Question: My problem is that my scrotum keep on tighting up. Like in the moring it tighting up.but later in the day it's not tight anymore can you tell me it does that? And can you tell me where your lymph noids his? Ok bye The simple part: lymph nodes are anywhere in the body, especially where the limbs extent from it, but they can be found anywhere. The tightness can be caused by soemthing irritating the scrotum or it can be the result of a last 'nice' dream just before yuo wake up. Or it may be the cold in the morning. It may be bothersome, but it is not a serious problem. Most often it passes again after a few years.

Question: My 3 year old son has been diagnnosed with atresia and stenosis of the urethra. Surgury is recommended. Can you tell what this is exactly - and what caused it. I would also like to know what the surgury entail and how necessary it is. Most probably the condition is inborn, but I cannot be sure since I haven't examined him. If there is a stenosis now, i.e. a narrowing, it will not grow as he does, so it will get worse with time. Therefore, it needs treatment, probably more than once to make sure than the urethra remains wide enough when he grows older. The type of surgery involved depends very much on the location, type and extent of the narrowing, so I cannot comment on that.

Question: What sort of care do I needto be taking after having my postate removed my psa was 7.5% so I only had a low rate of cancer I would like to not have a repate i am only 56 years old is my diat important in the control of cancer? That also depends on the size of the prostate and whether it is also obstructing the bladder outlet. And ofcourse on your health. Usually it takes a week or so in hospital and an initial recovery time of about a month. After that you be pretty normal again, but it may take several months before everything is really back to normal. It may take sveral weeks to become completely 'dry' again and potency may take much longer. Once cured you won't have to do anything special, no diet or anything. Just live in a healthy way and eat healthy food.

Question: For the past three years, I have experienced itchy hands and the bottom of my feet and in my private parts. I will wake up in the middle of the night, itching, my tongue will feel enlarged and sometimes I will break out in welps. I have been to the doctor and my regular doctor says there is notice of blood in my urine but he has never sent me to a specialist. I know what I am experiencing is not normal - I can take a benadryl and the itchy and rash goes away. Could I have a reaction due to something in my kidneys? I don't know. There are so many possible causes for itching, including many allergies, liver problems, diabetes, kidney problems, skin diseases, etcetera etcetera. If there is blood in the urine, it should be investigated by a urologist. The itching should probably best looked into by a specialist in internal medicine.

Question: I felt very worry because my penis is only 1.5'' and after erection is about 4.5''. I'm 27 years old now. I afriad I can get any girl because of my small penis. I also following problems: 1. Frequent urine at day & night, 2. Spraying while urinating, 3. Difficult peeing. You seem to have some urological problems which need the attention of a urologist. So you better find one and have it treated. I cannot help you through the internet. And don't worry about the penile length: I've seen some much smaller belonging to married men with many children.

Question: I am a 33 year old male. When I was about 16 years old, I caught the mumps. One of my testicles became enlarged. It then became very small, almost inexistent. Could this cause sterility, or have anything to do with hair loss? As long as the other testicle is okay, there is nothing to worry about. Hair loss on the head is a result of the male sex hormones - since the remaining normal testicle produces enough testosterone, this may still cause socalled 'male baldness'.

Question: the question I am requesting you to answer is this: Do you know of any medications, whether topical, injectible, or oral, that can or will destroy the nerves in the penis, permantly numbing the penis. Even if there's something non-medicinal that can do this I would be interested in knowing. Not that I know of. And neither could I think of any reason why someone would need it. It could be a side effect of a complete detachment of the penis, due to an accident, and re-attachment by surgery. But such surgery, if done deliberately, carries a very high risk of permanent loss of the penis as a whole.

Question: I just recently masturbated and I found a discoloration in my semen that looked like blood. I'm worried, what could it be and what should I do? If it is red, it will most probably be blood. If so, it may be caused by irritation, infection or cancer. If you are under the age of 45, it will be either infection or irritation. If it does not go away or repeats itself, then consult a urologist.

Question: I am a 49 yr.old male,considering 'testicular enhancement' (insertion of soft silicone prostheis into the scrotum, 'alongside' my testicles to enhance the appearence of the scrotum) Psychologically I should have done this years ago, I do not wish to be the 'largest' guy on the block, only lg. enough to avoid ridicule laughter and made to feel (real or imagined) less than a man. People even'friends' can be VERY cruel & thoughtless in this regard. I will go to any length to avoid the possibility of being seen nude or in underclothes with another male, because of this (small testicles) I will & have even avoided developing friendships with other males because of the possibility of showering or changing clothes in the same room & the potential for such extreme embarassment & mental anguish. With this said, what (besides risks common to any surgery) are the 'down-sides' to having this procedure. It would be performed by a board certified urologist? I need to know the real! risks vs. benefit ratio. Thank you in advance for a compassionate honest response. I did not even know it existed, and still doubt the existence of such a procedure. As far as I can tell, the problem seems to be psychological, not physical. I have seen many men with small, or even non-existent testicles. They have no problems with that. Since many problems may arise from such surgery (infection, pain, discomfort, psychological problems), I would rather find 'normal' friends and/or have psychotherapy, than risk surgery.

Question: I'm looking for further info re: long term outcomes- studies done on pediatric pts with complete bilateral duplication of the kidneys with grade 5 vesicoureteral reflux into the lower poles. newborn son dx with this in aug of 99. has vesicostomy for now. looking at repair in aug 00. looking for pros and cons of retunneling ureters thru bladder and placing bad ureter into good ureter. lower poles very low functioning about 10% or less on nuc scan. I would like to know complications of either of the above surgeries. there doesn't seem to be much info on what has happened to these kids 10 to 15 years down the line--what have they encountered??? he also seems to be way down on the growth charts for his age are kids with this tiny? He is also experiencing developmental delays along with everything. Is there something we are missing in the big picture. I'm an RN in a NICU? Maybe I'm paranoid. I know just enough but not enough. Kidneys, ureters, bladder aren't my NICU's expertise and not my strong point. Do you have info that could help us in our decisions for our son's future? As far as I know, there are only grades 1-4, but I take it your son has the worst grade. The eventual outcome depends very much on the present condition (after some time of drainage through vesicostomy) of both lower poles (that are often the biggest poles of the kidneys). The percentage does not tell me much: 10% of the normal value of one lower pole?, 10% of all function?, What? If the remaining function is adequate, then chances are that everything will be fine. Also, the lower poles are most often the best parts of the kidneys and the upper poles are the refluxing ones. To make it even more difficult, the upper poles usually drain into the bladder lower than the lower poles. So some questions need answering before I can tell anything about this. And what's a NICU? Something like an ICU?

Question: information about urinary tract infections in men Like what? I mean, we are here for specific questions, not to answer on general ones for which whole books are written.

Question: I feel a pain in my penis recently and this pain becomes aggravated when I pass out urine. Is this pain in any way related to me having a torn ligament in my ankle at the moment? Also,a few years ago, I had a growth of bladder stones which then disappeared by themselves. Or could this pain which I'm experiencing now be due to a recurrence of bladder stones or some infection? It will have nothing to do with the ankle problems, but may be caused by bladder/prostate/urethra problems, like infections, stones or other irritations.

Question: i have an uretry problem since june last year. i have seen a great deal of urologues, one gave me elmiron but still i am in pain. can you refer waht kind of medication i should i take to decrease the pain. I am afraid I cannot tell from a distance what your problem is. One of the reasons is that that you have not told me anything besides having a pain problem (where, since when, what other symptoms, etcetera).

Question: I am 26, white male, married. I have had a high concentration of blood in my urine. It first occured 5 months ago and sicne then only about 6 times. It turns my urine dark browninsh/red. I have suffered from cold sweats at night, lower back pain, no weight gain, minimal sleep,loss of energy, lypmnods in neck(3) swollen,.....most symptons come and go. I quit smoking 2 years ago, no caffiene or chocalate for a year, and quit chewing tobacco 5 months ago. Nothing has changed. Please help. I am plagued with general doctors who are tring their best but with no results. Among many other things, too much blood in the urine (some is okay) can be caused by infection, stones or cancer. You are much too young for cancer, so infections or stones are most probable. To find out, you are going to need a urologist, who will order X-rays and a cystoscopy and will probably do urine tests and ultrasound. I cannot tell what's wrong from a distance.

Question: i have had my urine tested by strip and found blood in it they did a urine test which had to be done straight away to see if the cells where morfic or dismorfic my where morfic and i was told that in some heathy males that the kidneys may have thin membranes and that red blood cell seep through these mebranes can you shed some light on this test which is done through a micro scope thank you In some people, males and females, the kidneys are just a bit more porous than in others. Normally, the kidneys bleed a lttle bit, but in those people they bleed a bit more, although the amount of blood loss should be hundred fold to cause anemia. Since the kidneys are made up of very tiny tubes, the red blood cells get compressed and damaged - these are called dismorphic. In your case the blood cells were normally looking, i.e. they are not from the kidneys, but from somewhere else. That means that further tests are necessary to determine if something is wrong.

Question: Can badder catheterization during and after surgery cause nerve damage around the bladder if not properly inserted? Can bladder catheterization after surgery cause nerve damage around the bladder the patient was not properly cared for. I have had bladder retention since a total abdominal hysterectomy in March 1999. Special testing proved positive nerve damage around my bladder area. I have resorted to self-catheterications daily. Catherization cannot cause nerve damage to the bladder, but large surgery nearby, like a hysterectomy, can. Sometimes, nerves of the bladder are already a bit low in number to begin with and slight damage by some type of surgery may be anough to bring the number below minimum level and thus cause bladder problems.

Question: I am in good health and have not changed my eating habits or drinking habits too much that I am aware of, but lately my stomach aches and I have terrible gas problems. I have tried over the counter drugs such as gas-x but nothing seems to help. This has become very embrassing lately even during intercourse. Any help? Any foods or drinks to avoid? As a urologist I know nothing about these problems - but your family doctor might.

Question: I am wondering if you can give me more information on some results of a recent urine sample. It was found that I had blood and protien in my sample. I am a 35 year old mother with hypothyoid disease. I have been trying to get pregnant for 14 months now. I have a schedualed ultra sound appt. on the 31st of Jan. Could you please give me any information on this. Blood can be caused by m,any things like infections or stones, or even cancer - but you are too young for that one. The protein is often a result of the blood cells, which also contain protein, which enters the urine when the fall apart. In any case, it needs to be checked by a urologist, especially when no signs of infections are found.

Question: I was wondering what is the average salary of a urologist I need to know for a report I am doing? Worldwide or nationwide? And, ofcourse, which nation?

Question: I am a 23 health active male who has been experiencing urine leakage recently.(Particularly when i sleep). The following are the only changes that have occured to my normal everyday routine: I was taking alot of the drug Tavist - D for a sinus cold. In addition I have started supplementing my diet with creatine monohydrate and glutamine to help my workouts. Could any of these be the cause of my problems? Probably not, although dietary supplements are a waste of money and may cause problems because control on the content of the pills is minimal, so they may contain other materials beside the stuff that's on the label. If the leaking persists after you've stopped taking them (which I would advise, since, despite what other people want you to think, any beneficiary effects have not been proven - besides financial ones for the manufacturers), I would surely consult your doctor.

Question: I HAD A URINE TEST AND THE DIAGNOSIS IS SQUAMOUS EPITHELIAL CELLS, BACTERIA AND CRYSTALS AND IT SAID NO UROTHELIAL CELLS IDENTIFIED. NO MALIGNANT CELLS IDENTIFIED WHAT DOES THIS MEAN. It means that everything is probably fine as far as the urine is concerned. But urine analysis is only one way to look at a problem and other types of analysis may be needed to answer a specific question.

Question: My 4 year old son was born with fistula -bladder to intestines-, abnormal urethra and undescended testes. Procedures performed; vesicotomy,colostomy at 2 months old, at one year old are repair of fistula, repair of urethra, lowering of testes and about 5-6 more procedures. To supposedly complete repair, but he continuosly suffered UTI. Doctors found kidney stone and so another procedure was performed, PCNL - performed last February 1999.June until September , UTI is persistent. I read through your Journal the repercussions of persistent UTI. What could be causing my childs persistent UTI? Having gone through several procedures were supposedly corrections to repair his problem. His doctors mentioned his case -congenital problem altogether- is the first in xxxxxx, I hope there has been similar cases you've handled we can relate to. My child also suffers constipation. He is also under the care of a pediatric gastro-enterologist. Kindly enlighten this concerned parent. Thank you for your time and hoping for your reply. Again thank you.
This is a complex problem and impossible for me to solve from out here. Your son has many urological problems and many possible sources for infections. It is impossible for me to pinpoint them without being able to review all data and view the patient. In some cases I know, the real problem that causes the infections may be disguised by all the other ones. In those cases it proved best to prescribe a longterm low-dose antibiotic to help prevent infections and sort the problem out a couple of years later when all other problems have become minimal and the cause of infections has either disappeared or reveals itself.

Question: HI MY PEOBLEM IS I GUESS WHAT WOULD BE CALLED PRE-EJACULATION.EVERY TIME IM GOING TO HAVE SEX I CAN'T LAST MORE THAN 30 SECOUNDS. I WANT TO KNOW WHY AND HOW CAN I CONTROL IT WITH OUT USING ANY TYPE OF SRAY?
This is a psychological problem often encountered in young men. It either gets cured by itself or sexual therapy is needed.

Question: recently i had a mag3 renal scan done in relation to kidney problems, i was diagnosed as having puj obstuction in my left kidney, my doctor says to leave it for now, i am concerned at leaving the problem untreated. Can you help with any more info. Thank you.
A PUJ obstruction means that the connection between the pelvis of the kidney and the ureter is narrow. This is most often inborn and sometimes leads to kidney failure at an early age. If it does not, then chances are that, while the connection is a bit narrow, the kidney will survive without any problems. If it was too narrow, then it would already habe been too late. There is a grey area here, in which we urologists may try to reconnect pelvis and ureter; this may be the case in relative young people (say, upto 30) when it appears that the kidney may be damaged in the long run. To find that out, the scan you just had is an excellent way. On the other hand, when the kidney has already been damaged a lot, there is no sense in trying to reconnect it. This will also show on the scan.
Ask your urologist.

Question: 1. If a female has blood in her urine, what causes other than infection or cancer could it be? Note: The female in question has no other symptoms than blood in her urine. The female in question is also taking the drugs: A. Lithium B. Ativan C. Aventyl D. Celebrex
Urinary tract stones. Near-infections. Or it may be normal in her case (depending on the amount of blood found, some people just lose a bit more blood in the urine than others - all lose some).

Question: I am an 18 year old uncircumsized male, and i have never really received instruction, from a doctor or otherwise, as to the proper care and treatment of my penis. What I do, is to retract the foreskin and thoroughly clean the head about once a week. However, i am unable to retract the foreskin when my penis is erect, and have recently been informed that this might be a problem. If so, how can it be cured?
If the foreskin gets stuck and won't go back, it usually still does every now and then. Because this may cause slight damages to the foreskin, in turn leading to small scars, this may lead to further narrowing and possibly infections. In those cases, a circumcision can be done to prevent further trouble.

Question: i have a bend in my penis to the left. i am now 19 and it has been this way as long as i can remember..the left side seems to be smaller and less rigid at the base then the right side when errect....i have heard there are exercises you can do to help straighten the penis...is this true..either way what is the reason for this and my options..thanks!
No, it is not true. Some men are born with a straight penis, but most are not. Both erectile bodies in the penis must be of the exact same length to make it straight, and most often they are not. In some, the curve is so severe that it needs straightening. This can only be done by surgery.

Question: I am a 30 year American male. I was diagnosed with Chronic Prostatitis recently and given large doses of Floxin to bombard the 'bacteria'. My question is about an apparent side effect of impotency. I have been experiencing difficulty in getting an erection. Before starting my second round of this drug (about three weeks ago) I had no problems, but recently it has been very difficult. I believe contributing factors could be stress and nervousness, but I feel that the floxin is a major cause.
You are wrong. It is the infection and the fact that something 'down there' is wrong that is causing this - it is mainly psychological. It will return to normal once the problems are cured.

Question: Have been dx.with enlarged prostate that is asystemical. Doctor wants to do transrectal ultrasound with possible biopsy. What do you think, Do not want to have any unneccessary procedures.The prostate should be about symmetrical. If it is not and you are above 45, then there is a chance of prostate cancer and an ultrasound of the prostate with biopsies taken necessary to (un)prove that. Remember that prostate cancer can usually be cured, but only if diagnosed early.

Question: I am a 29 year old male, for about 2 years I have suffered right flank pain with abdominal pain after sleeping 4 to 6 hours. I have just seen a gastrologist he did a colonoscopy, an abdonminal CT, and a small bowel follow thru.Nothing was found. I should add around 6 months ago I had a kidney stone removed by scope after several sever attacks. But since then I have had a clear IVP. But I'm still suffering. The gastrologist suggest I go back to my urologist because there was crystals and I had a high PH levels in my urine. He said that kidneys could cause abdonminal pain. My question is could I have a normal abdomnianal CT and IVP and still have somithing going on in my kidneys? And does this sound like anything serious to you?If IVU and CT are both normal, you can rest assured that the kidneys are probably okay. The only problem is that those investigations don't tell you much about the rate of excretion of the urine from the kidneys. For that, you'd need a renography. If that is normal too, then the kidneys are really okay.

Question: I am 35 years old and maintain a very active sex life with my wife.We have noticed quite a decrease in the volume of semen that I ejaculate. The strength of the ejaculation is also less. It used to shoot out and now flows out with much less of an impact. Are these changes common? Also, I have noticed somewhat of a numbness with my penis. It is not nearly as sensitive to touch as it used to be. Is this also common?Although semen production and the force with which it is expelled diminished with age, you are still too young for this. So you better find a real doctor and have it sorted out.

Question: During sexual relations it takes generally around 45 minutes to have an ejaculation. I was wondering if there was any physiological problem that I may have that is causing this delay. Thank you for your kind consideration.Most men have an ejaculation too soon, so I guess those consider you lucky. It has all to do with libido and degree of arousal. Generally, younger men have a shorter time span to get to ejaculation, but the time lapse may vary considerably.

Question: A little more then a year ago I had a scope through my belly button done to check the female organs. After that surgery I did not urniate for a week and my doctor didn't help me figure out what was wrong. I ended up in the hospital for three days with a very large bladder. He had waited to long and it was all out of shape. I had no feeling to go so I had to learn to cath myself for 3 months before I could get that feeling back. Ever since then I have alot of problems. I never had any problems before not even a bladder infection. Now when I have to go I have to go right now and I have pain after the urine is about done coming out. It's almost like my bladder doesn't want to be full or empty. I found out I have fibroids on top of my uterus and possible endometriosis. I am really not sure where to start for medical attention a urolgist or a gynecologists. Do you think with these symptons it is my bladder or the female problems are causing the problem. I would! appreciate any information you can give me. Thank you.Unless the gynecological problem are very big, like a big pregnant uterus, it has no effect on the bladder. So if you do have a bladder problem or problems with urinating, then the urologist is the first to consult, especially since you had a bladder problem before.

Question: In January, at the age of 58, I had a hystorectomy and a Burch Procedure. I'm not for sure of the spelling or Burch, but that is how it is pronounced. I have had many problems. Buring at the opening of the urethra, incomplete voiding (unless I squatlean forward, wait a minute, and void again, frequent infections, my bladder aches, and hip pain. Which of these symptoms might be the result of surgery? What is medically done during a Burch Procedure? I have seen a urologist several times, a urodynamic study was completed, as well as X-ray's taken when my bladder was filled with radio-active solution. When my urologist had collected all of the results, he said, 'There is nothing I can do, you will have to live with it.' I don't think I can learn to live with it, especially the pain at the urithea where it opens at the paraneum. I'm looking for answere, even it means traveling to see a top specialest in the field.In a Burch, the urethra is pulled up towards the pubic bone. One of the problems may be that it is pulled up too far and the urethra may get kinked, thus causing irritation during voiding. The only solution to this is to undo the surgery and perhaps do another later on. If you are living in the US, then you may contact dr Raz, who resides in one of the university hospitals in San Francisco.