For some people, the structure of the body changes due to a variety of circumstances, making it difficult for the bladder to work properly. When this occurs in women, it is often called a type of pelvic outlet relaxation disorder or more commonly pelvic relaxation. If you are suffering from this you may need to seek medical support from a trusted urologist. Do not overlook the treatment options that may be available to you.

What Is Pelvic Relaxation?

Over time and as we age, the body changes. The support system that helps to hold the bladder and the uterus in place, for example, can become weak. This happens for many reasons but most commonly because of:

• Being overweight or obese
• Smoking
• Giving birth
• Being older
• Other factors

When these elements occur, it can cause changes in the structure and relaxation of the pelvic. In some cases, the uterus comes down while in other situations, the bladder can also come down. This creates a sensation of pressure and discomfort in the pelvic area. It can also cause:

• Pain especially when the condition worsens
• Discomfort during sexual activity
• Bulging of the tissue located at the top of the vaginal opening

One of the most common symptoms of this condition occurs after childbirth. Childbearing, especially when a woman’s body is unable to regain strength in between pregnancies (because of the frequency of pregnancies in a short period of time), can be a big factor in the development of relaxation. In these instances, the bladder can leak, especially when a person sneezes, coughs, or laughs. This can also occur during sexual intercourse. It can be embarrassing and hard to explain. However, it can also be a problem related to your health, especially when it leads to a bladder infection, irritability, or irritation.

What You Should Do Now

If you are struggling with pelvic relaxation or you believe you could be at risk for it, realize there are treatment options that can help you. Many women, as well as men, can struggle from these types of changes within the structure of the body. To get any health, contact your urologist and schedule a consultation to learn more about your options.

When you come in to see our urologist one of the best in New York City, you’ll get the one on one care and attention you need to overcome the limitations that pelvic relaxation can often bring.

To find out what your options are and to ensure you have every treatment option available to you, call our offices at 646-205-3039 and schedule a consultation with one of the best urologists in New York City. Find out what your options are.

Do you have small, raised bumps on your penis? Are you wondering what is happening and, more importantly, what you need to do about them? In some situations, this may be a condition called pearly penile papules. While you may not realize it, it is not that uncommon and it does not indicate a high risk disease.

However, it is important that you visit your urologist to learn more about your condition and what treatment options may be available to you specifically.

What Are They?

Pearly penile papules are a small and benign type of growth that forms on the penis. They tend to be white in color, but can also be pink, yellow, or even a translucent color. In most cases, they are very small using only one or two millimeters in size. However, some can be larger and their shape may vary from one to the next. It is common for symptoms to vary among patients. Most often, they are found at the head of the penis or in this area and usually in a single or double row.

Why Do They Happen?

Researchers are not fully sure why some men develop this condition and others do not. They are not harmful in any way. They are also not any form of disease or any form of illness. They are not a symptom of an illness either. In some cases, they are simply considered a skin variation. Men of all races can develop them no matter where they are located or what their sexual preference is. It’s important to know they are not related to sexually transmitted disease. In addition to this, they are not contagious. You cannot infect someone with them.

What Treatment Is There?

What should you do about them? That is a question that only you can answer. For many men, there is no treatment necessary. While there is no need to have this condition treated, many men choose to talk to their doctor about treatment options. It is best not to try to pop them, freeze them, or use a wart remover on them. This can cause damage to the penis and lead to pain, infection, and much more complex outcomes. Instead, talk to your doctor about the treatment options that may be available to you for cosmetic improvement.

Call our offices today at 646-205-3039 to schedule an appointment with one of the best urologists in NYC to learn more.

Rajveer S. Purohit, MD, MPH

First consider your medical history. If you’ve had any trauma to the pelvis, sexually transmitted infections, had anything inserted in the urethra – particularly if it was traumatic – you are at risk for having a stricture. Also, if you’ve had a stricture in the past and have developed urinary symptoms you are at much higher risk of a stricture. These are just a few of many things in your medical history that raise the possibility of a stricture.
But the past history can be misleading – about 1/3rd of the time, patients can present with dense strictures that have no known cause (called idiopathic strictures).

One additional indication of a stricture is if you currently have bothersome urinary symptoms. These include obstructive urinary symptoms including a slow urinary stream, urinary hesitancy, and a sense of incomplete emptying after you urinate – which is a sensation that after you urinate you still feel that you retain urine in the bladder.

Some patients can also present with what are termed irritative urinary symptoms which include urinary urgency, frequency, night time urination and even incontinence.

What makes reliance on symptoms difficult is that many of urethral stricture symptoms also overlap with other common urinary problems such as benign prostatic obstruction (BPO) and overactive bladder. Furthermore, on physical exam you might have an enlarged prostate but the primary source of your symptoms is actually a urethral stricture.

A little confusing, huh?

So what kinds of tests can be done to determine more definitively if you do have a stricture?

Common noninvasive tests we perform are the uroflow and post-void residual. We ask patients to urinate with a full bladder into a machine that measures, over time, changes in the speed of their urination and the amount that was urinated. After urination, we measure the amount of urine your bladder is still holding (residual urine) using a hand-held portable ultrasound. Patients who have strictures will not only often have a slow urinary flow measured by the machine but also a characteristic change (flattening) in the graph that measures speed over time. Again, however, many of these uroflow findings are mimicked by benign prostatic obstruction (BPO) as well.

In considering this problem we’ve researched if minor tweaks in the noninvasive uroflow can help distinguish urethral strictures from BPO and presented our findings at the American Urological Association’s annual meeting in New Orleans in May 2015. We found that asking patients to increase their abdominal pressure while they urinated (termed Valsalva voiding) helped distinguish strictures from BPO. In patients with strictures alone Valsalva voiding will increase the speed of their urination while those with BPO will not. We think that this test will be particularly useful for those who may have had their strictures treated but are at risk for recurrence. Results from the presentation can be seen in the slide below.

The gold standard, however, for diagnosing the urethral stricture is more invasive x-ray studies called the Retrograde urethrogram (RUG) and sometimes voiding cystourethrogam (VCUG) and a study using a fiberoptic scope inserted into the urethra (with local anesthesia, of course!), called the cystoscopy.

We’ll talk in more about these tests on an upcoming blog post. Stay tuned!