Men's Health

Overview
Erectile Dysfunction (ED) is when a man is unable to keep an erection while having sex, caused by limited blood flow, neurological causes, drugs, and psychological causes. This may also be referred to as impotence.

Symptoms

• Inability to maintain an erection
• Depression
• Performance Anxiety

When to see a doctor

If you are suffering from the above symptoms please see a doctor to receive a physical examination and blood test to determine other conditions contributing to your condition.

Treatments we offer

• Weight loss / improved lifestyle factors
• Stop smoking and drinking alcohol
• Phosphodiesterase-5 (PDE-5) Inhibitors - increases the chemicals that allow the penis to become and remain erect

*Medications such as Viagra, Cialis, Levitra, or herbal supplements for ED are not known to be a safe or reliable treatment option.

Helpful Resources on ED:

Urology Care Foundation

Overview
Testosterone is an important hormone in males responsible for muscle strength, sex drive, and bone strength. As men get older, it is normal for their testosterone levels to drop. However, if the testosterone levels drop too low, men can have symptoms.

Symptoms

Initial symptoms of low testosterone

• Fatigue
• Little to no interest in sex (“low libido”)
• Feel sad, down, or depressed

After a year of low testosterone:

• Loss of muscle and bone strength
• Loss of facial or body hair
• Growing breast (“gynecomastia”)

When to see a doctor

Visit a doctor if you are experiencing the symptoms listed above. These symptoms can be the result of other conditions, and your doctor can determine if it is caused from low testosterone through a blood test.

Treatments we offer

Testosterone replacement comes in the form of shots, patches, gels, and tablets.

Men older than 60 are not always treated for low testosterone because it is normal. Men older than 60 may have testosterone replacement if:

• 2 or 3 blood tests prove low testosterone levels
• The symptoms of low testosterone bother them
• They have not had a heart attack or stroke

Helpful Resources on Low Testosterone:

Urology Care Foundation

Overview
Peyronie’s disease is when a male’s penis has an abnormal curvature during erection. Up to 7 percent of males experience Peyronie’s disease, and it is typically caused by penile trauma during sexual intercourse.

Symptoms

• Scarring on the penis
• Pain in the penis
• Poor erection

When to see a doctor

Visit a doctor if you are experiencing any of the above symptoms to properly diagnose and treat the problem.

Treatments we offer

Collagenase injections - injection into the penis to remove scar tissue, improving the penile curvature.

Helpful Resources on Peyronie's Disease:

National Institute of Health

Urology Care Foundation

Overview
Benign Prostatic Hyperplasia (BPH) is the medical term for an enlarged prostate. In men, the prostate gland (which surrounds the urethra) tends to get bigger in men as they get older.

Symptoms

• The need to urinate often, especially at night
• Trouble starting to urinate
• Having a weak urine stream

When to see a doctor
See a doctor if you are experiencing any of the above symptoms. These symptoms can be caused by other problems, so it is important for your doctor to determine if it is BPH or a different urologic condition.

Treatments we offer

• Waiting - Waiting to see if a patient’s symptoms change / improve over time without treatment. If the condition becomes worse, the patient can chose a treatment option
• Medicine
  • Option 1 - Medicine that helps to relax the muscles surrounding the urethra
  • Option 2 - Medicine that keeps the prostate from growing or even shrinks the prostate
  • In some cases, both types of medicines are used
• Surgerical Options
  • Greenlight Laser Prostatectomy
  • Bipolar and Monopolar Transurethral
  • Simple Prostatectomy (open and laparoscopic)
  • Urolift

Our BPH Specialist: Howard L. Adler, MD, FACS

Helpful Resources on BPH:

Urology Care Foundation

Overview
Kidney stones develop when a substance such as calcium, oxalate, cystine, or uric acid are at high level in the urine. The stone will move through the urinary tract and eventually be passed. If the stone gets stuck and block urine from passing, resulting in pain.

Symptoms

• Pain - in the side, lower abdomen, or groin
• Blood in the urine
• Gravel - passing smaller stones in your urine

When to see a doctor
Visit your doctor if you are experiencing any of the symptoms above to determine a treatment method.

Treatments we offer

• Anti-inflammatory drugs (Advil, Motrin, Aleve)
• Shock wave lithotripsy (SWL) - high-energy shock waves toward the stone used to break the stone into smaller pieces. Only used for stones 1 cm or less in the kidney and upper ureter
• Percutaneous nephrolithotomy (PNL) - minimally invasive surgery to remove the stone
• Ureteroscopy - Thing scope used to view the kidney stone and remove it or break it into smaller pieces

Our stone disease specialists : David A. Schulsinger, MD, FACS and Howard L. Adler, MD, FACS

Helpful Resources on Stone Disease:

StoneDisease.org

Overview
Most prostate cancers in the United States are identified through prostate-specific antigen (PSA) screening or digital rectal examination. Prostate-specific antigen is a protein in the blood produced by prostate cells. It is widely used as a screening test for prostate cancer. PSA is not specific for prostate cancer and can be elevated in benign conditions (infection, urinary retention).

Symptoms

• Pain / difficulty when passing urine
• Weak urine stream
• Need to pass urine more frequently (especially at night)

Testing for PSA level

• Digital rectal exam
  • Usually done at an annual physical
  • The doctor checks for an hard or lumpy areas in the prostate
• PSA blood test
  • Blood test to check for high PSA levels
  • High PSA levels does not necessarily mean a man has prostate cancer
• PCA3 urine test
  • Molecular diagnostic test to differentiate prostate cancer from other causes of elevated PSA
• 4Kscore blood test
  • This test gives a percentage of how likely a man with elevated PSA is to have aggressive prostate cancer

Our specialist: Howard L. Adler, MD, FACS

Helpful Resources on Elevated PSA:

Screening Test for Prostate Cancer

Prostate Care Program

National Institute of Health