Ask the experts

why do i have pain below the belt?

Pain below the belt should never be ignored by men. Here are a few things you should keep in mind if you have pain in the pelvic or groin area.

If you have a burning sensation when you urinate or if you have an urge to urinate, but nothing really comes out, you could have a urinary tract infection (UTI). If you have these symptoms, make an appointment with your doctor or urologist. You may need antibiotics to treat the infection. UTIs are not as common in men as they are in women, so men may be guided to have other tests to see if something else is causing the UTI.

Pain in the pelvic area, coupled with a hard time urinating and having flu-like symptoms, could mean you have prostatitis. Prostatitis is an inflammation or infection of the prostate gland. Make an appointment to see your health care provider if you think you have prostatitis. If it is caused by a bacterial infection, you may need antibiotics.

If you have sudden testicular pain that feels similar to a sharp kick to the groin, and it is accompanied by swelling of the scrotum or being uncomfortable when you talk or walk, you may have testicular torsion. Torsion is when the flow of blood to a testicle gets cut off because the cord that connects the testicles to the body becomes twisted. It is vital to get to a doctor right away with torsion. If you do have testicular torsion, it’s an emergency because the testicle will become damaged without proper blood flow.

Pain in the penis during erections and/or changes in curvature of the penis may be due to a relatively common urologic condition called Peyronie’s Disease. Fibrous scar tissue can form in the penis leading to these changes. Treatments are available and should be discussed with your health care provider.

Jason Jameson, MD is a urologist at Mayo Clinic in Arizona focusing on Men’s Health, Male Sexual Dysfunction, and General Urology.

Why Do I Have to Get Up so Often at Night to Urinate?

If you wake up two or more times each night to go to the bathroom, you could have nocturia. Nocturia is the medical term used for nighttime urination, and it can often get in the way of a good night’s sleep. It is important to note that Nocturia is not a disease in and of itself, but rather a sign of something else going on in our bodies. It can be caused by a lifestyle habit or a hidden health problem. 

Common causes of nocturia: 

  • Polyuria – making too much urine in 24 hours 
  • Nocturnal Polyuria – making too much urine at night 
  • Bladder Storage – bladder having problems storing and releasing urine 
  • Mixed Nocturia – more than one of these problems occurring at the same time

Things that can impact nocturia:

  • Drinking too much fluid or caffeinated drinks close to bedtime 
  • Underlying health issues like sleep disorders, bladder or urinary tract infections, an overactive bladder or high blood pressure 
  • Timing of medications like diuretics, which are also known as “water pills” 

Common ways to treat or manage nocturia:

  • Lifestyle changes (diet/exercise)
  • Behavior changes (curbing your fluid intake before bed)
  • Medication 
  • Review the times you are taking current medications (if you are taking diuretics, it may be helpful to take your pills earlier in the day)

Talk with your health care provider if you feel you may have nocturia. 

Aaron Spitz, MD is a urologist in Orange County, California. He is also the author of a new book (now available) called The Penis Book: A Doctor’s Complete Guide to the Penis From Size to Function and Everything in Between.

Are Kidney Stones More Common in the South?

Roughly 13 percent of men and 6 percent of women in the United States will have to deal with a kidney stone at least once during their lifetime. The majority of people with stones have a metabolic predisposition to stones that can, and should, be identified to prevent ongoing issues with stones. Urine contains many dissolved minerals and salts. When your urine has high levels of these minerals and salts, you can form stones. 

Kidney stones can start small, but can grow larger in size. Some stones stay in the kidney and do not cause any problems. Sometimes the kidney stone can travel down the ureter, the tube located between the kidney and the bladder. If the stone gets stuck in the ureter, it blocks the urine flow from that kidney and causes pain.

Dehydration, or not drinking enough water, can lead to stones. With warmer temperatures hitting the southern portion of the United States more often, not staying hydrated due to the hotter climate, could make a stone more common. 

Diet also plays a major factor in forming stones. Foods with high salt contents are a staple of many popular southern-style restaurants, and too much salt in the diet is a risk factor for forming stones. This is because too much salt is passing into the urine, keeping calcium from being reabsorbed from the urine and into the blood. Reducing salt in the diet lowers urine calcium, making it less likely for calcium stones to form.

Keep in mind that a diet high in animal protein, such as beef, fish, chicken and pork, can raise the acid levels in the body and in the urine. High acid levels can also make it easier for stones to form. 

Vitaly Margulis, MD is Associate Professor of Urology at University of Texas (UT) Southwestern Medical Center in Dallas, Texas.  |  SPRING 2018  |  UROLOGYHEALTH extra