Sexually transmitted diseases (STDs)
Sexually transmitted diseases (STDs) are a common concern for sexually active individuals. These infections can affect anyone, regardless of age, gender, or sexual orientation. While prevention is crucial, knowing when to consult a urologist for STD-related concerns is equally important. In this blog, we will discuss STDs, their symptoms, and when it’s time to seek professional help from a urologist.
STDs, also known as sexually transmitted infections (STIs), are infections that spread through sexual contact. They can be caused by bacteria, viruses, or parasites. Some of the most common STDs include:
6. HPV (Human Papillomavirus)
STDs can vary in terms of their symptoms and severity. Some infections may cause noticeable symptoms, while others can remain asymptomatic for extended periods. This is why regular testing and safe sexual practices are essential.
When to Consult Your Urologist:
1. Symptoms: If you experience any symptoms associated with STDs, such as genital itching, pain, sores, discharge, burning during urination, or any unusual changes in your genital area, it’s important to consult a urologist. Early detection and treatment can prevent complications and the spread of the infection to others.
2. Positive Test Results: If you’ve undergone STD testing, and the results come back positive for an STD, your next step should be to consult a urologist. They can provide guidance on treatment options, potential side effects, and help you understand the best course of action to manage and treat the infection.
3. High-Risk Behavior: If you engage in high-risk sexual behavior, such as having multiple sexual partners without protection or engaging in sex with individuals whose sexual history is unknown, it’s advisable to consult a urologist regularly for STD screenings. Prevention is key, and your urologist can provide valuable advice on safe sex practices and the use of protective measures like condoms.
4. Partner Diagnosis: If your sexual partner has been diagnosed with an STD, it’s crucial to consult a urologist for testing and guidance. Even if you don’t exhibit symptoms, you could still be carrying the infection and need treatment.
5. Pregnancy Planning: If you’re planning to become pregnant or are already pregnant, consulting a urologist is essential. Some STDs can impact fertility and pose risks to the unborn child. A urologist can help ensure a safe and healthy pregnancy.
6. Routine Check-ups: Regular check-ups with a urologist can help monitor your sexual health and detect any potential issues early. They can provide advice on vaccinations (such as the HPV vaccine) and recommend appropriate screenings based on your sexual history and risk factors.
Remember that early detection and treatment of STDs can prevent long-term health complications and protect your sexual partners from infection. It’s important to be open and honest with your healthcare provider about your sexual history and any concerns you may have.
In conclusion, STDs are a common concern, but they are manageable and treatable with the right medical care. Knowing when to consult a urologist is essential for maintaining your sexual health and preventing the spread of infections. Regular screenings and safe sexual practices are your best tools in the fight against STDs. Don’t hesitate to reach out to a urologist if you have any concerns or questions about your sexual health.
Within the realm of urology, many conditions are known to cause discomfort and distress to patients. One often overlooked but significant source of urological symptoms is pudendal nerve entrapment (PNE). PNE occurs when the pudendal nerve, responsible for sensory and motor functions in the pelvic region, becomes compressed or irritated. In this blog post, we will explore the causes, symptoms, diagnosis, and treatment options for pudendal nerve entrapment, shedding light on this frequently misunderstood condition.
Understanding the Pudendal Nerve
The pudendal nerve is a vital nerve in the pelvic region, responsible for providing sensation to the external genitalia, perineum, and rectum. Additionally, it plays a crucial role in controlling the muscles that are involved in urination, bowel movements, and sexual function. When the pudendal nerve becomes entrapped, patients may experience a variety of distressing symptoms.
Causes of Pudendal Nerve Entrapment
PNE can occur due to various reasons, including:
- Pelvic trauma or injury: Trauma to the pelvis, such as a fall or accident, can result in compression or entrapment of the pudendal nerve.
- Repetitive stress or overuse: Activities that put excessive pressure on the pudendal nerve, such as long-distance cycling, horseback riding, or sitting for prolonged periods, may lead to nerve compression over time.
- Post-surgical complications: Certain surgical procedures in the pelvic region, such as prostatectomy or hernia repair, can inadvertently damage or compress the pudendal nerve.
Symptoms of Pudendal Nerve Entrapment
The symptoms of PNE can manifest differently from person to person, but common complaints include:
- Chronic pelvic pain: This is the most prevalent symptom, characterized by persistent or recurring pain in the pelvic region, perineum, or rectum.
- Pain during sexual activity: Patients may experience pain or discomfort during sexual intercourse, affecting their overall quality of life and intimate relationships.
- Urinary and bowel dysfunction: PNE can lead to urinary urgency, frequency, or difficulty in initiating or maintaining urination. It may also cause constipation, incomplete bowel movements, or fecal incontinence.
Diagnosis and Treatment
Diagnosing PNE can be challenging due to its overlapping symptoms with other urological conditions. A thorough medical history, physical examination, and specialized diagnostic tests are essential for accurate diagnosis. These may include:
- Pudendal nerve block: An anesthetic injection near the pudendal nerve can temporarily relieve pain and confirm the involvement of the nerve in the patient’s symptoms.
- Electromyography (EMG) and nerve conduction studies: These tests assess the electrical activity and function of the pudendal nerve and surrounding muscles.
- Magnetic resonance neurography (MRN): This imaging technique can provide detailed images of the pudendal nerve and identify any anatomical abnormalities or compressions.
Once diagnosed, treatment options for PNE may include:
- Physical therapy: Pelvic floor physical therapy, including stretching, relaxation exercises, and biofeedback, can help alleviate symptoms and improve muscle function.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), neuropathic pain medications, and muscle relaxants may be prescribed to manage pain and reduce inflammation.
- Nerve decompression surgery: In severe cases of PNE that do not respond to conservative treatments, surgical release or decompression of the entrapped nerve may be considered.
In conclusion, pudendal nerve entrapment can have a profound impact on urological health. The compression or entrapment of the pudendal nerve can lead to symptoms such as urinary urgency, frequency, and incontinence. Additionally, it can cause sexual dysfunction, including pain during intercourse (dyspareunia), erectile dysfunction, and diminished genital sensation. These symptoms can significantly impair a person’s quality of life and require appropriate evaluation and management within the field of urology.
Rezum therapy in Dubai with our Rezum Expert Dr.Fouad Khoury
We are delighted to share that Dr. Fouad Khoury, a distinguished urologist and renowned expert in Rezum therapy; has recently been selected as a Rezum proctor for Boston Scientific, and has traveled to Dubai to share his expertise.
Dr. Fouad Khoury’s exceptional skills and extensive experience in urology, particularly in the innovative Rezum treatment; have made him a trusted authority in the field.
As a Rezum proctor, he has been chosen by Boston Scientific to provide comprehensive training and guidance to other healthcare professionals interested in incorporating Rezum therapy into their practice.
Dubai, known for its commitment to medical advancements and providing cutting-edge treatments; has become the destination for this significant collaboration.
Dr. Khoury’s visit to Dubai as a Rezum proctor reflects the global recognition of his expertise and the growing demand for Rezum therapy worldwide.
During his visit to Dubai, he conducted training sessions and lectures, sharing his knowledge, techniques, and insights regarding Rezum therapy with healthcare professionals; through these interactions, he gave other urologists the knowledge and abilities they needed to administer Rezum therapies successfully, guaranteeing patients received the best possible care.
Weight Loss procedures
There are several weight loss procedures that can be performed depending on the individual’s needs and medical condition.
Obesity is a chronic condition in which there is a high amount of fat in the body. It is defined as a Body Mass Index (BMI) of 30 to 34.9 and extreme obesity is a BMI of 40 or more. It’s a global problem that can affect all people and is associated with many comorbidities: cardiac problems, diabetes, high blood pressure, breathing difficulties, and other diseases.
Sleeve Gastrectomy is a restrictive bariatric procedure to treat extremely obese patients with a high BMI of 40 and above. It encourages weight loss by restricting the stomach size (during sleeve gastrectomy, about 80% of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana).
Who is the candidate for a sleeve gastrectomy?
Sleeve gastrectomy is indicated for people with BMI:
– 40 and more
– 27 to 40 associated with obesity complications (heart disease, high blood pressure, high cholesterol, severe sleep apnea, type 2 diabetes, infertility).
This procedure can be done in those conditions when diet, exercise or medication have not helped in reducing the patient’s weight.
Some TIPS before and after the procedure
A day before gastric sleeve surgery:
– Follow a liquid diet
– Do not eat or drink at least for 8 hours before the surgery
– Obtain adequate rest by getting to sleep early the night before the procedure
The procedure is performed laparoscopically under general anesthesia to keep you asleep and comfortable during the surgery. The surgeon makes small keyhole incisions in the upper abdomen to remove the larger and curved part of the stomach and staples the stomach vertically.
At the end of the procedure which takes one to two hours, the incisions are closed with sutures.
Depending on your recovery, you will stay in the hospital for one to two nights.
After the procedure the patient must:
1- Follow a specific diet:
-noncarbonated liquids for 7 days
-pureed foods for 3 weeks
-a lot of water to prevent dehydration
The patient will be able to progress to regular foods 4 weeks after the surgery.
2- Take some medications:
– A multivitamin twice a day.
– A calcium supplement once a day.
– Injection of vitamin B-12 once a month for life.
After the sleeve gastrectomy, medical checkups and laboratory tests are required the first several months after weight-loss surgery; and the patient should avoid strenuous exercises and lifting heavy weights until the approval of the surgeon.
-Can be performed laparoscopically.
-Shorter hospitalization and recovery time.
-Minimal post-operative pain
-The size of the stomach is reduced; so the patient feels full sooner.
Risks associated with sleeve gastrectomy can include excessive bleeding, infection, adverse reactions to anesthesia, blood clots, breathing problems… Those complications are immediately treated and can’t be fatal.
In the long term, the patient may have hypoglycemia, malnutrition, or recurrent vomiting; that’s why the medical checkup is very important.
Sleeve gastrectomy can provide long-term weight loss, but it depends on your lifestyle habits. The patient can lose approximately 60% or even more of his excess weight within two years.
When weight-loss surgery doesn’t work?
Sometimes, if the patient doesn’t change his lifestyle habits he will:
– Not be able to lose weight after the procedure
– Regain weight after a few years
After the procedure the patient must stay in contact with his doctor to do all the necessary tests and maintain his weight loss; and if he notices that he isn’t losing weight or developing complications, he should visit the doctor immediately.
Sometimes when the sleeve gastrectomy doesn’t give a satisfactory result; it must be accompanied by a second bariatric surgery (bypass gastric surgery) to be able to lose weight and achieve the goal.
What is gastric bypass surgery?
Gastric bypass surgery is a restrictive and malabsorptive surgical procedure. It is restrictive in the sense that it “reduces” the quantity of food that the stomach can hold and is “malabsorptive” in that it affects the absorption of food and calories into the bloodstream, and this combination has the highest success rate.
This surgery is more complicated than the sleeve gastrectomy because it doesn’t only work on reducing the size of the stomach; so the recovery period takes more time.
Types of Gastric Bypass surgery
-Roux-en-Y gastric bypass
Roux-en-Y the most common method of gastric bypass, is bariatric surgery for obese patients who have not the chance to lose weight through dieting, exercise, and medication.
It can be performed laparoscopically through tiny incisions or through a large open incision.
First, the surgeon reduces the size of the stomach; so it can hold a limited quantity of food, by cutting the top of your stomach and sealing it off from the rest of your stomach. The resulting pouch is compared to the size of a walnut and can hold a small quantity of food.
Then, the doctor cuts the small intestine and attaches a part of it directly into the pouch; food then goes into this small pouch of the stomach and then directly into the small intestine attached to it.
Food bypasses a big part of your stomach and the first section of your small intestine and enters directly into the middle part of your small intestine.
The small intestine is then cut into two parts:
-The lower section of the intestine is attached to the opening of the pouch creating; what is referred to as the “roux limb”.
-The upper part of the small intestine which transports digestive juices from the remaining part of the stomach is attached at the distal extremity of the roux limb.
The roux limb helps food to go around the lower stomach, duodenum, and a portion of the small intestine.
-Mini gastric bypass
This operation is performed under general anesthesia laparoscopically through tiny incisions or by an open surgery.
Your stomach is first stapled so that a pouch is created separately from the rest of your stomach.
In the Roux-en-Y procedure, the intestine is then divided and one end connected to the stomach pouch while the other end is reconnected back to the intestine; but with mini gastric bypass, the pouch is connected directly after the duodenum without dividing the intestine.
Gastric bypass surgery may be recommended when:
-Diet, exercise or medications have not help to reduce weight.
– BMI= 40 or more
– BMI is 35 to 39 with complications (type 2 diabetes, heart disease, high blood pressure, high cholesterol, sleep apnea…)
Risks and complications
Risks associated with this surgery can include excessive bleeding, infection, adverse reactions to anesthesia, blood clots, ulcers…
Those complications are immediately treated and can’t be fatal.
In the long term, the patient may have malnutrition or dumping syndrome leading to diarrhea and nausea; that’s why the medical checkup is very important.
Advantages of gastric bypass surgery
• Quick and dramatic weight loss (10 to 20 pounds a month in the first year following the surgery).
• Weight loss continues for 18-24 months post-surgery.
• Many patients maintain a weight loss of 60-70% of excess weight 10 years after the surgery.
• Improved health problems associated with severe obesity.
• Many patients are able to stop taking medications for diabetes and hypertension after losing weight.
After the surgery
The patient should:
-Eat in small quantities.
-Eat slowly and chewing the food thoroughly.
– Not drink and eat at the same time because the new stomach will not be able to hold both.
-Stop certain sugary foods; because it can lead to “dumping syndrome”.
-Vitamins supplementation specifically iron, VitB12, calcium and Vitamin D.
Gastric bypass after gastric sleeve
Gastric bypass after sleeve surgery is a type of revision procedure that may be necessary if you do not achieve the desired weight loss after the gastric sleeve; that only reduces the size of the stomach; and it is a less complicated surgery.
If the sleeve procedure fails to work, a bypass gastric surgery is required to reduce calories absorption through intestinal rerouting.
What is female infertility?
Female infertility can be discussed when a woman is unable to conceive a pregnancy after trying for at least one year without using any form of contraception. In some cases, female infertility can also refer to a woman’s inability to carry a pregnancy to term, resulting in miscarriages or stillbirths. Other signs of female infertility may include irregular menstrual cycles, hormone imbalances, or other medical conditions that affect fertility.
It is important to note that infertility is not always the result of female factors alone, and that male infertility or a combination of male and female factors may also be involved. Therefore, it is recommended that both partners undergo fertility testing and evaluation to identify the root cause of infertility and determine the best course of treatment.
How is female infertility diagnosed?
Female infertility is diagnosed through a series of medical tests and evaluations. Here are some common diagnostic procedures for female infertility:
1-Medical history: A doctor will take a detailed medical history of the patient and their partner, including information about menstrual cycle, sexual habits, and previous pregnancies.
2-Physical examination: A doctor will perform a physical exam to check for any physical abnormalities such as blocked fallopian tubes or endometriosis.
3-Hormone testing: Blood tests can be done to check hormone levels, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, and progesterone. Hormonal imbalances can affect ovulation and fertility.
4-Ovulation testing: This involves tracking the patient’s menstrual cycle to determine if they are ovulating regularly. This can be done through blood tests or ultrasounds.
5-Hysterosalpingography (HSG): This is an X-ray test that uses dye to determine if the fallopian tubes are open and functioning properly.
6-Laparoscopy: This is a surgical procedure that allows a doctor to view the reproductive organs and look for any abnormalities, such as endometriosis or ovarian cysts.
7-Genetic testing: In rare cases, genetic testing may be recommended to look for any genetic abnormalities that could be causing infertility.
By performing these tests, doctors can often identify the cause of infertility in women and recommend appropriate treatment options.
How we can treat female infertility?
The treatment options for female infertility will depend on the underlying cause. Some common treatment options include:
1-Medications: Medications may be used to regulate ovulation, stimulate the production of eggs, or treat underlying hormonal imbalances that can affect fertility.
2-Surgery: In some cases, surgery may be necessary to correct structural abnormalities that can interfere with fertility, such as blocked fallopian tubes, uterine fibroids, or endometriosis.
3-Intrauterine insemination (IUI): IUI involves placing washed sperm directly into the uterus around the time of ovulation to increase the chances of fertilization.
4-In vitro fertilization (IVF): IVF involves fertilizing eggs with sperm in a laboratory and then transferring the resulting embryo(s) into the uterus.
5-Donor eggs or embryos: If a woman’s own eggs are not viable, she may be able to use donated eggs or embryos to achieve pregnancy.
6-Surrogacy: In some cases, a woman may be unable to carry a pregnancy to term due to a medical condition, in which case surrogacy may be an option.
It is important to consult with a fertility specialist to determine the most appropriate treatment for your individual needs.
Risk factors of female infertility
There are many risk factors associated with female infertility, some of which include:
1-Age: As women age, their fertility declines, with a marked decrease in fertility occurring after the age of 35.
2-Polycystic Ovary Syndrome (PCOS): PCOS is a hormonal disorder that affects up to 10% of women of reproductive age, and can interfere with ovulation.
3-Endometriosis: This condition occurs when the tissue that lines the uterus grows outside of it, potentially causing damage to the reproductive organs.
4-Pelvic Inflammatory Disease (PID): PID is an infection of the female reproductive organs that can lead to scarring and blockages, making it difficult for eggs to travel from the ovaries to the uterus.
5-Hormonal imbalances: Any imbalances in hormones that regulate the menstrual cycle can interfere with ovulation and fertility.
6-Fallopian tube damage: Damage to the fallopian tubes, which transport eggs from the ovaries to the uterus, can be caused by infections, surgeries, or other conditions.
7-Uterine abnormalities: Structural problems with the uterus can interfere with implantation or increase the risk of miscarriage.
8-Lifestyle factors: Smoking, excessive alcohol consumption, and a sedentary lifestyle can all affect fertility.
9-Weight: Being either overweight or underweight can interfere with hormonal balance and ovulation.
It’s important to note that these are just a few examples of risk factors associated with female infertility. If you’re concerned about your fertility, it’s best to speak with a healthcare professional who can help you identify any potential issues and develop a plan to address them.
How to prevent female infertility?
There are several steps that women can take to help prevent infertility:
1-Maintain a healthy weight: Being overweight or underweight can disrupt normal ovulation and hormone production, leading to infertility. Maintaining a healthy weight through a balanced diet and regular exercise can help prevent infertility.
2- Don’t smoke: Smoking has been linked to decreased fertility in women. Quitting smoking can improve fertility and overall health.
3-Limit alcohol and caffeine intake: Excessive alcohol and caffeine intake can interfere with normal ovulation and hormone production. Limiting consumption of these substances can help prevent infertility.
4-Manage stress: Chronic stress can disrupt hormone production and ovulation, leading to infertility. Finding healthy ways to manage stress, such as meditation or exercise, can help prevent infertility.
5-Practice safe sex: Sexually transmitted infections (STIs) can cause pelvic inflammatory disease (PID), which can lead to infertility. Practicing safe sex and getting tested regularly for STIs can help prevent infertility.
6-Get regular check-ups: Regular gynecological exams can help detect and treat conditions that may cause infertility, such as polycystic ovary syndrome (PCOS) or endometriosis.
7-Consider fertility preservation options: If you are planning to delay pregnancy, or if you have a medical condition that may affect your fertility, consider fertility preservation options, such as freezing your eggs or embryos, to increase your chances of having a biological child in the future.
It is important to note that infertility can have various causes, and not all cases can be prevented. If you are having difficulty getting pregnant, it is recommended that you speak with a healthcare provider to determine the underlying cause and explore treatment options.
Freezing eggs, also known as oocyte cryopreservation, can be a beneficial option for women who are facing infertility due to various reasons. This process involves extracting a woman’s eggs from her ovaries, freezing them, and storing them until she is ready to use them in the future to try and conceive a child.
There are several reasons why a woman may choose to freeze her eggs. One of the most common is to preserve fertility before undergoing treatments that could affect her ability to have children, such as chemotherapy or radiation therapy. Women who are planning to delay childbearing for personal or professional reasons may also choose to freeze their eggs.
It’s important to note that freezing eggs does not guarantee a successful pregnancy in the future, but it does offer the possibility of using these eggs to conceive if natural conception is not possible. The success of egg freezing depends on various factors such as the woman’s age at the time of freezing, the number and quality of eggs retrieved, and the method used for freezing and thawing.
Overall, freezing eggs can be an effective option for women facing infertility, but it’s important to discuss the potential risks and benefits with a healthcare provider to determine if it’s the right choice for individual circumstances.
PRP treatment for erectile dysfunction
What is PRP?
A blood component known as platelet-rich plasma (PRP) is supposed to encourage tissue growth and healing. PRP therapy is used to repair muscle or tendon injuries, promote hair growth, and hasten surgical recuperation.
Additionally, it is employed as an experimental or different form of treatment for:
– Erectile dysfunction (ED)
– Peyronie’s disease
– Penis enlargement
– Sexual performance
How does it work?
White blood cells, platelets, plasma, and red blood cells are the four different parts of your blood.
Your blood’s plasma, which makes up around half of its volume, is its liquid component. Your blood needs platelets to clot properly after an injury. They also include growth factor-containing proteins, which hasten recovery.
The theoretical benefit of PRP for ED is to make the tissue and blood vessels in the penis healthier.
A small sample of your blood is drawn by a medical specialist, who spins it in a centrifuge to create PRP. The plasma and platelets are separated from the other components of your blood using a centrifuge.
In comparison to conventional blood, the PRP combination has a significantly higher percentage of platelets. PRP is created and then injected into your penis. This is called the Priapus Shot, or P-Shot.
You should be able to leave the clinic about an hour after the P-Shot because it is a brief treatment. Additionally, there is nothing you need to do to get ready for the treatment.
What does the research say?
A 2020 review Trusted Source looked at all the research available to date on PRP therapy for male sexual dysfunction. The review looked at three animal studies and two human studies for ED. The studies didn’t report any major adverse reactions to PRP therapy. The researchers concluded that PRP has the potential to be a useful treatment option for ED. However, it’s important to keep in mind that the studies had small sample sizes, and there weren’t adequate comparison groups.
- one centrifuge
- high performance
- less pain
- less inflammation because of RBC control
- low price
- PRP can be used in combination with many other substances to improve medical prognosis and outcome of many medical conditions.
How soon does the P-Shot start working?
Although everyone responds to the P-Shot at a different rate, there are undoubtedly early and normal responders who can benefit from the treatment’s effects before others. For instance, in certain early responders, the effects of this P Shot treatment might be felt as soon as 24 hours after administration. On the other hand, those who respond normally will start to see benefits after a few weeks, often 4 to 8 weeks following the initial therapy.
The nice thing about the Priapus shot is the fact that the results gradually improve over time. Even early responders who can benefit from quick results will notice the results continue to improve over the next few weeks as the injectable solution corrects the causes of ED and other sexual health concerns. Those who are younger or who have milder conditions may be able to enjoy results more quickly than others.
When do You See your best results?
After three to four months from the start of your initial therapy, your treatment’s effects will often reach their peak. Your best performance indicates that the Priapus injection is working as well as it can. Your outcomes will peak in part because by this time, all tissue regrowth and correction from the shot will be finished. Some men may not see their best results for at least six months if they had more severe issues or needed more treatments.
How long do results last?
One of the most exciting things about this treatment is that the results can last for 12 to 18 months at a time.
If they maintain a healthy lifestyle and respond favorably to the treatment, many men can benefit from the effects of this procedure for more than 18 months. This treatment is ultimately more economical for many guys because of how long it lasts.
How many sessions will you need?
Depending on how severe your disease is, you may need more P-shots to get the outcomes you want. Most men need three to six sessions on average to see the desired benefits, while some men may need more. These sessions are often spaced a few weeks apart so that your development can be tracked throughout the duration of your treatment plan and customized to meet your needs.
How Frequently Should You Have the Priapus Shot?
Many guys prefer to undergo annual treatments to preserve their results because the effects of this procedure linger for more than a year. In order for your results to remain consistent and for you to avoid having to deal with the signs of male sexual dysfunction for an extended period of time, your maintenance appointments should ideally be scheduled once every 12 to 18 months as needed.
Cystoscopy Bladder Scope Test
What is a cystoscopy?
A cystoscopy is a test to check the health of your urethra and bladder. You might also hear it called a cysto-urethroscopy or, more simply, a bladder scope.
Cystoscopy is a procedure that uses an instrument called a Cystoscope to look at the lining of the bladder (the area where urine is stored), the opening of the ureters (the tubes that connect the kidneys to the bladder), and the urethra (the tube that runs from the bladder to the outside of the body).
How Does the Test Work?
The Cystoscope is a thin instrument with a lens at the end so the inside of the bladder can be seen. It is usually attached to a television screen. The procedure is an outpatient test, which means you can get it at your doctor’s office, or clinic and hospital the same day. It may or may not require anesthesia, and it lasts for approximately 10-15 minutes.
The doctor inserts a tube into your urethra.
Who might need a cystoscopy?
The urologist may recommend a cystoscopy if you experience:
• Bladder control issues, such as urinary retention (being unable to empty the bladder all the way) or incontinence (Leaking or peeing when you aren’t trying, or pain when you pee)
• Bladder stones.
• Blood in urine (hematuria).
• Frequent urinary tract infections (UTIs), to find the cause of frequent urinary tract infections
• Painful urination (dysuria).
• Difficulty in passing urine – which may be due to prostate enlargement or a narrowing (stricture) of the urethra.
• Diagnose an enlarged prostate
• Diagnose bladder diseases like bladder cancer, that needs treating (including some early cancers)
• Bladder stones, and bladder inflammation (cystitis)
• Treat conditions: Removal of small tumors through the cystoscopy
• To monitor progress of conditions: Some patients have a routine cystoscopy after treatment for a bladder tumor.
What to Expect Before the cystoscopy
•No special preparations are required.
•You may eat, drink, and take your medication as usual.
What to Expect during the cystoscopy
1. You will remove any clothing, jewelry, or other objects and you will be given a gown to wear
2. You’ll lie down on an exam table on your back with your knees up and spread apart
3. You might get an IV (intravenous) line for sedative medications: if the cystoscopy is under anesthesia (in the hospital)
4. This will make you sleepy and not feel pain during the cystoscopy. In this case, your heart rate, blood pressure, breathing, and blood oxygen level will be watched during the procedure.
5. The cystoscope is inserted through the urethra into the bladder with a liquid or gel anesthetic is used during the insertion of the cystoscope to minimize pain or discomfort (In the Clinic).
6. If you’re a man, the opening is at the end of your penis.
7. If you’re a woman, it’s just above your vagina.
8. The test lets your doctor check the complete length of your urethra and the bladder for polyps, narrow areas called strictures, abnormal growths, and other problems.
9. Water or saline is infused through the cystoscope into the bladder. While the fluid fills the bladder, the wall of the bladder become stretched so the urologist can see clearly.
10. The Doctor will ask you how it feels when your bladder is full.
11. In case of an abnormal tissue is seen, the doctor will use the cystoscope to cut a small piece to send it to the lab for analysis. They’ll call this a biopsy or tissue sample.
12. Discomfort and pain during cystoscopy:
• You may feel discomfort when the cystoscope goes into the urethra and bladder; a strong need to pee when your bladder gets full.
• You may feel a slight squeeze if the doctor takes a tissue sample (Biopsy)
13. At the end of the procedure, the cystoscope is removed and you can empty your bladder.
What to Expect After the Cystoscopy
• You should drink plenty of fluids to flush out your bladder.
• You may experience some of the following:
• Blood-colored urine. This should go away in 2 to 3 days.
• Burning sensation with urination for 2-3 days
• Discomfort with urination for 2-3 days
Possible Complications of cystoscopy
• Urinary retention due to irritation and swelling from the procedure
• Bladder perforation (poking a hole in the bladder with the cystoscope)
When to contact your doctor or the clinic
if you notice any of the following after the cystoscopy:
• Shaking Chills or Fever: Sign of infection
• Bright red urine
• Peeing less than usual
• Worsening pain or discomfort on urination
• Lower back pain
• An inability to urinate
What are varicoceles?
Varicoceles are when veins called pampiniform plexus become enlarged inside your scrotum (the sac that protects and holds the testicles). About ten to fifteen males out of one hundred have varicocele; it is like getting a varicose vein in your leg.
This condition is most common in young men; and affects the left side of the scrotum more than the right side, because the male anatomy is not the same on both sides.
Varicoceles can be on both sides at the same time, but this is rare.
Your spermatic cord (each testicle is holding up by a spermatic cord) transfers blood to and from your testicles.
It’s not certain what causes varicoceles; but the principal cause could be a problem with blood flow in the spermatic cord.
Many experts believe a varicocele forms when the valves inside the veins in the cord prevent your blood from flowing properly; which leads the veins to dilate. This might cause damage to the testicle and lead to infertility.
When varicocele occurs in puberty, it’s often because of the immediate growth they undergo during puberty. The testicles need more blood than normal as they develop, and any problem in the veins can keep the blood from getting where it needs to go.
What are the symptoms of varicoceles?
Varicoceles often don’t present symptoms; but sometimes you may notice:
• Dull testicular pain or scrotal aching; which often gets better when you lie down, and get worse while doing certain activities.
• Inflamed testicle or scrotum.
• Male infertility.
• Sensation of a mass above the affected testicle.
• Enlarged veins that are quite noticeable.
• Testicular atrophy: The majority of the testicle comprises sperm-producing tubules. When damaged, as from varicocele, the testicle contracts and softens. We can’t explain why the testicle shrinks, but the malfunctioning valves allow blood to pool in the veins, which can result in increased pressure in the veins and exposure to toxins in the blood that may cause testicular damage.
• Infertility: Temperature changes inside the scrotum due to blood accumulation in veins; this higher temperature may affect sperm formation, movement (motility), and function.
In the physical exam, the doctor can feel above your enlarged testicle a mass that does not trigger discomfort upon palpation.
If you have a large varicocele, your doctor might ask you to stand, take a deep breath and hold it while you bear down (Valsalva maneuver); this helps your doctor detect abnormal amplification of the veins.
Sometimes the physical exam is inconvincing, so your doctor might order a scrotal ultrasound (a test that uses high-frequency sound waves to create precise images of the male’s testicles and surrounding tissues). In certain cases, other imaging might be recommended to rule out other causes for the varicocele, such as a tumor compressing the spermatic vein.
The size of the mass in your testicle helps your doctor classify your varicocele on a grading scale of 0-3.
A Grade 0 is the smallest, and can be diagnosed only with the help of an ultrasound.
Grade 3 is the largest, and means your varicocele is big enough that it changes the shape of your scrotum and can be diagnosed with the physical exam.
Varicoceles require treatment only if:
• You have pain
• You have problems with your fertility
• Your right testicle is growing more than the left
There are no medicines to prevent or treat varicoceles.
If you do need treatment, the goal will be to remove the veins that supply blood to your spermatic cord. You might have:
Varicocelectomy: This surgery is performed to remove enlarged veins in your scrotum; and to restore proper blood flow to your reproductive organs, under local or general anesthesia through a small cut into your scrotum.
Laparoscopic surgery: The doctor makes a small incision in your abdomen and passes a tiny instrument through the incision to see and repair the varicocele; this procedure requires general anesthesia.
After those two surgical treatments, you may notice:
• Varicoceles don’t go away, or come back
• Your testicular artery gets injured
Percutaneous embolization: A radiologist inserts a tube into a vein in your groin or neck through which instruments can be passed; the radiologist inserts a coil by using X-rays, to deflect blood away from the enlarged vein in your scrotum, under general anesthesia.
Risks that can follow this procedure include:
• Varicoceles don’t go away, or comes back
• The coil moves
• An infection
After embolization, you can return to work after two days, and begin exercising after seven to 10 days.
If you have the procedure to help with fertility, the doctor will test you in 3-4 months; that’s how long it takes for new sperm to grow. You’ll probably see improvements in 6 months, but it could take a year.
A little more than half of the infertile men who have the procedure benefit from it. Surgery is also successful for most teens who have it to fix slow testicular growth.
What is Gout?
Gout is a form of arthritis that causes sudden attacks of pain, redness, and tenderness in joints; especially the joint at the base of the big toe.
Gout occurs when your body has extra uric acid; so urate crystals accumulate in joints, causing inflammation and intense pain.
A crisis usually develops during the night because the body is inactive and has a low temperature.
Gout can be treated with medications and changes in diet and lifestyle.
Who is affected by Gout?
-Men are more affected by gout than women because they have higher levels of uric acid in their blood.
-Women are affected after menopause because in this period they reach these uric acid levels.
-People with high blood pressure.
-People with kidney disease.
-People with a family history of gout.
-People with congestive heart failure.
-A person who consumes: a diet high in animal proteins, alcohol, and diuretics.
What causes Gout?
Normally the human body makes uric acid when he breaks down chemicals called purines (substances found in certain food and drinks); the production of uric acid goes through the kidneys and exits the body with urine.
Sometimes the body produces an excessive quantity of uric acid, or the kidneys are not doing a good job to handle the uric acid out of the body, so gout occurs.
What are the symptoms of Gout?
The symptoms of gout always occur suddenly, and often at night (gout attack):
-Intense joint pain especially the large joint of the big toe.
-Inflammation and redness.
-When gout progresses, the patient will not be able to move normally the joints affected.
A gout attack can last a week or two.
Between gout attacks, you may have no symptoms at all.
How often do Gout attacks happen?
Gout attacks can occur frequently or after several years from the last attack.
But if gout isn’t treated, attacks may become more frequent and last longer.
Gout attacks can occur in the same joint or affect different joints.
How to diagnose Gout?
Doctors usually diagnose gout based on the symptoms of the patient and the appearance of the affected joint. Check Babame activity cube.
Other tests that help doctors:
-Blood test to measure the amount of uric acid in your blood.
–Aspiration: by using a needle to draw fluid from your affected joint, and the fluid is examined under the microscope.
How is Gout treated?
1-Some medications are used to treat gout symptoms and to prevent future attacks:
-Nonsteroidal anti-inflammatory drugs ( NSAIDs)
2-Medications to prevent gout complications:
-Medications that block uric acid production.
-Medications that help your kidneys to do a good job and remove uric acid from your body.
3-Changes in diet and lifestyle:
Medications are often the most effective way to treat gout attacks, but some changes in your lifestyle are important:
-Choose healthier beverages and foods:
*Avoid malted barley drinks (diuretic that increases the levels of uric acid in the body), fruit juice drinks with high fructose (because fructose stimulates the body to produce uric acid), coffee (caffeine is a diuretic), alcohol.
*You should drink a lot of water because it helps to remove uric acid from your body.
*Avoid foods high in purines: seafood, tuna, red meat, turkey, spinach, liver…
*Avoid foods high in fat and sugars to prevent obesity and diabetes.
*Types of food that might help gout:
Cherries, whole grains, eggs, cucumber, dark chocolate instead of sweets high in sugar, tomatoes, fat free dairy products.
*Exercise regularly and lose weight.
Kidney disease can lead to Gout?
Kidneys are responsible to filter wastes like uric acid (found in your blood) out of your body. But when you have chronic kidney disease, you will have an excessive quantity of uric acid in your blood because the kidneys cannot filter this waste out of the body; so gout occurs.
Gout may lead to kidney stones?
People with gout could be at a higher risk of developing uric acid kidney stones because they have a higher level of uric acid being excreted by the kidneys, and they have more acidic urine, which makes the uric acid more likely to form stones.
Physical and psychological issues can cause low libido in men; so don’t hesitate to book your appointment at Modern Care Clinic with dr. Fouad Khoury, to continue a normal sexual life and to avoid problems in your relationship.
What is low libido in men?
Low libido in men describes a decreased interest in sexual activity; it means that the man is losing interest in sex from time to time.
Why does libido decrease in men?
Testosterone is an important male hormone, produced in the testicles.
Testosterone is important for:
-building muscles and bone mass,
-your sex drive.
A young man with a low testosterone level will have a low libido; but with age, it’s normal to have a diminution of the testosterone hormone, and if it will be an issue for the older man; he will be able to consult his doctor to take supplements to increase his testosterone levels.
Taking certain medications can cause low libido in males by reducing testosterone hormone level:
-blood pressure medications,
-chemotherapy or radiation treatments for cancer,
-hormones used to treat prostate cancer,
-Restless legs syndrome (RLS)
Restless legs syndrome is the uncontrollable urge to move your legs.
Men with RLS are at higher risk for developing erectile dysfunction (ED) than those without RLS, which will cause a low sex drive.
Depression may be the main cause of decreased sexual desire in men; low libido is also a side effect of some antidepressants, including:
-serotonin-norepinephrine reuptake inhibitors (SNRIs)
-selective serotonin reuptake inhibitors (SSRIs)
Several chronic illnesses can reduce your sex drive:
-Type 2 diabetes.
-High blood pressure.
-Chronic lung, heart, kidney, and liver failure.
With age, the testosterone level and the man’s sexual capacity are reduced, which leads to a decrease in SEXUAL PLEASURE AND DESIRE.
Low self-esteem may also cause anxiety about sexual performance; which can lead to issues with the erection, and reduced sexual desire.
Alcohol abuse decreases the production of testosterone.
Side effects of low libido
A decreased sex drive is a very big issue for a man, it leads to several psychological problems like:
-Loss of self-confidence.
How to treat low libido in men?
The treatment of low libido in men depends on the cause; treatments include:
-Live a healthier lifestyle: eating a healthier diet, sleep enough, reduce stress, reduce alcohol consumption.
-Switch medication, if the one you’re on is affecting your libido.
-Testosterone replacement therapy.
– If your low libido has psychological causes, you may need to visit a therapist for relationship counseling.
You should know your body and tell your doctor what you’re feeling; that’s the only way to know if the problem is physical, psychological, or both.
You should know that the medications that help you get and keep erections don’t boost libido.