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F.A.Q.

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The presence of blood in the urine is called haematuria and needs to be assessed carefully, particularly if the patient can see red urine (macroscopic haematuria).
It can also happen that urine has a normal colour but the urine test identifies traces of blood (microscopic haematuria).
It is always necessary to see a doctor in case of haematuria. The most frequent causes include calculus of the urinary tract, infections but also tumours.
In order to exclude the presence of tumour, laboratory tests, urinary ultrasound, urinary cytology and/or flexible cystoscopy are necessary.
The presence of a tumor of the urinary tract must always be excluded and in order to do this laboratory tests, urinary tract ultrasound, urinary cytology and / or cystoscopy are required.

I’ve had a PSA test for a routine control and it proved to be high: what shall I do?

The prostate-specific antigen (PSA) is the main marker of prostate tumour. As for today every man over 50 (or 40 if there were cases of prostate tumour in his family) should have a PSA test once a year. Normal range is below 2.5 ng/ml.
PSA can raise over this limit in case of an inflammation of the prostate (prostatitis), of benign enlargement (prostatic hypertrophy or prostate adenoma) or a tumour.
If there is the slightest suspicion of prostate tumour it is necessary to perform a prostate biopsy, which is a painless day case test, on the urologist’s recommendation.

What is the prostate biopsy?

The prostate biopsy involves taking small samples of the prostatic tissue in order to exclude the presence of a tumour. It is carried out with transrectal ultrasound under local anaesthesia.
It is important to take at least 12 samples of the prostate to obtain a complete mapping of the prostate.
The number of samples depends on the prostate’s volume: the bigger is the prostate, the more samples are needed. In my personal experience 18-24 samples are necessary.
A preventive antibiotic course needs to be taken for a week. The procedure is performed as a day case with exception of patients receiving anticoagulant therapy and for those who need general anaesthesia.

What is PCA3 test, the new exam that avoid prostate biopsies?

PCA3 is a urine test carried out following a prostate massage during rectal examination. It identifies a particular gene which is associated with prostate tumour. However, prostate biopsy still represents the gold standard for diagnosis of prostate tumours.

If I undergo an operation for benign prostatic hypertrophy will I become impotent?

No. If there are no particular complications, this kind of operation will not interfere directly with the sexual function. The only frequent complication is retrograde ejaculation.

After nerve-sparing radical prostatectomy will I be able to have a normal sexual activity?

The answer is complex: after nerve-sparing prostatectomy around 50% of the patients have a normal erection with the aid of medicines (cialis, levita, viagra). In the other 50% of the cases it is possible to inject prostaglandins directly into the corpora cavernosa of the penis. This procedure is successful in 90% of the cases. Those patients who do not respond to medical treatments have the possibility of placement of a penile prosthesis.

Are Cialis, Levita, Viagra dangerous for the heart?

Absolutely not. The only contraindication is for those who take nitrates.

Can the penis break?

Yes, penis can break. If this occurs immediate intervention is necessary, therefore it is mandatory to go to an ER urgently.

Which are the normal dimensions of the penis?

9 cm when flaccid, 12,5 if pulling the glans while penis is flaccid, 15 cm in erection.

Which are the symptoms of varicocele?

a) there are no symptoms: the most common occurrence that varicocele is observed during an examination performed for another reason;
b) testicular pain: testicles ache especially if standing for a long time or during strenuous physical efforts;
c) infertility: infertility is often the first symptom for which a couple initiates medical investigations for infertility and varicocele is found.

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