Is This Normal? 10 Common Penile “Flaws” You May Have

12 Nov 2018 Blog

Written by Dr. Andrew Siegel

A penis is a special organ—a man’s joy, if not pride—and certainly one of his most prized, appreciated and cherished possessions, to which he has a significant attachment. As multifunctional as a Swiss Army knife, it allows him to stand to urinate (an undervalued capability), rises and firms to the occasion to allow for sexual penetration, and ejaculates genetic material–the means to perpetuate the species. A marvel of hydraulic engineering, within nanoseconds of sexual stimulation it is uniquely capable of increasing its blood flow 50 times over baseline, transforming its shape and size. Penis magic!

Each and every penis is unique. As variable as snowflakes, they come in every size, shape, and color. Beyond “size matters”—often a source of male preoccupation—men are often obsessed, if not preoccupied, with the appearance of their genitals. In my interactions with patients, concerns are often voiced about symmetry, color, pigmentation, angulation, spots, blemishes, vein patterns, shrinkage, and other oddities. Unless you are in the habit of closely inspecting other men’s genitals (as urologists are), you are unlikely to realize how common and completely normal most of these genital variations are.

10 Common Penile “Flaws” You May Have That Are Actually Quite Normal

  1. Penis leans to one side. No human is perfectly symmetrical and the flaccid penis rarely hangs perfectly centered. Wherever your penis naturally lies when you are clothed—whether left or right—is not indicative of your political leaning or left vs. right-sided brain predominance and is of absolutely no significance or consequence whatsoever!Interesting trivia: “Throckmorton’s sign” is a term used jokingly by medical students, residents and attending physicians. A positive Throckmorton sign is when the penis points to the side of the body where the pathology is, e.g., if a man is getting surgery for a right groin hernia and the penis points to the right side. The Throckmorton sign indicates the proper side of the pathology at least 50% of the time! Operating room humor!
  2. Slight penile curvature when erect. Again, although perfect symmetry may be desirable, the norm for the erect penis is not to be perfectly straight. There is often a subtle bend to the left, right, up or down. Some men have a penis that has a banana-like curvature. Slight bends—considered totally normal—are to be distinguished from Peyronie’s disease, a condition in which there is significant angulation due to scarring of the sheaths of the erectile chambers. It is a potentially serious condition that can cause painful erections and erectile dysfunction.
  3. One testicle hangs lower. If you ever wondered why one of your testes is slightly bigger or heavier and hangs lower than the testes on the other side, you are in good company. Paralleling women with breast asymmetry, the vast majority of men have testes asymmetry, so your mismatched gonads are perfectly normal.
  4. Dark genital skin. Hyperpigmentation (darkening) of the median raphe (the line running from anus to perineum to scrotum to undersurface of the penis) and other areas of the penis is extremely common. In fact, it is normal for the penile skin color to be darker than other areas of the body, because of the effect of sex hormones on the cells that produce pigment (melanocytes). The circumcision line, as well, is often deeply pigmented
  5. Freckles, moles and skin tags. The penis is covered by skin–just like the rest of the body–and is therefore subject to common benign skin growths, including moles, freckles and skin tags. These are generally harmless and usually, do not require any treatment unless desired for cosmetic reasons. However, if you have a growth that changes in size, color or texture, you should have it checked out because penile cancers do occur on occasion. Skin tags are small fleshy protuberances and can be confused with genital warts, so if you have any doubt, get checked.
  6. Other penis and scrotal bumps and lumps. Pearly penile papules are raised “pearly” bumps that appear around the corona (the base of the head of the penis). They consist of one or more rows of small, fleshy, yellow-pink or transparent, smooth bumps surrounding the penile head. They are benign and do not cause harm, but sometimes are treated for cosmetic reasons, usually with freezing or lasering. Sebaceous glands produce oil that nourishes the hair follicles of the genitals. These glands appear as numerous small yellowish bumps on the scrotum and penile base. In some men, they are prominent and referred to as sebaceous gland hyperplasia. At times, they can exist without a hair follicle even being present. Regardless, they are a normal occurrence.
  7. Scattered scrotal spots. Angiokeratomas are benign purplish skin growths with a scaly surface that are not uncommonly present on the scrotum. They consist of dilated thin-walled blood vessels with overlying skin thickening. These skin lesions can occasionally bleed and also cause fear and anxiety since they can resemble more serious problems such as melanoma. If in any doubt, get it checked out.
  8. Veiny vanity. Every man has a unique penile venous pattern, the anatomy as unpredictable as the distinctive venous anatomy of the hand and wrist. In some men, the veins are twisted and prominent and in other men, they are barely noticeable. No matter what the pattern, venous anatomy is highly variable and individualized and is normal.
  9. Loose skin. Unlike most other skin on the body that is more tightly attached, penile skin is loosely attached to underlying tissues, allowing for expansion with erections. Since the physical state of the penis can vary from totally flaccid to totally rigid, when the penis is fully deflated, the skin may appear to be somewhat floppy and redundant, which is absolutely normal. Scrotal skin often becomes increasing lax with the aging process, such that the testicles typically hang quite low in the elderly male, paralleling the common situation of pendulous breasts of the elderly female.
  10. Shrinkage. Penile size in an individual is quite variable, based upon penile blood flow. The more blood flow, the more tumescence (swelling); the less blood flow, the less tumescence. “Shrinkage” can be provoked by exposure to cold (weather or water), the state of being anxious or nervous, and participation in sports. The mechanism in all cases involves temporarily reduced blood circulation. Don’t worry, that sorry and spent looking penis can magically be revived with some TLC!

Bottom line: If you have an imperfect penis…welcome to the club! No penis or scrotum is perfect. Far from being an object of beauty, genital imperfections are the norm, so there is no need for feeling self-conscious. Just be happy that your little “fella” can function properly and enjoy his own happiness from time to time! Function over form!

Should You Be Screened for Prostate Cancer?

5 Nov 2018 Blog

According to the American Cancer Society, about 1 man in 9 will be diagnosed with prostate cancer during his lifetime. Other than skin cancer, prostate cancer is the most common cancer in American men.

It’s recommended that beginning at age 40 (depending on risk level), men should have a discussion with their health care provider about prostate cancer screening. It’s up to each individual to make an informed decision carefully considering the uncertainties, risks, and potential benefits of screening.

Benefits of Prostate Cancer Screening

Although screening is an individual decision, there are potential benefits to getting screened for prostate cancer:

  • The 5-year relative survival rate of prostate cancer is nearly 100%. 15-year is about 95%. This means that the survival rate is very high, it just needs to be detected first and early on.
  • Since the recent push to prevent prostate cancer, tests have become more diverse and more accurate. While they still aren’t 100% accurate, they can provide good insight to your urologist on whether further testing or other actions need to be taken.

What are the Screening Options for Prostate Cancer?

There are a couple options for prostate cancer screening, including:

  • Prostate Specific Antigen (PSA) – This blood test measures how much PSA is in a man’s blood.
  • Digital Rectal Exam (DRE) – Your doctor will insert a gloved, lubricated finger into the rectum to feel the prostate gland. They will assess if the shape, size and texture and feel normal.

Early detection can save lives. Visit our locations page to make an appointment with one of our urology specialists to decide if prostate cancer screening is right for you.

5 Diet Changes That May Reduce the Risk of Kidney Stones

22 Oct 2018 Blog

Urine consists of many dissolved minerals and salts. When there are high levels of minerals and salts in the urine, stones may form in the kidneys. Kidney stones may not cause any symptoms until they move around within the kidney or pass into the ureter (the tube that connects the kidney and the bladder).

While kidney stones are usually are a minor problem and pass on their own, they can cause severe pain. Medication is an option to improve the chance of passing a stone and offer pain relief. Surgery may be necessary for stones that affect kidney function, do not pass on their own, or cause severe pain that can’t be managed with medication.

Although there is no one-size-fits-all diet for preventing kidney stones, there are changes you can make to your diet that will reduce your risk of developing new stones.

  1. Stay Hydrated. Adults should drink about 2 liters of liquid daily (eight 8-ounce glasses). Remember to replace liquids that are sweat out (through exercise or hot weather) in addition to the daily recommended intake. Stick to mainly water and no-calorie or low-calorie beverages.
  2. Reduce Sodium Intake. Avoid salty foods that have a lot of sodium (the C.D.C. recommends staying under 2,300 mg per day). The following foods are high in salt and should be eaten in moderation:
    1. Cheese
    2. Frozen foods and meats
    3. Canned soups and vegetables
    4. Bread (bagels, rolls, baked goods)
    5. Salty snacks
    6. Read the full list here
  3. Eat the Recommended Amount of Calcium. If you take daily supplements, make sure you aren’t getting too much calcium. Eating calcium-rich foods and beverages daily is recommended, and you can usually get enough daily calcium without supplements.
  4. Eat More Fruits and Vegetables. At least five servings of fruits and vegetables daily are recommended (especially those who form kidney stones). Fruits and vegetables provide potassium, fiber, magnesium, antioxidants, phytate, and citrate, which may keep stones from forming. One serving equals one piece of fresh fruit or one cup of raw vegetables. Learn more here.
  5. Eat Less Meat. Animal protein (including meat, fish, poultry, pork) can raise your levels of uric acid, which can cause stones to form. Your healthcare provider may recommend limiting the amount of meat you eat on a daily or weekly basis and recommend eating more plant-based protein options.

Visit our locations page to make an appointment with one of our urology specialists.

Vasectomy – Myth or Fact?

15 Oct 2018 Blog

Because it is a permanent form of birth control, many men have questions or concerns before having a vasectomy. This is normal and to be expected.

To help you on your journey, our physicians are de-bunking these common vasectomy myths:

Myth: Vasectomy is a risky surgery.

Truth: Although vasectomies are a safe and effective surgery, all surgeries have risks. After a vasectomy procedure, mild discomfort, bruising, and swelling is normal. Most men recover within one to two weeks.

Myth: Vasectomy can always be reversed.

Truth: While many men are good candidates for a vasectomy reversal procedure, only about half of these procedures are successful. The tube that the sperm passes through, called the vas deferens, is reconnected during a vasectomy reversal. It is a more complicated surgery because there are different ways to reconnect the vas deferens. Because there is no guarantee that a vasectomy reversal will be successful, it is important to be sure that you want to get a vasectomy in the first place.

Myth: You’ll lose sexual function.

Truth: A vasectomy does not hinder your sex life as the production of testosterone is not affected. The procedure blocks sperm but does not reduce the amount of semen produced, so there is no noticeable difference when you ejaculate.

Myth: Vasectomy is 100% effective right away.

Truth: It can take two to three months following a vasectomy to ensure there is no live sperm. A backup form of birth control should be used during this time. After a year, only 15-20 out of 10,000 couples experience a pregnancy.

Have other questions about vasectomies and vasectomy reversals?

If you have questions about getting a vasectomy, contact your local NJU office to schedule a consultation with a urology specialist.

Dr. Scott Asroff Named Best of Burlington County 2018

2 Oct 2018 News

We’re pleased to announce that Scott W. Asroff, MDhas been named a 2018 Best of Burlington County winner by the Burlington County Times.

Honored as an Industry Leader, Dr. Asroff was named “Best Of” in Urology for 2018.  Read the complete list >

The Best of Burlington County is a list, compiled annually, of readers’ favorite businesses, products, and services in the community. More than 130,000 reader votes were cast in 2018.

Dr. Asroff practices general urology, with special interest in male reproductive health, stone disease, and urologic cancers. He practices in BordentownMount Laurel and Willingboro.

To make an appointment, please call 877-388-2778.

J.W. Childs Associates Forms Urology Management Associates with New Jersey Urology

5 Sep 2018 News

New Jersey Urology (NJU), the leading urology service provider in New Jersey, and J.W. Childs Associates (JWC), a leading middle-market private equity firm, have formed Urology Management Associates (UMA) that will provide administrative services to NJU. The establishment of UMA enables NJU to continue to focus on providing world-class urology services while remaining a physician-led organization. UMA plans to partner with additional urology groups to provide administrative practice management services initially in the greater New York metropolitan area with long-range plans to expand nationally.

Recognizing the benefits of scale, NJU recently merged with Delaware Valley Urology (DVU) to become the leading provider of urology services in New Jersey and the largest single-specialty urology group in the U.S. NJU provides complete urologic care and comprehensive individualized treatment for its patients, including men’s health, women’s health and cancer care.

Dr. Lewis Gold and Dr. Mitchell Eisenberg, operating partners at JWC and former President and CEO of Sheridan Healthcare, respectively, will join the board of UMA along with Adam Suttin, Managing Partner, David Fiorentino, Partner and Jeff Miller, Principal. Dr. Gold commented, “We are very excited to collaborate with NJU to continue to develop and expand a best-in-class urology practice management organization.”

Dr. Martin Goldstein, who was appointed President of NJU and Senior Vice President of Corporate Development and Acquisitions of UMA said, “We look forward to working with J.W. Childs Associates on expanding business opportunities for UMA while maintaining NJU’s medical practice independence. JWC’s expertise in managing large-scale practices and UMA’s ability to handle the significant administrative burden of NJU’s non-clinical operations will enable NJU and its physicians to continue to focus on high-quality clinical care to meet the demands of our patients.” Victor Houtz who has been the COO of NJU since 2009 has been named COO at UMA.

The Bloom Organization negotiated on behalf of the NJU and DVU physicians. Mr. Henry Bloom, the founder of The Bloom Organization, said, “Forming UMA shortly after the consummation of the NJU and DVU merger took an incredible effort from all parties and I commend everyone involved. I have represented physicians for the last 30 years and I believe that the growth potential for physician services is better now than I have ever seen. We found a great partner in JWC and its operating executives. I am excited to see this organization execute on its growth strategy in the coming years.”

J.W. Childs Associates is a Boston-based private equity firm focused on investing in middle-market growth companies. Since inception in 1995, JWC has invested $3.7 billion of equity capital in 50 companies across the healthcare, consumer, and specialty retail/e-commerce industries. The firm’s success has been built on its industry focus and the extensive operating expertise of its partners.

The Bloom Organization advised NJU on the transaction with DLA Piper LLP serving as its legal counsel. McDermott Will & Emery LLP advised J.W. Childs.

Join NJU for a ZERO Prostate Cancer Run/Walk this Fall

22 Aug 2018 News

New Jersey Urology is proud to present South Jersey’s ZERO Prostate Cancer Run/Walk to help end prostate cancer.

When: Sunday, November 4th | 9 a.m.
Where: Valenzano Winery (1090 Route 206, Shamong, NJ 08088)

The 2018 ZERO Prostate Cancer Run/Walk – South Jersey features a 5K run/walk, 1-mile walk, Kids’ Superhero Dash for Dad, and virtual Snooze for Dudes program. Stick around for the family-friendly post-race celebration. Run/walk participants will receive shirts, free food and prizes, and the opportunity to connect with others who are impacted by prostate cancer. 5K and 1 Mile participants 21 and over (must show valid id) will receive a free wine glass and wine on race day.

The funds raised from 2018 ZERO Prostate Cancer Run/Walk – South Jersey are invested around the country to provide research for new prostate cancer treatments, free prostate cancer testing, and education for men and families about prostate cancer. No other prostate cancer charity spends more per dollar on programs – more than 85 cents. ZERO puts every donation to good use.

REGISTER HERE

NJU Physicians Selected as South Jersey Magazine 2018 Top Physicians

10 Aug 2018 News

We’re proud to announce that two New Jersey Urology (formerly Delaware Valley Urology) physicians have been honored as South Jersey Magazine 2018 Top Physicians. These physicians were chosen by South Jersey Magazine readers, who were asked to nominate doctors who made a lasting impact. South Jersey Magazine also asked area hospitals and medical providers to nominate a select group of doctors they feel are worthy of the spotlight because of their dedication to their patients and their commitment to advancing health care in South Jersey.

South Jersey Magazine 2018 Top Physicians:

Read South Jersey Magazine’s complete list here >

Dr. Brian E. Weiss Joins New Jersey Urology

1 Aug 2018 News

We’re pleased to announce Brian E. Weiss, MD has joined our team in South Jersey.

Dr. Weiss has an undergraduate degree from the Wharton School at the University of Pennsylvania. He spent several years working in finance and biotechnology prior to entering medical school.

After receiving his medical degree from the Perelman School of Medicine at the University of Pennsylvania, he completed a surgical internship and urologic surgical residency at New York University Langone Medical Center in New York City. He complemented his training with a fellowship in Endourology, Laparoscopy and Robotic Surgery at Urology of Virginia/Eastern Virginia Medical School in Virginia Beach.

Dr. Weiss has a special interest in endourology, stone disease, and urologic oncology. He will practice in our Marlton and Mount Laurel offices.

To make an appointment, please call 877-388-2778.

5 Fascinating Myths About Robotic Surgery, Debunked

12 Jul 2018 Blog

With the robotic-assisted surgery arena growing bigger by the day—and commanded solely by the company behind da Vinci® robots—it’s no wonder that people may be becoming concerned about where the doctor ends and the machine begins (or simply fear robots will replace human beings altogether). In fact, these robots can be used in a variety of procedures—including urological, colorectal, cardiac, gynecological and thoracic surgeries. For urologists, the da Vinci robot is most commonly used to perform surgery for prostate cancer, as well as:

  • Bladder surgery
  • Kidney surgery
  • Urinary obstruction surgery
  • Uterine and vaginal vault prolapse surgery

We’re here to cast a better light on this misunderstood and life-changing surgical technique by dispelling some well-circulated myths and give you peace of mind when discussing your surgical options.

Myth #1: The robot performs the surgery and the surgeon is hands-off.

Fact: Though the word robot may imply autonomy, the robot serves as nothing more than a tool—not a replacement—for a surgeon.

During a robotic-assisted surgery, the surgeon is stationed at a console and manipulates the arms of the robot using hand and foot controls. When the surgeon stops, so does the robot; the robot is not simply handed instructions and then let loose on your insides.

Myth #2: Robots replace the hands of surgeons, so clearance of cancer may not be as likely.

Fact: The whole point of robotic-assisted surgery is that the robot is able to make precise movements in a way that human hands simply are not capable of. Additionally, the robots are equipped with cameras that offer 3D definition vision that surpasses the abilities of the naked eye. These heightened abilities of the camera allow the surgeon to get a sense of the hardness and texture of organs in the body, which means tactile sensation is neither needed nor missed.

Myth #3: The robot can malfunction during my surgery and put my life at risk.

Fact: The robot goes through a thorough check and maintenance exam prior to every procedure. If anything is suspected to be wrong, the robot will not be used. Additionally, the robot is built with multiple safety features that prevent any malfunction from occurring when it’s in use; the arms will lock in place or gently hover, but cannot be forced in any direction.

Myth #4: Robotic surgery has no clear advantages over any other type of surgery.

Fact: Like other laparoscopic procedures, robotic-assisted surgery offers distinct advantages over open surgery, including:

  • A shorter hospital stay and recovery time
  • Less blood loss during the procedure
  • Less risk of complications during and after surgery
  • Lower risk of infection

Coupled with that, a recent small controlled study revealed that compared to flouro-guided surgery, there was a 78 percent decrease in radiation exposure.

Myth #5: Any surgeon can perform robotic-assisted surgery.

Fact: Like any specialized skill, it takes a foundation of training and experience to execute a technique. Remember, it is the surgeon behind the machine who is ultimately performing the surgery. The robot is simply a tool, a means to an end to achieve the best possible outcome.

Robotic-assisted surgery requires a whole different set of proficiencies compared to open surgery or other laparoscopic techniques; many surgeons are still not yet trained to master the nuances of this device. At New Jersey Urology (NJU), we are proud to employ surgeons who have extensive experience in performing procedures using this advanced technology.

Don’t let technophobia get the better of you. If your urologic condition requires surgical intervention, schedule a consultation with the robotic surgery specialists at NJU today to discuss your options.

1 2 3 4 5 6

Search

+