9 Common Outpatient Procedures Your Urologist Might Recommend

There are many different reasons for an individual to see a urologist. From uncovering problems with incontinence to seeking answers about recurring UTIs, urologists offer a wide array of services. Established in 1987, Norman Urology Associates is committed to giving men, women, and children the best care possible. Utilizing the most recent diagnostic procedures and therapeutic strategies, we are dedicated to the early diagnosis, effective treatment, and prevention of urologic illnesses. Some of the most common outpatient procedures your urologist might recommend are outlined in this article. 

1. Vasectomies

Many men undergo this popular urological surgery. The American Urological Association estimates that 500,000 men in the US undergo vasectomies annually. A vasectomy is a surgical technique used for long-term male birth control. The vas deferens, which transports sperm from the testicles, is cut and sealed during the surgery to stop the flow of sperm to the semen. It is a short, minimally-invasive outpatient procedure usually completed within 30 minutes.

2. Vasectomy Reversals

A vasectomy can be reversed if a man who has previously had one decides he wants to attempt having children once again. However, the man is not guaranteed to be able to conceive again despite the vasectomy being reversed, as the successful reversal depends on several things. The vas deferens is repaired using microsurgery to allow for sperm to travel to the semen again.

3. Cystoscopy

A urologist can check the lining of the bladder and the urethra by performing a cystoscopy, which is another common urology procedure. In a cystoscopy, the urethra is used to implant a cystoscope, which is then directed to the bladder. A long, thin tube with a light and camera at the end makes up the cystoscope. This method is frequently employed to identify and treat bladder problems. It can also be used to determine whether the prostate is enlarged.

4. Prostate Procedures

A urologist might recommend a number of procedures to treat issues with the prostate, including:

• Prostate biopsy: A procedure to remove samples of tissue from the prostate for examination in a lab. 

• UroLift: A minimally invasive procedure done in-office to treat mild to moderate prostate enlargement.

5. Ureteroscopy

Kidney stones are diagnosed and treated via ureteroscopy. A ureteroscope is a specialized tool guided via the urethra, bladder, and up the ureter to the kidney stone's location. It is a long, thin tube with a light and camera. Larger stones need to be broken up, while smaller stones can be taken whole.

6. Lithotripsy

A urology procedure called lithotripsy employs shock waves or a laser to dissolve kidney, bladder, or ureter stones. Large stones are broken apart so they can pass through the urinary system by using a laser or shock waves.

7. Penile Plication

A surgical urology treatment called penile plication is performed to address Peyronie's disease-related penis curvature. Permanent sutures are inserted during this outpatient treatment on the side of the scarring that is causing the curvature.

8. Penile Implants and Prosthesis

Men with erectile dysfunction (ED) can acquire an erection with the help of penile implants or prostheses, which are devices inserted into the penis. Typically, these devices are only recommended as a last resort for ED. For example, men with severe Peyronie's disease who are unable to develop an erection due to the penis' curvature may be advised to use a penile prosthesis.

9. Circumcision 

The foreskin (skin covering the tip of the penis) is removed during circumcision. It is a treatment that is frequently carried out on newborn males all around the world, including in the US.

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The mission of Norman Urology Associates is to provide quality, cost-effective, outcome-based perioperative care to patients with specific medical and surgical needs. Our team works together to satisfy this mission by demonstrating mutual respect and consideration for all individuals involved in care, including patients, employees, and physicians. Head over to our website to learn more.

Are Vasectomies Reversible?

There are many reasons you may consider a vasectomy. Perhaps you and your partner have decided you do not want children and prefer this procedure instead of other popular forms of contraception that may have adverse effects on women. 

Maybe you do not have a partner and simply have decided on your own that you do not want children. Whatever the reason, it’s not uncommon for people to assume that a vasectomy is permanent sterilization for men. However, this would be an incorrect assumption as not only are vasectomy reversals possible, but they’re quite common and straightforward. 

Understanding Vasectomies

When an individual goes in for a vasectomy, the procedure is usually done in a urologist’s office and completed in under 20 minutes. If performing the procedure in an office causes the patient unease, a doctor may decide to complete it in an outpatient surgical center instead. 

The procedure starts with a doctor applying local anesthetics to the scrotum before making a small incision to access the vas deferens. Once this is achieved, the doctor will then remove a small part of the vas deferens and cauterize or stitch close the openings. 

This removes the possibility of sperm entering the vas deferens and leaving the testes upon ejaculation, even though sperm is still being produced in the body. When someone has this procedure done, sperm are slowly absorbed by the body as they are produced instead of exiting the body via ejaculation. Most patients report feeling little to no pain past the first day following the procedure and recover fully in about a week. 

Understanding the Types of Vasectomy Reversals

Though slightly more complicated than the initial vasectomy, vasectomy reversals are still relatively simple and non-invasive procedures that restore continuity in the male reproductive system. Unlike a vasectomy, a vasectomy reversal requires the patient to be fully anesthetized rather than locally anesthetized. Once the patient is unconscious, a doctor will begin by using a special microscope to remove the closed parts of the vas deferens and take a sample of vasal fluid. After this is done, there are two ways a urologist may proceed with the reversal. 

Option 1: Vasovasostomy

In this procedure, once the urologist has examined the vasal fluid, they will find that there either is or isn’t sperm found in the fluid. If there is sperm in the vasal fluid, it can be deduced that the pathway is clear between the testes and where the vas deferens was cut. In this case, the urologist will simply reattach the cut ends of the vas deferens with tiny stitches.

Option 2: Vasoepididymostomy

If a doctor finds that there is not any sperm found in the vasal fluid sample, it could mean that because of back pressure from the initial vasectomy, a sort of “blowout” occurred in the epididymal tube. This “blowout” can lead to blockage, and in this case, a urologist will need to go around the block and attach the vas deferens to the epididymis itself. 

Things to Consider

Your Body Is Still Producing Sperm

Many men are surprised to find out that even though they had a vasectomy, their bodies never stopped producing sperm. Because of this, your normal fertility is restored after a reversal. In most cases, you will be asked to abstain from sex for three weeks before trying to conceive to allow your body time to heal. 

Time Is a Factor

There is a common misconception that if your initial vasectomy was done years ago, the success rate of a reversal would decrease. This is only true if the vasectomy was done over 15 years ago. As long as the vasectomy was performed within the last ten years or so, there is a 95% success rate. 

Fertility Is Always a Factor

If you and your partner are interested in a vasectomy reversal, you should both be examined for any potential fertility issues and discuss all of your options. The health of the male and female are both critically important to successfully conceive.

A vasectomy is the most efficient form of male birth control outside of one thing — abstinence. Understanding how these procedures work will help you decide what is right for you. Head to our website for even more information on urologic health.

Is a Urinary Tract Infection (UTI) the Same as a Bladder Infection?

Bladder and urinary tract infections (UTIs) often present with the same or similar symptoms. So it’s easy to understand why people might use the terms interchangeably.

The definition of a UTI is broad. It is defined as an infection in any part of the urinary tract, including the urethra, kidneys, ureters, and bladder. But bladder infections are the most common type of UTI.

A bladder infection (cystitis) is a type of urinary tract infection, but not all UTIs are bladder infections. In other words, cystitis is a UTI that’s only located in the bladder. Cystitis is also the most common UTI-related diagnosis, especially in women.

What Is Cystitis?

In simple terms, cystitis– which, again, is a type of UTI - is a result of inflammation of the bladder and associated structures, most often caused by bacteria that enter through the urethra and travel up the urinary tract. E.coli (which is commonly found in the gastrointestinal tract) is the main culprit for these infections, but other bacteria like proteus, enterococcus, and klebsiella can contribute as well.

If left untreated, there is a danger these bacteria could travel further up the urological system into the kidneys, causing more serious illness.

Why Are Women More Likely Than Men to Develop a UTI?

About 40% to 60% of women in the US will develop a UTI in their lifetime. About 10% will contract a UTI annually.

Even more specifically, women between the ages of sixteen and thirty-five are the most vulnerable. And recurrences are common, so about half of female patients experience another UTI within the same year.

What’s more, this type of infection is more common in women than men by at least four times.

But why is this?

Mostly it has to do with physical anatomy. While there can be a number of other contributing factors, one key reason is that a woman’s ureter is shorter than a man’s. So bacteria can more easily travel to other urological structures, including the bladder.

What Are the Symptoms of a Urinary Tract Infection vs. a Bladder Infection?

As you’ll see, UTIs and cystitis share common symptoms, which is why you should see your doctor if you experience any of them. Your doctor can perform a urinalysis to determine a specific diagnosis. 

That said, common symptoms for both include:

Urinary Tract Infection

• A strong, persistent urge to urinate

• A burning sensation when urinating

• Passing frequent, small amounts of urine

• Urine that appears cloudy

• Urine that appears red, bright pink or cola-colored — a sign of blood in the urine

• Strong-smelling urine

• Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone

Bladder Infection

• A painful, burning sensation during urination

• Pain in the bladder which can also feel like an urgent need to urinate, even if you’ve just been

• Only producing a few drops when trying to urinate

• Leaking urine

• Cloudy or foul-smelling urine

• Blood in the urine

• Pelvic or stomach pain

Low-grade fever

Am I at Risk?

As we’ve already pointed out, being a woman is already a risk factor in and of itself. But there are other risk factors important to note here:

Sexual activity. Anything that encourages bacteria to travel up the urinary tract can put you at a higher risk of contracting a urinary tract infection (including bladder infections). The friction involved in intercourse can push bacteria into the urinary tract. 

Some birth control methods. Using a diaphragm and/or spermicidal gels can increase a woman’s risk of contracting a UTI and, potentially, a bladder infection. 

Menopause. In simple terms, a woman in menopause may experience a decline in estrogen, which can affect the urinary tract, making her more prone to infection.  

Blockages. An enlarged prostate or a kidney stone, for example, can trap urine in the bladder which can make a patient more vulnerable to infection. 

Use of catheters. Often when a patient is hospitalized or has neurological issues that affect their ability to control urination, a catheter is used to empty the bladder. This can introduce bacteria to the bladder, causing infection. And the longer the catheter is used, the more risk of infection. 

Prevention

There are many ways to lower your risk factor for contracting a UTI including:

• Drinking plenty of water.

• Drinking cranberry juice.

• Emptying your bladder after sexual intercourse.

• Avoiding potentially irritating feminine products like douches and powders.

• Wiping front to back. After a bowel movement, wiping towards the anus reduces the likelihood of bacteria entering the vagina or urethra.

But it’s important to remember, that even preventative measures sometimes fail to protect against infection. If you think you may have, or struggle with regular UTIs (including bladder infections), it’s time to make an appointment with your urologist. 

At Norman Urology, we specialize in treating disorders of the male and female urinary tracts, including UTIs and bladder infections. Our mission is to provide quality, cost-effective, outcome-based perioperative care to patients with specific medical and surgical needs. 
If you have questions, we’d love to hear from you. Why not set an appointment with us today?

Are Kidney Stones an Inherited Condition?

Anyone who’s ever passed a kidney stone will likely describe it as an excruciating experience. Symptoms can vary from severe, sharp pain in the side and back, to pain or burning sensation when urinating, to fever, chills, and even blood in the urine. And for most people, these are concurrent symptoms. 

Over half a million Americans wind up in the emergency room as a result of kidney stones each year. According to the data, the chances you will have a kidney stone in your lifetime are about 1 in 11. And about 12 percent of all Americans experience kidney stones on a recurrent basis. 

Although other factors play a role in developing this condition, if your relatives have a history of kidney stones, you’re even more likely to have them yourself. 

What Are Kidney Stones?

As their name suggests, renal (kidney) stones are small pebble-like deposits that can develop in one or both kidneys. These ‘pebbles’ consist of hard minerals and other compounds found in urine. 

They come in all shapes and sizes and they must migrate through the ducts that carry urine from the kidneys to the bladder in order to be excreted. Not surprisingly, the larger the stone the more painful it is to pass. 

Kidney stones are classified by the material they are made from:

• About 75 percent of kidney stones consist mostly of calcium.

• Renal stones can also be made up of uric acid (which is a normal byproduct of a healthy renal system).

• They can consist of cystine, which is a protein building block.

• They can be formed of a phosphate mineral called Struvite.

Kidney stones form when there are more of these minerals in the urine than the body can dissolve.

What Causes Kidney Stones?

In very simple terms, a key factor in the formation of kidney stones is too little water in the body. When a person is dehydrated, their urine contains less water which makes it easier for minerals, proteins, and compounds to cluster together to form stones. 

Lifestyle can certainly play a role in making someone more vulnerable to this condition. For example, a diet high in foods like animal proteins or foods that are high in sodium can facilitate the formation of kidney stones. 

Obesity and diabetes are also risk factors, and certain medications like diuretics may contribute to overall risk as well. 

Genetics can play a role as well.

So, They’re Hereditary?

The short answer is, yes. In general, individuals who have close relatives that have had kidney stones are more vulnerable to this condition themselves. 

Why is this? Variations in a gene called claudin-14 have been linked to an overall increased risk of getting kidney stones. Other genes can play a role as well.

For example, mutations in genes that play a heavy role in transmitting chemical signals from outside to inside cells or that are responsible for transporting materials within cells can up a person’s risk factor for getting kidney stones. These mutations can alter the level of calcium and other materials in urine, creating an imbalance that can lead to kidney stones.

Talk With Your Doctor

Kidney stone formation is specific to each patient, and a doctor can help you understand both your risk factors as well as the preventive measures that can reduce the likelihood of developing kidney stones. 

If you’ve had kidney stones or are concerned you might be genetically prone to them, the physicians and staff at Norman Urology specialize in treating disorders of the male and female urinary tract, including kidney stones.

We offer a number of procedures that help diagnose and treat kidney stones, including extracorporeal shockwave treatments that use ultrasonic waves to break up kidney stones. 

If you’ve previously had, have currently, or are just curious about your risk factors, why not book an appointment with us today?

10 Signs You Have an Enlarged Prostate and When To See Your Doctor

As our bodies age, some inevitable changes take place. For many men, one of those is an enlarged prostate. While unpleasant, having an enlarged prostate is incredibly common and benign and doesn’t increase your chances of developing prostate cancer. However, if left untreated, this condition can cause significant problems. 

The prostate is a gland that surrounds the urethra and produces a fluid that mixes with sperm cells from the testicles to make semen. When the gland grows bigger, it is referred to as an enlarged prostate. 

While a small number of men over 40 have an enlarged prostate, more than 90% of men over 80 have this condition. There are no risk factors, other than having normally functioning testicles.

So how do you know if you have an enlarged prostate? Here are 10 signs.  

1.     It is difficult for you to begin urinating 

Because your prostate is located beneath your bladder and the tube that transports urine from your bladder out of your penis passes through the center of your prostate, an enlarged prostate can block the flow of urine, making it more difficult for you to begin a stream.  

2.     You feel more urgency to urinate 

When your prostate pushes on your bladder, the urge to urinate comes on quickly and suddenly.

3.     Your urine stream is weak and stops and starts

An enlarged prostate can squeeze your urethra, making it harder to urinate because the passage for the urine is narrower.

4.     You feel as though you can’t fully empty your bladder

When your prostate becomes larger, it presses against your urethra and the bladder wall can thicken. At some point, this can cause your bladder to weaken, which means you can’t fully empty it. 

5.     Urinating more frequently

If your enlarged prostate pinches your urethra closed and it’s more difficult for you to empty your bladder, you’ll feel as though you must urinate more frequently. 

6.     You wake up multiple nights throughout the night needing to urinate

This increase in frequency can cause you to wake up two to three times (or more!) per night to urinate. 

7.     You develop bladder stones 

Bladder stones develop when there is crystallized, concentrated urine in your bladder. Because an enlarged prostate reduces flow, urine has time to crystalize.

8.     You are getting urinary tract infections (UTIs)

An enlarged prostate may make it more difficult for you to empty your bladder, leaving residual urine in your bladder. When it becomes stagnant, bacteria can multiply and cause a UTI. 

9.     Urinary leakage or dribbling

Constant dribbling, also known as overflow incontinence, is another consequence of an inability to fully empty your bladder. 

10.  You must strain or push to urinate

To overcome an obstructing prostate, your bladder may need to increase the force it exerts so you can urinate.

So, how do you know when to see your doctor? 

The bottom line is, that you should see a doctor for any symptoms of an enlarged prostate no matter how mild they are. This is because the severity of the symptoms doesn’t always reflect the seriousness of the problem. The earlier your urologist can diagnose an enlarged prostate, the less invasive, most effective treatment options they will have available to prevent this condition from impacting your lifestyle.

Lastly, while these types of lower urinary tract symptoms are frequently symptoms of an enlarged prostate, they can also be signs of more serious conditions such as a prostate infection or prostate cancer, both of which are usually very treatable when caught early.

Compassionate, skilled care 

The physicians and staff of Norman Urology Associates are fully committed to serving the urological needs of Norman and surrounding communities with the highest standards. Our highly-trained physicians treat any disorder of the urinary tract, including prostate enlargement, and will always treat you with compassion and as a partner in your medical care. Contact us to schedule an appointment.

5 Things You Can Expect During a Urologist Office Visit

At some point in life, the majority of us will need to see a urologist for any number of reasons. 

Symptoms that might trigger a referral from your primary doctor include things like:

Bladder issues, including incontinence, urinary tract infections, or interstitial cystitis (bladder pain). 

Kidney stones, which are hard deposits consisting of minerals and salts that can form inside the kidney and can be extremely painful.  

An enlarged prostate, which may put pressure on the bladder at the urethra which can lead to serious medical issues.

In this article, we’ll walk you through the 5 things you can expect before and during a urologist's office visit.

#1 Prepare Before You See Your Urologist

Before your visit, make a list of medications and supplements you currently take and write down any symptoms you’ve been experiencing, ensuring nothing is overlooked during the exam.

Write down questions so you get specific answers to them.

Remember to go to your visit with a full bladder in case your doctor wants to run a urinalysis (more on that later). 

#2 Fill Out Paperwork Once You Arrive

While in the waiting room, you’ll likely be asked to fill out some forms (especially if this is your first visit). Many doctors now use handheld computer devices to record your information rather than paper forms.

Doctors and their administrators need a record of things like date of birth, home address, and insurance information as well as prior medical history. If you have a family history of bladder cancer, for example, your physician will need to know that.

Sometimes it can seem overwhelming, but don’t rush yourself. Most offices allow you to fill out the remaining paperwork even after you’ve been called into the examination room.

#3 Measurements

Perhaps the most dreaded of all components of an examination at any doctor’s visit is the scale.  (Admit it, we’ve all had that sinking feeling as we realize we’ve put on a few pounds after the holidays!)

But doctors need a baseline weight if it’s your first visit, and for returning patients, this measures any big changes in weight that may indicate underlying issues.  

#4 Vital Signs

Just about every doctor will record your vital signs, so no surprises there. The doctor will assess things like blood pressure, heart rate, body temperature, and respiration. 

#5 Physical Examination

Before the physical examination begins, your doctor will review your measurements and vital signs and may ask you to elaborate on some of the information you provided when you filled out your paperwork.

So what kind of physical examinations can you expect your urologist to perform? It depends on the condition the doctor is treating or trying to diagnose, but two of the most common tests are:

A Urinalysis

Your doctor will have you urinate in a cup (this can be done in the office or at home) to use as a sample for testing.

A urinalysis is used to detect things like bacteria, white blood cells, blood, and nitrates. 

Based on your symptoms, for example, your doctor may suspect you have a UTI (urinary tract infection) and so order a urinalysis to confirm.

It’s a basic diagnostic test that helps your physician identify primary and underlying conditions. 

Digital Rectal Exam (DRE)

This is a simple procedure that allows your doctor to examine the lower rectum and surrounding areas including the prostate gland, uterus, ovaries– and of course – the bladder.

Your urologist will insert a lubricated, gloved finger into your rectum and apply pressure while they examine your bladder for any issues. 

While most people find this procedure uncomfortable, it takes just a few minutes to complete and generally isn’t painful. 

Meeting With a Specialist

After the exam, your urologist will discuss with you your condition and possible solutions. Your urologist may prescribe medication, physical therapy, or even surgery.

The physicians and staff at Norman Urology are dedicated to serving patients in Norman and surrounding communities. We offer comprehensive urological care and our physicians are highly trained to treat disorders of the male and female urinary tract, including incontinence, bladder conditions, and kidney stones. 

If you’re having symptoms of a possible urinary issue, why not schedule an appointment with us today? 

Why Are Seniors More Susceptible to UTIs? What Are The Symptoms?

Introduction

According to a study published in Aging Health, UTIs are the most common type of bacterial infection in those aged 65 or older, especially for nursing home residents. There are several different reasons that seniors are more susceptible to UTIs–both men and women. The symptoms of UTIs in seniors are the same as they are in younger people, but they can be more difficult to diagnose sometimes. Read on to learn more about why seniors are at higher risk for UTIs and how to spot the symptoms. 

Why Are Seniors More Susceptible?

Part of the reason for this is indwelling urinary catheters, which the elderly more often require. This same study mentioned above estimated that as many as half of nursing home residents with a urinary catheter will consequently experience symptomatic catheter-related UTIs. 

One of the main culprits for the increased frequency of UTIs in seniors is simply that our muscles, including the bladder and pelvic floor, weaken as we age. This can cause both incontinence (inability to control urination) and urine retention (difficulty urinating and completely emptying the bladder). The longer urine stays in the bladder, the higher the chance of bacteria (like E. coli) taking hold and multiplying. 

Other factors that contribute to increased levels of UTIs in seniors include weakened immune systems and kidney problems. Because diabetes affects the kidneys, it too can elevate UTI risk in seniors. 

The risk of UTIs is higher in women than in men due to their differences in anatomy. The urethra is shorter in women, making it easier for bacteria to enter the bladder. Additionally, after menopause, women produce less estrogen, and this can cause an imbalance of bacteria in the vagina, meaning there are more harmful bacteria than good bacteria. However, men can also experience UTIS if they have an enlarged prostate, which is more common in older men. Men who have enlarged prostates often have difficulty emptying their bladder fully, and this increases the ability of bacteria to grow. 

What Are the Symptoms of a UTI? 

Sometimes it’s difficult to recognize a UTI in seniors because the symptoms overlap with other illnesses. For seniors with Alzheimer’s or dementia, the difficulty is even greater because they may lack the ability to communicate their symptoms. If they have an infection, they may react by behaving erratically or seeming confused or disoriented. If you notice these changes in a senior with Alzheimer’s or dementia, it’s important to get them medical attention. 

The most common symptoms of a UTI include:

• Burning while urinating

• Frequent or urgent need to urinate

• A feeling the bladder is not completely empty

• Lower abdominal/pelvic pain

Untreated or severe UTIs can cause the following symptoms:

• Fever

• Severe abdominal pain

• Chills

• Fatigue

• Nausea/vomiting 

It is possible to have an asymptomatic UTI. Because there are no outward signs of infection, these UTIs may only be detected in yearly screenings. But that generally isn’t a problem, since most of the time, only seniors undergoing urological procedures or kidney transplants need to receive treatment for them. 

How Are UTIs Treated?

Doctors usually treat UTIs with a course of amoxicillin, a narrow-spectrum antibiotic that is less likely to cause antibiotic resistance. In more severe cases, a senior may require admission to a hospital for intensive care. 

How Can UTIs Be Prevented?

Here are some ways you can reduce the risk of UTIs for the seniors in your care. 

• Encourage them to drink plenty of water

• Ensure they empty their bladder often and fully

• Encourage them to wipe front to back

• Make sure they wear loose and breathable clothing, and if they are in diapers, change them frequently

• For seniors with dementia or Alzheimer’s, monitor behavior for increased confusion or agitation 

Conclusion

Do you suspect that a senior in your care has a UTI? Norman Urological Associates are here for you. Click here to make an appointment and speak with a urologist who can help you.

Should I See My Urologist Regularly Or Only When I Have Symptoms?

Some people go their whole lives without seeing a urologist. Others start seeing them later in life for prostate exams or pelvic exams–some children have medical conditions that require a urologist’s attention. 

Many people may think that only men of a certain age need to see urologists for their prostate issues, but urologists see people of all genders and ages for many different reasons. 

Here are some reasons you might need to see a urologist, regardless of age or gender. 

• Urinary Incontinence 

• Difficulty or Pain While Urinating

• Blood in Urine

• Frequent Urination

• Erectile Dysfunction

• Decreased Libido

• Penile or Testicular Abnormalities

• Pain in Your Lower Abdomen or Groin 

• Infertility Questions 

Not everyone needs to see a urologist regularly. One good way to know if you need to is if you see a urologist for a problem and they tell you to come back regularly. Once you have been seen by a urologist, they will know how often they want to see you and when depending on your issue and how they want to approach it. 

Men Over 40

One group that definitely should see a urologist regularly is men over the age of 40. Multiple conditions can occur in men over 40 that can be treated with a urologist’s help.

Benign Prostatic Hyperplasia 

Benign prostatic hyperplasia is a common problem for aging men. Because the prostate never stops growing, almost 90% of men will experience some symptoms of an enlarged prostate by age 85. This could cause discomfort or inconvenient symptoms, including a slow or weak urine stream, increased urges to urinate, or getting up during the night to urinate. If you notice any of these signs before you begin seeing a urologist regularly, schedule an appointment. 

Erectile Dysfunction

Erectile dysfunction means you’re unable to maintain an erection long enough to engage in sexual intercourse. It can be caused by different factors and affect men of any age; however, it occurs more frequently in men who are in their 40s and early 50s. Talking to a urologist about it can help men on the road to recovery.  

Urinary Conditions

Urinary conditions are common in men over 40 due to the continued growth of the prostate. This could manifest as changes in the urinary stream, frequency, getting up at night to urinate, or difficulty starting and/or stopping your urine stream.  

Testicular Changes

Testicular changes, like prostate changes, are not uncommon in aging men. Men should perform testicular exams on themselves once they get older so they can catch any problems early, including signs of testicular cancer, which include breast growth, soreness, and lower back pain. 

Prostate Cancer Screenings

Prostate cancer is one of the most common forms of cancer in men, and because it doesn’t present severe symptoms until it’s severely advanced, it’s a very dangerous kind of cancer. According to the American Urological Association, starting at age 40, all men should have prostate cancer screenings annually. 

Adult Women

There are several common pelvic floor disorders affecting women that require the care of a urologist, including urinary incontinence, dysuria, cystocele, rectocele, enterocele, and uterine prolapse. Most of the time, a woman will be referred to a urologist by her PCP if the PCP thinks the issue is something that requires urological care. If a woman is having problems with her reproductive or urinary systems, no matter what her age, she may benefit from seeing a urologist. Urological care usually stems from a referral by a PCP, so talking to your PCP about any issues you’re having is a good place to start. 

Norman Urology Associates Can Help

If you’re having any of the symptoms listed in this article, or you’re having other symptoms related to your urinary or reproductive systems, you may need a urologist. Schedule an appointment with Norman Urology Associates, and the team at Normal Urology can help you identify the problem and help you feel better soon.

Do UTIs Cause Cognitive Decline in Seniors?

As people get older, their immune systems slow down, responding less forcefully to infection. This leaves the elderly more vulnerable to illness. Not only is this elevated risk of infection concerning because of the physical effects, but the possible cognitive effects of a severe infection in the elderly can also be distressing. While there have been studies showing a link between urinary infections and cognitive decline in seniors, it tends to be an unmasking of a case of dementia that was already present or developing. 

What Is a Urinary Tract Infection? 

When bacteria enter the urethra and bladder, it can cause inflammation and infection. The infection can also travel up to your kidneys, but this is less common. When a urinary infection occurs, it can cause:

• Pain in your side, abdomen, or pelvic area

• Pressure in the lower pelvis

• Frequent need to urinate, urgent need to urinate, and incontinence 

• Painful urination

• Blood in the urine

• The need to urinate at night

• Abnormal urine color, cloudy urine, and strong or foul-smelling urine

If your doctor believes you have a UTI, they will take a urine sample and test it for white blood cell counts, red blood cell counts, and bacteria. They will then take a culture of the sample to test what kind of bacteria are present in the urine.

Treatment for a UTI is fairly straightforward. Your doctor will probably prescribe you some kind of antibiotic to take for several days. If the infection persists or if you get UTIs frequently, other interventions may be needed. 

What Is The Relationship Between Infection and Cognitive Decline in Seniors?

When an elderly person’s immune system detects an infection, its response may be weak and not capable of fending off illness. Then, when the infection becomes severe, the immune system launches a belated, stronger attack, resulting in systemic inflammation. This inflammation interrupts communication between immune cells and neural cells, which are crucial to cognitive function, and so a lessening of cognitive function may occur. Studies have shown that when cognitive decline results from infection in the elderly (like a UTI), it’s usually an ‘unmasking’ of dementia that was already present but exhibiting no symptoms, or an acceleration of the condition of someone predisposed to dementia. 

Unfortunately, those with or predisposed to dementia are more prone to infection, which in turn may lead to accelerated cognitive decline. In fact, acute delirium can be an indicator of infection in someone who has dementia. The relationship between cognitive and immune inflammation is bidirectional–one reinforces the other. 

A 2005 study published in Alzheimer's Disease & Associated Disorders noted “a positive association between episodes of infection and increased likelihood of diagnosis of dementia in the very elderly.” And other studies have shown that “hospitalization for common infections, such as pneumonia and urinary tract infections, is associated with at least 1.4-fold higher risk for dementia in otherwise well-functioning older adults.” The risk was the same whether the infection was severe or mild. 

How Can I Minimize My Risk of Urinary Tract Infections?

For post-menopausal women, an estrogen-containing vaginal cream, which changes the pH of the vagina, may be useful. Keeping the pelvic area clean and dry (especially during menstruation and after sex) and drinking plenty of fluids are all good ways to minimize the risk of a UTI. Talk to a healthcare provider if you have questions. 

Norman Urology Associates Can Help

If you are experiencing symptoms of a UTI and are unsure what to do, the team at Normal Urology can help you identify the problem and help you feel better soon. Contact our office today to make an appointment with one of our doctors.

Can UTIs Cause Delirium In Seniors?

Urinary tract infections are one of the most common conditions urologists treat, with women being especially vulnerable. Scientists estimate 50-60% of adult women will contract a UTI in their lifetime, with older women among the most susceptible to this type of infection.  

The good news is that they are highly treatable.

Common Symptoms

Patients commonly suffer some or all of the following symptoms:

• Burning sensation when urinating

• Frequent, persistent need to urinate

• Cloudy or strong-smelling urine

• Red or pink urine (which indicates there may be blood in the urine)

• Tenderness in the lower abdomen, above the pubic bone

Most doctors agree that if a patient has at least two of the symptoms above in addition to a positive urine culture, it’s time to treat them for a UTI.

But more alarming cognitive symptoms like confusion and delirium can also accompany a UTI in seniors. Most people aren’t aware of the connection between this type of infection and cognitive issues and may worry their loved one is showing signs of dementia. 

And sometimes, delirium can be the only symptom, making it all the more difficult to diagnose. 

What Is UTI Delirium?

Medically speaking, UTI delirium can look like disorientation but is different from dementia or Alzheimer’s in that it generally comes on quickly— within days or sometimes even hours vs. over the course of months or years. 

And confusion isn’t the only symptom that can accompany a UTI in seniors. Sometimes seniors with this condition can seem aggressive, restless, or withdrawn. And in more extreme cases, they may experience hallucinations.

How Does a UTI Affect The Brain?

So how does a UTI cause delirium, confusion, or hallucinations? It’s a urological condition, not a neurological one, right?

Scientists haven’t yet confirmed a direct link between UTIs and cognitive impairment but there is strong evidence to suggest it has to do with inflammation.  

When we contract any infection (including a UTI), our body’s immune system ramps up into high gear to help fight it off. In this process, our system releases chemicals and stress hormones, which can trigger inflammation. 

And inflammation can result in symptoms like fever and fatigue, as well as delirium or confusion in older adults. But why?

As we age, the blood-brain barrier (which protects the brain from things like viruses, bacteria, or fungi) becomes weaker and so infection and inflammation have greater opportunity to affect our brain’s normal function. 

It’s important to remember, not all seniors experiencing delirium have a UTI, and not all UTIs result in confusion and disorientation. 

Can There Be an Underlying Cause For Chronic UTIs?

While in many cases the diagnosis is pretty straightforward and only a urine sample is needed to confirm the infection, sometimes UTIs are secondary to larger issues. 

In both men and women, things like constipation and kidney stones can prevent the bladder from emptying properly, creating a breeding ground for bacteria to grow. 

An enlarged prostate gland in men can be responsible for recurrent infections, while a prolapse of the womb or vagina could be the hidden cause of chronic UTIs in women. 

Additional risk factors may include things like the use of a catheter, a diabetes diagnosis, or the presence of kidney stones. 

Treating a UTI In Older Adults

After an exam and confirmation of a UTI, your urologist will likely consider prescribing antibiotics. Most will prescribe a narrow-spectrum antibiotic (meaning, one that is only able to kill or inhibit a limited species of bacteria, like amoxicillin) since older adults don’t typically need powerful antibiotics for UTIs. 

Drugs commonly recommended for simple UTIs include:

• Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)

• Fosfomycin (Monurol)

• Nitrofurantoin (Macrodantin, Macrobid)

• Cephalexin (Keflex)

• Ceftriaxone

Over-the-counter medicines like ibuprofen can help ease pain as well as bring down a fever. 

A course of narrow-spectrum antibiotics will clear most infections quickly. If after a few days a patient is still experiencing symptoms, they should make an appointment with their urologist to explore further treatment options.

If you have or suspect you have a urinary tract infection, why not talk with the physicians at Norman Urology? 

We are experts in our field and have extensive experience treating urological conditions including UTIs and the underlying factors that can cause them. 

We’d love you to make an appointment with us today to learn more!

Painful Sex: Five Reasons Why Women Experience It and How to Get Help

1.     Pelvic floor dysfunction 

Stress affects more than your mind. It affects your body as well. The result can be anything from intestinal issues or headaches to pelvic floor dysfunction. When you’re stressed, you may be more prone to holding your breath, which can cause you to tighten your muscles and bear down on your pelvic floor. Long-term stress can cause your pelvic floor to stay contracted. The result is pain during penetration. 

Other causes of pelvic floor dysfunction are traumatic injuries to the pelvic area, pregnancy, overuse of pelvic muscles, or being overweight.

If your doctor diagnoses pelvic floor dysfunction, the most common way to treat it is by referring you to a physical therapist, who can provide biofeedback to help both strengthen your pelvic floor muscles and train them to relax. 

2.     Menopause or perimenopause

As women approach or reach menopause, their estrogen levels fall. These hormonal changes can cause thinning of the vaginal walls and vaginal dryness. Vaginal walls may become less elastic and more fragile, causing sex to hurt. The unfortunate consequence can be a domino effect. Sex is uncomfortable, so you won’t want to partake as often, which further contributes to a loss of tissue health and elasticity. 

There are both medical and non-medical treatments for menopause-related pain during sex, including engaging in more foreplay and using over-the-counter lubricants. Your doctor can prescribe a low dose of estrogen, either in the form of pills, cream, or a ring inserted into your vagina. The FDA also recently approved two non-hormonal medications to treat menopause-related dyspareunia.

3.     Pelvic organ prolapse 

Pelvic organ prolapse occurs when the muscles that support your pelvic organs – the bladder, uterus, small bowel, or rectum – become detached from their normal position and fall into the vagina, causing the out-of-place organs to make sexual penetration painful or uncomfortable. If your symptoms are severe enough to affect your quality of life, your doctor may recommend you have it repaired through surgery. 

4.     Infections 

Infections, either sexually transmitted or another type of condition, can cause vaginal irritation or changes, swelling, discharge, or blisters or sores, resulting in dyspareunia. Fortunately, your doctor should be able to easily diagnose and treat infections to restore your vaginal health.  

5.     Vulvodynia or vaginismus 

Both vulvodynia, pain on or around the vulva, or vaginismus, an involuntary contraction of the vagina, can make sexual penetration difficult or impossible. Vulvodynia can be caused by past vaginal infections, sensitive skin, hormonal changes, or pelvic floor weakness. Vaginismus can result from an anxiety disorder, a childbirth injury, prior surgery, or negative feelings about sex due to past trauma. The two disorders are treated similarly, either with physical therapy, counseling, topical therapy, or a combination. 

The bottom line is, you don’t have to tolerate painful sexual intercourse. Keep the lines of communication open with your partner and consult a qualified physician who can help you reclaim a healthy, pleasurable sex life. Visit our website for more information about our practice and to schedule an appointment with one of our specialists.

UTIs: Fact or Fiction?

Did you know 40 percent of women and 12 percent of men will feel the symptoms of at least one urinary tract infection in their lifetime? Furthermore, 1 in 5 women who have a UTI will have another one at some point. Even though men are less prone to developing a UTI, if they do develop one, they are likely to have another because the bacteria will hide in the prostate.

This information puts UTIs firmly in the “fact” category, but their severity can vary from person to person. 

What Causes UTIs?

UTIs occur when bacteria enter the urethra and travel to the bladder. In more serious cases, this bladder infection can spread to the kidneys and become life-threatening once it enters the bloodstream. A majority of the time, UTIs are cleared up in a matter of days with the aid of antibiotics. More complicated UTIs may not be treatable with antibiotics, however, and will require further medical attention.

Unfortunately, some people are just more prone to UTIs than others. Low estrogen levels in the vagina and sexual intercourse are known causes of UTIs in women, as well as condoms with sperm-killing foam. 

Diseases like diabetes are also known to increase the chances of developing a UTI because the body’s immune system is weaker and therefore more susceptible to infection. 

UTIs in women are generally viewed as uncomplicated and are treated easily, but UTIs in men and children should be evaluated by a urologist as they tend to be more complicated. 

What Are the Symptoms of a UTI?

The most common symptoms of a UTI include:

1. Blood in Urine

Although this can sometimes mean other issues in the urinary tract and should always be evaluated by a doctor, pink or cola-colored urine can be an indicator of a UTI.

2. Frequent Need to Urinate

Oftentimes UTIs present themselves with a frequent urge to urinate, but upon reaching the bathroom, only a few drops of urine can be produced. This can be very frustrating and is often the first sign people notice when they develop an infection.

3. Burning Sensation

If you are unable to produce a normal amount of urine and feel a burning sensation when doing so, you should speak to a healthcare provider. A burning feeling while urinating is one of the most common signs of a UTI.

It is important to note that if you develop a fever, chills, or back pain, it could be an indicator of a kidney infection and should be taken very seriously. If you experience these symptoms accompanied by the above, more common UTI symptoms, speak with your doctor right away.

How Do You Treat a UTI?

Treatment for uncomplicated UTIs involves a short round of prescribed antibiotics without a urine culture. All antibiotics are different, so depending on what your doctor prescribes you may take one pill a day or four, but this is usually limited to a 3 to 4-day process. Even if your symptoms subside after two days, be sure you finish the full round of medication that your doctor prescribes. UTIs will often return if not fully treated. Complicated UTIs may require antibiotics administered through an IV.

What if a UTI Frequently Returns?

For some women who are genetically predisposed to developing UTIs, it could be a lifelong issue. However, careful management can change how it affects their lives.

If you develop frequent UTIs, your doctor may put you on a low-dose nightly antibiotic for up to 6 months. This is shown to reduce UTIs by 95 percent. However, once you stop taking the antibiotics you may develop symptoms again. In this case, a doctor may try “self-treatment”. 

If this is pursued, a doctor will give you a urine culture device and a course of antibiotics. When you feel the onset of symptoms, you take a urine culture at home and begin the antibiotics. The urine culture is then tested by a urologist to find out if there are bacteria in the urine.

UTIs are never fun to deal with, and can potentially threaten your health a great deal. If you develop symptoms of a UTI, you should contact your doctor right away. Visit our website for more urology info and to schedule an appointment with one of our specialists.

6 Warning Signs of Prostate Cancer

Though it is a small organ, the prostate can cause huge problems to your health if left unchecked. Prostate cancer is one of the most common types of cancer Americans are diagnosed with, and it oftentimes develops without any symptoms.

If caught early, however, the survival rate for prostate cancer increases significantly. Urologists tell us that even though symptoms may not present themselves, there are 6 changes in your health you shouldn’t ignore. In this article, we will address these changes that may be indicative of prostate cancer.

What Is the Prostate and What Does It Do?

The prostate is a small, rubbery organ about the size of a walnut located in the groin — between the base of the penis and the rectum. It is a vital component in reproduction because it provides some of the seminal fluid for the sperm, allowing it to travel and survive longer.

While many other factors come into play to create the perfect environment for semen to travel safely and efficiently during reproduction —- without the prostate, there would be no reproduction at all.

6 Signs You Should Not Ignore

Firstly, if you are concerned about the health of your prostate, you should schedule an appointment with a urologist. Prostate cancer cannot be self-diagnosed. 

Secondly, these are signs that could indicate prostate cancer and should be checked on by a professional, even if they end up being harmless.

1. Weak Urine Flow

Weak urine flow is one of the least alarming signs in this list because it is often just a symptom of aging. Still, if your urine flow starts and stops beyond your ability to control it, it’s probably a good idea to have your prostate examined.

2. Frequent Urination

If a tumor develops on your prostate, it can put pressure on your bladder and cause you to urinate more than usual. Be mindful if you notice you are urinating more than normal, especially at night, as it could be an early sign of cancer.

3. Hematuria

Blood in your urine is often a sign of a urinary tract infection but is still a cause to have your prostate examined on the off chance it is a symptom of cancer development.

4. Issues With Ejaculation

Again, though these symptoms may also indicate other health issues, problems with ejaculation could be a serious indicator of a prostate issue. Painful ejaculation, decreased volume of ejaculate, and inability to maintain an erection could all be signs of the early stages of prostate cancer. If you experience any of these symptoms, schedule an appointment with a urologist to make sure your prostate is healthy.

5. Pain or Numbness

In the later stages of prostate cancer, it may cause pain in the lower back, hips, shoulders, or numbness in your legs and feet. It is worth noting that most people experience these symptoms after a diagnosis of prostate cancer has been made. Of course, these symptoms are also common in many other bodily issues, so they do not indicate prostate problems on their own.

6. Loss of Bowel Control

Like having a weak urinary flow, fecal incontinence can merely be a sign of old age. It can also be an indicator of prostate problems, however. If you are experiencing an inability to control your bowel movements, speak with a doctor about ruling out prostate cancer.

Like many forms of cancer, though very serious, early detection is of utmost importance. Speak with your doctor about any risk factors you may have of developing prostate cancer. They may recommend a prostate exam as early as 40 if you are particularly high-risk. Though there is no real way to prevent prostate cancer, regular prostate screenings, frequent exercise, and quitting smoking are all ways you can lower your risk. If you are experiencing any of these symptoms, you can educate yourself further about reproductive health on our website.

Causes and Treatments for Peyronie’s Disease

Peyronie’s disease is a connective tissue disorder that affects the male sex organ. The characteristics of this disease are not unlike Dupuytren’s contracture of the hand. Symptoms of Peyronie’s disease are grouped into three main characteristics — painful erections, bent erections, and palpable penile plaque. 

Though it lacks public awareness, Peyronie’s disease is quite common, with about 1 in 11 men suffering from it.

What Causes Peyronie’s Disease?

The common denominator between men with Peyronie's disease is the presence of scar tissue. It is thought that some form of mild penile trauma causes the disease. Though some men with the disease may not recall such an injury, vigorous sex is a common cause for mild penile trauma.

The three main characteristics of Peyronie’s disease can be linked to this point of trauma. The bent erections are due to the scar tissue from the injury, which does not stretch as well as regular tissue. This scar tissue is comprised of collagen, which can harden to the thickness of bone.

While most men with Peyronie’s disease report an upward bend of the penis, it has also been observed that some men experience bends in other directions, complex bends, divots in the sides of the penis, and even hourglass deformations. This palpable plaque is actual scar tissue that has been deposited on the outer erectile bodies of the penis. In severe cases, this plaque becomes calcified.

The painful erections that some men with Peyronie’s disease experience are thought to be from inflammation in the plaque and typically disappear on their own in about 12 months.

It is not certain whether or not erectile dysfunction is caused by Peyronie’s, but this can sometimes be the case. Most men with Peyronie’s report normal erectile function, but some report difficulty maintaining an erection — likely due to leaky veins in the penis. Peyronie’s does not typically affect the tissue within the erectile bodies, but it can affect the veins surrounding them and prevent them from closing properly.

How Do You Treat Peyronie’s Disease?

Peyronie’s Disease is unique in that spontaneous resolution is not at all uncommon. Typically, the disease has a sudden onset followed by quick progression and stabilization. If the disease has been stable for less than six months, it may spontaneously resolve itself even if it appears to be worsening. 

Most of the management of Peyronie’s depends on the extent of the disease’s stabilization, the severity of the defect, and the functionality of erection. Except for anti-inflammatory agents, medical therapy for Peyronie’s disease is no longer recommended by the American Urological Association.

A doctor may implement surgical therapy if the penile deformity has been stable for more than six months and prevents sexual relations. Penile-straightening surgery is a standard and simple operation that may be a viable option for men suffering from Peyronie’s disease. However, the exact method of straightening the penis will vary from patient to patient and depend on the curvature's severity.

Penile-straightening surgery does not come without complications, unfortunately. These complications include suture knots in the penis, numbness, penile shortening, and worsening erectile dysfunction. These complications (outside of penile shortening, which is not perceptible in most men) are rare.

For men with penile curvature greater than 90 degrees and erection loss that is unresponsive to medical therapy, a doctor may recommend penile prosthesis surgery. This surgery is considered somewhat of a last resort if the condition is unlikely to resolve itself. Many patients who receive this surgery choose an inflatable hydraulic implant in the erection chambers, allowing them to inflate their penis to achieve an erection whenever they want.

Understanding the symptoms and treatments of Peyronie’s disease can be key in catching otherwise unnoticed characteristics in the penis that could lead to further issues. Schedule an appointment with us today to stay on top of your urological health!

5 Foods that Could Be Irritating Your Bladder

If you’ve ever experienced urinary issues such as urinary frequency, urgency, or even incontinence, you likely haven’t thought of one of the things that can cause the issue to worsen—what you’re eating and drinking. 

Just like any other organ, the bladder can become irritated causing worsening symptoms or bladder discomfort. In this article, we will show you some of the most common foods and drinks that irritate the bladder and give you some alternative choices to soothe it instead. 

What Is the Bladder and What Does It Do?

The bladder is a balloon-like organ that sits in your lower abdomen. Along with the kidneys, ureters, and nerves, the bladder plays an essential role as part of the urinary system. 

The urinary system is responsible for filtering the blood and storing and eliminating the waste it has filtered. When kidneys have done their job filtering, the liquid waste travels to the bladder where it is stored as urine. Since the bladder is a muscle, it can store urine for long periods of time to avoid frequent urination. 

It’s normal for a healthy person to urinate (or release the liquid waste stored in the bladder) about six to eight times a day. People who drink a lot during the day may find they go as many as ten times or more. Certain medications may also affect the number of times you urinate in a day. 

When your bladder is irritated, you will likely notice a change in your urinary habits. You may experience a strong urge to urinate, more frequent urination than normal, or even pain in your lower abdomen where the bladder is located. 

5 Foods That May Irritate the Bladder

While there are many reasons your bladder may be irritated, one of the most common reasons (and the easiest to treat) is the food and drink you consume during the day. 

These foods and drinks could be causing your bladder irritation:

1) Coffee and Tea

Coffee and tea can cause bladder irritation for two reasons: First, the caffeine. Caffeine may act as a stimulant to stay alert, but it also acts as a diuretic, making urination frequency and urgency worse. If you think switching to decaf might help, think again. In addition to the caffeine, the acidic composition of coffee and tea are also irritating to the bladder. Therefore, it’s best to avoid them altogether. 

2) Chocolate

Chocolate can irritate your bladder for the same exact reason:  caffeine. While it has less caffeine than coffee and tea, it is still enough to exacerbate bladder symptoms. If you just absolutely need a sweet fix, though, stick with white chocolate for less caffeine. 

3) Citrus Fruits

Fruits such as oranges, lemons, and limes obviously have a high citric acid content. This citric acid is what can irritate the bladder. Whether you’re consuming it raw or in juice form, these citrus fruits can make symptoms worse. Feeling conflicted about how to get an adequate amount of fruit in your diet? Stick with fruits lower in acid such as apples, pears, or bananas. 

4) Alcohol

Beer, wine, and spirits can affect your bladder symptoms in two different ways: One, alcohol itself is irritating to the bladder and can increase urgency, frequency, or discomfort. Further, consuming too much alcohol disrupts the signals to your brain that it’s time to empty the bladder, which can cause incontinence. 

5) Carbonated Drinks

Whether it’s soft drinks, seltzer water, or champagne, the carbonation that gives these drinks their signature fizz can also worsen your symptoms. Be especially careful when it comes to many soft drinks as you get hit twice - once with carbonation, again with caffeine. 

If you have been experiencing changes in your urinary habits or you’ve been feeling bladder discomfort, be extra mindful of the food and drink you’re consuming during the day. Keeping a diary of what you eat and drink along with how you’re feeling can help you identify foods that may be making you feel worse. For help with your symptoms, the team at Normal Urology can help you identify the problem and help you feel better soon. Contact our office today to make an appointment with one of our doctors. 

Mythbusting: Leaking Urine Is NOT a Normal Part of Getting Older

This is a hard subject for most people to talk about, even with their doctor. Some even waive it off with excuses like “it happens only when I laugh,” or “that’s just what happens when you get older.”

The truth is, leaking urine—or urinary incontinence (UI)—is not a normal part of aging and is highly treatable. And that’s really good news!

UI Is a Symptom, Not a Disease

Leaking urine is not, in and of itself, a disease. It’s typically a symptom of something else that’s going on, so it’s important to listen to what your body is telling you, and not dismiss UI as inevitable as we age. 

And while it’s true that our bodies change in specific ways that may be a contributing factor (like weakening urinary tract muscles), leaking urine is not normal, and this symptom shouldn’t be overlooked. 

UI may be a way for our bodies to signal the existence of an underlying medical or physical condition like a urinary tract infection or neurological issues.

You Aren’t Alone

According to several studies, around 300 million people are affected by incontinence worldwide (about 5% of the population), and more than 25 million people in the US experience temporary or chronic urinary incontinence which can occur at any age. 

One national study polled 1,000 women between the ages of 50 and 80. Of the women polled, those in their 50s and 60s reported experiencing a leaky bladder in about 43% of cases. For those aged 65 and over, the number hovered around 51%.

It’s estimated that somewhere between 11 and 34 percent of men have some sort of UI, while more than 65% of men over the age of 65 admit to leaking urine throughout the day. 

The good news is, the majority of cases of urinary incontinence are manageable, and possibly even treatable. Education is the first step to a solution.

Are There Different Types of Urinary Incontinence?

Generally, there are five types of urinary incontinence:

Stress incontinence. Activities that put excess stress or pressure on the bladder can lead to leakage. Heavy lifting, laughing, coughing, sneezing, and even exercise can cause minor leaks. 

Overflow incontinence. When the bladder does not empty completely, some people experience frequent or constant dribbling of urine.

Urge incontinence: This is characterized by a sudden, urgent need to go to the bathroom often followed by a small amount of urine emptying from the bladder. 

Functional incontinence. For some individuals, conditions such as mental impairment or even arthritis make it difficult to arrive to the bathroom in time to prevent a leak. If one doesn’t understand the urge to use the bathroom or if their joints make undoing buttons or zippers difficult, bladder leaks can be a problem. 

Mixed incontinence. This constitutes a combination of any of the above types of incontinence. 

What Are My Risk Factors?

While anyone at any age can experience urinary incontinence for a variety of reasons, some with a higher risk include:

• Women (especially after pregnancy, childbirth, and/or menopause)

• Men with prostate problems

• Diabetics

• Obese people

• People experiencing long-lasting constipation

• Smokers

What Are My Treatment Options?

Thankfully there are a wide variety of options for treating urinary incontinence. 

It’s a good idea to go over all potential remedies with your doctor, but some treatment options may include some or any of the following:

• Medication 

• Lifestyle changes

• Kegel exercises

• Artificial urinary sphincter

• Botox

• Urethral sling

• Axonics Therapy

When to See Your Doctor

If you take nothing else away from this article, know that having a leaky bladder is not a lost cause and is not just a normal part of aging. 

If leaking urine has caused you to restrict activities or social interactions and has had a significant negative impact on your life, don’t put off seeing your doctor.  

The urologists at Norman Urology & Associates are sensitive to this often embarrassing condition and are highly trained to treat disorders of the male and female urinary tract. 

We’re here to serve you with compassion and medical care of the highest standards. We can help you manage your symptoms and walk you through the treatments that will be most effective for you. 

If you’re experiencing urinary incontinence, why not schedule an appointment with us today? 

Is There a Link Between Diabetes and Erectile Dysfunction?

The answer is yes. Erectile dysfunction — the inability to get or maintain an erection firm enough for sex — is common in men who have diabetes, especially those with type 2 diabetes. 

In fact, diabetes is considered to be the biggest risk factor for erectile dysfunction (ED).

According to a study conducted by the Boston University Medical Center, about half of all men with type 2 diabetes are likely to develop ED within 5-10 years of their diagnosis. 

In another study from Diabetic Medicine, data indicated that men with diabetes are three and a half times more likely to develop difficulty maintaining an erection. 

In addition, men with diabetes are likely to develop ED 10-15 years earlier than men without diabetes. 

How Can Diabetes Cause ED?

Diabetes is a chronic condition that affects how the body turns food into energy. 

Almost all of the food you eat is broken down into sugar (glucose), which is released into the bloodstream. When blood sugar spikes, the pancreas releases insulin in order to process glucose.

When your body either can’t produce enough insulin, or isn't able to process glucose properly, a number of health challenges can emerge, including erectile dysfunction.

Damage to Blood Vessels

Hyperglycemia (too much sugar in the bloodstream) actually decreases your blood vessels’ elasticity, which in turn causes them to narrow. This impedes blood flow and can damage both small and large blood vessels. 

This process can inhibit the flow of blood to the penis necessary to achieve and maintain an erection.

Nerve Damage

Hyperglycemia can damage nerves as well. 

There are four general types of nerve damage:

1. Peripheral 

2. Proximal

3. Focal

4. Autonomic

Autonomic nerve damage affects the heart, liver, bladder, stomach, intestines, eyes, and sex organs. It is this type that causes erectile dysfunction when it damages nerves that control erection with sexual arousal.

Sometimes ED Is a Red Flag for Other Health Conditions

Obesity, sleep apnea, and hypertension are just some of the underlying causes of erectile dysfunction and are in many cases precursors to a diagnosis of diabetes and/or heart disease. 

Being obese or overweight not only increases your risk factor for diabetes, but it can also cause hypertension which damages blood vessels, making it difficult for them to carry blood throughout the vascular system, including to the penis.

Research suggests that sleep apnea may cause a dip in a man’s testosterone and may also restrict oxygen, both of which are necessary for healthy erections.

Next Steps

• Talk with your doctor. Because ‘silent’ cardiovascular issues including erectile dysfunction often get overlooked, it’s a good idea to have your doctor test you for both diabetes and heart disease. 

• Ask about treatments. Oral and other medications, assistive devices, and penile implants are options you and your doctor can discuss.

• Better manage your diabetes. Managing blood sugar is key in preventing damage to blood vessels and nerves.

• Change your lifestyle. Taking the initiative to make better health choices like stopping smoking, losing that extra weight, limiting alcohol intake, and including physical activity in your daily routine are all effective. 

Don’t Hesitate to Address Your Health Challenges

Studies show the longer you have diabetes the better the chance you’ll experience some sort of sexual dysfunction. 

The two conditions are interrelated and are serious and when not addressed, they can significantly decrease quality of life. 

If you’re experiencing symptoms of ED, it’s important to seek medical help from a doctor with expertise in this field. 

The physicians at Norman Urology are dedicated to serving the urological needs of Norman and its surrounding communities. We treat our patients as partners as we discuss symptoms, diagnoses, and possible treatments. 

Why not schedule an appointment with us today?

4 Common Myths About Vasectomies

A vasectomy is a standard, minimally-invasive outpatient surgical procedure that blocks sperm from entering a man’s seminal fluid by cutting and sealing the tubes that carry them. Sperm cells stay in the testicles and are ultimately absorbed by the man’s body. 

Approximately half a million vasectomies are performed each year and are a highly effective form of male birth control. Vasectomies are nearly 100 percent effective in preventing pregnancy. (We should emphasize here that it does not protect against sexually transmitted diseases.)

While many men know what a vasectomy does, they may not have all of the correct information. There are many myths surrounding this procedure that can be easily debunked

Let’s take a look at four of the most common ones.  

Myth #1: A Vasectomy Will Negatively Affect Sexual Performance

Patients often mistakenly believe that a vasectomy will reduce the production of testosterone (a steroid hormone made in the testicles that is released into the bloodstream and is partially responsible for sexual awareness and arousability in men). 

Lower testosterone means lower libido, right? 

The fact is, a vasectomy has very little to do with testosterone. After the procedure, a man continues to produce normal testosterone levels, just as for a man who hasn’t had a vasectomy.

Many men report they prefer not wearing a condom and that their level of satisfaction after having a vasectomy is much higher. 

Myth #2: It Will Permanently Damage Sexual Organs

This surgical treatment focuses on the vas deferens, a muscular tube between the epididymis and the pelvic cavity. (The epididymis is a long, coiled tube that sits on the backside of each testicle, which carries and stores sperm cells made in the testicles.)

No sexual organs or tissue are involved in the operation. Therefore, the risk of damage to the testicles, penis, or other parts of the reproductive system is very low, and the procedure also has a low risk of complications or side effects. 

An obvious note, but one that bears repeating, is that men should be confident in the skill and experience of their doctor. (In very rare cases, patients have had to have a testicle removed due to loss of blood supply after a botched vasectomy.)

Myth #3: A Vasectomy Increases the Risk of Cancer or Heart Disease

The fact is, no proof exists of causality between vasectomies and cancer or heart disease.

According to the world-class, multi-specialty academic medical center, Cleveland Clinic:

“Many studies have looked at the long-term health effects of vasectomy. The evidence suggests that no significant risks exist. Men who have had a vasectomy are no more likely than other men to develop cancer, heart disease, or other health problems. This is spelled out in the Vasectomy Guideline of the American Urological Association.”

If you still have questions or concerns, don’t hesitate to discuss them with your doctor. 

Myth #4: It is Very Painful

The procedure itself should be close to painless. 

Vasectomies are most often performed using either local anesthesia or “twilight” anesthesia. 

In the case of local anesthesia, pain-blocking medicine is administered to the scrotum before the procedure. Patients may feel a pulling or tugging sensation, but any discomfort should be very mild. 

If you are particularly nervous about having a vasectomy, ask your doctor if full sedation might be the right option for you.

For a few days post-surgery, you may have some bruising and/or swelling, but the pain should be relatively mild and alleviated with over-the-counter pain medication, wearing tight-fitting underwear to support the testicles, or icing the area.

Consulting an Expert

If you are considering a vasectomy, we urge you to research and avoid falling victim to myths about the procedure.

The highly skilled physicians at Norman Urology are experts in the field of male reproductive medicine and have vast experience performing vasectomies. 

If you have questions, why not schedule a consultation with us today?

Preventing Cystitis: 7 Ways Women Can Keep Bladder Infections at Bay

Cystitis is a painful condition characterized by inflammation of the bladder, usually caused by an infection.

Also of note, women are more likely to suffer UTIs than men

The most common cause of cystitis is a lower urinary tract infection (UTI)--- an infection in the urinary tract which includes the ureters, kidney, urethra, and sometimes in more than one of these organs at once. 

More succinctly, cystitis is a urinary tract infection located in the bladder. 

This condition is usually mild and clears up on its own over a few days. However, in more serious cases, a patient may need antibiotics.

What Causes Cystitis?

A bacterial infection is the most likely cause of Cystitis. Although there can be other causes like anatomical abnormalities, certain drug reactions, or irritants like hygiene sprays or long-term use of a catheter.

What sorts of bacteria are we talking about? The most common culprit is Escherichia coli (more commonly known as E. coli) present in the perineum which can enter the urethra, travel to the bladder, and multiply.  

How Do I Know If I Have Cystitis?

There are many symptoms (alone or in combination) that can indicate the presence of Cystitis:

• Painful urination often described by many patients as a burning or stinging sensation

• A frequent, urgent need to urinate (even after you’ve just been to the bathroom)

• Passing only a small amount of urine when visiting the toilet

• Blood in the urine

• Pelvic discomfort and/or a feeling of pressure in the lower abdomen

• Passing cloudy, sometimes strong-smelling urine

• Low-grade fever

If you are experiencing any of these symptoms, it’s a good idea to talk to your doctor.

What Can I Do To Prevent Cystitis?

Approximately 60% of all women will experience Cystitis during their lifetime, and of those women, around 20-40% are more likely to have one again. 

Luckily, there are a number of effective methods to help prevent this condition. 

Let’s take a look at 7 ways women can keep bladder infections at bay: 

1. Drink plenty of water. Not only is it good for your body and skin, but drinking water also helps flush bacteria out of the bladder.

2. Urinate frequently--- the good news is you won’t have to worry about this if you’re drinking enough water!

3. Practice good hygiene. Remember, after having a bowel movement, wipe front to back which helps prevent bacteria from traveling from the anus to the urethra.

4. Try gently washing the space between your vagina and anus (the perineum). Again, this will help keep harmful bacteria away from your urinary tract. Just be careful and use a gentle cleanser so you don’t irritate the tender skin around this area.

5. If you suffer from frequent Cystitis, avoid the bath and take showers instead, since bacteria in the bathwater can easily travel into the urethra as you soak.

6. Avoid deodorant sprays and other feminine hygiene products. Patients who use these are 3.5 times more likely to get an infection that can lead to Cystitis.

7. While the research isn’t 100% clear, some patients report drinking cranberry juice (which contains proanthocyanidin) helps prevent infection. (Important note: doctors advise patients to avoid drinking cranberry juice if taking blood-thinning medication.)

When Should I See My Doctor?

If you are currently experiencing or frequently suffer from bladder infections, talk to your doctor who can assess risk factors, discuss prevention, and prescribe medication if necessary.

If you are experiencing any of the following, do not delay--- call your doctor right away:

• Nausea and vomiting

• Persistent and/or high fever

• Chills

• Back or side pain

If prescribed antibiotics and symptoms return afterward, ask your doctor about taking a different medication. 

In many cases, Cystitis causes only mild symptoms and resolves itself either naturally or with antibiotics. 

However, when untreated, a bladder infection can travel to the kidneys and even cause permanent damage to either or both of these organs.

If you have or suspect you have Cystitis, ask us about a cystoscopy which can help us examine your bladder without surgery.

The physicians at Norman Urology are experts in the field of urology and have years of experience in treating patients suffering from Cystitis. Make an appointment with us today to learn more!

Natural Ways You Can Help Prevent Kidney Stones

Nephrolithiasis, commonly referred to as kidney stones, are hard, pebble-like pieces of material that form in one or both of your kidneys when high levels of certain minerals are in your urine.

The stone formation is usually painless, but once they detach from the inner wall of your kidney you’ll know it! And for most people, this begins the most painful stage of passing a kidney stone.

Symptoms

Sometimes pain presents initially as a dull ache, but it can also come on suddenly. Many patients describe the pain as coming in waves, and as being excruciating.

Symptoms can include:

• Sharp, cramping pain in the back below the ribs

• Acute pain that radiates to the lower abdomen and groin area 

• Pain or burning sensation when urinating

• Nausea and vomiting

• Fever and chills

• Pink, red, brown, or cloudy, foul-smelling urine

The good news is that Kidney stones rarely cause permanent damage if treated by a healthcare professional. 

The bad news is, about 50% of patients who’ve had kidney stones previously will have a recurrence within seven years if preventative measures aren’t taken. 

What Natural Methods Can I Use to Prevent Kidney Stones?

Thankfully there are several effective ways to prevent kidney stones or a recurrence of them.

Let’s Talk About Animal Protein

In most cases, stones start to form when calcium mixes with oxalate (a compound found in many foods that, when consumed, leave the body during urination).  

When uric acid--- a byproduct of protein metabolism -- builds up, stones can begin to form.

Eating things like red meat, poultry, eggs, and seafood on occasion isn’t a significant risk factor, but eating a lot of these foods regularly can increase the level of uric acid which can cause kidney stones. 

Avoid These 6 Foods that Can Also Promote the Formation of Kidney Stones

Some foods are higher in oxalate, the compound that can promote the formation of kidney stones:

• Beets

• Chocolate

• Spinach

• Rhubarb

• Tea

• High-oxalate nuts like cashews, almonds, pine nuts, and Brazil nuts

Again, these foods aren’t a risk factor when eaten in moderation, although patients who have had kidney stones in the past should consult with their doctor to determine how much of these foods it’s safe to consume. 

Don’t Forget to Drink Your Water

Health gurus often prescribe drinking water for bright, healthy skin. But perhaps more importantly, drinking lots of water is also good for your overall health. 

According to the U.S. National Academies of Sciences, Engineering, and Medicine, drinking the recommended amount of water daily--- about 15.5 cups for men and 11.5 cups of water a day for women -- can help dilute the substances that cause kidney stones. 

If you aren’t accustomed to drinking so much water in a day, you can safely substitute a few cups of juices high in citrate (like orange juice or lemonade) as they can help block stone formation. 

Watch Your Salt Intake

High amounts of sodium in your diet can increase the amount of calcium in your urine, which can lead to stones. 

In general, physicians recommend limiting total daily sodium intake to 2,300 mg. But for those prone to kidney stones, it’s best to shoot for 1,500 mg per day. (Bonus: it can lower blood pressure and your heart will thank you!)

Talk With Your Doctor

If you’ve had or are concerned you might be prone to kidney stones, book an appointment with a doctor--- preferably a urologist -- who can assess your risk factors.

There are also some procedures available to help diagnose and treat kidney stones, including extracorporeal shockwave which is a procedure that uses ultrasonic waves to break up kidney stones. 

The physicians and staff at Normal Urology are dedicated to serving patients in Norman and surrounding communities. We offer comprehensive urological care and our physicians are highly trained to treat disorders of the male and female urinary tract, including kidney stones. 

If you’ve previously had, have currently, or are just curious about your risk factors, why not book an appointment with us today?