List Last 25 FAQs

Everyone is a little different about how they feel when a procedure like cystoscopy is done in the office. Hundreds of these procedures are done in our city weekly, and very few patients experience anything more than mild discomfort as a result. The cystoscope is a flexible camera system the size of a normal urinary catheter. It is connected to a lens system that allows the urologist to inspect the urethra and bladder. Each urologist may vary their technique a bit, but this system was adopted by most urologists so that this common procedure could be done in the office without much difficulty. If your condition is complex or there is a reason that immediate treatment of a problem would be needed, the cystoscopy would be done in the operating room with anesthesia. But for simple observation and diagnosis that isn’t needed.

Scrotal varicoceles occur when the veins that drain a testicle are enlarged. There are four grades of varicocele. Subclinical grade is a varicocele which is detectable with ultrasound. Grade 1 is detectable by touch only with valsalva, as when coughing or bearing down. Grade 2 is detectable by touch without valsalva, as when lying down or at rest. Grade 3 can be seen with the eye, and obvious without feeling them. They are more common on the left, since the left spermatic vein drains to the left renal vein which has more pressure than where the right drains; the inferior vena cava. Varicoceles can affect fertility by lowering sperm count and motlity. Rarely varicoceles can occur due to masses in the abdomen or vascular problems. Other than that, they are benign and wouldn’t require treatment unless fertility is an issue or they are bothersome in some way.

Testicular torsion is one of the emergencies encountered in Urology. With testicular torsion the cord bringing blood to and from the testicle is twisted, the blood supply to the testicle is interrupted and it will eventually die. How long that takes depends on the circumstances and the person, but most urologists consider four hours the maximum time of torsion to prevent injury. The more time torsed, the more injury will be incurred. A torsed testicle is usually very tender, and doesn’t retract normally with cremasteric muscle stimulus. It usually swells as well. Some people have intermittent torsion – the testicle rotates into a problematic position, but can be returned to normal anatomic position without treatment. If you suspect torsion, go to the emergency room for evaluation. If you have intermittent pain but no lasting torsion, make an appointment to be seen by your urologist for evaluation – sometimes surgery is done to ensure the testicle cannot torse. The opposite testicle is usually fixed in place when a surgery is done to prevent a torsion on the other side.

That depends on where they are. In the female vagina, the conditions are usually such that the sperm live for 4 to 5 days, so that fertilization can occur. Outside of that, they can only live for a few minutes or an hour, depending on moisture and other variables. Millions of sperm are ejaculated with each climax, so the number of sperm still living will dwindle with time until eventually they all die.

There is always sperm in the vas deferens, the tube that carries sperm from the testicles to the prostate where it is mixed with the rest of seminal fluid. During ejaculation the vas deferens undergoes rhythmic contractions that propel sperm forward. This occurs during orgasm no matter whether it is with masturbation or during intercourse. If sperm isn’t ejaculated for a long time, as would happen if a person were completely sexually inactive; or if a vasectomy were done to divide the vas deferens, they eventually die and are reabsorbed by the body, with no effect at all.