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Learn about Overactive Bladder

Overactive Bladder

What is an overactive bladder?

Overactive bladder, also called OAB, describes a combination of symptoms that can include:

-An uncontrolled frequent and sudden urge to urinate.

-Pass to urinate many times during the day and night.

-Urgency incontinence.

These symptoms can disrupt your life, even if you are able to get to the toilet in time when you feel an urge to urinate.

Symptoms

-The difficulty of controlling the sudden urge to urinate.

-Urgency incontinence.

-Urinate few times in 24 hours.

-Wake up few times at night to urinate.

Follow the link for more information about the symptoms of overactive bladder.

Causes

-Weak pelvic muscles: Pregnancy and childbirth can lead to the fragility of the pelvic muscles; so the bladder will sag out of its normal position. All of these factors can cause leakage.

-Nerve damage: Trauma and diseases (Parkinson’s, multiple sclerosis) can cause the damage of the nerves that sent signals to the brain and bladder to squeeze urine out of the body; so the patient will empty his bladder at the wrong time.

-Medicines that cause a rapid increase in urine production.

-Excess consumption of caffeine or alcohol.

-Infection: A urinary tract infection (UTI), can irritate the bladder nerves and cause compression to the bladder.

-Excess weight: The overweight causes extra pressure on your bladder. This can lead to urge incontinence.

-Hormonal  deficiency in estrogen after menopause

Sometimes the doctor doesn’t find a cause for the overactive bladder.

Risk factors

-Age: You have a high risk of having an overactive bladder when you get older. Age also raises your risk of other conditions that affect bladder control: BPH, diabetes…

-Women have more risk of developing an overactive bladder than men for several causes that affect the hormones and the pelvic muscles: menstruation, pregnancy, and menopause.

-Obesity

-People who have certain diseases like stroke or multiple sclerosis.

Complications

Overactive bladder can affect your life and cause:

-Depression.

-Anxiety.

-Sleep disorders (Waking up often at night to pee).

-Negative effects on sexuality.

 

Follow the link, to learn more about the diagnosis and treatment of overactive bladder.

Let’s know about UTI in men

UTI in men

What is a urinary tract infection?

A urinary tract infection (UTI) is an infection that affects any part of your urinary system (kidneys, ureters, bladder, and urethra).

There are 2 types of UTI:

-Upper tract: in the ureters or kidneys.

-Lower tract: in the bladder, urethra, or prostate in men.

Most urinary tract infections (UTIs) affect the bladder and the urethra, which is the tube that drains urine from the bladder to outside the body.

Urinary tract infections are more common in women.

Urinary Tract Infections in Men

UTI in men is more complicated and can affect the kidneys and the upper urinary tract, and leads to a severe case that will require surgery.

 Symptoms:

-Pain when you urinate.

-Frequent need to urinate.

-Difficulty to start urinating.

-A slow urine stream or urinary incontinence.

-A sudden need to urinate.

-Blood in the urine.

-Pain in the lower part of the abdomen, in the upper back, and below your stomach.

-Cloudy and bad-smelling urine.

In a severe UTI, a man can have these symptoms: fever, nausea, vomiting, and chills (when the infection affects the upper urinary tract).

Causes

Most UTIs in men are caused by a bacteria called Escherichia coli which already exists in the body; especially in older men after the age of 50.

In younger men, UTI is caused by sexually transmitted infections (STIs); Chlamydia and gonorrhea are the most two sexually transmitted bacterias.

Follow the link for more information about the causes of UTIs in men.

Risk factors

-Diabetes.

-Kidney stones.

-Prostate problems in older men: BPH, prostatitis.

-An abnormal narrowing of the urethra.

-Dehydration.

-Resist the urge to urinate for too long.

-Not been circumcised.

-A past UTI.

-Anal intercourse.

-Medication that affects the immune system.

-A procedure that used instrumentation on the urinary tract.

UTI Complications

If the lower UTI is not treated, your kidneys can be affected by the infection. If the kidney infection is untreated, the patient can have chronic kidney disease or kidney failure; and this infection can lead to sepsis.

Can urinary tract infections cause infertility in males?

Some urine infections can cause infertility in men:

Chlamydia

This is a sexually transmitted infection (STI) caused by bacterial infection. The symptoms include urination burn, enlarged testicles, and discharges from the penis. When this infection is not treated, it can cause infertility in men by blocking the production of sperm.

Gonorrhea

Gonorrhea is another STI that can cause infertility in men. The symptoms include green, yellow, or white secretions from the penis, dysuria, burn on the penis, pain in the enlarged testicles. It can lead to an infection of the prostate gland, and the diminution of the quality and the production of the sperm.

Mycoplasma

Mycoplasma (STI) can decrease the motility of sperm cells; which can lead to infertility.

 

Follow the link for more information about urinary tract infections in men.

 

 

 

 

 

 

UTIs in men

UTIs in men

Diagnosis of  UTIs in men

Your doctor will ask about:

-Your symptoms.

-Your sexual activity.

Before thinking about a prostate problem like BPH and get an ultrasound image of your prostate, the doctor required urine tests (urine analysis and urine culture) to confirm the diagnostic of UTI.

Treatment of UTIs in men

To treat UTIs, the doctor prescripts an antibiotic based on the nature of the bacteria that caused the infection.

The patient will probably start taking the antibiotic before getting the results of his urine test.

When the results are done, your doctor may change the prescription if the test shows that the bacteria causing your UTI is resistant to this antibiotic.

In case of a lower urinary tract infection, the treatment will take a week or less; and if you have an upper-tract infection, you may need to take antibiotics for up to 2 weeks.

Some tips to prevent UTIs in men

You should:

-Empty your bladder often.

-Drink a lot of water.

-Clean the area under the foreskin after showering if not circumcised.

-Clean your genital organ before and after sex; to remove bacteria.

-Clean from front to back when toileting.

-Wearing condoms during sexual relations.

-Urinate after sex, to remove any bacteria that might have been passed during intercourse.

Follow the link to know more about the prevention of UTI in men.

 

 

 

 

 

Let’s know about UTI in women

UTI in women

Women have a high risk (over 50 percent) of developing a urinary tract infection (UTI), especially in the case of pregnancy; where a urine test is required even if there are no symptoms because a urine infection can be dangerous for both maternal and infant health.

Causes

The essential cause is the bacterium Escherichia coli (E. coli), found in the digestive system. Chlamydia and mycoplasma bacteria can cause infection in the urethra, but not in the bladder.

When the infection is located:

-In the bladder: cystitis.

-In the urethra: urethritis.

-In the kidney: pyelonephritis.

The ureters are very rarely the site of infection.

Risk factors

-Sexual intercourse with multiple or new partners (especially Chlamydia and gonorrhea).

-Diabetes.

-Bad personal hygiene.

-Problems emptying the bladder completely.

-A urinary catheter.

-Inability to control bowel movements.

-Blocked flow of urine.

Kidney stones.

-Menopause.

Pregnancy.

-A procedure aimed at the urinary tract.

-A suppression of the immune system.

-Immobility for a long period.

-Using spermicides and tampons.

-Take a lot of antibiotics, which can destroy the natural flora of the bowel and urinary tract.

Symptoms

Common symptoms of a UTI include:

-Urinate frequently in small quantities.

-Blood in the urine.

-Bad smell of urine.

-Pain when urinating.

-Nausea and vomiting.

-Muscle aches and abdominal pains.

-In case of Cystitis: low fever, pressure, and cramping in the abdomen and lower back.

Complications

Some upper UTIs can lead to serious problems; recurrent or non-treated kidney infections can cause permanent damage.

I the case of pregnancy, kidney infections can lead to premature delivery or to low birth weight.

 

Follow the link for more information about urinary tract infections in women.

Diagnosis and treatment of UTIs in women

UTIs in women

Diagnosis of UTIs in women

First, the doctor will ask about the symptoms and the sexual activity of the patient; a urine analysis and urine culture will be required to prove the infection and determine the nature of the bacteria.

In case of recurrent UTIs, a doctor may request further diagnostic testing to determine the cause:

Diagnostic imaging: to assess the urinary tract by using ultrasound, CT and MRI scanning, radiation tracking, or X-rays.

Cystoscopy: This diagnostic exam helps the doctor to examine the lining of your bladder with a camera lens, which inserted through the urethra through a long thin tube.

Treatment of UTIs in women

-Antibiotic: The patient will probably start taking the antibiotic before getting the results of his urine test.

When the results (accompanied by an antibiogram) are done, your doctor may change the prescription if the test shows that the bacteria causing your UTI is resistant to this antibiotic.

-Medications for pain relief.

-Drinking lots of water.

-Urinating frequently.

If the infection is not treated, it can lead to kidney damage.

In case of recurrent infections in women:

-Take a single dose of an antibiotic after sexual intercourse.

-Take a single, daily dose of an antibiotic for 6 months.

-Undergo estrogen therapy in case of menopause especially put vaginal eggs.

Some TIPS to reduce the risk of UTIs in women:

-Drink lots of water and urinate frequently.

-Reduce the quantity of alcohol and caffeine.

-Urinate directly after sexual intercourse.

-Wipe from front to back after urinating and defecating.

-Maintain good personal hygiene of the genital area.

-Sanitary pads or menstrual cups are preferred to tampons. Avoid using a diaphragm or spermicide for birth control.

-Not use any perfumed product in the genital area.

-Wear cotton underwear.

Diagnosis and Treatment for Bladder cancer

How to diagnose Bladder cancer?

There are many tests that help to diagnose bladder cancer.

– Cystoscopy:
This procedure is required to identify and diagnose bladder cancer. A cystoscope is inserted under local or general anesthesia into your bladder from the urethra to view the inside of the bladder and take a Biopsy that will be examined in the laboratory.

– Urine cytology:
A sample of your urine is analyzed under a microscope to check some tumor markers in the urine.

After confirming that you have bladder cancer, your doctor may recommend some imaging tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body.

– CT scan of the abdomen and pelvis to determine if there is any propagation of the tumor outside of the bladder.

– Magnetic resonance imaging (MRI) scan:
MRI scans show detailed images of soft tissues in the body, like CT scans; but by using radio waves and strong magnets instead of x-rays.

– PET scan: can detect cellular changes in organs and tissues earlier than CT and MRI scans; by injected a radioactive chemical.

– Chest X-ray is performed to detect if any cancer has propagated to the lungs.

– Bone scan may be performed to look for metastasis to cancer in the bones.

Follow the link for more information about the diagnosis of bladder cancer.

How to treat Bladder cancer?

• Surgery
• Chemotherapy
• Radiation therapy
• immunotherapy for superficial cancers
Sometimes, combinations of these treatments will be used.

-Surgery:
Transurethral resection of bladder tumor (TURBT):
TURBT is a procedure to diagnose bladder cancer and to remove cancers in the cells of the bladder lining (no muscle-invasive cancers). It is performed during a cystoscopy by using an electric current to cut away or burn away cancer.

Cystectomy:
– A radical cystectomy is an operation to remove all the bladder and the surrounding lymph nodes when the tumor has spread beyond the bladder. In men, radical cystectomy consists of removing the prostate and seminal vesicles; and in women, a radical cystectomy may involve the removal of the uterus, ovaries, and part of the vagina. It can be done using Robotic Surgery.
– Partial cystectomy is the removal of a section of the bladder when the tumor is only in one region of the bladder. Chemotherapy or radiation therapy is often used in combination with this procedure.

Chemotherapy :
By using a drug to kill or stop the reproduction of cancerous cells.
Chemotherapy drugs can be delivered
– Intravenously: Intravenous chemotherapy is frequently used before cystectomy to have a high chance of curing cancer, or can be used to kill cancer cells that might remain after surgery.
– Intravesically directly into the bladder.
It depends on the stage of cancer.

Radiation therapy:
Destroys the DNA of cancer cells by using powerful energy, like X-rays and protons.
It can be used in fusion with surgery or chemotherapy. Radiation therapy can be delivered externally or internally.

Immunotherapy:
Immunotherapy is a drug treatment that helps your immune system to fight cancer, by using the body’s own immune system.
Immunotherapy can be performed:
• Directly into the bladder: Might be required after TURBT for small bladder cancers that haven’t grown into the deeper muscle layers of the bladder. This treatment uses bacillus Calmette-Guerin (BCG), which causes an immune system reaction; so the body can kill the tumor bladder cells.
• Intravenously: Immunotherapy can be performed intravenously for bladder cancer that’s advanced or that comes back after initial treatment.

Follow the link to know about BCG Therapy.

 

Maintenance Therapy For Bladder Cancer

Maintenance Therapy For Bladder Cancer … What is the role of BCG?

Bladder cancer can come back; for this reason, the patient needs follow-up tests for years after finishing the treatment.

The best follow-up treatment is the BCG: Bacillus Calmette-Guérinthat used since 1920 to attenuated the action of the tubercle bacilli that causes tuberculosis.

The action of BCG

The local immune response is closely linked to the interaction of three systems: the patient, the BCG (Mycobacteria), and the tumor. This interaction will give rise to a cascade of immunological events, some of which will be essential for the protective action of BCG against tumor recurrence and progression. There are three phases in the immune response to BCG. First, the BCG adheres to the urothelium and then is phagocytosed by antigen-presenting cells; this phase corresponds to the early release of inflammatory cytokines. These cytokines could be involved in certain undesirable effects but they could also participate in cytotoxic phenomena. The second phase is the recognition of bacterial antigens by CD4 helper lymphocytes. This cellular activation will lead to the third phase which is the amplification of cytotoxic populations capable of killing tumor cells. All of these cells also produce cytokines that help regulate the immune response.

Indications of BCG:

BCG (powder and solvent for suspension for intravesical use) is used to :

-curative treatment of urothelial carcinoma in situ.

-prophylactic treatment of relapses of urothelial carcinoma limited to the mucosa, no muscle-invasive urothelial carcinoma, urothelial carcinoma in situ.

Protocol of injection of BCG:

2-3 weeks after TURBT ( weekly for 6 weeks).

After a cystoscopy: Maintenance therapy consists of 3 treatments at weekly intervals given for a minimum of 1 year
up to 3 years; every 3 months for 2 years, then every 6 months for 2 years, and finally yearly.

What are the side effects of BCG?

It is common for patients to experience flu-like symptoms for 2–3 days after the treatment.

Other side effects include:

-Trouble to empty your bladder.

-Blood in your urine, dark urine.

-Urinary tract infections.

-Pain when you urinate.

-Vomiting, pain in the upper part of the stomach.

-Trouble breathing.

-Fatigue.

-Signs of a penis infection: burning, itching, odor, discharge, pain, tenderness, redness or swelling of the genital or rectal area, fever, not feeling well.

-Yellowing of your skin or eyes.

After the treatment (after 4 to 6 hours), the patient may present bladder symptoms: sudden need to urinate, frequent urination, stomach discomfort, bloating, and possibly loss of bladder control. If these symptoms last for more than 2 days; you should consult your urologist.

Follow the link for more information about BCG.

 

Facts About Bladder Cancer in Middle East

Bladder Cancer

Definition of the Bladder :

The bladder is an empty muscular organ that stores urine until it is discharged out of the body through the urethra, and which is located in your lower abdomen.

Where is bladder cancer located?

Bladder cancer begins in the cells of the bladder lining, most commonly in the urothelial cells; this cancer grows and forms a tumor.
Urothelial cells are found in your kidneys and the ureters which is the connection between your kidneys and your bladder.
Urothelial cancer can occur in the kidneys and ureters, too, but it’s more common in the bladder.
When a mutation occurs in the DNA of the bladder cells; cancer begins.

Types of bladder cancer

Different types of cells in your bladder can become cancerous; the type of bladder cancer depends on where the tumor’s cells begin. Doctors use this information to determine which treatment is the best for you.
The 3 main types of bladder cancer are:

– Urothelial carcinoma

Urothelial carcinoma or transitional cell carcinoma begins in the urothelial that line the inside of the bladder. Urothelial cells dilate when your bladder is full and contract when your bladder is empty. These same cells existent inside of the ureters and the urethra; so cancer can form in those places. Urothelial carcinoma is the most frequent type of bladder cancer in the United States.

– Squamous cell carcinoma
This type of cancer is triggered by chronic irritation of the bladder due to repeated urinary tract infections, especially in countries where the parasitic infection is the cause of bladder infections; and due to long-term use of a urinary catheter.

– Adenocarcinoma
Adenocarcinoma begins in cells that elaborate mucus-secreting glands in the bladder, and it’s very rare.
Some bladder cancers involve more than one type of cell.

Stages of Bladder Cancer…TNM staging system

This system is used by doctors to determine the stage of bladder cancer (Tumor, Nodule, and Metastasis).

Bladder cancer can be limited to the lining of the bladder or invasive (penetrating the bladder wall and possibly spreading to nearby organs or lymph nodes).

– Invasive bladder tumors can be classified from T2 (spread to the main muscle wall below the mucosa of the bladder) to T4 (tumor is extended beyond the bladder to nearby organs or the pelvic sidewall).

– Lymph node involvement classifies from N0 (no cancer in lymph nodes) to N3 (cancer in many lymph nodes, or in one or more bulky lymph nodes larger than 5 cm).

– M0 means the absence of metastasis outside of the pelvis, M1 means that the tumor has metastasized outside of the pelvis.

Follow the link for more information about stages of Bladder Cancer.

Signs of bladder cancer

Bladder cancer has no specific symptoms, so when the patient has: blood in the urine, pain during urination, frequent urination, or difficulty urinating; he should visit his urologist.

Risk factors

• Smoking
• Increasing age: especially when the patient is older than 55.
• Men have a high risk than women to develop bladder cancer.
• Certain chemicals products.
• Previous cancer treatment; a patient treated with the anti-cancer drug cyclophosphamide is at high risk of developing bladder cancer. People who already received radiation treatments focused on the pelvis for previous cancer have a higher risk of developing bladder cancer.
• Chronic bladder inflammation: due to repeated urinary infections, or long-term use of a urinary catheter; may expose the patient to bladder cancer.
• Personal or family history of bladder cancer.

 

Follow the link for more information about the diagnosis and treatment of bladder cancer.

Penile Prosthesis the BEST surgical treatment for ED in Middle East

Penile prosthesis

Definition

A penile prosthesis or Penile Implant is the best surgery that helps men with erectile dysfunctions when other treatments failed.

This procedure involves placing a prosthetic device or penile implant inside the penis and scrotum; so the patient can get a sufficient erection for sexual activities. And it lasts for 45 minutes to 1 hour under general or spinal anesthesia.

Penile implants are required when the medications are not efficient, and in some severe cases like Peyronie’s disease (fibrous scar tissue that develops on the penis and causes curved painful erections).

Follow the link for more information about Erectile Dysfunction.

 

Types of penile implants:

The patient should speak with his urologist to determine which implant is the best for him.

 

Type of penile implant

Advantages

Disadvantages

Three-piece inflatable

 -Natural and rigid erection.

-Provides flaccidity when deflated.

 

 -The implant may sometimes not be effective (because of the large number of its parts).

 -Requires the presence of a reservoir in the abdomen.

 

 

Two-piece inflatable

 -Provides flaccidity when deflated.

 -The fluid reservoir is part of the pump.

 -The erection is not firm enough.

Semirigid rod

 -Low chance of malfunction. ( due   to   the absence of the reservoir   and the   pump)

 – Easy to use.

 -Can be difficult to conceal under clothing.

 -a penis that is always slightly rigid.

 -possible difficulty with urination.

 

The inflatable implants required a pump inside the scrotum; so the patient should squeeze the pump to achieve an erection; the pump is located under the loose skin of the scrotal sac, between the testicles.

The device contains two chambers, and when the chambers are inflated by the pump; the patient then has an erection; when the patient is finished, he can deflate the device.

Follow the link for more details about the types of penile implants.

 

Which type of implant does the doctor choose?

There are several factors that the doctor put into consideration before deciding which implant will be the most suitable, including:

-The age of the man.

-Size of the penis, glans, and scrotum.

-Any history of previous abdominal or pelvic surgery.

-The presence of colostomy.

-A history of a kidney transplant.

-Whether or not the penis is circumcised.

-Health and well-being.

 Penile implants don’t increase sexual desire or sensation.

 

Who should not get an implant?

-patient with uncontrolled diabetes.

-presence of a pulmonary or urinary infection.

-bladder obstruction

-when the erectile dysfunction is the result of a relationship conflict (the cause should be medical).

 

Penile implant = LOW RISK

– Low risk of infection (1-3%).

-low risk of mechanical failure (95% working at 5 years).

 

Some TIPS before and after the surgery

Before the surgery you should:

– stop taking aspirin and anti-inflammatory drugs before 7 to 10 days.

– Stop eating or drinking after midnight before your surgery.

– Shave the surgery site.

After the surgery:

– Physical and sexual activities can be resumed after 4 or 6 weeks.

-the patient should take an antibiotic to prevent infection; and medications to ease the pain.

You should call your doctor if:

fresh and ongoing bleeding, significant discoloration of the penis, high fever, unable to urinate, cannot control pain, spreading redness, continuous drainage from the wound, progressive swelling of the penis, scrotum, or incision site.

 

Is the Prosthesis noticeable?

Men who have undergone the prosthesis surgery can notice the small surgical scar where the bottom of the penis meets the scrotal sac, or in the lower abdomen just above the penis, other people probably will be unable to know that a penile implant exists.

 

Finally, we believe that the penile implant is effective in its ability to restore the patient’s capacity to engage in sexual activities and regain what was lost due to a medical issue.

And the patient should not forget that ejaculation is not affected by this procedure.

Rezum in Middle East

Rezum Water Vapor

Rezum water vapor is the best therapy for prostatic hyperplasia.

We have a better prognosis with Rezum water vapor.

What is benign prostatic hyperplasia (BPH)?

BPH is the most common prostate problem in men especially at the age of 50 and over. It is a condition in which the prostate, a gland of normal volume 18 to 20g and which has the role of secreting a liquid that accompanies the sperm to nourish it, grows in size in the transitional zone.

BPH is also called benign prostatic enlargement and affects the urinary system; on the other hand, the congestion of the prostate does not cause urinary problems because it is located in the peripheral zone.

Having BPH does not seem to increase the risk of developing prostate cancer, but a man who has BPH may have undetected cancer at the same time.

To help detect prostate cancer in its early stages, a prostate screening is recommended every year for men from the age of 50. If the man has a family history of prostate cancer, the screening should be done at age 40. Screening tests for prostate cancer must be accompanied by a blood test for a substance called prostate-specific antigen (PSA) and the digital rectal exam (DRE).

Follow the link for more information about Prostatic hyperplasia.

Symptoms:

In BPH, the prostate gland surrounds the urethra or the enlargement of the prostate can lead to the blockage of the urethra so you can develop urinary problems: difficulty urinating, low stream of urine, frequent urination at night, constant need to urinate, dark reddish urine, weak lower limbs, back pain…

Diagnosis:

-digital rectal exam: the doctor inserts a finger into the rectum to check the volume of your prostate.

-urine test: to cancel the diagnosis of a urine infection that has similar symptoms.

-blood test to cancel a kidney problem.

-Prostate-specific antigen (PSA) blood test: PSA is a substance produced in your prostate; there is an increase in the rate of PSA in the case of BPH.

And a cystoscopy is recommended to look into the bladder.

Treatment:

Medication:

The first step and decision are to take a drug.

The options include:

-Alpha-blockers: These medications relax bladder neck muscles and muscle fibers in the prostate, so the patient can urinate without any problem. But the alpha-blockers can cause a delayed ejaculation (the seminal fluid goes back into the bladder).

-Medications that reduce the volume of the prostate but cause erectile dysfunction.

-Medications for erectile dysfunction (Cialis): these drugs given every day can also cause relaxation of the muscles of the bladder.

Medication may not have a good prognosis for life, sometimes it may last for 6 months.

Surgical treatment:

-Transurethral resection of the prostate (TURP): This operation is usually performed under general anesthesia, a surgeon passes an instrument called a resectoscope through the opening of the penis and into the urethra and rises towards the prostate to remove the excess prostate tissue. But the disadvantage is that the patient who takes anticoagulants must stop them before the operation, and this surgery causes a problem in ejaculation.

– 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 ejection depends on the volume of the prostate.

Follow the link for more information about the treatment of BPH.

Benefits of water vapor therapy :

– The procedure doesn’t cause complications, you do not have to stay in the hospital.

-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.

Follow the link for a descriptive interview about Rezum water vapor.