Interesting Prostate Problems

Interesting Prostate Problems

What is the Prostate ?

The prostate is a gland located in the lower urinary tract, under the bladder, and around the urethra. Only men have a prostate. It produces the fluid which carries semen. The prostate has smooth muscles which help to push out the semen during ejaculation.

A normal prostate is about the size of a large walnut and has a volume of 20 milliliters. The prostate slowly grows as men grow older.

2 main diseases affect the prostate

  • Prostate cancer
  • Benign prostate hyperplasia

One is independent of the other and they can both coexist in the same patient.

Prostate Cancer

Prostate cancer is a malignant tumor in the prostate. The treatment and experience depend on the specific characteristics of the tumor and the expertise of your medical team. Most prostate cancers develop slowly and do not cause symptoms. Fast-growing prostate cancer is less common. The risk of getting prostate cancer increases with age. This is why some authorities recommend screening after the age of 50 and sometimes at younger ages specially in the presence of positive family history. Prostate cancer is the most common cancer in elderly men in Europe. The survival rate for prostate cancer is relatively high and is still going up with the help of advanced technology.

Treatment of Prostate Cancer

If the cancer is still limited to the prostate, surgical removal of the prostate or radiotherapy carries high chances of curing the patient.

With the help of cutting edge technology, like robotic surgery, the removal of the prostate had become a routine quick surgery with outstanding functional outcomes. Meaning, early recovery and return to daily activities. Very high continence rates and preservation of erection when possible depending on the type of tumor.

The expertise of the team performing this surgery and the technology being used is in direct relation with the outcomes and patient satisfaction. When done in expert hands, average hospital stay is being only 1 to 2 days and most of the time, the patients are being sent home without foley catheter as we are performing a special reconstruction and anastomosis prosposed by Dr. Alex Mottrie that allows us to remove the catheter on day 2 post op.

For more information on treatment of prostate Cancer through surgical approach (Robotic assisted Radical Prostatectomy), please check the interview below in which Dr. Fouad Khoury describes the advantages of minimally invasive robotic approach for those kind procedures.


Benign Prostate Enlargement

Prostate diseases are usually associated with older age. They can cause bothersome symptoms in the lower urinary tract in men over the age of 50. These symptoms may be caused by an enlargement of the prostate, a condition which is known as benign prostate enlargement.

It is a common condition and is related to hormonal changes that happen as men grow older. Prostate diseases can be very worrying, however, it is not prostate cancer. It does not become prostate cancer, even if it is left untreated, however, can cause bothersome urinary symptoms. Both benign prostate enlargement and prostate cancer may develop with age and they can both coexist in the same patient.

Treatment of Benign Prostate Enlargement

Treatment can be medical or surgical depending on the case of the patient.

The main medications used in such treatments are:

  • Alpha-blockers
  • 5 alpha-reductase inhibitors
  • Muscarinic receptor antagonists
  • Phosphodiesterase 5 inhibitors
  • A combination of medications
  • Herbal medications

In more advanced cases, surgery is recommended especially in the presence of:

  • Kidney failure
  • Dilatation of your kidneys
  • Inability to urinate (urinary retention)
  • Recurring urinary tract infection
  • Recurring blood in the urine
  • Bladder stone


Click on the following link for additional knowledge about Dr Fouad Khoury’s porfolio and expertise.

Impressive Info about Kidney Stones

Impressive Info about Kidney Stones

Kidney Stones

Stone is a hard, solid mass that can form in the ureter, bladder, and kidneys. Bladder stones usually develop as a result of bladder outlet obstruction, meaning difficulty in emptying the bladder. On the other hand, kidney stones form when minerals or acid salts in your urine crystallize. Most stones leave your body while you urinate. However, in some cases the stones may become large, get stuck and need treatment to remove them. Anyone may develop a kidney stone during his or her lifetime. Stones can form if there is an imbalance in the way your body produces urine. This may be connected to how much you drink and whether there are substances in your urine which trigger stone formation. People often associate kidney and ureteral stones with pain. However, symptoms can vary from severe pain to no pain at all, depending on stone characteristics – such as the size, shape, and location of the stone in the urinary tract. Usually, stones that are in the kidney do not cause pain unless they obstruct the junction between the kidney and ureter called ureteropelvic junction. Therefore, pain is only experienced whenever there is an obstruction to the flow of urine. When the stone is in the ureter, it can cause severe pain when it obstructs the ureter and blocks the flow of urine.


Treatment can vary from medical to surgical.

Factors that influence the decision include:

  • • The symptoms
  • • Stone characteristics
  • • The medical history
  • • The kind of treatment available at the hospital and the expertise of your doctor
  • • Personal preferences of the patient

If the stone is likely to pass with urine, the doctor can prescribe medications to ease this process. This is called conservative treatment.

If the stone continues to grow or causes frequent and severe pain, you will get active treatment.

1. Conservative stone treatment

A significant number of kidney or ureteral stones will pass while you urinate. However, depending on the size and location of the stone, it will take some time to pass the stone. You may suffer from renal colic when the stone moves. If you have a very small stone there is a 95% chance of passing this stone within 6 weeks. Two very important factors influence the passage rate:

  • • The closer the stone is to the bladder, the higher the chance of passing it
  • • The bigger the stone, the smaller the chance of passing it There are 2 common conservative treatment options: Medical Expulsive Therapy (MET) and dissolving uric acid stones. In both cases you get medication.

2. Active stone treatment

Kidney stones or ureteral stones should be treated if they cause symptoms. There are 3 common ways to remove stones: shock-wave lithotripsy , ureteroscopy, and percutaneous nephrolithotomy.

Which active treatment option is best for you depends on many aspects. The most important factor is the symptoms the stone causes. Based on whether the stone is in your kidney or your ureter, the doctor may recommend different treatment options. If you don’t have symptoms you may still get treatment in case:

  • • The stone continues to grow
  • • You are at recurrent stone former
  • • You have an infection
  • • Your stone is significantly large
  • • You prefer active treatment

Flexible ureteroscopy with laser dusting or fragmentation of stone has gained a lot of popularity during the last 10 years because of its high success in yielding stone-free kidney or ureter.

It is being performed more and more even for large kidney stones, being less invasive that percutaneous nephrolithotomy, causes less pain and is done without a single scar.

The success of the treatment depends considerably on the material being used and the expertise of the doctor carrying the treatment. For more information, feel free to check Dr Fouad Khoury’s portfolio.

You can also check the following Impressive laparoscopic surgery for adrenal gland.

Impressive Chronic Pelvic Pain Info

Impressive Chronic Pelvic Pain Info

Pelvic Pain

Chronic pelvic pain is defined as pain that occurs below the umbilicus (belly button) that lasts for more than six months. It may or may not be associated with menstrual periods in female. Chronic pelvic pain may be a symptom caused by one or more different conditions.

Causes of Chronic Pelvic Pain

A variety of gynecologic, gastrointestinal, urologic, musculoskeletal and body-wide disorders can cause chronic pelvic pain.

A thorough history and proper physical examination are essential in order to determine the cause of the pain. Most patients become hopeless and end up on antidepressants after multiple failed attempts to relieve the symptoms.

It is indeed a challenging condition to treat, but if managed by the right team, success is always possible especially that many cases are caused by pudendal nerve entrapment.

If diagnosed properly, the release of the pudendal nerve by laparoscopic approach often cures the condition and patients go back to carry on their normal life after a longstanding period of misery.

For additional information about dr khoury’s surgeries, you can check the following Laparoscopic Sacrocolpopexy.



Female Urinary Incontinence

Urinary incontinence in Female

Female incontinence is any involuntary or unwanted loss of urine. It is considered a medical condition if it happens regularly. The risk of developing incontinence increases with age, but younger people may also develop it. Women are more likely to suffer from this condition than men.

Urinary incontinence causes social distress. This is why many people do not discuss the problem with their doctor as they feel embarrassed.
It is important to seek medical advice especially if the incontinence is affecting your quality of life. In most cases, incontinence can be treated or cured with various treatment options. These include pelvic floor exercises, medication treatment, or surgery. Together with your doctor, you can discuss which treatment is best for you. 

Common causes of Females Urinary incontinence

  • • Hormone deficiencies
  • • Weak pelvic floor muscle
  • • Neurological lower urinary tract dysfunction
  • • Urinary tract infections

Common risk factors in female include

  • • Pelvic surgery
  • • Childbirth
  • • Menopause

Urinary incontinence becomes more common with increasing age. However, it should not be seen as a normal part of ageing.


Types of urinary incontinence

There are different types of urinary incontinence, depending on how and when you lose urine.

1. Urge urinary incontinence

Urge urinary incontinence happens when you get a sudden need to urinate which you cannot postpone. The bladder muscle contracts and you lose urine without the ability to hold before reaching the toilet.

2. Stress urinary incontinence

Stress urinary incontinence occurs when you lose urine during certain activities that exert pressure on the pelvic floor such as:

  • • Coughing, sneezing, or laughing
  • • Running or jumping
  • • Lifting heavy objects

This happens because during these kinds of activities the pressure on your bladder increases. Your urethra or urinary sphincter cannot resist the pressure of a full bladder and will leak urine.

3. Mixed incontinence

This happens when you have a mixture of stress urinary incontinence and urge urinary incontinence.


Treatment varies depending on the type of incontinence. This is why it is very important to properly tell which type of incontinence you have in order to find the correct treatment.
Especially in certain cases, a wrong treatment may make your condition worse.

1. Medical Treatment is mostly used for urge urinary incontinence
The main types of medications used to manage incontinence are muscarinic receptor antagonists (MRAs), mirabegron, and estrogen.
In severe cases, intravesical BOTOX injections are being in order to control urge Urinary Incontinence .

2. Sub-urethral sling placement
Sling placement for management of stress urinary incontinence in female has shown to be a very successful procedure if performed by the trained personnel.
It is a same-day procedure of 5 to 10 minutes duration that provides a definitive relief to the patient. It is usually a pain-free procedure that can change your life forever.

For more insights you can visit our page Female Incontinence 



Remarkable Premature ejaculation Info

Remarkable Premature ejaculation Info


Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like, causing distress for one or both partners. It is the most common sexual problem for men. Estimates vary, but as many as 1 out of 3 men say they experience this problem at some time.
Premature ejaculation can happen from the time of the first sexual experience, while in others, it can develop after a period of normal sexual activity.

Causes of premature ejaculation

Some causes are psychological. However, it is now thought that some men (particularly those with lifelong premature ejaculation) have a chemical imbalance in the brain centers controlling this function.Some men have acquired premature ejaculation associated with erectile dysfunction.

Psychological factors are important and include

  • • depression or anxiety, particularly about performance
  • • feeling anxious about rejection by a sexual partner
  • • expecting failure
  • • negative sexual experiences in childhood
  • • religious beliefs
  • • stress
  • • problems within the relationship.


Pudendal Nerve Entrapment

A very important cause of premature ejaculation can be pudendal nerve entrapment.

This is often seen in men with acquired premature ejaculation, meaning that they used to have a normal ejaculatory function in the past and suddenly they develop premature ejaculations with no evident reason.

If pudendal nerve entrapment is shown to be the reason, definitive management and resolution of the premature ejaculation can take place by releasing the pudendal nerve entrapment.

For more interesting knowledge, please visit Erectile dysfunction

For further information or online appointment, visit our website modern care clinic.

Surprising Erectile dysfunction Facts

Surprising Erectile dysfunction Facts

Erectile dysfunction

It is a common male sexual disorder that becomes more prevalent with age; however, also seen in young individuals. It is the inability to get or maintain an erection that allows a satisfactory sexual activity. It can happen with or without any clear reason, on either occasional or regular basis. Some men with erectile dysfunction are not able to get an erection at all. This condition is not a life-threatening disorder, but it can have a negative impact on your quality of life and that of your partner.

Erectile dysfunction (ED) resulting from specific conditions such as


1. Prostate cancer

Prostate cancer is a malignant tumor in the prostate gland. It is the most common form of cancer in older men. Various treatment options for localized prostate cancer exist such as radical prostatectomy and radiation therapy. These treatment options can affect sexual health, and men frequently experience erectile dysfunction after treatment.

New therapeutic technology such as robotic surgery allows us to perform surgery with more precision. This allows us to spare the nerves around the prostate and help in preserving erectile function after such procedures.


2. Pudendal Nerve Entrapment

Pudendal Nerve Entrapment is a hot topic nowadays. It consists of the entrapment of the pudendal nerve in a specific area of the pelvis and results in a variety of symptoms such as pelvic and perineal pain. It has also been shown to be the cause of erectile dysfunction in large number of people, especially when the problem is of recent onset and is associated with pain upon urination or painful ejaculations.


Several psychological conditions have been associated with ED. These include:

  • • Stress
  • • Anxiety
  • • Depression
  • • Low self esteemn
  • • Inability to describe emotions

Social ideas of how men and women are supposed to interact can also contribute to ED. These can include unrealistic expectations about love and sexuality, and inappropriate male and female role models.
Causes of Erectile Dysfunction


A common cause of ED is heart disease. Other common causes are:

  • • Diabetes
  • • Nerve damage to the penis or the pelvic area
  • Pelvic surgery
  • • Radiation therapy to the pelvic area
  • • Low levels of testosterone
  • • Neurologic disease, like Parkinson’s


Erectile dysfunction (ED) is a problem that needs to be diagnosed correctly. Once we find the proper cause, it becomes possible to provide the correct treatment. Discussing ED with your doctor may be uncomfortable, but it is important to do so. Together you can discuss which treatment is best for you.

To have more insights about related topic, please visit Premature Ejaculation.

Also, you can find out more abour Dr Fouad khoury.

× Whatsapp Us