When Should You See a Urologist? – What to Know

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UUANJ earned the “Center of Excellence” destinction for BPH and Incontinence Care!

UUANJ earned the “Center of Excellence” destinction for BPH and Incontinence Care!

UUANJ earned the “Center of Excellence” destinction for BPH and Incontinence Care!

UUANJ earned the “Center of Excellence” destinction for BPH and Incontinence Care!

UUANJ earned the “Center of Excellence” destinction for BPH and Incontinence Care!

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When it comes to health problems, men are most likely to endure their symptoms longer before going to the doctor than women. Sometimes, it may be because they don’t feel like their condition is serious enough, and other times, they may find it embarrassing to have certain parts of their body checked.

The latter is the case when it comes to testicular issues. According to Urologic surgeon, Dr. Jonatahan Bingham, it takes the average man around six months to see a doctor after symptoms of testicular mass or tumor appear. Dr. Bingham is from Coordinated Health, which is part of Lehigh Valley Health Network.

Here’s when it’s time to visit your urologist:

Signs of prostate cancer

Your symptoms could mean you have prostate cancer, which is one of the most common cancers among men. Prostate cancer does not show noticeable symptoms at an early stage and can only be identified by having prostate cancer screenings. Having said that, you should highly consider going to the urologist if you feel worried about this condition.

Spotting early symptoms of prostate cancer makes it easier to cure. However, this means that you shouldn’t skip your appointments with your urologist to see symptoms and prevent them from becoming more serious.

Testicular pain

When you start to feel constant mild pains in your testicular area, it’s time to consult a urologist. If something doesn’t feel right, you need to have it checked right away to prevent any serious conditions. The urologist can also give you remedies and treatments to alleviate the pain.

Erectile dysfunction

Erectile dysfunction is common, particularly among older men. However, it is also typically tied to other medical issues that can be medical or psychological. When you observe that you have erectile dysfunction, consult the urologist right away to have any possible conditions treated.

Urinary issues

Issues like slowing of the urinary stream, painful urination, frequent urination, and sudden start and stop of the urinary stream are common among men as they grow older. That said, such issues could also be tied to the growth of the prostate gland.

It’s important to address these issues because they can lead to serious problems in the kidney or the bladder in the long run.

Blood in the urine

When you start to see blood in your urine, don’t delay testing and visit your urologist right away. Blood in the urine can signify prostate enlargement, kidney stones, or tumors in the kidney or bladder.

Kidney stones

Kidney stones may not be painful early on, but over time, it can cause excruciating pain and severe health conditions. Prolonging your treatment can lead to serious kidney issues that can be deadly. When you spot these symptoms, visit your urologist to prevent your condition from getting worse.

Conclusion

Men should not be ashamed or embarrassed to talk about testicular issues, especially if it’s for medical concerns. Visiting the urologist when symptoms first appear is essential to avoid any serious condition. More importantly, doing so will help relieve pain and stop issues that can be worrisome from appearing again.

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What Kind of Doctor Should I See For Testicular Pain?

Ball pain. Nuts aching. Sac is hurtin’. Regardless of what you call it, testicular pain is no fun.

You’re not alone. Testicular pain is really common. Unfortunately guys don’t talk about their berries being squeezed in vice grip.

Instead they suffer in silence and walk around like John Wayne just got off of a horse.

Maybe this is something serious though. Testicular torsion (twisted testicle) or epididymitis (bacterial infection) are no joke and require immediate medical attention. I’m certain cancer might be running through your mind as well.

So what kind of doctor should you see for testicular pain? At some point you’ll need a urologist. Maybe you had no idea there was a ball pain specialist. Or maybe you’ve seen 3 of them and no one seems to help.

Let’s get you some help for those achy breaky balls. Because when they’re aching, it’s hard to feel good about anything.

What causes testicular pain?

A good doctor develops a differential diagnosis for every patient complaint. A list of possible medical conditions that could be causing the symptom. For testicular pain this list includes but is not limited to:

Testicular torsion

Testicular torsion is fancy doctor speak for a twisted testicle. No blood is going to the testicle and this is not good.

It is usually seen in kids and young adults. It is exceedingly rare after age 40. It will cause severe, drop you to your knees pain with nausea or vomiting. Unless you get your ball “untwisted” with surgery in 4 hours or less, the testicle unfortunately dies due to lack of blood flow.

Although intermittent torsion can occur, this is pretty rare. If you’ve been aching for weeks to months then torsion is very unlikely.

Epididymo-orchitis

An infection of the testicle or epididymis typically presents with an acute onset (fast) of one-sided pain and swelling. An examination will clearly show swelling and tenderness. Usually this is caused by a urinary tract infection or sexually transmitted disease.

Varicocele

Swollen veins draining the testicle are seen in up to 15% of men. Sometimes visible as a “bag of worms in the sac”, varicoceles are more common on the left side. They can cause a heavy, dull ache that’s usually worse with standing throughout the day.

The veins will not “burst” but they can cause male infertility in addition to chronic pain. A surgical repair by a micro-surgical specialist will fix this issue for good.

Inguinal hernia

A hernia is a weakness of the abdominal wall. Bulging and pain can occur at this site of weakness as your “insides” are “poking out.” When this bulging occurs in the groin area we call this an inguinal hernia.

An inguinal hernia can extend into the scrotum leading to ball pain and swelling. This is usually obvious on a physical examination but at times can be subtle. This is treated with surgery to repair the weakened tissues.

Hydrocele

Another cause of a painful “big sac” is an accumulation of fluid around the testicle. A hydrocele most often occurs for no good reason. It can be a consequence of a trauma, infection or even cancer. An ultrasound of the scrotum will confirm the diagnosis.

Sometimes a hydrocele will go away on it’s own. If it doesn’t then surgery does the trick.

Epididymal cyst

Speaking of swelling of the sac you can also have lumps next to the testicle. The epididymis sits behind the testicle and carries sperm. Cysts can develop leading to a “third nut” as men have told me. These are universally benign and can be cut out if they are causing pain.

Testicular cancer

Testicular cancer most often presents with a painless firm mass of the testicle itself. I’ve included it because cancer should always be considered in a differential diagnosis. The good news is that cancer rarely causes pain and is easily ruled out with an exam and ultrasound.

Kidney stone

Kidney stones are bad enough but ball pain as well? When a kidney stone is traveling down the urine tube (the ureter) it can cause a referred pain to the testicle. If you have associated back or abdominal pain, nausea/vomiting or a history of kidney stones, evaluation with CT scan should be considered.

Post-vasectomy pain syndrome

This rare condition (1/500 vasectomies) is distinguished by the start of pain shortly after a vasectomy. We are not certain why it happens but it is not fun. Local anesthesia blocks of the spermatic cord can temporarily relieve the pain.

When necessary, microscopic denervation procedures can be performed with success rates up to 85%. Sometimes men even elect to have the vasectomy reversed (vasovasostomy) to re-hook the plumbing pipes. This releases the back pressure and solves the post-vasectomy pain as well.

Musculoskeletal cause

The testicle is connected to the spermatic cord. An anatomic structure containing blood vessels, nerves, the vas deferens and muscles running to the testicle. The muscles are known as the cremaster muscles.

The reason your balls hug tight to the body in cold water is the cremaster muscle contracting to keep your berries warm. This muscle is a continuation of the internal oblique muscle; a series of muscles fibers that make up your core abdominal wall.

When you suffer from low back pain, are hanging on to 40 extra pounds of belly fluff, or lifting heavy objects all day, you are straining your core abdominal muscles. Since these muscles are connected to the cremaster muscle, your testicle hurts.

Musculoskeletal strain is probably the cause of 95% of testicular pain seen by a urologist. If you’ve had normal exams, ultrasounds, urine tests and no one has been able to help you yet, then this is probably what’s going on. As a urologist, it’s not unusual to see 5-10 men per week for a 2nd opinion on ball pain.

Testicular pain evaluation

Regardless of the kind of doctor you see for testicular pain, every evaluation starts with a good history. Bilateral (both sides) or alternating pain eliminates almost all of the above conditions with the exceptions of post-vasectomy pain syndrome and musculoskeletal causes.

A physical exam can detect masses, lumps and swellings. Tenderness with an otherwise normal exam is seen with many of these conditions. Some doctors you see for testicular pain may be experienced (urologist) or inexperienced (pretty much everyone else) with performed a thorough and accurate exam for testicular pain.

When necessary imaging can be performed. A CT scan should be considered for suspected kidney stones. A scrotal ultrasound will confirm findings on a physical exam.

Sometimes a scrotal ultrasound will show incidental findings that are not felt on an exam (small hydrocele or cyst). If a doctor can’t feel it then it’s not the source of the pain.

Treatment for Testicular Pain

I’m going to assume that you’ve had a normal exam, imaging tests and have never had a vasectomy. This leads us to our diagnosis of chronic testicular pain (also known as orchialgia).

First and foremost, we recommend viewing this condition like headaches and backaches. Most headaches aren’t due to brain cancer. Most backaches don’t require a visit to the spine surgeon. They are musculoskeletal in nature.

When muscles and nerves are irritated, most exams are normal. Unfortunately quick fixes are not always possible.

Here are some options for treating chronic testicular pain:

Improved diet and exercise

It’s amazing how often clean eating and moving our body is the answer to chronic medical conditions. Eating chalupas on the couch never served anybody except the business owners of Taco Bell. The crap we eat causes inflammation. Inflammation causes chronic pain.

When we exercise we release our body’s natural pain killers called endorphins. Strengthening your core and lower back can help testicular pain over time.

As a result of diet and exercise you should start shedding some pounds from your belly. All this extra weight we carry in our midsection strains our back and core muscles. Lose the weight, lose the ball pain.

I’ve had more patients tell me their testicular pain resolved after weight loss than any other thing I’m about to suggest.

Pelvic physical therapy

Muscle tension of the lower abdomen and pelvic floor is associated with chronic testicular pain. An experienced pelvic physical therapist can identify any muscle imbalances, improving chronic pain. It doesn’t work for everybody, but there’s little risk in giving a session a try.

Off-label medications

Sometimes medications designed for another purpose are helpful for seemingly unrelated medical conditions. This is known as an off-label medication. For chronic testicular pain I’ve had success with Tamsulosin (prostate medication), hydroxyzine (anti-histamine) and amitriptyline (anti-depressant).

Every urologist has his or her favorite for helping men get a little relief. It’s really important to avoid narcotics at all costs. This is a chronic condition and the last thing you want is an opioid dependence.

Surgery

Some of the same microsurgical options are available for testicular pain. Referral to a urologist fellowship trained in microsurgery may be your last option for treating unresolved testicular pain. Performed under anesthesia in the office or surgery center, spermatic cord denervation or cryotherapy can have success rates of 70-85%.

Who’s The Best Doctor For Testicular Pain?

If you haven’t had an in-person visit with a doctor then you should start there. This is one of those instances where a physical examination is important. A scrotal ultrasound is not a bad idea either to dot the “I’s” and cross the “T’s. ”

If you’ve already been to a urologist, and are frustrated, then why not consider a second opinion with a VirtuCare specialist. We can review any medical records that you provide and do a deep dive to make certain nothing has been missed.

Our second opinion visits last on average 30 minutes so you know you won’t be rushed for time. We are hear to listen to you.

With our network of colleagues, we’d be happy to make a referral to a microsurgical expert if that’s what it takes to cure your testicular pain.

Unfortunately there are certain medical conditions that can’t be cured. But you at least deserve care from an expert who will listen and do everything they can to help.

Your family jewels deserve the best. 

Pediatric urology – features and indications for visiting a specialist

A pediatric urologist is a doctor who specializes in the prevention, diagnosis and treatment of diseases of the urogenital area in boys.

A pediatric urologist is a doctor who deals with the prevention, diagnosis and treatment of diseases of the urogenital area in boys. We asked Oleg Vladimirovich ABAIMOV, an urologist-andrologist at Euromed, about when to show a child to a pediatric urologist and what diseases children have to deal with most often.

When is a boy shown to a pediatric urologist?

The neonatologist examines the child immediately after birth. He assesses the child’s condition by a variety of parameters, looks at how all body systems work, including the urinary and genital systems, and looks at the state of the genital organs.

The next scheduled examination is at the age of three, before kindergarten, and then at the age of 7, before school. The doctor looks at how the baby is developing, whether it corresponds to his age.

Of course, if there are any problems, then they come to the pediatric urologist with specific questions, most often, the pediatrician directs.

What are the most common urological problems in boys?

The first thing they look at in the hospital is whether the testicles have descended into the scrotum, this is usually well understood even by a non-specialist. The testicles of a boy develop during the period when he is in the womb. Normally, they descend into the scrotum (the sac that sits behind the penis) before birth. If this does not happen, put diagnosis of cryptorchidism (undescended testicle). In rare cases, both testicles fail to descend.

This diagnosis is made in 5 out of 100 newborns. It usually occurs in premature babies or low birth weight babies.

In most cases, the testicles descend on their own within the first three months of life. If this does not happen before 6 months, treatment is prescribed. This can be a conservative way (give hormonal drugs) or surgical.

Another common condition that may require the attention of a urologist is phimosis. This is a condition in which the glans penis does not fully or partially open due to constriction of the foreskin. There are physiological and pathological phimosis. Physiological phimosis is often observed in children, its appearance is associated with structural features of the genital organs of the child. Only in 10% of newborn boys, the glans penis opens. In the majority, the skin of the foreskin is fused with the head of the penis, and this is considered a normal condition up to 3-4 years. In the process of penis growth, the head independently pushes the foreskin apart and opens. This process can continue until adolescence, during the puberty of the boy, hormones are activated that make the tissue of the foreskin more elastic and extensible, and the situation returns to normal.

Surgical intervention in this situation may be required only if phimosis prevents the separation of smegma (it stagnates and provokes swelling and inflammation) and / or urination, this is easy to understand: urine does not flow normally, the foreskin swells, an inflammatory process may begin due to stagnation of urine . In this case, of course, it is necessary to show the child to a pediatric urologist as soon as possible.

In no case do not try to dilute the foreskin yourself; this can lead to tissue ruptures and subsequent scarring and, as a result, cicatricial phimosis, which is treated only promptly.

Another disease that I would like to mention is hydrocele. With dropsy, there is an accumulation of fluid in the membranes of the testis, which leads to an increase in the scrotum, usually one half of it becomes noticeably larger than the other. The cause of this disease is usually a failure of the communication between the scrotum and the abdominal cavity, which normally releases fluid. Sometimes dropsy of the testicle goes away on its own by the age of three. If this does not happen, surgical treatment is performed. In any case, in the presence of dropsy of the testicle, a consultation with a urologist is required.

What symptoms should parents look for in order to understand that a child needs to be seen by a urologist?

You should contact a pediatric urologist if:

• the child has problems with urination, pain, swelling;

• you have noticed a decrease in urination, often this is due to the fact that the child is afraid to urinate because of pain and endures to the last;

• discharge from the penis;

• redness, rash on the genitals;

• swelling and redness of the penis and / or scrotum;

• injury to the scrotum;

• pain in the lumbar region, lower abdomen;

• urinary incontinence;

• infrequent urination;

• undescended testicle.

Almost all urological diseases are treated quickly and effectively, the main thing is not to delay contacting a doctor!

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Pediatric urologist consultation

The author of the article

Abaimov Oleg Vladimirovich
Head of the urological service, urologist, oncologist

What is the difference between a urologist and an andrologist?

What is the difference between a urologist and an andrologist

Medicine is one of the fastest growing areas. Science has gone through a long and complex history, as a result of which today many diseases can be treated, while the therapy is mostly painless, able to bring results as quickly as possible. However, people who are far from medicine cannot always determine which doctor is relevant for certain symptoms, andrologist and urologist are no exception. If you do not know how a urologist differs from an andrologist, we suggest that you familiarize yourself with the following material.

Male urologist

Urology is a science that studies diseases related to the genitourinary system. By the way, in Russia the concept was introduced relatively recently. Previously, the problems of patients were dealt with by surgery, since the treatment in most cases involved surgery. After surgery was defined as an independent branch, more time was devoted to the study of diseases of the genitourinary system, as a result, the concept of urology appeared. Technologies are being developed for this industry to accurately diagnose pathologies, and treatment does not always involve surgery.

With the active development of urology, other areas were formed, for example, urogenycology, andrology, urology in pediatrics, oncological urology, etc. There is also a branch of nephrology that involves the diagnosis and treatment of kidney pathologies.

What kind of doctor is a urologist? This is a specialist whose attention is focused on the genitourinary system. However, ailments of the genital organs are not within his competence. A urologist is a generalist doctor who diagnoses and treats diseases in both sexes.

The doctor treats:

• inflammation of the bladder;
• urolithiasis;
• cancer problems;
• trauma to the tracts of the urinary system;
• venereal pathologies and much more.

Also, a medical officer of this profile can perform surgical operations, for example, excision of benign and malignant neoplasms, plastic surgery, circumcision of the foreskin, and much more.

Andrologist: who is it and what does it treat

Andrology is a field of medicine that was formed as a result of the development of urology. Here, the doctor’s specialization is designed to work with the representatives of the stronger sex. Today, andrology is a separate branch.

Andrologist studies, diagnoses, prescribes therapy for diseases of the male reproductive system. In the common people, a doctor is called “male”.

The specialist works with patients suffering from:

• various venereal pathologies;
• infertility;
• sexual dysfunction;
• age-related problems that often lead to impotence;
• obese;
• underdeveloped sexual organ;
• prostatitis and other diseases.

Since the profession of an andrologist is closely intertwined with diseases of the genitourinary system, the doctor has knowledge in surgery and urology. An andrologist can perform operations related to the correction of the genital organs through plastic surgery.

Andrologist and urologist: what is the difference?

To understand how one specialist differs from another, it is worth considering the main features of the activities of doctors:

1. 1. Profile – both doctors are narrowly qualified specialists. A urologist is a doctor who sees both men and women. Andrologist is a male specialist.
2. 2. Diseases. Both medical staff can prescribe treatment and diagnose problems with the genitourinary system.

There is no more difference between a urologist and an andrologist. If a person experiences discomfort during urination, feels pain in the kidney area, suffers from infertility, thrush, decreased libido, he should consult a urologist, andrologist or urologist-andrologist.

A doctor is also useful in the following situations:

1. 1. Preventive examinations – it is recommended to visit a doctor at least once a year, which is important even if there are no complaints, because most diseases in the first stage do not have symptoms.
2. 2. In case of problems in intimate life. For men, this is sexual dysfunction, for women, reduced libido, the inability to reach the peak of pleasure, etc.
3. 3. Infertility – difficulties with conception with regular sexual intercourse.
4. 4. The presence of pain in the lower abdomen, pain during urination – a reason to make an appointment with a urologist.
5. 5. Do not delay your visit at elevated temperature.
6. 6. When neoplasms are found on the genitals.
7. 7. With discharges that are not considered normal – in the form of mucus, with purulent, bloody inclusions during urination.

Urologist-andrologist

A doctor whose competence includes the treatment of diseases of the genitourinary system in men and women is called a urologist-andrologist.

How is the appointment

A consultation is an important step that allows you to make a correct diagnosis and determine the correct treatment. At the initial appointment, the specialist interviews the visitor, listens to the symptoms, asks a series of questions to help collect an anamnesis and other information. Next, the doctor proceeds to the examination. If we talk about men, the doctor examines the genitals, testicles, prostate gland.

The urologist-andrologist assesses:

• the correct development of the genitals;
• testicular symmetry;
• condition of the venous system;
• analyzes the structural features of the penis, if any;
• determines the condition of the skin and mucous membranes.

If the doctor considers it necessary, the patient is recommended to do a series of studies, for example, to take tests, undergo a hardware examination. Based on the results, the doctor makes a diagnosis and selects a treatment. The latter is chosen on an individual basis, taking into account the characteristics of the disease and the general condition of the patient.

What methods are used to diagnose

A urologist-andrologist in Moscow in a private medical center is a highly qualified specialist with extensive experience in his professional field. For diagnosis, the doctor has everything necessary for the diagnosis to be accurate. So, to determine the type of disease can be used:

• clinical laboratory tests;
• blood test for prostate antigen;
• spermogram;
• ultrasound;
• MRI or CT;
• x-ray and more.

How a urologist-andrologist treats

After the diagnosis is confirmed, the urologist andrologist develops a therapy regimen that is highly likely to bring a positive result.