Fast Facts
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52 percent of men aged 40 to 70 report some degree of difficulty with erections.
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67 percent of men in their 70s have erectile dysfunction.
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34 percent of older men have some form of urinary incontinence.
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11 percent of men deal with urinary incontinence symptoms daily.
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1 in 9 men will be diagnosed with prostate cancer during their lifetime.
How Urology Fits In Overall Men's Health:
5 Reasons You Should See A Urologist
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A testicular growth.
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Blood in your urine.
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A sudden urge to urinate, followed by accidental leakage.
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Erectile dysfunction.
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Other sexual difficulties, such as premature ejaculation or curved erections.
Prostate Disease
Many men struggle with non-cancerous prostate diseases, especially as they get older.
Here are a few:
Benign Prostatic Hyperplasia (BPH): An enlarged prostate, which can cause difficulty urinating, leaking or dribbling, urge incontinence and other problems.
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Urolift: This prostatic urethral lift procedure, typically performed with local anesthesia, uses small implants placed into the prostate via a telescope in the urethra to elevate and hold enlarged prostate tissue so it can’t block the urethra. It requires no hospital stay and no cutting, heating or removal of prostate tissue.
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Transurethral Resection of the Prostate (TURP): Aided by a telescope in the urethra, your urologist can remove prostate tissue constricting the urethra and restricting urine flow. TURP, a decades-old procedure, is considered the gold-standard treatment for prostate enlargement with durable results.
Acute Bacterial Prostatitis: A sudden inflammation of the prostate gland, usually attributed to the same bacteria that cause urinary tract infections or sexually transmitted diseases.
Chronic Bacterial Prostatitis: A rare, recurring condition that causes prostate swelling, often with frequent urinary tract infections.
Chronic Prostatitis: In some cases, long-term pelvic or penile pain may occur without a bacterial infection. This condition may be inflammatory or non-inflammatory.
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Prostate Cancer
Tallwood Men’s Health also gives you access to the doctors of Tallwood’s Urology Oncology team -- part of the Hartford HealthCare Cancer Institute -- who treat more prostate cancer patients than any other hospital in Connecticut.
Who should get a prostate screening?
The prostate specific antigen test, better known as PSA, is a blood test that measures the level of the antigen. Higher PSA levels could indicate prostate enlargement, inflammation or possibly prostate cancer. But the test no longer is considered an essential tool to detect prostate cancer.
The U.S. Preventive Services Task Force in 2018 made these recommendations about the PSA test:
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If you are 55 to 69 years old, it’s your call after talking to your doctor about the test.
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If you are 70 or older, routine prostate cancer screenings are unnecessary.
Signs of prostate cancer:
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Trouble urinating.
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Difficulty having an erection.
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Blood in urine or semen.
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Deep, frequent pain in the lower back, belly, hip or pelvis.
How to determine the risk of prostate cancer?
Some groups, including men with a family history of prostate cancer or African American men, may be at higher risk for prostate cancer. Once you and your doctor have determined that prostate cancer screening is appropriate, you will complete a PSA blood test. PSA is not always cancer-specific and may be affected by other factors such as age, genetics, inflammation and prostate size.
Men with prostate cancer generally do not have any bothersome symptoms, which is why it's important to discuss with your doctor whether screening is appropriate.
If your PSA is elevated, our experienced urology group will work with you to navigate the next steps. We may recommend additional blood testing to better determine the risk of prostate cancer, an MRI or, ultimately, a biopsy to check for cancer.
When a biopsy reveals prostate cancer, it's important to realize that not all cancers act the same way. Our expert team will review treatment options, including active surveillance, surgery and radiation.
Many prostate surgeries, including those at Tallwood, use robotic assistance. The technological precision helps doctors preserve more of the surrounding nerves and blood vessels, reduce blood loss and, because of smaller incisions, ease your recovery period. In these types of procedures, you need a doctor like those at Tallwood Men's Health with considerable robotic-surgery experience.
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Post-Prostatectomy
More than 172,000 men were diagnosed with prostate cancer in the United States in 2014, according to the Centers for Disease Control and Prevention. Of those, an estimated 138,000 have their prostate gland removed with a prostatectomy.
Many experience urinary incontinence and erectile dysfunction. The Post-Prostatectomy Rehabilitation program at the Tallwood Urology & Kidney Institute addresses this issue using the latest diagnostic tools and therapeutic technologies.
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Incontinence
Male incontinence can be caused by an enlarged prostate, constipation, chronic cough, weakened sphincter or by prostate cancer treatment.
Stress incontinence: Leakage occurs with a laugh, cough, sneeze or physical activity. When the nerves or sphincter are damaged when the prostate is removed, the bladder may have inadequate support.
Urge incontinence: A powerful urge to urinate when the bladder muscles tighten so much that the sphincter can't control the urine.
Overflow incontinence: The bladder becomes so full, often as a result of a blockage of the urethra (the tube that removes urine from the body), that it overflows. The blockage is often caused by an enlarged prostate, narrow urethra or weakened bladder muscles.
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Erectile Dysfunction/Sexual Function
Having difficulties in the bedroom is a common problem, probably more common than you think. At Tallwood Men’s Health, we have experts to address your sexual function concerns whatever they may be: erectile dysfunction (ED), loss of libido, premature ejaculation or penile curvature.
Our multidisciplinary team will ensure that we also address potential linked conditions such as vascular disease, testosterone abnormalities or any psychological concerns.
Once you get past the difficulty of seeking help for trouble maintaining an erection during sex, you’ll find that a solution could be as simple as stopping smoking or avoiding alcohol and recreational drugs.
Our urologists can tell you if it’s more complex. Treatment options including oral medications, vacuum devices, urethral suppositories, penile injections and surgically-placed implants. Be cautious of over-the-counter sexual-enhancement supplements because they might contain unlisted ingredients that can interact with your other medications.
Also note that some men’s health centers offer non-FDA approved treatments such as shockwave therapy or stem cell/platelet rich plasma injections for erectile dysfunction. Always make sure you are seeing an ED expert like the board-certified doctors at Tallwood Men's Health.
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Peyronie’s Disease
Peyronie's disease results from scar tissue or plaque that forms on the penis, affecting the ability of the penis to expand during an erection. It results in various curvatures or deformities (an indentation or hourglass shape).
Peyronie’s disease can also affect blood flow in the penis with sexual stimulation, contributing to erectile dysfunction.
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Infertility
Did you know that 15 percent of couples struggle to conceive within the first year of trying? Fertility screening gives data that provides clues to why you might be having trouble conceiving.
When you see our male infertility experts at Tallwood Men’s Health, you will be assessed with a thorough history and physical exam. We also request a hormonal (blood work) and sperm evaluation (semen analysis).
Here are some common causes of male infertility:
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Low or absent sperm count (oligospermia or azoospermia, respectively).
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Slow sperm movement (asthenospermia).
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Sperm with abnormal shape or size (teratozoospermia).
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Abnormally dilated testicular veins, also known as a varicocele.
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Hormonal imbalance.
Don’t worry if your evaluation reveals an abnormality. There's a large “gray zone” with male fertility testing results. Our infertility experts will work with you to consider lifestyle factors and possibly recommend medications or minimally invasive surgical procedures.
Vasectomy
A vasectomy is difficult to beat for long-term birth control. With a lower failure rate that any other available form of birth control, vasectomies are a simple office-based procedure to give men some control over family planning.
After a vasectomy, only 15 to 20 of every 10,000 couples experience a pregnancy, according to the National Institutes of Health, sharply lower than oral contraceptives (500 pregnancies per 10,000 couples) and the use of condoms (1,400 pregnancies per 10,000 couples).
On men's to-know list: A vasectomy, a safe office procedure that doesn’t use a scalpel and usually takes less than 20 minutes, does not reduce sex drive, performance or pleasure. Local numbing medication assures that you will feel no pain.
It also does not change the amount or appearance of ejaculate significantly – only 10 percent of ejaculate is actually sperm. A vasectomy, in fact, does not affect sperm production. It only prevents sperm from joining the semen ejaculated from the penis. (The body reabsorbs any sperm produced.)
How does that happen? During a vasectomy, the duct carrying sperm from the testicle to the urethra (the vas deferens), is cut, sealed and secured. That's it. The no-scalpel procedure developed in the 1970s has helped relieve vasectomy anxiety with less pain and bleeding. Vasectomies are covered by almost all insurance programs.
If you have second thoughts after having a vasectomy, ask your Tallwood Men’s Health doctor about a reversal.
“Up to 6 percent of men change their minds after a vasectomy,” says Dr. Bieniek. “A vasectomy reversal is an excellent option for having children again but may require complex intraoperative decision making and vasoepididymostomy reconstruction. It is imperative that you have an experienced and well-trained surgeon on your side.”
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Kidney Stones
Kidney stones, hard deposits of crystalized salt and minerals, form when urine is too concentrated and cannot dissolve crystal-forming substances. With insufficient water, typical of dehydration in the hot-weather months, salt and minerals can stick together and form stones.
Kidney stones, which can form over months or years, can be extremely painful. Though most kidney stones pass on their own, they can create other medical problems if they break free from the kidney and become stuck in the ureter, the tube that carries urine from the kidneys to the bladder.
Call your doctor if you have sharp pains in your back that might radiate to your abdomen and groin, accompanied by nausea, vomiting, fever or blood in your urine.
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Renal (Kidney) Mass
Most kidney growths are both small and contained, meaning the tumor has not spread beyond its origins. The smaller the mass, the more likely it is benign. A larger mass, meanwhile, increases the likelihood of cancer.
Kidney Cancer
Tallwood surgeons were among the first in the nation to perform a laparoscopic nephrectomy – removal of the kidney -- in patients with kidney cancer. They also pioneered the hand-assisted laparoscopic nephrectomy (HALN), a standard in minimally invasive nephrectomy, and have taught the technique to more than 1,000 surgeons from the U.S. and overseas.
Now, more than 90 percent of patients with kidney tumors are treated using a minimally invasive surgical approach. Our surgeons have the laparoscopic and robotic skills and experience to best treat you.
Signs of kidney cancer:
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Bladder Cancer
Bladder cancer, the fourth most-common cancer among men, typically requires surgery. The Tallwood Urology & Kidney Institute treats the most bladder cancer cases each year in Connecticut. Early detection, followed by appropriate treatment, is critical.
Watch for these signs:
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Blood in the urine.
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Pain, burning during urination.
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Difficulty urinating.
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Feeling an urgent need to urinate even though your bladder is not full.
Possible symptoms of advanced bladder cancer:
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Blood In Urine (Hematuria)
Blood in your urine, also called hematuria, can be visible to the human eye or in such small quantities that it’s detectable only under a microscope.
Call your doctor if there are any indications of blood in your urine, sudden pain in your upper abdomen or back and sides, discomfort while urinating or if you having increased urinary frequency or urgency.
Possible causes of blood in the urine:
- Inflammation of the bladder, urethra, prostate or kidney.
- Infection of bladder, kidney, prostate or urethra.
- Kidney or bladder stones.
- Kidney failure.
- Polycystic kidney disease.
- Bladder or kidney cancer.
Tallwood Urology & Kidney Institute Locations