12 Urology Misconceptions Debunked

Unfortunately, there is a lot of false information about urology circulating around the general population. To help you make sense of it, Dr. Andrew Siegel is helping to debunk twelve common misconceptions about urology.

1. Misconception: Urologists only treat men.

Reality: Although gynecologists treat only females, urologists care for both genders. Providing healthcare to females is a routine part of urology training. After a physician completes a urology residency, they may complete additional training that focuses exclusively on female issues, including pelvic organ prolapse and urinary incontinence.

2. Misconception: When you drink water it immediately goes to your kidneys and makes you want to urinate.

Reality: The pathway between drinking and peeing is the following: mouth–> esophagus–> stomach–> small intestine–> bloodstream–> heart–> aorta–> renal arteries–> kidneys–> ureters–> bladder. The likely reason you get a sudden urge to urinate when you drink water is that the presence of the water triggers a conditioned response that results in an involuntary bladder contraction.

3. Misconception: You must drink 8-12 glasses of water a day to maintain your health.

Reality: Many people take the 8-12 glass/day rule literally and as a result end up in urologists’ offices with urinary urgency, frequency and often urinary leakage. Water requirements are based upon the ambient temperature and your activity level. If you are sedentary and in a cool environment, your water requirements are significantly less than when exercising vigorously in 90-degree temperatures. Human systems are extraordinarily well-engineered and your body will let you know when you are dehydrated. Heeding thirst is one of the best ways of maintaining good hydration status. Another method is to pay attention to urine color. Depending on hydration status, urine color can vary from deep amber to as clear as water. If your urine is dark amber, you need to drink more as a lighter color is ideal and indicative of satisfactory hydration.

4. Misconception: You must flood yourself with fluids to help pass a kidney stone.

Reality: The presence of a stone in the ureter often causes urinary tract obstruction. Overhydration in the presence of obstruction will further distend the already bloated and inflated portion of the urinary collecting system located above the stone. This distension can exacerbate pain and nausea that are often symptoms of colic. The collecting system of the kidney and the ureter have natural peristalsis—similar to that of the intestine—and overhydration has no physiological basis in terms of helping move the kidney stone passage process along (in my opinion, it is pointless and perhaps even dangerous). Drinking moderately in the face of a kidney or ureteral stone is sound advice.

5. Misconception: The presence of bacteria in the urine is a urinary infection and always needs to be treated.

Reality: Asymptomatic bacteriuria, common in the elderly, diabetics, and particularly in nursing home residents, is the presence of bacteria within the bladder without the presence of infection. Asymptomatic bacteriuria only needs to be treated in certain situations: pregnancy, in patients undergoing urological-gynecological surgical procedures, and in those undergoing prosthetic surgery (total knee replacement, etc.). Screening or treatment of asymptomatic bacteriuria is futile, inappropriate, and should be strongly discouraged. Using antibiotics in this circumstance does not result in a decrease of symptomatic episodes, increases the occurrence of adverse drug effects, promotes the selection of resistant bacteria, and increases the cost of treatment. I really wish that internists would heed this advice!

Bonus misconception: The fact that plenty of people have bacteria in the urine debunks the myth that urine is always sterile.

6. Misconception: You’re not having pain, so there’s no way you could have prostate cancer.

Reality: Early prostate cancer causes NO symptoms whatsoever, including pain. As a general rule, if cancer is causing pain, that cancer is at a more advanced stage, either spread to structures adjacent to the site of the cancer, or remote from the site. Therein lies the importance of screening for prostate cancer with digital rectal exam (DRE) and PSA (prostate specific antigen) blood test.

7. Misconception: All prostate cancer is slow growing and can be ignored.

Reality: Each case of prostate cancer is unique and has variable biological behavior. It is true that some cases are so unaggressive that no cure is necessary and can be managed with active surveillance. However, others are so aggressive that no treatment is curative. Many cases are in between these two extremes: moderately aggressive and eminently curable.

A recent major advance is the improvement in the ability to predict which prostate cancers need to be actively treated and which can be watched, a nuanced and individualized approach. Those who feel that prostate cancer should not be sought out and treated should be attentive to the fact that it is the second leading cause of cancer death, with 33,330 deaths in 2020, and furthermore, that death from prostate cancer is typically an unpleasant one.

8. Misconception: A PSA blood test is a substitute for a digital rectal exam (DRE).

Reality: It is entirely possible to have prostate cancer with a normal PSA, the only clue being an abnormal DRE. The PSA blood test is NOT a substitute for the DRE. Both tests provide valuable and complementary information about prostate health and should be done. I really wish that internists would heed this advice!

9. Misconception: You had a colonoscopy, so you don’t need a DRE.

Reality: Same “foyer,” different rooms. (The foyer is the anal canal, the rooms are the prostate and the colon). Examination of the colon via colonoscopy does not in any way evaluate the prostate.

10. Misconception: Vasectomy causes prostate cancer.

Reality: Vasectomy does NOT cause prostate cancer; however, men who undergo vasectomies have relationships with urologists, the specialists who manage prostate issues, and therefore, men who undergo vasectomy are more likely to undergo prostate cancer screening with digital rectal exam and PSA blood testing than the average man who does not see a urologist. For example, every male patient above the age of 40 who I see for a vasectomy consult gets offered a digital rectal examination and a prostate specific antigen blood test that screens for prostate cancer. Few refuse!

11. Misconception: Ejaculation requires an erection.

Reality: You do not need an erection to ejaculate, as many men with erectile dysfunction discover, although an erection certainly enhances the process.

12. Misconception: If you lose your erection after ejaculation, you have erectile dysfunction.

Reality: It is normal (physiological) to lose your erection after climaxing. The refractory period is the time it takes to be able to get another erection, which can be highly variable depending upon age and other factors.


7 Symptoms of Enlarged Prostate (BPH)

Benign Prostatic Hyperplasia, or BPH, is the enlargement of the prostate gland. About half of men over age 75 will experience symptoms of BPH. BPH is a very minor condition and is not related to prostate cancer. However, symptoms can cause discomfort and be inconvenient.

What Is BPH and How Does It Affect Me?

The prostate gland surrounds the urethra and assists in reproduction. As a man ages, the prostate gets larger and begins to put pressure on the bladder and urethra, causing uncomfortable symptoms. It may be responsible for blocking the flow of urine out of the bladder, and can cause issues in the bladder, urinary tract, or kidneys.

How Do I Know if My Prostate is Enlarged? (Symptoms of BPH)

If your prostate is enlarged, it may not be a sign of cancer, but it is something that you should discuss with your doctor. Many of the symptoms of an enlarged prostate tend to relate to urination. If you are concerned about an enlarged prostate, here are 7 symptoms to look for:

  1. Difficulty starting urination. The enlarged prostate alters the pressure of your bladder to pass urine. This can have damaging effects on your kidneys.
  2. Weak urine stream. As the urethra becomes constrained, urine passes at a much slower rate.
  3. Urgent need to urinate. You may go from not needing to urinate to suddenly needing to go because of how the bladder gets constrained.
  4. Issues with sleeping. Pressure from the enlarged prostate can interfere with nerve signaling in the middle of the night. This leads to you thinking you have to urinate when you don’t.
  5. Feeling unable to completely empty your bladder. You may not be able to completely empty your bladder, which can lead to Urinary Tract Infections(UTI) and stone issues.
  6. Urinary tract infection. A UTI is caused by the urine that sits in your bladder which you can’t fully empty, creating an environment for bacteria to thrive.
  7. Bladder stones. The leftover urine in your bladder can also crystallize to create bladder stones.

BPH can cause these symptoms, but having these symptoms doesn’t necessarily mean you have BPH. There are many reasons why you may have urinary issues. If you are at all concerned that you may have an enlarged prostate, you should consult a urologist.  You can find a list of locations near you here.

Treatment for BPH

Keep in mind, there is no permanent cure for BPH, but treatment options are meant to lessen the symptoms caused by BPH to help improve your quality of life. Your doctor may suggest lifestyle modifications, medication, or surgical options depending on the details of the individual case.

Lifestyle changes are typically recommended as the first option, especially in mild cases of BPH. Typical lifestyle changes that doctors recommend to help control BPH include:

  • Limiting intake of caffeine and alcohol
  • Exercises to strengthen pelvic floor muscles
  • Eating more fiber to help prevent constipation (which may worsen symptoms)
  • Diet and exercise to help reach and maintain a healthy weight
  • Limiting the consumption of fats and spicy foods

In moderate cases of BPH and cases in which lifestyle changes are not effective, a urologist may elect to prescribe medication.  Medication may be used to relax prostate and bladder muscles to relieve symptoms, shrink the prostate and prevent additional growth, or increase flow rate.

Beyond medication, there are minimally invasive procedures as well as surgical options to help with BPH. Minimally invasive procedures are preferred as they typically result in quicker recovery times and a less painful recovery.  In some situations, traditional surgical options are necessary based on the severity of the case and desired outcome.

For any treatment path, it is important to consult your urologist, discuss your options, and work together to determine the best treatment plan.

For More Information

You can learn more about men’s health services at New Jersey Urology through the link below.  If you would like to find a urologist near you or schedule an appointment, you can use the contact form on our contact us page or view our locations.


5 Signs of Bladder Cancer: What Women Should Know

Bladder cancer may not be on your radar even if you’re vigilant about getting routine GYN care. After all, it’s far more common among men than women, and the majority of cases affect patients over age 65. However, don’t let those stats keep you from learning to spot the warning signs.

While bladder cancer isn’t one of the most common cancers in women, about 18,000 women are diagnosed with bladder cancer every year in the United States (Source: CDC – Bladder Cancer)The Bladder Cancer Advocacy Network reports that women are more likely to be diagnosed with bladder cancer at an advanced stage because they may not be on the lookout for early signs.

Facts About Bladder Cancer in Women

While bladder cancer typically hasn’t been associated with women, it is important to understand the unique way that bladder cancer does affect women, and why it’s critical that bladder cancer isn’t overlooked.

  • Approximately 50% of cases are diagnosed while the cancer is still in the bladder. However, that percentage is lower in women, because symptoms are often overlooked.
  • Women have a 1 in 89 chance of developing bladder cancer in their lifetime (Source: American Cancer Society – Key Statistics for Bladder Cancer). However, bladder cancer in women is on the rise.
  • Approximately 90% of bladder cancer cases are in individuals over 55 years old, so it is important to be extra vigilant of early signs of bladder cancer as you age.
  • Bladder cancer has a high recurrence rate. If you have been diagnosed with bladder cancer, it is important to continue to receive regular exams in order to handle any potential recurrence.

Early Signs of Bladder Cancer in Women

Knowing the signs and symptoms can help you get diagnosed sooner, which may improve your prognosis. Here are five warning signs to watch for:

  1. Blood in the urine (hematuria). This is the most common early symptom of bladder cancer and typically the first sign of bladder cancer that is seen. It’s easy for women to overlook because it’s typically painless and can go weeks or even months between occurrences. Many women ignore this symptom because they attribute it to menstruation or menopause. If you are unsure if there is an issue, your best bet is to consult a urologist
  2. UTI-like symptoms. Bladder cancer can be mistaken for a Urinary Tract Infection (UTI) because many of the symptoms overlap. Patients may experience increased frequency and urgency of urination, pain with urination, or urinary incontinence. If you’ve noticed any urinary problems—you have to go all the time, or you feel like you have to go but can’t, or you have a hard time emptying your bladder—or if antibiotics don’t seem to be helping your UTI symptoms, talk to your doctor.
  3. Unexplained pain. More advanced bladder cancers are often associated with pain. Pain can occur in the flank area, abdomen, or pelvis. Patients can also develop pain in their bones if the cancer has spread to their bones. If you’re having aches and pains in those areas, tell your doctor—especially if you’ve also noticed spotting or UTI symptoms.
  4. Decreased appetite. Appetite loss is a common cancer symptom, and bladder cancer is no exception. If the cancer has grown or spread, you might experience weight loss or feel tired and weak. Of course, there are plenty of other things that can mess with your appetite, so don’t automatically assume the worst—but do talk to your doctor about it if it persists.
  5. Postmenopausal uterine bleeding. Any blood or spotting that you notice after menopause could be a symptom of bladder cancer or some other underlying issue. Similarly to blood in the urine, it may be easy to overlook, but it is recommended that you see your urologist to be safe.

Risk Factors of Bladder Cancer

By far, smoking is the biggest risk factor to be concerned about when it comes to bladder cancer. According to the National Institutes of Health, about 50% of women diagnosed with bladder cancer are smokers. Because the rate of occurrence is so much higher for smokers, if you notice any of the above symptoms and you smoke, let your doctor know as soon as possible.

Another major risk factor is previously having bladder cancer.  Bladder cancer has a 50-80% recurrence rate, which is among the highest of any form of cancer. This is why it is imperative to continue to see your physician and be on the lookout for any symptoms of bladder cancer if you’ve had it before.  When in doubt, get it checked out.

Age is another major factor. The average age of diagnosis in women is 73. Any woman over the age of 55 years old should keep an extra eye out for symptoms.

When to Make an Appointment with Your Urologist

Bladder cancer may be overlooked in women because it’s easy to chalk up symptoms to a stubborn UTI or normal vaginal spotting. Unfortunately, this means women are often diagnosed after the cancer has spread and become harder to treat. So if you’re worried, don’t just write off your symptoms. Call your doctor to determine if it’s a minor infection or something more serious. If it is bladder cancer, it’s easier to treat if you catch it early.

If you would like to talk to a urologist, you can see if we have a location near you or you can contact us to ask a question or make an appointment.

Written by Dr. Paul Littman


9 Treatment Tactics to Overcome Premature Ejaculation

Premature Ejaculation (PE) is a condition in which sexual climax occurs before, upon, or shortly after vaginal penetration, prior to one’s desire to do so, with minimal voluntary control. It is the most common form of male sexual dysfunction.

The key features are:

  • Brief time to ejaculation (often less than one minute)
  • Lack of control over ejaculation
  • Sexual dissatisfaction, distress and frustration of partner

How Long Should it Take to Climax?

In a study of more than 1,500 men, The Journal of Sexual Medicine reported that the average time between penetration and ejaculation for a premature ejaculator was 1.8 minutes, compared to 7.3 minutes for non-premature ejaculators.

Another study of 500 couples across five countries reported results ranging from 33 seconds to 44 minutes with the median being 5.4 minutes.

What Causes Premature Ejaculation?

PE can be psychological and/or biological and can occur because of over-sensitive genital skin, hyperactive reflexes, extreme arousal or infrequent sexual activity. Other factors are genetics, guilt, fear, performance anxiety, inflammation and/or infection of the prostate or urethra and also can be related to the use of alcohol or other substances.

PE occurs in up to 30% of men, involving all ages, ethnicities, and socio-economic groups. PE can cause embarrassment, frustration and loss of self-confidence and can be devastating to a relationship. It is very typical among men during their earliest sexual experiences.

PE can be lifelong or acquired and sometimes occurs on a situational basis. Lifelong PE is thought to have a strong biological component. Acquired PE can be biological, based on inflammation/infection of the reproductive tract or psychological, based upon situational stressors. PE can sometimes be related to Erectile Dysfunction (ED), with the rapid ejaculation brought on by the desire to climax before losing the erection.

Emphasis on ejaculation as the focal point of sexual intercourse tends to increase the performance anxiety that can initiate the problem. Once PE has occurred and established itself, fear of and mental preoccupation with the issue can actually induce the unwanted rapid ejaculation, creating a vicious cycle.

How to Overcome Premature Ejaculation

  1. Diversionary Thoughts: Non-erotic mental diversionary tactics (concentrating on thoughts other than ejaculating) may prevent PE. Baseball, work, counting backwards, etc., are examples of such thoughts, but these are rarely effective and diminish the pleasure of sexual intimacy.
  2. Down Tempo: This requires one to develop a mindfulness of the sensation immediately before ejaculation. By slowing the pace of pelvic thrusting and varying the angle and depth of penetration before the “point of no return” has passed, the feeling of imminent ejaculation may dissipate.
  3. Pause-Start Method: If slowing the tempo is not sufficient to prevent the PE, one may need to stop thrusting completely while maintaining penetration in order for the ejaculatory “urgency” to go away. Once the sensation to ejaculate subsides, pelvic thrusting may be resumed.
  4. Squeeze Technique: Originated by Masters and Johnson, as imminent ejaculation approaches, the penis is withdrawn and the head of the penis is squeezed until the feeling of ejaculation passes, after which intercourse is resumed. Although effective, it requires sexual interruption, is cumbersome and demands a very cooperative partner.
  5. Pelvic Floor Muscle Training: Contracting one’s pelvic floor muscles is a less cumbersome alternative to the Master and Johnson technique. Instead of the clunky and obvious squeeze technique, a more subtle and discreet method is to slow the pace of intercourse, pause the pelvic thrusting and do a sustained pelvic muscle contraction. This is an internal “squeeze” without the external hand squeeze and can achieve the same goal, short-circuiting the premature ejaculation. With sufficient practice and the achievement of “muscle memory,” this process can become easier and the problem of PE improved, particularly with commitment to a pelvic floor muscle training program.
  6. Decreasing Sensitivity: One method of doing so is by using thick condoms. Alternatively, local anesthetics in the form of topical creams, gels, and sprays can desensitize the penis. These include Lidocaine cream or gel, Lidocaine and Prilocaine (EMLA cream) or Lidocaine spray (Promescent) that are applied before intercourse. Another desensitization technique is increasing the frequency of ejaculation since PE tends to be more pronounced after longer periods of sexual abstinence. By masturbating prior to engaging in sexual intercourse, the PE may be controlled.
  7. Erection Pills: Viagra, Levitra, Cialis and Stendra, which are commonly used for ED, can have a role in the treatment of men with acquired PE that is due to ED.
  8. SSRI Antidepressants: These selective serotonin reuptake inhibitors can substantially delay ejaculation. One is generally started on a low dose, with an increase in dosage as necessary. Once an effective dosage is achieved, the medication can be used on a situational basis, several hours prior to sexual intercourse.
  9. Counseling: Since PE can be on a psychological basis, it may be beneficial to seek the counsel of a sexual therapist. This can be done in conjunction with some of the aforementioned techniques to hasten the resolution of the PE.

Although not life-threatening, PE is a common and distressing quality of life problem that is sometimes relationship-threatening. The good news is that there are a number of effective treatment options available, so one need not suffer with the problem.

Written by Dr. Andrew Siegel 


Do I Have Low Testosterone? 24 Questions Answered By A Urologist

Written by Dr. Andrew Siegel

There has been an “epidemic” of a clinical syndrome based on low testosterone levels. There is no subject rife with more confusion and misinformation than testosterone deficiency and its treatment. Hopefully, the following 24 questions and answers, pulled from those commonly asked by my patients at office visits, will help enlighten and inform you and clarify misconceptions and falsehoods.

Before we get started, here are some common abbreviations I’ll be using throughout this blog post:

  • T = Testosterone (the key male sex hormone)
  • TD = Testosterone Deficiency
  • TRT = Testosterone Replacement Therapy
  • E = Estrogen (the key female sex hormone)

Q: What exactly is testosterone?

A: Testosterone is an “anabolic” hormone, a chemical messenger that promotes growth via protein synthesis, which drives the building of muscle and bone mass as well as strength. Testosterone is equally an “androgenic” hormone, causing masculinization. T is made from cholesterol with most produced in the testes, with a small amount made in the adrenal glands (organs that sit above kidneys). Healthy men produce 6-8 mg testosterone daily, in a rhythmic pattern with a peak in the early morning and a lag in the later afternoon. If you find that you are most amorous in the early morning, now you have a good biochemical explanation.

Q: When does testosterone kick in and what does it do?

A: Testosterone surges around age 12-14 and drives puberty, causing the following:

  • Penis enlargement
  • Development of an interest in sex
  • Increased erections
  • Pubic, underarm, facial, chest and leg hair
  • Decrease in body fat
  • Increase in muscle and bone mass, growth, and strength
  • Deepened voice and prominence of the Adam’s apple
  • Sperm production
  • Bone and cartilage changes, including: growth of jaw, brow, chin, nose and ears (aka: the transition from “cute” baby face to “angular” adult face)

Q: Is testosterone important after puberty?

A: Throughout adulthood, T helps maintain libido, masculinity, sexuality, and youthful vigor and vitality. Additionally, T contributes to mood, red blood cell count, energy, and general “mojo.”

Q: What is Testosterone Deficiency and why does it occur?

A: Testosterone Deficiency (TD) is a clinical and biochemical syndrome characterized by relevant symptoms and signs in conjunction with a deficiency of T or T action. Symptomatic TD occurs in 2-6% of men.  There is approximately a 1% decline in T level each year after age 30. Most commonly it is an impaired testicular production of T. It can also happen because of a pituitary issue in which there is not enough production of luteinizing hormone (LH), the hormone that drives the testes to manufacture T. Furthermore, it can happen under circumstances of normal T levels when there are elevated levels of the hormone that strongly binds T (SHBG), reducing the amounts of T available for action. It is important to distinguish TD on the basis of testes impairment vs. pituitary impairment, as the management is different.                                                                                                          

Q: Is testosterone going to help my erections, which are not quite what they used to be?  

A: Maybe. Although testosterone is important for sexual function and for maintaining the health and vitality of the penis, one does not need high or even normal levels of T to obtain an erection. A good example is a pre-pubertal boy who gets erections all the time, but has no interest in sex. The more compelling role of T is in driving libido.

Q: Testosterone seems like such a vital hormone for men…is it for me?

A: ONLY under the circumstances of a testicular or pituitary problem causing the characteristic symptoms of TD coupled with a blood test that proves that low T levels is it worth pursuing a trial of TRT. It is only beneficial continuing the TRT if it is providing meaningful symptom improvement in the face of a normalized T level.

Q: How does testosterone get to the body tissues where it works?

A: Since T is a hormone – a chemical messenger that is made in one locale but works elsewhere – it needs to be transported to get to those cells where it acts. T circulates in the bloodstream. 60% is inactive as it is tightly bound to SHBG (sex hormone binding globulin), 38% is weakly bound to albumin, and 2% is free. The albumin-bound and free T are the biologically “active” forms of T.

Q: How does testosterone work?

A: Much of T is converted to dihydrotestosterone (DHT), a more potent form, which couples with a special receptor enabling it to move into the nucleus of cells and bind to DNA, where it provides the blueprint for protein synthesis. Some T does so without being converted to DHT and some T is converted to E, the main female hormone.

Q: What about the female hormone estrogen…is it important for men?

A: Yes! More than 80% of  estrogen (E) in males is derived from T. When levels of T are low, a decline in E levels will occur. E deficiency is important in terms of osteopenia (bone thinning) in men. As commonly happens with abdominal obesity, E levels become too high as abdominal fat is an active endocrine organ that converts T to E, causing:

  • Low T
  • High E
  • Breast development
  • The appearance of a smaller penis and general emasculation.

Q: Why have testosterone levels been dropping over the years?

A: Unhealthy lifestyle and the use of alcohol, steroids (for asthma, arthritis, connective tissue disorders and inflammatory bowel diseases) and opiate pain medications (methadone, tramadol, etc.) are risk factors.

Obesity has played a huge role. Diabetes and metabolic syndrome have contributed to the low T epidemic as well. Physical and psychological stress affect pituitary hormone synthesis, which can give rise to low T levels. Sleep apnea can contribute to TD. Environmental factors such as phthalates, commonly used in plastic products, as well as many other environmental exposures, are associated with low T levels.

Q: How important of a factor is obesity in causing testosterone deficiency?

A: Obesity is the single most common cause of testosterone deficiency in the developed world. More than half of men with TD are overweight or obese. The good news is that it is potentially reversible with weight loss.

Q: What is the issue with diagnosing low T based upon the established ADAM (androgen deficiency in the aging male) screening test?

A: The ADAM screening questions are very general and involve decreased libido, diminished erections, lack of energy, decrease in strength/endurance, loss of height, decreased joy, the presence of sadness or grumpiness, deterioration in sports performance, falling asleep after dinner and deterioration in work performance. These symptoms have an enormous overlap with changes that accompany normal aging, insufficient or poor quality sleep, overworking and/or an unhealthy lifestyle.

For example: a professional athlete of your choice who is at peak performance in his early 20’s. Fast-forward 30 years…how many of the aforementioned questions do you think will be answered positively? Is it low T? Possibly, but certainly not probably.

Q: What are the symptoms that indicate the possibility of testosterone deficiency?

A: 5 domains may be affected by TD: physicalsexualcognitiveaffect and sleep.

  1. Physical changes are reduced muscle mass and strength, increased body fat and abnormal lipid profiles, frailty, breast development, loss of body hair and central obesity.
  2. Sexual changes include decreased desire, diminished erection quality and weakened ejaculation and orgasm.
  3. Cognitive changes that may occur are impaired concentration, diminished verbal memory and altered visual-spatial awareness.
  4. Changes in affect can be a reduced sense of general wellbeing, decreased energy and motivation, anxiety, depression and irritability.
  5. Sleep issues include fatigue, tendency to sleep during the day and difficulties falling and staying asleep.

Q: How is testosterone deficiency diagnosed with lab testing?

A: The diagnosis of TD is made via a blood test for total T and free T as well as for the pituitary hormones LH and prolactin. In cases of obese or elderly men, SHBG can be useful. It is important to know that T levels can vary depending on the particular lab and can fluctuate on a day-to-day basis as well as depending on what time of day it is drawn, as T has circadian biorhythms. T can be temporarily suppressed by illness, nutritional deficiency and certain medications. Fasting T levels are generally higher than T levels after a meal. The bottom line is that T should be checked on at least two occasions.

Q: What is the first-line approach to treating testosterone deficiency?

A: Lifestyle improvement measures including:

  • Weight reduction
  • Exercising regularly
  • Management of sleep apnea
  • Stopping the use of opioids

Q: When should Testosterone Replacement Therapy (TRT) be used?

A: When TD fails to respond to first-line approaches in a man with characteristic symptoms and laboratory documentation of TD.

Q: What is the goal of TRT?

A: To restore T levels to the mid-normal range of levels observed for healthy men and alleviate the signs and symptoms of TD without causing significant side effects or safety issues.

Q: What are some of the testicular side effects of TRT?

A: Because TRT is an external source of T, it suppresses testes function, resulting in diminished sperm count, decreased fertility and the possibility of testes atrophy (shrinkage) with long-term use. Men who wish to retain fertility should not be put on TRT, but should consider the use of an oral medication that stimulates the testes to produce natural testosterone without suppressing sperm count.

Q: What are some of the other side effects of TRT?

A: Acne, oily skin, breast development, worsening of sleep apnea, hair loss, fluid retention, elevated blood count and aggression.

Q: How is TRT administered?

A: There are many different preparations: buccal (applied to the gums); transdermal (patches and gels); nasal gelinjections; and pellet implants. Each has advantages and disadvantages.

Q: What about treating TD without TRT?

A: Since TRT impairs sperm development and fertility and may result in testes atrophy, an alternative to TRT, called clomiphene citrate, works by stimulating the testes to produce natural T. It is approved by the FDA for both male and female fertility, but not for TD, so must be prescribed “off-label” for TD.

Q: Do men with TD on TRT need follow up?

A: Yes, regular follow up is imperative to ensure that the TRT is effective, adverse effects are minimal, and T blood levels are in-range. Periodic digital rectal exams are important to check the prostate for enlargement and irregularities, and, in addition to T levels, other blood tests are important including a blood count to check for increased hematocrit (thicker, richer blood) and PSA (Prostate Specific Antigen). With the commonly used gel products, absorption rates vary considerably from person to person depending on skin thickness, body hair, preparation, application site, degree of sweating, etc., so dose adjustments need to be made depending on T levels that are periodically checked.

Q: What about TRT in men with cardiac disease or prostate cancer?

A: To quote a review article from the Journal of Sexual Medicine (Dean et al: The ISSM’s Process of Care for the Assessment an Management of TD in Adult Men, 2015;12:1660-1686): “TRT use has been complicated by controversies regarding prostate cancer and cardiovascular risks. Although the absence of large-scale, long-term controlled studies with TRT limits the ability to make definitive conclusions regarding these risks, the weight of evidence fails to support either concern.”

Q: How about testosterone supplements or boosters that can be bought online?

A: The Internet is overrun with male “sexual enhancement” products. They capitalize on male insecurity, which has created a huge market, with hordes of men willing to pay top dollar for products that have misleading claims and are often mislabeled, contaminated and falsely advertised. Unfortunately, such supplements are exempt from the stringent regulatory oversight applied to prescription drugs, which requires reviews of a product’s safety and effectiveness before it goes to market. Do not waste your money!

Bottom Line: Testosterone deficiency (or low T) is a very real entity, but not as common as it’s been made out to be. The symptoms can be devastating, and when accompanied by lab testing confirming the suspected clinical diagnosis, testosterone replacement therapy can be magical. I had one patient who eloquently described his “world of black and white turning into a world of color” after his testosterone level was normalized. For many others with the syndrome, the beneficial effects of TRT are far more subtle. If your T level is normal, it is highly unlikely that your symptoms are on the basis of low T and TRT should not be a consideration.


Kidney Stones 101: Symptoms, Treatment and Prevention

Kidney stones are a common problem that I treat daily. Kidney stones are often related to our dietary habits, the amount of fluids that we drink, and our weight.

If you have ever suffered with a kidney stone, you know what excruciating pain is. Many women who have experienced both passage of a kidney stone and natural childbirth without any anesthesia will report that the childbirth was the less painful of the two!

Stones are a common condition that have occurred in humans since ancient times — kidney stones have even been found in an Egyptian mummy dated 7000 years old. The good news is that most of them will pass spontaneously without the necessity for surgical intervention. If surgery is required, it is minimally invasive (open surgery for kidney stones has virtually gone by the wayside).

How do kidney stones form?

Kidney stones form when minerals that are normally dissolved in the urine precipitate out of their dissolved state to form solid crystals. This crystal formation often occurs after meals or during periods of dehydration. Most kidney stones manifest themselves during sleep, at a time of maximal dehydration.

Dehydration is also why kidney stones occur much more commonly during hot summer days than during the winter. Anything that promotes dehydration can help bring upon a stone, including exercise, saunas, hot yoga, diarrhea, vomiting, being on bowel prep for colonoscopy, etc.

In addition to dehydration, another factor that can contribute to kidney stone formation is excessive intake of certain vitamins. The biggest culprit is Vitamin C, also known as ascorbic acid. When metabolized by the body, vitamin C is converted into oxalate, one of the components of calcium oxalate stones, the most common type of stone. The problem is that vitamin C is a water-soluble vitamin, so any excessive intake is not stored in the body but appears in the urine in the form of oxalate.

Additionally, excessive dietary protein intake, fat intake, and sodium are all associated with an increased risk for kidney stones. Having inflammatory bowel disease or previous intestinal surgery can also increase the risk for stones. Urinary infections with certain bacteria can promote stone formation. Having a parathyroid issue and high circulating calcium levels is another cause of kidney stones. Obesity is also a risk factor for kidney stones. Some stones have a genetic basis, with a tendency to affect many family members.

A kidney stone starts out as a tiny sand particle that grows as the “grain” is bathed in urine that contains minerals. These minerals are deposited and coalesce around the grain. They can grow to a very variable extent so that when they start causing symptoms they may range from being only a few millimeters in diameter to filling the entire kidney.

What are the symptoms?

Some stones are “silent” because they cause no symptoms and are discovered when imaging studies are done for other reasons. However, most stones cause severe pain known as colic. Colicky pain is often intermittent, originating in the flank area and radiating down towards the groin.  It often causes an inability to get comfortable in any position, and is associated with sweating, nausea, and vomiting. Kidney stones can also cause blood in the urine, sometimes visible and, at other times, only on a microscopic basis.

When a stone moves into the ureter (the tube running from the kidney to the bladder), it can become impacted and block the flow of urine. Stones can sometimes cause lower urinary tract symptoms such as urgency and frequency, particularly when the stone approaches the very terminal part of the ureter that is actually tunneled through the wall of the bladder.

How are they diagnosed?

Kidney stones are usually easily diagnosed, based upon their rather classical presentation. However, on occasion, a stone causes no symptoms whatsoever and is picked up incidentally on an imaging study such as an ultrasound, a CAT scan, or an MRI. The imaging study of choice for evaluating a kidney stone is an unenhanced CAT scan (without contrast). A plain x-ray of the abdomen is very useful for stones that contain calcium, and thus are readily visible on an x-ray.

How are they treated?

Most stones will pass spontaneously without intervention given enough time. Conservative management involves hydration, analgesics and the use of a class of medications known as alpha-blockers that can help facilitate stone passage by relaxing the ureteral smooth muscle. As long as the pain is manageable and there is progressive movement of the stone seen on imaging studies, conservative management can continue to be an option.

Intervention is mandated under the following circumstances: intolerable pain; refractory nausea and vomiting with dehydration; larger stones that are not likely to pass; failure of a stone to pass after a reasonable amount of time; significant obstruction of the kidney; a high fever from a kidney infection that does not respond to antibiotics; a solitary kidney; and certain occupations that cannot risk impaired functions such as an airline pilot.

There are a number of minimally invasive means of treating kidney stones depending upon the size of the stone, its location, and the degree of obstruction of the urinary tract. Gone are the days when treating a kidney stone required a painful incision and a prolonged stay in the hospital. Shockwave lithotripsy is commonly used to treat stones in the kidney or upper ureter. Typically done under intravenous sedation, shockwave lithotripsy uses shock waves directed at the kidney stone via x-ray guidance to fragment the stones into pieces that are small enough so that they then can then pass down the ureter, into the bladder and out the urethra with the act of urinating.

Another means of managing stones, particularly amenable to stones in the lower ureter but also applicable to any stone, is ureteroscopy and laser lithotripsy. This procedure is done under general anesthesia. A narrow lighted instrument known as a ureteroscope is passed up the ureter to visualize the stone under direct vision.  A laser fiber is then utilized to break the stone into tiny particles. The largest fragments are removed using a special basket. A ureteral stent is often left in place after this procedure to allow the ureter to heal as well as to prevent obstruction of the kidney.

What are the risk factors?

You are at high risk for kidney stones if you:

  • Don’t drink enough fluids
  • Have an occupation that requires working in hot environments
  • Exercise strenuously without maintaining adequate hydration
  • Are a male, since the male to female ratio of kidney stone incidence is 3:1
  • Had a previous kidney stone, since about 50% of people who have a stone will experience a recurrence
  • Have a family history of kidney stones
  • Have a urinary tract obstruction
  • Have an excessive intake of oxalate, calcium, salt, protein and fat
  • Take excessive amounts of vitamin C, A, and D
  • Have an intestinal malabsorption
  • Have gout
  • Have parathyroid disease

Can kidney stones be prevented?

The key to preventing kidney stones is to stay well hydrated, particularly when exposed to hot environments or when exercising for prolonged periods of time. It is also important to avoid overdoing it with certain vitamins—particularly vitamin C. The two biggest risk factors for kidney stones are, in fact, dehydration and excessive intake of vitamin C. Chances are that if you have a healthy diet, you have more than adequate intake of vitamin C and any extra is potentially dangerous. A good sign of adequate hydration is the color of your urine: the urine of a well-hydrated person will look light in color like lemonade, whereas the urine of a dehydrated person will look like apple juice.

So drink up, particularly on hot days…and squeeze some citrus fruit into your water instead of popping a vitamin C supplement…your kidneys will thank you!

Written by Dr. Andrew Siegel


The Prostate Gland: Man’s Center of Gravity

The prostate gland is a mysterious male reproductive organ that can be a source of curiosity, anxiety, fear and potential trouble. Since this gland is a midline organ nestled deep within the pelvis, I like to think of it as man’s “center of gravity.”

Where exactly is the prostate gland?

The prostate gland is located behind the pubic bone and is attached to the bladder (above) and the urethra (below). The rectum is directly behind the prostate (which permits access for prostate exam). The prostate is situated at the crossroads of the urinary and reproductive tracts and completely surrounds the urethra, allowing its many ducts to drain into the urethra. The relationship between the prostate and the urethra can potentially be the source of problems for the older male. When a man ages, the prostate gland gradually enlarges. This prostate enlargement can constrict and block the urethra, giving rise to bothersome urinary symptoms.

What is the prostate, what purpose does it serve, and how does it function?

The prostate is a male reproductive gland that produces prostate fluid, a nutrient and energy vehicle for sperm. The prostate consists of glandular and fibro-muscular tissue enclosed by a capsule of collagen, elastin and smooth muscle. The glandular tissue contains the secretory cells that produce the prostate fluid.

Semen is a “cocktail” composed of prostate fluid mixed with secretions from the seminal vesicles and sperm from the epididymis. The seminal vesicle fluid forms the bulk of the semen. The seminal vesicles and vas deferens (tubes that conduct sperm from testes to prostate) unite to form the ejaculatory ducts.

At the time of sexual climax, prostate smooth muscle contractions squeeze the prostate fluid through prostate ducts at the same time as the seminal vesicles and vas deferens contractions squeeze seminal fluid and sperm through the ejaculatory ducts. These pooled secretions empty into the urethra (channel that runs from the bladder to the tip of the penis). Rhythmic contractions of the superficial pelvic floor muscles result in the ejaculation of the semen.

What are the zones of the prostate gland?

The prostate gland is comprised of different anatomical zones. Most cancers originate in the “peripheral zone” at the back of the prostate, which can be accessed via digital rectal exam. The “transition zone” surrounds the urethra and is where benign enlargement of the prostate occurs. The “central zone” surrounds the ejaculatory ducts, which run from the seminal vesicles to the urethra.

Curious facts about the prostate:

  • The prostate functions to produce a milky fluid that serves as a nutritional vehicle for sperm.
  • Prostate “massage” is sometimes done by urologists to “milk” the prostate to obtain a specimen for laboratory analysis.
  • The prostate undergoes an initial growth spurt at puberty and a second one starting at age 40 or so.
  • A young man’s prostate is about the size of a walnut, but under the influence of aging, genetics and testosterone, the prostate gland often enlarges and constricts the urethra, which can cause annoying urinary symptoms.
  • In the absence of testosterone, the prostate never develops.
  • The prostate consists of 70% glands and 30% muscle. Prostate muscle fibers contract at sexual climax to squeeze prostate fluid into the urethra. Excessive prostate muscle tone, often stress-related, can give rise to the same urinary symptoms that are caused by age-related benign enlargement of the prostate.
  • Women have a female version of the prostate, known as the Skene’s glands.

Written by Dr. Andrew Siegel


4 Common Causes of Urinary Incontinence in Men

17 Feb 2020 Blog

Urinary incontinence (UI) in men—involuntary leakage of urine – is not an uncommon problem. As estimated 3.4 million men in the United States currently experience UI, making life difficult both physically and emotionally.  While often related to prostate problems, urinary incontinence has a variety of causes and can also be brought on by medical conditions such as diabetes and Parkinson’s disease, and by pelvic surgical procedures including prostatectomy.

However, like many conditions that were once thought to be an inevitable fact of aging, UI in men is often due to underlying conditions that are treatable. Urologists are experts in the evaluation and treatment of UI with an array of evolving and cutting-edge techniques.

Treatment is an important consideration for any man affected. The healthcare community has lately begun to take a closer look at inequities in medical treatment, and although there is limited data on urinary incontinence in those of different races, in one study African-American men had the highest prevalence of incontinence. Hispanic men are also widely impacted. The study concluded that ethnicity appears to be a contributing risk factor for UI.

4 Common Causes of Urinary Incontinence in Men:

The following are common causes of urinary incontinence:

  1. Prostate problems. Prostate problems, especially as men age, can result in problems with urinary control. If the prostate is enlarged, it may affect the flow of urine and cause a weak stream, frequent urination, and leaking. When the prostate is removed for cancer treatment, it is not uncommon to have stress incontinence, which is when physical movement such as coughing or sneezing triggers leakage.
  2. Conditions that cause nerve damage. Because muscles and nerves must work together to control the bladder, any condition that damages the nerves can create urinary problems. Conditions may include Parkinson’s disease, stroke, diabetes, multiple sclerosis, herniated discs, spinal cord injuries, and dementia.
  3. What and how much you drink. Certain types of beverages can stress the urinary system. Limiting the amount of alcohol and caffeine, both of which have a diuretic effect, can help bladder control issues. Although staying hydrated is important, it is vital not to overdo it with fluid intake as this can exacerbate bladder control issues.
  4. Weight status. Being overweight can exacerbate urinary incontinence.

Male Urinary Incontinence Home Remedies

There are a number of home remedies and lifestyle adaptations that are known to assist with UI, as well as help to prevent it. They can either be tried on their own, such as for mild cases of UI, or combined with other medical treatments. However, a consultation with a urologist is recommended to evaluate each individual case. With expert medical assistance, these home remedies can be adopted in addition to receiving any other necessary treatments.

  1. Watch Your Diet. Certain foods and drinks can be triggers for a bladder problem in men as well as women. These include notably alcohol and caffeine, as well as fizzy drinks, spicy foods, tomato products, chocolate, and citrus juices. To evaluate what might be a possible personal trigger, it’s useful to keep a food diary. Note what seems to be a trigger. For accurate analysis, try eliminating one product at a time, and give it about a week to see if symptoms change.
  2. Drink Fluids Moderately. Drink sufficient volumes to remain adequately hydrated, but do not overdo it as excessive fluid intake will contribute to urinary urgency, frequency and control issues.
  3. Lose Weight if You Are Overweight. Excess fat, especially around the belly area, puts extra pressure on the pelvic muscles and bladder. Physical activity is a great way to lose weight and alleviate pressure on the bladder and is also good for general health.
  4. Try Kegel Exercises and Bladder Control Techniques. Kegel exercises strengthen the pelvic muscles—those that help control urine leakage. A urologist can help guide you in these exercises. You can also practice bladder control. This entails urinating on schedule rather than going at every urge. Retraining the bladder can cut down on the frequency of the urge to go.
  5. Stop Smoking. If you do smoke, be aware that smoking irritates the bladder and can worsen UI symptoms.

Treatments for Male Urinary Incontinence

There are a number of treatment approaches for urinary incontinence to improve bladder control for men, depending on how severe it is and its underlying cause. A combination of treatments might be necessary. There are several categories of medications to treat overactive bladder and relax the bladder muscles and medications for men with incontinence caused by an enlarged prostate. Neuromodulation techniques include percutaneous tibial nerve stimulation, Botox injections in the bladder, and Interstim implantation. When indicated, surgical procedures are available to help alleviate incontinence issues.

Untreated Urinary Incontinence

It is widely acknowledged that UI remains greatly undertreated. Men, in particular, are much less likely to bring up the topic with their doctors as women. In fact, one study revealed that despite the wide variety of remedies for UI, only one in five symptomatic men sought treatment.

What’s more, the mental and emotional impact of urinary incontinence can be life-altering. Embarrassment, anxiety and depression are a significant part of the diminishing quality of life caused by this condition.

At NJU, We Can Help

At New Jersey Urology (NJU), our experts can help. Our experienced specialists are dedicated to treating urinary incontinence as well as other conditions with medical expertise and sensitivity. As the largest urology practice in the country—including 41 convenient locations and four cancer treatment centers—we are proud to treat a wide array of urological issues and accept most major insurance plans. Discover the NJU difference today. Contact us to learn more.

Written by Dr. Andrew Siegel 


Male Sexual Dysfunction: A Predictor of Heart Disease

Erectile Dysfunction (ED) serves as a good proxy for cardiac and general health. The presence of ED is as much of a predictor of heart disease as is a strong family history, tobacco smoking, or elevated cholesterol!

All fat is not created equal.

Having some fat on our bodies is not a bad thing. Fat serves a number of useful purposes, such as cushioning internal organs, providing insulation to conserve heat, and storing energy and fat-soluble vitamins. Fat is also part of the structure of the brain and cell membranes and is used in the manufacturing process of several hormones.

However, not all fat is the same. It’s important to distinguish between visceral fat and subcutaneous fat. Visceral fat– also referred to as a “beer belly” – is internal fat located deep within the abdominal cavity. Subcutaneous fat – also known as “love handles” – is superficial fat located between the skin and the abdominal wall.

In addition to the physical distribution of the fat being different, so is the nature of the fat. Although neither type is particularly attractive, visceral fat is much more hazardous to one’s health than subcutaneous fat. Visceral fat increases the risk of heart disease, diabetes and metabolic disturbances. Subcutaneous fat is inactive, relatively harmless, and generally does not contribute to health problems.

Visceral fat is essentially a metabolically active endocrine “organ” that does way more than just create an unsightly protrusion from our abdomens. It produces numerous hormones and other chemical mediators that have many detrimental effects on all systems of our body, including risk of diabetes, cardiovascular disease, low testosterone, erectile dysfunction (ED) and premature death.

So how can erectile dysfunction predict heart disease?

Visceral fat and metabolic syndrome are highly associated with low testosterone and poor erection and ejaculation function. The fatty tissue present in obese abdomens contains abundant amounts of the enzyme aromatase which converts testosterone to estrogen, literally emasculating obese men. So, visceral fat can steal away our masculinity, male athletic form and body composition, mojo, strength, and the ability to obtain and maintain a good quality erection.

This is why ED serves as a good proxy for cardiac and general health. The presence of ED is as much of a predictor of heart disease as is a strong family history, tobacco smoking, or elevated cholesterol.

FactoidThe penis can function as a “canary in the trousers.” Since the penile arteries are generally rather small (diameter of 1- 2 mm) and the coronary (heart) arteries larger (4 mm), it stands to reason that if vascular disease is affecting the tiny penile arteries and causing ED, it may affect the larger coronary arteries as well — if not now, then at some time in the future. In other words, the fatty plaque that compromises blood flow to the smaller vessels of the penis may also do so to the larger vessels of the heart and thus ED may be considered a genital “stress test.”

What does this all mean?

  • Visceral fat is a bad, metabolically-active form of fat that is highly correlated with metabolic syndrome, diabetes, heart disease and sexual dysfunction.
  • ED often occurs in the presence of “silent” heart disease (no symptoms) and serves as a marker for increased risk for heart disease (as well as stroke, peripheral artery disease and death). ED will often occur 3-5 years before heart disease manifests. Early detection of ED provides an opportunity to decrease the risk of heart disease and the other forms of blood vessel disease. ED has a similar or greater predictive value for heart disease as do traditional factors including family history, prior heart attack, tobacco use and elevated cholesterol. The greater the severity of the ED, the greater the risk and extent of heart disease and blood vessel disease.

What can I do?

Lifestyle intervention has the potential for reversing visceral obesity, metabolic syndrome and sexual dysfunction. This lifestyle intervention involves achieving a healthy weight, losing the belly fat, eating healthy, exercising regularly, quitting smoking, limiting alcohol intake, and managing stress.

Written by Dr. Andrew Siegel


Urine Color and Odor – What Does It Mean?

27 Jan 2020 Blog

Everyone has probably noticed at one time or another that the color and odor of their urine can change. While the difference may just be something you ate, the color and odor of your urine can also be indicative of a possible health condition. As such, it’s important to take notice of any changes in your urine and what these changes may mean – and to know when to contact a doctor for medical attention.

Urine Color

Urine color can range from pale yellow to deep amber, and there are many factors that can affect urine color including fluid balance, diet, medicine, and disease.

What Color Urine Is Best?

Your urine color will likely be different in the morning than at night. Because urine is more concentrated in the morning, it will optimally be a pale straw color if you’re well hydrated and healthy. At night, look for a pale yellow color, or closer to clear like water. If you are seeing a slightly more “concentrated” yellow color, it is likely a sign that you simply should be drinking more water.

Light Yellow or Dark Yellow Urine

How light or dark the color of your urine is depends on how much water you drink. Water and other fluids dilute the yellow pigments in urine, so the more you drink, the clearer your urine will be. In cases of dehydration, the urine can become a dark amber color. In general, very light (clear) colored urine is a good sign that you are drinking enough water. If you find yourself asking “why is my urine dark yellow?” there’s a good chance you need to drink more water (related: “How much water do I really need to drink?”). If your urine is reddish-brown, it may be more cause for concern.

Reddish-Brown Urine

Some foods, such as blackberries, beets or rhubarb – can turn urine a reddish-brown. More significantly, having blood in your urine can also make it appear reddish-brown, so it’s important to observe and take note of these subtle signs and symptoms.

Bright Yellow Urine

Some vitamins and supplements – such as Vitamin B – can turn urine bright yellow. Generally speaking, vitamin toxicity and overdose rarely leads to serious illness. If your urine color is causing concern, you can also contact us for further evaluation.

Light Green Urine

Light green urine is typically caused by dyes in food, though it could also be caused by medications such as antidepressants and drugs containing phenol. It is typically not a cause for concern, but be sure to keep watch and contact your urologist if you have accompanying conditions.

Urine Odor

Some foods (such as asparagus), vitamins, and antibiotics (such as penicillin) can cause urine to have a different odor. In most cases, urine odor is not a strong concern. However, there are a few scenarios where urine odor is a cause for concern and you should contact your doctor for further evaluation.

Sweet, Fruity Urine Odor

This may be caused by uncontrolled diabetes. If you have been diagnosed with diabetes, it is important to contact your physician to evaluate your current course of treatment. If you have not been diagnosed with diabetes, this urine odor could be an indication of an issue, and it is important to consult your doctor for testing.

Foul Urine Odor

Foul smelling urine is often a sign of a Urinary Tract Infection (UTI), as the presence of bacteria in the urine affects the odor. This is also often accompanied by cloudy or bloody urine.

When to See a Doctor

Sometimes, symptoms can be very vague or subtle which makes it very difficult to figure out what the problem is. If you are dehydrated your urine will be more concentrated and urinating may cause discomfort. Drink enough fluids to keep your urine light yellow or clear, this will help decrease discomfort.
Visible blood in the urine is often a sign of a urinary tract infection or kidney stone. Dark or orange urine may be a sign of liver malfunction. You should notify your doctor if you experience any of these symptoms.

If you have more questions about your urine color, and would like to consult a physician, please use our locations page to find a urologist near you, or simply contact us through our main contact form.


1 2 3 6

Search

+
Skip to content