Dr. Alexander Gotesman, M.D.

A circumcision would be best as if the foreskinblocks circulation after an erectionThat can lead to paraphimosis which is an emergency.

You would need a:

-Blood test (PSA AND BMP)
-CT abdomen and pelvis with and without IV contrast if you’re creatinine is normal
-And a cystoscopy

Kidney stones can lead to infection as they can serve as a media for bacteria to adhere to and multiply. If the urine is sterile, that shouldn’t be the case. Also, if a kidney stone causes obstruction and there is stasis of urine, that can also lead to infection. In either case, kidney stones are easily treated with ESWL as a simple outpatient procedure.

There are many treatments available, including medical therapy with alpha blockers, i.e., flomax, and 5 alpha reductase inhibitors, i.e., proscar, as well as minimally invasive procedures such as TUMT REZUM UROLIFT. TURP AND OPEN PROSTATECTOMY are other options. The minimally invasive treatments are very effective and I’ve done many of them and seen excellent results and have been able to get patients off of long-term medical therapy thereafter.

It may be due to obstruction for which a renal and bladder ultrasound with post-void residual is needed. Also, you may have that symptom due to bladder dysfunction for which a urodynamics evaluation is needed.

Pilates can help with stress urinary incontinence as it strengthens the pelvic floor muscles, but will not help for detrusor overactivity. To determine the cause of the incontinence, a urodynamics evaluation would be required.