The Facts About Pelvic Organ Prolapse

While many women find it difficult or embarrassing to discuss pelvic organ prolapse and its symptoms, understanding the facts can help. 

This common condition affects one in four women in their 40s, one in three by their 60s, and half of all women in their 80s.

What Is the Pelvic Floor? 

The pelvic floor is a group of muscles that stretch like a hammock or sling across your pelvic opening. Those muscles hold up the pelvic organs, including the bladder, uterus, vagina, small bowel, and rectum.

What is Pelvic Organ Prolapse? 

Pelvic organ prolapse occurs when one or more of your pelvic organs drop from their normal position. Types of pelvic organ prolapse include: 

Cystocele - This condition occurs when the tissue around your bladder and vagina becomes weak and stretches, causing your bladder to protrude into your vagina.

Rectocele - Rectoceles occur when weak rectal and vagina tissue allows your rectum (the bottom part of your large intestine) to protrude into the back wall of your vagina. 

Enterocele - An enterocele results when your small intestine bulges into your vagina.

Uterine - Uterine prolapses occur when your uterus sags or drops into your vagina. 

Who Is At Risk? 

There are many causes of pelvic organ prolapse, but these are the most common risk factors:

• At least one vaginal birth

• Being older when you have your first baby

• Giving birth to a large baby

• The weakening of the pelvic muscle with age 

• Being obese, which increases your risk by 40 - 75% 

• Prior pelvic surgery, such as a hysterectomy

• Chronic constipation or straining during bowel movements

• Family history of weak connective tissue

• Being Hispanic or white

• Chronic coughing, such as from smoking

• Having a vaginal tear during delivery

• Hormonal changes caused by menopause

What Are the Symptoms of Pelvic Organ Prolapse?

The symptoms of this condition vary, but different types of pelvic organ prolapse have common symptoms because they all involve one or more of your pelvic organs bulging into your vagina. 

Bladder prolapse can cause:

• Urine leakage 

• Difficulty urinating

• Feeling the need to urinate urgently and often 

Uterine prolapse can cause: 

• Urine leakage 

• A feeling of “fullness” in your pelvis 

• Lower back pain 

• Constipation

• Discomfort during intercourse 

Rectoceles may have no symptoms or may cause: 

• Vaginal pressure

• Rectal fullness

• Constipation

• Pain during intercourse

• A soft bulge of tissue that you can feel in your vagina or protrudes outside your body. 

Lastly, an enterocele can cause:

• A pulling sensation in your pelvis or lower back pain that lessens when you lie down 

• A tissue bulge in your vagina

• Painful intercourse.

How Does Your Doctor Diagnose Pelvic Organ Prolapse?

A simple pelvic exam is often enough to diagnose pelvic organ prolapse.  If your doctor believes more than one of your pelvic organs is out of place, they may order an ultrasound to create images of your pelvis.

• A dynamic pelvic MRI scan can confirm a pelvic organ prolapse and determine its severity. These detailed, three-dimensional images help your doctor decide if you need surgery. 

• A cystoscopy allows your doctor to view the inside of your bladder by inserting an endoscope, a thin tube with a small light and camera at the tip, through your urethra. 

• A cystourethrogram is an X-ray that takes pictures of your bladder before and during urination. 

• A pelvic CT scan.

Treatment for Pelvic Organ Prolapse

If your prolapse is mild, it may go away without any treatment. However, it can also worsen over time. The first line of treatment is physical therapy. Your physical therapist might recommend kegel exercises, in which you tighten and then release the muscles in your pelvic floor to strengthen them. 

Another treatment option is a pessary, a silicone device inserted into your vagina to help support the prolapsed organs. Lastly, your doctor may recommend surgery if other less invasive options don’t relieve your symptoms. The type of surgery varies according to the location and severity of the prolapse. 

When to See a Urologist 

If you have any symptoms of pelvic organ prolapse, see your urologist. The compassionate, knowledgeable physicians at Norman Urology Associates can help diagnose pelvic organ prolapse and identify your best treatment options. Let us know how we can help.

How and Why You Should Perform a Monthly Testicle Exam

Identifying any type of cancer in the early stages can save lives. Testicular cancer is no exception. 

A monthly testicle self-check is the best way to familiarize yourself with how your testicles normally look and feel so you notice any changes that could indicate cancer or a benign condition. 

What is Testicular Cancer? 

Testicular cancer is the result of cancer cells developing in the tissues of one or both testicles which then grow out of control to form a tumor. You have an increased risk of testicular cancer if you are between 15 and 35, have testicles that didn’t descend during birth, are a non-Hispanic white, have already had testicular cancer, have a family member who has been diagnosed, or if you have had issues with infertility. 

Testicular cancer is relatively uncommon. According to the American Cancer Society, only about one in every 250 males develops testicular cancer in their lifetimes. The average age of diagnosis is 33. About 6 percent of cases occur in children and teens while about 8 percent occur in men over the age of 55. The survival rate depends on if and how far the disease has spread. The five-year survival rates are: 

• 99 percent if it hasn’t spread beyond your testicles

• 96 percent if it has spread to nearby lymph nodes or structures 

• 73 percent if it has spread to other organs, such as your liver

Overall, testicular cancer is very treatable and has a cure rate of almost 95 percent, especially when it is detected in the earlier stages. 

Who Should Perform a Self-Exam?

Your physician should examine your testicles for any changes or abnormalities during your annual physical. Most doctors also recommend that men perform self-exams once a month starting after puberty. Although survival rates for testicular cancer are high, if you are diagnosed early, it is less likely that you will need chemotherapy. Exams have been shown to detect early-stage testicular cancer more frequently than diagnosis based on symptoms. 

In addition to testicular cancer, self-exams can help you identify benign conditions such as a viral or bacterial infection, cysts, or enlargement of the veins inside your testicle. 

How to Perform a Monthly Testicle Exam 

A monthly testicle self-exam takes just a few minutes. The shower is an ideal place to do the exam because the warm water helps relax your scrotum, making it easier to examine your testicles. 

Before you perform the exam, know that you don’t have to be concerned if one testicle is larger than the other or if one hangs lower than the other - that is completely normal. Also, keep in mind that you have an epididymis, a small, coiled tube, inside each testicle. Because it feels smaller and bumpier than the testicle it is attached to, some people mistake it for an abnormal mass.

Here's what to do: 

• Move your penis out of the way and examine each testicle one at a time, gently rolling them between your fingers.  

• Each testicle should feel firm, but not hard.

• Check for any swelling or lumps, bumps, or other changes in the size, shape, or consistency of your testicles. 

• Feel for any hard lumps or smooth rounded masses. 

Contact your physician if you notice any swelling, lumps, or other changes in either of your testicles. 

Expert Urological Care in Norman 

The physicians at Norman Urology are committed to providing state-of-the-art diagnosis and treatment for testicular cancer and other disorders of the urinary tracts of males and females. Our team treats every patient as a partner in their own medical care. That means we listen compassionately and demonstrate respect for each other and our patients. Contact us to schedule an appointment.

The Warning Signs of Bladder Cancer

Pain, burning sensation during urination, or having to urinate more than usual are uncomfortable and inconvenient. These symptoms can be from urinary tract infections or other minor ailments, but they can also be warning signs of something more serious, such as bladder cancer. 

What Is Bladder Cancer?

Bladder cancer occurs when the urothelial cells in your bladder grow out of control. As these cells develop, they form tumors. These tumors can spread to other parts of the body. Bladder cancer is the cause of more than 16,000 deaths a year. It is much more common in men than in women. Men have a 1 in 28 chance of developing bladder cancer, while women have only a 1 in 91 chance. 

Early Signs of Bladder Cancer

Fortunately, bladder cancer is very treatable if you catch it early. However, you should always see your urologist for any possible symptoms. These are the earliest signs of bladder cancer: 

• Blood or blood clots in your urine – In the earliest stages of bladder cancer, you may have bleeding but no pain. However, the blood can be enough to change the color of your urine, or it may be invisible, and your doctor may find it during a routine urinalysis. 

• Pain or burning during urination – This can be caused by tumors that form from cancer cells in your bladder lining.

• Frequent urination or feeling like you need to urinate throughout the night – Tumors forming in your bladder can irritate and prevent it from holding as much urine as it should.

Advanced Bladder Cancer Symptoms

Since early bladder cancer doesn’t always cause noticeable symptoms or discomfort, it can be missed until it reaches more advanced stages. Symptoms of advanced bladder cancer include:

• Having difficulty urinating – If you have more advanced tumors from bladder cancer, it can cause obstructions in your urinary tract, making it difficult to urinate. It can also increase the risk of kidney failure. 

• Lower back pain on one side of the body – A tumor spreading into nearby tissues, such as your pubic bone or flank area, causes this. 

• Loss of appetite or weight loss – This can indicate that bladder cancer has spread to other organs such as lymph nodes, lungs, liver, or kidneys.

• Fatigue or weakness – Cancer cells use nutrients from your body, preventing your cells and organs from functioning correctly. The result is fatigue and weakness.

• Swollen feet – Bladder cancer cells can prevent lymph fluid from draining, causing fluid to build up in your legs, and resulting in foot swelling.

• Bone pain – If bladder cancer spreads to your bones, it can cause skeletal complications such as bone pain and fractures.  

Tests to Check for Bladder Cancer

There are a variety of diagnostic tests your urologist may use if they suspect you have bladder cancer. These include: 

• Cystoscopy – Your urologist will insert a small tube with a lens inside your urethra. They can use the lens to examine your urethra and bladder for signs of disease.

• Biopsy – During the cystoscopy, your urologist can collect a cell sample from your bladder for testing. 

• Examine a urine sample – Your urologist will look at a urine sample under a microscope. 

• Imaging tests – During imaging tests, which may include a CT urogram or a retrograde pyelogram, your urologist can examine the structure of your urinary tract for signs of cancer.

When to See a Urologist  

You should see your urologist if you have any early or late warning signs of bladder cancer. The compassionate, knowledgeable physicians at Norman Urology Associates can determine if bladder cancer is causing your symptoms and develop a treatment plan. Please contact us so we can help. 

The Unbearable Pain of Kidney Stones: How Your Urologist Can Help

Kidney stones can be incredibly painful. Also known as renal calculi, nephrolithiasis, or urolithiasis, these hard deposits are made of minerals and salts inside your kidneys.

There are five types of kidney stones: calcium oxalate, calcium phosphate, struvite or infection, uric acid, and cystine. 

When you pass a kidney stone, it moves from your kidney to your ureter and then into your bladder. From there, it travels into your urethra.

Your kidneys are extremely sensitive. A kidney stone can block the flow of urine, causing pressure. In addition, your ureter is narrow, inflexible, and not meant to accommodate stones, which also causes pain. Lastly, your ureter might spasm when it is trying to squeeze out the stone, resulting in extreme discomfort. 

So how can your urologist help? They may start by using various diagnostic tests to determine if the source of your pain is indeed a kidney stone. 

Diagnostic Tests

Urine tests determine if you have high levels of minerals in your urine that form kidney stones.  

Blood tests can reveal if you have too much uric acid or calcium in your blood, which can cause stones to form. 

CT scans or ultrasounds can show kidney stones.

If a kidney stone isn’t too large, you may only need to take pain medication and drink lots of water to pass it. Alpha-blockers, which relax your ureter, can also be helpful. Other effective remedies, such as citrate, can help dissolve kidney stones. 

But if your kidney stone is too big to pass or becomes lodged in your urinary tract and causes complications, your urologist may need to pursue other treatments. 

Treatment Options

• Shock wave lithotripsy: This nonsurgical method during which your urologist will apply shock waves from outside your body to blast the kidney stone into smaller pieces.

• Percutaneous Nephrolithotomy (PCNL): Your urologist makes a small incision in your back and then inserts a tube and a miniature fiberoptic camera into your kidney to remove or break up a stone.

• Ureteroscopy (URS): Your doctor inserts a small telescope into your kidney through your urethra and bladder to the stone in your ureter. They may use a basket device to remove it or a laser to break it into smaller pieces and then take it out.

• Pyelolithotomy: Your urologist removes the kidney stone through an incision in the area at the center of your kidney. It can be performed as an open surgery or laparoscopically. 

Prevention 

Among patients who have passed a kidney stone, the recurrence rate is 60 to 80 percent. 

The easiest ways to prevent kidney stones are simple lifestyle changes such as: 

• Drink plenty of water so you urinate frequently and avoid the build-up of calcium or uric acid.

• Reduce the amount of salt in your diet because sodium can make urine calcium and cystine too high.  

• Eat the recommended amount of calcium.

• Eat more fruits and vegetables and less meat.

• If you have high urine oxalate, eat foods with low oxalate levels such as apples, broccoli, and grapes. 

If diet and lifestyle changes aren’t enough to prevent kidney stones, your urologist may recommend preventative medications. Such medications include: 

• Thiazide diuretics - Lowers high calcium levels in your urine.

• Potassium citrate - Makes urine less acidic and raises citrate levels to prevent uric acid or calcium stones. 

• Allopurinol - Lowers the level of uric acid in the blood.

• Acetohydroxamic acid (AHA) - Helps prevent urinary tract infections, which can cause infection stones. 

• Cystine-binding thiol drugs - Helps prevent cystine stones by binding to cystine in the urine.

• Vitamin supplements - Some can increase your risk of forming kidney stones. Ask your urologist and dietitian which over-the-counter nutritional supplements could be helpful.

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 urinary tract disorder, including kidney stones, and will always treat you as a partner in your medical care. Contact us to schedule an appointment.

The Benefits of Pelvic Floor Therapy

What is The Pelvic Floor?

The pelvic floor is a group of muscles and ligaments between the tailbone (coccyx) and the pelvic bone located– you guessed it! - in the pelvis. These muscles support the bladder, uterus, colon, and bowel, much like a sling. A dysfunction in the pelvic floor can lead to an inability to effectively relax and coordinate those muscles which can result in things like incontinence, pain, and long-term constipation. 

Symptoms present differently in men and women. For example, in women, this condition may be the result of a long or difficult labor and in men, this condition may be linked to erectile dysfunction. 

What is Pelvic Floor Therapy?

This therapy is effective in treating problems related to the pelvic floor. It’s a set of special routines and exercises– some of which you can even do at home – that help relieve symptoms. 

This therapy includes things like Trigger Point therapy, Kegels, electrical stimulation, and biofeedback.

The pelvic floor muscles can develop ‘knots’ called trigger points that are sensitive and painful when pressure is applied (internally and/or externally). Trigger Point therapy involves things like stretches (think common yoga positions) and injections of anesthetic and anti-inflammatory medications like steroids. 

Sometimes a type of internal massage of the affected muscle can release painful tension in the pelvic floor muscles. Other times, biofeedback can be a good treatment option. Biofeedback is a technique that involves placing internal electrodes against the pelvic floor muscles which provides useful feedback and helps a patient gain awareness over control of the pelvic floor muscles. 

What Causes Damage to the Pelvic Floor?

While causes of pelvic floor dysfunction are not fully understood by the medical community, a few of the known factors include things like:

• Constipation and/or straining when having a bowel movement

• Frequently lifting heavy things

• Obesity

• Traumatic injuries to the pelvic area

• Pregnancy (especially with long and/or difficult labor)

• Pelvic surgery

• Advancing age

• Cancer

There may also be a link between this condition and heredity.

What are Some of the Symptoms of Pelvic Floor Dysfunction?

Incontinence

This is a condition that causes a lack of ability to control urination or bowel movements. There are different types of urinary incontinence:

Stress Incontinence

Leaks can happen when pressure is exerted on the bladder during activities like exercising, lifting heavy objects, sneezing, coughing, or laughing. 

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 or copious amount of urine emptying from the bladder. You may find you need to urinate more often, even waking throughout the night to go to the toilet. Urge incontinence can result from minor conditions like an infection but can also be a sign of a more serious condition. 

Functional Incontinence

This type of incontinence is typically characterized by a secondary condition like arthritis or mental impairment which keeps you from getting to the bathroom in time. If, for example, you suffer from severe arthritis, you may struggle with buttons or zippers before you’re able to sit on the toilet in time. 

Mixed Incontinence

This type of incontinence is characterized by a combination of any of the above types of incontinence.

Pelvic Pain

There are many causes of pelvic pain, so it’s important to get the right diagnosis. If you are experiencing prolonged pelvic pain, or pain during and after intercourse, it may be that there is an issue with the muscles and connective tissue that make up the pelvic floor. In that case, your doctor may recommend pelvic floor therapy to correct the problem. 

Prolapse

Prolapse is caused by weakness in pelvic floor muscles which results in an inability to support the pelvic organs. The pelvic organs drop and can cause patients to feel a sense of heaviness in the pelvic area.

Other Symptoms Can Include:

• Difficulty urinating or having bowel movements

• Feeling like your bowel movements are not complete

• Long-term constipation

• Stopping and starting while urinating

• Painful urination

• Lower back pain

When Should I See My Doctor?

If you’re experiencing any of the symptoms listed above, it’s time to see a urologist. The urologists at Norman Urology can walk you through the best therapies and exercises that will be most effective in strengthening your pelvic floor.  

If you’re experiencing symptoms of a weakened pelvic floor, why not schedule an appointment with us today?

Confronting The Postpartum Incontinence Myth: When to Talk to Your Urologist

Becoming a mother can be one of life’s most joyful events. But while it’s a joyous event, that doesn’t mean it’s easy! 

Just as your body experiences significant changes while pregnant, your body will also experience substantial changes postpartum. During pregnancy, organs are moved around to accommodate the growing baby, and once the baby is born, those organs start moving back to their original positions. It’s no small feat carrying a human for nine months! 

And to add to postpartum stress, some mothers may have false expectations based on myths about post-pregnancy incontinence. 

Let’s set the record straight, and do some myth-busting around the issue of post-pregnancy incontinence.  

A Quick Word About the Bladder

Your bladder, which rests under the uterus, is a muscular organ located above the pelvic bone and held in place by the pelvic muscles. A tube (the urethra) lets urine flow from the bladder and out of your body. Your bladder muscle relaxes as urine fills the bladder, and the sphincter muscles help keep the bladder closed until you’re ready to urinate. 

The nervous system is an essential component of bladder control. When your bladder is full, it sends signals to the brain, and in turn, the brain sends a message back to the bladder signaling it’s time to empty it. 

The short story is that muscles and nerves must be in sync for the bladder to function properly. 

What Happens to My Bladder When I’m Pregnant?

When a woman is carrying a child, the baby can place a lot of pressure on the bladder, which can lead to leakage (urinary incontinence). Since your bladder rests under the uterus, as your growing baby expands, the bladder compresses and leaves less room for urine and incontinence occurs.

While this issue usually goes away within a few weeks after birth, bladder control problems may continue for some women long after giving birth. 

What Causes Bladder Control Loss in Women After Pregnancy?

Several conditions can cause post-pregnancy incontinence, including:

• Pelvic Organ Prolapse: If the pelvic muscles that hold the bladder in place become weak, the bladder can slip out of position (a condition called cystocele). 

• Pelvic Nerve Damage: If a woman experiences a long or difficult delivery, pelvic nerves can become damaged and may not send signals to the brain when the bladder is full. 

• Injury: In instances where a doctor uses forceps to facilitate the delivery, pelvic floor muscles and anal sphincter muscles (which help keep urine from leaking) may be damaged. 

• Prolonged Pushing: Prolonged and difficult labor can also cause nerve damage and weakening of the pelvic muscles that hold the bladder in place. 

It should be noted that the risk of incontinence after pregnancy is often determined by your particular pregnancy, type of delivery, and even the number of children you have. 

Treatments

One prevailing and stubborn myth about post-pregnancy incontinence is that it is inevitable and is a permanent condition. Neither of these statements is true! 

In cases where women do experience incontinence after having a baby, there are a number of excellent treatment options. Let’s take a look at a few. 

Kegel Exercises

Kegel exercises are an easy way to strengthen your pelvic floor. Imagine you are trying to stop the flow of urine so that the pelvic and bladder muscles contract and tighten. Doing these exercises once a day can go a long way to help with incontinence. 

Pelvic Organ Prolapse

In the case of Pelvic Organ Prolapse, there are several treatments available: 

• A doctor may recommend something called Cystocele repair, which is a surgery to correct the bladder prolapse. 

• Or your urologist may recommend Enterocele/Rectocele repair, which is a surgery that corrects issues with the small bowel and rectal prolapse. 

• Finally, a surgery called a Sacrocolpopexy repairs the prolapse of the vaginal vault and restores it to its normal position and function.

Coaptite Injection

This procedure involves the injection of an agent underneath the lining of the urethra to prevent incontinence. It is used to achieve closure at the bladder neck to mid-urethra. 

Urethral Sling

This minimally invasive, outpatient procedure is used to provide support to the urethra or bladder neck. The sling itself is usually made from synthetic material or, in some cases, a strip of the patient’s own body tissue.

When to See Your Doctor

Most post-pregnancy urinary incontinence resolves itself, but if you’re experiencing symptoms for six or more weeks after giving birth, it’s time to consult the experts. 

The Norman Urology physicians are experts in the field of urology, and we can walk you through the best exercises and treatments that will be most effective in keeping your bladder healthy. 

We have years of experience helping patients attain and maintain bladder health and are also trained to perform many minimally-invasive, outpatient surgeries for those who would benefit. 

We’d love to talk with you today!

What to Know About Ureteral Stents

The ureters are tubes consisting of smooth muscle that aid in carrying urine from the kidneys to the urinary bladder. Sometimes, these tubular organs can become narrowed or blocked, preventing urine from draining properly. A urologist may use a ureteral stent to aid in keeping the ureter(s) open. 

Ureteral stents are made of thin, flexible polyurethane or silicone tubes that are about 10-15 inches long and about ¼ inch in diameter. A doctor can line the entire length of the ureter with a ureteral stent to widen it and prevent blockages.

Who Needs a Ureteral Stent?

Most commonly, ureteral stents are implanted to help urine move around a kidney stone that’s blocking proper urine flow, but sometimes a ureteral stent is used to enable urine flow around broken kidney stones which can also cause blockages. 

Ureteral stents may also be used to prevent blockages caused by postoperative swelling of the ureter.

Other reasons a urologist may prescribe a ureteral stent can include conditions like:

Blood Clots

Sometimes caused by a bladder infection (cystitis), infection of the prostate (prostatitis), or ureteral stones (fragments of a kidney stone that have traveled to the ureter), blood in the urine can clot which may block the flow causing sudden, intense pain and an inability to urinate.

Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease can be caused by swelling of the ileum (the intersection between your small and large intestines) and can put pressure on the ureter so that it can’t drain properly.

Build Up of Scar Tissue

Scar tissue– whether caused by surgery, physical trauma, or health problems like endometriosis or cancer– can narrow the ureteral tube and cause urine to back up into the kidneys.

Ureteropelvic Junction Obstruction

This is a hereditary condition that causes a narrowing (or stricture) of the ureteral tube. 

What to Expect When Having this Procedure

Ureteral stenting is typically an outpatient procedure so that the patient can return home the same day (although someone else should do the driving home). 

This is a procedure that generally requires anesthesia so the patient is asleep during the operation. 

Your urologist may recommend that patients drink a lot of water following the procedure to facilitate kidney and bladder function.

You may notice blood in the urine (which can come and go randomly) or feel some discomfort after this type of surgery, but these symptoms should resolve within a few days. 

In general, ureteral stents are temporary and are removed after a relatively short period of time. Typically doctors remove the stent within days or weeks of having the surgery. However, some patients require stents for months or even years for several reasons including things like tumors that can put pressure on the ureter. 

When to See a Specialist

If you are experiencing any one of the following symptoms, you should make arrangements to see a urologist as soon as possible:

• Changes in how much urine you are producing

• Pain in your abdomen, lower back, or sides just below your ribs

• Fever, nausea, vomiting

• Difficulty urinating

• Recurring urinary tract infections (UTIs)

The urologists at Norman Urology are experts in treating ureteral blockages and other urological issues. They can diagnose a ureteral obstruction by checking your urine and blood for signs of an infection and perform MRIs, CT scans, or ultrasounds to identify the location and cause of a blockage. The specialists at Norman Urology can also use medical devices like ureteral stents to relieve symptoms and resolve the problem. 
Whether you are experiencing symptoms of a ureteral blockage or any other urological issue, we encourage you to schedule an appointment 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 from 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 also play a role.

Are Kidney Stones 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?

The Basics of Erectile Dysfunction

Most people avoid talking about sexual dysfunction, even with their doctor, as it can bring about feelings of inadequacy, shame, and embarrassment. This may be especially true for men who experience erectile dysfunction. Some studies indicate that up to 90% of men avoid talking with their doctor about treatments.  

But erectile dysfunction (ED) is far more common than most people realize. It’s indeed more prevalent in older men – the risk of experiencing ED increases with age – but the well-regarded Massachusetts Male Aging Study suggests that approximately 52% of men have or will experience some form of ED at some point in their lives. 

Thankfully, many advanced treatments can help. 

What is Erectile Dysfunction?

The clinical definition of ED is the persistent inability to achieve or maintain an erection sufficient to engage in satisfactory sexual performance. 

At one time, this type of dysfunction was considered to be an entirely psychological problem. And while it is one factor, we now know that physiological problems are equally likely to cause ED. 

Causes and Risk Factors

The most common causes of erectile dysfunction are abnormalities in penile arteries and veins (or both) and they are especially prevalent in older men. If the ED is the result of arterial issues, likely the patient may also have arteriosclerosis, which is a hardening of the arteries. Damage to or hardening of endothelial cells can prevent blood vessels from dilating properly, which can inhibit the blood flow to the penis necessary to achieve and maintain an erection. 

As mentioned above, there can be psychological components as well as physical factors that contribute to erectile dysfunction. Men who are depressed, have anxiety disorders, or are under considerable amounts of stress can suffer from ED. Sometimes there is a relationship between depression, cardiovascular disease, and erectile dysfunction, which is why men with these symptoms need to be fully evaluated by their physician. 

One often-cited reason for ED is that if the tissue in the body of the penis (cavernous smooth muscle) deteriorates or has a growth of excess tissue (fibrosis), it can cause problems achieving and maintaining an erection. 

Diabetes is also a leading cause of ED. Just under 11 million adult men in the United States have diabetes, and anywhere between 35 to 50 percent of these men experience symptoms of erectile dysfunction. This can be the result of premature and severe hardening of the arteries and peripheral neuropathy which affects the nerves controlling erections.

Some medications including blood pressure medications and some antianxiety/antidepressant medications can interfere with a man’s ability to achieve and maintain an erection. Again, it’s a good idea to consult your physician so he can evaluate whether medications are contributing to erectile dysfunction.

Hormonal imbalances which can occur as a man ages may be a contributing factor to ED. An imbalance in testosterone, for example, may inhibit a man’s ability to achieve and maintain an erection. 

Treatments

The good news is that there are many treatment approaches to help patients who suffer from ED. 

There are controllable factors that can mitigate ED, and patients can help themselves simply by improving their lifestyle habits. This may include:

• Losing weight

• Exercising

• Quitting smoking

• Seeking treatment for high blood pressure

• Adjusting certain prescription medications

Hormone treatment is effective in treating ED for those with imbalances and can include shots, pills, or creams. For men with this type of imbalance, testosterone replacement therapy may be a highly effective treatment. 

Other drugs like Viagra and Cialis can help improve the blood flow to the penis necessary to achieve and maintain an erection. 

Penile implants are also used as a more permanent treatment for ED. The procedure involves implanting a device in the penis that can be inflatable or non-inflatable. An inflatable device allows a man to achieve an erection by pressing a pump implanted in his scrotum. A non-inflatable penile implant involves bendable silicone rods implanted in the erection chambers of the penis. 

When to See Your Doctor

While it’s understandable that some men may feel embarrassed to talk about this issue, even with their doctor, it’s crucial that they do if they want help alleviating symptoms of ED. 

But if you’re hesitant about consulting a physician, remember, they have seen most, if not all, of your symptoms before. So don’t feel like you’re the only person in the world with erectile dysfunction.

Try to remember: your doctor is your ally, and if at any time a physician makes you feel as though you should feel embarrassed about your problem, it’s definitely time to find a new one. 

The urologists at Norman Urology are experts in treating erectile dysfunction and other urological issues. They can help you manage your symptoms and walk you through available treatments.

If you’re experiencing ED, we encourage you to schedule a consultation with us today!

Take Control of Your Bladder Health

What Do We Mean by Bladder Health?

The bladder is an expandable bag-like organ that sits in the pelvic area between your stomach and your legs. It is normally the size of a grapefruit but can expand and contract in size. 

A healthy bladder is one that:

• Empties 4-8 times every day (about every 3-4 hours)

• Can hold up to 400 to 600 ml of urine

• May wake you up once at night to use the toilet (also giving you enough time to get to the toilet)

• Empties completely each time you go

• Does not leak

Patients can actively participate in fighting some of the most common bladder health problems.   

Working with your doctor to address your specific issues, you can tailor a strategy that fits your lifestyle. Below are some ways you can be proactive and take back control of your bladder health.

Let’s Get Physical

If you’re having bladder trouble, the last thing you think you may need is physical activity. But don’t be fooled! Regular physical activity is great for your cardiovascular system, but it’s also an effective way to reduce bladder leakage issues. 

In contrast, prolonged sitting and low physical activity levels are linked with the development of lower urinary tract symptoms. 

Effective exercises can include things like squats (which target your glute and pelvic muscles), and Kegels (exercises focused solely on strengthening the pelvic floor muscles).

How Much Liquid Are You Drinking a Day?

Ask your doctor if drinking fewer liquids throughout the day would be a healthy option. They can generally provide advice based on your health history, how much you work, your general activity level, and even the local climate. 

The key, of course, is to balance drinking fewer liquids throughout the day and maintaining proper hydration. 

And it probably goes without saying, but water above all other fluids is the best choice you can make.

Keep a Healthy Weight

Studies suggest there is a strong link between body mass index and bladder health. In other words, the heavier you are, the more likely you may have or will develop leakage.

Studies have shown that “each 5-unit increase in body max index (BMI) is associated with a 60-100% increased risk of daily urinary incontinence.”

Avoid Constipation

It’s an uncomfortable and even embarrassing topic, but constipation can have a big effect on bladder health. 

Physiologically, the rectum is close to the bladder, so if you have large amounts of stool in your colon, it can push up against the bladder, causing it to contract when it is not supposed to. This can cause accidental ‘leaks’ or create the feeling of a constant urgent need to pass urine. 

Professionals direct patients to eat enough fiber, which helps with regular bowel movements. Some medications can help as well so it’s worthwhile to talk to your doctor. 

Consider Surgical (and Other) Options

There are a number of surgical treatments available to treat incontinence, many of which are minimally invasive, outpatient procedures.

Some patients find a urethral sling is the best option to treat bothersome stress incontinence (leakage of urine with activity, coughing, laughing, or sneezing).

For those with an overactive bladder, botox injections can be an excellent treatment option. And there are even artificial urinary sphincters that allow manual control of the flow of urine from the bladder. 

The Norman Urology physicians are experts in the field of urology, and we can walk you through the best exercises and treatments that will be most effective in keeping your bladder healthy. 

We have years of experience helping patients attain and maintain bladder health, and are also trained to perform many minimally-invasive, outpatient surgeries for those who would benefit. 

We’d love to talk with you today!

The Link Between Erectile Dysfunction and Heart Disease

Although erectile dysfunction (ED) and heart disease may seem unrelated, medical studies on the subject have shown there is a strong link between the two. In fact, men who have ED are more likely to be diagnosed with heart disease than smokers or those with a family history of coronary heart disease. 

In one study, 57% of men who had bypass surgery and 64% of men hospitalized for a heart attack had experienced ED at some point. 

What Are the Symptoms of ED?

In general, erectile dysfunction is the inability to achieve and sustain an erection, making intercourse impossible. Roughly 1 in 10 adult men suffer from erectile dysfunction on a long-term basis. And while many men make the mistake of thinking ED is just part of getting older, it’s not!

But let’s be careful to avoid the mistake of lumping this condition in with other sexual issues like infertility, low sex drive, or premature ejaculation. Erectile dysfunction is a diagnosis all on its own with specific treatments to address it. 

What Causes Erectile Dysfunction?

As with many other conditions, ED can be the result of one or several factors, but blood vessel problems are its leading cause. In fact, some doctors view this dysfunction as a barometer for overall health especially since it can be a warning sign of heart disease. 

Generally, three things must happen for a man to achieve and maintain an erection:

• The nerves of the penis must function properly

• There must be adequate blood circulation to the penis; and

• There must be sufficient brain stimulus

In the case of vascular issues, atherosclerosis– a thickening or hardening of the arteries caused by the buildup of plaque in the inner lining of the artery –  can block the vessels that supply blood flow to the penis that’s necessary to achieve or sustain an erection. Hypertension (high blood pressure) and high cholesterol can also play a role in erectile dysfunction, but atherosclerosis alone is responsible for 50%-60% of all ED cases in men over 60. 

How Can ED be Treated?

Today there are a number of surgical and non-surgical options for treating ED. 

Non-surgical solutions include things like medication, lifestyle changes (like quitting smoking and losing weight), seeking help from a qualified sex counselor, or changing a medication that has been linked to ED (e.g. some diuretics or antiarrhythmics which control irregular heart action). It goes without saying that you should only change medications with your doctor’s advice and approval. 

Some men find that mechanical aids are helpful in getting and maintaining an erection. A vacuum pump, for instance, helps draw blood into the penis and causes an erection. A band slips off the base of the pump onto the base of the penis to help maintain the erection. 

Highly effective surgical options are available as well. Penile implants, for example, can be placed in the penis as a permanent, convenient treatment option. There are several different types of implants and your urologist should walk you through each of them to decide which is best for you. 

When to See Your Doctor

Some men may feel embarrassed to talk about this issue, even with their doctor. But if you’re hesitant about consulting a physician, remember, they have seen most, if not all, of your symptoms before. So don’t feel like you’re the only person in the world with erectile dysfunction.

Try to remember: your doctor is your ally, and if at any time a physician makes you feel as though you should feel embarrassed about your problem, it’s definitely time to find a new one. 

The urologists at Norman Urology are experts in treating erectile dysfunction and other urological issues. They can help you manage your symptoms and walk you through available treatments.

If you’re experiencing ED and are concerned about a link to heart disease, we encourage you to schedule a consultation with us today!

Why You Shouldn’t Feel Embarrassed to Discuss Your Urologic Health

For some of us, seeing a doctor is stressful and uncomfortable. But when it comes to discussing certain urological issues, there can also be an element of embarrassment or even shame.

Most of us cringe at the thought of having an in-depth conversation with our physician about things like erectile dysfunction or incontinence. But when you stop for a minute to put things into perspective, a frank conversation with your doctor for a relatively short period of time is far less embarrassing (and painful) than continuing to live with distressing symptoms which could be signs that something is seriously wrong. And many symptoms are treatable, so don’t rob yourself of the chance to work with your doctor to alleviate them!

Let’s get comfortable talking about two conditions with embarrassing symptoms that most people find hard to discuss: erectile dysfunction and incontinence. 

Erectile Dysfunction

Understandably, this condition is highly embarrassing for most men. But it’s more common than you may think. One study found that around 52 percent of men experience some form of erectile dysfunction (ED), and the number goes up for men between the ages of 40 and 70. Some estimates indicate about 30 million men are affected by this condition yet it still continues to be under-reported. 

There are many reasons why a man may not be able to get or maintain an erection ranging from physical to emotional and mental issues. 

The Mayo Clinic lists some common causes of ED:

• Smoking/alcohol use

• Diabetes

• High cholesterol

• Heart disease

• Blood vessel blockage

• Obesity

• Metabolic syndrome

• Medication-related ED

• Anxiety, stress, or depression

The good news is that many of these causes are treatable. And speaking to your doctor about symptoms is even more important when you consider that erectile dysfunction can sometimes be an indication of a more serious underlying issue like heart disease and diabetes. 

Incontinence

Many people suffering from urinary incontinence believe it’s just an embarrassing part of life they will have to learn to live with. It’s just not true!

The first step toward getting help is having an open conversation with your physician about your specific symptoms. Only then can your doctor determine what type of incontinence you’re suffering with, which allows them to select a treatment plan that makes sense. 

There are a number of different types of urinary incontinence (UI), all of which can have embarrassing results, including:

Stress incontinence. Leaks can happen when pressure is exerted on the bladder during activities like exercising, lifting heavy objects, sneezing, coughing, or laughing. 

Urge incontinence: This is characterized by a sudden, urgent need to go to the bathroom often, followed by a small or copious amount of urine emptying from the bladder. Urge incontinence can result from minor conditions like an infection but can also be a sign of a more serious condition. 

Functional incontinence. This type of incontinence is typically characterized by a secondary condition like arthritis or mental impairment which keeps you from getting to the bathroom in time. 

Mixed incontinence. This type of incontinence is characterized by a combination of any of the above types of incontinence. 

When talking about your symptoms with your doctor, resist the urge to minimize them. Your physician can diagnose whether the problem is temporary or persistent, or if there could be a more serious condition lying beneath those symptoms. 

There are many, many effective treatments that can help relieve symptoms, and talking about UI with your doctor openly is the best way to learn about those treatments. 

When to See Your Doctor

If you’re hesitant about talking with your doctor, remember, they have seen most if not all of your symptoms before. So don’t feel like you’re the only person in the world with an embarrassing urinary problem.

If you suspect a more serious underlying problem, or when symptoms negatively impact your day-to-day activities, don’t hesitate to make an appointment with your physician. Your urologist can provide you with information on lifestyle changes and medical treatments that can resolve or lessen symptoms. 

Try to remember: your doctor is your ally, and if at any time a physician makes you feel as though you should feel ashamed of your problem, it’s definitely time to find a new one. 

The urologists at Norman Urology are experts in treating erectile dysfunction, incontinence, and many other urological conditions. They can help you manage your symptoms and walk you through the treatments that will be most effective for you. 

If you’re experiencing any urology-related symptoms, we encourage you to schedule an appointment with us today!

What You Need to Know About Testicular Cancer

You may not hear about it as often as some other cancers, but testicular cancer can affect a man in the prime of his life, just as it did NFL punter Josh Bidwell at age 23. The good news is that it is treatable. In fact, with chemotherapy, Bidwell was eventually able to return to professional football. 

So what are the risk factors and what should you be looking for?

What Are the Risk Factors?

While the exact cause of this type of cancer is unknown, there are a number of risk factors associated with an increase in the likelihood a man will develop testicular cancer.

Three well-known risk factors for testicular cancer include:

• Age

• Cryptorchidism

• Family history

Age as a Risk Factor

While testicular cancer can occur at any age, it is often referred to as the “Young Man’s Disease” because it is most common among men ages 20-35 years old, with an average age of 33 at the time of diagnosis. 

Why is this? Nearly all testicular cancers show up in the germ cells which are responsible for making sperm. A young man’s testes are more actively producing testosterone and sperm than an older man’s, which raises the risk of cancer. 

What is Cryptorchidism?

Cryptorchidism, often referred to as an undescended testicle, is fairly common, affecting between 3 and 5 percent of full-term boys at birth (with a higher incidence in cases of premature birth). 

While this condition often resolves itself within the first six months of life, about 0.8-1% of full-term boys will need treatment for an undescended testicle. This can be the result of a testicle never having been formed to begin with, a shrunken testicle forming before birth (due to a twist or blockage of blood vessels), or a testicle that has formed but remains within the abdominal cavity or in the groin just above the scrotum.  

Why Is This Condition Considered a Risk Factor?

While not directly linked to the fact a testicle hasn’t descended, there is a significant correlation between this sort of abnormality and the likelihood of cancer showing up later. Scientists and doctors have observed that cancer is most often detected in an undescended testicle, and if diagnosed, the risk of cancer in the normal testicle goes up. And the higher the testicle sits, the higher the risk of testis cancer. 

Family History

Men who have brothers diagnosed with testicular cancer are 8-12 times more likely to also develop testicular cancer. There is also evidence that a man is 2-4 times more likely to get testicular cancer if his father has or had testicular cancer. 

This disease is considered to be highly heritable, passing from one generation to the next. The good news is that because testicular cancer is rare, it is also rare that it runs in families. 

What Are the Symptoms?

In general, this type of cancer shows up in only one testicle. Signs and symptoms to be aware of include:

• Feeling a lump or swelling in either testicle

• Feeling heaviness in the scrotum

• Experiencing a dull ache in the lower belly or groin

• Experiencing a sudden swelling in the scrotum

• Feeling pain or discomfort in either the scrotum or testicle or both

• Enlargement or tenderness of the breast tissue

• Back pain

If you detect any of these symptoms for more than two weeks, do not hesitate to make an appointment with your doctor. As with any cancer, early detection is key.

Is Testicular Cancer Treatable?

Happily, this is one of the most treatable types of cancer, with a highly positive prognosis for patients who are treated for testicular cancer.

In fact, with early detection, almost all men treated for testicular germ cell tumors are likely to survive with little chance it will return more than 5 years later. 

In almost all cases, treatment includes surgical removal of the affected testicle– an operation referred to as an orchidectomy or orchiectomy. (It’s important to note that this procedure does not negatively affect a man’s fertility.) 

In some cases, chemotherapy is highly effective in curing testicular cancer. 

Should I See My Doctor?

Even if you’re not experiencing symptoms, your doctor can help you identify and understand your risk factor(s). And if you are experiencing any of the symptoms listed above for more than two weeks, don’t wait. Call for an appointment today. 

At Norman Urology, we are dedicated to serving the urological needs of Norman and surrounding communities. We offer state-of-the-art diagnosis and treatment with comprehensive care for both men and women. If you are concerned about your symptoms or just want to learn more about testicular cancer, we hope you will schedule a visit with us today.

Let’s Talk About Male Infertility

Infertility can be incredibly painful to discuss for both men and women. And for some, there is a deep shame around the inability to conceive. Men are certainly not immune to it. Many see infertility as a threat to their masculinity.

And that’s why it’s important to drop the stigma and start talking about it openly as a medical issue without attaching shame to the condition. About 8-12% of couples worldwide struggle with getting pregnant. And male infertility is not a rare syndrome– about 10% of all males in the US encounter infertility.  

How Is Infertility Defined?

The standard diagnosis is made when couples have not conceived after a year of frequent intercourse without the use of prophylactics. And there may be reason to see a doctor sooner if either partner has a known condition that can affect fertility (a history of undescended testicles or advanced female age for example). 

Stereotypically, when a couple is unable to conceive, initial discussions and treatments focus on female infertility. But the reality is that in 40 to 50% of instances where couples cannot conceive the cause is male infertility. So most doctors recommend that both partners be evaluated simultaneously. 

Symptoms

While the obvious symptom is the inability to father a child, there may also be other symptoms to look for which may lead to a diagnosis of male infertility:

• Difficulty ejaculating or ejaculating only small volumes of fluid

• Reduced sexual desire

• Erectile dysfunction

• Tenderness or pain and swelling (and possibly a lump) in the testicle area

• Intermittent respiratory infections

• Loss of smell

• Gynecomastia (abnormal breast growth)

• Signs of chromosomal or hormonal abnormalities that can present as decreased facial or body hair

If you are experiencing any of these symptoms, don’t wait to make an appointment with your doctor because there are several treatments available that can increase your likelihood to conceive a child.

Causes

Under normal conditions, a man produces cells called sperm which are made in the testicles. Sperm is stored in the epididymis, a tube that connects the testicle to the vas deferens, an organ that travels into the pelvic cavity just behind the bladder and moves sperm to the urethra in preparation for ejaculation. 

Most often, the cause of infertility in men is related to the process of making or moving the sperm, but things like substance abuse, smoking, stress, and obesity can also cause poor sperm function.

One common cause of infertility in men is varicocele, a condition where the veins in the scrotum become enlarged and get tangled so that the testicles are heated up to an extent that it impairs sperm function.  

Other causes are related to semen production. A healthy man’s reproductive system produces sugar-rich fluid (fructose) called semen that nourishes sperm and aids in their motility towards a female egg. If there are factors affecting the production of healthy semen, sperm may have a shorter lifespan which can reduce the likelihood of conception. 

Some men naturally have a low sperm count (oligospermia) or may not produce sperm at all (azoospermia). Other men may have a genetic disease like Klinefeflter’s Syndrome which affects their ability to have children. Conditions like diabetes and certain autoimmune disorders can also contribute to fertility problems.

Treatments

In the case of men who produce no semen, some medications can help, while other medications may be used to treat things like hormonal imbalances and erectile dysfunction.

Depending on the cause of infertility, surgery may be required to resolve issues relating to a defect or blockage. Doctors may recommend an outpatient procedure called a varicocelectomy, which repairs dilated veins above the scrotum. 

If the infertility isn’t resolved with treatments like these, couples may choose assisted reproduction which can include things like intrauterine insemination (IUI), in vitro fertilization, or intracytoplasmic sperm injections (ICSI). 

Talk With Your Doctor

If you and/or your partner are struggling with infertility, don’t hesitate to make an appointment with your doctor. Many male infertility issues are treatable and reversible. The physicians at Norman Urology are experts in male health and treating issues of infertility. If you are concerned about infertility, we invite you to make an appointment today to discuss treatments and options.

Why Female Sexual Health Matters, and Why It Should Be Talked About More

What Do We Mean By ‘Sexual Health’?

Sexual health involves discussions around so much more than disease prevention. And after a history of neglect, today’s scientists and doctors are researching and treating a much broader slate of issues concerning female sexual health.

Sexual health can be defined in many different ways. The World Health Organization defines it as “a state of physical, emotional, mental and social well-being in relation to sexuality: it is not merely the absence of disease, dysfunction or infirmity.”

Another term used these days to denote sexual health is “sex positivity,” which can encompass the candid discussion of everything from relationship styles to nudity, safer sex, body positivity, and gender identity. The idea is to be able to dialogue and engage with others without feeling ashamed or inadequate. 

Female sexual health encompasses so much more than anatomy. It can mean learning to set healthy boundaries, forming deeper connections with our partners, and even talking about what pleases us and what turns us off. 

Anatomy Lessons

Certainly, any candid discussion of female sexual health must address a woman’s anatomy. 

Many people do not understand a woman’s complete sexual anatomy, which is complex and interdependent. Let’s face it. The vagina is complicated!

For some women, it’s helpful to have a conversation with their doctor about the various parts of the whole: from the clitoris to the urethra to vestibular bulbs, once you know where things are and what they do, you’re better prepared to talk about things like healthy boundaries, intimacy issues, body positivity, and even how menopause can affect a woman’s sexual drive. 

A Word About Disease Prevention

No discussion of female sexual health would be complete without touching on the issue of sexually transmitted diseases. 

Women need to work with their doctors and educate themselves about how diseases are transmitted, what treatments are available, and perhaps most importantly, how to prevent disease transmission in the first place. 

If you have questions about sexually transmitted diseases and risk factors or diagnoses, don’t wait. Call your doctor and make an appointment. There’s no reason to feel embarrassed or ashamed. 

Promoting Healthy Boundaries

Female sexual health involves setting and maintaining healthy boundaries with our sex partners. 

To be fully healthy, we have to be able to confidently and clearly communicate our wants, needs, and limitations to our partners. Unfortunately, many women only recognize their boundaries once they’ve been crossed. 

Establishing boundaries can be learned, but it takes practice to implement them. 

Building Deeper Connections

There are many reasons people want to have sex, and not all of them involve orgasms. 

For example, some women who have reached menopause may not have the same level of drive that they did when they were younger. But they still want to enjoy sex with their partners because it promotes both sexual and emotional intimacy, and strengthens bonds.

For some women, cuddling is a natural segue into sexual intimacy. But unless they share this desire with their partners, they may never feel quite “ready” to have sex. 

It’s important to talk with your partner about these things candidly so expectations are clear and you can build intimacy and a satisfying sex life.

The “Talk”

Taking charge of your own sexual health can be empowering, so remind yourself of that if you start to feel embarrassed or shy when talking about it. 

Some things to think about before you start a conversation:

Admit your discomfort at the outset. Feeling anxious about telling someone else something so intimate about yourself is normal. Vulnerability is often uncomfortable, but if you’re brave enough to stay with it, it can lead to great outcomes.

Acknowledge contributing factors. Sometimes conflicts in a relationship can be a huge barrier to a satisfying sex life. Resentment is most definitely not an aphrodisiac! Are you allowing each other enough time to enjoy sex? What feels romantic and what feels routine?

When To See Your Doctor

Female sexual health is a multi-layered, complex subject. If you have questions or concerns, and especially if you are experiencing symptoms of an STD, don’t wait to see your doctor. 

The physicians at Norman Urology are trained to treat all aspects relating to female sexual health. We’d be happy to talk about your questions and needs. Why not make an appointment with us today?

Is Prostate Cancer Hereditary? Should I Ask for Genetic Testing?

By now, most of us have heard about the BRCA gene test for women who may be susceptible to breast cancer. But is there a genetic test for prostate cancer?

The short answer is yes. Let’s start with the basics.

What Does the Prostate Do?

The prostate is just one of several organs in a man’s reproductive system. The prostate is a walnut-sized organ that sits in front of the rectum, just below the bladder. 

The fluid produced by the prostate, along with sperm cells from the testicles and fluids from other glands, make up semen. The muscles of the prostate (which surrounds the urethra) help ensure semen is forcefully expelled outwards during ejaculation. 

Symptoms of Prostate Cancer

So what are the symptoms of prostate cancer? Bearing in mind these symptoms can be evidence of conditions other than prostate cancer, signs to watch for include:

• Blood in the urine or semen

• Difficulty starting urination

• Trouble emptying the bladder completely

• Weak or interrupted flow during urination

• Frequent need to urinate, especially at night

• Pain or burning sensation during urination

• Painful ejaculations 

• Unintentional weight loss

• Bone pain

If you are experiencing any of these symptoms, don’t wait to call your doctor. When cancer is identified early, treatment success rates go up. 

What Are the Risk Factors?

If you are male, then you are at risk for developing prostate cancer. About 13% of American men will get prostate cancer during their lifetime. But one dominant risk factor for developing prostate cancer is age. The average age of a man at diagnosis is 65 or older. Some men have additional risk factors, including race and a family history of prostate cancer. 

Black men are at increased risk of prostate cancer, tend to get it younger, and tend to have a more aggressive type of prostate cancer than ethnicities. Diet may also play a role in promoting cancer risks. A diet high in fat and low in fruits and vegetables may also contribute to developing prostate cancer. 

Is There a Genetic Link? 

It’s been well documented that genes may play a role in a man’s susceptibility to developing prostate cancer, so taking a detailed family history is a crucial tool in assessing risk, and your doctor may screen you based on these facts. 

There are a few genes that, when they mutate, can play a role in a patient’s susceptibility to prostate cancer. These genetic mutations can hamper the BRCA1 and BRCA2 genes that typically protect against cancer. 

Patients who have a family history of prostate cancer face a higher risk than patients who don’t. The three factors that have been identified in terms of a genetic predisposition for prostate cancer are:

1. Three or more first-degree relatives (i.e. father, brother, son, etc.) with diagnoses

2. Three successive generations of either the maternal or paternal lineages with diagnoses

3. At least two relatives who were affected at or before age 55

Any one of these criteria can increase the possibility of developing hereditary prostate cancer. 

When to See Your Doctor

The standard recommendation for prostate cancer screening is every two years for men between the ages of 55 to 69. But if you have any of the symptoms listed above in this article, we recommend that you make an appointment sooner rather than later. 

Testing for hereditary prostate cancer can be as simple as a blood or saliva test. Your doctor may also offer genetic counseling which involves a comprehensive cancer risk assessment, genetic testing, and risk management advice. Depending on your risk factors and cancer stage, your doctor may suggest radical prostatectomy which is the surgical removal of the prostate and pelvic lymph nodes. 

If you are experiencing symptoms or suspect you may have prostate cancer, the physicians at Norman Urology are here to help. We are specialists in this area and are trained in the latest methods of cancer treatments and procedures. We’d love to hear from you today!

How to Avoid UTIs This Summer

Can you quickly name a physical ailment that tends to flare up during a particular time of year? Probably the most well-known relationships between seasons and illnesses are the winter flu season and the spring allergy swing. You’re probably all too familiar with these troublesome times, but you might not know that UTIs peak during a different time of the year. The incidence of urinary tract infections tends to rise during the summer months. Here we break down the causes and cures for urinary tract infections so you can avoid them this summer.

Signs of a UTI

There are three distinct kinds of urinary tract infections, but the most common affects the bladder and urethra. Instances of common UTI symptoms include:

• Urinary frequency issues

• Pain or a burning sensation during urination

• Lack of urgency to urinate 

• Urine with a strong odor 

• Urine that is cloudy, pink, or dark in color

• Discomfort in the lower abdomen

• Loss of control or Involuntary urination

A UTI can progress into a kidney infection or other complications if left untreated. However, despite their prevalence, UTIs can be avoided to some degree. You can reduce your risk of a urinary tract infection (UTI) by following the advice in this article, which applies to people of all ages.

UTIs in the Summer

Similar to the ideal conditions for the development of the common cold during the winter, a UTI thrives in the warm, active environment of summer. For starters, the warm weather of summer promotes the expansion of bacteria and germs. Dehydration, which is more likely when temperatures are higher, is another risk factor for developing a UTI.

For bacteria, wet swimsuits are like a veritable paradise. The risk of a urinary tract infection (UTI) is also increased by holding in urine, as you might do if you're going to be outside for a while. Finally, summer is a peak season for sexual activity, and sex can spread bacteria to the urinary tract.

Strategies to Prevent Summertime UTIs

Though it's not always possible to prevent one, you can lessen your chances of contracting a urinary tract infection. Here are a few measures that may help you avoid infection.

Clean from Front to Back

Wipe your genitalia from front to back after using the restroom to reduce the risk of spreading E. coli, which is commonly found in the rectum. Avoiding the anus reduces the likelihood of transferring E. coli to the urethra.

If you're suffering from diarrhea, it's even more crucial that you follow this advice. Having diarrhea makes it more difficult to control bowel movements, which may increase the likelihood of E. coli spreading to the urethra.

Stay Hydrated

Do your best to maintain a steady fluid intake throughout the day. The increased urination helps remove bacteria from the urinary tract. It's recommended that you drink 6-8 glasses daily.

You can also increase your fluid intake by drinking sparkling water, decaffeinated herbal tea, milk, or smoothies made from fruit and vegetables if you find it difficult to drink that much water. Caffeine and alcohol can irritate the bladder and should be avoided if possible.

Don’t Hold It

Urine retention can lead to bacterial growth, so try not to hold it in. Do your best to not go more than 3-4 hours without urinating, and make sure that every time you do, your bladder is completely empty. Since pregnancy increases the risk of a UTI, this is of utmost importance for pregnant women. The risk can be amplified if you're trying to hold it in.

Urinate After Sex

The risk of a urinary tract infection (UTI) rises dramatically for sexually active people, particularly women. This is because urethral bacteria can spread rapidly during sexual activity. Urinate right before and after sexual activity to lower your risk. The goal is to eliminate any potential UTI-causing bacteria. Washing your genitalia gently before engaging in sexual activity is also recommended. Maintaining a sanitary environment there can prevent bacteria from entering the urethra.

Avoid Scented Products

More than fifty different types of microbes are found in the vagina, with many of these being Lactobacilli. These bacteria play an important role in maintaining vaginal health and pH balance. The use of scented feminine hygiene products has been linked to an increase in the spread of harmful bacteria. This may lead to vaginal yeast infections, bacterial vaginosis, or urinary tract infections. Try to refrain from using:

• Scented tampons and pads 

• Douches

• Fragrant talcs

• Aerosol deodorants

Though there are several things to keep in mind, there are ways you can reduce the chances of developing a UTI this summer. Head over to our website for more information about UTIs and overall urinary health.

Is There a Link Between Diabetes and Urological Health?

Diabetes is a common condition that affects approximately 37 million Americans. And over 50% of those men and women with diabetes have some kind of bladder dysfunction. 

There’s no question there is a strong link between diabetes and urological health. 

What Is Bladder Dysfunction?

Bladder dysfunction is a broad term that covers a spectrum of conditions relating to the lower urinary tract including:

• Urinary urgency (or no urgency even if the bladder is overfilled)

• Frequent urination

• Hesitancy (difficulty starting a urine stream)

• Nocturia (waking up more than once to urinate during the night)

• Decreased bladder sensation

• Increased bladder capacity

• Impaired ability to empty bladder

• Incontinence

How Does Diabetes Cause Incontinence?

In the case of incontinence, damage to the nerves that control the bladder can result in difficulty urinating or urinary incontinence. In some cases, the urethral sphincter may fail to contract because the bladder is chronically overfilled, thereby stretching and damaging the muscles of the bladder, which can lead to leakage (incontinence). 

What Other Urinary Issues Can Diabetes Cause?

Urinary Retention

While incontinence is certainly one of the side effects that may affect patients with diabetes, the condition can also cause something called urinary retention. 

In a patient without diabetes, when urinating, the external sphincter muscle relaxes, and when finished urinating, the muscle contracts again. 

In the case of a diabetic patient, muscle control is damaged which means that even with an overfilled bladder, the sphincter may fail to relax (which causes urinary retention - which can increase the risk of infections). 

Urinary Tract Infections

According to the National Center for Biotechnology Information, urinary tract infections are more common, more serious, and carry worse outcomes for those patients with diabetes.  

You should keep an eye out and call your doctor if you are having symptoms like:

• Frequent, strong urge to pee

• A burning, painful sensation when urinating

• Urine that has a strong smell, is cloudy, dark, or bloody

• Pain in the back and/or lower abdomen

• Fever or chills

A Vicious Cycle

It can feel like a vicious cycle for diabetics who may experience extreme thirst when excess glucose is in the blood, which in turn means they’re probably drinking more liquids, which can then result in a full (or overfilled) bladder. 

That’s why it’s crucial for diabetics to see their doctor regularly and report any lower UT issues they may be having. 

How Can I Prevent These Conditions From Developing?

One answer, while obvious, is to properly manage your diabetes. You can reduce your chances of developing lower urinary tract issues by doing things like:

• Sticking to your target glucose numbers (high glucose numbers can increase the risk of UTIs)

• Keeping an eye on blood pressure and cholesterol levels

• Leading a physically active life

• Keeping a healthy weight

• Ditching the cigarettes if you are a smoker

• Wiping front to back after going to the bathroom to reduce the likelihood of spreading harmful bacteria

Talk With Your Doctor

How diabetes affects urological health 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 diabetes-related urological issues. 

If you’re experiencing diabetes-related urological issues, the physicians and staff at Norman Urology are here to help. We specialize in treating disorders of the male and female urinary tract, including diabetes-related complications.
If you’re diabetic and are concerned about symptoms you may be experiencing, why not book an appointment with us today?

Are There Foods That Can Irritate My Bladder?

The urinary system is a collection of organs whose primary function is to remove waste from blood circulation. This waste is converted to urine in the bladder. The bladder, like other areas of the body, can get inflamed. If food becomes the cause of bladder discomfort, it may be necessary to alter your diet.

What is the bladder?

The bladder is an organ that resembles a balloon tucked behind the pelvic bone. It is a muscle-based component of the urinary system. The kidneys produce urine by removing waste from the circulation. Urine is subsequently transported to the bladder, where it accumulates until urination.

What is urinary tract irritation?

Most individuals urinate between six and eight times per day (maybe more if you drink plenty of water). However, the bladder is similar to other organs in the body. Changes in urine can make you feel uncomfortable and humiliate you if it becomes inflamed and you experience an accident.

What symptoms are associated with bladder irritation?

The following physical symptoms are related to bladder irritation:

• A strong need to urinate (urgency).

• The frequent need to urinate (frequency).

• Lower abdominal discomfort.

Could inflammation of the bladder indicate a disease?

Occasionally, urinary tract issues induce bladder irritation. Urinary tract infections (UTIs) can cause transient discomfort and urgency. Chronic conditions such as interstitial cystitis (IC) can cause persistent bladder pain. IC is an inflammation of the bladder wall (swelling).

Normally, bladder discomfort by itself is not an emergency. However, if you have a fever, chills, and lower back or side pain, you should seek medical attention.

Are there foods that irritate the bladder?

The bladder collects waste, including food and beverage remnants. A variety of foods can irritate your bladder if you have a bladder disorder, such as IC. Common and uncommon foods can both cause irritation:

• All alcoholic beverages, including champagne

• Apples and apple juice

• Bananas

• Brewer’s yeast

• Canned figs

• Cantaloupes

• Carbonated drinks

• Cheese

• Chicken livers

• Chiles/spicy foods

• Chocolate

• Citrus fruits and juices

• Coffee

• Corned beef

• Cranberries

• Fava beans

• Grapes and raisins

• Guava

• Lima beans

• Nuts — hazelnuts (also called filberts), pecans, and pistachios

• Mayonnaise

• NutraSweet™

• Onions (raw)

• Peaches

• Pickled herring

• Pineapple

• Plums and prunes

• Rye bread

• Saccharin

• Sour cream

• Soy sauce

• Strawberries

• Tea — black or green, regular or decaffeinated, and herbal blends that contain black or green tea

• Tomatoes

• Vinegar

• Vitamins buffered with aspartame

• Yogurt

How are foods that irritate the bladder identified?

A method of elimination is used to determine whether a food irritates the bladder. Not all individuals with bladder sensitivity are impacted by the same foods. Your healthcare professional can assist you in identifying foods that irritate the bladder. To evaluate bladder discomfort by eliminating foods, you can: 

• Keep a food journal to record which foods are bothersome and which are not.

• Remove the foregoing foods from your diet for many days.

• Once your symptoms have subsided, you can gradually reintroduce foods.

• Start with a tiny bit of one food and gradually increase it over several days.

• If discomfort returns after reintroducing a food, discontinue consumption of that food.

• Repeat the gradual reintroduction of foods to discover those that irritate the bladder.

How do I deal with bladder irritation?

You can alleviate discomfort by avoiding foods that irritate your bladder. However, eliminating foods from your diet does not mean you cannot have them ever again. You could possibly appreciate them in moderation (once in a while). Ingesting foods that irritate the bladder in moderation or by accident will be less painful if you consume copious amounts of water.

Living with bladder irritation can be a frustrating experience, but you may take steps to eliminate dietary irritants and lessen pain. Avoid meals that irritate your bladder, and keep in mind the importance of water. 

When you consume foods that irritate your bladder, drinking enough water helps you feel more at ease. The experts at Norman Urology Associates are here to help you enjoy your favorite foods without experiencing discomfort. Visit our website for more information on how we can help you.

Are Kidney Stones Common in Children?

Over the past 20 years, kidney stones in kids and teenagers have increased in frequency. Although they can happen to kids of any age, including premature infants, the majority of stones affect teenagers. When minerals and other components often found in urine come together to create a hard stone in the urinary tract, kidney stones can develop. They may also develop if the urine contains insufficient amounts of other elements that aid in preventing the formation of stones.

The ureter, the tube that links the kidney to the bladder, and the kidney are where stones often develop. Rarely do they develop in the bladder.

Symptoms of Kidney Stones in Children

Kidney stones in children can develop over time without showing any symptoms. However, if a stone begins to pass through the ureter, a tube that connects the urinary tract to the bladder, it may cause symptoms such as:

• Sudden, severe pain in the back or side

• Nausea and vomiting

• Groin pain as the stone passes down the urinary tract

• Severe stomach pain only (young children especially)

• Burning or pain while peeing

• Blood in pee (hematuria)

• Fever and urinary tract infection​

Diagnosing Kidney Stones in Children

When a stone is discovered in a child's urinary system by x-ray, ultrasound, or computed tomography (CT) scan, the diagnosis is generally confirmed.

An ultrasound is the recommended test for a child who may have a stone. This is due to the fact that ultrasounds are quick, non-radioactive, and capable of detecting the majority of stones. Although a CT scan can detect very small stones, many medical professionals will first order an ultrasound as CT scans expose the patient to a small amount of radiation. Only if a stone is suspected but cannot be seen with ultrasound will they then perform a CT scan.

Treatment for Kidney Stones in Children

The objectives are to relieve pain in children who have kidney stones and to aid the stone's passage into the bladder and out through the urine. Occasionally, you can accomplish this at home by consuming a lot of water and other liquids. Acetaminophen and ibuprofen, both available over-the-counter, can control discomfort. 

To make the passing of the stone easier, other oral drugs might be administered. a child's physician could advise using a strainer to help remove the stone from the urine so that it can be examined in a laboratory.

Children who are vomiting or are in excruciating pain may occasionally require hospitalization in order to receive IV fluids and stronger painkillers. A urologist may be required to assist children with huge stones or stones that won't pass on their own. In order to break the stone into tiny fragments that may be passed down the urinary tract, the urologist may use lithotripsy.

It may sound scary, but rest assured this operation is very safe and does not harm the kidney. While a child is under anesthesia, the urologist may also use a scope that enters the bladder and travels up the ureter to remove the stone. The stone can then be "grabbed" by the urologist and taken out of the body.

Preventing Kidney Stones in Children

You can assist a child in a variety of ways to lower the risk of further kidney stone development. Children with kidney stones should:

• Drink a lot of fluid throughout the day (urine should usually look very pale yellow). Ask your healthcare team for an amount that's right for a child. If a child has kidney disease and needs to limit fluid, please discuss this with the team.

• Limit salt in the diet.​

• Eat more fruits and vegetables, especially citrus fruits.

• Eat fewer meats, processed foods, fast food, and sodas.

• Avoid food and drinks with high fructose corn syrup.

• ​Keep a healthy weight.

• Eat the recommended amount of calcium-rich foods and drinks. Cutting back calcium in the diet is not recommended and can sometimes actually increase stone risk. On the other hand, don't take a calcium supplement unless your doctor says a child needs one.

A pediatric nephrologist, a kidney specialist who treats children with kidney stones, may be referred by a doctor to a child. The cause of a child's kidney stone formation may be found by blood testing and a 24-hour urine collection test. With this knowledge, a registered dietitian nutritionist (RDN) can provide detailed dietary advice, and your doctor and medical staff can offer medications to lower a child's chance of developing kidney stones in the future.