What happens when a man’s testosterone is low?

Testosterone is a male sex hormone that plays an important role in a man’s life. It is important to normal sex drive, energy and even mood. However, testosterone levels normally tend to decrease in men as they age. Although these decreases are generally normal and may even go unnoticed, they can also be severe and cause symptoms that are problematic.

Symptomatic low testosterone is a real problem that men can face when low levels of the hormone result in negative side effects. One of the most prominent symptoms is low energy and tiredness to the point of fatigue. A patient with low testosterone can also experience decreased libido or sex drive, or even erectile dysfunction. Personality can also be affected by low testosterone for those who experience moodiness, anxiety, and differing levels of stability.

Dr. Paul Arnold of Palm Harbor, FLThere are many causes of low testosterone, with simply aging being the most common reason. Men can also experience low testosterone after an injury to the testicles, chemotherapy, certain types of infections, or autoimmune diseases. In addition, there are also medications that can lower testosterone levels.

Many men with low testosterone experience no symptoms at all and, for these men, a urologist would not recommend treatment. For men who do experience the negative symptoms, one option is testosterone replacement therapy.

With testosterone replacement therapy, the hormone is brought into the body through gels, patches, or injections. The supplemental hormone brings testosterone back to normal levels and, in most cases, the patient will notice the change quickly. Energy levels, mood, and libido see quick improvements. And when testosterone replacement therapy is closely monitored by a urologist, the risks are minimal.

According to Dr. Paul Arnold, for patients receiving testosterone replacement therapy, “It’s like a light switch from their symptoms prior to treatment to post treatment.” Symptomatic low testosterone can be a difficult and depressing condition for those who miss the active life they once had. Fortunately, the urologists at the Advance Urology Institute can help you feel better and live with energy and a positive outlook again. For more information about testosterone replacement therapy, visit the Advanced Urology Institute website.

Surgical Options for Overactive Bladder

If you feel frequent, sudden urges to urinate that you cannot control, you might be suffering from overactive bladder. This condition can lead to feelings of embarrassment or shame, but it’s a common problem and can be treated in a variety of ways. For many people, overactive bladder can be treated with lifestyle changes such as special diet, weight loss, regularly timed trips to the bathroom, and exercises to strengthen the pelvic floor. Dealing with symptoms by using absorbent pads is also an option.

However, for some people, these methods are not enough to ensure they can live a healthy, fulfilling life. In these situations, surgical intervention is an option to correct overactive bladder problems.

Augmentation Cytoplasty

One of the options for treating overactive bladder is called augmentation cytoplasty. This procedure increases the size of the bladder. The surgeon accomplishes this by removing a small part of the intestine and using it to replace parts of the bladder in order to increase its capacity. For some people, this procedure allows them to resume normal bladder function. For others, the use of a catheter may be necessary for the rest of their life.

Urinary Diversion Surgery

Another surgical treatment option for overactive bladder is urinary diversion surgery. This procedure involves diverting urine from the bladder. One option for bypassing the bladder involves linking the ureters, which normally connect the kidneys to the bladder, to an ostomy bag outside of the body. Another option involves the creation of a new bladder inside of the patient’s body, which means they will be able to continue normal urinary function.

Bladder Removal

Bladder removal surgery, or a cystectomy, is the last resort option for patients with overactive bladder for whom no other treatment has been successful. For men, bladder removal surgery also involves the removal of part of the prostate; for women, it involves removal of the uterus, ovaries and part of the vagina. Because this is a risky procedure that involves multiple organs, it is usually only used for more serious urological conditions such as bladder cancer or birth defects. Removal of the bladder necessitates the use of a urinary diversion such as an ostomy bag or a stoma.

An overactive bladder can be a debilitating condition, but there are many options for treatment. If you are dealing with this issue, the physicians at Advanced Urology Institute are here to help you reach a diagnosis and find a treatment to restore your quality of life.

Prostate Cancer Types of Treatment

Prostate cancer is one of the most prevalent types of cancer men face. According to board certified urologist Dr. Arash Rafiei, “One in nine men will have prostate cancer in their lifetime.” Although somewhat common, not all cancers in the walnut-shaped prostate gland are the same. Every case of prostate cancer is different and affects men differently. Urologists work with their patients to find the most effective treatment option based on each patient’s individual needs.

Dr. Arash Rafiei: Urologist in Orange City, FLUrologists will consider their patient’s health, age, and the type cancer when deciding how to proceed. For some cases, the best treatment is none at all. When a patient has slow growing prostate cancer that is not spreading, a urologist may suggest holding off on treatment while monitoring the growth through routine appointments. The cancer needs to be taken seriously and watched closely, but invasive treatment is not always necessary for the patient’s health.

When treatment for the prostate cancer is needed, there are two main options: radiation and surgery. Both options offer the same level of prostate control and urologists will discuss the pros and cons of each with their patients. For surgical options the urologist may suggest a radical prostatectomy or robotic surgery. Both are well-tested invasive options that produce very good patient outcomes.

Radiation therapy is another common cancer treatment option. The radiation is centered on the prostate to kill cancer cells. The radiation will also kill some healthy cells as well, causing side effects. This is a non-invasive option that, like surgery, has its pros and con that a patient and doctor will want to discuss. Follow-up appointments to determine if the cancer responded to the treatment will also be necessary.

In addition to radiation and surgery, there are also some newer options that can be utilized in prostate cancer treatment. For instance, cryotherapy uses very cold temperatures to kill cancerous tissues and cells in the prostate by freezing them. There are also treatments using intense ultrasound waves centered on the prostate to destroy the cancer cells. These procedures are newer and there is less data on when they are the most effective, but they are options to consider.

All cancer is serious and can be a stressful and frightening prospect. Having a dedicated urologist who will listen and suggest the best treatment for each patient is key to success. Whether the best option is observation, radiation, surgery or a newer procedure, the Advance Urology Institute is a team of dedicated urologists with an array of treatment options for their patients.

What is the best treatment for enlarged prostate?

All men can experience difficulties caused by an enlarging prostate. As Board Certified Urologist Dr. Arash Rafiei says, “All men have prostates, and as we age our prostates enlarge, some more than others.” Yet each man’s situation and health is different. The symptoms of an enlarged prostate will differ greatly between individuals and the best treatment option for one may not be the best option for another.

Urologist in DeLand, FL: Dr. Arash RafieiFor most men, the symptoms of an enlarging prostate include the slowing of their urine stream, pushing to urinate, and having to go to the bathroom frequently. Many men also have the feeling of not fully emptying their bladder after urination. In many cases, men will find that they need to wake up multiple times in the night to go to the bathroom.

Because the symptoms of an enlarging prostate differ for everyone, the first thing a urologist will ask is if the symptoms are bothering the patient. For some men, the symptoms, especially in their early stages, are not a problem. Men may notice that they urinate a little more often. It may also take a bit longer for them to urinate when they do. They may have to get up once or twice at night when they did not have to before. A lot of men see these symptoms as inconveniences that they can adapt to and live easily with. In these cases, the urologist and their patient will just want to continue to watch the situation and may not need to take any action.

For men with more severe prostate enlargement the symptoms may be causing issues that are negatively affecting their lives. In these cases, their urologist may recommend medical therapy. Urologists will recommend medication that will help slow the growth of the prostate and relax the muscles around the bladder. This treatment will help make urination easier for men you have been experiencing difficulties. Slowing prostate growth will also give the patient more time before more invasive treatment options become necessary.

For cases where medication does not produce successful outcomes there are plenty of procedures that can help. One common procedure is a transurethral resection of the prostate. For this procedure a resectoscope in inserted through the tip of the penis and into the urethra. The urologist uses this device to trim away excess tissue on the prostate, relieving pressure on the urethra. This is an outpatient procedure and often helps relieve the patient’s urinary problems.

Another procedure that is new and becoming more common for treating enlarged prostates is Urolift. For this cutting-edge treatment, a urologist separates and lifts the prostate from the urethra using a suture, relieving pressure on the urethra and allowing better urine flow. A plus side to Urolift is that, unlike in a transurethral resection, no prostate tissue is removed allowing for quicker recovery. Most patients return home the same day as the procedure.

Having plenty of treatment options is the key to successfully managing prostate enlargement. The urologists at Advance Urology Institute get to know and understand their patients in order to find the best option for each individual. For more information, visit the Advanced Urology Institute website.

Talk With Your Doctor About Erectile Dysfunction

The first step in treating erectile dysfunction is talking to your doctor about it. Unfortunately, for many men this can be difficult as erectile dysfunction is often a sensitive subject for those experiencing it. However, the issue is far more common than most men realize. As Chelsea Ferrell , physician assistant, states, “Fifty percent of men over 50 have some degree of erectile dysfunction, so you do not have to be embarrassed to speak to your doctor about it.” Urologists and PAs discuss erectile dysfunction with patients on a daily basis.

Chelsie Ferrell, Physician Assistant at DeLand, FLUrologists can usually diagnose erectile dysfunction during the appointment by asking a few questions about medical history and having a conversation with the patient. Once diagnosed, urologists try to discuss erectile dysfunction with the patient by reassuring him that even in the most severe cases there are still plenty of treatment options available. Because there are so many options available, the decision really is up to the patient working with his urologist to decide the best treatment for a successful outcome in his case.

There are plenty of different treatments available for erectile dysfunction and, in many cases, if one does not work another will. The most common options are pills like Viagra and Cialis, or generic versions of these pills that offer the same effects at a lower price. Others prefer the vacuum erection device. This is a cylindrical pump that the penis goes into and works like a vacuum to draw blood to the area, with a band that goes around the base of the penis to keep the erection.

Many men respond to at least one of these treatments. However, for those who do not there are still plenty of options. The urologist may want to try injection therapy. Men can give themselves small, relatively pain-free injections of a treatment into the base of the penis that will stimulate an erection. If injection treatment does not help, then the urologist may suggest a penile prosthesis. An implant is surgically inserted into the penis attached to a pump in the scrotum that can be used to give the patient an erection. This treatment will correct the patient’s erectile dysfunction for life.

Talking to your doctor about an issue as common as erectile dysfunction does not have to be an uncomfortable experience. And with the many options available now to treat erectile dysfunction, the right option is just a conversation away. Chelsea Ferrell PA at the Advanced Urology Institute is one of the many friendly and intelligent professionals helping patients find their best treatment option. For more information, visit the Advanced Urology Institute website.

The Two Most Common Female Urology Problems

Although it can feel embarrassing to discuss them with your doctor, problems with your kidneys, bladder and other parts of the urinary system are very common and are usually highly treatable. For women, two of the most common problems are urinary tract infections (UTIs) and urinary incontinence.

Urinary Tract Infection

Chelsie Ferrell, PA of DeLand, FLA urinary tract infection is an infection of a part of the urinary system which includes the bladder, kidneys, ureters and urethra. A UTI can occur when bacteria enters the urinary system, usually via the urethra. Symptoms of a UTI include a strong, constant need to urinate, a burning sensation during urination, and urine that is cloudy or pink or red-tinged and has a strong smell. There also may be pain around the pelvis. Although UTIs are usually not serious, if the infection spreads from the bladder into the kidneys, complications can occur. If you are diagnosed with a UTI, your doctor most likely will prescribe antibiotics to help clear up the infection.

UTIS are more common in women than men because women have shorter urethras. There are easy steps you can take to prevent getting a UTI. Drinking plenty of liquids, wiping from front to back after using the restroom, and urinating soon after sexual intercourse are all important preventative measures you can take to reduce your risk of developing a UTI.

Incontinence

Urinary incontinence, or the involuntary release of urine, is also a common problem for women, especially those who have given birth or have gone through menopause. These life events weaken the pelvic floor, making muscle control around the bladder more difficult. Incontinence also can be caused by weak or overactive bladder muscles or nerve damage.

Incontinence can vary in severity. For some women, this means only a few drops of urine being released when they cough or laugh. Others may experience a sudden urge to urinate and lose control of their bladders before they have time to get to a restroom. This can cause feelings of embarrassment and keep women from participating in activities they enjoy. Thankfully, urinary incontinence is very treatable. If it is becoming a major nuisance in your life, talk to your doctor about specific treatment steps to permanently help deal with the issue rather than addressing the symptoms.

Although problems with the urinary system can feel embarrassing, it is important to remember that you are not alone and that these issues are treatable. The physicians at Advanced Urology Institute are here to help with any urological issues you may be facing. For more information, visit the Advanced Urology Institute website.

Discussing a Sensitive Topic: Erectile Dysfunction

Erectile Dysfunction, also called ED, is the inability for a man to get or maintain an erection firm enough for sexual activity. It is a very personal and sensitive issue that can be difficult to talk about. Although ED is a common issue that affects many men, it can still cause feelings of embarrassment and shame. This makes open conversations, even with a trusted urologist, difficult in some cases.

Dr. Billy Vanasupa of St Augustine, FLA urologist is a doctor who specializes in the urinary tract and male reproductive system. They are the doctor a patient will most likely to go to about his ED. Urologists see countless cases of ED on a regular basis, and to them it is not a major issue at all. However, good urologists understand that ED can be an embarrassing issue for their patients and they immediately begin their visits by creating a comfortable environment where doctor and patient feel at ease discussing it.

One such urologist who works to create a comfortable environment is Dr. Billy Vanasupa. When talking about his approach with patients who see him for ED, Dr. Vanasupa says, “I always try to make my visits light, make some jokes here and there, and make them feel comfortable.” His goal is to make his patients laugh so they are less nervous and feel they can easily talk to him. Dr. Vanasupa removes the stigma of ED so he and his patient can openly discuss this sensitive topic.

Once everyone is comfortable discussing the topic, the urologist will ask background questions like whether the ED occurred slowly or abruptly. The patient will be asked if he has tried any medications. The doctor’s questions are to help determine root causes for the issue and will include asking about diet, alcohol and drug use, and stress factors. Finding possible causes for ED is an important first step in treating it.

The urologist and patient will discuss best treatment options for ED. In many cases, oral medication, possibly along with some minor lifestyle adjustments, will fix the issue and allow healthy men to return to their normal sexual activity. For some men, oral medication does not help. The urologist may suggest injections. Patients will learn in the office how to administer a very low-pain injection at the base of the penis. There are very few cases where neither the oral or injected medication solves the issue.

Outcomes are best when the patient feels comfortable talking to his urologist about sensitive issues. The Advanced Urology Institute has urologists who can treat erectile dysfunction in a way that puts a patient at ease. For more information, visit the Advanced Urology Institute website.

How the Prostate Changes As You Age

For the early part of men’s lives, their prostate is an organ that they never notice. The walnut-shaped reproductive organ located just below the bladder does its job without causing any interruptions in their daily lives. However, this changes as men age. Beginning around age 40, their prostates begin to grow. According to board-certified urologist Dr. Billy Vanasupa, “There’s no rhyme or reason, it just does.”

The rate of growth is different for everyone. The prostate will grow faster in some men than in others. In some cases, the enlarging prostate can cause problems immediately for a man in his early 40s. In other cases, men may be in their 80s or 90s before they begin to see the effects of a growing prostate. Most commonly though, men in their late 50s and early 60s begin to experience urinary issues that begin slowly and increase in severity.

Some of the most common issues are the slowing of the urine stream, pushing to urinate, having to go back to the bathroom 10-15 minutes after urinating, feeling like the bladder may not be fully emptied, and having to get up frequently at night to go to the bathroom. All the symptoms can be associated with the frequent and sudden urge to use the bathroom.

These symptoms are a sign that it is time for a man to see his urologist. The symptoms will only increase in severity without treatment as the prostate continues to grow. The urologist will begin by helping a patient understand what is causing the issue, using a diagram to show where the prostate is and how it presses on the urethra as it grows. The enlarging prostate makes it difficult for urine to pass through the urethra on its way out of the body.

Treatment begins with medication to help with urination. These medicines help slow the growth of the prostate and relax the muscles around the bladder to make urination easier. A urologist also will do a PSA test to screen for prostate cancer. Not all cases of prostate enlargement are connected to cancer growth, but it is important to screen for the disease as a precaution.

Men’s bodies change in many ways as they age, and the prostate is no exception. Urologists at the Advanced Urology Institute focus on making sure their patients understand how their bodies are changing with age and how they can work with their urologist to stay in the best shape. For more information, visit the Advanced Urology Institute website.

How common is erectile dysfuntion?

Erectile dysfunction, also known as ED, is the inability of a man to get or maintain an erection firm enough for intercourse. ED is a very common issue that can negatively affect a man’s self-confidence and his relationship with his partner. Many men see urologists for help with ED when this happens.

Dr. David Harris of Fort Myers, FLThe primary symptom of ED is trouble getting and maintaining an erection, and reduced sexual desire is often associated with it. There are many factors that can cause ED, and they can be divided into two categories: mental and physical. Depression, anxiety and stress are mental factors that can cause ED. There are also physical factors, including heart disease, diabetes, high blood pressure and substance abuse. There are plenty of cases when it is a combination of mental and physical factors that cause ED.

All men are at risk for erectile dysfunction; however, there are some factors that increase the likelihood of developing it. Heart disease and diabetes are key risk factors that increase the likelihood of ED. Tobacco use causes damage to arteries, restricting blood flow and raising the chances of ED. Drug and alcohol use are risk factors as well. Men who are overweight, and especially those who are obese, are also at greater risk of developing erectile dysfunction.

A urologist can diagnose ED by performing a physical exam and asking a few questions. Once diagnosed, urologists can consider a variety of options for treatment, depending on the patient. The first option is usually oral medication. Urologists will try different medications to help patients maintain erections. If none are effective, then the urologist may prescribe injections. Small injections can be made to the shaft of the penis that dilate the blood vessels in the penis, allowing better blood flow and erections. The patient can administer these injections himself as needed.

Erectile dysfunction is not uncommon and as Dr. David Harris says about treating it, “As urologists, we are the leading authority.” Urologists see cases of ED on a daily basis and are accustomed to having conversations about it and finding the best way to solve the issue with their patients. In most cases a patient who is motivated to work with his urologist on finding the best treatment will eventually find a solution that works. The Advanced Urology Institute helps many patients explore their options and treat their ED so they can continue their normal lives and activities. For more information, visit the Advanced Urology Institute website.

Becoming a Urologist with Paul Arnold, MD

From a young age, Dr. Paul Arnold knew he wanted to become a physician. Growing up as an athlete, he had to deal with many broken bones and made frequent visits to the doctor’s office. ”I found the physician as a healer,” he explains, “and wanted that as my path and destination from [when I was] very, very young. Didn’t know what kind of doctor, but my idols were my orthopedic surgeons that I would see all the time.”

Dr. Paul Arnold of Palm Harbor, FLAs a student at the University of Florida, Dr. Arnold became even more interested in scientific subjects, particularly in biology. He earned his undergraduate degree in zoology before moving on to the University of South Florida, where he attended medical school. During his surgical rotations, he realized that his interest was in the field of urology. He continued to research urology while in medical school and completed his residency in this field at Ohio State University. He holds certifications with the American Board of Urology and the American College of Surgery, in addition to a specialization in laser BPH surgery.

Having grown up in Miami, it made sense for Dr. Arnold to choose to practice urology in his home state. In addition to his work with AUI in Palm Harbor, Dr. Arnold has served as the assistant chief of staff at Helen Ellis Memorial Hospital since 2008; prior to that, he was the chief of surgery at Helen Ellis for two years. He is also an active member of the urological community. He participates in research for medical device and pharmaceutical companies and has published multiple papers on topics related to the diagnosis and treatment of urological issues. He specializes in the treatment of impotence and incontinence for both men and women. He also is experienced with the use of GreenLight Laser therapy and lectures internationally on the subject.

Part of the appeal of urology for Dr. Arnold is that it has a high patient success and recovery rate. As he puts it, “With urology, there is definitely a problem and a solution to it, and so you definitely have a high rate of accomplishment.” Like all physicians with the Advanced Urology Institute, Dr. Arnold’s goal is to diagnose and treat urological issues as quickly and effectively as possible in order to help his patients live the lives they deserve. For more information, visit the Advanced Urology Institute website.