Archive for the ‘Ejaculatory dysfunction’ Category

Statins, Cholesterol and Erectile Dysfunction

September 4, 2016

Statins are a group of medicines that can help lower the level of cholesterol in the blood.  Having a high level of cholesterol is potentially dangerous, as it can lead to a hardening and narrowing of the arteries (atherosclerosis) and cardiovascular disease (CVD) such as coronary heart disease, chest pain, heart attacks,  strokes, and even erectile dysfunction\impotence.  Cholesterol that narrows the blood vessels can decrease the blood flow to the penis thus making it difficult to achieve and maintain an erection adequate for sexual intimacy.

Before taking statins, every man or woman should give strong consideration to lifestyle changes such as losing weight, exercising regularly, limiting alcohol consumption, and consider smoking cessation.  All of these actions can decrease the cholesterol levels.  All of these lifestyle changes can also improve sexual function.

Bottom Line:  Elevated cholesterol levels are deleterious to your health.  Consider lifestyle changes before starting statins.  Your erections and your partner will thank you!

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When It Hurts When You Ejaculate-Coming and Going

July 23, 2013

It is not an uncommon complaint for men to have pain at the time of ejaculation. This is almost always a result of inflammation and can be resolved with medication. Pain at the time of ejaculation can be felt in the area between the anus and the scrotum or in the urethra, a tube that runs from the bladder to the end of the penis. The condition can cause discomfort in the testes and certainly interferes with sexual pleasure.

Painful Ejaculation can be caused by an inflammatory condition of the prostate gland which can make the prostate feel sore and irritated, STDs may cause inflammation in the prostate and the urethra and cause pain with ejaculation and pain with urination, obstruction to the ejaculatory ducts that get distended and then cause pain when the seminal vesicles contract at the time of ejaculation, and finally, psychological problems can manifest themselves as painful ejaculation.

To find the cause of painful ejaculation, a semen sample and urine sample taken after ejaculation (post ejaculation urine analysis) is examined. A sample of the urethral lining is taken to see if there is any infection, such as a sexually transmitted infection. A test that looks at the inside of the bladder and urethra (cystoscopy) may also be done, although this is not a usual procedure for diagnosing painful ejaculation. For some men it can be hard to describe the exact location of the pain.

Treatment
If no physical cause is found, some behavioral techniques to relax the muscles in the pelvic area may help some men. When the cause is prostatitis the use of medications such as ‘alpha blockers’, muscle relaxants, analgesics, and some anti-inflammatory drugs may help. Specific antiviral and antibiotic medications can be given if the cause of painful ejaculation is due to an infection such as herpes.
If the cause is psychological, counseling may help deal with any underlying concerns.

Bottom Line: Painful ejaculation is not life-threatening, but may affect sexual pleasure and can cause a man distress, anxiety and lower self esteem. In most instances the cause can be determined and effective treatment is available..

Libido Letting You Down? Solutions to That Problem

September 1, 2012

For men, Libido is your sex drive and it is different from ability to get an erection or be able to achieve a successful pregnancy. Women’s libido is also different from orgasm or her ability to have an egg unite with a man’s sperm. In women, gynecologic conditions may make engaging in sexual intimacy difficult or painful and ultimately impact her libido.

Libido is the name Freud gave to our sex drive. Libido is a multifactorial situation which is influenced by hormones, psychological and physical factors, romance, and the opportunity for fulfillment. It is normal for libido to decline with age going much faster for women after menopause than for men in middle age, which has about a 1% decline each year. But nearly all couples in their 60s and 80% of couples in their 70s continue to find enjoyment with engaging in sexual intimacy.

Hormonal deficiency is a common cause of deteriorating sex drive in both men and women. The solution is very simple and consists of replenishing the deficiency with testosterone in men and estrogens in women. However, hormones won’t solve the problem if there is some other underlying reason for the sex drive going into the tank.
So what is a man and a women with a loss of severe decrease in their sex drive to do? If you are suffering from fatigue, your sex drive deficiency may be a result of anemia, thyroid deficiency, or kidney disease. A few blood tests will make the diagnosis and help your doctor put your libido back on track.

Next talk to your doctor about all of your medications including, over the counter medicines, herbal medications and supplements. If the problem is related to medications, you can usually note the onset of libido problems that occurred shortly after staring a medication that can plummet your sex drive.

If you have heart disease or have suffered a heart attack and you or your partner is fearful that sex will worsen your cardiac problem or cause another heart attack, speak to your physician. A good rule of thumb is that if you can climb two flights of stairs without chest pain or severe shortness of breadth, then it is probably safe for you to engage in sexual intimacy with your regular partner.

If you are a woman and are going through the menopause, that doesn’t mean that you have bury your sex life forever. As a matter of fact, menopause for many women enhances their sex life as they are no longer worried about conception and fear of pregnancy. Some women do lose their sex drive after menopause and this may be a result of estrogen deficiency. Talk to your doctor about hormone replacement therapy.

I suggest that if you are a woman, try estrogen first. That works for most women as it reduces their hot flashes and pumps up their libido. However, testosterone may also be effective for women in small doses as it is for men who require larger amounts of testosterone in order to restore their libido. Testosterone is available for men and women in a topical gel or a small rice-sized pellet inserted under the skin and replaced every four to six months.

Women may lose interest in sex after menopause because of vaginal dryness (VD). This VD isn’t treated with antibiotics but with topical estrogen creams or vaginal rings impregnated with estrogen or vaginal pellets of estrogen. If a woman can’t take estrogens, then there is always lubricating creams and jellies such as the old standby, K-Y Jelly that alleviates VD and the discomfort associated with the loss of lubrication.

If you are a man and are suffering from erectile dysfunction (ED), this may also impact your sex drive as well. Certainly check your hormones because if low testosterone is the problem, then replacement therapy with gels, injections, or pellets will restore your sex drive 85% of the time.

For both men and women: get lots of exercise. Regular exercise promotes good health. It not only makes you feel good all over, but restores the blood supply to the pelvic area in both men and women.

How about aphrodisiacs?
You will probably receive unsolicited E mails and mail from companies offering an improvement in sex drive and creams and lotions to make a man’s penis bigger. Absolutely none of these studies have withstood scrutiny by medical professionals and probably are a waste of your time and hard earned money. I am an amateur magician and what they have to offer would be real magic if they worked the way the marketing materials described. A loss of sex drive has a problem since the beginning of recorded history and every society and culture have been looking for the magic elixir or potion that can restore the fountain of youth. The ancients have ground up dried beetles (Spanish fly) and rhinoceros horns but to no avail, except that Spanish fly can make you sick. Included in the myths of aphrodisiacs include oysters. They, too, will not restore a man’s libido or potency. According to the FDS, there is no scientific proof that any over the counter aphrodisiacs work to treat decreased libido problems. According to Dr. Ruth Westheimer, “The largest sex organ is not between our legs but between our ears.”

A few words about Viagra, Levitra, and Cialis. These are prescribed medications for the treatment of ED and will not resolve problems with libido or sex drive. The drugs are very effective for ED but will not cure loss of sex desire.

Bottom Line: Problems with a man or woman’s libido is common to many middle aged men or women. Many of the problems are related to hormone deficiency and can be effectively treated.

Got Premature Ejaculation? Give Kegels a Try

January 14, 2012

Premature ejaculation is a common condition that impacts so many American men. It leads to a source of frustration not only to the man but to his partner as well. There are dozens of folklore treatments but since none universally effective, that leaves many men continuing to suffer the embarrassment of premature ejaculation or PE. There are medical options, which include oral medication with SSRI or selective serotonin reuptake inhibitors and sex therapy that teach the squeeze technique.

However, a non-medical solution consists of pelvic floor exercise, more commonly called a Kegel exercise (named after Dr. Arnold Kegel), consists of contracting and relaxing the muscles that form part of the pelvic floor, which are referred to as the “Kegel muscles”. Several tools exist to help with these exercises, though many are ineffective. These exercises are usually done to reduce urinary incontinence and aid with childbirth in women, and reduce premature ejaculatory occurrences in men, as well as increase the size and intensity of erections.
Kegel exercises are employed to strengthen the pubococcygeal muscle and other muscles of the pelvic diaphragm. Kegels can help men achieve stronger erections and gain greater control over ejaculation. The objective of this may be similar to that of the exercise in women with weakened pelvic floor: to increase bladder and bowel control and sexual function.
Sexual function
Kegel workouts can provide men with stronger erections. Research published in 2005 issue of BJU International, have shown that pelvic floor exercises could help restore erectile function in men with erectile dysfunction. There are said to be significant benefits for the problem of premature ejaculation from having more muscular control of the pelvis. In men, this exercise lifts up the testicles, also strengthening the cremaster muscle, as well as the anal sphincter muscles, as the anus is the main area contracted when a Kegel is done. This is because the pubococcygeus muscle begins around the anus and runs up to the urinary sphincter.

Find a quiet and private place to practice your reverse Kegels. You’ll need to take your time when you first begin. You need to be patient if you don’t feel like you’re understanding the technique right away. You’ll need to settle into a place without any interruptions. Then, you will need to:
1. Relax the penile area completely and clear your mind of tension and anxiety. You want to be calm and relaxed so that the blood can flow into your penis.
2. Begin contracting the penile muscles. Focus on contracting the muscles near the front of your penis while keeping the rest of the pelvic area as relaxed as possible. The goal is to make your penis become stronger and more erect without actually having an erection.
3. Breathe deeply and slowly as you push out the muscles in the penile area and maintain focus on strengthening only the top and lower end of the penis. Take note of how relaxed and loose the muscles directly under your penis are.
4. Let go of the contraction and breathe more deeply as you exhale. Let your penis relax, then take another deep breath and contract again. Make sure you are only focusing on the front of your penis; push out, hold for a few seconds, then relax the muscles.
5. Repeat the cycle for at least 10-15 times per session so that you feel comfortable with the movement. The entire process will feel awkward at first, but it’s very important to focus on relaxation and keeping the muscles as loose as possible outside of the contractions. You can work your way up to 40-50 exercises per session as your penis becomes stronger.

Practicing Kegels for PE treatment isn’t the most effective PE cure but good results still possible so you should try it especially in a combination with other remedies such as SSRIs. The best thing about Kegels exercises it their absolute safety and the cost is just right-it’s free!

Bottom Line: Kegel exercises are not just for women but can also be used by men to treat premature ejaculation. Remember, a Kegel a day may keep your ejaculation away….or at least delayed for a few minutes!


The Straight Dope on Dope-Sex and Marijuana

November 19, 2011

The occasional use of marijuana may enhance a man’s sexual performance. However, the long term effects of marijuana and not so pleasurable. The long-term affects include erectile dysfunction and loss of orgasm. Marijuana may also impact a man’s fertility.
Erectile Dysfunction
The Journal of Sexual Medicine published a study suggesting a link between marijuana and erectile dysfunction. The active ingredient in marijuana is tetrahydrocannabinol, or THC. When a person uses marijuana, THC interacts with proteins in the brain called cannabinoid receptors. This interaction impairs the person’s brain function. There are also cannabinoid receptors present in penile tissue. Perhaps the interaction with THC may impair penile function (possibly causing erectile dysfunction)
Problems with Orgasm
In a study from Australia, men who used marijuana every day were four times more likely to have problems reaching orgasm than men who didn’t use weed. In addition, men who used marijuana every day were three times more likely to experience premature ejaculation than men who didn’t.
Other male daily users said they reached orgasm too slowly.
Fertility
Marijuana can also affect a man’s fertility. More specifically, THC hinders sperm cells’ ability to swim to an egg cell. And, if the sperm even reaches the egg, it will have a harder time fertilizing it.
Marijuana can also cause fertility issues for women. If a woman uses marijuana, THC can travel to her uterus, cervix, vagina, and vaginal fluids. Sperm cells that come into contact with THC from the woman behave much like sperm cells from a man who uses marijuana and the “swimmers” may have trouble reaching and then fertilizing the egg .
Therefore, couples who want to conceive are advised to avoid marijuana use.
The Bottom Line
If you’re experiencing erectile dysfunction or problems with orgasm, consider your marijuana intake. And if you planning on starting a family, you should steer clear of the weed.

This blog was modified from Marijuana and Male Sex Health, Published on May 31, 2011 on SexHealthMatters.org

Retrograde Ejaculation or Shooting Blanks

October 26, 2011

Most men experience the joy of ejaculation when the semen, sperm mixed with prostatic fluid, travels outside of the body at the time of orgasm. Retrograde ejaculation occurs when semen goes into the bladder instead of leaving the penis during ejaculation. Retrograde ejaculation isn’t harmful but it can impair fertility since it affects the delivery of sperm to the vagina during intercourse.
During normal ejaculation, internal muscles, called sphincters, close off the opening of the bladder to prevent semen from entering as it passes through the urethra. In retrograde ejaculation, the bladder opening doesn’t close properly and some or all of the semen is allowed to enter the bladder instead of being ejected out the tip of the penis. As a result, semen mixes with urine in the bladder and leaves the body during the next urination.
Retrograde ejaculation does not interfere with a man’s ability to have an erection or an orgasm. Men often first become aware that they have retrograde ejaculation when fertility problems arise. The condition also occurs after prostate surgery where the sphincters can be damaged or injured during the surgery. A common sign indicating retrograde ejaculation is if a man’s urine appears cloudy after sexual climax.
Retrograde ejaculation may occur either partially or completely. Men with incomplete retrograde ejaculation may notice a decrease in semen that comes out during ejaculation. Complete retrograde ejaculation can also be called dry orgasm or dry ejaculation since there is orgasm without the discharge of semen.
Since retrograde ejaculation isn’t harmful, it typically doesn’t require treatment unless it interferes with fertility. In such cases, treatment depends on the underlying cause.
If your doctor discovers that a prescribed medication, such as alpha blockers, is the cause, switching to a comparable medication or discontinuation of the drug often restores normal ejaculation.
Unfortunately, if retrograde ejaculation is caused by surgery or diabetes, it is often not correctable. However, some medications have been shown to improve muscle tone of the bladder neck and therefore reduce the loss of semen into the bladder during ejaculation. These medications include: epinephrine sulfate and epinephrine-like drugs (such as pseudoephedrine, imipramine, midodrin, desipramine and brompheniramine maleate).
Alternatively, men are sometimes encouraged to ejaculate when their bladder is full since having a full bladder can increase bladder neck closure.
If the above measures are not options or are not successful and fertility is still a concern, it is also possible for an urologist to retrieve sperm from a man’s urine following an orgasm and use it for artificial insemination.
It is also possible for men, prior to receiving treatments or surgeries that bring the risk of retrograde ejaculation, to have their semen cryopreserved (frozen) for insemination later.

Bottom Line: Retrograde ejaculation or sperm going backward into the bladder is not a very common problem but can be a problem if a man wishes to achieve a pregnancy with his partner. The condition does not need treatment unless a man wishes to achieve a pregnancy.

Hold On, I’m Comin’! New treatment for Premature Ejaculation

October 24, 2011

Until recently there has been no medical treatment for premature ejaculation. Premature ejaculation is the most common sexual disorder in men even superseding erectile dysfunction or impotence. In the past, topical anesthetic like xylocaine jelly applied to the penis have never been shown effective for men and have provided. And the jelly rendered the female partner with numbness in her vagina and made it difficult for her to achieve enjoyment from sexual intimacy.

PROMESCENT, a topical, metered dose spray is available as an over the counter product and does not require a medication. The spray has a prompt onset of action (10 minutes) and in preliminary clinical experience the product has shown effectiveness with minimal side effects.

How to use PROMESCENT
Simply spray 3-10 times on the head and shaft of the penis 10 minutes before intercourse. Rub the spray lotion into the skin until it is completely absorbed. Remove any excess lotion with a wet towel to avoid transfer to your partner. Dosing should not exceed 10 sprays per use. Excess numbness may cause a temporary loss of erection.

For more information I suggest you go to http://www.Promescent.com.

Bottom Line: Premature ejaculation is a common disorder affecting millions of American men and secondarily impacting their partners. Promescent is an effective treatment using a topical gel.

TSA Pat Down…With a “Happy Ending”!

December 1, 2010

A 47 year old gay man was arrested at San Francisco International Airport after ejaculating while being patted down by a male TSA agent.  Percy Cummings, an interior designer from San Francisco, is being held without bail after the alleged incident, charged with sexually assaulting a Federal agent.

According to Cummings’ partner, Sergio Armani, Cummings has “multiple piercings on his manhood” which were detected during a full body scan.  As a result, Cummings was pulled aside for a pat-down.  Armani stated that the unidentified TSA agent spent “an inordinate amount of time groping” Cummings, who had apparently become sexually aroused.  Cummings, who has a history of sexual dysfunction, ejaculated while the TSA agent’s hand was feeling the piercings.  The TSA agent, according to several witnesses, promptly called for back up.  Cummings was thrown to the ground and handcuffed.

A TSA spokesperson declined to comment on this specifc case, but said that anyone ejaculating during a pat-down would be subject to arrest.

Men’s Health Talk

August 3, 2010

Please join me for a talk on men’s health at St. Charles Surgical Hospital (1717 St. Charles Avenue) on 8-26-10 at 6:30 P.M. Talk is free and refreshments will be served.

Impotence: 14 Secrets for Success

April 28, 2010

Sure it’s a night you’ll remember. For all the wrong reasons.

It had been a hectic week. You’d been working hard on that proposal, and never once made it home before midnight. Tonight, you were going to make it up to your wife.

You brought roses. She uncorked your favorite wine. After dinner, when you took the phone off the hook, she slipped behind you, kissing your neck in that way of hers that always drives you crazy. Everything seemed to unfold according to plan.

Everything, that is, except a certain part of your anatomy. A certain crucial part.

And that left you to wonder: What in tarnation is going on? Is this going to happen the next time? What the heck can I do about it?

Plenty. Realize, first, that you’re not the only man in the world who’s had this happen. “If men are honest, every one of them will tell you they’ve sustained an impotence episode at one time in their lives,” says Neil Baum, M.D., director of the New Orleans chapter of the Male Infertility Clinic and an assistant professor of urology at Tulane University School of Medicine. “Not every incident is a ten.”

“It can be devastating when it occurs,” he says. “A man’s whole concept of his masculinity may be undermined. ”

Experts sayan estimated ten million men suffer from impotence, the term used when a man is unable to achieve and maintain penetration until he ejaculates.

Until the early 1970s, experts thought that most erection problems pointed to underlying problems in the psyche. Today, the medical community recognizes that almost half of all impotent men have a physical or structural problem that’s at least partly responsible.

What can you do to keep erection problems at bay?

Here’s what our experts advise.

Give yourself time. “As a man gets older, it may take a longer period of genital stimulation to get an erection,” says Dr. Baum. “For men aged 18 to 20, an erection may take a few seconds. In your thirties and forties, maybe .a minute or two. But if a 60-year-old doesn’t get an erection after a minute or two, that doesn’t mean he’s impotent. It just takes longer.”

The time period between ejaculation and your next erection also tends to increase with age. In some men aged 60 to 70, it may take a whole day or longer to regain an erection. “It’s a normal consequence of aging,” says Dr. Baum.

Consider your medication. Drugs your doctor has prescribed might be at the root of the problem. Or it might be those over-the-counter antihistamines, diuretics, or sedatives you’re using. Realize, of course, that what affects your neighbor may have no effect on you.

More than 200 drugs have been identified as problematic. Drug-induced impotence is most common in men over 50, says Dr. Baum. In fact, in an American Medical Journal study of 188 men, drugs were the problem 25 percent of the time.

If you suspect your medication, consult your doctor or pharmacist. He may be able to change the dosage or switch you to a different drug. Do not, however, attempt to do this on your own.

Beware of recreational drugs. Troublemakers that Richard E. Berger, M.D., a urologist with Harborview Medical Center in Seattle, Washington, lists in his book BioPotency: A Guide to Sexual Success, include cocaine, marijuana, opiates, heroin, morphine, amphetamines, and barbiturates.

Go easy on the alcohol. Shakespeare hit it on the head when he said in MacBeth that alcohol provokes desire but it takes away the performance. That happens because alcohol is a nervous-system depressant. It inhibits your reflexes, creating a state that’s the opposite of arousal, says Dr. Berger. Even two drinks during cocktail hour can be a cause for concern, he says.

Over time, too much alcohol can cause hormonal imbalances.

“Chronic alcohol abuse can cause nerve and liver damage,” says Dr. Baum. “When you have liver damage, you cause a dynamic where the man has an excess amount of female hormones in his body.” You need to have the right proportion of testosterone for everything to work properly.

Know that what’s goodfor the arteries is goodfor the penis. “In the last five years, it’s become quite evident that the penis is a vascular organ,” says Irwin Goldstein, M.D., co-director of the New England Male Reproductive Center at Boston University Medical Center in Massachusetts. The very things that clog your arteries-dietary cholesterol and saturated fat-also affect blood flow to the penis. In fact, says Dr. Goldstein, all men over age 38 have some narrowing of the arteries to the pems.

So watch what you eat. “High cholesterol is probably one of the leading causes of impotence in this country,” says Dr. Goldstein. “It appears to affect erectile tissue.”

Don’t smoke. Studies show that nicotine can be a blood vessel constrictor, says Dr. Baum. A study of healthy adult mongrel dogs at the University of California at San Francisco showed that the inhalation of smoke from just two cigarettes was enough to prevent five dogs from getting a full erection and a sixth dog from maintaining one. The researchers believe that inhalation of cigarette smoke blocks erection by inhibiting the smooth muscle relaxation of the erectile tissue.

Do what you need to feel good about your body. Are you thinking about taking off a few pounds?

Studying karate? Starting a weight-training program? Do it. “Sex is body contact,” says James Goldberg, Ph.D., research director of San Diego’s Crenshaw Clinic in California. “The more a person feels good about his body, the better he’ll feel going into the event.”

Don’t overdo it on the exercise. If you exercise excessively, you’ll stimulate the body’s natural opiates, the endorphins. “We’re not sure how they work, but they tend to lessen sensation,” says Dr. Goldberg. “Over the short run, exercise is good for you. Beyond a certain point, though, the body gets into the habit of protecting itself.”

Wait out pain. Your body also produces its own opiates when you’re in pain, says Dr. Goldberg. These opiates can tum off any sexual stimuli. “There’s not much you can do,” he says, except wait for a better time.

Relax. Being in a relaxed frame of mind is crucial. Here’s why. Your nervous system operates in two modes. When the sympathetic nerve network is dominant, your body is literally “on alert.” Adrenal hormones prepare you to fight or take flight. Nerves shuttle your blood away from your digestive system and penis and into your muscles.

You can tum on your sympathetic nervous system just by being too anxious, says Dr. Baum. “For some men, the fear of failure is so overwhelming that it floods the body with norepinephrine, an adrenal hormone. That’s the opposite of what you need to have an erection.”

The key here is to relax and let your parasympathetic nervous system take over. Signals that travel along this network will direct the arteries and sinuses of the penis to expand and let more blood flow 111.

Avoid whole-body stimulallts. That means caffeine and certain questionable substances touted as potency enhancers. “The main thing during sex is to be relaxed,” says Dr. Goldberg. “Stimulants tend to have an overall effect. They constrict the smooth muscle that must dilate before an erection can occur.”

Refocus your attemioll. One way to relax is to focus with your partner on the more sensual aspects of intimacy. Play with and enjoy each other without worrying about that erection.

“The skin is the largest sexual organ in the body,” says Dr. Goldberg, “not the penis. So don’t be led by your penis. The whole body has to react.”

Plall ahead. Dr. Berger thinks it is a good idea to decide in advance what you’ll do if you don’t get an erection. “What are your alternatives?” If you’re not so focused on the erection itself, it will make it easier for the erection to come back, he says.

Talk to your partller. Don’t risk increasing the tension in the bedroom by maintaining a sullen silence.

Together. you can play detective and figure out what’s going on. Pressure at work? Strain over a child’s illness. A touchy issue you two haven’t resolved yet?

“If you understand some of the things that can cause impotence, you can find a way to explain it without attributing it to something that’s not there,” says Dr. Berger. “And you should talk about what your alternatives are. Will you continue your lovemaking in a different way? Don’t let the erection, or lack of it, interfere with your intimacy.”

PANEL OF ADVISERS

NEIL BAUM. M.D., is director of the New Orleans Male Infertility Clinic, a clinical assistant professor of urology at Tulane University School of Medicine, and a staff urologist with Touro Infirmary in New Orleans, Louisiana.

RICHARD E. BERGER. M.D., is a urologist with Harborview Medical Center in Seattle, Washington.  He is the author of Biopofency: A Guide fa Sexual Success.

JAMES GOLDBERG. PHD., is research director of the Crenshaw Clinic at San Diego, California, and a clinical research pharmacologist.

IRWIN GOLDSTEIN. M.D., is co-director of the New England Male Reproductive Center at the Boston University Medical Center in Massachusetts and is an assistant professor of urology at Boston University School of Medicine.