Men's Services

Adult CircumcisionHydroceles | Incontinence | Low Testosterone/hypergonadism
| Peyronie's Disease | Premature Ejaculation | Prostatitis | Vasectomy

Adult Circumcision

Circumcision is the surgical removal of the foreskin covering the tip of the penis. It is most commonly performed on infants; however, some adults choose to have the procedure for religious, cultural, cosmetic, personal hygiene or medical reasons.

Adult circumcision is more complicated than infant circumcision, but it is still considered a minor surgical procedure. Adult circumcision is performed in an out-patient procedure while the patient is under general anesthesia. The man will leave the hospital on the same day as the operation. He should arrange to rest at home for about a week before returning to work.

Hydroceles

Diagnosis

Testicles develop near kidneys in the abdomen and descend from that location to their normal position in the scrotum towards the end of pregnancy. In order for the testicles to leave the abdomen, a muscle ring in the groin on each side opens and allows the testicles to drop down to the scrotum. As the testicle descends, the lining of the abdomen also drops to line the scrotum. This channel closes in most boys. If that channel remains open, or reopens, a small amount of fluid can go from the abdomen to the scrotum through this passage. This results in hydrocele. If the channel remains opens or reopens widely, then a portion of the intestine can pass down the channel towards the scrotum. This results in an inguinal hernia.

Hydroceles can also develop due to inflammation or injury within the scrotum. These sometimes resolve over a few months but many remain and require medical attention. Hernias can also be the result of increased pressure that forces part of the intestines through a weak spot in the abdominal wall - straining during bowel movements, heavy lifting, coughing, sneezing or obesity.

About 10 percent of male infants have a hydrocele at birth. Seldom causing symptoms, this swelling of the scrotum does not bother a baby and usually disappears in the first year of life, even though the appearance may worry new parents. In older males, a hydrocele usually remains painless but may cause discomfort due to the increased size of the scrotum.

Treatment

Hydroceles require surgical repair if they cause symptoms, such as growing large or changing size significantly during the day. If the hydrocele is uncomplicated, an incision is made in the scrotum. The hydrocele is removed, removing the tissues involved in the hydrocele. If there are complications, such as a hernia, an incision is made in the inguinal (groin) area. This approach allows repair of hernias and other complicating factors at the same time. In children it is preferable to approach the condition through an inguinal incision in order not to miss a hernia that may otherwise manifest itself later if the scrotal approach is used.

After surgery, there will be discomfort that will require pain medication. In most cases, pain is reduced during the first week so that pain medication is no longer necessary. It may be necessary to restrict full activity for a couple of weeks, depending on your child's age and whether or not both sides were treated. If your son still plays on straddle toys, such as a rocking horse, he may have to avoid them for a time. The testicle and scrotum may stay swollen for several weeks after surgery before returning to normal. After surgery, less than 1 percent of cases have a hernia or hydrocele return.

Incontinence

Diagnosis

Incontinence is the loss of voluntary control over you urinary functions.

There are six main types of urinary incontinence:

  • Stress -  Losing urine involuntarily during certain physical activities: coughing, laughing or sneezing; lifting; walking or performing other forms of exercise; moving to get up from a chair or out of bed.
  • Urge - Inability to control the sudden urge to urinate. A large amount of urine may be released. Urge incontinence may occur after a sudden change in position or activity.
  • Mixed - A mixture of stress and urge incontinence.
  • Overflow - Failure of the bladder to empty normally. The bladder remains at least partially full, and small amounts of urine are leaked on a nearly continuous basis.
  • Neurogenic - Related to defects in the nervous system, which conducts urination signals between the bladder and the brain. Patients may have severe, total incontinence.
  • Post-prostatectomy - Occuring after prostate surgery; may take the form of stress and/or urge incontinence.

Treatment Options

Guadalupe Urology currently offers several therapies for treatment of Incontinence including:

  • Medication Therapy
  • Traditional Urodynamics (bladder function testing)
  • Interstim Therapy
  • Surgical Treatments

Low Testosterone / Hypogonadism

Diagnosis

Low testosterone or hypogonadism in men is a condition that results from the inability of the testes to produce enough of the sex hormone testosterone, sperm or both. As part of their reproductive systems, men have external genital organs called the testes.

Hypogonadism can affect men of any age, from fetal development, through puberty and adulthood. During each of these stages the symptoms of this condition are very distinct. If you have a family history of certain conditions such as Kallman's syndrome, undescended testicles as an infant, infertility, decreased sex drive, erectile dysfunction, or hemochromatosis, you may be at greater risk for developing hypogonadism.

Treatment

Several testosterone delivery methods exist.

These include testosterone injections, patches, and topical ointments.

Peyronie's Disease

Diagnosis

Peyronie's disease is characterized by the formation of hardened tissue (fibrosis) in the penis that causes pain, curvature, and distortion, usually during erection.

According to a report published in 1995 by the National Institutes of Health, Peyronie's disease occurs in about 1% of men. It is most common between the ages of 45 and 60, but it also occurs in young and elderly men.

Peyronie's disease may be mild or severe, and may develop rapidly or over time. Symptoms include the following:

• Hardened tissue (plaque) in the penis
• Pain during erection
• Curve in the penis during erection
• Distortion of the penis (e.g., indentation, shortening)

Treatment

Treatment options for patients with Peyronie's disease are limited. The goal of treatment is to reduce pain and maintain sexual function. Surgery is the only effective treatment, and because Peyronie's may resolve on its own, physicians often advise waiting 1 or 2 years before choosing this option.

• Surgery
• Medication Therapy

Premature Ejaculation

Diagnosis

Premature ejaculation (PE) is a term used to describe a condition in which a man regularly ejects semen (i.e., ejaculates) very soon after the onset of sexual arousal, or sooner than he or his partner wishes. This condition, which is also called rapid ejaculation, is the most common type of sexual dysfunction in men under the age of 40.

The cause for premature ejaculation is unknown, although, in most cases, it is thought to be the result of psychological factors (e.g., anxiety, guilt). Rarely, the condition is caused by a physical problem, such as over sensitivity of the genitals or abnormal hormone (e.g., testosterone) levels. Certain medications (e.g., psychiatric drugs) may cause premature ejaculation.

Treatment

Treatment for premature ejaculation may include sexual therapy, counseling, medication, or a combination of these methods. Getting enough exercise and sleep, and eating a healthy diet are also important.

Prostatitis

Diagnosis

Prostatitis is a common and painful disease of the prostate gland and its surrounding structures.

Symptoms:
• Frequent and urgent need to urinate
• Burning sensation during urination
• Pressure or pain in genital area and lower back
• Sexual problems
• Fever and chills

Treatment

Medication
Acute bacterial prostatitis is treated with antibiotics.

Vasectomy

If you’re certain that you don’t want to have any more children, a vasectomy may be the right form of contraception for you and your partner.

A vasectomy is a simple operation that makes a man infertile or unable to father children. The procedure takes a few minutes to perform in a doctor’s office.
The operation is safe, simple and effective. It makes a man permanently sterile. Surgery to reconnect the vas deferens (vasectomy reversal) is available, but the reversal procedure is difficult and may not always work. For these reasons, men thinking of having a vasectomy should carefully consider their decision.

 

© 2011 Guadalupe Urology ~ Robert T. Ryan, III, M.D. ~ Seguin | Gonzales | Cuero | Yoakum