Enlarged Prostate and Labiaplasty

A male reproductive system contains a gland called prostate that produces the fluid carrying sperm during ejaculation. When the gland becomes bigger it comes to be known as enlarged prostate. It is a common in men as they grow older. The growing gland presses the urethra causing bladder and urination problems. 

Though the cause of enlarged prostate is not known, it has been linked to aging and the testicles. However, men who have had their testicles removed may not develop enlarged prostate. The symptoms may include

·         Dribbling after urination.

·         Urinary retention.

·         Incomplete emptying of bladder.

·         Incontinence.

·         Urge to urinate frequently at night.

·         Urination followed by pain or bloody urine.

·         Slow or delay the urinary system.

·         Straining while urinating.

·         Weak urinary system.

At Dr. Safir’s, the treatment for enlarged prostate may be based on the severity of the symptoms. The treatment may start with some self-care measures such as the patient being asked to

·         Urinate at the firs urge.

·         Avoid alcoholic beverages after dinner.

·         Avoid drinking fluids 2 hours within bedtime.

·         Avoid medications containing decongestants or antihistamines as they may increase the symptoms.

The patient may be prescribed medications such as 

·         Alpha-1 blockers to relax muscles of bladder neck and prostate. It may help to urinate easily.

·         Finasteride and dutasteride to reduce size of prostate increasing the urine rate. 

Additionally, surgical procedures may also be performed. The two most common surgical procedures are

1.      TURP (transurethral resection of the prostate). The patient is administered a general anesthesia or spinal anesthesia. The surgeon may insert a cystoscope or endoscope through urethra. A special cutting tool may then be inserted that removes prostate n pieces with an electric current.

2.      TUIP (transurethral incision of the prostate). It may be performed on men having smaller prostate. A cystoscope or endoscope is inserted and incisions may be made in the prostate enlarging the urethra opening and bladder outlet.  

Labiaplasty is a cosmetic procedure performed in women to improve the vagina’s external appearance by reducing labia. In some women, the labia may be asymmetrical or big on one or both sides while in others it occurs after childbirth or aging. Labiaplasty may be either labia minora or labia majora.

At Dr. Safir’s, Labiaplasty is performed under local anesthesia and may be performed in 1-2 hours. It is done on an outpatient basis without requiring any need for hospitalization. The after surgery precautions may include avoiding sexual activities and heavy strenuous activities for 6 weeks. It may also be recommended to maintain local hygiene. 

Erectile Dysfunction and Urinary Incontinence

Among the various specializations of medical science is urology that studies urinary tracts of males and females and male reproductive system. The surgeons specializing in the fields of urology are called urologist who may diagnose, treat and manage disorders such as erectile dysfunction in men and urinary incontinence in women.

An erectile dysfunction is a sexual dysfunction where a man is unable to develop or maintain an erection of the penis during sexual activity. Usually, to achieve a normal erection may require coordination between vascular, neurologic, hormonal and psychological factors. Any condition or factor that may interfere with the coordination may cause erectile dysfunction. The causes of erectile dysfunction are generally grouped into either endogenous factors or exogenous factors. The endogenous factors include endocrine imbalances, cardiovascular, other medical conditions and emotional causes. On the other hand, exogenous factors may include medications, surgery, trauma, irradiation, smoking, alcohol and substance abuse.

Similarly, in women, urinary incontinence is the inability of the urine to keep leaking from urethra. Urethra is the tube carrying urine out of body from bladder. Urinary incontinence may be classified as 

·         Stress incontinence. It may occur during coughing, sneezing, laughing or exercise.

·         Urge incontinence. It may create a strong and sudden need to urinate followed by bladder contraction and loss of urine.

·        Overflow incontinence. It may occur because of the bladder not able to empty completely resulting in dribbling.

Urinary incontinence may be caused by neuromuscular disorders, dementia, medications such as diuretics, antidepressants, tranquilizers, antihistamines, etc., pregnancy, infection or inflammation of urinary tract, weight gain, Alzheimer’s disease, bladder cancer and spasms, pelvic prolapse and spinal injuries.

During an initial treatment at Dr. Safir’s the patient may be asked to alter their lifestyle by avoid smoking, reduce obesity and control alcohol and substance abuse. The patient may be prescribed medications such as Viagra that has a longer effect, increases penile blood flow and produces erection. Also, penile prostheses may be used that are semi-rigid or inflatable devices. During the procedure, the patient may be administered general anesthesia and incisions are made in the abdomen and perineum. The device is inserted through these incisions along with fluid reservoir and pump that are placed in groin and scrotum respectively. The devices are connected by tubes and may be tested before closing the incisions.

The treatment for urinary incontinence at Dr. Safir’s follows many approaches. It may involve methods such as bladder retraining and kegel exercises. Both these methods may help to strengthen the muscles of pelvic floor. In some cases, surgeries such as anterior vaginal repair and vaginal sling procedures may be performed. An anterior vaginal wall repair may tighten the front wall of the vagina. It either sinks the bladder into the vagina or sinks urethra into the vagina. On the other hand, in a vaginal sling procedure,  a sling made of mesh tape or tissue graft is used that supports urethra.