Ask a Urologist: Dato Dr Selvalingam from Sunway Medical Centre Velocity Malaysia

Dato Dr Selvalingam replied 2 years ago

Pain below the umbilical cord may arise from the bladder.

Dark color of urine – this is possibly the appearance of blood in the urine (hematuria). There are also foods like beetroot, peppers, rubarb and foods that have dyes that can change the color of urine.

As a first step, you should get a urine test for certainty.

If it is valid that there is blood in the urine, this may stem from several possibilities, namely:
1.Infection (urine infection)
2. Prostate gland problems
3. Urinary stones

It is advisable to get a kidney / bladder / prostate system ultrasound or a more sensitive CT scan.
You may also need an endoscopic exam, which is a cystoscopy.
The presence of blood in the urine is a symptom that should be addressed and requires initial doctoral treatment.

Dato Dr Selvalingam replied 2 years ago

We only need to drink 2L of water a day. If we drink too much water (> 3L a day) we will always pee.

If you urinate frequently even though you don't drink enough water, there are several possibilities:
1. Need to check for diabetes
2. Infecton in the urine (UTI). In this situation the urine may smell or have blood
3. Stones in the urinary tract can also cause frequent urination but are usually accompanied by pain
4.Overactive Bladder (OAB)

You should do urine microscopy and kidney ultrasound as a first step, in addition to a doctor's examination. If the test results are normal, you may be experiencing an Overactive Bladder (OAB).
OAB is a condition in which the bladder becomes sensitive and even though there is not much urine, you have an urge to urinate. This situation can occur if you have problems with constipation, diabetes or prostate problems. This situation can also get worse if you smoke, drink coffee / tea or carbonated drinks.

As a first step, avoid the above drinks. You can also do pelvic floor exercises.
If the problem still doesn't go away, there are drugs such as Vesicare and Betmiga that can treat this situation but you must go through a doctor's examination.

Dato Dr Selvalingam replied 2 years ago

You need to undergo further examinations such as CT Cystogram and Cystoscopy if a fistula is found.

The risk of developing a fistula is usually after childbirth (difficult birth) or gynecological surgery.

One more situation where the patient has difficulty controlling urination is in the case of an overactive bladder. Fistulas, if proven to be present, require surgery. Overactive bladder (OAB) can be treated with medication.

Dato Dr Selvalingam replied 2 years ago

For lumps on the shaft of the penis, it must be examined by a doctor to get a diagnosis. It may be due to a viral infection such as HPV or in serious cases, testicular cancer.

Dato Dr Selvalingam replied 2 years ago

Some possibilities for this problem:
1. The infection involves the urethra (urethritis). Especially for men who are sexually active
2. Prostatitis (inflammation of the prostate gland, although this is more often for men aged 40 and above)
3. Muscle / nerve problems in the pelvic region (may include back pain)

Doctoral examination can identify between these 3 conditions.

Dato Dr Selvalingam replied 2 years ago

Thank you for your question.

The risk factor for testicular cancer is not directly related to diet.
Risk factors are mainly related to genetics, presence of small volume testis with associated infertility or history of undecended testis.

However like any other cancer patient, the recovery from cancer will include taking care of general health.
I assume he has had the testis removed? Sometimes your doctor may give one dose of chemotherapy after surgery to reduce risk of recurrence. It is however important for him to continue long term followup with his doctor. He will also have to do self examination of the normal testis on a regular basis.

General diet advice would be to reduce animal protein , increase fibre , vegetable and fruit intake.
If fertility is a issue (with single testis), food rich in zinc is recommended. He can still consume egg and fish as a source of protein.

Important is that the diet should be balanced and in moderation. Can consult a nutritionist/dietician.
There are artificial sweeteners to replace sugar but they also have their risk. Its ok to take sugar in small amounts.

Reducing rice is one way to reduce carbohydrate intake if this is a concern.
It is also recommended regular exercise in cancer survivors. This is a good way to improve your immunity.

Dato Dr Selvalingam replied 2 years ago

Possibilities:
1. Urine infection
2. Vaginal infection
3. Urethral caruncle (red swelling at urethral meatus)
3. If you're post menopausal, it could be due to stiff urethra

My advice is to have a urine check to exclude urine infection. It'd also be good to have a Gynaecology examination to make sure there is no Gynae problem.

Dato Dr Selvalingam replied 2 years ago

Pain in the testicles after ejaculation

Possibilities:

1. Prostatitis (inflammation of the prostate gland)
2. Infection in the semen
3. Urinary infection
4. Testicular infection
5. Problems with the urinary tract (urethra) – this is usually accompanied by urinary problems such as pain when urinating and short urine streams.

The following checks are recommended:

1. Microscopic examination of urine to check for infection if any
2. Semen test including semen culture to make sure there is no infection
3. Ultrasound of the kidneys / ureters / bladder and testes

You should also get a doctor's examination.

Treatment:
1. Antibiotics if there is infection
2. Prostate medication in case of prostatitis

Dato Dr Selvalingam replied 2 years ago

Painful urination may be caused by:

1. Urinary infection
2. Stone problems
3. Narrowing of the urethra (blocked urinary tract) – this is usually accompanied by short urine streams
4. Prostate problems such as prostatitis for men
5. Tumors in the bladder / urinary tract (bladder cancer) – especially if one is a heavy smoker and there is blood in the urine

Urine examination and ultrasound of the renal system can be done.
If there is blood in the urine you may need to have a CT scan of the kidney system and cystoscopy, which is an examination of the urinary tubes.

Treatment depends on diagnosis.

Stone problems, narrowing of the urethra and tumors may require surgery.

Dato Dr Selvalingam replied 2 years ago

Purple bumps on the surface of the testes – there are several possible conditions:

1. Angiokeratoma, which is a lump caused by a 'dilated vein' or a venous blood vessel lump. It is usually not dangerous.
2. Varicocele – This is also caused by a lump in the vein and mainly applies to the left side of the testis. But this can cause pain and it is felt when standing or doing exercises. It also can cause infertility (sperm quality decreases)

For the first condition there is usually no treatment. Whereas for varicoceles, surgery may be performed if it causes infertility.

It is important to get a doctoral examination to confirm the diagnosis.

There are times when ultrasound of the kidneys and testicles may provide more information.

Dato Dr Selvalingam replied 2 years ago

The unintentional erection may not be related to varicocele. There is a condition known as priapism that can cause this. You will need to investigate with a urologist.

One of the tests that the doctor will do is a Full Blood Count (CBC) to check all your blood counts.
Priapism means the penis gets erected even without arousal and difficult to soften.
Sometimes previous injury to the penis can also cause this condition. You may also need to do ultrasound Doppler of the penis.

Dato Dr Selvalingam replied 2 years ago

Frequent urination can be caused by many conditions:

1. Urine infection
2. prostate problem (BPH) in men
3. Spine problems
4. Diabetes
5. If large amount of urine especially at night this can be due to condition called nocturnal polyuria
6. Urinary stones
7. Constipation
8. Medication (such as heart medication, diuretics)
9. Over consumption of water (> 3 L/day)
10. Too much coffee/tea/carbonated drinks /alcohol
11. Overactive Bladder (OAB)- this condition may be associated with stress and anxiety.

Your doctor will examine you and do the necessary investigation
The treatment will depend on diagnosis
In case of overactive bladder , medication such as Solifenacin and Mirabegron can be used to treat the condition
Exercises such as Pelvic Floor Exercises may also help in some cases

Dato Dr Selvalingam replied 2 years ago

Thank you for your question of the flaccid penis
If your partner is > 45 years old and is having difficulty in voiding best to check with the doctor
He may have a prostate problem. Prostatitis can occur in men in their 40s. BPH can occur in men >50 years old
BPH may often be associated with ED
ED can worsen in the presence of Diabetes/Hypertension or if your partner is a smoker
It also may be compunded if there is any symptoms of stress or anxiety.
Best to get a check with your doctor. Ensure that he is not on any recently started medication that may also cause ED
There are now a choice of medications he can try once the cause can be determined.
Thank You

Dato Dr Selvalingam replied 1 year ago

Thank you for your question. if you have a lump in your testis and gynecomastia, you will need to have it checked. Although not common, testicular tumour secreting hormones should be ruled out. Your doctor will do some blood test and an ultrasound of the testis. These test should not be expensive and would be advisable to do. A clinical examination by the doctor is important.

Dato Dr Selvalingam replied 1 year ago

Thank you for your question.

The foreskin does have some natural role in lubricating and covering the glans penis.It is also considered as a sexual organ. After circumcision there will be keratinization of the glans (formation of a layer over glans)- this may sometimes cause pain to partner and may require use of lubricant.

Men may also have some pain on erection if the remaining skin is short after circumcsion but this usually resolves. However , conversely in various studies, many circumcised patient continue to have good sexual satisfaction. Therefore don’t be too worried as you can continue to have sexual satisfaction even though there is no covering foreskin.