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53 Q&A related to urology

Free testosterone | Urology | 10-2011
Total testosterone levels in the blood vary considerably and should be requested only when there s a need to establish whether castrate level testosterone has been achieved on ADT androgen ...

Surgery for stress relief | Urology | 09-2009
Multiple pregnancies do strain or damage the pubo-urethralis muscle, which is anchored to the pubic bone, and slings around the urethra just below the bladder neck. When this support is ...

Multicultural urine | Urology | 09-2009
This kind of bacteriology report is common when the collection wasn t a mid-stream sample after three swabs of the finger-separated vulva in women. If the woman is symptomatic, and ...

Urine chlamydia test catches most cases | Ob/Gyn | 06-2009
Although a cervical swab provides the most sensitive and specific test result for chlamydia, a urine chlamydia also has high specificity and is a good alternative if you re unable ...

Testing testosterone | Urology | 04-2009
Testosterone testing may be considered for two conditions to see if castrate level has been achieved for men undergoing hormone treatment for prostate cancer, and secondly to assess dysfunctional sex ...

When is a UTI really gone? | Urology | 04-2009
I think there may be some controversy on this point. I believe that follow-up urine testing is unnecessary for women who have had an attack of cystitis, often associated with ...

Do hair loss products skew PSA counts? | Urology | 03-2009
This is an interesting question, and I don rsquo t have the full answer. What we do know is that with finasteride 5 mg Proscar we expect a 40 reduction ...

PSA testing in the elderly | Urology | 02-2009
The idea behind stopping the testing at age 70 is based on the fact that the average male life span in Canada is 78. As it may take about 10 ...

Peyronie’s — setting things straight | Urology | 12-2008
Nothing much has changed in our understanding of this strange malady since Count Peyronie first described it in 1743. The prevalence is 3.2 of the Caucasian population, and very rare ...

Telltale signs of testicular torsion | Urology | 10-2008
Classically, lifting the scrotum is supposed to aggravate the pain when we re dealing with torsion and lessen the pain associated with epididymitis. There are exceptions to the rule, and ...

Can a man transmit STIs after prostate surgery? | Urology | 09-2008
Yes, secretions from Cowper's gland, for example, can contain the virus. Patients with a vasectomy, by the way, would have a normal ejaculate, except that it doesn't contain spermatozoa.

When to treat asymptomatic bacteriuria | Urology | 08-2008
In older men, we may be dealing with a large residual bladder stone or a bladder diverticulum. A simple ultrasound can rule these conditions in or out. If neither is ...

Managing urinary reflux in kids | Urology | 07-2008
There are heated debates among pediatric urologists on when and for how long affected children should be treated with antimicrobial agents, if at all, and when corrective surgery is advisable. ...

Managing urinary reflux in kids | Pediatrics | 07-2008
Evidence supports the notion that recurrent urinary tract infections UTIs may lead to scarring and impede renal functioning. Reflux, however, doesn't necessarily lead to infections or damage the kidneys. Having ...

Colitis meds affect sperm count | Urology | 06-2008
Azathioprine can certainly interrupt spermatogenesis. It should be stopped for at least 3 months then you would order a repeat semen analysis. Remember that spermatogenesis takes 72 days.If your patient ...

Colitis meds affect sperm count | Gastroenterology | 06-2008
If your patient has a reduced sperm count, you should try stopping the sulfasalazine temporarily and see what happens. This might be the answer and in your case, is probably ...

How to beat recurrent UTIs | Urology | 05-2008
Long-term broad-spectrum antibiotics must not be used because they don't help and instead invite difficult resistant organisms. Instead, ascertain that there are no reversible underlying conditions, such as stone disease, ...

How to beat recurrent UTIs | Geriatrics | 05-2008
Asymptomatic bacteriuria -- when a significant growth of the same organism is found on 2 consecutive cultures in the absence of UTI symptoms -- is common in seniors, especially women, ...

When to check out microscopic hematuria | Urology | 04-2008
The condition is common but I don't think there's unanimous consensus. Some urologists will insist on cystoscopy and, if negative, upper tract imaging, like doing an ultrasound on every single ...

Undescended adult testicles: remove them? | Urology | 03-2008
At 61, the risk of cancer in an abdominal testis is quite remote. And, like an impacted wisdom tooth after age 40, or appendix after 50, surgery is probably not ...

Embarrassing postvoid dribble | Urology | 01-2008
The logical explanation is that an enlarged prostate, just above the sphincter, compromises the tap's ability to close completely. This explanation is supported by the finding that surgical removal of ...

Anal Pap for anal sex | Obstetrics Gynecology | 11-2007
There are no guidelines as yet for an anal Pap. If anal sex is practiced, then you should obtain cultures from the rectal area. Anoscopy is reserved for cases of ...

PSA guidelines for the young and old | Urology | 08-2007
PSA guidelines keep changing, but I have no hesitation in recommending the test. I start at age 40 for men with a family history of prostate cancer or with an ...

Relieving urinary retention post-op | Urology | 06-2007
Post-op urinary retention can partly be avoided by being aware of its possibility and encouraging the emptying of the bladder before surgery. This is particularly important with lower abdominal procedures, ...

Interstitial cystitis in men | Urology | 05-2007
Less than 10 of interstitial cystitis cases occur in men. Why this condition is more common in women, particularly high achievers, is unknown. I consider the same treatment for men ...

Premature ejaculation in teenagers | Psychiatry | 04-2007
An excellent review of the assessment and management of premature ejaculation appears in amp lt i amp gt J Sex Marital Ther amp lt i amp gt 2000 26 293-320. ...

Botulinum toxin for an overactive bladder? | Urology | 04-2007
Perhaps it does, but it's unlikely to be used for that condition. Besides oxybutynin, there's been a deluge of new products for this condition. Some contain oxybutynin in transdermal or ...

Can a hot diet cool cancer? | Clinical Pharmacology, Nutrition | 03-2007
Capsaicin, the major spice in red peppers, is a compound that's been used for some time as an analgesic and as a topical irritant. It's been a flavouring agent for ...

Recent advances in interstitial cystitis | Urology | 02-2007
Phenazopyridine is unlikely to help, and I haven't been impressed with intravesicular hyaluronic acid instillation. Weekly dimethylsulfoxide DMSO infusion with heparin and or bicarbonate may be more useful than DMSO ...

Can bupropion cause scrotal pain? | Clinical Pharmacology, Urology | 01-2007
The quick answer would be no. Bupropion is an effective antidepressant that, like most drugs, has been associated with a number of adverse effects. Epididymal pain, however, is not considered ...

How to approach asymptomatic pyuria | Nephrology | 08-2006
Pyuria is defined as the presence of more than 3-5 white blood cells per high power field in the spun urine. This may be the result of infection that's been ...

Could antibiotics eliminate catheter urosepsis? | Geriatrics | 05-2006
As regards chronically catheterized older patients, I'm not aware of any benefit from either long-term prophylactic antibiotic treatment or abbreviated antibiotic therapy at the time of catheter change. amp lt ...

Do beta-blockers worsen ED? | Cardiology | 04-2006
Erectile dysfunction is common in patients with vascular disease, and it's always a challenge to sort out whether the medication is a cause or an aggravating factor. The best randomized ...

Revisiting the risks of vasectomy | Cardiology | 02-2006
To my knowledge, there's no reason to believe that a vasectomy increases the risk of a heart attack. I realize this has been claimed by some people, but I don't ...

Are anabolic steroids advisable in older men? | Endocrinology | 02-2006
Testosterone replacement is indicated for men with documented testosterone deficiency, based on measurements of free or bioavailable testosterone. As a supplement, this hormone is a controlled substance that shouldn't be ...

Does double incontinence call for a catheter? | Geriatrics | 11-2005
Stool and urine are very irritating to perineal skin and, in combination with prolonged contact, may result in decubitus ulceration. Nevertheless, chronic indwelling Foley catheters should be avoided as much ...

Does finasteride prevent prostate cancer? | Oncology | 09-2005
Good question The prostate cancer prevention trial, a seven-year clinical trial asking if finasteride could prevent the development of prostate cancer, was published in lt i gt NEJM lt i ...

Timely treatment of childhood enuresis | Pediatrics | 07-2005
Enuresis is either primary or secondary. Primary enuresis involves developmental bedwetting from birth, and all children eventually outgrow it. If the patient has a normal physical exam and you're sure ...

Full workup for STDs | Obstetrics Gynecology | 06-2005
When patients ask to be checked for STDs, I usually ask why. Have they had intercourse without condoms or are they screening so they no longer have to use them ...

Can ED drugs raise a migraine? | Cardiology | 10-2004
As you know, these compounds share similar properties by inhibiting PDE-5 however, there are differences between them. Although the pharmaceutical companies have provided trials against placebo, very little comparison data ...

Does chlamydia cut prostate Ca risk? | Infection | 05-2004
The only reference that I could find in the medical literature to suggest such a link was a meeting abstract referenced in AIDS Patient Care STDs 2002 16 620 . ...

Is glycosuria without hyperglycemia a concern? | Nephrology | 04-2004
Glycosuria, also known as glucosuria, refers to the presence of glucose in the urine. Normally, less than 0.1 of glucose filtered by the glomeruli appears in the urine, as it's ...

Prostate Tx with alpha-blockers and cardiac effects | Cardiology | 03-2004
As you know, the ALLHAT Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial study was stopped prematurely because the alpha-blocker doxazosin was found to be less effective than the ...

Managing hot flushes after hormone Tx for prostate cancer | Endocrinology | 02-2004
This is a challenging problem. In women, low-dose clonidine has had only modest results in treating hot flushes, but it may be worth a try. A recent JAMA article suggests ...

Phimosis in a 10-year-old: is surgery warranted?" | Pediatrics | 10-2003
It's been shown that topical steroids, such as 0.1 betamethasone valerate cream applied twice daily, are somewhat effective for the treatment of phimosis. Remember, however, that the natural history of ...

Managing hypercalciuria in sarcoidosis | Nephrology | 05-2003
Hypercalcemia occurs in about 10 of patients with sarcoidosis it s thought to be due to elevated levels of 1,25-dihydroxyvitamin D3 calcitriol produced by macrophages within the granulomas. This causes ...

Lithotripsy: when are antibiotics warranted? | Cardiology | 04-2003
There's a spectrum of patients with mitral valve prolapse, calling for different approaches. Patients warranting prophylaxis consist of those with previous endocarditis or structural abnormalities of the mitral valve, including ...

Do "tight foreskins" in kids need steroids? | Pediatric | 01-2003
Controlled studies from both Europe and North America show that steroid creams are reasonably effective 67-80 success rates in treating boys with phimosis. The most commonly used agent from the ...

A cocktail for renal colic relief | Nephrology | 04-2002
Ultimately, the best analgesic treatment for renal colic is either spontaneous passage of the stone, or removing the stone or ureteral obstruction. But until then, the patient needs pain control ...

BEWARE OF NSAID Urology | Urology | 04-1995
amp quot NSAID Urology amp quot is a generic term utilized to describe different pathophysiologic entities associated with the prostaglandin inhibitors. There is an uncommon idiosyncratic interstitial nephritis IN that ...

ENURESIS = AGING? | Geriatrics | 03-1995
With normal aging there is a postural diuresis at night such that normal patterns include up to two voids per night, especially with conditions such as peripheral edema, congestive heart ...

IGA Urology CASTS A SHADOW | Urology | 06-1994
When IgA Urology was initially described in the 1970s it was thought to be a benign condition of recurrent hematuria typically accompanying upper respiratory infections. Now it is well established ...

HYPERURICEMIA DOSEN'T GO TO GOUT | Urology | 04-1994
Hyperuricemia in the absence of recurrent acute or chronic gouty arthropathy or urate nephrolithyasis should not be treated. The critical question is whether chronic hyperuricemia leads to renal impairment. There ...



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