Urology Blog

The Role of Laparoscopic Prostatectomy in Treating Prostate Cancer

Prostate Cancer Chattanooga TNProstate cancer is a condition that, when diagnosed, is graded. The grade of a cancerous prostate tumor is reached by assessing size and other characteristics that indicate potential aggressiveness. When a tumor appears to be on the aggressive side, radical prostatectomy may be advisable. This surgical procedure removes the entire prostate gland. In some situations, the early removal of the affected gland may provide an effective cure as well as a reduced risk of recurrence. Laparoscopic prostatectomy is a minimally-invasive technique that offers meaningful benefits.

Before the development of laparoscopic procedures, men needing a prostatectomy underwent traditional open surgery. Open surgeries require a larger incision to accommodate surgical instruments as well as visual access to the surgical site. The extensive nature of open surgery incurs a longer recovery period. Laparoscopic procedures are conducted with an instrument that enables viewing of the surgical area via a small camera on the end of a tube. No large incisions are needed, only a few small incisions through which tiny instruments can be inserted.

Why More Men are Choosing Laparoscopic Prostatectomy

Virtually any patient who has been diagnosed with localized prostate cancer may be a good candidate for prostatectomy. The benefits of this closed procedure versus traditional open surgery include:

  • Less trauma to the abdominal wall
  • Smaller, more discreet incisions
  • Less bleeding during surgery
  • Better visual magnification of the surgical site
  • Shorter hospital stay than traditional open prostatectomy
  • Less need for pain medication after surgery
  • Earlier return to normal activities
  • Better nerve-sparing capability

What is Laparoscopic Prostatectomy Like?

This minimally-invasive procedure can last between 2 1/2 and 3 1/2 hours. Before surgery, general anesthesia is administered. The anesthesiologist monitors vital signs throughout the procedure. Small incisions are made to visualize and access the prostate. The catheter and camera are inserted through one and surgical instruments are inserted through the others. Using these instruments, the surgeon removes the prostate gland as well as the seminal vesicles, two fluid-filled sacs next to the prostate gland. After these structures are removed, the urethra is attached to the bladder neck. Depending on the diagnosis, nearby lymph nodes may be biopsied at the time of surgery.

If you are experiencing symptoms of an enlarged prostate or have been diagnosed with prostate cancer, or if you have a higher risk for either of these conditions, contact our Chattanooga office. We can help you navigate your treatment process. Call (423) 778-5910.

Can BPH Affect Your Sex Life?

Benign prostatic hyperplasia is the condition we refer to as BPH. It is the condition in which a man’s prostate has become enlarged. Studies have indicated that approximately half of all men develop BPH between the ages of 51 and 60. In the over-80 age group, nearly 90 percent of men experience the symptoms of an enlarged prostate.

Most men recognize bladder issues as a sign of BPH; a need to urinate frequently and being met with weak urine flow. BPH can also cause a full bladder sensation immediately after urinating. The pressure on the bladder may make it difficult to start urinating and to fully empty the bladder, leading to dribbling. These are relatively well-known facts about BPH. What might not be as obvious is the connection between an enlarged prostate and sexual issues. Some issues relate to BPH directly and some to the type of treatment a man is prescribed to manage his prostate health.

  1. Diminished sexual satisfaction may occur when a man is woken several times a night by his need to urinate. Sleep issues often coincide with anxiety and, together, the two may result in a general decline in sexual satisfaction.
  2. Libido may decrease as a side effect of certain medications prescribed to treat an enlarged prostate. This most commonly occurs with 5-alpha-reductase inhibitors. If libido decreases after beginning a course of oral medication for BPH, a man should speak with his doctor about alternative treatment modalities such as straight alpha-blockers or laser ablation.
  3. Erectile dysfunction affects up to 10 percent of men who undergo TURP for the treatment of BPH. TURP, or Transurethral Resection of the Prostate, is a minimally invasive procedure that also carries a risk of incontinence and impotence. As an alternative to this technique, many men consider laser ablation to reduce the symptoms of BPH.
  4. TURP may also cause retrograde ejaculation, a condition in which semen enters the bladder rather than exiting the body from the penis. When a man has retrograde ejaculation, conception becomes a challenge because, although he will reach climax and have an orgasm, it will be what we call “dry.”

At UT Urology, we are continually researching treatments that help men maintain sexual and prostate health throughout their lifetime. To learn more about current treatment options for BPH, call our Chattanooga office at (423) 778-5910.

Why Do My Balls Hurt?

Enlarged Prostate Chattanooga TNEvery man has an innate knowing that his testicles are a delicate area of his body. Even the topic of testicular pain is a sensitive one to discuss. The testicles are front and center, so to speak, which makes them vulnerable on a physical level.  Emotionally, the testicles are known to support male sexual development and virility throughout adulthood. Injury or pain in the testicles, then, can understandably present a fair amount of concern. Here, we discuss what testicular pain may mean.

Does testicular pain suggest cancer?

This is the big question, so we’ll tackle it first. Urologists may see one or more patients every week who are concerned about testicular pain. While pain itself is clearly a common issue, the correlation between pain and testicular cancer is very weak. Testicular cancer is actually quite rare, accounting for only one percent of all cancers that affect men. Furthermore, it is more likely that testicular cancer will present as swelling or a painless lump in one of the testicles. Men can and are encouraged to learn how to perform self-checks to spot testicular cancer or other changes to their anatomy.

Potential Causes of Testicular Pain

  • Testicular torsion is a type of pain that may more commonly affect young men (aged 10- to 20-years). This condition can be serious due to its restriction of blood flow to the testes. Torsion typically occurs quickly and causes intense pain. If comfort does not improve within a few minutes, prompt medical attention should be sought.
  • Epididymitis is a painful problem that involves inflammation in the tube at the back of the testicle. This condition is typically caused by infection. Often associated with STIs like chlamydia, it is also possible for a basic urinary tract infection to cause epididymitis. A course of antibiotics may be prescribed to resolve the infection.
  • Orchitis is also related to infection. This inflammation occurs in the testicles themselves and may improve with antibiotics.
  • Hydroceles can cause dull pain that also creates a sense of nausea. This condition involves fluid accumulation near or within the epididymis.
  • Spermatocele is an uncomfortable problem related to fluid accumulation in the testicles.
  • Varicoceles are a type of varicose vein, or swollen vein, in the testicle.

Most cases of testicular pain can be easily treated with nonsurgical or microsurgical techniques. Don’t let pain bench your quality of life. Call our Chattanooga office at (423) 778-5910 to schedule a consultation.

What To Expect After Your Vasectomy

Vasectomy Chattanooga TNApproximately half a million men in our country undergo vasectomy treatment each year. This form of long-term birth control may be very common but that doesn’t mean it is an easy decision to make. Many men think about a vasectomy for years before making their final decision. In many cases, it’s not the question of permanence that stops them, it’s questions about what to expect after this procedure.

Understandably, there will be apprehension about choosing to have a delicate area of the body operated on. Many stories have been passed around about the aftermath of a vasectomy, which doesn’t help matters. Here, we want to clear up any misconceptions you may have about what it’s like to have a vasectomy. The more you know, the more peace of mind you can have about this advantageous procedure.

Vasectomy Recovery Timeline

Initial Recovery

Vasectomies are performed as an outpatient procedure. It is possible to drive yourself home or have a loved one drive you to and from your appointment. We recommend going straight home after the procedure and committing the remainder of the day to rest. We may prescribe pain medication to use as directed for a few days. During this time, you may want to stay home and stay off your feet as much as possible. Rest supports the healing process and reduces the severity and duration of post-operative swelling. An ice pack may also be applied for approximately 20 minutes, several times a day. A cloth should be placed between the ice pack and the skin.

Making Progress

During the first few weeks of vasectomy recovery, many men feel more comfortable with a little extra support. An athletic supporter, bike shorts with compression, or other garments that fit more tightly can create a sense of security around the healing scrotum.

Exercise is clearly off-limits, and it is important to also remember that “heavy lifting” includes anything that weighs more than a gallon of mild. If as healing progresses and physical strength improves, lifting is a no-no, as are exercises such as squats and crunches. After about two weeks of recovery, most activities can be resumed, so be patient with your body as it recovers.

What about sex?

This is a common question we hear from our vasectomy patients. Usually, patients can resume sexual intercourse about a week after their vasectomy. It is important to keep in mind, though, that sperm may remain in the vas deferens for several months, which means pregnancy can still occur. A reliable method of birth control should be used until we have confirmed sterilization.

Get the facts about vasectomy treatment in our Chattanooga office. Call (423) 778-5910 to schedule a consultation.

Could a Vasectomy Affect Your Sex Life?

Vasectomy Chattanooga, TNUndergoing a vasectomy is an enormously personal decision for every man who considers this permanent form of pregnancy prevention. The benefits of the procedure are clear. What isn’t clear to many potential patients is how having a vasectomy may affect their sex life. Will orgasm change after a vasectomy? Erection or ejaculation? We answer these questions here.

Ejaculation after Vasectomy

A vasectomy stops sperm, not semen. The procedure modifies the vas deferens, the small tube that transports sperm into the ejaculatory ducts, where semen passes through after production in the seminal vesicles. Not only does a vasectomy leave semen production intact, but it also does not change the characteristics of the ejaculate other than to eliminate sperm. Semen output should remain the same in terms of quantity, consistency, and color.

Orgasm after Vasectomy

There is an old myth that a man who has had a vasectomy may find it more difficult to reach orgasm. This is a complete myth. Sexual climax is the result of physical and psychological stimuli during intercourse and does not rely on sperm nor the vas deferens for optimization. Some studies even suggest that men report better orgasms after their vasectomy.

About Libido

The 2017 study conducted among 294 couples in Germany revealed numerous facts about the effects of vasectomy on sexual wellness. Contrary to misconceptions, a man who has a vasectomy is not “less manly,” nor do they feel that way, according to the study. In fact, many of the men who participated in the study revealed that they had more sex after their vasectomy, as well as better erectile function and generally improved sexual satisfaction.

At the time of the study, the Guttmacher Institute for family planning research noted that only 8 percent of contraception in the United States fell into the vasectomy category. This is despite the high success rate (only 15 to 20 accidental pregnancies for 10,000 men) and low risk associated with vasectomy.

What Works for You?

Every situation is unique. We prioritize education among our patients and helping them overcome obstacles that relate to misperceptions about vasectomy treatment and how it may affect quality of life. If you’re ready to learn more, contact our Chattanooga office at (423) 778-5910.

Medical Options for Enlarged Prostate

Enlarged Prostate Chattanooga TNThe prostate is an important part of the male reproductive system. It is here that fluid is produced and supplied to nourish the sperm in the ejaculate. This small organ that sits just above the rectum and behind the bladder is normally about the size of a walnut. When a man reaches his mid-30s, hormonal changes combine with diet, lifestyle habits, and family genetics to affect the prostate. It is at this time that the organ may begin to enlarge.

Prostate enlargement is an event that may occur over several years, decades even. By the time a man reaches his 50s, he may have diagnosable benign prostatic hyperplasia, or BPH. This condition describes an enlarged prostate gland that may cause symptoms. The urethra, the tube that travels from the bladder to the penis, travels through the prostate. If the gland enlarges to a point of pressing on the urethra, urine flow may change.

Symptoms related to an enlarged prostate may be treated in several ways. There is no “right” treatment for every man, which is why comprehensive medical care is a must. At UT Urology, men in the Chattanooga area receive a high level of personalized care that looks beyond prostate size to consider all factors related to this condition and how it may be improved.

Determining the Right Level of Care

To fully understand benign prostatic hyperplasia, a urologist will likely perform a digital rectal exam to estimate prostate size. Imaging such as ultrasound may also be performed. However, symptoms are as important as size when it comes to determining the right level of care. Some men may develop symptoms with only mild enlargement, and some may have a very large prostate but no symptoms. Doctors will ask questions about urination and may also order lab tests to screen for prostate cancer and evaluate kidney function.

Treating Benign Prostate Hyperplasia

When there are few symptoms affecting a man’s quality of life and no indication of prostate cancer or kidney or bladder problems, no immediate treatment may be prescribed. Periodic prostate exams may be scheduled more frequently and lifestyle modifications may be recommended. In some instances, non-surgical treatment such as medication or other conservative approach such as Rezūm water vapor therapy.

Prostatic enlargement in which symptoms such as urinary frequency (day and night) and urgency, weak flow, or irregular flow are the norm may require surgical intervention. Even here, several treatment options exist. As often as possible, the most conservative and minimally-invasive technique is selected.

Our priority is to help each of our patients understand their treatment options for BPH. For more information, call our Chattanooga office at (423) 778-5910.

Minor Annoyance or Major Warning Sign?

MEN'S HEALTH Chattanooga TNIt is no secret that men are notorious for avoiding the doctor until they absolutely must receive medical care. The notion that subtle symptoms are merely a minor annoyance could be very, very wrong. It is our intent to help men in the Chattanooga area make sense of urologic symptoms; to understand their origin and, most importantly, find an appropriate way to correct the problem.

Here, we want to discuss signs that you or a man you love needs to see a urologist.

  1. Erectile Dysfunction. Historically, the topic of erectile dysfunction has been one that men have avoided. Only recently has it become recognized as a widespread problem. A urologic examination seeks to understand erectile dysfunction in the wider context of general health. Is the obvious problem linked to another, such as hypertension? Understanding the nature of erectile dysfunction, a urologist can then discuss appropriate treatment.
  2. Frequent urination. There are several reasons why a man may need to urinate frequently. Whether this occurs primarily at night or becomes disruptive of daytime activities, frequent urination is a problem to explore with a urologist. The underlying issue could be an enlarged prostate, infection, or urinary incontinence. With proper treatment, the problem can become much more manageable.
  3. Difficulty urinating. Sometimes, urinary difficulty goes hand in hand with a frequent need to urinate. This could relate to an enlarged prostate and the inability to adequately release urine.
  4. Blood in the urine. If urine is pink-tinged or red, a urologic exam should be scheduled right away. This holds true even if evidence of blood comes and goes. Thorough testing is necessary to determine the cause of blood in the urine, which might be infection or kidney or bladder cancer.
  5. When a couple has difficulty conceiving, it is important for both partners to undergo a thorough health examination revolving around fertility. Studies suggest that 25% of infertility cases relate directly to a male reproductive issue.

Our medical needs change as we go through life. At some point, men will be best served by the inclusion of a urologist in their general healthcare team. To schedule a visit at UT Urology, call (423) 778-5910.

Managing Peyronie’s Disease Begins with a Conversation

Men have a historic reputation for being particularly mindful of a certain part of their body. The penis has been scrutinized by just about every man who has lived. Various characteristics, such as a slight lean or curve, can make a man self-conscious and even concerned that his anatomy is somehow abnormal. In most situations, a minor curvature or lean to one side indicates nothing more than that, a curve or lean. However, if a man also experiences pain or sexual dysfunction related to a curved penile shaft, he may benefit from a thorough conversation with his doctor.

Peyronie’s Disease: What is It, Exactly?

The term Peyronie’s disease is used to describe an obvious curve in the penile shaft. According to research, this condition has been more commonly diagnosed in men between the ages of 40 and 70. However, experts have suggested that there could be many cases involving younger men that simply haven’t been formally diagnosed. Until recently, there hasn’t been much talk about the way the penis may curve or understanding of why this may happen to some men.

Scientific data demonstrates that Peyronie’s disease is a condition that involves either scar tissue or the accumulation of thick plaque in the tubular membrane that assists erectile function. When thick tissue forms on one side of the penile shaft, the erection will be shorter on that side, causing it to curve, sometimes uncomfortably, to the shortened side. It is believed that plaques and scar tissue both relate to a previous injury to the penis, either when erect or when flaccid.

Symptoms of Peyronie’s Disease

The most recognizable symptom of Peyronie’s disease is the sharp curvature of the penile shaft. Additionally, men may develop symptoms including:

  • A hard lump or area of thickened tissue on one side of the penis
  • An hourglass-shaped penile shaft
  • Loss of penile girth or length
  • Painful erection and/or sexual intercourse
  • Erectile dysfunction

Treating Peyronie’s Disease

A board-certified urologist should be consulted for the diagnosis and treatment of Peyronie’s disease. A thorough medical evaluation can identify the stage of disease, acute or chronic, and viable treatment options that align with the stage of disease and a man’s preference for care. While it is possible and sometimes ideal to treat Peyronie’s disease with surgery, recent advances in treatment include an injectable that dissolves the plaques that are causing shaft shortening on one side.

It is no secret that many men tend to tackle problems without asking for help. Peyronie’s disease is not an instance in which you want to do this. Get the help you need by calling our Chattanooga urology office at (423) 778-5910.

Fellowship-Trained or Board-Certified: What is the Difference and Why Should You Care What Certification Your Urologist Has?

Urologist Chattanooga, TN When choosing a healthcare provider, there are certain qualifications one looks for. In the general setting in which a doctor will be chosen to perform basic general checkups and relevant screenings, most patients look for a physician who is board-certified. Instinctively, many people will look for the same when they need a specialist. At UT Urology, patients from the Chattanooga area are most likely to see a fellowship-trained urologist. Here’s why that matters.

Board Certification

The American Board of Urology sets the standard for the board-certification of urologists in our country. Physicians who have completed their training and residency requirements within the specialty of urology may apply for board-certification; a two-part examination process through which competency is confirmed.

Fellowship Training

Specializing in any area of medicine means that a physician has completed extensive schooling and advanced training. First, the specialist obtains their initial 4-year college degree just to enter medical school. This post-graduate training continues for another 4 years. Residency, which is usually a five-year program, then offers the physician the advanced training they desire to specialize in their chosen area, such as urology. A select few residency-trained physicians receive an invitation to complete Fellowship program in their area of specialty. Fellowship training is usually a one-year commitment.

What does fellowship training mean for a doctor? Expertise. A fellowship-training program is overseen by leaders in their field, providing the training physician with the opportunity to learn the most advanced diagnostic and treatment protocols available. The added level of expertise and insight translates into a higher standard of patient care.

The Urology team at UT Urology includes fellowship trained specialists across multiple areas of urologic care. Our physicians have received fellowship training in areas including female urology, microsurgery, robotic urology, and men’s health and reproductive urology. The extensive training that our team has undergone enables us to achieve accurate diagnoses and to develop treatment plans that achieve optimal patient outcomes.

We proudly serve patients from the Chattanooga area with professional care in a friendly environment. Contact UT Urology for specialized care in the treatment of erectile dysfunction, low testosterone, Peyronie’s Disease, kidney stones, overactive bladder, and more.

We’re here to help. Call (423) 778-5910 to schedule your visit.

Are You Wondering about Penile Implants?

Penile Implant, Chattanooga TNPenile implants have been used for more than 30 years. As common as it has been to treat longstanding erectile dysfunction with implanted devices, there isn’t much talk about this form of treatment. Until recently, there wasn’t’ much open communication about erectile dysfunction at all. You may have only heard about penile implants in your own research about how to live a more fulfilling life by improving sexual performance. If this is a treatment that has peaked your interest, chances are you have a lot of questions. Here, we touch on some of the everyday details that men want to know about penile implants.

  • Yes, orgasm is still possible. So is ejaculation. Studies have even shown that some men who have had difficulty reaching orgasm before receiving a penile implant regain this function.
  • Yes, a penile implant does show up on walk-through airport security devices. Some men alert security personnel of their implant before they step into the x-ray machine. Many men have penile implants so telling airport security should not be an embarrassing experience.
  • No, erection cannot occur naturally after a penile implant has been installed. Implant devices are easy to use and they provide immediate results, so most patients do not find this to be a problem.
  • Yes, you can still play sports and enjoy your normal physical activities with a penile implant. After a few weeks, the implant will feel completely normal. The only sport that may require a few modifications is cycling. Due to the presence of the implant, men may want to switch a smaller seat to one that is wider with an indentation in the center.
  • No, the length and size of your erection will not change with a penile implant in place. What does change, however, is the appearance of your flaccid penis. After a short time, patients get used to their soft penis appearing semi-hard after surgery.

Many benefits can be gained with a penile implant. At UT Urology, we have a compassionate staff who can answer your questions about erectile dysfunction and the value of penile implants as a form of treatment. Call our Chattanooga office for a consultation.

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