Male Urology

Male urology encompasses a range of conditions affecting a man’s urinary and reproductive systems. As a result, men are likely to suffer from several related conditions, such as erectile dysfunction, urinary obstruction, urinary tract infections, bladder cancer and prostate cancer. in men, Dr Mampa deals with the male organs including the penis, testes, scrotum, and prostate. It is important for all men to see a urologist as they get older because health problems can happen to anyone.

Prostatitis is a group of conditions that includes acute and chronic bacterial prostatitis and chronic pelvic pain syndrome (CPPS). It can cause infection, inflammation and pain in the prostate gland. People assigned male at birth with asymptomatic inflammatory prostatitis don’t have symptoms

An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. An enlarged prostate is often called benign prostatic hyperplasia (BPH).

Symptoms of a lower UTI can include: feeling a strong urge to urinate (pee) and more often than usual, a constant, dull pain in the pubic region and pain when urinating (dysuria) cloudy urine (pee) or blood in your urine (haematuria) urine that smells unusually unpleasant.

A urethral (u-REE-thrul) stricture involves scarring that narrows the tube that carries urine out of the body, called the urethra. As a result of a stricture, less urine comes out of the bladder. This can cause problems in the urinary tract, such as infection
Causes
Men are more likely to have a urethral disease or injury because of their longer urethra. For this reason, strictures are more common in men. They are rare in women and in infants.

Stricture (narrowing of the urethra) can happen at any point from the bladder to the tip of the penis. This narrowing restricts or slows the flow of urine in.

Some common causes are:
trauma to the urethra
infection such as a sexually transmitted disease
damage from surgical tools
conditions that cause swelling
In most cases, no cause can be found.

In adults, urethral strictures are most often due to:
injury from a fall onto the scrotum or perineum
prostate surgery
kidney stone removal
urinary catheterization
other surgical tools

Symptoms
Simply put, the urethra is like a garden hose. When there is a kink or narrowing along the hose, no matter how short or long, the flow is reduced. When a stricture is narrow enough to decrease urine flow, you will have symptoms. Problems with urinating, UTIs, and swelling or infections of the prostate may occur. Severe blockage that lasts a long time can damage the kidneys.

Some signs are:
bloody or dark urine
blood in semen
slow or decreased urine stream
urine stream spraying
pain with urinating
abdominal pain
urethral leaking
UTIs in men
swelling of the penis
loss of bladder control

Urine contains many dissolved minerals and salts. When your urine has high levels of these minerals and salts, you can form stones. Kidney stones can start small but can grow larger in size, even filling the inner hollow structures of the kidney. Some stones stay in the kidney, and do not cause any problems. Sometimes, the kidney stone can travel down the ureter, the tube between the kidney and the bladder. If the stone reaches the bladder, it can be passed out of the body in urine. If the stone becomes lodged in the ureter, it blocks the urine flow from that kidney and causes pain.

Symptoms
Common symptoms of kidney stones include a sharp, cramping pain in the back and side. This feeling often moves to the lower abdomen or groin. The pain often starts suddenly and comes in waves. It can come and go as the body tries to get rid of the stone.
Other signs of a kidney stone include:

A feeling of intense need to urinate.
Urinating more often or a burning feeling during urination.
Urine that is dark or red due to blood. Sometimes urine has only small amounts of red blood cells that can’t be seen with the naked eye.
Nausea and vomiting.
For men, you may feel pain at the tip of the penis.
Causes
Low Urine Volume
A major risk factor for kidney stones is constant low urine volume. Low urine volume may come from dehydration (loss of body fluids) from hard exercise, working or living in a hot place, or not drinking enough fluids. When urine volume is low, urine is concentrated and dark in color. Concentrated urine means there is less fluid to keep salts dissolved. Increasing fluid intake will dilute the salts in your urine. By doing this, you may reduce your risk of stones forming.

Adults who form stones should drink enough fluid to make at least 2.5 liters (⅔ gallon) of urine every day. On average, this will take about 3 liters (100 ounces) of fluid intake per day. While water is likely the best fluid to drink, what matters most is getting enough fluid.

Diet
Diet can also affect the chance of forming a stone. One of the more common causes of calcium kidney stones is high levels of calcium in the urine. High urine calcium levels may be due to the way your body handles calcium. It is not always due to how much calcium you eat. Lowering the amount of calcium in your diet rarely stops stones from forming. Studies have shown that restricting dietary calcium can be bad for bone health and may increase kidney stone risk. Health care providers usually do not tell people to limit dietary calcium in order to lower urine calcium. But calcium intake should not be too high.

Instead of lowering dietary calcium intake, your health care provider may try to reduce your urine calcium level by decreasing your sodium (salt) intake. Too much salt in the diet is a risk factor for calcium stones. This is because too much salt is passing into the urine, keeping calcium from being reabsorbed from the urine and into the blood. Reducing salt in the diet lowers urine calcium, making it less likely for calcium stones to form.

Because oxalate is a component of the most common type of kidney stone (calcium oxalate), eating foods rich in oxalate can raise your risk of forming these stones.

A diet high in animal protein, such as beef, fish, chicken and pork, can raise the acid levels in the body and in the urine. High acid levels make it easier for calcium oxalate and uric acid stones to form. The breakdown of meat into uric acid also raises the chance that both calcium and uric acid stones will form.

Bowel Conditions
Certain bowel conditions that cause diarrhea (such as Crohn’s Disease or ulcerative colitis) or surgeries (such as gastric bypass surgery) can raise the risk of forming calcium oxalate kidney stones. Diarrhea may result in loss of large amounts of fluid from the body, lowering urine volume. Your body may also absorb excessive oxalate from the intestine, resulting in more oxalate in your urine. Both low urine volume and high levels of urine oxalate can help to cause calcium oxalate kidney stone formation.

Obesity
Obesity is a risk factor for stones. Obesity may change the acid levels in the urine, leading to stone formation.

Male Urology

  • Vasectomy (Male Sterilisation) – Vasectomy is a form of male birth control that cuts the supply of sperm to your semen
  • Prostate Cancer – Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.
  • Bladder Cancer –
    This cancer typically affects older adults. It’s usually diagnosed early, when it’s still treatable. It’s likely to recur, so follow-up tests are typically recommended.
    The most common symptom is blood in the urine.
    Treatments include surgery, biological therapy and chemotherapy.

Circumcision

Circumcision is the surgical removal of the foreskin from the penis. Benefits include a lower risk of some diseases.

Hydrocele Repair

The repair involves making an incision just below the belt line and dissecting down to the hole in the muscle layer.

Testicular Torsion

Testicular torsion is a painful condition where your testicle twists and loses its blood supply. It requires emergency care

Recurrent Urinary Tract Infections (UTIs)

Recurrent urinary tract infections are usually new infections with different bacterial organisms.

Haematuria

Hematuria is blood in the urine. When the urine is red or pink this could be linked to blood in the urine and is called “gross” or “visible” hematuria

Frenuloplasty

Frenuloplasty helps to get rid of the bending of the penis. Circumcision used to be a commonly practised operation and, on many occasions, was performed with excellent results.

Pelvic Organ Prolapse

Pelvic organ prolapse is when one or more pelvic organs drop from their position. This makes a bulge in the vagina, called a prolapse. The muscles and connective tissues of the pelvic floor typically hold the pelvic organs in place. Pelvic organs include the vagina, bladder, uterus, urethra and rectum.

Fistulae

An anal fistula is an abnormal passageway that develops from inside your anus to the skin outside. It usually develops in the upper part of your anus (butthole), where your anal glands are. When these glands become infected, drainage from the infection can create a fistula.

Recurrent UTIs (RUTI)

Recurrent UTIs (RUTI) are mainly caused by reinfection by the same pathogen. Having frequent sexual intercourse is one of the greatest risk factors for RUTIs. In a subgroup of individuals with coexisting morbid conditions, complicated RUTIs can lead to upper tract infections or urosepsis.

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  • Telephone +27 11 922 1141
  • Telephone +27 11 740 9013/4

Contact Us

Arwyp Medical Centre,
22 Pine Avenue,
Kempton Park, 1619