Sex can be a sensitive topic for any couple. Some people are shy about their bodies or feel embarrassed discussing a subject so private and personal. But there are times when sexual issues need attention, and Peyronie’s disease can be one of those times.
Peyronie’s disease can make intercourse difficult—and sometimes impossible. Plaques (scar tissue) form just beneath the skin of the penis, which becomes less flexible. As a result, the penis starts to bend. The extent of the curvature varies, but it can be as high as 90 degrees.
If there are lots of plaques, the penis might take on an hourglass shape. It could also narrow at the tip (a “bottleneck” deformity) or at the base (a “cobra head” deformity). For some men, there is a “hinge” effect that could make the penis unstable during an erection
Peyronie’s disease can be painful, too. And some men develop erectile dysfunction. They may have sex less often or stop having sex altogether.
There’s an emotional component to Peyronie’s disease as well. Men may feel ashamed of the way their penis looks, have doubts about their masculinity, and worry that their partner will think they’re less attractive. They may also feel anxious about their partner’s sexual satisfaction and fear changes in the relationship. Depression is common, as many men miss the robust sex life they once enjoyed.
And Peyronie’s disease impacts partners. They often notice that the relationship has changed and miss what used to be. If the man with Peyronie’s withdraws, partners may feel isolated or neglected.
Fortunately, like many sexual problems, Peyronie’s disease can be treated in several ways. The process starts with a conversation. And good communication between partners can make treatment more successful.
Broaching the subject
Couples might start the conversation when they’re alone and feeling relaxed. Here are some sample openings:
There’s something that’s been on my mind lately—something sexual—and I was hoping we could talk about it.
I really enjoy our intimate times together, but there’s something troubling me. Can we talk?
It’s okay to admit to feeling nervous or awkward. Often, the subject has been on the partner’s mind, too, but they haven’t been sure how to approach it. Starting the dialogue might bring a sense of relief.
Opening up
Peyronie’s disease comes with a range of emotions, and it’s good to get those out in a constructive way. Frustration, depression, fear, anxiety—they’re all valid. When such feelings are out in the open, couples gain some perspective. They can listen to each other, reassure each other, and approach the future together, as a team.
Keeping the conversation going
Talking about Peyronie’s disease doesn’t need to be a “one and done” conversation. Over time, and as treatment progresses, feelings and perceptions might change. Checking in with each other from time to time can enhance the overall dialogue.
Learning together
Peyronie’s disease isn’t a term people hear every day. For some, it might be brand new. Researching the topic together is another way to keep the conversation going. Some couples share what they discover online, on television, or in magazines. They might also attend doctor’s appointments together and ask questions.
Exploring together
Peyronie’s disease doesn’t have to stop a couple from being intimate, and sex is more than intercourse. Couples can focus on what is possible and enjoyable. This part of the conversation can be creative and fun.
Staying supportive
Encouragement is important for couples facing Peyronie’s disease, and each partner can be a cheering section of sorts. For example, after a man finishes a round of treatment, a partner might say, “That couldn’t have been easy. I’m proud of you!” Or if a man has trouble keeping an erection during a sexual encounter, the partner might say, “That’s okay. I love what we do together.”
Considering counseling
Even when they have the best of intentions, couples may still struggle with communication. This is when a couples counselor might help. A trained therapist can teach strategies for expressing thoughts clearly, listening respectfully, and responding constructively. Urologists can make referrals for therapy.
For single men
For single men with Peyronie’s disease, starting new sexual relationships can be especially daunting. If they are still getting to know a new partner, they may be unsure of what to disclose and when.
Much of the advice above can apply to single relationships. Building trust takes time, but couples just starting out can still have similar conversations about Peyronie’s disease and its effects on intimacy.
A man might say, “Before we take the relationship further, there’s something I want to talk to you about.” If the relationship has been supportive and based on trust up to this point, chances are the partner will respond positively and be open to discussing other options for intimacy while the man seeks treatment.
Wrapping up
Sometimes the hardest part of having a sexual discussion is starting it. But all it takes is a deep breath. It may not be perfect or go exactly as planned, but starting the conversation is usually better than not having it at all.
Having a vasectomy is a step that should be carefully considered because it’s a permanent form of birth control. (It’s true that vasectomies can be reversed, but doing so requires a second, more involved procedure.) The following Q&A goes over many of the questions many men have as they’re contemplating having a vasectomy.
What happens during a vasectomy?
A vasectomy is a simple surgical procedure done to prevent pregnancy. It involves cutting two tiny tubes called the vasa deferentia. (One tube is called a vas deferens or vas.)
Typically, sperm cells travel through the vasa deferentia before they’re mixed with semen and ejaculated out of the body. By cutting these tubes, the sperm cells’ path is blocked. Instead of being ejaculated, the cells are absorbed by the man’s body.
What is a conventional vasectomy?
During a conventional vasectomy, the surgeon accesses the vasa deferentia through one or two small incisions in the scrotum, the sac that holds the testicles. After the vasectomy is done, the scrotal incisions are closed with dissolvable stitches.
What is a no-scalpel vasectomy?
With a no-scalpel vasectomy, the puncture heals on its own, and no stitches are necessary.
With a no-scalpel vasectomy, the surgeon accesses the vasa deferentia through a tiny puncture made in the scrotum. The puncture heals on its own, and no stitches are necessary.
How effective is a vasectomy?
After it takes effect, a vasectomy is about 99.95% effective in preventing pregnancy. This success rate makes it the second most effective form of birth control available. (The first is abstinence—not having sex at all.)
Where are vasectomy procedures done? How long do they take?
Most vasectomy procedures can be done in a urologist’s office. Occasionally, they may be done at a surgical center or hospital. They take about a half hour, and men can go home the same day.
Is a vasectomy covered by health insurance? How much does it cost?
Vasectomies are often covered by health insurance in the United States. A man should check with his insurance company for details on his specific coverage and his out-of-pocket costs. Costs can vary depending on location and the type of surgery needed.
Does it hurt to have a vasectomy?
Men are given local anesthesia (the area is numbed), so there shouldn’t be any pain. There might be some minimal discomfort after the anesthesia wears off. This can usually be managed with ice packs (placed over clothing) or acetaminophen (Tylenol). Aspirin or ibuprofen are not recommended, as they raise the risk of bleeding or bruising.
Can there be complications after a vasectomy?
All surgical procedures have some risk, but complications after a vasectomy are rare. In fact, the American Urological Association notes that complication rates are around 1% to 2%. Complications can include the following:
Sperm granuloma. When a vas deferens is cut, stray sperm cells can leak out. The immune system responds, which can lead to inflammation and, eventually, a small mass called a sperm granuloma. The mass is benign (not cancerous). A sperm granuloma can cause some temporary discomfort, but it usually goes away on its own. Pain medications may help. If it is especially bothersome, it may need to be surgically removed.
Infections. Some men develop an infection after their vasectomy. The infection is usually treated with antibiotics.
Hematoma. A hematoma occurs when blood collects in the scrotum after surgery. It often goes away on its own, but men should call their doctor if their scrotum gets bigger or becomes painful.
Post-vasectomy pain syndrome. About 1% to 2% of men have chronic pain after vasectomy due to fluid buildup in the scrotum. Pain medications and warm baths may help. In more severe cases, surgery—or a vasectomy reversal procedure—may be needed.
Research shows that men who have vasectomies are not at higher risk for cancer or ED.
No. Research shows that men who have vasectomies are not at higher risk for cancer or ED.
What is the vasectomy recovery period like?
Most men take it easy for a day or two after their vasectomy. There may be some pain and swelling, but these symptoms can be managed with pain medication and cold packs.
Men who work desk jobs usually go back to work the next day. Heavy lifting is restricted for about a week, so men with more physically demanding jobs may need to adjust their routine.
Men should avoid ejaculation—through partnered sex or masturbation—for about a week.
Is a vasectomy effective immediately?
No. It takes time for sperm cells to “clear” each vas deferens after a vasectomy. For this reason, couples need to continue using another form of birth control for a few more months or about 20 ejaculations.
After that period, men can see their urologist for a semen analysis. The doctor will check a semen sample for sperm cells. If some remain, couples should continue using birth control for a bit longer. If the semen is clear of sperm, other birth control methods should no longer be needed.
The best way to know whether sperm cells have cleared is to have a semen analysis with a urologist.
What happens to sperm cells after a vasectomy?
Instead of being ejaculated, sperm cells are absorbed by the body. This process is harmless.
What is sex like after a vasectomy?
Sex drive and orgasms feel the same as they did before the procedure. Semen volume should also be about the same, as sperm makes up a small percentage. Partners don’t feel a difference either.
Some men find sex to be more exciting after a vasectomy because they can be more spontaneous. The anxiety of unwanted pregnancy is reduced.
Does a vasectomy protect against sexually transmitted infections?
No. While vasectomies are extremely effective in preventing pregnancy, they do not protect against sexually transmitted infections (STIs) like HIV, HPV, and gonorrhea. Couples should still practice safe sex by using condoms and/or dental dams. Regular testing for STIs may also reduce the risk of transmission.
Can a vasectomy be reversed?
Yes. In general, vasectomy is considered a permanent decision, and men should think carefully before having one. But there are times when a man decides he would like to father children after all. That’s when a vasectomy reversal may be considered.
A vasectomy reversal procedure reconnects the ends of the vasa deferentia, giving sperm cells a clear path out of the body. (In some cases, the end of a vas may need to be connected to the epididymis, a coiled tube that links a testis with a vas deferens. The epididymis stores sperm cells.)
Vasectomy reversals are more involved than vasectomies, and they don’t always lead to pregnancy. Success can depend on how much time has passed between the vasectomy itself and the reversal. The longer the time frame, the less likely a pregnancy will happen.
It also takes time—sometimes a few months to a year—before sperm cells reappear in the semen.
Other factors, including a man’s overall health and the health and age of his partner, play a role in getting pregnant, too.
Besides vasectomy reversal, are there other ways to become a biological father after having a vasectomy?
Yes. It might be possible to retrieve sperm cells from the testes. These cells can then be used for in vitro fertilization (IVF).
Some men have their sperm frozen and stored by a sperm bank before their vasectomy, just in case they change their mind about fatherhood later.
“You are what you eat” has been a popular phrase in English for decades. And it makes sense. Much of a person’s overall health is linked to their eating habits. A balanced, nutritious diet can lower risk for a variety of health conditions, like heart disease and diabetes. And a diet full of fast food and TV dinners could have the opposite effect.
Scientists have studied the way a man’s eating habits may affect his ability to get erections. Not surprisingly, men with healthier diets often fare better.
This notion applies to sexual health, too. For example, scientists have studied the way a man’s eating habits may affect his ability to get erections. Not surprisingly, men with healthier diets often fare better.
So what should men eat? While choosing healthy foods is wise, researchers have found that the Mediterranean diet could be an easy, effective path to better erections in the future.
For example, a 2020 JAMA Network Open study investigated the link between diet and erections in over 21,000 men aged 40 to 75 living in the United States. The researchers discovered that men who followed a Mediterranean or similar diet were less likely to have erectile dysfunction (ED) compared to those who didn’t.
And in 2021, researchers presented preliminary results on this topic at the European Society of Cardiology’s annual meeting. After reviewing data from 250 men with high blood pressure and ED, they reported that the Mediterranean diet could be linked to better erectile function.
What is a Mediterranean Diet?
A Mediterranean diet is widely eaten in countries around the Mediterranean Sea, such as Spain, Italy, and Greece.
A Mediterranean diet is widely eaten in countries around the Mediterranean Sea, such as Spain, Italy, and Greece. Because it encompasses a variety of cultures, there’s no one “official” Mediterranean diet. But diets in this geographic area have some similarities:
More plant-based foods. Fruits, vegetables, whole grains, nuts, and legumes (like beans and chickpeas) are staples of a Mediterranean diet.
Limited red meat, eggs, and dairy. Red meat is seldom eaten on a Mediterranean diet. Eggs and butter are used sparingly.
Moderate amounts of lean meats. Mediterranean diet followers eat poultry, like chicken and turkey, every once in a while.
More seafood. Fish and shellfish—such as salmon, tuna, and clams—might be eaten several times a week.
Healthy fats. Monounsaturated fats, like olive oil and avocados, are favored over saturated fats and trans fats, which are found in items like red meat, cakes, cookies, and processed foods.
Fewer desserts. Sweets and traditional desserts are eaten in moderation. Fruit is a frequent dessert substitute.
Alcohol. Alcoholic beverages, such as red wine, are included in a Mediterranean diet, but only if safe to do so. People should avoid alcohol if they are pregnant, tend to misuse alcohol, or have a health condition that worsens with alcohol use.
Fewer processed foods. Following a Mediterranean diet often means preparing meals from fresh, basic ingredients rather than relying on processed foods.
Mediterranean Diet and ED: What’s The Connection?
How might a Mediterranean diet help with a man’s erections?
It’s good for the cardiovascular system
This system includes the heart and the roughly 60,000 miles of blood vessels throughout the body. Some of these blood vessels are in the penis. Because a firm erection depends on blood flow, these blood vessels need to be clear.
Research suggests that the Mediterranean diet keeps the lining of blood vessels healthy and reduces the risk of atherosclerosis (hardening of the arteries), which can interfere with blood flow. With the path open, blood can flow to the penis—and form an erection—more easily.
It helps with the production of nitric oxide
This chemical plays an important role in erections. Before blood can flow into the penis for an erection, the arteries need to relax and dilate. Nitric oxide is essential for this process.
It lowers a man’s risk for diabetes
Men with diabetes are at higher risk for ED than men without diabetes. They also tend to get ED several years earlier.
High blood sugar can damage blood vessels and nerves. As noted above, blood vessel damage can limit blood flow into the penis. And nerve damage can interfere with signals from the brain that “tell” the penis to start an erection when a man is sexually aroused.
It helps with weight management
The heavier a man is, the higher his risk for ED. A healthy diet, combined with physical activity, can be a good way to manage weight. That said, people still need watch their calories, even with a Mediterranean diet.
Putting it All Together
So can eating a Mediterranean diet prevent ED altogether? Could it cure ED?
Scientists aren’t sure yet, but they’re interested in finding out. For now, research suggests that men who follow a healthier diet could be less likely to develop ED later. But researchers don’t know yet whether diet can prevent ED altogether or whether changing dietary habits can improve ED in men who already have trouble with erections.
The good news, however, is that a healthy diet benefits the body from head to toe. And many people find that taking care of the whole body improves their sexual health as well as their overall wellbeing.
Jimenez-Torres, Jose, et al. “Mediterranean Diet Reduces Atherosclerosis Progression in Coronary Heart Disease: An Analysis of the CORDIOPREV Randomized Controlled Trial” (Originally published: August 10, 2021) https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.120.033214
Prostate Cancer Myths and Popular Beliefs: What’s True and What’s Not True?
Men looking for information on prostate cancer have a lot of information to sift through. And while there is plenty of reliable information out there, there are also quite a few myths and misconceptions swirling around, often spread online through unreliable sources or by word via well-meaning but uninformed people.
But it’s important to know the facts. Prostate cancer is the second most common cancer in men, according to the American Cancer Society. In fact, about 1 in 8 men will be diagnosed with prostate cancer during their lifetime.
The goal of this article is to debunk false information and clarify some of the issues medical scientists still debate. For topics still in debate, we put this information into context using current, peer-reviewed research.
Here are some of the most common questions and areas of debate.
Do vasectomies raise a man’s risk for prostate cancer?
When considering their birth control options, many men choose vasectomy. This surgical procedure is simple, safe, and effective, with an estimated success rate of 99.95%.
For many years, scientists have investigated whether a vasectomy can raise the risk of prostate cancer.
Over the last few years, it has been reported that vasectomies do not cause prostate cancer. The Mayo Clinic reports that “[a]lthough there have been some concerns about a possible link between vasectomy and testicular or prostate cancer in the past, there’s no proven link.”
It’s possible that vasectomy itself might not increase risk, but more prostate cancer cases might be discovered during pre-vasectomy medical exams.
Does frequent ejaculation reduce risk for prostate cancer?
Scientists have studied the relationship between ejaculation frequency and prostate cancer for several years. Some think that ejaculation flushes out harmful substances in the semen that could be linked to prostate cancer.
Research results have been mixed. For example, the authors of a 2018 Journal of Sexual Medicine study found that men who ejaculate 2 to 4 times a week were at lower risk for prostate cancer. But other researchers have reported no association.
Does eating flaxseeds affect prostate cancer risk?
Flaxseeds are a popular dietary supplement. They are thought to help with constipation, diabetes, heart disease, and other conditions. Could prostate cancer be another?
Scientists don’t know for sure. Flaxseeds contain phytoestrogens, which are similar to estrogen, a hormone naturally produced by the body. Some researchers believe that this property might affect the risk of hormone-related cancers, like prostate cancer. Other studies have found that flaxseeds don’t impact prostate cancer risk at all.
Nowadays, the effects of flaxseeds on prostate risk isn’t clear, and scientists continue to study the relationship.
The effects of flaxseeds on prostate risk isn’t clear
However, some experts suggest that men who already have prostate cancer might benefit from flaxseeds, as flaxseeds have been associated with lower PSA levels and decreased tumor aggressiveness. (PSA is a protein made by the prostate. Lower PSA levels suggest that prostate cancer cells are growing more slowly.)
Can pomegranate reduce or slow down prostate cancer growth?
In the past, studies have suggested that drinking pomegranate juice might slow the growth of prostate cancer cells. It was thought that pomegranates contained antioxidants and other substances that might reduce inflammation and lower PSA levels.
However, experts now report that there isn’t enough evidence to support the use of pomegranate for the treatment or prevention of prostate cancer.
Is prostate cancer less dangerous than other types of cancers because it grows more slowly than other types of cancers?
Many men with prostate cancer have a good prognosis, especially if the cancer is caught early and hasn’t spread outside the prostate gland. Prostate cancer tends to grow slowly, and men might not need treatment right away. (In this case, they might opt for active surveillance: Their cancer will be closely monitored, but they won’t receive treatment until they have symptoms or until the cancer becomes more aggressive.)
However, this isn’t the case for all men. The American Cancer Society estimates that 268,490 new cases of prostate cancer will be diagnosed in 2022, and about 34,500 men will die of the disease this year.
So the answer is, “No, it’s not less dangerous.” Men need to follow their doctor’s treatment instructions as prescribed and keep themselves as healthy as they can. Doctors can guide men on healthy lifestyle habits.
Is prostate cancer a disease of older men only? Do young men ever get prostate cancer?
It’s true that prostate cancer is more common in older men. According to the American Cancer Society, about 60% of new prostate cancer cases are diagnosed in men aged 65 or older. The average age at diagnosis is 66. And prostate cancer is rare in men younger than 40.
But that doesn’t mean prostate cancer isn’t possible in younger men. Forty percent of new cases are in men under age 65. And some men have risk factors, such as a family history of prostate cancer, that could make them more vulnerable when they’re younger.
Men who are concerned about their prostate cancer risk should ask their doctor about screening.
Does prostate cancer run in families?
Scientists aren’t certain what, exactly, causes the disease
Prostate cancer can run in families. If a man has a first-degree relative (parent or brother) with prostate cancer, his risk for developing prostate cancer is about 2 to 3 times higher than average. His chances of having prostate cancer go up even higher if he has more than one first-degree relative with prostate cancer and if these relatives were diagnosed at a younger age.
Still, most cases of prostate cancer are not family-related. Scientists aren’t certain what, exactly, causes the disease.
Can an enlarged prostate (aka BPH) lead to prostate cancer?
It is possible for a man to have an enlarged prostate and prostate cancer, even at the same time. But there’s nothing about an enlarged prostate that makes a man more likely to get prostate cancer.
The medical term for an enlarged prostate is benign prostatic hyperplasia (BPH). The word benign is an important one here, as it means there is no cancer present. As a man gets older, his prostate gland usually becomes larger. For some men, this isn’t a problem. But for others, the prostate growth squeezes the urethra (the tube that allows urine to exit the body) and makes urination difficult.
Enlarged prostate and prostate cancer do have similar symptoms, including trouble passing urine. Men who experience these symptoms should see their doctor for a checkup. (Learn more about enlarged prostate treatments.)
Does prostate cancer always have symptoms?
Actually, prostate cancer often has no symptoms, especially in its early stages. That’s why it’s so important to be screened, especially for men with risk factors.
Prostate cancer often has no symptoms
Common symptoms include urination difficulties, painful ejaculation, and blood in the urine or semen. Other urologic conditions, such as prostatitis (inflammation of the prostate), can have these symptoms, too. That’s why doctors do a complete checkup if men have these symptoms.
Is PSA testing reliable for diagnosing prostate cancer? Does having a high PSA level means a man has cancer?
PSA stands for prostate-specific antigen, a protein produced by the prostate. It is used to screen for prostate cancer, but it is not the only test that is used.
Having high levels of PSA could mean that a man has prostate cancer. But it could mean other things as well. For example, men with prostatitis or an enlarged prostate (benign prostatic hyperplasia or BPH) may also have elevated PSA levels.
If a man’s PSA screening shows high PSA levels, his doctor will consider his health history, symptoms, and the results of other tests (such as a digital rectal exam) to decide how to proceed. If prostate cancer is suspected, a biopsy may be done. During a biopsy, a small portion of prostate tissue is removed and examined for cancer cells.
Does having a prostate biopsy cause cancer to spread? Can prostate cancer cells “break off” during a biopsy?
If a doctor suspects prostate cancer due to a man’s symptoms, family history, etc., a prostate biopsy is usually the next step in evaluation. During a biopsy, a surgeon removes a small piece of tissue. A pathologist examines the sample under a microscope. If cancer cells are found, doctors use biopsy information to determine the stage and grade of the cancer and develop a personalized treatment plan.
Some patients worry that cancer cells can break off and spread during the biopsy procedure.
While there have been case reports of this happening, it is quite rare. The benefits of having a biopsy far outweigh the risk of cancer cells spreading during the procedure.
Does prostate cancer always require surgery?
Radical prostatectomy — the surgical removal of the prostate gland — is a common prostate cancer treatment.
But not all men with prostate cancer have surgery. For example, radiation, chemotherapy, and hormonal therapy are other treatment options.
In some cases, the cancer doesn’t need to be treated right away. As mentioned above, some men may choose active surveillance. If their cancer doesn’t appear to be aggressive, they may hold off on any treatment. At that point, a healthcare professional regularly monitors their cancer’s progress, and treatment begins only when necessary.
When recommending prostate cancer treatment, specialists consider many factors, including the stage and risk level of the cancer and the patient’s age, overall health, and treatment preferences.
Note: Another surgical option is orchiectomy — removal of the testicles. These organs produce testosterone, a hormone that helps prostate cancer cells grow. Removing the testicles greatly reduces the amount of testosterone available to cancer cells.
Can prostate cancer negatively affect a man’s sex life? Do men still enjoy sex after prostate cancer treatment?
Sexuality is a big concern for men with prostate cancer, and rightly so. Certain treatments, such as surgery to remove the prostate gland (radical prostatectomy), can damage the nerves responsible for erections. This can lead to erectile dysfunction (ED). Treatments might also change the way that ejaculation and orgasms feel.
Fortunately, there are treatments available for ED and other sexual issues. It may take some time and adjustments, but men can still enjoy sex after prostate cancer.
Does prostate cancer impact a man’s fertility?
Prostate cancer treatment may make it more difficult for a man to father a child. Some men have their testicles removed as part of prostate cancer treatment, and without these organs, they cannot produce sperm. If the prostate and seminal vesicles are removed, there will be no prostatic fluid produced to protect sperm cells.
Radiation and chemotherapy can affect the production of sperm and prostatic fluid, too.
Some men bank their sperm before their treatment begins. With this method, their sperm is frozen and used later for in vitro fertilization. It may also be possible to extract sperm from the testicles, if they haven’t been removed.
Surgery for Localized Prostate Cancer – Weighing Your Options
Men who have been diagnosed with prostate cancer typically have many questions. That is certainly understandable. Perhaps the most common question: What can you expect from treatment?
Treatment decisions are often based on the extent of the cancer. The term localized is used to describe prostate cancer that hasn’t spread outside the prostate gland. Another term for localized cancer is organ-confined cancer.
A cancer diagnosis typically includes a discussion of cancer stages– the degree to which the cancer has progressed. Here’s an overview:
Stage 1.
Stage 1 is the earliest stage of prostate cancer, when cells are not growing as quickly. The tumor can’t be detected during a digital rectal exam (DRE).
Stage 2.
During stage 2, the tumor is confined to the prostate gland. The tumor might be detected during a DRE. At this stage, the cancer is still found only in your prostate gland, but the risk of it growing and spreading to other areas is higher.
Stage 3.
During stage 3, the tumor is growing. At this point, it is likely to continue to grow and may begin to spread, even to other areas of the body, like the seminal vesicles (glands that produce seminal fluid), bladder, or rectum.
Stage 4.
At stage 4, cancer has spread outside the prostate gland. It is no longer localized.
Treatment decisions are often based on the extent of the cancer.
Localized prostate cancer is treated in several ways. A combination of treatments may be recommended. Here are some examples:
Active surveillance involves monitoring the cancer through regular tests. Treatment begins if and when necessary.
Watchful waiting is a wait-and-see approach similar to active surveillance. However, regular testing is not done.
Radiation therapy uses high energy rays to destroy cancer cells or slow down their spread.
Hormonal therapy (also called androgen deprivation therapy or ADT), cuts the supply of testosterone and other male hormones that fuel the growth of prostate cancer cells.
Cryotherapy (cryoblation) destroys cancer cells by freezing them.
Surgery is another option.
The surgical procedure for treating localized prostate cancer is called a radical prostatectomy, and it involves removing the entire prostate, seminal vesicles, and some surrounding tissue. Sometimes, lymph nodes are also removed.
By far, the most common procedure is robot-assisted laparoscopic prostatectomy (RALP).
Robotic surgery is routine nowadays
In laparoscopic procedures, about 6 small 1- to 2-inch incisions are made in the abdominal wall. These incisions are called “ports,” and they provide access for surgical instruments. One of the instruments, the laparoscope, includes a tiny camera that guides the surgeon’s movements.
With a robotic procedure, the surgeon sits at a computer monitor and controls the movements of a robot that holds the instruments. Robotic surgery is routine nowadays, and surgeons using this technology receive thorough training.
Laparoscopic prostatectomies can be done without robots, too. In a traditional laparoscopic procedure, the surgeon holds the instruments.
In rare cases, an open prostatectomy is performed. In an open procedure, the surgeon will remove the prostate through one long incision (about 8 to 10 inches). Usually, the incision is between the belly button and pubic bone (called a radical retropubic prostatectomy) or between the anus and scrotum (a radical perineal prostatectomy).
No matter the type of surgery, there are two potential key complications to prepare for:
Erectile dysfunction (ED)
ED is difficulty getting and keeping an erection rigid enough for intercourse. It’s not uncommon after prostate cancer surgery. That’s because the prostate gland is surrounded by nerves that are essential for erectile function. While surgeons take care to preserve as many nerves as possible, some nerve damage can occur.
Often, men undergo nerve-sparing procedures. In these cases, the surgeon takes special measures to keep erectile nerves intact. Research suggests that nerve-sparing surgeries have better erectile function outcomes than non-nerve-sparing procedures.
Many men find their erectile function improves over time, but recovery will likely require patience. It can take up to two years after surgery to see sustained progress in erectile firmness. Fortunately, there are several treatments for ED.
Incontinence
Leaking urine after prostatectomy is quite common. It might be difficult to empty your bladder, or urine might leak when coughing or working out. Some men feel like they have to urinate right away. This side effect usually goes back to normal within a few months, but it can be frustrating while enduring it. Various assistive and therapeutic strategies are available.
Older men are more likely to have trouble with erections or incontinence than younger men. However, both conditions can be treated in men of all of ages.
Is Robot-Assisted Laparoscopic Prostatectomy (RALP) Better Than Open Prostatectomy?
Not necessarily. All types of surgery are effective for removing the prostate gland and treating prostate cancer. And the sexual and urinary side effects are similar for all approaches.
However, laparoscopic approaches do have some advantages over open prostatectomy:
They’re less invasive.
They use smaller incisions, which heal more quickly.
There is typically less bleeding and less pain.
Most men have shorter hospital stays (usually about a day or two, compared to a few days with open prostatectomy).
Men are catheterized for a shorter period of time. (A catheter is a thin tube that allows urine to flow from the bladder to a collection bag.)
How about robotic vs. traditional laparoscopic prostatectomy? Research presented in 2020 suggests that men who have robotic procedures have better bladder control after surgery. Future research may shed more light on this issue.
The decisions we make with our patients about their treatment path require processing and understanding a good deal of information. Questions are always welcome. Comprehensive support will be provided both before and after surgery.
You might already have an exercise program for toning your abs, biceps, triceps, hamstrings, and quads. By stressing your muscles through exercise, you can improve stamina, posture, and mood, reduce the risk for chronic disease, and generally support your overall health.
How about your pelvic floor?
Your pelvic floor muscles support your pelvic organs, including your bladder. They are sometimes compared to a hammock—a layer attached to your sit bones (i.e., bones in the lower part of your pelvis), tail bone, and pubic bone—that keeps your pelvic organs in place.
Just like any muscle group, your pelvic floor can weaken over time. This happens as we age, but it can also happen after certain circumstances, such as pregnancy, childbirth, or prostate surgery. Being overweight can take a toll on pelvic floor muscles, too.
Just like any muscle group, your pelvic floor can weaken over time.
It’s easy to keep your pelvic floor muscles in shape. Kegel exercises (also called pelvic floor muscle training) have been around for decades. They were first developed by American gynecologist Arnold Kegel in the 1940s. But they’re not just for women. Men benefit from Kegels too.
Why should men and women do Kegels?
Urologists often recommend Kegel exercises to people with overactive bladder, pelvic organ prolapse, and other urologic issues, such as incontinence (urine leakage). Strengthening and toning pelvic floor muscles can help with these problems.
Kegels can have sexual benefits, too. Men may have improved erections. Women who do Kegel exercises regularly often find that vaginal penetration becomes more comfortable. Orgasms may intensify for both men and women.
One you learn the technique, Kegel exercises are easy to do. You need no special equipment, and they can be done anywhere. They’re also discreet; nobody will know when you’re doing Kegels.
Note: Kegels aren’t appropriate for everyone. In some cases, pelvic floor problems develop because the muscles are too tense and are difficult to relax, making Kegels less effective. Your doctor can guide you on your personal situation.
How do I get started with Kegels?
While Kegels are simple, they need to be done correctly, so talk to a doctor or other healthcare professional before making them part of your routine.
The most important aspect of Kegel exercises is making sure you’re working the right muscle group. Here are some ways to make sure:
Imagine that you’re about to pass gas. Squeeze the muscles that would stop you from doing so. The pulling sensation you feel when you squeeze indicates your pelvic floor muscles.
The next time you urinate, stop the urine flow midstream, paying attention to the muscles you use. If you can stop the flow, you have found your pelvic floor muscles.
Women might try putting a finger inside their vagina, then imagining they’re stopping their urine stream. When squeezing the muscles, they should feel a tightness around their finger.
It can take time and practice to determine which muscles to target.
Each time you squeeze those muscles, you’re doing a Kegel.
At first, try holding each Kegel for a second or two. Then relax for a few seconds. Then Kegel again. This pattern of repeated squeezing and relaxing is the core component of a Kegel exercise program.
Over time, as your pelvic floor starts to strengthen, you should find that you can hold Kegels for longer durations. Ten seconds is a good goal, but if you can’t do it at first, that’s fine. Your ability to hold the Kegel for longer periods of time should improve with repetition.
Create a Kegel exercise plan
Once you’ve gotten the hang of Kegels, make them a daily routine. Some experts recommend doing Kegel exercises 3 times a day in sets of 10 to 15 squeeze-relax repetitions (sometime called reps).
You can also vary your position. Consider doing some of your Kegels while standing, others while sitting, and the rest while lying down.
Another way to vary your Kegels is to do short or long reps. Short reps are quick in succession: you hold each Kegel for a couple seconds, relaxing for a few seconds in between each one. For long Kegels, you hold each Kegel for a longer period (such as 10 seconds) with an equal rest time in between each one. Doing short and long reps gives your pelvic floor more comprehensive training.
A word about weights: Some people use special weights or cones to enhance their Kegel practice. You might see some of these products for sale. Such devices should be purchased and used only with the guidance of a qualified healthcare professional.
Tips for doing Kegel exercises
As you start out with Kegels, keep these tips mind:
Make sure you’re relaxing your pelvic floor muscles between each Kegel squeeze. This resting period is part of the program and to avoid injury, it’s important not to skip it.
Make sure the muscles in your stomach, back, thighs, and buttocks stay relaxed while you do your Kegel exercises. Focus on your pelvic floor only.
Breathe normally. Don’t hold your breath while you’re doing Kegels.
Don’t do Kegel exercises while you’re urinating. This can actually weaken the pelvic floor and damage your kidneys and bladder.
Don’t overdo it! As the saying goes, “all things in moderation.” This idea applies to Kegels. If you do too many Kegels, your pelvic floor can become too tight, and that can lead to urine leaks, pelvic organ prolapse, and sexual pain.
Getting Results
Once you start a regular routine of doing Kegels, you should start seeing a difference in about 4 to 6 weeks. This might mean fewer urine leaks, fewer trips to the bathroom, or improved sexual health. However, for some people, improvement takes longer, so we encourage you to stick with it.
What You Should Know About Kidney Stones During Pregnancy
Kidney stones are a fairly common urological problem, affecting about 1 in 10 people at some point in their life. But kidney stones can be a particular challenge for pregnant women. The way stones are diagnosed and treated may need to be adjusted during pregnancy for the safety of the mother and her baby.
Still, pregnant women with kidney stones have several treatment options. And it’s important to know that without treatment, kidney stones can lead to premature labor, so it’s necessary to address them.
What are kidney stones?
Kidney stones are small, crystallized masses that form in the kidneys or ureters (the tubes connecting the kidneys to the bladder). Most stones are made from calcium, but they can also be formed from uric acid, struvite, and cystine, which are naturally occurring compounds in the human body. Kidney stones come in various shapes and sizes and can be smooth or jagged, small as a pea, or as large as a golf ball.
Most kidney stones are small enough to pass through the urinary tract on their own. A person with a small kidney stone might not have any symptoms.
But larger stones can block urine flow and cause a significant amount of pain. In fact, abdominal pain is one of the most common symptoms of kidney stones. Some people have nausea and vomiting, along with a need to urinate more urgently and frequently. Blood in the urine is another symptom.
How common are kidney stones in pregnant women?
It’s estimated that kidney stones occur in about 1 of every 500 to 3,000 pregnancies, so having kidney stones during pregnancy is fairly rare.
However, research suggests that risk for first-time kidney stone formation is higher at certain points in a pregnancy.
In 2021, the American Journal of Kidney Diseases published a study on the topic. Researchers found that in pregnant women, risk for developing first-time symptomatic kidney stones increased during the second and third trimesters of pregnancy.
Interestingly, the peak time to develop kidney stones was during the first 3 months after delivery. About a year after the delivery date, risk returned to pre-pregnancy levels.
Risk was higher in pregnant women who were obese.
Why are pregnant women more at risk for kidney stones?
Pregnant women are more prone to kidney stones for the following reasons:
Pregnant women are more susceptible to dehydration. A growing baby puts pressure on a woman’s bladder, increasing the need to urinate. As a result, pregnant women might not drink as much fluid as they should, and dehydration can lead to kidney stones.
Changes occur in urine composition during pregnancy. Pregnant people tend to have more calcium in their urine, and most kidney stones are calcium-based.
Hormonal changes in pregnant women make it more difficult to clear urine from the body. Pregnant women have higher levels of the hormone progesterone, which contributes to urinary stasis (halting of or slowing of urine flow). As a result, stone-forming compounds have more opportunity to crystallize.
How are kidney stones diagnosed in pregnant women?
Diagnosis starts with a medical history. Designing a personalized treatment plan requires knowing more about your symptoms, your pregnancy, and your medical background.
Lab tests are also an important diagnostic tool. These include blood tests and urine tests. Urine tests may reveal if stone-forming substances are present.
Imaging tests may also be ordered. These tests can reveal the location, size, and shape of any kidney stones:
Ultrasound. Ultrasound technology uses sound waves to create images of internal organs. (It’s also used to monitor the development of a baby in the uterus.) No radiation is used with ultrasounds, so they are perfectly safe for both the patient and the fetus. For a kidney stones diagnosis, ultrasound technicians focus on the kidney and pelvic area.
Magnetic resonance (MR) urography.Urography refers to imaging of the urinary tract: kidneys, ureters, bladder, and urethra. Magnetic resonance (MR) technology creates images using magnet and radio waves. Like ultrasound technology, MR does not use radiation.
Low-dose computed tomography (CT scan). A CT scan (sometimes called a “cat scan”) uses x-rays to create images. Because this method does involve radiation, it is recommended for the second and third trimesters only, not the first trimester.
How are kidney stones treated in pregnant women?
Kidney stone treatment in pregnant women requires a team approach. Urologists work with obstetricians and other healthcare specialists to make sure treatment is safe and appropriate.
Initial therapies may include the following:
Observation. Generally, treatment starts with observation, a “wait and see” approach, as most stones pass on their own. Some doctors recommend bed rest, increased fluid intake, and a low-salt diet.
Pain relief. Patients might be given pain relievers, such as acetaminophen. Other medications, such as non-steroidal anti-inflammatory drugs (NSAIDS) might be prescribed depending on the stage of the pregnancy. Patients should take their medication exactly as prescribed.
Hydration. Patients may be advised to drink more fluids. Others may receive hydration via intravenous (IV) fluids at the doctor’s office to help stones pass.
If stones do not pass easily, procedures to extract stones or effect passage of urine around stones are considered. If symptoms are not severe, such procedures might be delayed until after the baby is born. In the case of more serious symptoms, trouble urinating, or a urinary tract infection, the patient may undergo treatment during the pregnancy. (In emergencies, these procedures might take place right away.)
The treatment team will carefully consider choices related to any anesthesia and related drugs given during these procedures.
Procedures to extract stones or effect passage of urine around stones include the following:
Ureteroscopy. Patients undergoing ureteroscopy receive anesthesia. Once it has taken effect, the urologist places a long, thin instrument called a ureteroscope through the urethra and bladder to the ureter or kidney. The ureteroscope is like a tiny telescope that allows the doctor to see into the affected area. The ureteroscope also has a grasping mechanism that allows it to either remove the stone or break it into smaller stones that can pass through urine.
Stent. A stent is a plastic tube that is surgically placed in the ureter to keep it open. With a stent, urine—and the stone—may flow through the ureter more easily. Stents are temporary; in pregnant patients, they are usually replaced every 4 to 6 weeks.
Nephrostomy tube. A nephrostomy tube is a type of catheter used to drain urine from the kidney. Typically, urine flows from a kidney to the bladder through a ureter that connects these two organs. With a nephrostomy tube, urine bypasses the ureter and bladder. The surgeon creates a special opening called a stoma on the patient’s side. The nephrostomy tube runs from the kidney and through the stoma, connecting to a urine collection bag outside the body.
Like stents, nephrostomy tubes are temporary and may need to be changed periodically. Patients receive thorough instructions on the care of their tube and the changing of their urine collection bag.
Resources
American Academy of Family Physicians
“Magnetic Resonance Imaging (MRI)” (Last updated: June 23, 2020) https://familydoctor.org/magnetic-resonance-imaging-mri/
American Journal of Kidney Diseases
Thongprayoon, Charat, et al. “Risk of Symptomatic Kidney Stones During and After Pregnancy” (Published: April 15, 2021) https://www.ajkd.org/article/S0272-6386(21)00402-9/fulltext
American Urological Association
Assimos, Dean, et al. “Surgical Management of Stones: AUA/Endourology Society Guideline (2016)” (Published: 2016) https://www.auanet.org/guidelines/guidelines/kidney-stones-surgical-management-guideline
Healthline.com
Seladi-Schulman, Jill, PhD “Caring for Your Nephrostomy Tube” (Update: September 18, 2018) https://www.healthline.com/health/nephrostomy-tube-care
MedlinePlus.gov
“CT Scans” (Page last updated: April 12, 2021) https://medlineplus.gov/ctscans.html
“Ultrasound” (Page last reviewed: December 15, 2020) https://medlineplus.gov/lab-tests/sonogram/
Semins, Michelle J. and Brian R. Matlaga “Kidney stones during pregnancy” (Published online: February 11, 2014)https://www.nature.com/articles/nrurol.2014.17″ https://www.nature.com/articles/nrurol.2014.17
O’Dwyer, Marie Claire, MB BCh BAO, MPH “Are Pregnant people More Likely to Develop Kidney Stones?” (September 22, 2021) https://www.jwatch.org/na54060/2021/09/22/are-pregnant-women-more-likely-develop-kidney-stones
UpToDate
Preminger, Glenn M., MD and Gary C. Curhan, MD, ScD “Kidney stones in adults: Kidney stones during pregnancy” (Topic last updated: November 11, 2021) https://www.uptodate.com/contents/kidney-stones-in-adults-kidney-stones-during-pregnancy
Urology Care Foundation
“Pregnancy and Kidney Stones” (Summer 2019) https://www.urologyhealth.org/healthy-living/urologyhealth-extra/magazine-archives/summer-2019/did-you-know-pregnancy-and-kidney-stones
“Preventing and Treating Kidney Stones” (Summer 2014) https://www.urologyhealth.org/healthy-living/urologyhealth-extra/magazine-archives/summer-2014/preventing-and-treating-kidney-stones
Physicians have been using urinalysis, or urine testing, as a diagnostic tool for about 6,000 years. Nowadays, with updated and improved methods, it remains an effective, quick, and easy way to find out more about your overall health. In fact, you may have already had one at an annual physical or other medical appointment.
In our office, we use urinalysis to diagnose urologic conditions, like kidney stones and urinary tract infections. We also use urine tests to monitor your progress if you’ve already been diagnosed.
What do we look for?
A urinalysis has 3 main parts: a visual test, a microscope test, and a dipstick test
In general, a urinalysis has 3 main parts:
A visual test
The color of your urine can tell us a lot. Normal urine is usually clear or pale yellow. But if it has a red, pink, or brown tint to it, that could signify blood in your urine (hematuria). If it’s cloudy, you might have an infection. If it’s foamy, that could be a sign of kidney disease.
A microscope test
We use a microscope to look for what isn’t so obvious. For example, blood can be present in your urine even if it looks normal. This is called microhematuria. The blood cells are so small, you can’t see them with the naked eye. They can be detected only with a microscope.
In addition, a microscope test can show bacteria and white blood cells – two signs of infection. It might also show us crystals in your urine that could eventually develop into kidney stones.
A dipstick test
This test tells us whether certain chemicals or other substances, such as proteins and sugars, are in your urine. It measures your urine’s acidity (pH). A higher pH might indicate kidney stones, urinary tract infections, or other urological conditions. It also measures the concentration (also called the specific gravity) of your urine, which tells us how hydrated you are.
The dipstick itself is a strip of specially-treated plastic that we place in your urine sample. If certain chemicals are present or fall within abnormal ranges, areas of the dipstick will change color.
Sometimes, a dipstick test is done with tablets placed in the urine sample. But the general idea is the same; the tablets can detect certain chemicals in the urine.
Taken together, all of these analyses give clues that help us diagnose your urological problem. We’ll also conduct a physical exam and consider your health history, family medical history, medications, and lifestyle habits to get a complete picture.
We use urinalysis to diagnose urologic conditions, like kidney stones and urinary tract infections
How do I prepare for a urine test?
We can do a urinalysis here at the office. Or you might prepare your urine sample at home and bring it to us. We’ll give you specific instructions ahead of time. For example, we might ask for a fasting urine sample taken first thing in the morning. If that’s the case, then you’ll collect your urine before eating anything that day.
We might also advise you not to take certain medications or supplements beforehand, as these can affect the results. Similarly, some foods and beverages can make urine change color. We’ll let you know the specifics for your urine test. And as always, if you have any questions, please give us a call.
What is a “clean-catch” sample?
Giving a urine sample is fairly simple, but it’s important for it to be a clean-catch sample. When you urinate, germs from your genital area can mix in with urine. The clean-catch method eliminates this mixing as much as possible.
For this test, we’ll give you a clean catch kit. Your kit will contain sterile wipes, a sterile cup, and a label with your name on it.
Start by washing your hands thoroughly with soap and water. Take the lid off the cup.
Use the sterile wipes to clean your genitals before you urinate. Women will wipe the inner folds of their labia and the area around their urethra. Men will clean the tip of their penis. (Uncircumcised men should retract their foreskin first.)
Next, start urinating into the toilet bowl. Then stop for a moment. In other words, hold the flow of urine.
Carefully position the cup so that urine can flow into it.
When the cup is about halfway full, stop the flow again. Put the cup aside and finish urinating into the toilet bowl.
Put the lid securely on the cup without touching the inside. Be sure not to touch the urine either.
We’ll let you know where to place your sample. If you collect your sample at home, it should be refrigerated unless we tell you otherwise.
Once your sample is analyzed by the lab, we’ll contact you and go over the results and next steps.
Urinalysis doesn’t always give a complete picture of your health, but it will tell us what needs watching and follow-up. Remember, we are always here to answer your questions.
Resources
European Association of Urology
“Urine Test” (Last updated: February 2021) https://patients.uroweb.org/tests/urine-test/
HealthCommunities.com
“Urinalysis” (Page last modified: July 23, 2015) [Accessed via www.archive.org]
“Clean catch urine sample” (Page last updated: January 5, 2021) https://medlineplus.gov/ency/article/007487.htm
“Urinalysis” (Page last updated: June 9, 2020) https://medlineplus.gov/urinalysis.html
National Kidney Foundation
“What is a Urinalysis (also called a “urine test”)?” https://www.kidney.org/atoz/content/what-urinalysis
StatPearls [Internet] via PubMed.gov
Milani, Daniel A. Queremel and Ishwarlal Jialal “Urinalysis” (Last update: May 9, 2021) https://pubmed.ncbi.nlm.nih.gov/32491617/
Urology Care Foundation
“What is a Urinalysis?” https://urologyhealth.org/urology-a-z/u/urinalysis
WebMD
“The Truth About Urine” (Reviewed: February 15, 2020) https://www.webmd.com/urinary-incontinence-oab/truth-about-urine
Urine Leakage During Exercise
Exercise and Incontinence
You’re on your morning run, or playing tennis, or in a cardio class. Whatever you’re doing, your blood is pumping, and you’re working up a sweat. You’re crushing it!
And then it happens. You feel a little urine leak. Your concentration falters and you feel a sense of dread. Is there a restroom nearby? Will anyone notice?
Urinary incontinence while you’re exercising is pretty common, but that doesn’t make it any less inconvenient or embarrassing. The good news is that there are treatments available to resolve incontinence. You can maintain the exercise program that’s so crucial for maintaining good health.
Why do I leak urine when I exercise?
The culprit is stress urinary incontinence (SUI). Typically, the sphincter muscles in your urethra contact to keep urine in your bladder. When you urinate, these muscles relax, and urine is released.
With SUI, pressure on your bladder or urethra makes the sphincter muscles open, sometimes only momentarily, letting urine out. You might notice urine leakage when you laugh, cough, sneeze, too. That’s also considered “stress” urinary incontinence because it’s the pressure caused by movement that puts pressure on the bladder/sphincter and leads to the leakage of urine.
Other types of urinary incontinence are urge incontinence and overflow incontinence.
What can I do about stress urinary incontinence?
First, come see us. We can evaluate your symptoms and help you work out a treatment plan to offer you long-term relief. Here are some of the options:
Non-Surgical Approaches
Pelvic floor exercises and therapy
Kegel exercises are an easy way to strengthen your pelvic floor muscles. They involve squeezing and releasing these muscles several times a day. We will teach you how to do them. We might also refer you to a pelvic floor physical therapist.
Keeping your pelvic floor muscles strong is essential throughout your SUI treatment. It’s a good idea to exercise them every day.
Bladder training
This approach starts with a bladder diary. You’ll keep a log of how much and how often you drink fluids, urinate, and leak urine. With this information, we’ll work out a urination schedule. For example, you might start by urinating every hour. Gradually, you’ll increase the amount of time between bathroom visits, training your bladder to hold urine for longer periods.
Vaginal pessary (for women)
Some women have SUI due to pelvic organ prolapse, when pelvic organs, such as the bladder or uterus, drop into the vagina. A vaginal pessary is a silicone device you can place in your vagina to give these organs more support. There are several different types of pessaries. Some you can insert and take out yourself; others stay in place for up to three months. We’ll guide you through the process.
Clamp/clip device (for men)
Men can wear a special clamp on the penis that presses against the urethra and restricts urine flow. This device cannot be worn constantly, but it may help in short-term situations.
Surgical Approaches
Stress urinary incontinence can also be treated surgically. Some of your options might include:
Slings. A sling is typically made out of a soft mesh material. In both men and women, a sling can be surgically placed under the urethra to provide support.
Urethral injections (for women). A woman may choose to have a bulking agent injected into her urethra to thicken it and provide support. This is a short-term solution, however, and you may need to have repeat injections after a year or so.
Burch procedure (for women). This technique is also called a bladder neck suspension or retropubic colposuspension. During this procedure, stitches are used to attach the bladder neck and urethra to surrounding abdominal tissue. This supports the urethra and sphincter muscles (the muscles that open and close the urethra).
Artificial urinary sphincter (more common in men). An artificial sphincter is a surgically implanted device. It includes a cuff that is placed around the urethra, a reservoir placed in the abdomen, and a pump. In men, the pump is usually placed in the scrotum; in women, it is placed in the labia. The cuff is filled with fluid and keeps the urethra closed. When you need to urinate, you activate the pump. The fluid then travels from the cuff to the reservoir so that urine can be released. After a few minutes, when you’re finished urinating, the fluid flows back into the cuff to close the urethra again.
Can I still exercise with SUI?
As you can see, there are permanent solutions for urine leaks during exercise. Once you see a urologist and start taking action, you can free yourself from strategies that just hide the problem, like wearing dark clothes and using absorbent products. You’ll no longer have to plan your workout around bathroom breaks, and you’ll have more beverage options when you hydrate.
You’ll also have more choices for exercise, since you won’t be limited to low-impact workouts that put less pressure on your bladder. Instead, you’ll be able to pick other activities, try new ones, or mix and match for variety.
Don’t let incontinence keep you from staying fit. Many people stop their exercise program because of urine leaks, but physical activity is an essential part of staying healthy. Avoiding exercise can raise your risk for other health problems, like obesity and diabetes.
Remember, we are always here to answer your questions and suggest solutions. Just give us a call.
Resources
American Academy of Family Physicians (familydoctor.org)
You probably know that stress can have some negative effects on your health. That missed deadline at work can trigger a pounding headache. Worrying about a sick family member might keep you awake all night. And an unexpected car repair bill can leave a queasy feeling in your stomach.
Stress might have an effect on your fertility as well. While the scientific data isn’t firm, several studies have suggested a link between stress and male infertility.
For example, research has shown that stress may lead to a decline in testosterone, a hormone needed for sperm production.
Research also suggests that men under stress may have poorer semen quality. That means that sperm cells aren’t well-formed and could have trouble swimming and fertilizing an egg cell.
While day-to-day stress is difficult enough, the situation can become compounded if you and your partner have been trying to conceive for a while.
Research also suggests that men under stress may have poorer semen quality
Fertility treatment is complex. You’re juggling appointments with specialists and opening up about a very personal part of your life. You and your partner are likely having emotional ups and downs – feeling sad, optimistic, frustrated, disappointed, hopeful, sometimes in a short period of time.
What can you do? It’s easy for us to say “relax.” But that could be one of the keys to increase your chances of conceiving.
We can’t stop stressful events from happening. But we can control how we react to them. Here are some time-tested stress management strategies that may also work for you:
Put a positive spin on it. If you can, reframe the way you view a problem. Is there a way to turn a negative into a positive? Can you break down a problem into small steps and handle them one at a time? Remind yourself that you are doing the best you can.
Try perspective-building activities. You may have heard the expression, “Don’t sweat the small stuff, and remember… it’s ALL small stuff.” Well, built into disciplines such as meditation, yoga, and tai chi, are exercises that help put the challenges of everyday life into perspective. These activities might help release you from the thought patterns that can lead to unproductive stress. Even just listening to music you enjoy may help transport you to a place where you can view challenges from a fresh perspective.
Participate in activities you enjoy. When you’re involved in activities that bring you joy, it also helps put stress in perspective, or at least puts stress on the back burner. Contemplating fun activities gives you something to look forward to and to reflect back on and has the effect of pushing stress-inducing thoughts to the side. It’s important to find out what brings you peace and happiness and incorporate it in your routine.
Take care of your relationship. You and your partner are a team, not just in your desire to have a child, but in all that you do. Providing the support to your partner that you would hope to receive from her helps you each shield one another from stress-inducing events.
Take care of yourself. It’s easy to let self-care slide when you’re feeling stressed. Make sure you’re eating right, getting enough sleep, and exercising. Exercising regularly is a good way to manage anxiety and depression, too (it impacts brain chemistry). It’s important to limit your use of alcohol or recreational drugs because they have a harmful impact on your physical and emotional health over time and can themselves become stress agents.
Ask for help. Recognize that you may not be able to do everything yourself and there’s no shame in asking for a hand. If your work schedule or responsibilities are too demanding, see if you can adjust your hours or delegate some of your work. The same applies to activities outside of work. See if there is a way to get some help with your to-do list. Even handing off simple chores such as running errands or home maintenance tasks can help reduce your stress levels.. Try not to overextend yourself and feel free to say “no” if someone is asking too much of you – or if you find you’re asking too much of yourself.
Reach out to others. Confiding in a trusted friend or relative may bring comfort, and that person might have insight for dealing with a stress-inducing problem that would otherwise been unobtainable. Support groups, where you can share insights with others experiencing similar challenges, may also be available to you, or to you and your partner.
See a professional. Therapists can help us see our lives with a new perspective. If you find that your stress levels are escalating or tough to manage, seeing a counselor is a wise choice. An objective third party can make suggestions you might not have thought of. If you’d like to see a therapist, let us know. We can refer you to a local professional.
We can’t guarantee that stress management will improve fertility, but taking good care of yourself during this difficult time will produce benefits for you and your partner. Together, you’ll be able to handle what comes next.
