Male Conditions

As a man, it can be difficult to deal with and discuss urologic conditions. Don’t suffer any longer. The expert urologists at Prevea Health can help. Together, our experts have been providing outstanding care to men in our community for more than 15 years. Using the latest treatment and surgical techniques, they will treat your condition and get you back to your healthiest.
 

Our experts also perform vasectomies. The no-scalpel vasectomy procedure is available in Sheboygan.
 

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Benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is a condition that causes the prostate gland to become enlarged, but not cancerous. The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a man’s life. Benign prostatic hyperplasia often occurs during the second growth phase.
 
As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and inability to empty the bladder completely cause many of the problems associated with benign prostatic hyperplasia.
 
Some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia. Symptoms include frequent and urgent urination (eight or more times a day), trouble starting strain of urine and feeling of incomplete bladder empting, a weak or interrupted urine stream, and urinary incontinence.
 
Treatment options include:

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Erectile dysfunction

Erectile dysfunction (ED) is the inability to achieve or maintain an erection firm enough for sexual intercourse. ED can be a total inability to achieve an erection, an inconsistent ability to do so or a tendency to sustain only brief erections.
 
The National Institutes of Health estimates that ED affects as many as 30 million men in the United States. Incidence increases with age: About 4 percent of men in their 50s and nearly 17 percent of men in their 60s experience a total inability to achieve an erection. The incidence jumps to 47 percent for men older than 75. However, ED is not an inevitable part of aging and is treatable at any age.
 
ED often has a physical cause, such as disease or injury. It can also be a side effect of medications. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED.
 
Treatment options may include:
  • Lifestyle changes (e.g.: Quit smoking, reduce alcohol consumption, lose excess weight and increase physical activity)
  • Cutting back on or replacing medicines that could be causing ED
  • Psychotherapy and behavior modifications 
  • Oral or locally injected drugs, vacuum devices and surgically implanted devices

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Male infertility

Infertility occurs when a couple is not able to get pregnant after one year of unprotected sex.
Infertility in men can be caused by different factors and is usually evaluated via a semen analysis. A specialist will evaluate the number of sperm (concentration), motility (movement) and morphology (shape). A slightly abnormal semen analysis does not mean that a man is infertile. However, analysis can help determine if and how male factors are contributing to infertility.

Conditions that can contribute to abnormal semen analyses include: 
  • Varicocele is a condition in which the veins on a man’s testicles are large and cause them to overheat. The heat may affect the number or shape of the sperm.
  • Medical conditions or exposures such as diabetes, cystic fibrosis, trauma, infection, testicular failure, or treatment with chemotherapy or radiation.
  • Unhealthy habits such as heavy alcohol use, testosterone supplementation, smoking, anabolic steroid use and illicit drug use.
  • Environmental toxins, including exposure to pesticides and lead.
Male infertility may be treated with medical, surgical or assisted reproductive therapies depending on the underlying cause. Medical and surgical therapies are usually managed by an urologist who specializes in infertility. 
 

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Peyronie’s disease

Peyronie’s disease is a disorder in which scar tissue called plaque forms in the penis. The plaque builds up inside the tissues of a thick, elastic membrane called the tunica albuginea. The most common area for the plaque is on the top or bottom of the penis. As the plaque builds up, the penis will curve or bend, which can cause painful erections. Curves in the penis can make sexual intercourse painful, difficult or impossible. Peyronie’s disease begins with inflammation, which can become a hard scar.
 
Medical experts do not know the exact cause of Peyronie’s disease, but many believe it may be the result of an acute injury to the penis, chronic or repeated injury to the penis or an autoimmune disease 
 
The signs and symptoms include hard lumps on one or more sides of the penis; pain during sexual intercourse or during an erection; a curve in the penis either with or without an erection; narrowing or shortening of the penis; and erectile dysfunction.
 
Treatments include oral and injectable medications.
 

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Prostatitis

Prostatitis is inflammation of the prostate gland. The condition is called bacterial prostatitis when it is caused by an infection with bacteria. Acute bacterial prostatitis starts quickly and chronic bacterial prostatitis lasts for three months or more. Ongoing irritation of the prostate that is not caused by bacteria is called chronic nonbacterial prostatitis.

Any bacteria that can cause a urinary tract infection can cause acute bacterial prostatitis. Some sexually transmitted diseases (STDs) can cause bacterial prostatitis, including chlamydia and gonorrhea. Symptoms of acute prostatitis can start quickly, and can include chills, fever, urinary frequency, pain with urination, pain with ejaculation and perineal pain.
 
Urinary symptoms include:
  • Blood in the urine
  • Burning or pain with urination 
  • Difficulty starting to urinate or emptying the bladder
  • Foul-smelling urine
  • Weak urine stream
 
Treatments include:
  • Antibiotics
  • Anti-inflammatory medications
  • Chronic pain medications such as tricyclic antidepressants
  • Prostate relaxing medications
  • Physical therapy

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Testosterone deficiency

Testosterone is a hormone produced by the testicles that assists in developing male sexual characteristics. It also aids in maintaining muscle mass, adequate levels of red blood cells and bone growth, and sexual function.
 
As men age, the amount of testosterone the testicles produce begins to decrease, starting at age 30. It continues throughout the remainder of a man’s life. 

Testosterone deficiency can be caused by:
  • Injury, infection or loss of the testicles
  • Chemotherapy or radiation treatment for cancer
  • Genetic abnormalities such as Klinefelter's Syndrome (extra X chromosome)
  • Hemochromatosis (too much iron in the body)
  • Dysfunction of the pituitary gland or hypothalamus
  • Inflammatory diseases, such as sarcoidosis (inflammation of the lungs)
  • Medications, especially hormones used to treat prostate cancer and corticosteroid drugs
  • Chronic illness
  • Chronic kidney failure
  • Cirrhosis of the liver
  • Stress
  • Alcoholism
  • Obesity (especially abdominal)
Testosterone deficiency can be treated with intramuscular injections, given anywhere from two to 10 weeks apart, and testosterone gel applied to the skin. It can also be absorbed via long-acting subcutaneous pellet or a testosterone stick that is applied like underarm deodorant. Your testosterone replacement treatment plan will be tailored to your lifestyle.
 

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Varicocele

A varicocele is the swelling of the veins inside the scrotum. These veins are found along the cord that holds up a man's testicles (spermatic cord). A varicocele forms when valves inside the veins that run along the spermatic cord prevent blood from flowing properly. The blood backs up, leading to swelling and widening of the veins. 
 
Varicoceles develop slowly most of the time. They are more common in men ages 15 to 25 and are most often seen on the left side of the scrotum. A varicocele in an older man that appears suddenly may be caused by a kidney tumor, which can block blood flow to a vein. The problem is more common on the left side than the right.
 
Symptoms include enlarged, twisted veins in the scrotum, a painless testicle lump, scrotal swelling or a bulge in the scrotum. A jock strap or snug underwear may help ease discomfort. You may need other treatment if the pain does not go away or you develop other symptoms. Surgery to correct a varicocele is called a varicocelectomy. 
 

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Vasectomy

A vasectomy is surgery to cut the vas deferens. These are the tubes that carry sperm from the testicles to the urethra. After a vasectomy, sperm cannot move out of the testes. A man who has had a successful vasectomy cannot impregnate a woman. 
 
A vasectomy is done in the surgeon's office using local anesthesia. You will be awake but not feel any pain. For this procedure:
  • After your scrotum is shaved and cleaned, the surgeon will inject a shot of numbing medicine into the area.
  • The surgeon will make a small cut in the upper part of your scrotum. The vas deferens will then be tied off and cut apart.
  • The wound will be closed with stitches or surgical glue.
You may have a vasectomy without a surgical cut. This is called a no-scalpel vasectomy (NSV). For this procedure:
  • The surgeon will find the vas deferens by feeling your scrotum.
  • You will get numbing medicine.
  • The surgeon will then make a tiny hole in the skin of your scrotum and then clip the ends of the vas deferens.
  • In a regular vasectomy, a small incision is made on each side of the scrotum. In a no-scalpel vasectomy, a sharp instrument is used to pierce the skin and make a single opening. 

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