Here you will find the answers to some frequently questions about Urology. You can use the form below to send your question.

Some time ago, I started to feel pain and burning sensation in the penis while urinating. My scrotum began to ache constantly. I also feel somewhat different smell in the urine. What this can be?

These symptoms may be several types of problem. There may be urinary tract infection, presence of urinary calculi (stones in the kidneys, ureters or bladder), urethral, or testicular inflammation. Typically, a complete medical history is necessary, associated with clinical examination and probably additional tests. Look for an urologist to make a full assessment. Remember that the longer it takes to see a doctor, the more difficult it can be to solve the problem.

A light burned in the penis - quite possible - and semen with a more pasty consistency (whitish) would be symptoms of a sexually transmitted disease?

The symptoms you refer may represent an infection, transient inflammation of the urethra or even can occur in normal people. Our explanations are more specific when you already have a diagnosis made by your doctor. Look for an urologist for further information

I wonder how do I do to be able to extend my erection while performing sexual intercourse. When I stand too long without sex I get orgasm very easily.

The erection should remain long enough for penetration and to allow the relationship until the ejaculation and also to allow the orgasm of the partner to approximately half the time. Ejaculation is a reflex triggered by stimulation of the penis. This reflex is automatic and every man is born with the characteristic to ejaculate quickly. Humans have learned that sex can be done as an act of love and pleasure, so learned to control the ejaculatory reflex, in order to prolong sexual intercourse. However, the ability to control this reflex undergoes numerous local influences, emotional and psychological. It is not possible to assess what the exact problem you are experiencing with you without examining you. Look for an urologist for further information.

I would like to know if after Prostate Surgery (Benign Hyperplasia) man becomes impotent, being necessary to resort to penile prosthesis. My urologist told me that what happens is this: man still have pleasure in a sexual relationship, but does not ejaculate more and the liquid goes into the bladder and is excreted in the urine. Is it correct this information ?

Most prostate surgery does not cause impotence. The retrograde ejaculation occurs in about 75% of people operated. In the case of patients undergoing treatment for benign diseases, the probability of impotence is practically zero. In the case of patients operated for of the prostate cancer, the risk for impotency range from 30 to 100%, depending on the event (disease stage, tumor size, state of sexual function before the operation age). However, in any case erection that the patient has the sensation of orgasm remains practically the same. Only ejaculation is absent (in cancer) or is retrograde (in cases of benign disease).

I wonder if all male urethritis occurs after sexual contact with a person with a venereal disease. Is there any other disease whose symptom is pus through the penis?

The urethritis can be inflammatory or infectious source and either type can produce urethral secretion. In general, the inflammatory cause urethritis originate in rheumatic diseases or irritation produced by manipulations of the urethra. The usually infectious urethritis are sexually transmitted diseases. Although they admit that it is possible to acquire a urethritis without direct sexual contact (from clothes, bathrooms, sheets), it is known that this form of contamination is unlikely. The most accepted is the contamination that occurs by direct contact with an infected person. In some cases, multiple contacts are needed to get the disease, but it is possible to acquire with an only contact. The use of male or female condoms is very effective protection against the urethritis. Women may also have urethritis, but in these, the causative agents of these infections attack mostly the vagina, the cervix and the horns. If you need further information feel free to contact us again or look for a urologist.

What are the treatment options for kidney stones?

Complex stones are becoming increasingly rare and with this therapy is becoming increasingly ambulatory (the patient does not need to be hospitalized). However, successful management requires competence in all aspects, from diagnosis, patient preparation, indication of the form of treatment to care postoperatively. The challenge today is to employ the optimal approach for each specific situation.
The Santa Casa de Misericórdia –ISCMPA- has today all the alternatives for use in the treatment of urinary tract calculations. We can mention:

1. Lithotripsy extracorporeal shock wave: the doctor locates the calculation with the aid of fluoroscopy or ultrasound, or both, and the machine breaks the calculation and the patient eliminates it through the urine into fragments like grains of sand.

2. Percutaneous intracorporeal lithotripsy: the doctor locates the calculation with a device fluoroscopy or ultrasound, puncture the kidney through the lumbar region with a needle, dilates the path and puts nephroscope lens that allows the visualization of the calculation, it breaks with the use ultrasound and remove the fragments.

3. Laparoscopic intracorporeal lithotripsy (used in complex cases): the physician performs a laparoscopy, enters the kidney collecting system (known as the renal pelvis) and removes the calculation, whole or fragmented.

4. Intracorporeal lithotripsy: for calculations of ureter (calculate it locked on the path between the kidney and bladder): the doctor locates the calculation Radioscopy and enters the ureteroscope through the urethra passes through the bladder and is consistent with the calculation. Apparatus which can be rigid, semi-rigid or flexible, with the use of one or the other will depend on the location and type of calculation. Uses an energy source to break it (ultrasonic, electro-hydraulic, pneumatic or laser) and then remove it. A feature often used in emergencial situations is to drain the kidney with the use of a catheter known as "Double J" which drain the kidney and the doctor has time to properly plan the best procedure. The "Double J" is for temporary use and should be removed always once the problem is solved.

What is the optimal size of the penis?

The normal size of brazilian man penis was little studied. In general the average says that any size between 4 to 18 cm at rest and 7 to 27 cm is in the normal upright. What really matters is sexual function. In this case, since you can get and maintain erections sufficient for penetration, which will enable sexual intercourse until the end, there is no need to worry about your penis size. The discussion on the individual preferences of men and women as the best penis size is very controversial and involves cultural, emotional and intimate. There is no consensus on this issue. The Brazilian Society of Urology condemns performing procedures to stretch the penis by now, they still consider all types as treatments in development (still under clinical evaluation).

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Na década de 1980 as cirurgias endoscópicas e laparoscópicas deram um grande salto com o advento das microcâmeras.

Surgiram os primeiros robôs médicos, como o braço robótico PUMA 560, que em 1985 auxiliou uma biópsia durante uma neurocirurgia.



Em 1999 o Dr. Mirandolino Mariano faz a primeira cirurgia por laparoscopia, publicando o relato de caso da técnica pioneira em 2002, no Journal of American Urological Association.