Dr. Ralph Zagha. Board Certified in Urology

Conditions Treated

Voiding Issues
Irregular voiding can range from inability to void, voiding too often, and urinary incontinence (leakage of urine). The determination of the underlying cause is
critical as it shapes the treatment plan. Treatments typically begin with fluid management, night time fluid reduction, and decreasing the use of caffeine and
alcohol. Medications are usually added if symptoms are still present. More invasive options are reserved once other non-invasive treatments have been exhausted.

Urinating too often (Over Active Bladder)
OAB is not a normal part of getting older but a treatable medical condition. OAB happens when the bladder muscle starts squeezing to push urine out before you’re ready to go — even if your bladder isn’t full. Normally, you can control the muscles that keep urine in the bladder so you go only when you want to. But sometimes you may leak urine when you don't want to. This condition is called urinary incontinence.

Urinary Incontinence (leakage of urine)
Leakage of urine is never considered normal after infancy. Different types of urinary incontinence include urge incontinence, stress incontinence (which occurs with laughing and/or coughing), overflow incontinence (which can occur with retention of urine), and functional incontinence (when unable to access the bathroom in time). Treatment options depend on the underlying condition, but can range from fluid management, medications, pelvic floor exercises (Kegel), neurostimulation (such as Urgent PC and Interstim), and Botox bladder injections.

Please click on the following useful links to learn more about this condition.
Urgent PC - http://www.uroplasty.com/patients/urgentpc
Interstim - http://www.medtronic.com/patients/overactive-bladder/about-therapy/
Botox - http://www.botoxforincontinence.com/

Urinary Retention
Urinary retention is the inability to empty the bladder. With chronic urinary retention, you may be able to urinate, but you have trouble starting a stream or emptying your bladder completely. You may urinate frequently; you may feel an urgent need to urinate but have little success when you get to the toilet; or you may feel you still have to go after you've finished urinating. With acute urinary retention, you can't urinate at all, even though you have a full bladder.
Acute urinary retention is a medical emergency requiring prompt action. Chronic urinary retention may not seem life threatening, but it can lead to serious problems and should also receive attention from a health professional. Anyone can experience urinary retention, but it is most common in men in their fifties and sixties because of prostate enlargement. A woman may experience urinary retention if her bladder sags or moves out of the normal position, a condition called cystocele. The bladder can also sag or be pulled out of position by a sagging of the lower part of the colon, a condition called rectocele. Some people have urinary retention from rectoceles. People of all ages and both sexes can have nerve disease or nerve damage that interferes with bladder function.

Prostate Enlargement
The prostate is a male reproductive gland that produces the fluid that carries sperm during ejaculation. It surrounds the urethra, the tube through which urine passes out of the body. An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems. An enlarged prostate is often called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. It is not cancer, and it does not raise your risk for prostate cancer.

Erectile Dysfunction
Erectile dysfunction, or ED, is the inability to achieve or sustain an erection suitable for sexual intercourse. Causes include medications, chronic illnesses such as high Blood Pressure and Diabetes, poor blood flow to the penis, drinking too much alcohol and smoking.

Blood in Urine
Seeing blood in your urine can cause more than a little anxiety. Yet blood in urine — known medically as hematuria — isn't always a matter for concern.
This can be due to a number of common drugs, including blood thinners. But urinary bleeding can also indicate a serious disorder.There are two types of blood in urine. Blood that you can see is called gross hematuria. Urinary blood that's visible only under a microscope is known as microscopic hematuria and is found when your doctor tests your urine. Either way, it's important to determine the reason for the bleeding.Treatment depends on the underlying cause. Blood in urine caused by exercise usually goes away on its own within one or two days, but other problems often require medical care.

Kidney Stones
A kidney stone is a solid piece of material that forms in a kidney when substances that are normally found in the urine become highly concentrated. A stone may stay in the kidney or travel down the urinary tract. Kidney stones vary in size. A small stone may pass on its own, causing little or no pain. A larger stone
may get stuck along the urinary tract and can block the flow of urine, causing severe pain or bleeding. Kidney stones are one of the most common disorders
of the urinary tract.

Kidney Cancer
Kidney cancer includes various forms, including clear cell, papillary, sarcomatoid, transitional cell, and others. Some patients are diagnosed before the cancer
has metastasized (spread) to other parts of the body, while others have metastatic disease when their cancer is initially diagnosed. Surgery may be the first course of treatment, or systemic treatment — that is, a treatment that is injected into the bloodstream or swallowed — may be recommended prior to surgery
(though this tends to be rare).
http://www.kidneycancer.org/
http://www.cancer.gov/cancertopics/types/kidney

Prostate Cancer
Prostate cancer is the most common cancer among men (after skin cancer), but it can often be treated successfully. Several types of cells are found in the
prostate, but almost all prostate cancers develop from the gland cells. Gland cells make the prostate fluid that is added to the semen. The medical term for a cancer that starts in gland cells is adenocarcinoma.
http://www.cancer.gov/cancertopics/types/prostate

Bladder Cancer
Definition of bladder cancer: Cancer that forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas
(cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation.
http://www.cancer.gov/cancertopics/types/bladder

Scrotal Issues
The scrotum usually consists of a very flexible and wrinkly skin sack which accommodates the testicles. It’s shape and size is usually adjusted to the size of the testicles in a way that it looks “filled out”. Some conditions such as undescended testicles (testicles remain in the groin area and need to be surgically moved down into the scrotum or removed in order to eliminate risk of cancer), testicular atrophy (testicles were originally “normal” in size, but have shrunk over time due to several conditions such as hormonal imbalance or testosterone abuse), removal of one or both testicles due to cancer, and originally smaller size of the testicles compared to the scrotal sack may require a surgical correction of the scrotal aesthetics. Fluid in the scrotum, called hydrowells, can be drained or surgically corrected.

Male Infertility
Male infertility refers to the inability of a male to achieve a pregnancy in a fertile female. In humans it accounts for 40-50% of infertility. Male infertility
is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.