Low Testosterone Symptoms with Dr. Brian Hale

My name is Brian Hale. I’m a board certified urologist working with Advanced Urology Institute. Men with low testosterone usually have fatigue or loss of sex drive. That’s the thing that would prompt me to check a testosterone level. Lot of times they come in with erectile dysfunction and then I have to kind of bring that out of them [and ask] “Are you also having symptoms of low testosterone?”. If they do, we try to address that first before we treat erectile dysfunction.

What is Vasectomy Recovery Like?

The no-needle no-scalpel vasectomy is a quick, minimally invasive outpatient procedure that takes 10-15 minutes. It is fail-safe on a majority of patients and highly unlikely to cause complications.

“At Advanced Urology Institute, we conduct no-needle no-scalpel vasectomies with very high success rates,” says Dr. Yaser Bassel, a board certified urologist at Advanced Urology Institute, Tampa, Florida. “It’s basically a 10-15 minute office procedure done under local anesthesia,” he adds.

What does the procedure involve?

During a no-needle no-scalpel vasectomy, you undress from the waist down and cover yourself using a sheet. Your skin is sterilized with antiseptic, and then sterile drapes are placed around your scrotum.

With the surgical site—the scrotum—numbed using an external agent, your urologist uses a device called a hemostat to expose your vas deferens through the skin of your testes. The vas deferens is then sealed to prevent sperm flow into semen. After sealing off your vas deferens, the surgeon bandages your scrotum—no closing of sutures is necessary.

Is the procedure painful?

The sensation associated with the procedure is comparable to a rubber band snapped at the entry site. You will feel some tugging as the vasectomy is done, but you should not expect to have any sharp pain.

Soon after the procedure, you can expect some mild discomfort. The discomfort may intensify as the anesthesia wears off, usually one or two hours after your procedure.

“The tenderness and soreness can be managed effectively with over-the-counter pain medication and cold compresses,” says Dr. Yaser Bassel. “It is advisable that you speak with your doctor about any pain, redness, soreness, or discomfort you may experience after the procedure.”

Likewise, you should make sure to read your urologist’s written instructions, review them thoroughly with your spouse, and ask questions regarding any concerns.

You should also not drive yourself home. Make sure to arrange for your transportation in advance. Your doctor will determine when you are ready to go home, and you should not speed up the process.

Once you leave the doctor’s office, you should go directly home to rest. Wear a snug scrotal garment or jockey shorts immediately after your surgery, and for up to one week, to avoid stretching the wound.

What should you expect during recovery?

You will need to follow basic self-care procedures to keep yourself comfortable and reduce the risk of infection or stretching your wound. Immediately after the procedure, you should take a day or two from work to rest.

“Once you arrive home, lie down and apply some ice on your scrotum, and rest for at least 20 minutes. You’ll then apply the ice periodically for the rest of the day,” says Dr. Yaser Bassel. “The ice will reduce the swelling and block your pain receptors to minimize the pain,” he adds.

A cold compress applied for the first 24-48 hours will minimize your pain and prevent swelling, but you will still need to monitor the progress of your surgical site. Should the pain, bruising, redness, and swelling worsen the first few days after your procedure, you should contact your physician for help.

With good scrotal support, you can ease into regular non-strenuous activity the day after your vasectomy procedure. However, it would be best if you avoid heavy lifting, working out, and other strenuous activities until at least the third day after your procedure. Lifting any weight above 10 pounds may stretch and reopen your wound. Plus, you should not shower or bathe for one or two days after the procedure.

“If any activity causes pain, put it off and rest some more before trying it again,” says Dr. Yaser Bassel. “Likewise, you should avoid having sexual relations soon after your no-needle no-scalpel vasectomy,” he affirms.

Since sperm will not immediately diminish in your semen, you will temporarily have to use external birth control when having sexual intercourse. It usually takes up to 3 months for sperm to be completely absent in semen.

You should also have your semen analyzed for the presence of sperm before you engaging in sex without using contraception.

Why Advanced Urology Institute?

At Advanced Urology Institute, we offer the no-needle no-scalpel procedure that takes less than 20 minutes and guarantees that you will enjoy contraception with the lowest complication rate, least amount of pain, and shortest recovery period.

Our urologists have been performing this procedure for years. Your safe and effective surgery will allow you to enjoy your sex life without worrying about an unintended pregnancy. We will also guide you through the recovery process to help you achieve the best possible outcome.

Are you thinking of getting a vasectomy? Schedule your consultation today with one of our knowledgeable and experienced urologists.

For additional information on vasectomy, vasectomy reversals, and other contraception issues, visit the Advanced Urology Institute website.

The Advantages of Laparoscopic and Robotic Surgery with Dr. Amar Raval

My name is Amar J. Raval and I’m with Advanced Urology Institute.Laparoscopic and robotic surgery is unique because it minimizes your pain, it [does] small incisions, and less hospital stay. So those three things are a big deal and patients recover faster and can go home with minimal pain and discomfort.

Let alone with robotic and laparoscopic techniques, the visualizations are significantly improved. You’re able to small anatomy in great detail, in 3D and also make fine movements to have a nice outcome and surgery.

Advances in Prostate Cancer Research

Prostate cancer is one of the most common types of cancer in men. However, it might not show any symptoms until it reaches an advanced stage. A considerable number of men only realize they have the disease when it is already adversely affecting their lives.“This cancer is a big thing, with huge effects on the lives of patients,” says Dr. Jonathan Jay, a board certified urologist at Advanced Urology Institute in Naples, Florida. “The condition can cause urinary incontinence, reduced sexual desire, erectile dysfunction, changes in orgasm, and infertility, among other problems,” he adds.

Treatable Condition

The good news is that there are various treatments and management options for prostate cancer, even if it is found at a later stage. When detected early, the cancer is highly treatable, and most men with the disease survive.

“Prostate cancer is quite complex, which makes it difficult to predict how fast or slow it will grow and the risk associated with it,” says Dr. Jonathan Jay. “That is why, during diagnosis, we evaluate several factors to determine the aggressiveness of the tumor. After we determine the risk associated with the cancer, we are better placed to recommend the right treatment for our patients, which can yield great results,” he affirms.

The cancer is categorized as low risk, intermediate risk, or high risk depending on its ability to grow and spread to other areas of the body. Low risk prostate cancer is slow-growing and unlikely to spread quickly. In contrast, a high risk cancer is likely to spread rapidly outside the prostate.

Improved PSA Screening

One recent advance in prostate cancer research is the proper use of the prostate-specific antigen (PSA) test. Although the PSA test has had its limitations, it is still valuable for identifying and categorizing cancer as high risk or low risk, aggressive or indolent. When correctly used, it shows with accuracy those patients who have the aggressive type of cancer. This finding effectively guides the doctor to develop a more targeted treatment plan.

“The PSA got a bad reputation because it was used wrongly,” says Dr. Jonathan Jay. “But today, urologists understand that the PSA is still a very valuable tool in prostate cancer diagnosis and treatment. And it is now known that the significance of the PSA is not in whether it is elevated relative to the average, but in how it changes over time,” he asserts.

Studies have shown that the PSA is not abnormal just because it is elevated compared to the average. If the PSA of a man is stable over time, it doesn’t show prostate cancer, let alone an aggressive type of the disease. But if the PSA of a man has been stable for a prolonged period and then changes suddenly, it shows that something is wrong.

“If your PSA is one over the years, but changes to 3, then something is wrong, regardless of the fact that 3 is still within the normal range,” explains Dr. Jonathan Jay. “And if you’ve had a PSA of 6 over the past many years, then it’s not abnormal since it remains stable, regardless of the fact that it’s not within the normal range,” he adds.

Enhanced Precision with Molecular Biology

Significant progress has been made in prostate cancer research in the area of biopsies. Traditionally, prostate cancer has been confirmed and graded through a biopsy. To confirm a diagnosis, a urologist takes 8-12 needle biopsies along the prostate in a random sample and examines the cells under a microscope. However, while a biopsy tends to provide more accuracy than a typical PSA, it doesn’t give a perfect picture of the cancer.

“It is difficult to detect an aggressive cancer through the way cells look or behave,” says Dr. Jonathan Jay. “Besides, a biopsy may miss the specific areas of the prostate that would help to distinguish an aggressive from an indolent cancer,” he adds.

Advances in this area have ensured more accuracy and reduced the risk of misdiagnosis. For instance, abnormal prostate cancer genes can now be used to identify high risk cancer. The look of genes, occurrence of virulence factors, behavior, and other features are studied to better understand how likely it is that a cancer will grow and spread.

“Nowadays, we look at genes to determine the aggressiveness of prostate cancer,” says Dr. Jonathan Jay. “For example, genes of cancer cells may contain virulence factors or show how fast the cells will multiply and spread to other areas. This helps determine which cancer should be treated faster, and which categories of patients may benefit from therapeutic interventions,” he adds.

Apart from genomics, urologists can now use magnetic resonance imaging (MRI) technology before a biopsy to look for areas in the prostate that are suspicious of the cancer. This is possible thanks to new technology that fuses MRI images with real-time ultrasound to guide prostate needle biopsies to areas of specific concern.

Why Seek Prostate Cancer Treatment At Advanced Urology Institute?

At Advanced Urology Institute, we understand that prostate cancer is highly treatable when detected early and accurately.

We offer comprehensive prostate cancer care that includes the use of the latest research knowledge and techniques. With the advances in prostate cancer research, we can know who has aggressive or indolent cancer with greater accuracy, minimizing the chances of overtreatment and unnecessary biopsies.

Moreover, our urologists are acquainted with up-to-date prostate cancer knowledge, tools, and techniques. All of this helps guide treatment and enables us to develop more targeted treatment plans for our patients.

When you come to see us at our Naples, Florida office for diagnosis or treatment, we will consider your unique situation from a point of knowledge and recommend the best possible treatment for you.

For more information on prostate cancer treatment and diagnosis, visit the Advanced Urology Institute website.