WE ARE ASKED IN CONSULTATION

Benign prostatic hyperplasia (BPH) is not a cancer nor does it increase the risk of developing it, therefore, it is not a dangerous disease in itself. However, if not treated properly, it can lead to major complications that do seriously affect health and quality of life. Among the possible consequences of uncontrolled BPH are: acute urinary retention (inability to urinate), recurrent urinary tract infections, bladder stone formation, progressive damage to the bladder or kidneys. Therefore, although it is not malignant, it does require medical attention and urological follow-up. With early diagnosis and appropriate treatment, BPH can be effectively controlled and complications avoided.

The prostate helps us to maintain good urinary continence. It also produces much of the seminal fluid, which is like "gasoline" for the sperm.

There are many, but some of the most common are: getting up to urinate at night, urinating many times when getting up in the morning, dropping a few drops at the end of urination, weak urinary stream, having to strain to start urinating.

We may only need to do an ultrasound of the prostate, bladder and kidneys, along with a blood test.

Prostate cancer in its early stages usually has no symptoms, so the only way to detect it early is through medical check-ups. The main tests are the PSA blood test and digital rectal examination. In advanced stages, symptoms such as difficulty urinating, increased urinary frequency, blood in the urine or bone pain may appear. If you are over 50 years of age, or if you have a family history, it is advisable to see a urologist even if you do not have any discomfort.

Prostate cancer is curable, especially when detected in early stages. If the tumor is localized, cure rates exceed 90% with treatments such as surgery, focal therapy or radiotherapy. In advanced cases, although it is not curable, there are very effective therapies that allow it to be controlled for years. Early detection is essential to increase the chances of cure. For this reason, periodic urological check-ups are recommended from the age of 50 (or earlier if there is a family history).

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.

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.

You have to live with it. It is true that it can be operated, but in the future it can reappear and therefore it is necessary to undergo check-ups to stop it in time. The key is to keep it under control.

Most patients do not reach two years. Now there are new treatments with immunotherapies that are achieving longer survivals.

Age, smoking and exposure to industrial paints and dyes. In addition, patients with chronic catheterization or lithiasis may have an increased incidence of bladder cancer of the squamous subtype, which is caused by a foreign body inside the bladder.

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 a silicone prosthesis that is placed in place of the testicle so that the aesthetic impact is minimal. They are available in various sizes to place the type of prosthesis more in accordance with the anatomy of each person.

After surgery for testicular cancer, when we know what type of tumor is affecting you, we will start with systemic treatment. Even with metastases, the testicular tumor is cured in most cases.

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.

Most likely it is nothing but it is best not to be overconfident. Penile tumor sometimes grows very slowly and gives few symptoms.  

Only in some cases, when the tumor is advanced.If the tumor is caught early, the treatment is much less aggressive. 

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.  

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.

It is usually related to smoking and obesity. Although there are also other risk factors such as age or first-degree family history that may play a role.

The most frequent areas to which kidney cancer can spread are the bones, liver, lungs, brain and distant lymph nodes.

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.

When prostate problems are present, pain may manifest in various areas of the body depending on the specific condition and its severity. The most common causes of pain are prostatitis and advanced prostate cancer. The following are the areas where pain may occur: - In the perineum (area between the anus and the genitals): when there is prostatitis. - Lower abdomen, especially if there is urinary obstruction due to an enlarged prostate. - Lower back: in advanced prostate cancer, pain may radiate to the lower back due to bone metastases. It may also appear in chronic prostatitis due to persistent inflammation. - Groin and inner thighs: some prostate conditions may cause pain radiating to the groin or inner thighs due to pressure on nearby nerves. - Testicles and penis: some forms of prostatitis may cause pain in the testicles or base of the penis, as inflammation can affect nearby nerves and tissues. - Anus or rectum: The prostate is very close to the rectum, so inflammation may cause rectal pain or a feeling of pressure. It may be felt more when sitting for long periods of time.

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.

Treatment ranges from conservative maneuvers such as bladder catheterization to the need for surgery. The type of surgery depends on the origin and size of the fistula and may require a vaginal, abdominal or laparoscopic approach. In cases of fistulas from the urinary tract to the digestive tract, a colostomy may be required, i.e. a bag to collect the feces.

In case of radiotherapy, fistulas usually have a more complex treatment. Radiotherapy is an effective treatment in multiple tumors and its complications are rare. However, on isolated occasions, especially in association with pelvic surgery, it increases the risk of development of fistulas from the urinary tract to the vagina or the gastrointestinal tract.

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.

There are several treatments that can improve the incurvation, from non-invasive therapies to surgery. It is necessary to understand what stage of Peyronie's disease we are in and what symptoms we have in order to consider the best treatment for each case.

Yes, although as a last option. When there is a very important curve or Peyronie's is accompanied by erection problems, sometimes the only alternative is surgery.

There are no "magic pills" but we do have some oral treatments that improve some aspects of Peyronie's disease.

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

Try to regain your self-confidence by confronting the problem. Walking away will only increase apprehension and prevent any form of intimacy with your partner. Be patient, regaining self-esteem is a gradual process. Savor the intimate moments as a couple and enjoy the preliminary moments.

When all other treatments have failed and the patient has no contraindications.

Yes, they are very frequent, especially after the age of 40.

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

Currently, in Spain, the best alternative is a testosterone gel that is applied every morning on the skin and, after some time, we can proceed to injectable testosterone.

Testosterone treatment in men with hypogonadism is very safe and has very few side effects. It has been shown not to increase the risk of heart disease or prostate cancer.

Some symptoms improve within a few weeks, although others may take up to six months. The treatment greatly improves the general state of health, but it does not work quickly. In addition, to complement the treatment and make it more effective, it is necessary to associate eating habits and physical exercise.

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

Approximately up to 85% of men improve. In our experience, it depends on the level of control at the start of treatment and the commitment of the patient.

In some situations there are surgical procedures that can improve intercourse time, although you need to know the pros and cons.

Yes, premature ejaculation can produce an uncomfortable situation with our partners and negative feelings of our own. This can produce an anxious situation that undermines our erection and blocks our desire.

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

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.

If everything goes well, you should be able to leave the same day. It is a technically complex and relatively long surgery, but once it is finished, you will be able to go home within a few hours.

If the vasovasostomy fails to repermeabilize the seminal duct, the next step is testicular biopsy to obtain spermatozoa. In fact, on many occasions these are two procedures that are performed simultaneously.

At first, you may notice red or brown sperm. This is because the incision and suturing of the vas deferens may bleed, and this may stain the sperm. To confirm the effectiveness of the surgery and the presence of sperm in the semen, it is recommended to perform a semen analysis approximately three months after the procedure. This analysis will evaluate the concentration, motility and morphology of the sperm, providing information on the recovery of fertility.

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.

Infertility can be an emotional problem for the couple. In this matter, nothing is anyone's fault. Listen to how your partner feels without judgment and tell him or her how you feel.

It will depend on the quality of the semen analysis and the eggs. It will also depend on your age and whether there has been fertility at some point. No one technique is best for everyone. They all have pros and cons. So talk to your reproductive expert to understand the advantages and disadvantages of each strategy so that you can make a consensual decision.

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.

Yes, sexual desire, orgasm sensation and ejaculation will remain the same. The penile prosthesis is responsible for providing a firm erection, but does not directly affect the ejaculation process. Therefore, the penile prosthesis allows you to regain erectile function and enjoy a satisfying sex life, without interfering with your ability to ejaculate.

The length of the penis is not increased. On the contrary, in some cases a shortening of 1-2 cm is observed. Some prosthesis models allow a 10% increase in size when activated, to try to counteract the loss of penile length caused by erectile dysfunction.

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.

No. Self-catheterization may be a marginal option in some patients but it is not an effective treatment to solve the problem in most people.

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.

The postoperative period will depend on the type of intervention performed. If it has been treated with lithotripsy, the patient will not need hospitalization, since it is an outpatient procedure. However, if endoscopic surgery was performed, the patient is usually hospitalized for at least one day with a double J catheter in place to protect the kidney.

The double J catheter presents a series of side effects such as discomfort and irritation caused by the end of the catheter inside the bladder. In order to minimize them, in addition to medical treatment, we try to keep the catheter as short as possible.

The length of time a person will need to wear a double J catheter will depend on the complexity of the procedure. Typically, after ureteroscopic surgery or retrograde intrarenal surgery, the time ranges from one week to 10 days. However, if the surgery is more complex, it may be necessary to wear the catheter for about 15 days, and this period may be extended to 21 days.

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.

Yes, it is very common. After the age of 40, a large percentage of men have urinary symptoms and that can be associated with incontinence. Get prostate checkups if you are over 50 or if you have any urinary symptoms.

Yes, there are different techniques depending on the cause of the incontinence and its severity. Generally, it is a last resort because there are other effective and safe options.

Yes, there are drugs for urge incontinence. When there is urgency or urgency of urination there are several medications that can help.

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.

Basically, if in your day-to-day life, you involuntarily leak urine when you laugh, sneeze or strain.

Most patients with voiding urgency do not have urinary incontinence, but should consult a specialist.

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 case of pelvic floor weakness and stress incontinence, surgery is performed for the treatment of stress urinary incontinence. However, in case of overactive bladder there is no clear surgical treatment.

Patients with overactive bladder show in the urodynamic study detrusor bladder muscle contractions during filling, which allows the diagnosis of overactive detrusor. In addition, the urodynamic study provides information on bladder capacity, the elastic capacities of the bladder, how bladder emptying works and the presence of stress urinary incontinence, among others.

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.

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.