Dr Juan Arocena García-Tapia is a prestigious specialist in Urology and an expert in urological cancer: prostate, kidney, bladder and testicular. He has more than 15 years of experience working in hospitals across Spain and is currently Head of the Urology Service at Xanit in Marbella and the Urology Service at the Costa del Sol Hospital. Dr Arocena graduated with a doctorate in Medicine from the University of Navarra and has been presented with several awards for his outstanding academic career, such as the Spanish Urological Record Prize to the best annual publication.
What is urology?
Urology is the medical-surgical specialty that focuses on the study, diagnosis and treatment of pathologies affecting the urinary tract, adrenal glands and retroperitoneum of both sexes and the male reproductive tract.
What conditions can a urologist help with?
You may need to see a urologist for many reasons. Patients may be referred to a urologist if they may need treatment for a condition relating to bladder, urethra, ureters, kidneys, and adrenal glands. With regards to men, urologists treat disorders related to the epididymis, penis, prostate, seminal vesicles, and the testes.
Some common disorders that are treated by urologists include the following:
- Recurrent urinary tract infections
- Urinary incontinence; overactive bladder
- Interstitial cystitis
- Enlarged prostate
- Kidney stones
- Male and female infertility
- Sexual dysfunction (male or female)
- Cancers throughout the urinary tract (such as kidney, bladder, prostate, penile, and testicular cancers)
Dr Arocena will offer services for prostate cancer screening and prostate-specific antigen checks. Andrology services with sexual and erectile dysfunction, male incontinence, male fertility, well man clinic will also be offered. Additionally Dr. Arocena offers renal ultrasounds for bladder and kidney functioning and kidney stone prevention, overactive bladder and urinary flow investigations. Services for Lower Urinary Tract Symptoms (LUTS) examinations, female incontinence, prostatitis, Urinary Tract Infections (UTI) will also be available.
Treatments and Diagnosis
An overactive bladder is a common condition causing the bladder to contract suddenly when the it is not full. The symptoms for an overactive bladder may include:
- Going to the toilet more frequently
- A sudden feeling of urgency to pass urine
- Nocturia: waking to go to the toilet more than once at night
- Urge incontinence whereby urine can leak before you can get to the toilet during a feeling of urgency
Urinary incontinence in females is a very common problem, with four out of every ten women experiencing some form of incontinence over their lifetime. The main types of female incontinence are:
- Stress incontinence: for example, leaking urine when coughing or laughing. Pregnancy, childbirth, menopause, hysterectomy and obesity can all lead to stress incontinence
- Urge incontinence: where a patient has an overactive bladder
- Sudden urgency, which can result in leaking
- Mixed incontinence: a combination of stress incontinence and overactivity
You will be asked questions about your symptoms and medical history, including:
- Whether the urinary incontinence occurs when you cough or laugh
- Whether you need the toilet frequently during the day or night
- Whether you have any difficulty passing urine when you go to the toilet
- Whether you're currently taking any medication
- How much fluid, alcohol or caffeine you drink
You may also need to have some tests and examinations so the specialist can confirm or rule out things that may be causing incontinence. Ocean Medical Clinic provides a full service for women suffering with Female Incontinence. Dr Arocena is an expert in this area and can offer specialised advice and treatment methods to suit your individual needs.
Urinary incontinence in men (male incontinence) is the inability to control the bladder and stop the flow of urine. Some men will experience frequent urges to pass urine, which is known as urge incontinence or sometimes known as an overactive bladder. Although it affects more women, it is a common condition in men and depending on the cause, can be temporary or permanent.
Causes Of Male Incontinence:
Sometimes treatment for prostate cancer can cause urinary incontinence. Surgery and radiotherapy can damage the muscles of the valve of the sphincter, which controls urine flow.
Kidney stones (renal lithiasis, nephrolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. Most stones are formed in the kidney and some can travel down the ureter and into the bladder. These stones can cause obstruction of urine flow resulting in severe pain. Kidney stones are more common if you do not drink enough fluids, if an individual is taking certain types of medication, or if they have a medical condition that raises the levels of certain substances in the urine.
A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter. At that point, you may experience these signs and symptoms:
- Severe pain in the side and back, below the ribs
- Pain that radiates to the lower abdomen and groin
- Pain that comes in waves and fluctuates in intensity
- Pain on urination
- Pink, red or brown urine
- Cloudy or foul-smelling urine
- Nausea and vomiting
- Persistent need to urinate
- Urinating more often than usual
- Fever and chills if an infection is present
- Urinating small amounts
Who is at a higher risk?
- Family or personal history: If someone in your family has kidney stones, you're more likely to develop stones too. If you've already had one or more kidney stones, you're at increased risk of developing another
- Certain diets high in protein, sodium (salt) and sugar may increase your risk of some types of kidney stones
- Being obese
- Digestive diseases and surgery
Prevention of kidney stones may include a combination of lifestyle changes and medications.
You may reduce your risk of kidney stones if you:
- Drink water throughout the day. For people with a history of kidney stones, doctors usually recommend passing about 2.5 litres of urine a day.
- Eat fewer oxalate-rich foods. These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, nuts, tea, chocolate, black pepper and soy products.
- Choose a diet low in salt and animal protein. Reduce the amount of salt you eat and choose nonanimal protein sources, such as legumes. Consider using a salt substitute, such as Mrs. Dash.
- Continue eating calcium-rich foods, but use caution with calcium supplements. Calcium in food doesn't have an effect on your risk of kidney stones. Continue eating calcium-rich foods unless your doctor advises otherwise.
Erectile dysfunction (commonly known as impotence) is the ongoing inability to obtain or sustain an erection. Erectile dysfunction is associated with an array of medical conditions such as high blood pressure and fats, diabetes, obesity, smoking, alcohol, types of medications, recreational drugs, low testosterone, neurological diseases and sleep disorders. Nowadays there are a wide range of treatments that may be appropriate such as oral drugs (Viagra, Cialis, Levitra), injections such as Caverject and vacuum devices.
Prostate Cancer & Check-Ups
Prostate cancer is the most common cancer in men in the UK. Worryingly, prostate cancer can have very few symptoms, so screening is vital.
Symptoms Of Prostate Cancer
- Frequent urination
- Difficulty maintaining a steady stream of urine
- Having to urinate during the night
- Blood in the urine
- Change in sexual function and performance
Two tests are commonly used to screen for prostate cancer
- Digital rectal exam (DRE): A doctor inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
- Prostate specific antigen (PSA) test: Measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.
As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. Many factors such as age and race, can affect PSA levels. Some prostate glands make more PSA than others. PSA levels also can be affected by:
- Certain medical procedures
- Certain medications
- An enlarged prostate
- A prostate infection
Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results. Only a biopsy can diagnose prostate cancer for sure.
With a specialist andrologist & consultant urologist as part of our core medical team, we are able to offer a range of services and treatments for male infertility problems. Treatments range from semen analysis to advanced micro-dissection testicular sperm extraction.