Most people are quick to visit an emergency room when an arm is broken or a cardiologist after signs of a heart ailment. However, it is common – especially for men – to overlook ailments arising in the urinary tract and reproductive systems. Neglecting to go to an urologist when potential problems present themselves can lead to larger issues.
A properly functioning urinary tract and reproductive system are essential for a pain-free body and clean bill of health. HealthScene Ohio spoke with Dr. Adam Esham of Adena Regional Medical Center about two main areas of urology, kidney stones and male fertility, and the causes and treatments for both.
HealthScene Ohio: How does a kidney stone form?
Adam Esham: Kidney stones form when the urine becomes supersaturated with salt and minerals. For example, too much calcium in the urine.
HSO: When urine becomes supersaturated with salt and minerals – resulting in a kidney stone – is this because of a change in diet or exercise?
AE: The main cause of increased saturation is dehydration. This could be exercise induced. Diet can also lead to increased minerals in the urine.
HSO: What is a kidney stone made of?
AE: On average, 60-80 percent of kidney stones are calcium-based, 10 percent are uric acid and the remaining 10 percent are different materials.
HSO: What are the symptoms associated with a kidney stone? Are there additional symptoms not noticeable at first?
AE: The most common initial symptom is flank pain. Other initial symptoms could be blood in the urine, nausea and vomiting. The main cause of (kidney stones) is dehydration. This could be exercise induced. Diet can also lead to increased minerals in the urine.
HSO: How much pain can one expect when passing a kidney stone? Are there any helpful ways to manage the pain?
AE: The amount of pain and discomfort is different with every patient and stone.
The pain can be managed from over-the-counter pain medicine to prescription narcotic medication depending on the amount of pain present.
HSO: Are there any other options to get rid of the stone?
AE: The options for managing a stone can range from observation (to) medical expulsive therapy to surgical treatment.
HSO: Medical expulsive therapy is a therapy that allows the stone to pass without surgery. How is this done?
AE: Medical expulsive therapy includes fluids, pain medication and, potentially, off-label use of medication.
HSO: Does holding your urine in actually cause damage to your bladder?
AE: It depends. Holding your urine on occasion is not harmful but, if done on a consistent basis, can lead to permanent damage to the bladder.
HSO: Can the type of underwear a man wears have any adverse effects on his sperm count?
AE: There have been some studies that show wearing looser-fitting underwear, such as boxers, can increase sperm count.
HSO: Can tight-fitting underwear (briefs) decrease sperm count?
AE: Tight-fitting underwear can lead to decreased sperm counts by affecting testicular temperature.
HSO: How do certain foods or beverages impact male fertility?
AE: Alcohol and caffeine have been shown to reduce sperm count. An unhealthful diet is harder on the body and, thus, may lead to lower sperm counts as well. While no specific foods can necessarily help fertility, healthful foods will help overall bodily health. High antioxidant foods may improve sperm counts and healthier sperm.
HSO: Can an STI lead to reduced fertility?
AE: Certain sexually transmitted infections may lead to infertility by causing scar tissue.
HSO: What options are out there for men who want children, but deal with low fertility?
AE: It depends on the reason for the decreased fertility. If the patient has problems with low count and motility, then a procedure that helps with blood flow in the testicles may help. If the number is very low, then the only option may be to undergo evaluation by a reproductive specialist.
Zachary Konno is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. Adam Esham is a Robotic Surgery Urologist with Adena Health System in Chillicothe. Esham earned his medical degree from Northeastern Ohio Universities College of Medicine and completed his urology residency at University of Texas Medical Branch. A native of southern Ohio, he enjoys spending time outside with his children, mountain biking, road biking, fishing, hunting, golf, tennis and cooking.
