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How to treat varicoceles?

February 24, 2022 Comments Off Sexual Health

Varicoceles

What are varicoceles?

Varicoceles are when veins called pampiniform plexus become enlarged inside your scrotum (the sac that protects and holds the testicles). About ten to fifteen males out of one hundred have varicocele; it is like getting a varicose vein in your leg.
This condition is most common in young men; and affects the left side of the scrotum more than the right side, because the male anatomy is not the same on both sides.
Varicoceles can be on both sides at the same time, but this is rare.

What are the causes of varicoceles?

Your spermatic cord (each testicle is holding up by a spermatic cord) transfers blood to and from your testicles.
It’s not certain what causes varicoceles; but the principal cause could be a problem with blood flow in the spermatic cord.
Many experts believe a varicocele forms when the valves inside the veins in the cord prevent your blood from flowing properly; which leads the veins to dilate. This might cause damage to the testicle and lead to infertility.
When varicocele occurs in puberty, it’s often because of the immediate growth they undergo during puberty. The testicles need more blood than normal as they develop, and any problem in the veins can keep the blood from getting where it needs to go.

What are the symptoms of varicoceles?

Varicoceles often don’t present symptoms; but sometimes you may notice:
• Dull testicular pain or scrotal aching; which often gets better when you lie down, and get worse while doing certain activities.
• Inflamed testicle or scrotum.
• Male infertility.
• Sensation of a mass above the affected testicle.
• Enlarged veins that are quite noticeable.

Complications

• Testicular atrophy: The majority of the testicle comprises sperm-producing tubules. When damaged, as from varicocele, the testicle contracts and softens. We can’t explain why the testicle shrinks, but the malfunctioning valves allow blood to pool in the veins, which can result in increased pressure in the veins and exposure to toxins in the blood that may cause testicular damage.
• Infertility: Temperature changes inside the scrotum due to blood accumulation in veins; this higher temperature may affect sperm formation, movement (motility), and function.

Diagnosis

In the physical exam, the doctor can feel above your enlarged testicle a mass that does not trigger discomfort upon palpation.
If you have a large varicocele, your doctor might ask you to stand, take a deep breath and hold it while you bear down (Valsalva maneuver); this helps your doctor detect abnormal amplification of the veins.
Sometimes the physical exam is inconvincing, so your doctor might order a scrotal ultrasound (a test that uses high-frequency sound waves to create precise images of the male’s testicles and surrounding tissues). In certain cases, other imaging might be recommended to rule out other causes for the varicocele, such as a tumor compressing the spermatic vein.
The size of the mass in your testicle helps your doctor classify your varicocele on a grading scale of 0-3.
A Grade 0 is the smallest, and can be diagnosed only with the help of an ultrasound.
Grade 3 is the largest, and means your varicocele is big enough that it changes the shape of your scrotum and can be diagnosed with the physical exam.

How to treat varicoceles?

Varicoceles require treatment only if:
• You have pain
• You have problems with your fertility
• Your right testicle is growing more than the left

There are no medicines to prevent or treat varicoceles.
If you do need treatment, the goal will be to remove the veins that supply blood to your spermatic cord. You might have:

Varicocelectomy: This surgery is performed to remove enlarged veins in your scrotum; and to restore proper blood flow to your reproductive organs, under local or general anesthesia through a small cut into your scrotum.
Laparoscopic surgery: The doctor makes a small incision in your abdomen and passes a tiny instrument through the incision to see and repair the varicocele; this procedure requires general anesthesia.

After those two surgical treatments, you may notice:
• Varicoceles don’t go away, or come back
• Hydrocele
• Your testicular artery gets injured

Percutaneous embolization: A radiologist inserts a tube into a vein in your groin or neck through which instruments can be passed; the radiologist inserts a coil by using X-rays, to deflect blood away from the enlarged vein in your scrotum, under general anesthesia.

Risks that can follow this procedure include:

• Varicoceles don’t go away, or comes back
• The coil moves
• An infection

Recovery

After embolization, you can return to work after two days, and begin exercising after seven to 10 days.
If you have the procedure to help with fertility, the doctor will test you in 3-4 months; that’s how long it takes for new sperm to grow. You’ll probably see improvements in 6 months, but it could take a year.
A little more than half of the infertile men who have the procedure benefit from it. Surgery is also successful for most teens who have it to fix slow testicular growth.

What is Gout?

November 18, 2021 Comments Off Common Solutions Kidney stones

Gout

What is Gout?

Gout is a form of arthritis that causes sudden attacks of pain, redness, and tenderness in joints; especially the joint at the base of the big toe.
Gout occurs when your body has extra uric acid; so urate crystals accumulate in joints, causing inflammation and intense pain.
A crisis usually develops during the night because the body is inactive and has a low temperature.
Gout can be treated with medications and changes in diet and lifestyle.

Who is affected by Gout?

-Men are more affected by gout than women because they have higher levels of uric acid in their blood.
-Women are affected after menopause because in this period they reach these uric acid levels.
-Obese people.
-Diabetic people.
-People with high blood pressure.
-People with kidney disease.
-People with a family history of gout.
-People with congestive heart failure.
-A person who consumes: a diet high in animal proteins, alcohol, and diuretics.

What causes Gout?

Normally the human body makes uric acid when he breaks down chemicals called purines (substances found in certain food and drinks); the production of uric acid goes through the kidneys and exits the body with urine.
Sometimes the body produces an excessive quantity of uric acid, or the kidneys are not doing a good job to handle the uric acid out of the body, so gout occurs.

What are the symptoms of Gout?

The symptoms of gout always occur suddenly, and often at night (gout attack):

-Intense joint pain especially the large joint of the big toe.
-Inflammation and redness.
-When gout progresses, the patient will not be able to move normally the joints affected.

A gout attack can last a week or two.
Between gout attacks, you may have no symptoms at all.

How often do Gout attacks happen?

Gout attacks can occur frequently or after several years from the last attack.
But if gout isn’t treated, attacks may become more frequent and last longer.
Gout attacks can occur in the same joint or affect different joints.

How to diagnose Gout?

Doctors usually diagnose gout based on the symptoms of the patient and the appearance of the affected joint. Check Babame activity cube.

Other tests that help doctors:
-Imaging test
-Blood test to measure the amount of uric acid in your blood.
–Aspiration: by using a needle to draw fluid from your affected joint, and the fluid is examined under the microscope.

How is Gout treated?

1-Some medications are used to treat gout symptoms and to prevent future attacks:
-Nonsteroidal anti-inflammatory drugs ( NSAIDs)
-Colchicine
-Corticosteroids

2-Medications to prevent gout complications:
-Medications that block uric acid production.
-Medications that help your kidneys to do a good job and remove uric acid from your body.

3-Changes in diet and lifestyle:
Medications are often the most effective way to treat gout attacks, but some changes in your lifestyle are important:
-Choose healthier beverages and foods:
*Avoid malted barley drinks (diuretic that increases the levels of uric acid in the body), fruit juice drinks with high fructose (because fructose stimulates the body to produce uric acid), coffee (caffeine is a diuretic), alcohol.
*You should drink a lot of water because it helps to remove uric acid from your body.
*Avoid foods high in purines: seafood, tuna, red meat, turkey, spinach, liver…
*Avoid foods high in fat and sugars to prevent obesity and diabetes.
*Types of food that might help gout:
Cherries, whole grains, eggs, cucumber, dark chocolate instead of sweets high in sugar, tomatoes, fat free dairy products.
*Exercise regularly and lose weight.

Kidney disease can lead to Gout?

Kidneys are responsible to filter wastes like uric acid (found in your blood) out of your body. But when you have chronic kidney disease, you will have an excessive quantity of uric acid in your blood because the kidneys cannot filter this waste out of the body; so gout occurs.

Gout may lead to kidney stones?

People with gout could be at a higher risk of developing uric acid kidney stones because they have a higher level of uric acid being excreted by the kidneys, and they have more acidic urine, which makes the uric acid more likely to form stones.

Low libido in men

October 12, 2021 Comments Off Sexual Health

Physical and psychological issues can cause low libido in men; so don’t hesitate to book your appointment at Modern Care Clinic with dr. Fouad Khoury, to continue a normal sexual life and to avoid problems in your relationship.

What is low libido in men?

Low libido in men describes a decreased interest in sexual activity; it means that the man is losing interest in sex from time to time.

Why does libido decrease in men?

-Low testosterone

Testosterone is an important male hormone, produced in the testicles.
Testosterone is important for:
-building muscles and bone mass,
-sperm production,
-your sex drive.
A young man with a low testosterone level will have a low libido; but with age, it’s normal to have a diminution of the testosterone hormone, and if it will be an issue for the older man; he will be able to consult his doctor to take supplements to increase his testosterone levels.

-Medications

Taking certain medications can cause low libido in males by reducing testosterone hormone level:
-blood pressure medications,
-chemotherapy or radiation treatments for cancer,
-hormones used to treat prostate cancer,
-corticosteroids,
-certain antidepressants.

-Restless legs syndrome (RLS)

Restless legs syndrome is the uncontrollable urge to move your legs.
Men with RLS are at higher risk for developing erectile dysfunction (ED) than those without RLS, which will cause a low sex drive.

-Depression

Depression may be the main cause of decreased sexual desire in men; low libido is also a side effect of some antidepressants, including:
-serotonin-norepinephrine reuptake inhibitors (SNRIs)
-selective serotonin reuptake inhibitors (SSRIs)

-Chronic illness

Several chronic illnesses can reduce your sex drive:
-Type 2 diabetes.
-Obesity.
-High blood pressure.
-High cholesterol.
-Chronic lung, heart, kidney, and liver failure.

-Sleep problems

-Aging

With age, the testosterone level and the man’s sexual capacity are reduced, which leads to a decrease in SEXUAL PLEASURE AND DESIRE.

-Stress

-Low self-esteem

Low self-esteem may also cause anxiety about sexual performance; which can lead to issues with the erection, and reduced sexual desire.

-Alcohol

Alcohol abuse decreases the production of testosterone.

-Drug use

Side effects of low libido

A decreased sex drive is a very big issue for a man, it leads to several psychological problems like:
-Depression.
-Loss of self-confidence.
–Erectile dysfunction.
-Relationship conflict.
-Low self-esteem.

How to treat low libido in men?

The treatment of low libido in men depends on the cause; treatments include:
-Live a healthier lifestyle: eating a healthier diet, sleep enough, reduce stress, reduce alcohol consumption.
-Switch medication, if the one you’re on is affecting your libido.
-Testosterone replacement therapy.
– If your low libido has psychological causes, you may need to visit a therapist for relationship counseling.

You should know your body and tell your doctor what you’re feeling; that’s the only way to know if the problem is physical, psychological, or both.
You should know that the medications that help you get and keep erections don’t boost libido.

Robotic Surgeries in Middle East

September 20, 2021 Comments Off Robotic surgery

Robotic Surgeries have been on the rise lately as a revolutionary tool in the field of medicine and surgeries. The term “Robotic Surgery” mainly refers to the case where surgeries are performed with the assistance of robotic systems allowing surgeons to perform complex operations through very miniature incisions and resulting in better outcome and enhanced patient recovery.

Robotic-Assisted Urologic Procedures

Many urologic procedures are performed through the robot but the 3 most essential urologic surgeries through robot are:

– Partial and Total Nephrectomy (kidney surgery)

– Prostatectomy (prostate surgery)

– Cystectomy (bladder surgery)

Robotic Surgeries in Middle East

Kidney Surgery (in case of kidney cancer)

When kidney cancer is diagnosed, your doctor may recommend a partial nephrectomy (the surgeon removes also the tumor, in order to preserve as much healthy kidney tissue as possible); or a radical nephrectomy (the surgeon removes all the affected kidney).
Surgeons can perform kidney surgery through open surgery or minimally invasive surgery.

Traditional open surgery is performed through a long incision in your side, abdomen, or back; and during this procedure, the surgeon looks directly at the surgical area and removes part or all of the kidney using hand-held tools.

The best minimally invasive procedure to perform a kidney surgery (radical or partial nephrectomy) is robotic-assisted surgery, possibly with da Vinci technology.
Surgeons using the da Vinci system may be able to perform kidney surgery through a few small incisions (cuts) and a 3D high-definition vision system using tiny instruments.

When the nephrectomy through the robot is done, the patient:

– Will not present any complications.

-Will stay in the hospital for one or two days maximum.

-Will not lose a lot of blood.

-May experience less pain.

-Through the robot, we can complete lymph node dissections that may match or surpass what most experienced open surgeons are able to offer.

Prostate Surgery

In case of a prostate cancer, the robotic surgery has an essential role in tumor resection; without causing incontinence and erectile dysfunction.

A radical prostatectomy can be performed through open surgery, which requires a large incision in your abdomen, or a minimally invasive technique.

There are two minimally invasive techniques: laparoscopic prostatectomy and robotic-assisted prostatectomy, possibly with da Vinci technology.

With the da Vinci system, the surgeon can achieve the procedure with more precision through small incisions; while the cancerous prostate gland is resected with clarity, the erectile function is not affected most of the time and the patient experiences a faster return of urinary continence.

Through the robot, the patient may stay in the hospital for a shorter amount of time and the urinary catheter is no longer kept for several days.

Bladder surgery

A cystectomy is a major surgery to remove all the bladder (radical cystectomy) or part of the bladder (partial cystectomy), and this procedure helps to treat bladder cancer.

When the disease is in an advanced stage, the bladder should be removed completely. Through the traditional surgeries, people needed to have an external pouch to collect their urine; but now with the robot which gives more precision, surgeons have developed ways to construct a bladder substitute: a neobladder (your urologist uses a long piece of the small intestine to create a continent reservoir to store urine).

Bladder cancer presents a special challenge for robotic surgery which has multiple advantages for patients:

– A better view of the tissue through the 3D high-definition view.

-Less blood loss than open surgery.

-Low risk of complications and infections.

-Decreased pain.

-Shorter recovery period especially for a partial cystectomy.

What is hematuria?

September 8, 2021 Comments Off Common Solutions

Hematuria

Seeing blood in urine should never be ignored; because it can be a sign of a serious medical problem.
It is the most common sign of bladder cancer that is usually painless, the urine color might change to orange, bright red, or brown.

What is hematuria?

Hematuria is the presence of blood cells in the urine. We have two types of hematuria:

-Gross hematuria: when the blood present in the urine is visible to the naked eye.

-Microscopic hematuria: when the blood in your urine can only be seen through a microscope.

Hematuria is just a symptom, so you should visit your doctor who will determine the cause by ordering some tests…When the origin of the blood in your urine is defined, the doctor can start the adequate treatment.

Where blood in urine might come from?

Blood in your urine can come from your kidneys, and from several parts of your urinary tract:

– Ureters

– Bladder

– Urethra

What are the causes?

– Urinary tract infection (UTI).

– Pyelonephritis or kidney infection.

– Kidney stones.

– Enlarged prostate – BPH.

– Injury to the urinary tract.

– Kidney disease (when your kidneys aren’t working properly).

– Sickle cell disease: a hereditary defect of hemoglobin in red blood cells that can cause blood in the urine.

– Cancer: kidney cancer, bladder cancer, or prostate cancer.

– Medications: the anti-cancer drug cyclophosphamide and penicillin, and anticoagulants can cause urinary bleeding.

What are the symptoms?

Some patients suffer from:

– Frequent, painful, or urgent urination.

– Nausea, vomiting, fever, or pain in the abdomen.

But bloody urine often occurs without other signs or symptoms; so when you see blood in your urine you should directly book an appointment with the doctor.

You should note that urine can also change colors due to food choices.

What are the risk factors of hematuria?

– Age: Many men older than 50 have a high risk of hematuria due to an enlarged prostate gland.

– Patients with existing diseases that are known to cause hematuria.

– Patient who has a family history of kidney disease or kidney stones.

– Certain medications: overuse of pain medications, anticoagulants like Aspirin, and the anti-cancer drug cyclophosphamide and penicillin.

– Smoking.

How is hematuria diagnosed?

The doctor’s goal is to find the cause of hematuria by ordering several tests, and a physical exam which includes a discussion of your medical history.

– Urine analysis and urine culture are required.

– Urine cytology: a urine test that can determine the presence of any abnormal cells.

– Imaging tests: an imaging test is required to find the cause of hematuria; your doctor will recommend a CT or MRI scan or an ultrasound exam.

–Cystoscopy: A test that uses a device called a cystoscope to examine the bladder and urethra.

How is hematuria treated?

The treatment of hematuria depends on the cause of blood in urine. The information collected from the medical history, physical exam, urine tests, and imaging tests will be used to determine the best treatment option; for example, when the cause is a UTI, the best treatment is the use of antibiotics.

5 Minutes Prostate Surgery With Our Rezum Expert Dr. Fouad Khoury

August 17, 2021 Comments Off Prostate Surgeries

52 years old male patient:

45 gr prostate with failure to improve symptoms on medical treatment.

Taking into consideration the patient’s age and sexual activities; he was insisting on undergoing a procedure to relieve his symptoms while preserving EJACULATION.

A 5 minutes prostate procedure (REZUM) as shown in the video, was done by our Rezum Expert Dr.Fouad Khoury under local anesthesia.

There is no need for the patient to sleep in the hospital, or to be hospitalized.

Prostate treatment in Middle East

Rezum water vapor

Recently approved by the FDA in 2015, makes it possible to perform a prostate surgery in 5 minutes while preserving EJACULATION AND SEXUAL FUNCTION.

This operation consists of throwing steam through an instrument into the enlarged area of the prostate; the vapor carries energy that will be diffused into the molecules which will be killed and discarded by the immune system.

It lasts 5 to 10 minutes under local anesthesia and the number of vapor ejections depends on the volume of the prostate.

Benefits of REZUM

– The procedure doesn’t cause complications, no need to be hospitalized.

– Return to daily activities in a few days.

– Relatively painless.

– Improvement of symptoms after 2 weeks.

– Symptoms continue to improve for up to 3 months.

– A good prognosis of up to 15 years.

– This procedure doesn’t cause sexual dysfunctions.

After this operation, the doctor can give an antibiotic for a few days to prevent infection.

Facts about bladder prolapse in Middle East

August 10, 2021 Comments Off Common Solutions Surgeries

Bladder Prolapse

What’s bladder prolapse?

A cystocele or a prolapsed bladder occurs when ligaments that hold your bladder up and the muscle between a woman’s vagina and bladder are weak; for this reason, the bladder will fall into the vagina.

There are three grades of cystocele:

– Grade 1: The bladder falls only a short way into the vagina.

– Grade 2: The bladder falls to the opening of the vagina.

– Grade 3: The bladder comes out of the opening of the vagina; it’s a severe grade.

Causes and Risk factors

There are several causes and risk factors:

– Pregnancy and childbirth: Women who have had a vaginal delivery, multiple pregnancies, or whose infants had a high birth weight have a higher risk of anterior prolapse; because the pregnancy and the delivery may involve straining the muscles of the floor of the pelvis.

– Age: especially after menopause, when the production of estrogen decreases; so the muscles around the vagina are not strong anymore.

– Hysterectomy.

– Family history or genetic factor (some women are born with weak connective tissues).

– Obesity: Women who are obese are at higher risk of anterior prolapse.

– Constipation.

– Chronic coughing.

– Lifting heavy objects.

– Smoking.

What are the symptoms of a cystocele?

– Seeing something bloating through the vaginal opening.

– Difficulty to urinate.

– Feeling the need to urinate frequently.

– Frequent urinary tract infections.

– Pain in the pelvic area or lower back.

– Painful sex.

– Difficulty to insert tampons or applicators.

How is bladder prolapse diagnosed?

Prolapsed Bladder can be diagnosed with a clinical history and a pelvic exam. The exam may be done while you are lying down, straining or pushing, or standing; the doctor may measure the severity of the prolapsed bladder by seeing in which part of the vagina the bladder has fallen.

Other tests and imaging studies may also be done to check the pelvic floor, and confirm the diagnosis of a prolapsed bladder:

– Cystoscopy: a long tube is passed through the urethra to examine the bladder.

– Urodynamics: to measure the capacity of the bladder to hold and release urine.

– X-rays

– Ultrasound

– MRI

How to treat the prolapsed bladder?

1- No treatment if the prolapse is:

– Not causing you problems.

– Not blocking your urine flow.

2- Behavior therapy

– Kegel exercises (which help the muscles of the pelvic floor to be strong).

– Pelvic floor physical therapy.

– Pessary: a vaginal support device to hold the bladder in place.

3- Estrogen replacement therapy

4- Weight loss

5- Surgery:

A moderate or severe prolapsed bladder may require reconstructive surgery to move the bladder into a normal position; and it can be performed through the vagina or the abdomen, under a spinal or general anesthetic.

The surgical treatment is the best therapy for bladder prolapse; but if a woman is planning for a pregnancy, surgery is contraindicated.

The patient usually goes home the day of the surgery, and the recovery time typically takes four to six weeks.

Follow the link for more information about bladder prolapse treatment.

How can a cystocele be prevented?

– Maintain a healthy weight.

– Avoid lifting heavy objects.

– Treat constipation.

– Stop smoking.

Let’s know about male infertility!

July 23, 2021 Comments Off Common Solutions

Male Infertility

Nearly 1 in 7 couples is infertile, which means there is no pregnancy even though they’ve had frequent, unprotected sexual intercourse for a year or longer.

The male factor can be the cause of infertility, and this can lead to a stressful relationship.

When to see a doctor?

If no pregnancy after a year of regular unprotected intercourse, and if there is:

– Erection or ejaculation problems, low sex drive, or other sexual problems.

– Pain or swelling in the testicle area.

– Testicular or sexual problems.

– A groin, testicle, penis, or scrotum procedure.

– A partner over age 35.

What are the causes of male infertility?

– Sperm Disorders.

– Varicoceles.

– Retrograde Ejaculation.

– Immunologic Infertility.

– Obstruction.

– Hormones.

– Medications.

Sperm Disorders

The most common problem is with the production and maturation of sperm. Sperm may:

– Not grow enough.

– Have a strange form.

– Not move the right way.

– We can have oligospermia (low number of sperm) or azoospermia (absence of sperm completely).

Sperm problems can be congenital; but sometimes a toxic lifestyle can reduce sperm count: smoking, drinking alcohol, and taking certain medications.

Other causes of low sperm numbers include long-term sickness (such as kidney failure), childhood infections, or hormonal testosterone disorder.

Damage to the reproductive system can cause low sperm numbers or the total absence of it ; which can cause the obstruction of the tubes that the sperm travel through.

Varicoceles

Varicoceles are overinflated veins located in the scrotum; they are more common in infertile men (40 out of 100). They stop the growth of sperm by blocking blood drainage and lead blood to flow back into your scrotum from your belly; the testicles are then too distended and hot to touch for making sperm, which can cause low sperm number.

Retrograde Ejaculation

Retrograde ejaculation is when semen goes into your bladder instead of out the penis. This happens when nerves and muscles in your bladder don’t close during orgasm; it can be caused by some procedures, medications, or health problems of the nervous system; signs are turbid urine after ejaculation and dry ejaculation.

Immunologic Infertility

Sometimes a man’s body makes antibodies that attack his own sperm because of a certain surgery or infection. Antibodies prevent sperm from moving and working normally in order to fertilize the egg.

Obstruction

Sometimes the tubes which sperm travel through can be blocked; some infections and surgeries (such as vasectomy) can cause blockage. Any part of the male reproductive tract can be blocked, which can lead to infertility because the sperm from the testicles can’t leave the body during ejaculation.

Hormones

A very low pituitary hormone level causes poor sperm growth.

Chromosomes defects

Hereditary disorders such as Klinefelter’s syndrome; in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) cause abnormal development of the male reproductive organs.

Medication

Certain medications have side effects on sperm production, function, and delivery. These medications help to treat:

– arthritis

– depression

– digestive problems

– infections

– high blood pressure

– cancer

Risk factors

Several factors can increase the risk of male infertility:

– Smoking.

– Abusing illegal drugs.

– Drinking alcohol.

– Don’t maintain a healthy weight.

– Being exposed to toxins.

– Overheating the testicles.

– Having a history of undescended testicles.

– Having genetic disorders.

– Having testicular injuries.

– Testicular cancer and treatment.

What are the complications of male infertility?

– Stress and relationship problems.

– Expensive and involved reproductive techniques.

– High risk of testicular and prostate cancer.

Prevention

Some measures must be taken into consideration to prevent infertility:

– Don’t smoke.

– Don’t drink alcohol.

– Steer clear of illicit drugs.

– Avoid being overweight.

– Don’t get a vasectomy.

– Avoid things that overheat the testicles.

– Reduce stress.

Follow the link to know how to treat male infertility.

How to treat male infertility?

July 23, 2021 Comments Off Common Solutions

Male infertility

How is male infertility diagnosed?

Diagnosis starts with a physical examination to evaluate your general state of health and identify any physical problems that may have consequences on your fertility. The doctor required the presence of the two partners and some tests:

Semen Analysis

Semen analysis is a routine lab test that helps to determine:

– Sperm volume, concentration, and count per ejaculation.

– PH of the sperm.

– Velocity: how fast your sperm travels.

– Morphology: Size and shape of your sperm.

– Color.

– Viscosity: liquefaction time of the sperm.

– Motility of the sperm.

– Viability of the sperm.

If the semen test shows low sperm numbers or the total absence of the sperm, it may not mean you are permanently infertile; more testing may be needed.

Transrectal Ultrasound

Your doctor may order a transrectal ultrasound. A probe is inserted in the rectum, and sound waves are delivered to the nearby ejaculatory ducts. This imaging technique can help the doctor to see if some structures such as the ejaculatory duct or seminal vesicles are blocked or present some problems.

Testicular Biopsy

If semen analysis shows oligospermia or azoospermia; you may need a testicular biopsy, which can be done with general or local anesthesia. A small cut is made in the scrotum, and a small piece of tissue from each testicle is removed and evaluated under a microscope. The biopsy helps to find the cause of male infertility; and to collect sperm for use in assisted reproduction (such as in vitro fertilization; IVF).

Hormonal Profile

The health care provider may check your hormones to know how well your testicles make sperm; by evaluating the FSH level (FSH is the pituitary hormone that tells the testicles to make sperm).

Can male infertility be treated?

When the diagnosis of male infertility is confirmed, the curative phase begins to increase the couple’s chance of having a child.

Depending on the cause of infertility, treatments may include:

Medications:

– Hormone therapy to increase the number of sperm, when infertility is caused by high or low levels of certain hormones.

– Treatments for sexual intercourse problems; when certain sexual problems in men cause infertility (premature ejaculation or erectile dysfunction), and in some cases the couple should consult a sexologist.

– Antibiotic treatments if there is an infection.

Surgical treatment :

For example, a varicocele can often be surgically corrected or an obstructed vas deferens repaired. Prior vasectomies can be reversed. When there is no sperm in the ejaculation, sperm can often be retrieved directly from the testicles or epididymis using sperm retrieval techniques.

– Assisted reproductive technology (ART): in ART sperm can be obtained through normal ejaculation, surgical extraction, or donor individuals, depending on your specific case and wishes. The sperm is then inserted into the female genital tract or used to perform in vitro fertilization or intracytoplasmic sperm injection (ICSI).

In IVF, the egg and sperm (of which there are many) fertilize on their own in the laboratory. In ICSI, the selected sperm is directly injected into the egg.

What about Fertility Preservation?

When you have medical and sexual issues that affect your fertility; freezing your sperm is the best method to preserve your fertility and increase the chance of having a child.

WHO IS A CANDIDATE FOR FERTILITY PRESERVATION?

Fertility preservation is an option when a man:

– Is diagnosed with cancer at a young age.

– Has sexual dysfunctions.

– Expects to have surgery especially a vasectomy.

– Has an autoimmune, hormone, or genetic disorder.

– Experienced trauma.

– Hopes to have children later in life.

– Has high-risk occupations.

– Have low sperm counts for no known reason.

Overactive Bladder in Middle East

June 17, 2021 Comments Off Common Solutions

Overactive bladder diagnosis and treatment are very necessary to continue your life without depression and stress.

Overactive Bladder Diagnosis

We can have the same symptoms of OAB in :

-Urinary tract infection.

-BPH.

-Bladder cancer.

-Interstitial cystitis, prostatitis.

When you have these symptoms you should visit your urologist who will:

-Ask about your symptoms and your medical history.

-Do a physical exam for your abdomen, your rectum, and the organs in your pelvis.

-Bladder Diary: The patient should note how many times he goes to the bathroom and when he leaks urine; the bladder diary helps you track: when and how much fluid you drink, when and how much you urinate in 24 hours, how often you have the urgency feeling to urinate, when and how much you leak urine.

Other Tests

-Urine test: Your doctor will require a urine analysis and urine culture to determine if there’s a urine infection.

-Bladder scan: This ultrasound imaging shows how much urine is still in the bladder after you go to the bathroom.

-If there is any doubt about the diagnosis, the urologist required a cystoscopy or urodynamic testing.

Overactive Bladder treatment

Overactive bladder can interrupt your social life, but there are ways to combat the problem.

Natural Treatment for Overactive Bladder

-Bladder training: This type of training helps the patient to control the urge of urinating; he will able to control himself.

-Pelvic floor exercises: Called Kegels exercises; you tighten, hold, and then relax the muscles that you use to start and stop the flow of urination.

Drugs for Overactive Bladder

In the overactive bladder, we have contraction of the muscles in the bladder wall at the wrong time. A group of drugs called anticholinergics help by blocking the nerve signals related to bladder muscle contractions; these medications increase bladder capacity and decrease the urge to urinate.

Anticholinergic drugs include:

Darifenacin (Enablex)

Fesoterodine (Toviaz)

Oxybutynin (Ditropan, Ditropan XL, Gelnique, Oxytrol)

Solifenacin (Vesicare)

Tolterodine (Detrol, Detrol LA)

Trospium (Sanctura)

These drugs have several side effects:

-dry eyes

-dry mouth

-Constipation

To relieve dry mouth it is necessary to drink small amounts of water (because large amounts can worsen the symptoms of the overactive bladder) and suck a sugar-free candy; the doctor will recommend eye drops to relieve dry eyes and a diet rich in fiber for constipation.

Bladder injections

OnabotulinumtoxinA, also called Botox, is a protein injected in small doses directly into the bladder to relax the muscles. The effect of this protein lasts for 6 months so repeated injections are necessary.

Side effects of Botox injection: urinary tract infections and urinary retention.

Nerve stimulation

Helps to treat an overactive bladder by adjusting nerve messages from the brain to the bladder.

We have 2 types of nerve stimulation:

-Sacral nerve stimulation (SNS)

-Percutaneous tibial nerve stimulation (PTNS)

Follow the link for more information about nerve stimulation.

Surgery

Surgery is required for people with severe symptoms who don’t respond to other treatments.

We have 2 types of surgeries:

-Surgery to increase bladder capacity by using pieces of your bowel to replace a portion of your bladder. This surgery is required only in cases of severe urge incontinence that doesn’t respond to any other treatment.

-Bladder removal: This procedure is the last solution of severe overactive bladder and consists of removing the bladder and surgically constructing a replacement bladder (neobladder) or an opening in the body to attach a bag on the skin to collect urine.

Some TIPS to prevent an overactive bladder

-Maintain a healthy weight.

-Do physical activities and exercises.

-Reduce your consumption of caffeine and alcohol.

-Stop smoking: smoking is irritating to the bladder muscle.

-Treat your chronic conditions, such as diabetes, that might lead to overactive bladder symptoms.

-Do Kegel exercises for the pelvic muscles.