WE ARE ASKED IN CONSULTATION

Yes, some prostate medications worsen erection, sexual desire and ejaculation, but there are alternatives to improve symptoms without side effects.

Not at all. In recent years we have more and more technology that allows us to perform minimally invasive prostate surgery without causing sexual side effects.

Yes, very much so. Prostate problems can lead to impotence and premature ejaculation. That's why sometimes early treatment of prostate hyperplasia can prevent you from developing sexual problems.

It is good to drink at least 2 liters of water a day and avoid foods high in saturated fats, condiments, spices and pepper. It is also advisable to reduce the intake of coffee and alcohol, especially white drinks and beer.

Robotic surgery is recommended in a variety of situations where its advantages can significantly improve patient outcomes compared to traditional open or laparoscopic surgery. It is considered especially beneficial in complex procedures where high precision and surgical dexterity are required in confined spaces, in patients with comorbidities and/or when urinary or erectile function is sought to be preserved.

It is normal to bleed after a prostate biopsy for one to two weeks, depending on the type of bleeding. There may be blood in the urine, stool and/or semen.

At the age of 50 it is advisable to have a PSA, a blood test to measure the Prostate Specific Antigen that helps to detect possible abnormalities in the prostate. If you have a family history of breast or prostate cancer, it is recommended to start screening at around 45 years of age due to the increased risk associated with prostate cancer.

It is sufficient to perform PSA and a digital rectal examination -especially if the PSA is higher than 2.5-. On some occasions ultrasound, flowmetry or even genetic tests can be performed to study different aspects of the prostate.

No, a urine culture does not detect cancer, as its purpose is to identify urinary tract infections through the presence of bacteria. However, other urine tests, such as a urinalysis or urine cytology, may suggest the presence of cancer by detecting blood or abnormal cells in the urine. If there is suspicion of cancer in the urinary system, additional studies such as biomarker tests, ultrasound, CT scans or biopsies are required to confirm the diagnosis. If you detect blood in the urine with no apparent cause, it is essential to see a physician for further evaluation.

Bleeding in the urine, stinging when urinating or the sensation of incomplete voiding.

When the bleeding is visible to the naked eye, it should always be studied. When it is microscopic, i.e., it is not visible to the naked eye, when it must be studied whenever it is significant (more than 3 red blood cells per field) especially in patients with risk factors: over 40 years of age or smokers or exposed to certain dye or paint substances.

In general it is good. These tumors are usually diagnosed before they infiltrate the muscle, allowing the bladder to be preserved. The problem lies in the fact that it is a chronic disease that has recurrence and relapses over time. It requires many check-ups and treatments and the patient must adhere to them without skipping check-ups, which can lead to metastasis.

Robotic surgery is recommended in a variety of situations where its advantages can significantly improve patient outcomes compared to traditional open or laparoscopic surgery. It is considered especially beneficial in complex procedures where high precision and surgical dexterity are required in confined spaces, in patients with comorbidities and/or when urinary or erectile function is sought to be preserved.

It can be many things. Testicular tumor is rare, but we know that a timely diagnosis is almost 100% curative. Therefore, ask for a visit so that we can explore you and do an ultrasound.

Yes, the vast majority of testicular cancers are curable. The earlier we make the diagnosis, the better the chances of cure with minimal treatment.

First we perform surgery to determine the type of tumor and its local extension. Then, depending on various factors, other treatments may be necessary.

It is highly unlikely, but we advise you to have it checked to be sure. 

Although rare, it is possible to have penile cancer. If you have a spot on your penis that does not go away or a non-painful lump, it is advisable to consult a urologist.  

No, it is done with local anesthesia and does not hurt. Afterwards you may have some discomfort, but it is much less than you imagine.

The surgeon will try his best to make sure that this is not the case, with conservative treatments and surgeries.

To know if a kidney cyst is malignant, it is important to perform a series of studies and medical evaluations. The most common steps to determine the nature of a kidney cyst are: Renal ultrasound: ultrasound can show the shape and size of the cyst, as well as the presence of any suspicious features, such as irregular walls or inhomogeneous fluid. Computed tomography (CT): If the cyst has suspicious features on ultrasound, a CT scan may be done to obtain more detailed images. This helps to identify if there are solid masses within the cyst or changes in the cyst walls that suggest malignancy. Magnetic resonance imaging (MRI): is useful to better characterize the cyst and may provide additional information about its composition. This is particularly useful if there is doubt after the CT scan. Bosniak classification: The Bosniak classification system is used to categorize renal cysts based on their appearance on imaging and help determine the risk of malignancy. Biopsy: In some cases, if the cyst is suspected to be malignant or if imaging tests are inconclusive, a renal biopsy may be performed to obtain a sample of the tissue and examine it under the microscope. In general, benign kidney cysts do not cause symptoms. However, if a cyst becomes large, it may cause pain in the back or abdomen. If the cyst is malignant, there may be additional symptoms such as blood in the urine, unexplained weight loss or fatigue.

In general, in patients with renal tumors under 4 cm that are treated surgically, cure rates of over 90% are achieved. If the mass is large and has spread outside the kidney, the prognosis is worse, especially if any of the following factors are present: anemia, high lactate dehydrogenase level, high blood calcium level, spread to two or more distant sites, or if the person's general condition is unfavorable.

Kidney cancer is curable in early stages. It is key that, once kidney cancer is treated, the patient is followed closely. In advanced stages of the tumor, surgery can help palliate symptoms and, in selected patients, can be combined with other treatments such as chemotherapy or immunotherapy to improve survival and quality of life.

Surgery is the standard treatment, achieving cure rates of over 90% in small tumors. There are various types of surgery depending on the size of the tumor, but whenever possible, the aim is to remove only the tumor, preserving the rest of the kidney and renal function.

Shock waves help regenerate blood vessels in the perineal muscles, which reduces prostate inflammation and muscle contractures and increases blood flow to the prostate gland.

Acupuncture improves the symptoms of prostatitis and can be considered an effective and safe therapeutic alternative.

First of all, an evaluation by a urologist specializing in reconstructive urology should be performed. He or she will adequately evaluate the patient's condition in order to propose an individualized treatment.

The expulsion of gases through the urine may indicate the existence of a fistula of the urinary tract and the digestive tract. This is a communication between the two. In itself it is not serious. It may be associated with an increase in urinary tract infections. A proper study of the origin of the fistula is necessary, which may be related to urological processes such as previous surgeries or digestive processes such as infections or diverticulitis.

In case of urinary fistula, either with the vagina or the gastrointestinal tract, involuntary urine leakage or gas emission through the urethra may occur. If not operated, these symptoms do not disappear. Occasionally, fistulas may close spontaneously by placing a bladder catheter, but surgical intervention is usually required.

If the fistulas are not operated, the probability of spontaneous healing is low, although sometimes they can close with the placement of a bladder catheter. However, the time required is not short, requiring several weeks.

Yes, there are two diseases that can cause it: Peyronie's disease and congenital penile incurvation.

There are 5 symptoms that Peyronie's can produce: pain in the penis, incurvation, shortening, erectile dysfunction and "strangulation" of the penis (also known as hourglass deformity).

It seems that there are several genes that can increase the risk of having Peyronie's disease. In other words, it has a strong genetic component. On the other hand, some men explain that after an intense sexual intercourse -sometimes after a penile crunch- they began to feel discomfort.

No. Most commonly it is a plaque of fibrosis. It typically appears on the penis and is mildly painful on examination.

The drugs sold on the Internet for erectile dysfunction have not passed the necessary health controls and in many cases are dangerous.

It is a myth that these types of drugs cause heart attacks or angina pectoris. There are many studies with more than 20 years of follow-up that show that treatment with drugs for erection problems is effective and safe.

Chances are your partner already knows. Talk openly with your partner about what is happening to you and how it makes you feel. Your partner needs to be an ally in finding the best solution, and that involves communication and dialogue.

When a man does not respond to treatment with pills, the best alternative is usually the placement of a penile prosthesis.

No. Testosterone is an essential hormone for men's health, influencing bone mineralization, muscle mass, sex life and avoiding obesity and diabetes.

Yes. Men with low testosterone are more at risk for low sex drive and erection problems. Some studies also point out that low testosterone may increase the risk of penile incurvation.

It is very easy. With a blood test (fasting and in the morning) we can study the state of the hormonal axis that regulates testosterone and androgens.

It is not recommended. It will cause you to stop producing testosterone on your own and become dependent on the medication. If you need testosterone, it is a very safe and effective medication; but taking it without needing it is a mistake.

No. A man with premature ejaculation has the problem for months or years.

Of course. The same principles we apply to the treatment of premature ejaculation can be used to teach you to have more sexual control.

Premature ejaculation is defined as an intercourse time of less than 2 minutes. In Europe, studies suggest that the average intercourse time is around 5 minutes.

Yes, pelvic floor rehabilitation can help you gain more sexual control.

Yes, it is possible to reverse a vasectomy. However, undoing a vasectomy is a very complex procedure - called vasovasostomy - which succeeds in re-repermeabilizing the seminal duct only 50% of the time.

The most common side effect of vasectomy is scrotal pain, which usually subsides with anti-inflammatory drugs, although 1% of men have chronic pain, bleeding is very rare and infection is exceptional.

Yes, your ejaculate will be the same with the difference that it no longer contains sperm. But from the point of view of the macroscopic characteristics of the sperm, it is completely normal.

No, caution must be taken through some other contraceptive method in the relations until the next analysis that confirms that you can no longer have children. In general, a seminogram is usually performed 3 months after the vasectomy to ensure the results, and until that time it is possible to be fertile.

No. Erection, sexual desire, testosterone and intercourse time are not affected after vasovasostomy. It is common for the first few days or weeks to have somewhat less sexual desire due to pain and swelling, but within a few weeks it should be fully restored.

Vasovasostomy is performed under local anesthesia and sedation. Additional medication may be added after surgery to make the postoperative period as bearable as possible. In addition, it is highly recommended to wear a scrotal jockstrap (or tight underwear) to try to reduce pain and tension on the suture.

During the first days after vasovasostomy, it is advisable to lead a less active life. There is no need to rest, but intense physical activity and heavy lifting are contraindicated. As you feel better you will be able to progressively lead a more normal life. You will be able to resume physical activity after approximately 3 weeks, if the evolution is good.

After a vasovasostomy, it is recommended to abstain from sexual intercourse for a period of 3 weeks. This time allows for adequate healing and reduces the risk of complications, such as opening of the suture due to the intense muscle contractions that occur during ejaculation. It is essential to follow your doctor's instructions and attend follow-up visits to ensure optimal recovery before resuming sexual activity.

No. Unfortunately, many men have a normal semen analysis and may have problems conceiving, or vice versa. The semen analysis is a guide, but it is not definitive.

It is a very common situation that affects many couples. We have to make a study of the woman and the man to see where the problem may be, in addition to giving you recommendations to increase the probability of fertilization.

The semen analysis does not predict 100% fertility. Far from it, it indicates that there may be a problem in the man that decreases the risk of fertilization. However, with an abnormal semen analysis you can be fertile.

The 5 most useful tips are: do not smoke, do not drink alcohol, do intense physical exercise, take care of your diet (avoid processed foods) and avoid being overweight. All these factors improve your health and the probability of improving your fertility.

Three-component prostheses are practically unnoticeable, even when naked. The malleable prostheses, by elongating the penis, may be more noticeable, although they are not at all conspicuous.

It is a surgery that causes few problems. The most relevant is the infection of the prosthesis, which occurs in 2% of cases. To avoid it we use antibiotics during and after surgery, together with antibiotic-impregnated prostheses to further minimize this risk. The implantation of a penile prosthesis is a surgical procedure that, although generally safe, may involve certain complications: >> Intraoperative complications: - Perforation of the corpora cavernosa: During dilatation, crural perforation of the proximal end of the corpus cavernosum may occur. This situation is relatively frequent and requires immediate attention to avoid major complications. - Urethral injury: Although uncommon, there is a possibility of damage to the urethra during prosthesis placement, which may require additional interventions. >> Postoperative complications: - Infection: One of the most significant complications is infection of the prosthesis, which may lead to the need to remove the device. However, with improvements in surgical techniques and prosthesis design, the incidence of infection has been greatly reduced to below 5%. - Mechanical failure of the prosthesis: Although modern prostheses are designed to be durable, there is the possibility of mechanical failure that may require revision or replacement of the device. - Erosion or extrusion: In rare cases, the prosthesis may erode surrounding tissues or even extrude, which may require additional surgical intervention. - Shortening of the penis: Some patients may perceive a decrease in penile length after implantation, especially if there was previous fibrosis in the corpora cavernosa. - Postoperative pain: It is common to experience pain and swelling in the operated area during the first few weeks, although this usually resolves with time and proper management. For all these reasons, it is essential to perform this surgery with a very experienced team that guarantees the success of the surgery.

It is not usual. Especially with malleable prostheses, which have less surgical material, the feel is practically normal. With inflatable prostheses there are a few more structures, although they remain discreet even during sexual intercourse.

Penile prostheses have an estimated average life of about 10 years and once this time has passed, the prosthesis can be changed with a surgery as simple as the first one.

It may be due to congenital, inflammatory, infectious or traumatic reasons. It can also occur due to urethral tumors, dermatological diseases or medical procedures involving the introduction of an instrument through the urethra.

If left untreated, the situation may worsen over time. As the obstruction increases, the bladder will begin to hold urine and problems such as acute urinary retention, bladder diverticula, hydronephrosis, renal failure or stones in the bladder, kidney or ureter may occur.

The symptoms of urethral stricture are very common to other diseases of the urinary tract or prostate. Therefore, to confirm the problem it is necessary to perform diagnostic tests.

This will depend on the location of the stricture, the length and the previous surgeries we have performed on the stricture. The first step is to perform an internal urethrotomy, but in many cases more aggressive surgeries will have to be performed.

A person with a double J catheter can lead a more or less normal life as long as the catheter allows. It is recommended to drink plenty of water or fluids and avoid holding the urge to urinate too much. As far as work is concerned, a double J catheter does not prevent you from working, as long as the work is not excessively physical. There would be no inconvenience in exercising, but it could have a series of consequences associated with it, such as blood with urine.

A healthy, varied, Mediterranean diet should be followed, abundant in water, avoiding salt, not only that which is added, but also that which comes from some foods such as cold cuts, avoiding sugars and reducing the intake of saturated fats.

Many studies have been done on this. What they have been able to say is that, if the water you drink from the tap is good, with little calcification, there would be no problem in terms of the creation of stones. If it is mineral water, which is bought in supermarkets, it is important to look at the label and buy the one with the lowest sodium concentration.

The loss of the renal unit can occur in those patients with stones that show few or no symptoms, since they grow silently and become large.

Yes, it is not as common as in women, but it can also affect us. Especially in men with prostate problems or prostate surgery incontinence is more or less frequent.

Yes, strengthening the pelvic floor is very effective in treating urinary incontinence, regardless of the cause.

Some substances such as caffeine, alcohol, spicy foods or carbonated beverages, among others, can worsen urinary incontinence, but we must always look for other causes.

Yes, there are protective measures to limit the extent of incontinence so that you can live as normal a life as possible, but our advice is always to get to the diagnosis in order to solve it.

The amount of liquids ingested is directly related to the amount of urine produced. The appropriate amount is at least 1.5 liters, taking into account that all foods contain a variable volume of water. In the case of stress urinary incontinence, it may be useful to take the precaution of emptying the bladder when any activity involving physical exertion is planned.

Treatment is individualized depending on the type of incontinence and severity. A study is required to see when the incontinence appears.

In general, pelvic floor exercises performed with a specialist in pelvic floor physiotherapy are recommended.

In general, an active lifestyle, avoidance of excess weight and assessment by a specialist in pelvic floor physiotherapy are recommended.

Overactive bladder, unlike stress urinary incontinence, does not have such a marked component with age, so it also appears in younger people.

Overactive bladder is related to involuntary bladder muscle contractions, so rehabilitation exercises are focused on the bladder.

Men also have symptoms of overactive bladder and specific treatment should be considered.

In addition to hygienic-dietary measures, there are specific oral and patch drugs for the treatment of overactive bladder. The use of botulinum toxin is also useful to manage overactive bladder.

No, UTI is not contagious. It is true that sexual intercourse is a risk factor for developing it, but it is not a contagious disease.

Drink plenty of water, avoid compulsively washing the genital area to avoid irritating it and favoring the appearance of urinary tract infection. Make sure you are well lubricated during penetration during sexual intercourse, empty your bladder completely at the end of intercourse, avoid spending too much time with a wet genital area at beaches or swimming pools, avoid using diaphragms or condoms without lubricant or with spermicide as contraceptive methods.

Excessive discharge and itching. It does not usually cause the need to urinate frequently. The existence of back pain and fever may indicate that the infection is affecting the kidney and therefore, medical evaluation should be performed and appropriate treatment should be prescribed. In many occasions the management can be done at home with antibiotics.