Thinking of having a vasectomy reversal?

July 7, 2021 in Fertility, Penile, Testes

Are you thinking of having a vasectomy reversal? Do you know all the facts?

What is a vasectomy?

A vasectomy is a surgical procedure performed on men to make them sterile or to be used as a long-term contraception. During the procedure the vas deferens (a duct that takes sperm from the testicles to the urethra) are cut and tied or sealed to prevent the delivery of sperm.

What is a vasectomy reversal?

A vasectomy reversal is usually requested when a couple decide to try for more children. During the procedure the previous cut ends of the vas deferens are put back together to ensure that the sperm cells can travel to the urethra from the testicles. This procedure can usually be done in 2 hours and is done under general anaesthetic. A vasectomy reversal is a common procedure that has a success rate of around 95%. At our practice we have been serving the North West for almost a decade, helping patients to achieve their wish of expand their family.

What are the risks and side effects of having a vasectomy reversal?

Any operation that requires you to go under general anaesthetic carries risks, however these are generally quite small. Please discuss any concerns with medical staff before the procedure, so that you have a full understanding of what will happen.

Side effects

Common- you will experience some pain and discomfort after the operation. You are advised to take pain killers for 2-3 days.
Occasional- after this operation, infection and/or swelling may occur in the scrotum or wound. If this occurs you may require further treatment.
Rare- bleeding after the operation may occur which may result in bruising and swelling of the scrotum; which may result in further treatment.

Please contact us to find out any further information about this operation.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Mens Health

June 16, 2021 in Bladder, Fertility, Kidney, Penile, Prostate, Testes

This week is men’s health week (14th-20th June 2021). While the focus is on men’s mental health, we also think it is important that we talk about men’s physical health. Since lockdown last year the way we see our GPs has changed. We hope to answer some of your men’s health questions that you may not have answers to. Simple, yet very important!

Fatigue, weight gain, hair loss and changes to sexual behaviours may be caused by a low level of testosterone. This can be easily diagnosed with a blood test!
An enlarged prostate, medically known as benign prostatic hyperplasia, is not a warning sign of cancer. It can however cause uncomfortable symptoms such as pain when urinating or urinary incontinence.
Prostate cancer is the second most deadly cancer for men in the UK. When caught early it can be very treatable. Always attend your prostate examinations!
Erectile dysfunction should not be considered normal and is not something that comes with age. If you are suffering from erectile dysfunction it is important that you speak to a medical professional about possible causes and treatment.
Men between the ages of 20-40 are most likely to have a tumour that is caused by testicular cancer. It is important that you carry out self-examinations and go and get any changes checked out.
A prostate specific antigen (PSA) test can pick up inflammation and even cancer of the prostate by looking at the levels of protein in the blood. It is important that you have this test annually.

If you have noticed any urological changes and would like to speak to a specialist at Urology Clinics Manchester please call us on 01613271269 or email us on info@urologyclinics.co.uk

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Erectile dysfunction & the possible treatments

May 18, 2021 in Fertility, Penile

Erectile dysfunction is the inability to get or maintain an erection in order to have sexual intercourse. Although it is more common in older men, around 25% of men under the age of 40 are affected by erectile dysfunction.

If you are suffering with erectile problems, it could be caused by a number of different reasons. These can include:

Problems with blood flow
Diabetes causing nerve damage or a low testosterone level

The best initial step is to seek your GPs opinion; as come cases can easily be dealt with. If you are referred to a specialist you will need a blood test at your consultation to check for any unknown causes for the erectile problem. In many cases the erectile dysfunction cannot be cured, however symptoms can be managed by using medication such as Viagra or Cialis.

It always helps to maintain a healthy and active life style, with a balanced diet to ensure that your weight stays at a healthy level. Reducing habits such as smoking and drinking can also help minimise the risk of developing erectile dysfunction.

Many men with erectile dysfunction (ED) have this problem due to a reduction of blood flow to the into penis. Previous research has shown sufferers of heart disease benefit from shocks waves over a period of time to help promote the growth of new blood vessels, which can tell to prevent further heart problems. This research has been extrapolated to help find a treatment for ED patients.

ED 1000 therapy is a relativity new treatment. The process is 9 weeks long, and uses small shock waves to help increase the number of blood vessels and therefore improve the flow of blood to the penis. The treatment consists of two 20-minute treatments a week for three weeks, then a three-week break followed by a further two treatments a week for three weeks. The pain free treatment is done in an outpatient clinic while the patient is awake and does not affect any day to day activities. Research has shown that the effects of ED 1000 can last over two years.

This treatment helps to increase the number of men who benefit from the use of medications such as Viagra, therefore resulting in a better patient satisfaction rate. Medical trials have shown that ED 1000 therapy can help two thirds of men achieve better erections with medications such as Viagra. Although this treatment is primarily for patients with vascular related erectile dysfunction, ED 1000 therapy has also been used to treat patients with ED problems related to diabetes.

Urology Clinics Manchester are currently the only clinic in the North West of England that offers ED 1000 Therapy. Please contact us to find out more or if you wish to known if ED 1000 is the right treatment for you. Often patients will come to us with a referral from their GP, however we also welcome self-referrals.

If you have never seen a specialist about your erectile dysfunction, we can offer a full consultation with the appropriate tests as needed prior to receiving the ED 1000 therapy.

Please note that the ED 1000 treatment is given at the discretion of the specialist. A consultation with us does not grantee that ED 1000 is the right treatment plan for you.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

An educational report written by some of the experts at Urology Clinics Manchester

March 24, 2021 in Penile

Human Papilloma Virus (HPV) status may impact treatment outcomes in patients with pre-cancerous penile lesions (an eUROGEN Study).

Penile intra-epithelial neoplasia (PeIN) is a known precursor for penile cancer. It may be undifferentiated or differentiated. The former is related to high-risk Human Papilloma Virus (HPV) and associated with p16 over-expression. Patients may present with red patches or lesions on the penis which on occasion may affect sexual activity.

This study will assess associations between p16 status, patient parameters, treatment choice and outcomes. Data were collected on patients diagnosed with PeIN, who were referred to a single European Network, between 2008 and 2018.

The following parameters were collected utilising patient records: demographics, smoking status, performance status, comorbidities, HPV/p16 status, lichen sclerosus (LS) status, treatment and clinical response. Log rank, Kaplan-Meier, Pearson Chi-Squared and Fishers Exact test were utilised to determine significance.

One hundred thirty-seven patients were identified with PeIN and no invasive cancer. Staining for p16 was available in 91 patients and 74 patients were p16+.

There were no significant differences in disease-free survival (DFS) for smoking status, performance status, comorbidities and lichen sclerosus, although patients with lichen sclerosus tended to recur sooner.

Overall, p16+ patients showed significantly better DFS over p16- patients (n = 67; 10.4 vs 7.4 months; p = 0.023). In p16+ patients receiving treatment with imiquimod alone or with surgery, response rates were 100% vs 54% without imiquimod (n = 56; p = 0.017). In p16- patients receiving treatment with imiquimod alone or with surgery, response rates were 100% vs 56% without imiquimod (n = 17; p = 0.99). Overall 13.6% of patients progressed to cancer.

The results indicate treatment combinations with immunotherapy tend to provide better responses despite p16 status. Patients with p16+ disease have a longer disease-free survival. Approximately 14% of patients progress to invasive disease. However, given the limitations in this study, further research is required to confirm these findings.

Written by Arie Parnham, Maurice Lau and Vijay Sangar

https://pubmed.ncbi.nlm.nih.gov/32710000/

Varicocele

September 12, 2020 in Fertility, Penile, Testes

A varicocele (which is pronounced VA-RI-KOH-SEAL) is defined as an enlargement of the veins within the scrotum (this is the loose sac of skin that holds the testicles). A varicocele is similar to a varicose vein that can be found in the legs.

Interestingly, varicoceles are more commonly seen in the left testicle than the right.

Most varicoceles develop and grow slowly over time and are relatively easy to diagnose. In most cases there is no need for any treatment.

This is often symptomless condition; however, some men may experience symptoms such as:

Sharp pains
Dull aching
Pain that gets worse when you stand or exercise
Pain that gets worse as the day goes on
Pain that improves when you lay on your back

Over time as the varicocele grows, it can cause some complications including:

Shrinking of the testicle – the varicocele can lead to the affected testicle shrinking and softening. This reason for this is unknown, however it may be linked to a pool of blood in the testicle.
Infertility – the varicocele can cause the temperature of the testicle to increase which can affect the quality and volume of sperm that is produced – but not everyone with a varicocele will experience this.
Swelling of the testicle – the enlarged vein can lead to an enlarged testicle.

There seem to be no risk factors that will put a man at an increased chance of developing a varicocele.

Treatment

In many cases, treatment is not necessary and many men with a varicocele will be able to have children. However, if the varicocele is known to be causing problems, then you may be offered surgery to seal off the affected vein and direct the blood flow through normal, healthy veins.

Contact our expert team at the Urology Clinics Manchester Men’s Health Clinic now.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of the doctor. Always seek medical advice with any questions regarding a medical condition.

Penis Cancer

July 12, 2020 in Penile

Penis Cancer: Find out what Urology Clinics Manchester have to say

Penis cancer or penile cancer may present as phimosis, a lump, bleeding, pain or discharge. It is paramount that men are examined thoroughly under the foreskin. If this is not possible palpation will help to decide if any masses are present. Penile cancer is predisposed by phimosis, smoking, and HPV infection. In some cases, there may be a pre-malignant lesion such as Erythroplasia of Queryat or Bowen’s disease (these are red velvety lesions on the glans or shaft).

It is common for many men with penis cancer to present late for various reasons, mostly embarrassment, and on realising their diagnosis they are often helpless. Some form of amputation or excision is usually required followed by reconstruction. This can have a significant impact on a man’s quality of life, causing relationship problems, sexual dysfunction, depression, employment and financial issues, body image and self-worth problems and in some cases suicide.

Patients with suspected cancer or pre-malignant lesions should be referred urgently to the Urologist.

Urology Clinics has expertise in seeing patients with all types of penile problems. We cover the entire North West of England, North Wales and the Isle of Man. Additionally, we work closely with Teams in London, West Midlands, Northern Ireland and Europe. Our Clinical experts have one of the largest penile practices in Europe, which aligns with our global expertise. If you have concerns or symptoms which are worrying you please contact our expert team here.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Balanitis

July 12, 2020 in Penile

Balanitis: Urology Clinics Manchester discusses the causes, management and symptoms

Balanitis is inflammation of the glans penis. Inflammation of the foreskin (posthitis) may also occur in combination with this (balanoposthitis). It is common and is predisposed by diabetes. Tight foreskin may also cause this, although cycles of inflammation and scarring also contribute to the formation of phimosis.

Typically, patients will present with irritation but rarely have urinary symptoms.

Management revolves around initial advice on hygiene and analysis for possible diabetes. In recurrent episodes, a circumcision may be advisable. Patients who present acutely should have herpes excluded (if sexually active), and where necessary, be treated and referred to a specialist. In those with ulceration and lymphadenopathy treatment is urgent as failure to resolve may be due to more sinister pathology.

Commonly, yeast/fungal infections may be the cause. In such cases topical or oral therapy is useful. In others, faecal bacteria may be the causative organism; hence metronidazole or flucloxacillin may help.

Patients should be considered for circumcision if phimosis or recurrent problems occur.

Some of the more common symptoms include:

A sore, itchy, smelly penis
A build-up of thick fluid
Swelling and/or redness
Pain when urinating

Adults with balanitis can also experience phimosis; which is when the foreskin will not pull back.

Balanitis can be caused by a number of factors, which can include:

Build-up of smegma due to insufficient hygiene
Irritation from urine or soap
Thrush
A bacterial infection
Sexually transmitted infection

Your GP will usually be able to diagnose balanitis by just looking, and may suggest a treatment. If the symptoms do not improve within a week you may have to undergo further tests to see if there is an infection. You may also be referred to a dermatologist, urologist or sexual health specialist.

Most cases can be treated by good hygiene and use of ointments. If you have balanitis then you should try to clean your penis once a day with lukewarm water once a day, then towel dry them. Avoid using any scented soaps or bubble baths, try to use a gentle soap that is available at the pharmacy. Depending on the cause of the balanitis, your GP will supply you with an ointment. This can be:

Steroid cream- to help irritated skin
Anti-fungal cream – if there is a yeast infection
Antibiotic cream – if there is a bacterial infection

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

What is Phimosis?

July 12, 2020 in Penile

What is Phimosis? When does it occur and what options do you have?

Phimosis is narrowing of the foreskin. It can occur commonly in adults and is caused by recurrent balanitis, inflammation and trauma. Although it is not a serious condition, you should still go to see your GP, if you think that you or your son has balanitis.

The presenting symptoms are variable and include poor stream, spraying, ballooning, recurrent attacks of balanitis and pain, although sometimes patients may present because of cosmesis concerns.

A phimosis itself can lead to recurrent infections and also predisposes to penis cancer, which is rare.

Some of the more common symptoms of balantis include:

A sore, itchy, smelly penis
A build-up of thick fluid
Swelling and/or redness
Pain when urinating

Adults with balanitis can also experience phimosis; which is when the foreskin will not pull back.

Balanitis can be caused by a number of factors, which can include:

Build-up of smegma due to insufficient hygiene
Irritation from urine or soap
Thrush
A bacterial infection
Sexually transmitted infection

The foreskin itself, but not phimosis, pre-disposes to HIV infection. Randomised controlled trials have shown circumcision to reduce the risk of contracting HIV but only in heterosexual males; this has led to widespread circumcision programmes in Africa, led by the WHO. In the UK this is currently NOT recommended because of the lower incidence.

In cases of symptomatic phimosis, a Circumcision is commonly undertaken. It is not unusual to find red patches on the glans in such cases. These usually resolve after circumcision. If they do not, topical anti-fungal therapy may help and if no resolution occurs a biopsy may be needed.

At Urology Clinics we commonly see patients who require circumcision. On some occasions circumcisions can go wrong or be unsatisfactory; Urology Clinics has the expertise to help in such circumstances. Please get in touch if you would like to speak to our expert team.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Premature ejaculation

March 3, 2020 in Fertility, Penile, Testes

Premature ejaculation (PE) is one of the commonest male sexual disorders, affecting up to 40% of those that are sexually active. PE can be lifelong or acquired, the latter secondary to surgery or psychological, endocrine or neurological pathology.

Premature ejaculation is common in men of all ages and can be caused by many different reasons, such as prostate problems, medications, anxiety, stress or relationship issues. Ejaculation is controlled by the central nervous system. When men are sexually stimulated, signals are sent to your spinal cord and brain. When men reach a certain level of excitement, signals are then sent from your brain to your reproductive organs. This causes semen to be ejected through the penis (ejaculation).

Sometimes this occurs in conjunction with erection problems (erectile dysfunction). This is when men are not able to get or sustain an erection that’s firm enough for sexual intercourse. Since an erection goes away after ejaculation, it can be tough to know if the problem is premature ejaculation or erectile dysfunction. Erectile dysfunction should be treated first. Premature ejaculation may not be a problem once the erectile dysfunction is treated.

Although it is not uncommon to experience premature ejaculation, this should only occur once in a while, with a normal duration of around five to six minutes. If it occurs frequently then you may need to seek the opinion of a doctor, who can give the necessary help and rule out any underlying medical conditions.

Premature ejaculation may be linked to several factors including serotonin levels, age and psychological factors. All of these should be discussed with your consultant before deciding on the most appropriate treatment option for you.

We now offer new therapies for premature ejaculation such as Fortacin Spray (this is a cutaneous spray that reduces the sensitivity of the head of the penis to delay ejaculation). Another common treatment that we recommend is Psychosexual Therapy, from our partner organisation, alongside medical treatments.

if you are suffering with ejaculatory problems or erectile issues please contact our team.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

What is Peyronie’s Disease and what are my treatment options?

March 3, 2020 in Penile

Peyronie’s disease affects men of all ages across the world. It is thought to happen in about 4 out of 100 men between the ages of 40 and 70. It is rare in young men but has been seen in men in their 30s. Peyronie’s Disease is a benign condition, caused by scar tissue forming in the penis. The scar tissue can be caused by different traumas ranging from vigorous sex, a low tackle on the rugby field or conditions like diabetes. These can cause fibrous plaque to build up in blood vessels and penile tissue. This plaque build-up then restricts that side of the penis from expanding when the penis becomes erect. This scar tissue can result in a bent, rather than straight, erection. For most men with Peyronie’s disease, they can still have sex, however, in some it can cause discomfort, erectile dysfunction or difficulty with sex.

Peyronie’s disease is often split into 2 stages: the acute phase and the chronic phase. During both phases, the bent/curved penis may cause problems with sex. Patients also may have erectile dysfunction.

Acute Phase: The acute phase usually lasts for 5 to 7 months but can last up to 18 months in rare cases. During this time, the plaques form in the penis, the bending/curving of the penis gets worse and patients may feel pain when the penis gets hard.

Chronic Phase: The chronic phase is when the plaque stops growing and the penis doesn’t bend any further. If there was pain with erection during the acute phase, it often will have ended by this

There are many different treatments for Peyronie’s disease, however, some are more successful than others. Vacuum pump therapy (SomaCorrect) is a very good initial treatment which is successful in some cases. Surgical procedures such as plication and incision & grafting can also be used to correct the curvature in the penis.

For men who experience pain with Peyronie’s disease, the best treatment is painkillers but a course of low-intensity shock waves can reduce the pain. This can be used alongside other therapies to ensure that symptoms associated with Peyronie’s are reduced.

Please contact us if you wish to have a consultation with one of our doctors and find out which treatment would help you get the best result for Peyronie’s disease.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.