It is the sixth most common type of cancer in the United States.

Symptoms include:

Blood in your urine
A frequent urge to urinate
Pain when you urinate
Low back pain
Smoking is a major risk factor for bladder cancer. Exposure to certain chemicals in the workplace is another. People with a family history of bladder cancer or who are older, white or male have a higher risk.

Treatments for bladder cancer include surgery, radiation, chemotherapy and biologic therapy. Biologic therapy, or immunotherapy, boosts your body’s own ability to fight cancer.

Urinary Incontinence

Urinary Incontinence

Also called: Overactive bladder

Urinary incontinence is loss of bladder control. Symptoms can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age.

Most bladder control problems happen when muscles are too weak or too active. If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh or lift a heavy object. This is stress incontinence. If bladder muscles become too active, you may feel a strong urge to go to the bathroom when you have little urine in your bladder. This is urge incontinence or overactive bladder. There are other causes of incontinence, such as prostate problems and nerve damage.

Treatment depends on the type of problem you have and what best fits your lifestyle. It may include simple exercises, medicines, special devices or procedures prescribed by your doctor, or surgery.

Kidney Stones

Kidney Stones

Also called: Nephrolithiasis

A kidney stone is a solid piece of material that forms in the kidney from substances in the urine. It may be as small as a grain of sand or as large as a pearl. Most kidney stones pass out of the body without help from a doctor. But sometimes a stone will not go away. It may get stuck in the urinary tract, block the flow of urine and cause great pain.

The following may be signs of kidney stones that need a doctor’s help:

Extreme pain in your back or side that will not go away
Blood in your urine
Fever and chills
Vomiting
Urine that smells bad or looks cloudy
A burning feeling when you urinate

Kidney Cancer

Kidney Cancer

 

Also called: Hypernephroma, Renal cancer

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and clean your blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes inside your kidneys. It happens most often in people over 40. Risk factors include smoking, having certain genetic conditions and misusing pain medicines for a long time.

Often, kidney cancer doesn’t have early symptoms. However, see your health care provider if you notice

Blood in your urine
A lump in your abdomen
Unexplained weight loss
Pain in your side
Loss of appetite
Treatment depends on your age, your overall health and how advanced the cancer is. It might include surgery, radiation, chemotherapy or biologic therapy. Biologic therapy boosts your body’s own ability to fight cancer.

Benign Prostate Hyperplasia

Benign Prostate Hyperplasia (BPH)

The prostate is a male reproductive gland that produces the fluid that carries sperm during ejaculation. It surrounds the urethra, the tube through which urine passes out of the body.

An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems.

An enlarged prostate is often called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. It is not cancer, and it does not raise your risk for prostate cancer.

Causes
The actual cause of prostate enlargement is unknown. Factors linked to aging and the testicles themselves may play a role in the growth of the gland. Men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH.

Similarly, if the testicles are removed after a man develops BPH, the prostate begins to shrink in size.

Some facts about prostate enlargement:

The likelihood of developing an enlarged prostate increases with age.
BPH is so common that it has been said all men will have an enlarged prostate if they live long enough.
A small amount of prostate enlargement is present in many men over age 40 and more than 90% of men over age 80.
No risk factors have been identified other than having normally functioning testicles.
Symptoms
Less than half of all men with BPH have symptoms of the disease, which include:

Dribbling at the end of urinating
Inability to urinate (urinary retention)
Incomplete emptying of your bladder
Incontinence
Needing to urinate two or more times per night
Pain with urination or bloody urine (these may indicate infection)
Slowed or delayed start of the urinary stream
Straining to urinate
Strong and sudden urge to urinate
Weak urine stream
Exams and Tests
After taking a complete medical history, your doctor will perform a digital rectal exam to feel the prostate gland. The following tests may also be performed:

Urine flow rate
Post-void residual urine test to see how much urine is left in your bladder after urination
Pressure flow studies to measure the pressure in the bladder as you urinate
Urinalysis to check for blood or infection
Urine culture to check for infection
Prostate-specific antigen (PSA) blood test to screen for prostate cancer
Cystoscopy
In addition, you may be asked to complete a form to evaluate the severity of your symptoms and their impact on your daily life. Your score may be compared to past records to determine if the condition is getting worse.

Treatment
The choice of a treatment is based on the severity of your symptoms, the extent to which they affect your daily life, and the presence of any other medical conditions. Treatment options include “watchful waiting,” lifestyle changes, medication, or surgery.

If you are over 60, you are more likely to have symptoms. But many men with an enlarged prostate have only minor symptoms. Self-care steps are often enough to make you feel better.

If you have BPH, you should have a yearly exam to monitor the progression of your symptoms and determine if any changes in treatment are necessary.

SELF-CARE

For mild symptoms:

Urinate when you first get the urge. Also, go to the bathroom when you have the chance, even if you don’t feel a need to urinate.
Avoid alcohol and caffeine, especially after dinner.
Don’t drink a lot of fluid all at once. Spread out fluids throughout the day. Avoid drinking fluids within 2 hours of bedtime.
Try NOT to take over-the-counter cold and sinus medications that contain decongestants or antihistamines. These medications can increase BPH symptoms.
Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms.
Learn and perform Kegel exercises (pelvic strengthening exercises).
Reduce stress. Nervousness and tension can lead to more frequent urination.
MEDICATIONS

Alpha 1-blockers (doxazosin, prazosin, tamsulosin, terazosin, and alfuzosin) are a class of medications also used to treat high blood pressure. These medications relax the muscles of the bladder neck and prostate. This allows easier urination. Most people treated with alpha 1-blocker medication find that it helps their symptoms.
Finasteride and dutasteride lower levels of hormones produced by the prostate, reduce the size of the prostate gland, increase urine flow rate, and decrease symptoms of BPH. It may take 3 to 6 months before you notice much improvement in your symptoms. Potential side effects related to the use of finasteride and dutasteride include decreased sex drive and impotence.
Antibiotics may be prescribed to treat chronic prostatitis (inflammation of the prostate), which may accompany BPH. Some men note relief of their BPH symptoms after a course of antibiotics.
SAW PALMETTO

Many herbs have been tried for treating an enlarged prostate. Saw palmetto has been used by millions of men to ease BPH symptoms and is often recommended as an alternative to medication. Some studies have shown that it helps with symptoms, but there is evidence that this popular herb is no better than a dummy pill in relieving the signs and symptoms of BPH. Further studies are needed. If you use saw palmetto and think it works, ask your doctor if you should still take it.

SURGERY

Prostate surgery may be recommended if you have:

Incontinence
Recurrent blood in the urine
Inability to fully empty the bladder (urinary retention)
Recurrent urinary tract infections
Kidney failure
Bladder stones
The choice of a specific surgical procedure is usually based on the severity of your symptoms and the size and shape of your prostate gland.

Transurethral resection of the prostate (TURP): This is the most common and most proven surgical treatment for BPH. TURP is performed by inserting a scope through the penis and removing the prostate piece by piece.
Transurethral incision of the prostate (TUIP): This procedure is similar to TURP, but is usually performed in men who have a smaller prostate. It is usually performed without the need for a hospital stay. Like TURP, a scope is inserted through the penis until the prostate is reached. Then, rather than removing the prostate, a small incision is made in the prostate tissue to enlarge the opening of the urethra and bladder outlet.
Simple prostatectomy: An open prostatectomy is usually performed using general or spinal anesthesia. An incision is made through the abdomen or perineum (the area behind the scrotum). Only the inner part of the prostate gland is removed. The outer portion is left behind. This is a lengthy procedure, and it usually requires a hospital stay of 5 to 10 days.
Most men who have prostate surgery have improvement in urine flow rates and symptoms. See prostate removal for a description of complications.

Other, less-invasive procedures are available. These use different forms of heat to destroy prostate tissue. None have been proven to be better than TURP. Patients who receive these less-invasive procedures are more likely to need surgery again after 5 or 10 years. However, these procedures may be a choice for:

Younger men (many of the less-invasive procedures carry a lower risk for impotence and incontinence than TURP, although the risk with TURP is not very high)
Elderly patients
Patients with severe medical conditions, including uncontrolled diabetes, cirrhosis, alcoholism, psychosis, and serious lung, kidney, or heart disease
Men who are taking blood-thinning drugs
Another form of treatment is prostatic stents.

Support Groups
See: BPH support groups

Possible Complications
Men who have had long-standing BPH with a gradual increase in symptoms may develop:

Sudden inability to urinate
Urinary tract infections
Urinary stones
Damage to the kidneys
Blood in the urine
Even after surgical treatment, a recurrence of BPH may develop over time.

When to Contact a Medical Professional
Call your doctor right away if you have:

Less urine than usual
Fever or chills
Back, side, or abdominal pain
Blood or pus in your urine
Also call your doctor if:

Your bladder does not feel completely empty after you urinate
You take medications that may cause urinary problems, like diuretics, antihistamines, antidepressants, or sedatives. Do NOT stop or adjust your medications on your own without talking to your doctor
You have taken self-care measures for 2 months without relief
Alternative Names
BPH; Benign prostatic hypertrophy (hyperplasia); Prostate – enlarged

References
Roehrborn CG. Male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Med Clin North Am. 2011 Jan;95(1):87-100.

McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011 May;185(5):1793-803. Epub 2011 Mar 21.

Kirby R, Lepor H. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 87.

Roehrborn CG, McConnell JD. Benign prostatic hyperplasia: etiology, pathophysiology, epidemiology, and natural history. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 86.

Update Date: 9/19/2011
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School.

Low Testosterone

Low Testosterone

The human body functions within a relatively narrow range of normal. When chemicals such as hormones fall outside those normal levels, there can be consequences that affect the body at a cellular, organ, or systemic (body-wide) level.

Blood tests used to measure testosterone are usually performed in the morning. Testosterone sampling is difficult since the levels normally tend to bounce around a fair bit during the course of the day. The normal value for total testosterone in males is 270-1070 ng/dl. However, this depends to some extent on the individual laboratory being used, and the range can vary as a result. In women, there is debate about the accuracy of testosterone measurements, because the circulating values are so much lower than in males and are harder to accurately measure.

With advancing age, in both men and women, the amount of testosterone the body produces gradually falls. Free testosterone levels can be measured and normal levels depend upon an individual’s age. Interestingly, menopause itself does not seem to play a role in a reduction of testosterone levels in women beyond that of advancing age.

What are the causes of low testosterone?

Low testosterone levels may be caused by a number of factors. For example – there may be a problem at the level of the hypothalamus or pituitary to produce appropriate amounts of LH and FSH to stimulate testosterone production. Another possibility is that the organs that make testosterone do not function normally or are not able to respond to stimulation by the brain. Also, as mentioned, changes in SHBG can account for the amount of testosterone that is available to exert its effects.

When the problem is in the organs that produce testosterone (the ovaries or testes, for the most part), it is called a “primary” problem”. In medical terminology, the decrease in normal testosterone production is called “hypogonadism.”
When the problem is related to the pituitary and its ability to regulate testosterone, it is called “secondary hypogonadism,” and
If the problem is thought to be at the level of the hypothalamus, it is called “tertiary hypogonadism.”

Erectile Dysfunction

Erectile Dysfunction

Also called: ED, Impotence

Erectile dysfunction (ED) is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But male sexual dysfunction is not a natural part of aging.

Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don’t see your doctor, these problems will go untreated.

Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight or stopping smoking may also help.

Urinary Retention

Urinary Retention

On this page:
What is the urinary tract?
What causes urinary retention?
What are the symptoms of urinary retention?
How is urinary retention diagnosed?
How is urinary retention treated?
What are the complications of urinary retention?
What are the complications of treatments for urinary retention?
Hope through Research
For More Information
Urinary retention is the inability to empty the bladder. With chronic urinary retention, you may be able to urinate, but you have trouble starting a stream or emptying your bladder completely. You may urinate frequently; you may feel an urgent need to urinate but have little success when you get to the toilet; or you may feel you still have to go after you’ve finished urinating. With acute urinary retention, you can’t urinate at all, even though you have a full bladder. Acute urinary retention is a medical emergency requiring prompt action. Chronic urinary retention may not seem life threatening, but it can lead to serious problems and should also receive attention from a health professional.

Male and female urinary tracts.
Anyone can experience urinary retention, but it is most common in men in their fifties and sixties because of prostate enlargement. A woman may experience urinary retention if her bladder sags or moves out of the normal position, a condition called cystocele. The bladder can also sag or be pulled out of position by a sagging of the lower part of the colon, a condition called rectocele. Some people have urinary retention from rectoceles. People of all ages and both sexes can have nerve disease or nerve damage that interferes with bladder function.
What is the urinary tract?
The urinary tract consists of the organs, tubes, and muscles that work together to make, move, store, and release urine. The upper urinary tract includes the kidneys, which filter wastes and extra fluid from the blood, and the ureters, which carry urine from the kidneys to the bladder. The lower urinary tract includes the bladder, a balloon-shaped muscle that stores urine, and the urethra, a tube that carries urine from the bladder to the outside of the body during urination. If the urinary system is healthy, the bladder can hold up to 16 ounces-2 cups-of urine comfortably for 2 to 5 hours.
Muscles called sphincters squeeze shut the tubes from the bladder to help keep urine from leaking. The sphincter muscles close tightly like a rubber band around the opening of the bladder, which leads into the urethra.
Nerves in the bladder tell you when it is time to urinate. As the bladder first fills with urine, you may notice a feeling that you need to go. The sensation to urinate becomes stronger as the bladder continues to fill. As it reaches its limit, nerves from the bladder send a message to the brain that the bladder is full and the urge to empty your bladder intensifies.
When you urinate, the brain signals the bladder muscle to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax. As these muscles relax, urine exits the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs.
What causes urinary retention?
Urinary retention can be caused by an obstruction in the urinary tract or by nerve problems that interfere with signals between the brain and the bladder. If the nerves aren’t working properly, the brain may not get the message that the bladder is full. Even if you know that your bladder is full, the bladder muscle that squeezes urine out may not get the signal that it is time to push, or the sphincter muscles may not get the signal that it is time to relax. A weak bladder muscle can also cause retention.
Nerve Disease or Spinal Cord Injury
Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are
vaginal childbirth
infections of the brain or spinal cord
diabetes
stroke
accidents that injure the brain or spinal cord
multiple sclerosis
heavy metal poisoning
pelvic injury or trauma
In addition, some children are born with nerve problems that can keep the bladder from releasing urine.
Prostate Enlargement: Benign Prostatic Hyperplasia
As a man ages, his prostate gland may enlarge. Doctors call the condition benign prostatic hyperplasia (BPH), or benign prostatic hypertrophy.
As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. As a result, the bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so urine remains in the bladder.
Infection
Infections cause swelling and irritation, or inflammation. A urinary tract infection (UTI) may cause retention if the urethra becomes inflamed and swells shut.
Surgery
During surgery, anesthesia is often administered to block pain signals, and fluid is given intravenously to compensate for possible blood loss. The combination may result in a full bladder with impaired nerve function. Consequently, many patients have urinary retention after surgery.
Medication
Many medicines work by calming overactive nerve signals. Various classes of drugs that block various signals may be used to treat allergies, stomach cramps, muscle spasms, anxiety, or depression. Some medicines are used to treat urinary incontinence and overactive bladder. The drugs that may cause urinary retention include
antihistamines to treat allergies
fexofenadine (Allegra)
diphenhydramine (Benadryl)
chlorpheniramine (Chlor-Trimeton)
cetirizine (Zyrtec)

anticholinergics/antispasmodics to treat stomach cramps, muscle spasms, and urinary incontinence
hyoscyamine (Levbid, Cystospaz, Anaspaz, Gastrosed)
oxybutynin (Ditropan, Ditropan XL, Oxytrol)
tolterodine (Detrol, Detrol LA)
propantheline (Pro-Banthine)

tricyclic antidepressants to treat anxiety and depression
imipramine (Tofranil)
amitriptyline (Elavil, Endep)
nortriptyline (Aventyl, Pamelor)
doxepin (Novo-Doxepin, Sinequan)
Bladder Stone
A stone formed anywhere in the urinary tract may become lodged in the bladder. If the stone is large enough, it can block the opening to the urethra like a bathtub plug.
Cystocele and Rectocele
A cystocele occurs when the wall between a woman’s bladder and her vagina weakens and allows the bladder to droop into the vagina. The abnormal position of the bladder may cause urine to remain trapped. In a rectocele, the rectum droops into the back wall of the vagina. Cystocele and rectocele are often the results of a dropping of the pelvic support floor for the bladder. This sagging can pull the bladder out of position and cause urinary problems such as incontinence or urinary retention.
Constipation
A hard stool in the rectum may push against the bladder and urethra, causing the urethra to be pinched shut, especially if a rectocele is present.
Urethral Stricture
A stricture is a narrowing or closure of a tube. Men may have a narrowing of the urethra, usually caused by scarring after a trauma to the penis. Infection is a less common cause of scarring and closure in the urethra.
What are the symptoms of urinary retention?
Acute urinary retention causes great discomfort, and even pain. You feel an urgent need to urinate but you simply can’t. The lower belly is bloated.
Chronic urinary retention, by comparison, causes mild but constant discomfort. You have difficulty starting a stream of urine. Once started, the flow is weak. You may need to go frequently, and once you finish, you still feel the need to urinate. You may dribble between trips to the toilet because your bladder is constantly full, a condition called overflow incontinence.
How is urinary retention diagnosed?
Your doctor will order a number of tests to diagnose your condition.
History of Complaints and Physical Examination
A physician will suspect urinary retention by your symptoms and will attempt to confirm the diagnosis with a physical examination of the lower abdomen. The physician may be able to feel the distended bladder by lightly tapping on your lower belly. Tapping or striking for diagnostic purposes is called percussing.
Urine Sample
A urine sample will be examined for signs of infection, which may be a cause or a result of urinary retention.
Bladder Scan
A bladder scan uses a portable ultrasound device that can determine how much urine is in your bladder. You will be asked to urinate, and then your doctor or nurse will use the bladder scan to determine the post-void residual (PVR). The word residual refers to the amount of urine left in the bladder after urination. If you typically have a PVR of 100 milliliters or more, you are considered to have chronic urinary retention.
Cystoscopy
Your doctor may use a cystoscope to see inside your bladder and urethra. The cystoscope has lenses like a telescope or microscope. These lenses let the doctor focus on the inner surfaces of the urinary tract.
Some cystoscopes use optical fibers made of flexible glass that carry an image from the tip of the instrument to a viewing piece at the other end. The fiber-optic cystoscope is as thin as a pencil and has a light at the tip. The doctor can use the cystoscope to find and perhaps remove a stone that may be blocking the bladder opening. The device can help the doctor identify narrowing of the urethra from prostate enlargement or UTI.
X Ray and Computerized Tomography (CT) Scan
A conventional x ray may show a spot where the urinary tract is narrowed or obstructed. It may show that the bladder is out of its normal position. CT scans use multiple x-ray images to construct a better view of internal organs, which may help find stones or other obstructions.
Blood Test for Prostate-specific Antigen (PSA)
Men may be given a blood test to measure their PSA, a substance in the blood that may indicate prostate cancer or other prostate problems. A high PSA score may prompt further tests, such as a transrectal ultrasound, with or without biopsy of the prostate.
Prostate Fluid Sample
The doctor may ask for a prostate fluid sample to check for prostatitis-inflammation of the prostate-a condition that can cause the prostate to swell and pinch the urethra. The doctor will obtain the sample by inserting a gloved finger into the rectum and massaging the prostate until fluid drains through the urethra. A doctor will not massage a prostate for prostatic fluid if urinary retention is suspected as the primary diagnosis. Only when urinary retention is ruled out would the doctor do this test.
Urodynamic Tests
Urodynamic tests include different techniques to measure the bladder’s ability to empty steadily and completely. In a pressure flow study, you will be asked to empty your bladder so that a special catheter can measure the pressure required to start a stream. This pressure flow study helps to identify bladder outlet obstruction from prostate enlargement or cystocele.
If your doctor or nurse thinks your urinary problem is related to nerve damage, you may be given an electromyography. This test measures the muscle activity in the urethral sphincter using sensors placed on the skin near the urethra and rectum. Sometimes the sensors are on the urethral or rectal catheter. A catheter is a thin, flexible tube that can be guided into openings of the body. Muscle activity is recorded on a machine. The patterns of the impulses will show whether the messages sent to the bladder and urethra are coordinated correctly.
How is urinary retention treated?
Catheterization
With acute urinary retention, treatment begins with the insertion of a catheter through the urethra to drain the bladder. This initial treatment relieves the immediate distress of a full bladder and prevents permanent bladder damage. Long-term treatment for any case of urinary retention depends on the cause.
The cause of acute urinary retention may be temporary. For example, if you have retention after surgery, you will probably regain your ability to urinate after the effects of the anesthesia wear off. In such cases, you may need to have a catheter inserted once or twice with no other treatment required after you have shown you can urinate on your own.
If you have chronic urinary retention, or if acute retention appears to become chronic, further treatment will be necessary. You may need to continue using a catheter if other options do not work for you. You may be taught to catheterize yourself as needed. You will need to learn sterile technique to avoid UTIs.
Treatments to Relieve Prostate Enlargement
The treatments for prostate enlargement range from medication to surgery. For more information, see the fact sheet Prostate Enlargement: Benign Prostatic Hyperplasia from the National Kidney and Urologic Diseases Information Clearinghouse.
Surgery for Women with Cystocele or Rectocele
Women may need surgery to lift a fallen bladder or rectum. The most common procedure for cystocele and rectocele repair is for the surgeon to make an incision in the wall of the vagina to find the defect or hole in the membrane-a wall of tissue called fascia-that normally separates the vagina from the other pelvic organs. The surgeon places sutures in the fascia to close up the defect, then closes the incision in the vaginal wall with more stitches, removing any excess tissue. These suturing steps tighten the layers of tissue that separate the organs, creating more support for the pelvic organs.
Treatments for Men with Urethral Stricture
If a man is diagnosed with urethral stricture, a doctor can perform a procedure called dilation, in which increasingly wider tubes are inserted into the urethra to widen the stricture. An alternate method is to inflate a small balloon at the end of a catheter inside the urethra.
A surgeon can repair a stricture by performing an internal urethrotomy. The surgeon advances a catheter up to the stricture and uses a knife or laser to make an incision that opens the stricture.
Another treatment for urethral stricture in men is placement of a wire mesh tube, called a stent, to keep the passage open.
What are the complications of urinary retention?
Urinary Tract Infection
Urine is normally sterile, and the normal flow of urine usually prevents bacteria from growing in the urinary tract. When urine stays in the bladder, however, bacteria have a chance to grow and infect the urinary tract.
Bladder Damage
If the bladder becomes stretched too far or for long periods, the muscle may be permanently damaged and lose its ability to contract.
Chronic Kidney Disease
If urine backs up into the kidneys, permanent kidney damage can lead to reduced kidney function and chronic kidney disease. If you lose too much of your kidney function, you will need dialysis or a kidney transplant to stay alive.
What are the complications of treatments for urinary retention?
UTI from Catheter Use
Placement of a urinary catheter provides an opportunity for bacteria to enter the urinary tract. Bacteria may come from the patient’s anus and perineum or from the health worker’s hands. Health workers must take great care, using sterile technique, when placing a catheter. If you are performing clean intermittent catheterization, you must follow the same sterile procedures every time you handle the catheter.
Incontinence and Erectile Dysfunction After Prostate Surgery
Transurethral surgery to treat an enlarged prostate may result in loss of bladder control or erection problems in some men. These problems are usually temporary. Most men recover their bladder control in a few weeks or months, and most recover their sexual function within 1 year after the operation.
Hope through Research
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has many research programs aimed at finding and improving treatments for urinary disorders. Researchers supported by the NIDDK are working to develop methods for preventing UTIs in patients who must use urinary catheters. One team of researchers is developing a catheter that gradually releases an antiseptic agent while it stays in the urinary tract. Another team is studying the use of benign bacteria on a catheter to inhibit the growth of disease-causing bacteria.
The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.
For More Information
American Urological Association Foundation
1000 Corporate Boulevard
Linthicum, MD 21090
Phone: 1–800–828–7866 or 410–689–3700
Fax: 410–689–3998
Email: auafoundation@auafoundation.org
Internet: www.UrologyHealth.org
Society of Urologic Nurses and Associates
P.O. Box 56
East Holly Avenue
Pitman, NJ 08071-0056
Phone: 1-888-TAP-SUNA (827-7862) or 856-256-2335
Email: suna@ajj.com
Internet: www.suna.org
You may also find additional information about this topic by visiting MedlinePlus at www.medlineplus.gov.
This publication may contain information about medications. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.gov. Consult your doctor for more information.
National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way
Bethesda, MD 20892–3580
Phone: 1–800–891–5390
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nkudic@info.niddk.nih.gov
Internet: www.kidney.niddk.nih.gov
The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1987, the Clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. The NKUDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases.
Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This publication was reviewed by J. Curtis Nickel, M.D., Queen’s University at Kingston, Ontario.
This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.
NIH Publication No. 08-6089
October 2007

UTI’s

UTI’s – Urinary Tract Infections

The urinary system consists of the kidneys, ureters, bladder and urethra. Infections of the urinary tract (UTIs) are the second most common type of infection in the body. You may have a UTI if you notice

Pain or burning when you use the bathroom
Fever, tiredness or shakiness
An urge to use the bathroom often
Pressure in your lower belly
Urine that smells bad or looks cloudy or reddish
Less frequently, nausea or back pain
If you think you have a UTI, it is important to see your doctor. Your doctor can tell if you have a UTI by testing a sample of your urine. Treatment with medicines to kill the infection will make it better, often in one or two days.

Prostate Problems

Prostate Problems

For men under 50, the most common prostate problem is prostatitis.
For men over 50, the most common prostate problem is prostate enlargement. This condition is also called benign prostatic hyperplasia (BPH). Older men are at risk for prostate cancer as well, but this disease is much less common than BPH. More information about prostate cancer is available from the National Cancer Institute.

For younger men, the most common prostate problem is prostatitis. For older men, it’s an enlarged prostate.

What is prostatitis?
Prostatitis means the prostate might be inflamed or irritated. If you have prostatitis, you may have a burning feeling when you urinate, or you may have to urinate more often. Or you may have a fever or just feel tired.
Inflammation in any part of the body is usually a sign that the body is fighting germs or repairing an injury. Some kinds of prostatitis are caused by bacteria, tiny organisms that can cause infection or disease. If you have bacterial prostatitis, your doctor can look through a microscope and find bacteria in a sample of your urine. Your doctor can then give you an antibiotic, a medicine that kills bacteria.

If you have bacterial prostatitis, your doctor can look through a microscope and find bacteria in a sample of your urine.
Most of the time, doctors don’t find any bacteria in men with prostatitis. If you have urinary problems, the doctor will look for other possible causes, such as a kidney stone or cancer.
If no other causes are found, the doctor may decide you have a condition called nonbacterial prostatitis.
You may have to work with your doctor to find a treatment that’s right for you. Changing your diet or taking warm baths may help. Your doctor may give you a medicine called an alpha-blocker to relax the muscle tissue in the prostate. No single solution works for everyone with this condition.

Work with your doctor to find a treatment that’s right for you.