Care Through and Through
Below you will find some of the most commonly asked questions about urological symptoms, infertility, and more.
Frequently Asked Questions
[Children #1] My child is in elementary school but is still wetting the bed. Should I be worried?
Bed wetting (nocturnal enuresis) is involuntary urination while asleep. It can be indicative of a medical issue when it occurs past the age when bladder control usually begins. More precisely, it is unusual when a person who is 5 years of age or older wets the bed more than once a month and this continues for 4 months. One factor that causes nocturnal enuresis is emotional stress. Doctors used to prescribe anti-depressants to treat this kind of stress, but enuresis can now be treated with other medications. However, in rare cases, the cause may be vesicoureteral reflux disease: a disease in which urine regurgitates into the kidney. You may want to seek medical advice if your child is past the age of 5 but still wetting the bed frequently, but in most cases it is not a problem.
[Children #2] My child suddenly has frequent urination. What is the cause?
Children go through a sensitive period and may have frequent urination due to small ’stressful’ problems at home or at school. In most cases, there is no need to worry much and you can just keep an eye on it, but if the issue persists and is particularly bothersome, please consult a doctor.
[Children #3] The tip of my son’s penis is red and swollen, and a little pus appears. Is treatment needed?
Yes, this condition seems to be glans prepuce and requires an antibiotic. Furthermore, intensified inflammation can cause pain and result in adhesion of the foreskin to the glans.
[Children #4] Suddenly, my son has pain in his testicles. What might be the cause?
There may be torsion of the testicle. Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that carries blood to the scrotum. The decreased blood flow can cause sudden and severe pain as well as swelling. If not fixed within 6 hours, an infarction will result (local death of the tissues due to cut-off blood supply) and surgery will be needed. Because of this tight time constraint, most children have surgery after a testicular torsion. In rare cases, testicular volvulus occurs, in which the testicle does not become an infarction, but the pain is the same and the appearance is indistinguishable, so it is still necessary to see a specialist. If treatment is delayed for too long, infertility may occur after adulthood.
[Children #5] One side of my son’s scrotum is swollen. What should I do?
Causes include varicocele, scrotal edema, inguinal hernia, and a testicular tumor. Varicocele may be painful. Also, testicular development may be delayed. If there is a difference in the growth of the testicles or if there is pain, surgery is suggested. Microscopic low-level ligation, which does not sacrifice testicular arterial blood flow, is strongly recommended in terms of testicular growth. Unlike adults, most scrotum edema disappears spontaneously, so it is okay to just observe what happens. The frequency of testicular tumors has an initial peak in infancy and a second peak in puberty. Most testicular tumors from kindergarten to school age are benign tumors, and in many cases surgery to preserve the testicles and remove only the tumor is fine. Eventually a diagnosis by a specialist will be required.
[Females #1] There is pain when urinating, frequent urination, and after urinating I feel like I need to urinate again. Should I be concerned?
It is likely acute cystitis so you need to consult the doctor and take antibiotics.
[Females #2] I do not feel relieved after urination. I go to the toilet many times. Is it abnormal?
It is probably cystitis but there are instances that a urine test result may be normal. Please contact a physician to run further laboratory tests.
[Females #3] I have no symptoms, but urinalysis always points out pyuria (white blood cells in the urine). Should I be treated?
Chronic cystitis might be a possible finding. However, if the underlying disease is clear and a physician has not diagnosed you with bladder cancer or bladder stones, no special treatment is necessary.
[Females #4] I have vaginal bleeding or spotting or unusual discharges (smelly, pus or cheese like).
Discharges or spotting for women are usually normal but there are rare cases of urethral cancer. Please see a doctor to confirm via medical examination.
[Females #5] There is a urine leak or uncontrolled bladder and a pad is essential to keep the underwear clean. Is it unavoidable because of my age?
If urine leaks out when you sneeze or carry heavy objects, it is stress urinary incontinence, which happens more often in women who have given birth. The likelihood and severity of it may also increase with age. On the other hand, if urine leaks out without feeling the urge to urinate, it may be urinary incontinence . It is also possible to have a mixture both types, but each type requires different medication. Currently, there are quite a lot of good medicines, so please come in for a consultation.
[Females #6] I have intermittent-like urination and weakness during urination. Is this a problem?
The cause may be abnormal urinary function. It may put a strain on your kidneys, so please consult a doctor. Oftentimes, the problem is solved with medication.
[Penis #1] The entire circumference of the skin on the tip of the penis is swollen. Is this all right?
A possible consequence is phimosis (a condition where the foreskin is too tight to be pulled back over the head of the penis). If the swelling is severe, the skin may be cut, or if it is incarcerated (it cannot return to its original state), it may be necrotic (the tissue may rot). If it’s mild, you can recover soon and the swelling will go down on its own, so you don’t have to see a doctor. However, if it persists or worsens, see a doctor as soon as possible.
[Penis #2] There is a small, white lump on my penis. Is it okay to leave it as it is?
If the number and size of the lumps do not change for many years, it is neither an infectious disease nor a neoplasm (tumor), so you can leave it alone. However, if it gets bigger or the number increases, it may be due to condyloma (a viral infection) and you’ll need to consult a doctor.
[Penis #3] I have a white pus-like substance on the tip of my penis. What should I do?
If you are uncircumcised, the foreskin covers the tip of the penis. When you take a bath, gently peel back the foreskin (skin surrounding the glans penis) and wash with mild body soap. Rinse gently with lukewarm water. If you flip the foreskin back, be sure to put it back in place. Never overdo it if you have pain, redness and inflammation. If the condition persists despite regular and careful washing, it may be a symptom of something more serious.
[Penis #4] The tip of my penis is red and swollen. Should I go to the hospital?
Bacterial infection might be a possible cause, so please see a doctor.
[Penis #5] I am uncircumcised and the tip of my penis has begun to swell underneath the foreskin. Is this all right?
You may have phimosis. In some cases, swelling may not go down by itself and the condition can be solved via surgery (circumcision). There is cause for concern if the swelling is painful and the foreskin is difficult or impossible to pull back. If this condition remains for many years, one may develop a urination disorder, which may later lead to bladder and kidney problems.
[Penis #6] There is blood and discharge that lets off a foul odor. Should I be concerned?
Since one of the possible causes is penile cancer, please see a doctor.
[Penis #7] There is a considerable lump on my penis. Could it be a disease?
Yes, it might be Peyronie’s disease: a benign condition that can be caused by thickening of tissues called plaque that forms inside the penis. It can result in a bent or curved penis which can cause pain during an erection. It can lead to sexual dysfunction and may require treatment. Most times this can be relieved with oral medication, but local injection may be necessary. If it still does not improve, surgery may be needed.
[Penis #8] There is an ulcer (open, painful wound) around my penis. I’m afraid it may be a sexually transmitted infection. Should I be worried?
If you have had sexual contact, you may have been infected with syphilis. Furthermore, syphilis has been on the rise in the Tohoku region so please be careful. Finally, please also be aware that syphilis may progress even if the initial lesion has disappeared. We recommend having a medical examination and STD (sexually transmitted disease) test.
[Penis #9] Multiple blisters have appeared on the skin near my penis, causing pain. Is it a sexually transmitted infection?
A herpes infection may be suspected. The virus can lead to illness due to weakened physical strength and a compromised immunity system. The blisters may also form ulcers. Treatment is a must.
[Semen #1] I have blood mixed in with my semen. Should I be worried?
In many cases, this is of little pathological significance and does not signify a problem. However, a medical examination is recommended because it may be caused by a disease of the prostate or sperm.
[Semen #2] The amount of ejaculated semen is decreasing. What is the reason for this?
The most common cause is retrograde ejaculation wherein the semen enters the bladder instead of going out of the penis during orgasm. It may occur after prostate surgery or as a side effect of medication, and in these cases it is nothing to worry about. However, it may also be a symptom of neurological disorder or diabetes. If you have noticed that your throat often tends to be dry and your water intake has increased, you may have diabetes. Be careful if you have a history of diabetes in your family.
[Semen #3] I have a lot of jelly-like semen. Is it abnormal?
In most cases, this not a serious health problem, but it can become a concern when attempting to have children. If semen does not liquefy into a smooth liquid, it may have trouble traveling to the egg. It is recommended that a semen test be performed to check for abnormal sperm count and movement.
[Semen #4] My semen seems to be yellow and cloudy. Is there something wrong?
Semen is composed of sperm and seminal plasma, which contains various proteins. The color tone itself is not a health problem. However, there may be sperm gene damage from a related cause. Recent research suggests that white blood cells can produce a substance called cytokines which can cause genetic damage to sperm. Why would there be enough cytokines to cause damage? If you have a genital infection, especially a purulent one (in which a pus-like substance is produced), the white blood cell count may sharply increase and become mixed into the semen. Therefore, it is a good idea to seek medical advice if you are trying to conceive a baby.
[Testes & Scrotum #1] Capillaries on the scrotum’s skin are dotted in places, and my pants get bloody. What should I do?
The aging of the scrotum’s capillaries can lead to such spotting. It often stops naturally, so you can just keep observing it if this phenomenon is recent. If it persists or you want to stop the bleeding quickly, consult a doctor.
[Testes & Scrotum #2] The skin on my scrotum is itchy and bleeds if I scratch it. What should I do?
Are there small insects or eggs on the skin? In that case, it is pubic lice (also called crabs), so please see a doctor. Other causes may be dry skin or allergies. If you have persistent itchiness, it is recommended to see a doctor.
[Testes & Scrotum #3] My scrotum seems swollen. Is that okay?
Swelling of the scrotum may be caused by varicocele, inguinal hernia, hydrocele, or testicular tumors. If when you are standing the left scrotum is swollen, you probably have a varicocele. It is recommended to be medically examined.
[Testes & Scrotum #4] My testicles feel heavy. Is it abnormal?
If symptoms appear when standing and it is always on the left side, you may have a varicocele. Chronic prostatitis is also a possibility if symptoms appear on both sides. If, when sitting for a long time or when riding a bike, the discomfort spreads from the testes to the perineum (area between the anus and the genitals), this may also be a sign of prostatitis.
[Testes & Scrotum #5] My testicles are painfully swollen and there is a ‘rubbing-like sensation’ when I walk. Should I see a doctor?
There is a high possibility of epididymitis. Please see a doctor immediately.
[Testes & Scrotum #6] There is a lump on my scrotum. What is it?
In most cases it is a benign lesion, but in rare cases it may be a testicular tumor. It is necessary to have an ultrasound examination by a specialist. If the semen lump is large and annoying, a doctor may use a fine needle to relieve it. In most cases, the storage of many dead sperm may be the cause of the lump. If lumps continue to form even after using the needle technique, the cause of the lump can be surgically removed.
[Testes & Scrotum #7] My testicles are hard and slightly more swollen than before. It doesn’t hurt, so is it okay to ignore it?
Absolutely do not ignore it, as it may be a testicular tumor. See a urologist immediately. Testicular tumors have been increasing in recent years. Additionally, they are among the most common solid tumors in the early years of life. Misplaced shame on the part of the patient often delays the start of treatment and the tumor progresses in stage.
[Urination #1] I get up many times in the middle of the night to pee. Is it because of my age?
Yes, it is common with aging that nocturia, the frequency of wanting to urinate in the night, increases. Antidiuretic hormone (ADH) inhibits the production of urine. The amount of antidiuretic hormone secreted becomes less and less as persons get older. The decrease of ADH leads to more frequent nocturia. However, in rare cases, there may be an abnormality in the hormone. You can minimize nocturia by not drinking water before going to bed. Although some doctors used to recommend water intake before bedtime for the prevention of cerebral infarction (stroke), it has since been concluded that water intake before bedtime is not effective in preventing cerebral infarction. Therefore, it is safe to refrain from drinking water before going to bed.
[Urination #2] It is difficult to urinate even though I have the urge. What should I do?
If you have a strong urge to urinate but it is difficult or you are unable to urinate, then you may have acute cystitis, urethritis, or kidney problems. It is necessary to see a doctor as soon as possible. We advise extra caution for elderly men, alcohol drinkers, persons who have urinary retention (incomplete emptying), and persons who are taking medication.
[Urination #3] Barely any urine comes out and it is not painful. Is it abnormal?
A possible cause of this is anuria, a condition wherein urine is no longer produced. It is an emergency that can progress to uremia. Furthermore, delayed treatment can lead to chronic renal (kidney) failure and may require dialysis (purification of the blood using a machine). The cause may be dehydration, heart failure, or overuse of painkillers.
[Urination #4] Is there a way to increase the amount of urine without relying on diuretic drugs?
Cucumber-based crops (members of the plant family cucurbitaceae) such as cucumber, melon, and watermelon likely have a diuretic effect. Coffee and tea containing caffeine also have a diuretic effect. These can increase the production of urine.
[Urination #5] I had blood in my urine and it was not painful. Should I be worried?
If you had blood in your urine and did not experience any pain, and perhaps the symptoms suddenly disappeared, it is certainly a cause for concern. These symptoms are called asymptomatic gross hematuria. The main causes are urothelial cancers such as bladder cancer, ureteral cancer and renal pelvis cancer. See a urologist immediately.
[Urination #6] I have bubbles in my urine. Is this serious?
In most cases of having air bubbles that pass in the urine (pneumaturia) you do not have to worry too much about it. However, you should be careful if you have diabetes. Especially people with diabetes may have develop these symptoms in relation to anaerobic bacteria that dislike oxygen, and those bacteria can cause emphysematous cystitis: an infection of the bladder wall. Furthermore, take note if there is an accompanying fever, chills, or lower back pain, which, exceedingly in conjunction with diabetes, can lead to life-threatening sepsis due to emphysematous pyelonephritis (a severe infection of a part of the kidney). If you experience these additional symptoms, you should immediately see a urologist with an inpatient facility (e.g a large hospital that accommodates patients overnight and that has a urologist).
[Urination #7] Why is my urine milky?
It’s a medical condition called chyluria: when there is chyle in the urine, which results in the urine appearing milky white. Chyle is comprised of large quantities of dietary lipids, proteins, and fat-soluble vitamins. Chyluria happens when the lymphatic and urinary systems do not communicate normally. You should seek treatment if you are experiencing chyluria as it is an indication of abnormality in the body; it may be caused by something quite serious such as a parasitic infection. Even on its own, chronic chyluria can lead to malnutrition and fat-soluble vitamin deficiency.
[Urination #8] I have dark-colored urine in the morning. Do I have to worry?
There is a slight chance that a liver or kidney disorder, even kidney failure, is causing the dark color. However, most causes of darker urine in the morning are not serious reasons for concern. When sleeping, your body secretes a urine-concentrating hormone (antidiuretic hormone), resulting in darker-colored urine. This is also why urinary calculi (solid particles in the urinary system) are more likely to form during sleep. To avoid complications, we recommend that you do not consume foods and drinks high in oxalic acid for dinner; foods such as beans, beer, beets, berries, chocolate, coffee, cranberries, and dark green vegetables like spinach. Furthermore, if you have not made any significant changes in your diet recently, nor changed your usual amount of water intake, and your urine is suddenly much darker than usual, you may want to seek medical counsel.
What kind of medical insurance can I use at the Kanto Clinic?
We readily accept National Japanese health insurance and Japanese employee’s health insurance.
We always do our best to accommodate any kind of health insurance that you may have. However, the applicability of private or travel health insurance depends on the conditions set by your insurance provider. So, please contact your insurance provider first if you are unsure about your coverage.
We also accept patients without health insurance, but please keep in mind that your out-of-pocket cost may be high, depending on the treatment and services that you receive.
If you cannot find the desired information, or are worried about your condition, please feel free to come in for a consultation.
Peace of mind leads to greater health.