My Penis Stuff

Kidney stones are made of salts and minerals in the urine that stick together to form small “pebbles.” They are usually painless while they remain in the kidney, but they can cause severe pain as they break loose and travel through narrow tubes (ureters) to exit the body during urination.

Symptoms of a kidney stone include severe pain on one side of the back, just below the rib cage (flank pain). The pain may spread to the lower abdomen, groin, and genital area. Other symptoms include blood in the urine (hematuria), painful or frequent urination (dysuria), and nausea and vomiting.

A kidney stone is usually treated by increasing fluid intake and taking medications to relieve pain until the stone has passed. This typically occurs within a few days. If the stone seems unlikely to pass on its own or is causing severe pain, treatment options include a shock wave treatment (lithotripsy), which can break up a large stone into smaller pieces that are easier to pass, or very rarely, surgery.

If a stone is stuck in a ureter, a long, thin microscope (ureteroscope) can be passed through the urethra and bladder to the ureter. The stone may be taken out using a tiny basket on a wire passed through the ureteroscope. The stone can also be broken up using laser and then flushed out of the ureter with fluids inserted through the ureteroscope.

There are four different types of kidney stones, and they can be as small as grains of sand or as large as a golf ball. Kidney stones occur most often in adults and are rare in children.

An inguinal hernia occurs when a small portion of the bowel bulges out through the inguinal canal—a passage or opening through the muscles of the abdominal wall—into the groin. The bulge usually contains tissue lining the inside of the abdomen as well as fatty tissue from inside the abdomen or a loop of intestine.

There are two types of inguinal hernias:

• Direct inguinal hernias occur when a weak spot develops in the lower abdominal muscles. Often the cause of the hernia is not known, but lifting, straining, or coughing or being obese, pregnant, or constipated are often thought to be causes of hernias.
• Indirect inguinal hernias occur when the inguinal canal fails to close before birth. The hernia may appear in a male’s scrotum or in the fold of skin at the opening of a female’s vagina. This is the most common type of inguinal hernia, and it may occur at birth or later in life. Indirect hernias are more common in males.

Symptoms of an inguinal hernia may come on gradually or suddenly and may include a bulge in the groin or scrotum and discomfort, pain, or a feeling of heaviness. Other symptoms may develop if tissue in the hernia becomes trapped (incarcerated) or if the blood supply to the trapped tissue is cut off (strangulated).

An inguinal hernia may require surgery. In some cases, hernias that are small and painless may never need to be repaired.

An undescended testicle (cryptorchidism) is one that remains inside the body and has not moved down into the scrotum. Normally the testicles, which form inside the abdomen of an unborn baby boy, descend into the sac beneath the penis (scrotum) by the time the baby is born.

One or both testicles may be affected. In most cases, the testicle will descend without treatment by the time the baby is 3 months old. If this does not happen, a doctor may advise surgery—laparoscopy or orchiopexy—to move the testicle into the scrotum.

A male who has undescended testicles has an increased risk of testicular torsion, hernia formation, infertility, and testicular cancer.

Hypospadias is a common birth defect where the urethra does not extend to the tip of the penis. Instead, the opening of the urethra is located somewhere along the underside of the penis, running along a soft groove. The scrotum may also be incompletely formed or divided into separate sacs or lobes. In many cases of hypospadias, particularly when the genitals are incompletely formed, the testicles do not descend.

Hypospadias can usually be corrected with reconstructive surgery, which is usually performed when the boy is between 6 months and 2 years of age. A boy who has hypospadias should not be circumcised because the foreskin may be needed during surgery.

Hypospadias may be caused by an intersex disorder, which is a condition that is caused by abnormalities in the chromosomes or endocrine system that can produce female characteristics in a male baby.

Torsion of a testicle is a condition in which the blood supply to the testicle is cut off. This occurs when a testicle twists on the spermatic cord.

Torsion of a testicle is most likely to occur in boys around the time they reach puberty, but it may occur in younger and older males as well. Torsion of a testicle may occur for no apparent reason, even during sleep. It may also occur after strenuous physical activity.

Symptoms of torsion of the testicle include:

• Severe pain in the scrotum.
• Nausea and vomiting.
• Abdominal pain.

This condition needs to be corrected as soon as possible to restore normal blood flow. If left too long, the tissue of the testicle can die from lack of blood. Often emergency surgery is needed.

Everyone gets angry from time to time. Anger and arguments are normal parts of healthy relationships. But anger that leads to threats, hitting, or hurting someone is not normal or healthy. This is a form of abuse. Physical, verbal, or sexual abuse is not okay in any relationship. When it occurs between spouses, partners, or in a dating relationship, it is called domestic abuse or domestic violence.

Domestic abuse is also called intimate partner abuse. It is not the same as an occasional argument. It is a pattern of abuse used by one person to control another. Abuse includes:

• Hitting, pushing, shaking, slapping, kicking, pinching, and burning or threats to hurt you, your children, or pets. Drugging you with medicine, tying you up, and physical punishment of any kind also are kinds of abuse.
• Controlling behavior, such as limiting contact with your family or friends, or limiting you access to money.
• Not trusting you or spying on you, such as repeatedly calling or checking up on you for no good reason.
• Name-calling, insults, threats, or putting you down in front of others.
• Forcing you to have sex or do other sexual acts. This can range from unwanted touching to rape, sodomy, forced nudity, forcing you to watch pornography, or forcing you to act out pornography. Preventing you from using birth control or protecting yourself from sexually transmitted diseases (STDs) is also abuse.

Domestic abuse is a common form of violence and is a major problem. About 25% of women and 8% of men in the United States have been physically or sexually abused by a partner. It can happen to anyone, at any age, no matter what race or religion they are, no matter what their level of education is or how much money they make.

• Teens may experience dating abuse.
• Older adults can be targets of both domestic abuse and elder abuse.
• Men can be abused in relationships.

Abuse can cause lasting health problems and emotional pain. You are more likely to have long-term health problems if you have an abusive partner. Women who are sexually abused by their partners have more sexually transmitted diseases and unwanted pregnancies.

During pregnancy, abuse can cause problems such as poor weight gain, infections, and bleeding. It may increase your baby’s chance of low birth weight, premature birth, and death.

Abusers often blame the victim for the abuse. They may say “you made me do it.” This is not true. Every person is responsible for his or her actions. They may say they are sorry and tell you it will never happen, even though it already has.

Once abuse starts, it usually gets worse if steps are not taken to stop it. If you are in an abusive relationship, ask for help. This may be hard, but know you are not alone. Your family, friends, fellow church members, employer, doctor, or your local YMCA, YWCA, police department, hospital, or clinic can help you. The National Domestic Violence Hotline can help you find resources in your area. Call toll-free: 1-800-799-7233.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

Emergencies

Do you have any of the following symptoms that require emergency treatment? Call 911 or other emergency services immediately.

• You think you are in immediate physical danger.
• You or someone else has just been physically or sexually abused.
• You have been physically hurt and do not have someone who can safely take you to emergency care.

Symptoms to Watch For

It is important to watch for signs of intimate partner abuse. If your partner has any of the following behaviors, the National Domestic Violence Hotline can help you find resources in your area. Call the hotline toll-free: 1-800-799-7233.

• Calls you names or tells you that you are crazy
• Criticizes things you do and say, or criticizes how you look
• Blames you for the abuse he or she commits
• Limits where you can go, what you can do, and who you can talk to
• Unexpectedly checks up on you at your workplace, home, school, or elsewhere
• Apologizes for abusive behavior and tells you it will never happen again, even though it already has

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home Treatment

Once abuse starts, it usually gets worse if steps are not taken to stop it. If you are in an abusive relationship, ask for help. This may be hard, but know you are not alone. Help is available. The National Domestic Violence Hotline can help you find resources in your area. Call toll-free: 1-800-799-7233.

If you feel threatened, it is very important to develop a plan for dealing with a threatening situation. If your partner has threatened to harm you or your child, seek help.

• Anytime you are in danger, call 911 .
• If you do not have a safe place to stay, tell a friend, a religious counselor, or your doctor. Do not feel that you have to hide what is happening.
• Have a plan for how to leave your house, where to go, and where to stay in case you need to get out quickly (safety plan). Do not tell your partner about your plan. For help in developing your plan, call:
  • The National Domestic Violence Hotline toll-free at 1-800-799-7233. They can help you find resources in your area.
  • Your local YMCA, YWCA, police department, hospital, or clinic for the local crisis line for names of shelters and safe homes near you.
• Teach your children how to call for help in an emergency.
• Be alert to warning signs, such as threats or drinking. This can help you avoid danger.
• If you can, make sure that there are no guns or other weapons in your home.
• If you are working, contact your human resources department or employee assistance program to find out what help is available to you.
• If you are seeing a counselor, be sure to go to all appointments.

If you are no longer living with a violent partner, contact the police to obtain a restraining order if your abuser continues to pursue you, threaten you, or act violently toward you.

If you know someone who may be abused

Here are some things you can do to help a friend or family member.

• Let your friend know you are willing to listen whenever she or he wants to talk. Don’t confront your friend if she or he is not ready to talk. Encourage your friend to talk with her or his health professional, human resources manager, and supervisor to see what resources might be available.
• Tell your friend that the abuse is not her or his fault and that no one deserves to be abused. Remind your friend that domestic violence is against the law and that help is available. Be understanding if she or he is unable to leave. She or he knows the situation best and when it is safest to leave.
• If your friend has children, gently point out that you are concerned that the violence is affecting them. Many people do not understand that their children are being harmed until someone else talks about this concern.
• Encourage and help your friend develop a safety plan. This plan will help keep your friend and her or his children safe during a violent incident, when preparing to leave, and after leaving.

The most important step is to help your friend contact local domestic violence groups. There are programs across the country that provide options for safety, legal support, support, and needed information and services. To find the nearest program:

• Call the National Domestic Violence Hotline at 1-800-799-7233.
• See the National Coalition Against Domestic Violence’s Web site at http://www.ncadv.org/resources/state.htm.

The most dangerous time for your friend may be when she or he is leaving the abusive relationship, so any advice about leaving must be informed and practical.

Symptoms to Watch For During Home Treatment

If problems from domestic abuse become more frequent or severe, use the Check Your Symptoms section to determine if and when you need to see your doctor.

Prevention

To prevent violence

• Be alert to warning signs, such as threats or drunkenness, so that you can avoid a dangerous situation. If you cannot predict when violence may occur, have a safety plan for use in an emergency.
• If you are no longer living with a violent partner, contact the police to obtain a restraining order if your abuser continues to pursue you, threaten you, or act violently toward you.
• Learn how to recognize signs of teen relationship abuse in your teen.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment

If you have made an appointment with your doctor, you may be able to get the most from your visit by being prepared to answer the following questions:

• Have you ever been emotionally or physically abused by your partner or someone important to you?
• Have you been hit, slapped, kicked, or otherwise physically hurt by someone?
• Has anyone forced you to have sexual activities?
• Has anyone threatened you?
• Are you afraid of your partner or anyone else?
• Has the abuse increased recently?
• What kind of injuries has the abuse caused?
• Have you thought of committing suicide?
• Has the abuser threatened violence against your children? Is he or she violent toward your children?
• Has the abuser hurt a pet or destroyed things that belong to you?
• Does the abuser control most or all your activities every day?
• Has the abuser ever been treated for a mental health problem?
• Has the abuser threatened or tried to commit suicide?
• Does the abuse happen when the abuser is drunk?
• Does the abuser use legal or illegal drugs? Does the abuse happen when the abuser is “high”?
• Does the abuser have access to guns or other violent weapons?
• Do you have any risk factors that increase your chances for domestic violence?

Treatment Overview

Catheters used to manage urinary incontinence include:

• Standard catheter. This is a thin, flexible, hollow tube that is inserted through the urethra into the bladder and allows the urine to drain out. The standard catheter is used for intermittent self-catheterization.
• Indwelling Foley catheter. This type of catheter, which remains in place continuously, has a balloon on the end that is inflated with sterile water after the end is inside the bladder. The inflated balloon prevents the catheter from slipping out. Urinary tract infections are more likely to occur with long-term use of an indwelling catheter than with intermittent self-catheterization. For more information, see the topic Care for an Indwelling Urinary Catheter.
• Condom catheter or Texas catheter. This is a special condom that fits over the penis and is attached to a tube that collects urine. Condom catheters are only for short-term use, because long-term use increases the risk of urinary tract infections, damage to the penis from friction with the condom, and urethral blockage.

What To Expect After Treatment

Catheterization may cause some discomfort during the procedure. A condom or Texas catheter does not cause much discomfort, because it is not inserted into the urethra, but indwelling catheters may cause some discomfort while in place.

Why It Is Done

Catheters can be used to treat severe incontinence that cannot be managed with medicines or surgery.

How Well It Works

Catheters do not cure incontinence but rather allow you or a caregiver to manage incontinence.

These devices are effective. But some men find catheters uncomfortable or painful and stop using them.

Risks

Using a catheter increases your risk for:

• Urinary tract infection.
• Damage to the urethra.
• Damage to the skin of the penis.

What To Think About

The use of catheters can be under your control and can be designed to fit into your lifestyle.

Topic Overview

Male babies who are not circumcised have a greater chance of urinary tract infections in the first year of life than babies who have been circumcised. Keeping your young son’s penis clean may help prevent these infections and other problems.

Retracting the foreskin for cleaning

Do not force the foreskin back over the tip of the penis. Initially, a baby’s foreskin may be difficult to pull back over the tip of the penis. After the first few years of life (though it may take somewhat longer), the foreskin will gradually become more retractable. By the time a boy is 3 or 4, his foreskin is usually fully retractable. Up to this time, wash or instruct your son to wash the outside of the penis with soap and water. Pushing your son’s foreskin back too early can cause scar tissue formation and damage.

When the foreskin is easy to retract, clean under it regularly. To clean under the foreskin, gently push it as far as possible toward the body. Carefully wash the entire area with soap and water. When the area is cleaned and rinsed, replace the foreskin over the head of the penis.

A boy as young as 3 or 4 can be taught to clean under his foreskin as a normal part of his hygiene. Before puberty, occasional cleaning is recommended. When a boy reaches puberty, he needs to clean under his foreskin daily.

If your son’s foreskin does not fully retract by the time he reaches puberty, call your doctor for advice.

Treatment Overview

Several types of behavioral methods are used for treating urinary incontinence: bladder training, habit training, biofeedback, and pelvic muscle exercises. Men who have incontinence due to physical or mental limitations (functional incontinence) can try timed voiding and prompted voiding.

Bladder training

Bladder training (also called bladder retraining) is used to treat urge incontinence. Bladder training attempts to increase how long you can wait before having to urinate. A health professional will teach a person about the structure of the lower urinary tract and the causes of incontinence.

A voiding schedule is first established. Then you are trained to resist the first urge to urinate and refrain from urinating until the scheduled time. The intervals between scheduled bathroom visits are increased until you can refrain from urinating for several hours.

Biofeedback

Biofeedback is a technique for learning to control a body function that is not normally under conscious control, such as skin temperature, muscle tension, heart rate, or blood pressure.

Men with incontinence are taught bladder-sphincter biofeedback methods along with pelvic floor exercises. These techniques record bladder, rectal sphincter, and abdominal pressures as well as electrical activity. As the information is recorded, it is displayed for you. By watching the information, you learn to relax your bladder and abdominal muscles and contract your pelvic floor muscles based on the information displayed.

Learning biofeedback requires practice in a lab or other setting under the guidance of a trained therapist. Home biofeedback units also are available.

Timed voiding

Timed voiding is also called habit training. It is used to treat urge incontinence. It sets a schedule for urinating (voiding) that is determined by your personal habits and does not attempt to increase how long you can wait before having to urinate or to teach you to resist the urge to urinate.

Prompted voiding

Prompted voiding requires a caregiver to prompt the incontinent person to urinate. The goal is to decrease the chance of accidents by making the person aware of the need to urinate periodically. Prompted voiding usually is used in combination with timed voiding for people who are unaware of their bodily functions, such as people who have dementia.

What To Expect After Treatment

See the How Well It Works section below.

Why It Is Done

Behavioral methods may be used to treat urge incontinence.

How Well It Works

Bladder training

• The initial response rates to bladder training are moderate.
• Most people who use bladder training have fewer symptoms of incontinence. Some people completely eliminate their incontinence.

Biofeedback

Biofeedback has been successful in treating men who have urge incontinence following removal of their prostate gland.

Timed voiding

Timed voiding reduced the frequency of incontinence accidents in the majority of the people who used this method.

Prompted voiding

People who use prompted voiding generally have 1 to 2 fewer incontinence accidents per day.

Risks

There are no risks associated with this treatment.

What To Think About

Behavioral methods require a high level of motivation.

Prompted voiding requires a committed caregiver to be successful.

Surgery Overview

An artificial sphincter is a device made of silicone rubber that is used to treat urinary incontinence.

An artificial sphincter has an inflatable cuff that fits around the urethra close to the point where it joins the bladder. A balloon regulates the pressure of the cuff, and a bulb controls inflation and deflation of the cuff. The balloon is surgically placed within the pelvic area, and the control pump is placed in the scrotum.

The cuff is inflated to keep urine from leaking. When urination is desired, the cuff is deflated, allowing urine to drain out.

What To Expect After Surgery

Because these procedures involve abdominal surgery, hospitalization is required.

You will most likely be able to leave the hospital the day after having the surgery.

Why It Is Done

Installation of an artificial sphincter may be done for:

• Urinary incontinence caused by the removal of the prostate.
• Severe continual leakage of urine from the urethra.
• Severe urinary incontinence for which other methods of treatment have failed.

How Well It Works

Artificial sphincter placement is the most reliable treatment for men who have incontinence after prostate removal for cancer.

In cases of severe stress incontinence and persistent leakage, implantation of an artificial sphincter has been successful in relieving incontinence in up to 90% of men.

Risks

Complications with this type of surgery include needing another surgery, or revision, in 27% of cases, in which 5% reported erosion of the part of the urethra surrounded by the artificial sphincter and 3% developed infections.

What To Think About

Because complications may occur, this is a treatment method that generally is reserved for people for whom all other treatment options have failed. Some people may prefer to manage their symptoms with absorbent pads and changes in habits rather than have this surgery.