- Low Testosterone
- Erectile Dysfunction (ED)
- Enlarged Prostate/BPH
- Peyronie’s Disease
- Male Urinary Incontinence
Treatments & Conditions
Urological Disorders Treated by Dr. Alvi
As a highly trained urologist in Mesa, Arizona, Dr. Kashif Alvi diagnoses and treats a wide spectrum of urological disorders affecting both men and women. The most common conditions we treat include:
What is Low Testosterone?
Testosterone is a sex hormone produced primarily in a man’s testicles, but women also produce it in their ovaries during puberty. Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines, typically about one percent a year after age 30 or 40.
Testosterone is beneficial for bone density, fat distribution, muscle strength, growing facial and body hair, red blood cell production, sex drive (libido), and sperm production. As a man ages, his hormones decrease. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease called hypogonadism, or Low-T. Low testosterone levels can affect men's sex drive, erections, mood, muscle mass, and bone density.
For women, low testosterone can affect sex drive (low libido), mood, energy levels, blood cell production, cause muscle weakness, and affect reproduction.
Other Symptoms of Low-T Include:
- Change in sleep patterns
- Sexual dysfunction
- Emotional changes
- Weight gain
Low testosterone (low-T) is underproduction or lack of production of testosterone in men and women. Causes of low-T include chronic medical conditions such as diabetes, infections, obesity, or other hormonal conditions.
The bottom of a man's normal total testosterone range is about 300 nanograms per deciliter (ng/dL). The upper limit is about 800ng/dL. A lower-than-normal score on a blood test can be caused by a number of conditions, including diabetes, obesity, injury to the testicles, etc. For women aged 50 and older, testosterone levels lower than 20 ng/dL are considered low.
Low Testosterone Treatment
Having a gradual decline in your testosterone level as you age is to be expected. Treatment is necessary if you're experiencing symptoms related to low testosterone, also called hypogonadism, a disease in which the body is unable to produce normal amounts of testosterone.
Testosterone replacement therapy can improve the signs and symptoms of low testosterone. Depending on your case, Dr. Alvi may prescribe testosterone as injections, pellets, patches, or gels.
Testosterone gel is mainly used as a first-line treatment for low testosterone in men. Common testosterone gels include Androgel®, Fortesta®, and Testim®. Testosterone gel is noninvasive. It is rubbed onto the shoulders or upper arms once daily.
Testosterone gel is available in either packet or pump form and is generally clear and colorless. If testosterone levels are low, Dr. Alvi customizes a dosage and type of testosterone gel for each patient depending upon the results before lab tests.
Testosterone may also be given by a deep muscular injection, every two weeks. Dr. Alvi will instruct you or your partner on how to inject it into the arm, thigh, or buttock.
As with any form of testosterone supplementation, testosterone levels, complete blood count, and prostate specific antigen levels need to be monitored on a regular basis.
Dr. Alvi performs testosterone implants in the form of small pellets (Testopel®), which slowly deliver testosterone over the course of 3 to 6 months. During a 15-minute office procedure, the testosterone pellets are implanted under the skin in the buttock using local anesthesia and gradually dissolve over a few months. This testosterone delivery method gives a slow, steady, and constant infusion of testosterone into the body.
What is Erectile Dysfunction?An erection is the result of increased blood flow into the penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with the penis. When a man becomes sexually excited, muscles in the penis relax. This relaxation allows for increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa. As the chambers fill with blood, the penis grows rigid, and become erect, formally known as an erection. An Erection ends when the muscles contract and the accumulated blood can flow out through the penile veins. However, sometimes men cannot achieve or maintain an erection during sexual activity, and are diagnosed with a condition called Erectile Dysfunction (ED). According to the Cleveland Clinic, as many as 52 percent of men experience erectile dysfunction. As a man, having this psychological or physiological condition can cause stress, relationship strain, and low self-confidence. Patients suffering from erectile dysfunction should first be evaluated for any underlying physical and psychological conditions. ED is a treatable condition, and there are several treatments available. The type of treatment generally depends on the underlying cause of ED. If you suffer from ED, it is important to talk to your doctor. Dr. Alvi at Urologic Surgeons of Arizona can help identify the underlying cause of your ED, and figure out the most appropriate treatment. Treatments for ED range from oral medication, penile implants, penile injections, and hormone therapy.
Erectile Dysfunction TreatmentOral Medications After a complete evaluation, Dr. Alvi may prescribe a customized regimen of oral medications that are extremely successful at treating erectile dysfunction for most men. All medications will enhance the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows a man to have an erection during sex. Penile Injection Therapy Several medications are commonly injected directly into the penis to achieve an erection. Dr. Alvi may prescribe custom medications that increase blood flow to the penis and cause strong erections. Dr. Alvi teaches patients to use a fine needle to inject the medications into the base or side of their penis. Injection therapies typically produce an erection that lasts about 20 to 40 minutes. Since it can be embarrassing to discuss ED, many men look for treatment options online. However, not all treatments are safe for all men. Disclaimer: Using home remedies might be dangerous, and you should not self-prescribe for ED. In addition, many of the treatments available on the Internet are scams. They may not help your ED, and could damage your health.
What is Benign Prostatic Hyperplasia?Benign Prostatic Hyperplasia (BPH) is the name for the condition that is given to men with an enlarged prostate . The prostate is located directly beneath the bladder and in front of the rectum. Since the upper portion of the urethra passes through the prostate, if the gland becomes enlarged, it can obstruct the passage of fluid through the urethra and result in a weak stream, excessive daytime or nighttime urination (nocturia), or a complete inability to urinate (retention). Dr. Alvi will use Rezūm, UroLift, and GreenLight Laser Therapy to treat men with BPH.
What is Male Urinary Incontinence?
As with women, there are different types of urinary incontinence , or unintentional loss of urine, in men, there are three different types of incontinence, called stress incontinence, urge incontinence, and overflow incontinence. Some men may have one or a combination of all three.
Stress incontinence is the uncontrollable loss of urine when pressure is exerted on the bladder, urge incontinence is the involuntary loss of urine followed by a sudden unstoppable urge to urinate, and overflow incontinence is characterized by constant dribbling of urine, accompanied by frequent, yet small urination.
Male Urinary Incontinence is most commonly caused due to prostate problems. There are multiple therapies that are tailored to treat different types of incontinence. While urge incontinence is generally medically managed, stress incontinence usually requires a surgical procedure (i.e. placement of a sling or artificial urethral sphincter) for treatment.
Male Urinary Incontinence Treatment
A sling is a device designed to support the muscles around the Urethra to its proper position for optimal function of the urinary sphincter, restoring urinary control. It is highly effective, minimally invasive procedure to correct mild to moderate incontinence.
Artificial Urinary Sphincter (AUS)
The Artificial Urinary Sphincter is placed inside the body to provide urinary control. The sphincter is closed unless the control pump, which is located inside the scrotal sac, is squeezed. This opens the sphincter cuff temporarily for a few minutes allowing urination. The cuff then closes automatically. It has proved to be highly effective in treating male incontinence following prostate surgery.