Ultrasound scanning is the main primary investigation for many of the urological disorders associated with men. The male urinary tract includes the kidneys, the bladder and the prostate. Other urological conditions affecting men involve the scrotum, testes and penis.
Ultrasound examination can be performed on the patient's bedside in acute situations where the patient is admitted to accident and emergency or as routine investigations. Routine investigations are being performed in an NHS hospital following a doctor's referral or by the private sector. Doctor's ultrasound referral is not always required when your scan is undertaken by a private ultrasound provider.
As NHS waiting times for routine ultrasound investigations can be as long as 6 weeks+, it is very common these days for the patient to book a private ultrasound instead. Having your ultrasound scan performed by a private ultrasound clinic such as Sonoworld has the advantage of being able to choose the most suitable time and the date and the ultrasound results will be with you and your doctor significantly faster than the NHS. You can also combine your private urinary tract scan with any other ultrasound scan for men and blood tests for a wholistic diagnosis.
Common Urological Condition
The most common urological conditions affecting men are:
Kidney stones are very common affecting 1 in 10 people and although can happen in all ages they are more common in people aged 30 to 60. Symptoms normally include loin pain that sometimes is associated with blood in the urine.
Ultrasound of the kidneys will identify any calculi responsible for the symptoms.
Urinary Tract Infection
Urinary tract infections are uncommon in males and ultrasound is being used to identify any structural abnormality of the urinary tract.
Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) is characterized by progressive enlargement of the prostate gland resulting in bladder outlet obstruction and increasingly difficult voiding. It is typically a disease of the elderly and rarely affects males younger than age 40. The mean age at which patients develop symptoms is between 60 and 65 years.
BPH is characterized by a spectrum of lower urinary tract symptoms (LUTS) previously referred to as prostatism:
Decreased force of the stream
Hesitancy and straining to void
Interruption of stream
The sensation of incomplete bladder emptying
Frequency and nocturia
Treatment begins when the patient's health is at risk due to urinary tract infections, bladder dysfunction, or other urinary conditions, or when urinary symptoms are sufficiently bothersome to the patient and need to be improved.
Prostatitis is inflammation of the prostate characterized by symptoms such as urinary frequency and/or painful urination. Symptoms may include malaise, low back and perineal pain, fever, and chills. Prostatitis may be acute (rare) or chronic (common). Prostatitis is typically treated with antibiotics.
Erectile dysfunction (ED), defined as the inability to maintain an erect penis with sufficient rigidity for sexual intercourse, is estimated to affect 10 million men in the United States and over 30 million men worldwide. Men between the ages of 40 and 70 years are typically affected. Risk factors for ED include diseases such as diabetes, hypertension, and arteriosclerosis. Many medications may cause ED, including high blood pressure medications and antidepressants. The risk of developing an ED is increased with alcohol and tobacco use. ED may occur after surgical procedures, such as radical prostatectomy.
Infertility generally refers to the inability of a couple to achieve conception after one year of unprotected intercourse. In about half of infertile couples, the male possesses at least one of the factors leading to infertility. Possible causes of male infertility may involve hormonal disorders, abnormalities in sperm production, ejaculatory disorders, or poor sperm quality. A testicular ultrasound will be able to identify any structural abnormalities that may be causing male infertility.
Vasectomy and Vasectomy Reversal
A vasectomy is a form of male contraception in which the vas deferens, ducts for sperm transport, are surgically closed. Although normal sperm production continues in the testes, the sperm is no longer able to travel through the vas deferens to reach the urethra and therefore it degenerates in the body. Vasectomy is the most common urologic surgical procedure and is typically performed in the office with local anaesthesia. Vasectomy has no effect on sexual desire or performance.
A vasectomy reversal can be surgically performed to reopen the vas deferens and allow sperm to travel through the ducts to the urethra for men who later decide that they want to have conception occur.
Scrotal swelling and/or pain may have various causes, including the following benign conditions:
Hernia - protrusion of an organ through an abnormal opening in the wall of the cavity that surrounds it
Epididymitis - inflammation of the epididymis, the organ in which sperm mature
Hydrocele - accumulation of fluid in a sac-like cavity around the testicle
Spermatocele - a cyst of the epididymis
Cancers of the Urinary Tract in Men
Prostate cancer is the second most common cause of cancer deaths in men, with close to 40,000 deaths and more than 125,000 new cases per year in the United States. African-Americans have a higher incidence and mortality. No clear causes have been identified, although a familial predisposition has been demonstrated and increased risk has been associated with cigarette smoking and a high-fat diet.
Routine screening for prostate cancer is recommended starting at age 50 except in high-risk cases that include men with a family history of prostate cancer and African-American men. In these high-risk men, screening is recommended beginning at age 40.
Depending on the age and general health of the page, treatment options range from:
Testicular cancers are rare overall, yet they are the most common solid tumour of young adult males. Approximately 8,000 new cases occur annually with 400 deaths in the United States. Primarily because of effective chemotherapy, they have become the most curable of all cancers. No clear causes have been identified; however, 10% of patients have a history of an undescended testicle.
All patients undergo surgical removal of the testicle (known as radical orchiectomy) to stage the disease and determine further treatment. Testicular cancer is very responsive to radiation therapy and chemotherapy.
Penile cancer is an uncommon disease-account for 0.5% of malignancies in men in the United States. It occurs more frequently in older men and has been associated with chronic inflammatory disease, venereal disease, human papillomavirus infection, and phimosis. Circumcision appears to be protective against the development of cancer of the penis. The most common causative factor is poor hygiene.