Associated Urological Specialists offers expertise in treating your most personal issues. We are experts in treating erectile dysfunction (ED), low testosterone (low T), penile curvature (Peyronie’s Disease), and our doctors have performed thousands of vasectomies.
Many men experience erectile dysfunction as it is a natural part of aging. It also can be caused by other medical conditions such as diabetes, high blood pressure, high cholesterol, obesity, and also may be a side effect of treatments for prostate cancer. ED is also a side effect of many common medications. ED can cause significant stress and frustration and can also cause tension in relationships.
Over the counter supplements that supposedly treat ED typically do nothing other than offer a placebo effect. We offer many proven treatments including oral medications including generic forms of Viagra and Cialis, affordable injectable medications, and several of our urologists have extensive experience in offering penile implant surgery. We also are now offering shock wave treatment for ED.
There are many "men's health" clinics that advertise "custom treatments" for erectile dysfunction. Most of these clinics are not staffed by urologists and just charge higher prices for generic medications or treatments our physicians can provide at a fraction of the cost or perhaps can even be covered under your health insurance.
Peyronie's disease or penile curvature can be a serious problem and can impair quality of life. While some curvature is normal, severe penile curvature can cause difficulty achieving erections, cause pain with erections, or make intercourse difficult if not impossible. We offer state of the art medical and surgical options for the management of Peyronie's disease to get the situation straightened out.
Vasectomy is a sterilization procedure for men who no longer desire any more children. This procedure is typically done quickly in the office with local anesthetic and is more than 99% effective in preventing unwanted pregnancy. Patients typically take it easy with activities for the first 48 hours after the procedure and then can resume normal activities. The experts at Associated Urological Specialists have performed thousands of vasectomy procedures and will make your experience as quick and painless as possible.
A urethral stricture is a narrowing or blockage in the urethra which can cause bothersome urinary symptoms such as incomplete bladder emptying, weak urinary stream, or infections. Strictures can result from prior infection, especially sexually transmitted diseases like Gonorrhea or Chlamydia, prior injury such as trauma from a car or bike accident, or from prior surgery. The initial treatment for a stricture usually involves dilation where a guidewire is placed into the bladder and then progressively larger urethral dilators are passed to open up the narrowed area. If this fails, an endoscopic procedure known as a urethrotomy can be performed where a scope is placed into the urethra and under direct vision, the stricture is cut with a knife or laser. If this fails or if the stricture is too long, a larger operation called a urethroplasty can be performed where the narrowed area is cut out and the two healthy ends are sewn back together. For very long strictures, occasionally tissue grafts, often from the cheek lining, are used to bridge the gap during repair.
Low T is also a very common issue as men get older. The main side effects of low testosterone include decreased energy, decreased libido, and weight gain. There are many over the counter supplements available for low T but supplements are not studied or FDA approved so may be dangerous. Our experts offer multiple options to treat low T in a safe and effective manner and these can include testosterone gels, patches, injection, or longacting under the skin pellets.
There are many "men's health" clinics that advertise "custom treatments" for low testosterone. Most of these clinics are not staffed by urologists and just charge higher prices for generic medications or treatments our physicians can provide at a fraction of the cost or perhaps can even be covered under your health insurance.
Penile cancer is a rare type of cancer typically affecting older uncircumcised men. This often shows up as a reddish mass on the penis and sometimes can be hard and painful. Typical biopsy and surgical resection is needed to confirm diagnosis and treat penile cancer.
A varicocele is caused by dilated veins around the testicle. This is similar to varicose veins in the legs and a varicocele can cause testicular discomfort, especially with standing or straining. Varicoceles can also lead to infertility as it can alter the temperature of the testicle and inhibit normal sperm production. Many varicoceles are small and are asymptomatic or cause vary minimal pain. Larger varicoceles can be palpated around the testicle and have a characteristic “bag of worms” feel. Large, symptomatic varicoceles can be surgically repaired by clipping the dilated veins through a small groin incision. Alternatively, the large vein draining the testicle can be embolized by an interventional radiologist. Even after treatment, varicoceles may recur but this is relatively uncommon.
Prostatitis is an infectious or inflammatory of the prostate that can cause very bothersome symptoms. Symptoms can include urinary frequency, urgency, burning, and pelvic pain. The condition can be difficult to treat and can become chronic. Evaluation includes a digital rectal examination to palpate the prostate, which is often boggy or tender during an active infection, and a urinalysis to determine if a bacterial infection is present and to determine which antibiotics are appropriate. If an initial urine sample is negative, further samples after prostate massage can also be performed to try and express bacteria from the prostate. Imaging of the prostate with ultrasound may also be used to make sure that that a cavity of infection (abscess) is not present. Prostatitis can also be non-bacterial and due to inflammation. Treatment of prostatitis often begins with antibiotics, often for at least 2-4 weeks, if it is caused by a bacterial infection. Other useful medications include anti-inflammatories such as ibuprofen, and alpha-blockers such as Flomax or Uroxatral to relax the prostate smooth muscle. In chronic cases with persistent pelvic pain, occasionally anti-depressants or muscle relaxants may be used.
- Symptoms – Difficulty urinating, pelvic or lower back pain, painful orgasm.
- DX – a Urine test to check for infection; other tests if needed.
- TX – Usually medication.
A hydrocele is an accumulation of fluid around the testicle. It is not dangerous but can be uncomfortable for patients and can feel heavy when standing or make it uncomfortable to sit. It is typically diagnosed by physical exam and ultrasound of the scrotum. Hydroceles typically do not resolve on their own so they can be treated either with a simple drainage procedure in the office or with outpatient surgery.