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 ....

Varicocele

Overview

Varicocele is a mass of enlarged veins that develops in the spermatic cord, which leads from the testes (testicles) up through the inguinal canal (passageway in the lower abdominal wall) to the circulatory system. The spermatic cord is made up of blood vessels, lymphatic vessels, nerves, and the vas deferens (duct that carries sperm from the body). If the valves that regulate bloodflow from these veins become defective, blood does not circulate out of the testicles efficiently, which causes swelling in the veins above and behind the testicles.

A varicocele can develop in one testicle or both, but in about 85% of cases it develops in the left testicle. The left spermatic vein drains into the renal vein between the superior mesenteric artery and the aorta; these two arteries can compress the renal vein and thus impede bloodflow from the spermatic vein. The right spermatic vein drains into the vena cava (the vein that returns blood to the heart) and develops varicocele less often. A unilateral (one-sided) varicocele can affect either testicle.

Because of the impaired circulation of blood created by a varicocele, the blood does not cool as it does in a normal vein. The increased temperature of the blood raises the temperature of the testes, which is believed to contribute to infertility, as heat can damage or destroy sperm. The raised temperature may also impede production of new, healthy sperm.

Incidence and Prevalence

Incidence of varicocele is 10-20% and is highest in men between the ages of 15 and 25. The sudden appearance of varicocele in an older man may indicate a renal tumor blocking the spermatic vein.

Approximately 40% of infertile men have a varicocele and among men with secondary infertility — those who have fathered a child but are no longer able to do so — prevalence may be as high as 80%.

Causes

A varicocele develops when the valve that regulates bloodflow from the vein into the main circulatory system becomes damaged or defective. Inefficient blood flow causes dilation (enlargement) of the vein.

Signs and Symptoms

Most men who have a varicocele have no symptoms. Asymptomatic (symptom-free) cases are often diagnosed during a routine physical examination. Signs and symptoms may include the following:

Ache in the testicle
Atrophy (shrinkage) of the testicle(s)
Feeling of heaviness in the testicle(s)
Infertility
Palpably (evident to the touch) enlarged vein
Visibly enlarged vein

Recurrent or constant discomfort or pain in the genital region should be reported to a urologist or primary care physician to determine the cause.