Urology Clinic of Lake Charles, LA

Dr. Reed Fontenot, Jr.
Dr. Stacy McBroom
Dr. John Upshaw

News

July 18, 2008
Computerized Tomography Findings In Pediatric Renal Trauma - Indications For Early Intervention?
UroToday.com - The study out of Children's Hospital of Pittsburgh evaluated CT scans for blunt renal trauma to see if they correlated with the need for operative intervention when urinary extravasation was present.

A total of 17 patients with grade IV blunt renal trauma and urinary extravasation were identified between 2000 and 2007. Each CT scan was reviewed to determine location, size and number of sites of extravasation, as well as the presence of contrast material in the ipsilateral ureter. These were then compared to the findings at the time of surgery - whether surgey included stent placement, percutaneous urinoma drainage, angiographic embolization and nephrectomy. Read entire article here.

July 15, 2008
Increased Risk Of Kidney Stone Disease Due To Global Warming, Predicts UT Southwestern Researchers
Global warming is likely to increase the proportion of the population affected by kidney stones by expanding the higher-risk region known as the "kidney-stone belt" into neighboring states, researchers at UT Southwestern Medical Center and UT Dallas have found.

Dehydration is one of the risk factors linked to kidney-stone disease, and the paper suggests global warming will exacerbate this effect. The researchers predict that by 2050, higher temperatures will cause an additional 1.6 million to 2.2 million kidney-stone cases, representing up to a 30 percent growth in some areas. Read entire article here.

Information
Prostate cancer is the second leading cause of death among men. In 2002 it is estimated that 30,200 men will die from prostate cancer and 189,000 men will be diagnosed (American Cancer Society Facts & Figures 2002). The incidence of prostate cancer increases with age with 75% of all prostate cancers being diagnosed in men over the age of 65.

Prostate Cancer Management
The critical focus for the treatment of prostate cancer is to treat those cancers where it is necessary, and not to treat those that do not need it.

Decisions about the best management of prostate cancer can be complex and depend upon the:

Pathology of the cancer (unlike other cancers, prostate cancer often progresses very slowly)
Stage of the disease (non-metastatic (localized or locally advanced), metastatic or hormone refractory)
Age and general health of the patients at diagnosis
The impact that treatment can have on quality of life, including sexual activity.
Patient's preference for treatment
PSA at diagnosis

Please visit the National Prostate Cancer Coalition for more information.

August is National Immunization Awareness Month
Vaccine-preventable disease levels are at or near record lows. However, we cannot take high immunization coverage levels for granted. To continue to protect America's children and adults, we must obtain maximum immunization coverage in all populations, establish effective partnerships, conduct reliable scientific research, implement immunization systems, and ensure vaccine safety.
Read more ....

Male Infertility

Overview

Infertility is the inability to conceive (reproduce) after at least one year of unprotected intercourse. Since most people are able to conceive within this time, physicians recommend that couples unable to do so be assessed for fertility problems. In men, hormone disorders, illness, reproductive anatomy trauma and obstruction, and sexual dysfunction can temporarily or permanently affect sperm and prevent conception. Some disorders become more difficult to treat the longer they persist without treatment.

Sperm development (spermatogenesis) takes place in the seminiferous tubules (ducts) of the testes. Cell division produces spermatozoa (mature sperm cells) that contain one-half of a man's genetic code. Each spermatogenesis cycle consists of six stages and takes about 16 days to complete. Approximately five cycles, or 2 ½ months, are needed to produce one mature sperm. Mitochondria (energy-generating organelles) inside each sperm power its tail (flagellum) so that it can swim to the female egg once inside the vagina. Sperm development is ultimately controlled by the endocrine (hormonal) system that comprises the hypothalamic-pituitary-gonadal axis.

Because sperm development takes over 2 months, illness that was present during the first cycle may affect mature sperm, regardless of a man's health at the time of examination.

Incidence and Prevalence
According to the National Institutes of Health, male infertility is involved in approximately 40% of the 2.6 million infertile married couples in the United States. One-half of these men experience irreversible infertility and cannot father children, and a small number of these cases are caused by a treatable medical condition.

Causes and Risk Factors

The primary causes of male infertility are problems with sperm production or delivery. Impaired production or delivery may result from hormonal dysfunction, trauma or defect in the reproductive system, and illness:

Cryptorchidism (failure of testes to descend; can impair spermatogenesis)
Cystic fibrosis (may cause absence of sperm, vas deferens, or seminal vesicles)
Ductal obstruction (caused by repeated infection, inflammation, or developmental defect)
Hemochromatosis (metabolic disorder; causes iron deposition in the testes)
Hormone dysfunction (caused by disorder in the hypothalamic-pituitary-gonadal axis)
Drugs
Retrograde ejaculation
Sexually transmitted diseases (STDs; cause obstruction, infection, and scarring)
Sickle cell anemia (can cause hypogonadism)
Systemic disease (fever, infection, kidney disease, metabolic disorder; can impair spermatogenesis)
Testicular cancer
Testicular trauma (damage to testes)
Varicocele

Certain drugs used to treat hypertension, arthritis, and digestive disease, as well as chemotherapy drugs are associated with sperm production problems and infertility.

Retrograde ejaculation occurs when impairment of the muscles or nerves of the bladder neck prohibit it from closing during ejaculation, allowing semen to flow backwards into the bladder. It may result from bladder surgery, a developmental defect in the urethra or bladder, or disease that affects the nervous system, including diabetes. Diminished or "dry" ejaculation and cloudy urine after ejaculation may be signs of this condition.

Inflammatory infections of the prostate (prostatitis), epididymis (epididymitis), and testicles (orchitis), can cause irreversible infertility if they occur before puberty.

Testicular trauma, resulting from injury, surgery, or infection can trigger an immune response in the testes that may damage sperm. Though their effects are not fully understood, antibodies can impair a sperm cell's ability to swim through cervical mucus or to penetrate a female egg.