Diseases We Treat

Bladder Cancer

The most common sign of a bladder tumor is blood in the urine - either blood that can be seen by the naked eye or blood that is detected by a physician on a urine sample.  Although most bladder cancers cause no symptoms at all, bladder cancers can mimic a urinary tract infection or an “over-active” bladder and can cause frequent urination, pain with urination, or difficulty controlling the urine stream.  Most tumors, however, are “silent.”  Because the diagnosis can be hard to make on symptoms alone, evaluation by a physician is mandatory. Most importantly, all cases of blood in the urine should be evaluated, since blood may be the only sign of a bladder malignancy.

The doctor's evaluation will include a radiologic study (an ultrasound, a special kidney X-ray called an “IVP”, or a CAT scan) and a cystoscopy.  Cystoscopy is usually performed in the doctor's office, when the doctor places a small, flexible telescope into the urethra to look at the bladder.  Although most of the evaluations are normal, sometimes they do reveal a tumor, a stone, or a large prostate (in men).

BPH

The prostate is a walnut-sized gland in a man's reproductive system that is located just below the bladder and surrounds the urethra, the tube that carries urine from the bladder and out through the penis. The prostate gland's function is to make and store seminal fluid, which is a milky liquid that nourishes sperm and is released during ejaculation.   If the prostate grows too large, it can make it difficult for the bladder to empty the urine.  The gland is only necessary for reproduction and is can be removed or resected if it blocks the bladder or has cancer in it.

Benign Prostatic Hyperplasia (BPH) is the abnormal growth of benign prostate cells. Eventually, the prostate's increased size will compress the urethra, interfering with the normal flow of urine. More than half of the men in the United States between the ages of 60 and 70 and as many as 90 percent between the ages of 70 and 90 have symptoms of BPH. For some men, the symptoms may be severe enough to require treatment. Benign tumors are not cancer. They can usually be removed and, in most cases, they do not return. Cells from benign tumors do not spread to other parts of the body. Most important, benign tumors of the prostate are not a threat to life.

Erectile dysfunction (impotence)

Erectile Dysfunction (impotence) is the inability to obtain or maintain an erection sufficient for sexual intercourse. It is a condition that affects approximately one in every ten men in the United States. While erectile dysfunction can become more frequent with age, it can also be caused by high blood pressure (hypertension), diabetes, vascular problems, or other disease processes.

Many men experience isolated episodes of erectile dysfunction at some time in their lives, usually as a result of fatigue, stress, or alcohol or drug consumption. If the condition continues to interfere with normal sexual activity, however, a full evaluation is recommended.  There now exist many successful options to treat this condition.  Oral medications, including Viagra, Levitra, and Cialis, are popular and effective for many patients.  MUSE urethral pellets and Caverject penile injections have also been successfully employed to achieve erections.  Likewise, vacuum constriction devices, although rarely used, are another alternative.  Ultimately, if these options fail to work or if the patient is unhappy with these treatments, surgery is performed to implant a device into the penis that creates excellent erections on demand.

Hematuria

Incontinence

Infertility

Kidney Cancer

Kidney Stones

http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/index.htm

Prostatitis

Testicular Cancer

Urethral Stricture

Urinary Tract Infection

Vasectomy

Each year, over 500,000 men in the United States choose vasectomy as their method of contraception.  During a vasectomy, a small part of the vas deferens (the tube that carries sperm from the testicle to the urethra) is removed and the ends of the vas are sealed, making it a permanent method of contraception.  It is not immediately effective, however.  Although sperm can no longer exit the testicles, sperm may remain in other parts of the reproductive system.  Any man who has undergone a vasectomy should therefore not have unprotected intercourse until a semen analysis shows that no sperm are reaching the ejaculate.  This can take more than 4-6 weeks to occur.  Just as important to note is that a vasectomy is considered nearly 100% effective, but not completely “fail-safe”.  Indeed, no method of birth control is truly 100% completely effective except for abstinence.

Prostate Cancer

Prostate cancer is the most commonly diagnosed malignancy in men. In 2002, close to 200,000 cases were diagnosed in the United States.  Moreover, it is estimated that almost 40,000 men will die of the disease this year alone! The risk of developing prostate cancer increases as men age and therefore most urologists recommend routine screening for prostate cancer starting at age 50.  Black men and men with a strong family history of prostate cancer are at even high risk, and screening for these men should begin at age 40.

When a prostate cancer grows, it is because cells in these tumors are abnormal. They keep dividing and replicating without the usual control of normal cells and they do not die (they have become “immortal”). Because they continue to grow and because they have acquired certain properties unique to cancer cells, they can invade and damage nearby tissues and organs. Just as harmful is their propensity to break away from the organ of origin and enter the bloodstream and lymphatic system and to other organs. This type of spread is called metastasis.