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Urologic Care for Conditions of the Genitals

Urologists diagnose and treat problems related to the genitalia, in this area primarily focusing on conditions affecting male genitalia, and referring women to Virtua’s’ knowledgeable gynecologists. Male genital conditions can pose health risks, cause pain, and interfere with sexual health. They come from problems that are congenital or developmental, as well as problems stemming from microbes, injury or disease.

Virtua’s urologists are trained and skilled in the full range of interventions sometimes necessary for conditions affecting the genitalia.
  • testicular cancer. A less-common but still significant type of cancer, testicular cancer is seen more often in younger men.   The Virtua staff has significant expertise in evaluating and identifying this condition, which is highly treatable especially when found early.  Men who discover a lump or abnormality in a testicle are understandably concerned about testicular cancer and absolutely correct in seeking evaluation, even though such abnormalities are often benign.
    • If testing confirms a cancer, the Virtua urologic team helps coordinate a plan for prompt intervention usually with surgery, often followed by radiation therapy, chemotherapy, or both.   The approach almost always means removing the diseased testicle preserving the nondiseased testicle, which can provide for normal hormonal reproductive function.
    • Virtua’s urologists work in close coordination with Virtua’s medical and radiation oncologists to integrate chemotherapy and radiation therapy into the treatment sequence, as appropriate.   Radiation therapy can sometimes be delivered in the physician-office urology center.
  • infection and inflammation. Infection and significant irritation can sometimes affect the urethra, the vas defrens, the epidymis (epidymitis), foreskin of the penis (balantitis) or other structures with reproductive functions.   Severe, chronic urinary infections can impact the genitals but, more commonly, sexually transmitted diseases can cause drainage, pain and tissue injury or external lesions.   These STDs include venereal disease, herpes, chlamydia, yeast infections, genital warts, and other conditions.   Virtua’s urologists have extensive experience in diagnosing and treating these conditions, which they can usually address medically.
  • variocele. Abnormally swollen veins in the spermatic cord of the scrotum are not an unusual condition in men.   They constitute, in effect, varicose veins in the vessels draining blood from the testicle.  Pressure causes valves in the veins to fail. The condition can cause pain and problems in appearance of the scrotum.  Fortunately, symptoms of variocele are usually minor, as they normally also are for hydrocele, the build up of fluid around a testicle.   However, variocele can cause shrinkage of the testicle that can affect male fertility, and the earlier it is corrected the better, ideally in adolescence, relative to this risk.  In roughly half of men, variocele will not affect fertility; however, specialists cannot predict the affect on fertility on a given individual early out.   The condition can also result in decreased size and testosterone production in the testicle.
    • In addition to physical examination, Virtua’s urologists may use venography or ultrasound to help confirm the condition.  They have ample experience in determining when intervention is necessary.  If the patient is an adult, the urology team can perform a semen analysis to try to determine if the variocele is compromising fertility.   If variocele appears to be the cause of the male fertility problem, the patient can undergo treatment; however, damage may already be done to the testes.  Varioceles are readily treatable, with variocelectomy, a procedure available in a surgical and nonsurgical approach that targets the abnormal vein.
    • Open surgery has been a long-term, dependable approach to variocelectomy.   The urologic surgeon accesses the abnormal vein through an a small incision (1.5 cm.) in or near the groin and ties or cuts off the abnormal vessel.   Blood flow will reroute itself around this vein, as the vein withers.
    • Today, urologists or interventional radiologists at advanced centers such at Virtua Our Lady of Lourdes also have the option of using a catheter approach to ablate or seal off, and thus collapse, distended and unsightly veins in the scrotum.   The procedure requires only a small incision to access the femoral artery in the leg, by which the surgeon advances a catheter to scrotal vein via the vena cava and renal vein.   With the help of X-ray guidance, the surgeon treats the veins with a heat source at the end of the cather or blocks the vein with an embolizing agent.   The problem vein gradually recedes and collapse in the weeks following this minimally invasive outpatient procedure.
  • phimosis. Some uncircumcised young men experience difficulty withdrawing the foreskin (prepuse) of the penis due to attachments of the foreskin to the glans (head) of the penis.   Virtua urologists can easily diagnose this condition and guide patient, or patient and parents, in a gradual, watchful approach that often involves gentle manipulations or topical agents.   The condition will normally resolve itself by the late teen years.   For those for whom this conservative, noninvasive approach is not successful, surgical release of the adhesions or a circumcision are ready operative solutions provided by the Virtua team.   A related condition in which the foreskin will not return to its normal position over the glans of the penis can be similarly addressed.
  • circumcision. For infants whose parents elect circumcision for them, or adult men who chose the procedure, Virtua’s urologists can provide this safe, easy procedure.   For men with adhesions due to phimosis or due to the need for a revised circumcision for this or cosmetic reasons, the operation is simple and straightforward, and can be done with anesthesia ranging from local to regional to general.   This is normally an outpatient procedure but sometimes involves an overnight stay in the hospital as a caution against bleeding.
  • trauma. Traumatic penile, scrotal or testical injuries in men due to sports or accidents or other stresses can be mild and passing or extremely painful, requiring the attention of urologist.   Virtua’s urologists know when conservative healing or surgical intervention are best for a specific injury.
  • undescended testicle. If one or both testicles have not descended into the scrotum, as part of normal development, Virtua’s urologic specialists can resolve the problem through minimally invasive surgery.
  • inguinal hernia. A small portion of the bowel can protrude past its normal confines and bulge into the groin area.  Virtua’s urologists will refer this condition to Virtua’s experienced general surgeons for repair.
  • testicular torsion. Sometimes the spermatic cord, one of which conducts the blood vessels and ducts to and from each of the testicles, can become twisted as a result of rotation of the testicle, cutting off blood flow to the testicle.   This condition causes severe pain and requires urgent medical treatment, as the testicle can begin to suffer permanent damage within a few hours.   Ultrasound can help to confirm the condition, which occurs most commonly in adolescent males. Some men have a natural predisposition to the condition or may develop it after trauma or strenuous exercise; in other cases, no cause is obvious.   The Virtua urologist can sometimes manually reposition the testicle to relieve the torsion if the testicle does not do so on its own.   Even if this noninvasive intervention is successful, though, surgery is required to reposition the testicle and secure both testicles to a proper, stable location.   If the testicle is not saved in time, it must be removed to prevent serious infection.
  • Peyronie’s disease. Scar tissue within the penis can cause penile curvature during erection.   Nonsurgical treatments are still underdevelopment, and the Virtua’s team can review these and the surgical options for correcting the shape of the penis.
  • penile curvature. For congenital penile curvature, reconstructive procedures can be successful.
Patients treated for urologic cancers at Virtua have the opportunity to enroll in clinical trials of new therapies and treatments. Virtua urologists and cancer-care specialists are actively involved in such trials with sponsoring companies, clinical research organizations, and national cooperative research groups.


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