Men's Health

Get the comprehensive, expert care you need for a wide range of urologic issues that can affect your overall well-being, as well as specific men’s health concerns that can interfere with relationships, work performance and your enjoyment of life.

Personalized Men’s Health Care Near You

Wherever you live in the Oklahoma City metro or across the region, you’ll appreciate easy access to the highly trained urologists and urologic specialists at OU Health’s convenient locations near you.

You’ll become part of an expert urology team using evidence-based medicine that focuses on your needs. And you’ll work with our experienced urologists to develop an individual treatment plan that addresses your specific condition.

Advanced Urology & Men’s Health Services

Take advantage of OU Health’s extensive urology services, including a kidney stone program and a program for urologic reconstruction, incontinence and neurogenic bladder that treats urethral stricture disease, prostate cancer complications, neurogenic bladder issues and more.

Innovative Treatments for Men’s Health Conditions

At OU Health, you also gain access to innovative treatments and advanced care for a wide range of men’s health issues, including:

• Benign prostatic hyperplasia (BPH) – Enlarged prostate
• Erectile dysfunction (ED)
• Kidney stones – Concentrated mineral crystals in urine that form into stones
• Low testosterone (low T) and other hormone-related conditions
• Male-factor infertility
• Peyronie’s disease – Penile curvature or other physical abnormality
• Prostate cancer complications – Includes male incontinence, bladder neck contractures
• Urethral stricture disease – Narrowing of urethra from scar tissue

Get more information about many of these men’s health conditions below.

Kidney Stones

A common condition affecting up to 10 percent of people, kidney stones form when tiny minerals in urine become concentrated. Oklahoma’s hot summer climate increases kidney stone risk because you may not drink enough water to flush these minerals from urine before stones form. Talk with OU Health urologists about steps you can take to prevent or treat kidney stones.

Symptoms & Diagnosis

When actively passing a kidney stone, especially a very large stone, you may experience back pain, painful urination, blood in urine, fever, nausea and vomiting. Small stones may pass on their own with observation, but severe symptoms require diagnosis, typically by CT scan (preferred for greater detail), X-ray or ultrasound, followed by prompt treatment.

Kidney Stone Treatments

Appropriate treatment depends on size and location of the stone and may include:

• Extracorporeal shockwave lithotripsy (ESWL) – Least-invasive common treatment technology; does not require incisions or scopes; uses sound/shock waves guided by real-time X-ray imaging to break stone into tiny pieces that can pass through urine pain free; typically allows a quick return home and back to work
• Ureteroscopy with laser lithotripsy – For small stones; uses endoscopic device inserted into bladder and miniature image-guided laser to break stone into small pieces for removal through urine
• Percutaneous nephrolithotomy (PCNL) – For larger stones inside kidney; minimally invasive procedure using small incision through the back; tiny instruments break up stone and remove pieces; typically requires overnight hospital stay with or without drainage tube and 1-2 weeks for at-home recovery

Urethral Stricture Disease

Internal scar tissue that narrows the urethra, the tube from the bladder extending to the tip of the penis, can create difficulty or pain with voiding, urinary tract infections, blood in urine or issues with urgency or frequency. Symptoms may resemble enlarged prostate (BPH) in middle-aged men, so be sure to get a complete exam from your urologist, especially if simple prostate medications don’t help.

Causes, Symptoms & Diagnosis

A short procedure called a cystoscopy allows your doctor to view the inside of the urethra to diagnose the condition and help determine the cause, which may include:

• Previous urologic surgery – Procedures such as transurethral resections for enlarged prostate or removal of bladder tumors requiring a large scope or catheter, or radiation for prostate cancer, may inadvertently damage tissue and create scarring in urethra
• Trauma – Direct injury such as saddle trauma (falling on bicycle crossbar or similar groin-area injuries); symptoms may develop immediately or may take months or years; severe trauma such as car accidents may fracture the pelvis and disconnect urethra from bladder
• Infection or inflammation – Includes chronic conditions such as lichen sclerosus (LS), balanitis xerotica obliterans (BXO), sexually transmitted infections (STIs); may also appear as penile skin discoloration and scarring
• History of hypospadias – Congenital issue with formation of urethra in boys; early surgical repair procedures may lead to later development of urethral stricture

A quick additional X-ray with injectable dye helps your doctor view the full length of the urethra and determine the exact length and location of the stricture.

Urethral Stricture Treatments

Depending on the length and location of the narrowing, your doctor will determine the best treatments options for your specific situation, such as:

• Endoscopic management approaches – Common treatments include dilation (special instruments stretch open the stricture) or direct vision internal urethrotomy (laser or knife cuts the stricture); best options if stricture is short and in a reachable location, if it’s your first attempt at treatment or if you’re unable or unwilling to undergo surgery
• Reconstructive surgery – Potentially curative or a longer-term option, especially if multiple dilations haven’t resolved the issue; typically involves removing scarred urethra and replacing or adding with a graft; minimally invasive by OU Health fellowship-trained urethral reconstruction surgeons using small incision for highly technical operations; typically requires 1- to 2-day hospital stay

Treatments for Prostate Cancer Complications

If you experience urinary issues, scarring or complications from radiation therapy or from prostate cancer surgery, although relatively rare, you’ll want to talk with the expert urologists and urologic surgeons at OU Health about your situation and options.

• Male incontinence – Urinary leakage related to muscles damaged from prostate-related treatments; options may include:
  • Male sling – For mild leakage; small incision under scrotum provides access to wrap sling around urethral area for increased resistance
  • Adjustable balloon – Minimally invasive, X-ray-guided procedure to place small adjustable balloon device (UroMedica’s ProACT) in position of removed prostate to add resistance; tiny ports within scrotum allow adjustment based on degree of incontinence
  • Artificial urinary sphincter – Placement of Boston Scientific AMS 800 device, the current gold standard for moderate to severe urinary stress incontinence; 1-2 small incisions under or through scrotum to place cuff around urethra for stable compression to minimize leakage; tiny control pump and reservoir inside scrotum allows fluid movement from cuff for voiding; typical hospital stay of less than one day
• Bladder neck contractures – Scarring within the prostate area that creates difficulty with urination following prostate surgery or radiation; diagnosed by looking inside the bladder with cystoscopy procedure; treatment may include:
  • Transurethral incision of bladder neck (TUIBNC) to open the area; procedure may be repeated or augmented with medication injections for recurring issue
  • Urinary diversion for rare instances; requires complete bladder removal or bladder neck reconstruction surgery

Erectile Dysfunction (ED)

Erectile dysfunction (ED) or impotence means the inability to achieve or maintain a rigid erection. Occasional ED happens, but ongoing erectile dysfunction deserves evaluation and treatment. Problems with erections can greatly affect relationships, as well as a man’s confidence and quality of life. That’s why your ED diagnosis at OU Health results in a comprehensive treatment plan formulated for your particular situation.

Potential Causes of ED

Because erectile dysfunction may signal other problems, your OU Health urologist evaluates your overall health for potential related conditions or causes such as:

• Diabetes mellitus
• Heart disease
• Hypertension / high blood pressure
• Medication side effects
• Obesity
• Previous prostate cancer treatments
• Vascular conditions

OU Health Treatments for ED

Depending on the level of dysfunction and motivation, you can take advantage of many treatment options for ED, both nonsurgical and surgical.

You’ll start with activities to address any underlying conditions, such as the need for weight loss, diabetes control or heart health, that may contribute to erectile issues. You may need to allow time to heal from prostate cancer treatment or to correct low testosterone levels that can contribute to low libido and improve response to treatment.

Then, your doctor may recommend one or more options such as:

• Nonsurgical care – Next steps after managing underlying health issues include:
  • Oral medications – Viagra® (sildenafil), Cialis® (tadalafil) or Levitra® (vardenafil); may be taken on demand before intercourse or on a scheduled basis to increase the body’s natural response to stimulation
  • Penile (intercavernosal) injections – Used if oral medications aren’t beneficial; direct injection can cause erection; your doctor will teach the technique in the clinic and use ultrasound at the initial injection to analyze and measure penile blood flow
  • Vacuum erection devices
  • Intraurethral suppository – Medication placed at the tip of the penis to trigger an erection
• Surgical treatment – Placement of inflatable or bendable penile prosthesis from Boston Scientific or Coloplast; best option when nonsurgical actions or other treatments haven’t resolved the issue or side effects aren’t tolerated; procedure typically performed in operating room with approximately one-day hospital stay; cylinders placed within penis draw fluid from reservoir located either behind the bladder or under abdominal muscles with control pump in scrotum; follow-up studies show excellent satisfaction

Peyronie’s Disease

Scarring within structures of the penis that causes curvature, known as Peyronie’s disease, may result from an acute or chronic injury to the penis, specifically during sexual activity, although little is known about why it happens. Mild issues don’t require treatment, but some men may experience debilitating symptoms that interfere with sexual function and cause relationship stress.

Symptoms & Diagnosis

Although penile curvature remains the primary symptom associated with Peyronie’s disease, other signs include:

• Pain with erection – Related to inflammation caused by scarring; acute phase typically lasts for first 6-12 months; anti-inflammatory medications can help resolve pain before attempting corrective treatments
• Palpable scar tissue within the penis
• Erectile dysfunction (ED) – Often associated with Peyronie’s although not the cause of poor erections; must address both issues because fixing one may not fix the other
• Hourglass deformity or penile shortening

Treatments for Peyronie’s Disease

Mild curvature that does not inhibit sexual activity and pain that has resolved needs no treatment. Otherwise, you and your doctor can choose from multiple treatment options for Peyronie’s disease, including:

• Collagenase injections (Xiaflex) – Only FDA-approved treatment that involves injecting medication directly into scar; followed by reshaping or modeling of penis; process repeats for several cycles over a few months for best results
• Surgical procedures
  • Penile plication – Places sutures in or removes wedge of tissue from side opposite curvature to straighten penis; most common surgical treatment with years of data showing good results
  • Penile grafting – Replaces scarred area with graft; good option for very severe curvature or severe shortening; a more-invasive choice associated with risk of worsening ED
  • Penile prosthesis – Single operation that can fix both curvature and ED; typically reserved for Peyronie’s situations also involving unsuccessful ED treatment

Male-Factor Infertility

As many as 15 percent of couples experience difficulty when trying to conceive. A male factor contributes to the problem in approximately 50 percent of such situations.

With accurate evaluation by OU Health’s urology experts, who perform diagnostic testing to pinpoint the cause of the condition, you or your loved one can find effective treatment, which may include assistive reproductive techniques or microsurgical options.

You’ll receive extensive guidance from highly trained and compassionate urologic specialists who also collaborate with OU Health’s gynecology and reproductive medicine services. You and your partner can participate in thorough evaluations and consultations that result in the optimal recommendations and specific treatment you need to help you start or grow your family.

Talk with your OU Health urologist about male-factor infertility, or if your semen analysis results or sperm count fall outside the average range. You can get the help you need at an OU Health urology location near you.

Low Testosterone (Low T)

This common condition affects men of all ages and can negatively affect your quality of life. Symptoms include:

• Low energy and fatigue; decreased exercise capacity
• Decreased interest in sex (low libido)
• Decreased concentration, focus and/or memory
• Irritability or moodiness
• Problems with sex, including erectile dysfunction
• Sleep disturbance
• Weight gain and/or loss of muscle mass
• Fertility issues, addressed with testosterone-stimulating drugs only as you and your partner try to conceive, because testosterone therapy can decrease sperm production

Personalized Low T Treatment Options

You and your OU Health men’s health doctor and urologic specialists work together to determine if low testosterone actually affects your situation. If so, you’ll collaborate in developing a treatment plan to fit your specific needs with options such as:

• Injectable testosterone, including testosterone enanthate and cypionate – Learn to inject yourself at home and reduce the need for frequent office visits
• Topical testosterone – Various formulations; often covered by insurance
• Subcutaneous pellets – Tiny pellets placed under the skin of the buttocks slowly dissolve for four months of continuous treatment
• Long-lasting injectable testosterone – Administered by a healthcare professional; five shots per year maintains appropriate treatment levels
• Testosterone patches – Topical treatment avoids the risk of transferring medication to a loved one; may create skin irritation around patch site
• Testosterone-stimulating alternatives – Medications (hCG, clomiphene citrate, anastrozole, others) administered to stimulate production of your own testosterone or used with injectable testosterone, depending on your condition and goals

You benefit from ongoing monitoring and management of testosterone replacement therapies by OU Health’s experienced providers. They understand the nuances of your situation and work with you to optimize your care while also helping you avoid potential side effects or problems in other health areas.

Get a comprehensive evaluation and individualized treatment recommendations for low testosterone by contacting a convenient OU Health urology location near you.

Team-Based Approach to Expert Care for You

While you work directly with an expert OU Health urologist, you’re supported by a comprehensive team of experts from many urologic subspecialties, including fellowship-trained urethral reconstruction surgeons, and specialists from other healthcare disciplines.

No matter what your situation or choice of treatment options, including potential surgical correction, you benefit from the exceptional evidence-based team approach to care at OU Health. Our collaborative methods bring together multiple specialists and scientific evidence from across medical fields to develop your treatment plan and deliver the best possible care to meet your needs.