Men’s Health

Prostatitis Facts and Men’s Health

Prostatitis, and the pelvic pain associated with it, is considered one of the most common urological problems men face. Since prostatitis can affect men of any age, it accounts for nearly 25% of all men’s visits to their medical providers in regards to pelvic or urological issues. Chronic prostatitis (when the symptoms will not go away) is the number one cause of visits to a specialist in men under 50 years of age.  

Causes and Symptoms

Generally, bladder infections and inflammation cause the symptoms of prostatitis. Symptoms include:

  • Difficulty and/or pain when urinating
  • Frequent need to urinate, often at night
  • Pain in the bladder or between the sexual organs and the anus
  • Difficulty and sometimes painful ejaculation
  • Fever or chills
  • Intense burning sensation when urinating
  • Difficulty fully emptying bladder

Diagnosis and Next Steps

If a patient’s family doctor suspects prostatitis, he or she will likely refer the patient to a urologist. Patients should be prepared to undergo a comprehensive physical exam that may include a digital rectal examination (DRE), in order to whether the prostate gland has become enlarged or is tender. During the DRE, the provider will examine the rectum with a lubricated gloved finger, checking the prostate and also for any signs of prostate cancer. Patients undergoing a DRE will be asked by the provider to indicate levels of pain when tissue near the prostate is pressed.

If the DRE does not provide a full diagnosis, a provider may order other tests, including taking urine specimens, ultrasounds, urodynamics (urine flow studies), or a cystoscopy.

Patients suffering from any of the symptoms of prostatitis, or from any pain in the prostate, should contact a urology specialist immediately.

Some conditions that may contribute to prostatitis include:

  • Recent insertion of a catheter or other medical instrument in the urethra
  • Recent bladder infections
  • Abnormal urinary tract or multiple urinary tract infections
  • Engagement in rectal intercourse
  • Enlarged prostate

Patients for whom any of these conditions are present should notify their providers during their initial visit.

If you have been suffering pain in or around your prostate and are concerned you may be suffering from prostatitis, Associated Urologists of North Carolina’s board certified specialists offer personalized care for every one of their patients. Their main branch and administrative office is located at 3821 Ed Drive, Raleigh, NC 27612 and can be reached at 919-758-8723. Contact information and driving directions for all eight of AUNC’s offices throughout the region can be found at our “Contact Us” page on our website.

Benign Prostatic Hyperplasia Info for North Carolinians

Benign prostatic hyperplasia, or BPH, is the enlarging of the prostate gland. It is a very common condition for men over 60 and is often seen as simply a natural part of the aging process. While this condition may be a discomfort and can cause many urinary symptoms, it is not usually dangerous. There are treatments that should however be considered for quality of life.

The prostate gland is a small walnut-shaped gland that is beneath the bladder and surrounds the urethra. The urethra carries urine outside the body however, so as the prostate enlargens it can pinch the urethra. This pressure on the urethra will often weaken the stream and require more effort to void the bladder.

Symptoms from this pressure on the urethra include: a frequent urge to urinate, needing to urinate at night, the inability to easily start urination, dribbling after one attempts to finish urination and a weak, inconsistent stream. Sexual function should not be affected. If symptoms advance, a blockage of the urethra is possible. This would prevent any urine from being expelled and would cause a serious problem with trapped urine.

Benign prostatic hyperplasia is not connected to prostate cancer and is not a sign of cancer. Symptoms are often similar between the two conditions though, so it’s important to have a physician examine your prostate if you believe you are showing signs of BPH. The majority of men do experience prostate enlargement as they age, so it is not a cause for alarm if you are diagnosed with the BPH. With medications and certain lifestyle changes, like not drinking too much liquid before bed it is very possible to learn to live with BPH.

For more serious cases, surgery may be necessary. This is not often the case, though. Men with BPH should watch out for blood in urine, fever and chills or more intense pain in the lower abdomen, since those are signs of a more serious blockage. If you are having concerning symptoms you believe may be benign prostatic hyperplasia you should see a urologist at your next convenience to get an exam.

Associated Urologists of North Carolina have offices in Raleigh, Brier Creek, Apex, Durham, Chapel Hill, Cary, Wake Forest, Clayton, Dunn, Clinton and are very knowledgeable on how to handle uncomfortable symptoms that occur as the prostate changes with age. It can be frustrating to have to deal with these symptoms, but you may not have to. Call 919-758-8677 today to set up an appointment.

More Information on Prostate Cancer Treatment in North Carolina

The prostate is a male-specific organ involved in both sexual and urinary functioning. It is small and positioned in front of the bladder. The urethra, which carries semen and urine out of the body, passes through the prostate. Semen is partly produced within the prostate and then stored there, keeping it healthy before it’s excreted.

As men age, it is very common for the prostate to enlarge or for cancer to develop. Only non-melanoma skin cancer is a more common cancer among men. Men 65 or over make up 60% of prostate cancer cases, so the risk does increase with age. One in seven men will eventually be diagnosed. Thankfully, prostate cancer generally stays confined and is extremely slow moving.

Because it is slow moving and confined to the prostate, often people will show no symptoms for a long time. With no symptoms in early stages, regular prostate exams become a necessity in order to achieve early detection. Many men will get a yearly exam once they reach 40 or 50 years old. Different doctors have very different recommendations on when to start exams and how often they should be done. The slow moving, isolated character of the illness make some physicians believe early, frequent exams have more downside than upside, while others disagree.

Treatment varies based on many factors. If prostate cancer forms later in life, it may not be worth treating since one will likely pass from other causes before it grows enough to be a problem. In these cases, doctors employ a “watchful waiting” method. The tumor will be monitored to make sure it doesn’t suddenly advance or spread beyond the prostate. For those who are younger or have more aggressive prostate cancer, there are a number of ways to treat it before it becomes a problem.

Treatment options include hormone treatments, since certain hormones can spur prostate cancer cells to grow. Chemotherapy and radiation treatments are other options, as they are with many cancers. Surgery to remove the cancerous area of the prostate is also common. A newer method that shows a lot of progress, is to use high intensity focused ultrasound waves (HIFU) directed toward the specific cells that need to be eliminated. This is less intrusive and has very little recovery time and few complications.

Here in the Raleigh Durham area of North Carolina we are lucky to have a HIFU expert, Dr. Frank Tortora, who has been practicing the procedure for over 10 years. Dr. Tortora is one of Associated Urologists of North Carolina’s 15 board certified urologists. Men in Raleigh, Durham, Chapel Hill, Cary, Wake Forest, Clayton, Dunn, Clinton and the surrounding areas should contact Associated Urologists of North Carolina to see if a HIFU procedure with Dr. Tortora would be right for them or if they have any other concerns with their prostate. AUNC can be reached at (844) 371-HIFU (4438).

Erectile Dysfunction (ED): Signs and Next Steps

Anywhere from 5-15% of men who suffer from erectile dysfunction in the United States. Erectile dysfunction, also called impotence can have many causes, some of which are common, like aging, while others can be a sign of a much more serious underlying condition. Most men are aware that this is a common problem, and have seen countless Viagra and Cialis commercials, but are unprepared when they begin to suspect erectile dysfunction is affecting them.

Unlike many other conditions, erectile dysfunction is pretty easy to diagnose. It is more of a symptom of another issue, rather than its own disease, though. Any man who frequently has a difficult time achieving and maintaining an erection at desired moments, has erectile dysfunction. An occasion instance of failing to get and stay erect is common for men of all ages and is unlikely to have any greater significance, but if it’s more than an occasional issue, it would be wise to consult a physician.

The sexual functioning of a man has many elements, so it may be difficult to ascertain which is dysfunctioning. For one’s physical health, the least troubling possibility is simply that there is performance anxiety or relationship issues that are mentally making it difficult for the man to perform. Counseling for anxiety or relationship counseling can often solve this as a cause for erectile dysfunction quite easily. Aging is another common cause, and another that is no reason for alarm. Around two-thirds of men over the age of 70 have significant erectile dysfunction, so by itself this symptom could simply be a sign of aging. It is, however, treatable for all age-groups so if it is affecting one’s standard of life, it can certainly be addressed.

Now for some more serious potential underlying causes. Those who lead less healthy lifestyles are much more likely to report erectile dysfunction as alcohol, smoking, poor diet and lack of exercise are all risk factors. These behaviors can lead to health issues like diabetes, atherosclerosis and peripheral vascular disease that have much more serious implications than the embarrassment and disappointments of erectile dysfunction. Because a healthy blood flow to the penis is a necessary condition of achieving an erection, blockages that prevent this can be a sign of a high risk for a heart attack.

There really isn’t an easy way to know the underlying causes of your erectile dysfunction though, until you visit a physician to be examined. It may be something as simple as overthinking and anxiety, or it could be much more serious. If you live in Raleigh, Durham, Chapel Hill, Cary, Wake Forest, Clayton, Dunn, Clinton and the surrounding areas and are concerned about potential impotence, you should contact Associated Urologists of North Carolina at 919-758-8677.

Vasectomy: What You Need To Know

Vasectomy is a word that may inspire fear in some men. They might think of it as a painful procedure that ends their sexual drive and romantic life. Getting a vasectomy, while a serious decision, is not a risky, expensive or love-life ending decision. Vasectomies are a permanent form of birth control that makes impregnating a sexual partner nearly impossible under normal circumstances.

It is the most effective form of birth control for those who are sexually active, with only 0.15 percent of women becoming pregnant in the first year after their male partner received the procedure. This despite the first year being the most risky since for the first three months after the procedure there is still some chance of pregnancy while the last of the sperm is expelled from the vas deferens. While being a very effective birth control method, it does not offer any protection against sexually transmitted diseases so protection should still be used unless with a faithful partner.

To get an idea of what a vasectomy involves, let’s break down the procedure. A vasectomy is a very quick procedure, only lasting half an hour on average. It is also a very inexpensive procedure, with a cost of around $1,000 that is usually covered by insurance plans. The patient will not need to go to a hospital for the surgery, but generally will just go to their urologist’s office. The urologist will start by making sure the area is ready to be operated on. This will likely involve cleaning and shaving the area of incision.

After making sure the area is prepped, a local anesthetic will be applied, and then an incision will be made in the scrotum. The entire operation involves simply severing the vas deferens and then tying off or otherwise sealing the two ends before placing them back in the scrotum. The vas deferens carries sperm from the testes up to the prostate so it can be mixed into the semen. Without this tube to transport sperm, the semen will not have sperm included and can not induce pregnancy in a partner.

After the procedure, there will only be a couple days of soreness and life will then proceed as before. The most important thing to consider before getting a vasectomy though is: how certain are you that you never wish to have any (or any more) kids? Every year around 600,000 men get vasectomies done, so it is a common, safe and effective procedure. Around 5 percent of them end up trying to get it reversed though. There are vasectomy reversal procedures, but they are more complicated. These are often not covered by insurance companies and are much more expensive as well. Because the process of reversing a vasectomy is more complicated, these procedures are done in hospitals.

So, if you are interested in a more permanent form of birth control, getting a vasectomy is a great option. Think it over carefully before you decide to do it, but the in vast majority of cases, the procedure is safe, inexpensive and does not in any way inhibit quality of life – including your sex life. If you are interested in investigating if a vasectomy is right for you, seek out a great local urologist who can give you and your partner the information you need to make the right decision. Associated Urologists of North Carolina’s 15 board certified urologists would be proud to assist in this process. We serve those in and around Raleigh, Durham, Chapel Hill, Cary, Wake Forest, Clayton, Dunn, Clinton and can be reached at 919-758-8677.


Male Kidney Issues & Pain

AUNC wants our patients to be well informed and aware of any urological problems or discomfort they might be experiencing. One of the main urological issues that people struggle with is pain in the kidneys. If you’ve felt discomfort in your kidneys, or think you might have kidney pain, these are some specifics that might prove helpful in determining when to contact us.

Symptoms and Causes

If you’re suffering from aches in your back or lower sides, what you’re feeling might not be due to musculoskeletal issues – you might actually be feeling kidney pain. If you are experiencing pain that moves towards your side and groin area, or if you have a fever or urinary symptoms, then your kidneys are the likely source.

Kidney pain typically feels like a dull ache on one side of your upper back, and it can be caused by a number of different infections or injuries:

  •      Kidney Stones
  •      Pyelonephritis — kidney infection
  •      Polycystic kidney disease
  •      Kidney infarction – an obstruction of the blood supply to your kidney or kidneys
  •      Hemorrhage of the kidney
  •      Kidney cancer or tumor
  •      Renal vein thrombosis (RVT) – the formation of a clot in the vein that drains blood from the kidneys

Kidney pain can be on either or both of your sides, and is diagnosed based upon your medical history, a physical, and lab tests. Those tests may include blood, pregnancy and urine tests. A CT scan or MRI of your abdomen and pelvis may also be ordered.

Treatment for kidney pain is often pain medication that may be supplemented with an antibiotic if the pain is due to a bacterial infection. Most patients enjoy a positive outcome and quick turn-around if they contact their urologist as soon as they notice kidney pain symptoms.

AUNC offers patients in the Raleigh-Durham area, as well as parts of eastern NC, 15 board-certified urological specialists who see patients at 8 clinics throughout the region. Our offices can be found in Raleigh, Apex, Cary, Clayton, Clinton, Dunn, and Wake Forest. You can find addresses and phone numbers for all of our offices at the contact page on our website


Kidney Stones: Symptoms and Treatment

Kidney stones are often considered the most uncomfortable and common urological issues in men, and they can also be found in women. Here, you’ll find what the common signs and symptoms of kidney stones are and how our 15 board-certified specialists can help patients throughout the Piedmont region who are suffering from kidney stones.


It’s possible you already have a kidney stone and just don’t yet know that you do – a kidney stone may not cause symptoms until it begins moving around within your kidney or when it passes into your ureter (the tube connecting your kidney and your bladder). Once this happens, you are likely to experience some or all of these symptoms:

  •      Sharp and severe pain in your side and back, below your ribs
  •      A radiating or “spreading” pain that moves into your lower abdomen and groin
  •      Pain that comes in waves and fluctuates in intensity
  •      Sharp pain during urination
  •      Pink, red or brown urine
  •      Cloudy or foul-smelling urine
  •      Nausea and vomiting
  •      Consistently needing to urinate
  •      Urinating more often than usual
  •      Infection leading to fever
  •      Urinating small amounts of urine even though high levels of urgency are experienced

When Is It Time To See A Urologist?

If you are suffering from any of these symptoms, go ahead and contact your urologist. Certainly contact your doctor immediately if you cannot sit still or find a comfortable position to sit, feel pain that is accompanied by vomiting or fever, have blood in your urine, or difficulty passing urine.

AUNC’s FASTrack Kidney Stone Care

AUNC would like to save our patients a trip to the emergency room by offering FASTrack. FASTrack is a program for that offers fast relief and care of kidney stones problems, pain and complications. We have a full services diagnostic and treatment center on the premises ready to help.. Patients can find clinics with FASTrack in two locations: Raleigh, at 3821 Ed Drive,Raleigh, NC 27612, and in Cary, at 105 SW Cary Pkwy, Cary, NC 27511

HiFu Prostate Cancer Treatment: What You Need To Know

AUNC is committed to bringing our patients the most technologically advanced medical treatment options, so we are proud to offer HIFU to patients with stage one or stage two prostate cancer. HIFU, a non-invasive treatment approved by the FDA in October, 2015, presents a gentler treatment option with fewer side effects, such as erectile dysfunction and incontinence than treatments like radiation.

Since the FDA did not approve the procedure until recently, American men have needed to travel abroad in order to receive this treatment. Now, men in the Raleigh-Durham region can have access to and receive this alternative treatment option.

How It Works

The HIFU procedure removes cancerous cells without making a single incision or utilizing a scalpel by using Sonablate ultrasound technology to remove cancerous cells. The welcome result is an outpatient procedure usually doesn’t even require pain medication. HIFU’s non-invasive technique also does away with concerns about dealing with erectile disfunction and urination problems that often come with invasive prostate surgery.

HIFU is performed by customizing a transducer to match the patient’s body, which then focuses sound waves in only the specific, small area of cancerous tissue. This allows healthcare professionals to treat prostate cancer with next to no damage to healthy cells.


HIFU is ideal for men with slow-growing lesions on their prostate gland that are being watched. The treatment can help men with prostate cancer who are seeking alternative treatment and would like to benefit from a less invasive treatment with a shorter recovery time.

Note: prostate cancer is the most common cancer found in men, and it is the second leading cancer-related cause of death in men. If you are a stage one or stage two patient, HIFU is an option for you.

If you would like to know more about AUNC’s relationship with the HIFU procedure, please visit our partner site at HIFU Prostate Services (HPS). There, you will find more background information about the procedure, patient testimonials, and a contact portal (located at the bottom of the home page) that will help you set up an appointment. (844) 371-HIFU (4438).

Men’s Bladder Health

A man’s bladder is much like a car battery, in that it’s easy to take for granted how essential it is to you on a daily basis. Even if you practice a healthy lifestyle and see your primary care physician regularly, it’s possible that you may suffer from or notice symptoms of bladder problems. In general, it’s best to see a physician or specialist as soon as symptoms are discernible instead of waiting them out – better to be safe than sorry with such an essential part of a man’s health.

Bladder Problems and their Symptoms

Urinary incontinence: This is a loss of bladder control. There are varying degrees of incontinence. The bladder may leak urine, or a person may have complete lack of control over the bladder.

Nocturia: If you’re suffering from frequent nighttime urination, you may have nocturia. People with nocturia usually feel an urgent and frequent need to urinate at night, even though they may be unable to go when they get to the bathroom. Nocturia affects more than just the bladder, because it disrupts sleep patterns.

Urgency: Feeling a high level of urgency to urinate can be a sign of bladder problems.

Frequent Urination: Frequent urination is when someone urinates more often than is usual. This happens because the sensation occurs before the bladder is actually full.

Urinary Hesitancy: If you’ve ever felt a strong urgency to urinate, and then made it to the bathroom and either been unable to go, or it’s taken much longer than usual to start urinating, you may be suffering from urinary hesitancy. This can cause great discomfort since the urge to urinate cannot be eased by being able to use the bathroom.

If you are suffering from any of these symptoms, we recommend you schedule an appointment at one of our eight convenient North Carolina locations. There, one of our 15 board-certified urologists will meet with you and discuss both your diagnosis and treatment options. We have two Raleigh offices; our main one at 3821 Ed Drive and the other in Brier Creek, at 10208 Cerny Street, Suite 202. We also have offices in Apex, Cary, Clayton, Clinton, Dunn, and Wake Forest. You can find the respective address and phone number for all of our offices at the contact page on our website.

HiFu Cancer Treatment now available in North Carolina

High Intensity Focused Ultrasound, or HIFU, is an exciting new treatment for prostate cancer that is all the buzz in the medical community. Although, to say it’s new is not quite accurate since it’s been used successfully internationally for years. But HIFU is new in the United States and here in North Carolina’s Research Triangle. Just last October, the FDA approved the procedure after seeing the evidence of over 50,000 men who successfully treated early-stage prostate cancer.

HIFU is non-invasive, has virtually zero recovery time, and because it targets only the unhealthy cells, it rarely has side-effects like erectile dysfunction and urinary incontinence that other prostate cancer treatments see. So, with all the exciting news and the safe, effective track-record, you may be wondering, where can I find a urologist certified to use HIFU?

As you may be aware, North Carolina is one of the top places in the world for medical and technological research. Because of that, it’s no coincidence that our state is the homebase of the HIFU procedure, made by SonaCare Medical. SonaCare is based in Charlotte, and in fact, there are more HIFU-trained urologists in North Carolina than any state other than Florida. We have more than New York and New Jersey combined.

As a procedure that is relatively new though, you may be wondering if these doctors have the experience yet to perform the procedure safely. Thankfully, because HIFU uses high intensity ultrasound waves to carefully target only cancerous cells, it is actually a much safer procedure than surgery or radiation. In addition, here in the Raleigh Durham area, we are lucky to have Dr. Frank Tortora, who has been performing this procedure for years.

Dr. Tortora, based in Cary, North Carolina, would fly with patients to Mexico or the Bahamas to do the procedure before the FDA finally decided to approve it. Not only has Dr. Tortora practiced this procedure for 10 years and with over 100 HIFU cases, but he’s been practicing urology in general for 30 years. Those living in the Triangle area of North Carolina are fortunate to have a man of his experience working in their region.

North Carolina has really shown itself to be a key part of the global progress in medical advancement of recent years. One of these advancements our state should be proud of is the use of high intensity focused ultrasound on prostate cancer cells. HIFU is an important step forward in the fight against prostate cancer, which is the most diagnosed cancer in men. Men in Raleigh, Durham, Chapel Hill, Cary, Wake Forest, Clayton, Dunn, Clinton and the surrounding areas should contact Associated Urologists of North Carolina to see if a HIFU procedure with Dr. Frank Tortora would be right for them. We can be reached at (844) 371-HIFU (4438).