Dr. David H. Ewalt, MD

Hydroceles are typically painless, and surgical repair or removal, called hydrocelectomy, is only necessary if they continue to grow. In a hydrocelectomy, the surgeon makes an incision in or near the scrotum and uses suction to drain the fluid. The sac that contained the fluid may be cut and removed as well, or it may be stitched onto the back of the testis and epididymis, before the incision is closed.

This procedure may be done at an outpatient facility, so a hospital stay is usually not required. Normal activities can be resumed a few days following surgery, but exercise and other strenuous activities should be avoided for about two to four weeks.

Spinal cord injury medicine seeks to stabilize the spine and to alleviate the symptoms of spine damage. Practitioners of spinal cord injury medicine are called spinal cord injury specialists. Spinal cord injury medicine is an interdisciplinary field, meaning physicians of various specialties may be trained to treat spinal cord injuries.

Damage to the spinal cord may initially be diagnosed through X-ray, MRI, or CT scans. Patients can also undergo spinal exams to evaluate their sensory ability and strength. Injuries to the spinal cord can be complete (no feeling or sensation) or incomplete (some feeling or sensation remains). Conditions spinal cord injury medicine specialists may treat include:

• Paralysis, such as paraplegia (loss of function in the legs), or quadriplegia (loss of function from the neck down)
• Spine fracture or trauma, which can lead to impairment and/or significant pain
• Spinal infections
• Myelopathies, such as herniated disks, spinal tumors, and rheumatoid arthritis
• Inflammatory diseases such as ankylosing spondylosis, and degenerative conditions like Lou Gehrig's disease (ALS)

Treatment for spinal cord injuries often involves surgery, either directly after an injury occurs or at a later date. Surgery for spine injuries is intended to ease spinal compression and stabilize the spine. Surgical procedures can involve shifting vertebrae, removing bone, or altering spinal placement with implantable devices. Patients with significant spinal trauma may require urgent surgical intervention.

Surgical treatments can be complemented by rehabilitative physical therapy to improve mobility. Spinal cord injury specialists also treat complications arising from a spinal injury, such as respiratory or bladder conditions. Some patients with spinal cord injuries may require lifelong treatment. Spinal cord injury specialists aim to help these patients successfully adjust and lead an improved quality of life. An emerging treatment for spinal cord injuries is neural prosthetics, which replicate patients' lost nerve function. Neural prostheses may be used as artificial body parts or assistive devices that patients may cognitively control. Other assistive devices include wheelchairs and scooters.

Spinal cord injury specialists may collaborate with physical therapists, radiologists, neurologists, urologists, and orthopedists.

Urinary tract infections are extremely common: 12% of all men and 40-50% of all women will have a urinary tract infection during their lifetime. They are more common in women because women have shorter urethras, so bacteria have a shorter distance to travel from the outside of the body to the bladder and cause an infection. Some people also have urethras that are an unusual shape or have an obstruction in the urethra that makes getting a UTI more likely. Also, certain chronic illnesses like diabetes weaken the immune system, so any bacteria in the body are more likely to cause an infection.

A urinary tract infection can be diagnosed very quickly by a doctor. A sample of urine can be examined under a microscope for the presence of bacteria or white blood cells. There are also diagnostic strips that can be used to test a urine sample without the need for a microscope. Once a diagnosis is made, treatment is a course of oral antibiotics, and most patients feel better within just a few days. There are some things that patients can do themselves to help reduce the risk of getting a urinary tract infection in the future. Stay well hydrated, wipe from front to back after going to the bathroom, wear breathable cotton undergarments, and don't hold it in when patients feel the urge to go.