Question 1

What tests are needed for benign prostatic hyperplasia (BPH) in older adults?

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

Frequent nighttime urination and a weakened urine stream in men in their late 60s may be early signs of benign prostatic hyperplasia (BPH).

The prostate-specific antigen (PSA) blood test is a basic marker used to assess the risk of prostate cancer. However, PSA alone cannot clearly distinguish between prostate cancer and BPH. Since BPH involves enlargement of prostate tissue that compresses the urethra, it is important to evaluate the size and shape of the prostate through ultrasound.

A transrectal ultrasound (TRUS) is an effective way to assess the internal condition of the prostate. In addition, uroflowmetry and post-void residual measurement help evaluate urine flow rate and how much urine remains in the bladder, which are useful for determining the severity of urinary symptoms.

Before starting medication for BPH, it is also advisable to assess kidney function and bladder function to rule out potential complications.

Basic evaluation for BPH typically begins with medical history and urinalysis, followed by imaging and functional tests. These examinations are generally quick and non-invasive, so there is no need for excessive concern.

✅ What is BPH?

Benign prostatic hyperplasia is a common condition associated with aging, in which the prostate gradually enlarges and compresses the urethra, leading to various urinary symptoms.

Although it becomes more common after the age of 50, it can also occur in younger individuals due to factors such as diet, stress, and prolonged sitting habits.

✅ Common symptoms of BPH

✔ Weak urine stream

✔ Difficulty starting urination

✔ Intermittent urine flow

✔ Prolonged urination time

✔ Frequent urination

✔ Nocturia (waking up at night to urinate)

✔ Urgency (sudden need to urinate)

✔ Feeling of incomplete emptying

✅ Diagnostic tests for BPH

✔ Medical history and symptom scoring (IPSS)

Evaluates frequency, urgency, and nocturia based on standardized scoring.

✔ Digital rectal examination (DRE)

A physical exam to assess prostate size, firmness, and abnormalities.

✔ Uroflowmetry + post-void residual measurement

Assesses urine flow strength and remaining urine after voiding.

✔ Urinalysis and PSA blood test

Checks for infection and evaluates prostate cancer risk.

✅ Treatment options

Many patients can manage symptoms effectively with medication. However, if symptoms do not improve or complications occur—such as acute urinary retention, recurrent infections, bladder stones, or kidney dysfunction—surgical treatment may be considered.

There are various treatment options depending on the patient’s condition:

✔ HoLEP (Holmium Laser Enucleation of the Prostate)

Removes enlarged prostate tissue completely with minimal bleeding and low recurrence rate.

✔ UroLift

A minimally invasive procedure that lifts and holds prostate tissue to relieve urethral compression without cutting or removing tissue.

✔ Waterjet robotic surgery (Aquablation)

Uses high-pressure water jets for precise, heat-free tissue removal.

✔ Plasma TURis

Removes tissue using low-temperature plasma energy.

✔ Rezum therapy

Uses steam to reduce prostate tissue; suitable for older patients or those with comorbidities.

✔ iTind procedure

A temporary implant expands the urethra and is removed after several days, maintaining improved urine flow.

✅ Treatment cost considerations

The cost of BPH treatment varies depending on the procedure, hospitalization, and insurance coverage. Common procedures such as HoLEP, Aquablation, and Rezum differ significantly in cost.

Rather than comparing cost alone, it is more important to determine which treatment is most appropriate based on prostate size, symptoms, and overall health condition.

As the prostate continues to enlarge with age, symptoms of BPH may gradually worsen. If left untreated, it can lead to complications such as urinary tract infections, cystitis, pyelonephritis, bladder stones, and bladder dysfunction.

At our clinic, we carefully assess each patient’s condition based on extensive clinical experience and provide accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If you have persistent symptoms suggestive of BPH, we recommend visiting a urology clinic for evaluation.

Thank you, and we hope this information was helpful.

Question 2

Sudden Scrotal Discomfort in Adolescence: Differentiating Torsion from Positional Pain

Accepted Answer

Hello, this is Dr. Je-man Ryu, Director of Goldman Urology at Seoul Station.

Your main symptoms are discomfort in the upper left scrotum and lower abdomen over the last 4 days. As you noted, testicular torsion is an emergency that involves unbearable pain and vomiting. If your pain levels are low and there is no fever or swelling, other causes are more likely. Habits like sitting in a chair for long periods or certain postures can irritate the blood vessels and nerves in that area. Conditions like varicocele or epididymitis can also cause heavy or tingling sensations in similar areas. Since this has persisted longer than your previous episodes, it is important to get it checked to rule out underlying issues. I recommend an evaluation to ensure proper recovery.

Question 3

Will self-medicating with antibiotics affect the accuracy of STD testing?

Accepted Answer

Hello, this is Dr. Je-man Ryu. Taking antibiotics or antivirals before a test can indeed compromise the accuracy. Even a short 2-day course can temporarily suppress the pathogen levels, potentially leading to a 'false negative' result. It is best to consult a specialist about the appropriate timing for testing after stopping the medication to ensure a definitive diagnosis.

Question 4

Experiencing Sensation of Ejaculation Without Fluid: Understanding Retrograde Ejaculation

Accepted Answer

The symptoms you're describing are highly indicative of 'Retrograde Ejaculation,' where semen enters the bladder instead of being expelled through the urethra. This is distinct from azoospermia (sterility). It often relates to the muscle function at the bladder neck. A post-ejaculatory urinalysis can confirm this, and depending on the cause, it can often be managed with medication.

Question 5

Why does my urine turn bright yellow after taking cold medication?

Accepted Answer

This is a very common side effect of certain medications, particularly those containing Vitamin B (Riboflavin) or specific dyes used in syrups. As these components are metabolized and excreted through the kidneys, they can intensely color the urine. It is generally harmless and should return to normal once the medication is stopped.

Question 6

Could recent changes in ejaculation timing be a sign of Premature Ejaculation?

Accepted Answer

Hello, this is Dr. Je-man Ryu, Director of Goldman Urology at Seoul Station.

It sounds like you are experiencing significant concern regarding sudden changes in ejaculation timing, especially amidst the fatigue of a long-distance relationship and professional life. Based on your description, rather than a definitive diagnosis of premature ejaculation, it is highly likely that this is a temporary phenomenon caused by physical exhaustion and changes in ejaculation habits.

First, repeatedly practicing rapid ejaculation while viewing highly stimulating visual content can cause the brain and body to become accustomed to that speed, potentially reducing your ability to control ejaculation during actual intercourse. Furthermore, getting only 3-4 hours of sleep makes the nervous system hypersensitive, which is a major cause of reaching the point of climax earlier than usual. This is because your control over the muscles involved in ejaculation weakens when your overall condition is poor.

Beyond surgical options, it would be beneficial to restore your physical condition through regular sleep and combine this with pelvic floor muscle strengthening and ejaculation control training to desensitize yourself to stimulation.

At our urology clinic, we provide customized treatment plans by carefully assessing each patient's symptoms and health status based on extensive clinical experience. Finding the exact cause is the first step in treatment, so if these uncomfortable symptoms persist, I recommend seeking a professional urological evaluation. I hope this answer was helpful. Thank you.

Question 7

Overcoming Psychogenic Urinary Frequency: When Stress Affects Bladder Control

Accepted Answer

Hello, this is Dr. Je-man Ryu, Director of Goldman Urology at Seoul Station.

It is understandable that you are feeling frustrated since your symptoms have not improved despite seeking help from both urology and mental health professionals. Psychogenic frequency is a condition where the bladder reacts hypersensitively due to psychological factors or tension, even when there are no clear physical abnormalities. Recovery can take time.

If treatment feels slow, check if you are hyper-focusing on bladder sensations. You might have developed a fixed hypersensitivity where you feel discomfort even when the bladder is only slightly full. In such cases, behavioral therapy to gradually expand bladder capacity should be combined with medication.

I recommend keeping a voiding diary to objectively track your actual urine volume and frequency. Based on this, training to gradually increase the interval between bathroom visits is a fundamental solution. Our clinic provides tailored treatment plans based on rich clinical experience to address these delicate issues. Please consider a follow-up consultation to recalibrate your approach.

Question 8

Could it be Male Menopause at 41? Symptoms of Fatigue and Low Libido

Accepted Answer

Hello, this is Dr. Je-man Ryu, Director of Goldman Urology at Seoul Station.

As a man in his early 40s, it's natural to be concerned about recent symptoms of anemia and decreased sexual function. Male menopause generally occurs after the 40s as testosterone levels decline, which can lead to lethargy and erectile dysfunction. However, your existing anemia can also lower overall vitality, potentially causing a loss of libido or erectile issues.

The absence of nocturnal emissions is not necessarily an indicator of health problems in adult males. However, if accompanied by decreased erectile strength and reduced sexual interest, it may point toward hormonal imbalances or blood flow issues. A blood test can confirm your testosterone levels and the severity of your anemia. Based on those results, appropriate prescriptions and lifestyle adjustments can effectively help you regain your vitality. I recommend visiting a specialist for an accurate diagnosis.

Question 9

What Happens During a Urology Visit for Cystitis? Diagnosis and Treatment Process

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

Discomfort during urination after sexual activity is a common symptom in women, and it can be evaluated not only in gynecology but also by a urology specialist.

Even if the urine volume is small, testing can still be performed as long as a minimum sample amount is obtained. Therefore, it is helpful to drink enough water before your visit to ensure a smooth examination.

Although your urinary frequency has improved, the presence of residual discomfort (such as a feeling of incomplete emptying) may indicate that the inflammation has not fully resolved. If symptoms have persisted for more than a month, early treatment is important to prevent progression to a chronic condition.

Unusual odor in urine may occur due to bacterial growth or inflammatory byproducts, and symptoms can typically be improved with appropriate antibiotic treatment.

The cost of treatment may vary depending on the specific tests performed, but in most cases, health insurance coverage applies, making it generally affordable. Additionally, increasing your daily fluid intake is important for preventing recurrent cystitis.

At our clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 10

How often should adults urinate per day?

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

In general, the normal frequency of urination for adults is about 4 to 6 times per day, and urinating more than 8 times a day is typically defined as urinary frequency.

If you are urinating around 10 times a day, this may fall into the category of frequency. However, if you are drinking more than 2 liters of fluid per day, this could simply be a natural response to increased fluid intake.

Regarding foamy urine, if the foam disappears within about 5 minutes, it is often considered a temporary and non-concerning finding, rather than persistent proteinuria. However, if you would like to confirm your condition more accurately, a urinalysis can be considered.

Frequent urination may also be an early sign of changes in prostate health or bladder function. Therefore, it is important to observe whether symptoms persist even after adjusting your fluid intake.

If the discomfort continues, we recommend visiting a urology clinic for basic urine testing and prostate evaluation to assess the severity of any potential voiding dysfunction.

At our clinic, we carefully evaluate each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 11

Is foamy urine normal in teenagers?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

Foamy urine can be associated not only with systemic conditions such as proteinuria or diabetes, but also may reflect the condition of the kidneys or urinary tract.

It is positive that you are exercising regularly and have lost weight. However, if your symptoms are more noticeable during the daytime, it is important to evaluate the possibility of orthostatic proteinuria (which occurs during activity) or changes in urine concentration.

Proteinuria may be a sign of reduced kidney function, and similar findings can also appear in inflammatory conditions such as cystitis or urinary tract infections.

Rather than worrying on your own, it would be advisable to visit a urology clinic for proper evaluation, as early testing can help prevent potential health issues.

At our clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 12

What causes pain during urination?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

A burning or warm sensation during urination may indicate that the urethral lining has become sensitive, even if it does not appear in test results. It is reassuring that both your urinalysis and STI tests are normal, but if symptoms persist, it is important to consider conditions such as non-infectious urethritis, prostatitis, or an overactive bladder.

Even when test results are normal, factors such as concentrated urine, certain foods, or alcohol consumption may irritate the urethra and cause a lingering burning sensation. Additionally, stress or fatigue can temporarily increase nerve sensitivity, which may also lead to discomfort during urination.

It would be advisable to revisit a urology clinic and review your current symptoms in detail to determine whether additional testing or treatment is needed. Identifying the underlying cause is important for effective health management.

At our clinic, we carefully evaluate each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 13

Diagnosis and Treatment Options for Anal Condyloma (Genital Warts)

Accepted Answer

Condyloma (genital warts) is caused by the Human Papillomavirus (HPV) and is highly contagious. The cauliflower-like shape is a classic diagnostic feature. Unlike skin tags, condyloma tends to vary in shape and can spread rapidly if untreated. Because it is easily transmitted through skin contact, your partner should absolutely be evaluated. Treatment options include laser therapy, electrocautery, or cryotherapy, and we focus on both removing the visible lesion and managing the underlying viral activity to prevent recurrence.

Question 14

Is HoLEP Surgery Safe and Effective for Benign Prostatic Hyperplasia (BPH)?

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

I understand how difficult it can be when symptoms of benign prostatic hyperplasia (BPH) do not improve despite ongoing medication.

If there has been little to no improvement after long-term medical therapy, it is reasonable to consider procedural or surgical treatment options.

There are several treatment methods available for BPH, including:

HoLEP (Holmium Laser Enucleation of the Prostate)

UroLift

Rezum (water vapor therapy)

Choosing the most appropriate treatment depends on each patient’s individual condition.

Among these, HoLEP is a procedure that uses a holmium laser to separate and remove the enlarged prostate tissue from its outer capsule.

Unlike conventional laser treatments that vaporize tissue, HoLEP completely removes the obstructive prostate tissue, providing results similar to open surgery.

HoLEP is widely selected because it offers:

Fast recovery

Minimal bleeding

Effective symptom relief

Many patients are understandably concerned about the cost of surgery, especially those who are working or supporting their families.

In many cases, patients decide to proceed with surgery after experiencing persistent symptoms such as weak urine flow or frequent nighttime urination despite long-term medication.

The cost of HoLEP is generally more affordable compared to other surgical options because it is covered by national health insurance.

In Korea, the total cost typically ranges from approximately 2 to 3 million KRW.

If you have private health insurance, part of the cost may be reimbursed, so it is advisable to check with your insurance provider in advance.

Another advantage of HoLEP is that it is performed using an endoscopic approach, which means there is minimal pain and bleeding compared to traditional open surgery, while still achieving a comparable therapeutic outcome.

If you are considering treatment options for BPH, it is important to consult with a urology specialist at a clinic that offers multiple treatment modalities, including HoLEP, Rezum, and robotic waterjet surgery, to determine the most suitable approach.

Since the size and shape of the prostate vary from person to person, the optimal treatment method may differ depending on:

Symptom severity

Duration of the condition

Presence of complications

Selecting a personalized treatment plan is essential for achieving the best outcome.

I hope this explanation regarding HoLEP for BPH has been helpful.

Thank you.

Question 15

Do I Need Surgery for Kidney Stones? When Severe Pain Requires Treatment

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

If you are considering surgery for urinary stones (urolithiasis), it is important to understand your condition and the available treatment options.

When a stone blocks the ureter, it can cause severe pain due to swelling of the kidney.

If the stone is larger than 5 mm, the likelihood of spontaneous passage decreases, and further evaluation is required to determine the exact size and location.

What is a urinary stone?

Urinary stones are formed when substances in the urine crystallize and harden into stone-like structures within the kidney.

As these stones move along the urinary tract, they can cause intense pain.

Dehydration increases the risk by allowing crystals to remain in the urine longer.

A family history, dietary habits, and lifestyle factors can also contribute to stone formation.

One of the main challenges of urinary stones is not only the severity of pain but also the high recurrence rate.

Common symptoms of urinary stones

Flank or lower abdominal pain: severe, stabbing pain that may last from minutes to hours

Hematuria: visible or microscopic blood in the urine

Urinary symptoms: frequency, pain during urination, or a sensation of incomplete emptying

Fever and chills: may indicate infection and require urgent care

Causes and risk factors

Low fluid intake: reduced urine volume promotes stone formation

Dietary factors: high salt or excessive animal protein intake increases risk

Metabolic conditions: obesity, hypertension, diabetes

Genetic predisposition: family history of urinary stones

Diagnosis and treatment based on stone size

Accurate diagnosis requires imaging studies such as urinalysis, X-ray, ultrasound, or CT scan to determine the stone’s size and location.

≤ 5 mm: may pass naturally with hydration and medication

≥ 6 mm: lower likelihood of passage → shock wave lithotripsy recommended

≥ 1 cm: may require ureteroscopy or surgical removal

Treatment options

Extracorporeal Shock Wave Lithotripsy (ESWL)

A non-invasive method that uses high-energy shock waves to break stones into smaller fragments.

It is typically performed without anesthesia or hospitalization.

Ureteroscopy and robotic-assisted surgery

An endoscope is inserted into the ureter to directly fragment and remove stones.

Advanced systems, including AI-assisted technologies, can improve precision and safety.

Prevention and lifestyle management

To prevent recurrence:

Drink at least 2 liters of water per day

Reduce salt and animal protein intake

Engage in regular physical activity such as walking, jogging, or light jumping exercises, which may help facilitate the passage of small stones

When to seek treatment

Urinary stones should be treated early to prevent complications such as kidney damage.

If you have been diagnosed with a urinary stone, timely treatment is strongly recommended.

At Goldman Urology Clinic, we provide 24-hour emergency care across all branches to ensure prompt treatment whenever symptoms occur.

We carefully evaluate each patient’s condition to provide an accurate diagnosis and personalized treatment plan.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 16

Bacterial vs Non-Bacterial Prostatitis: Do Treatment Methods Differ?

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

Prostatitis is one of the common urological conditions in men under the age of 50 and can occur even in relatively young individuals. It is a condition characterized by inflammation of the prostate gland and is generally classified into acute or chronic types depending on symptom duration and clinical course.

Prolonged sitting cannot be definitively identified as the direct cause of prostatitis. However, it may act as a contributing factor by applying continuous pressure to the perineal area, potentially impairing blood circulation and worsening symptoms.

✅ Common symptoms of prostatitis

✔ Persistent discomfort or pain in the perineum, lower abdomen, or pelvic area

✔ Burning sensation during urination, urinary frequency, or a feeling of incomplete emptying

✔ Pain during urination, decreased sexual function, or discomfort during ejaculation

✔ Sudden fatigue, chills, or a general decline in physical condition

✅ Causes and risk factors

✔ Spread of inflammation from prior infections such as urethritis or bacterial infections

✔ Reduced immunity due to excessive alcohol consumption, stress, or chronic fatigue

✔ Lifestyle factors such as prolonged sitting or pressure on the perineal area

✔ Increased pelvic muscle tension or urinary reflux caused by elevated urethral pressure

Prostatitis can be broadly classified into bacterial and non-bacterial types.

Bacterial prostatitis is often caused by pathogens associated with urethritis, including gonorrhea, chlamydia, ureaplasma, and mycoplasma genitalium. In addition, intestinal bacteria such as E. coli or Klebsiella may also be responsible. When the causative organism is identified, antibiotic treatment generally leads to favorable outcomes.

In contrast, non-bacterial prostatitis is characterized by the absence of a clearly identifiable cause. The underlying mechanism is not well understood, and standard urine tests alone may not provide an accurate diagnosis. In such cases, more advanced diagnostic methods such as multi-PCR testing can be used for a more precise evaluation, which is essential for establishing a personalized treatment plan.

Chronic prostatitis may present with a combination of pain, urinary symptoms, and sexual dysfunction. Due to the complexity of symptoms, it may sometimes be mistaken for other conditions or perceived as multiple coexisting disorders.

✅ Treatment approach

Accurate diagnosis through comprehensive evaluation of multiple potential causes is essential for effective treatment. Consulting with an experienced urologist can help shorten the treatment period and reduce the risk of recurrence.

To prevent recurrence, appropriate medical treatment should be combined with lifestyle modifications. Avoiding excessive alcohol consumption and smoking, maintaining regular exercise, and managing stress can all be beneficial.

At Goldman Urology Clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing an accurate diagnosis and personalized treatment plan.

Identifying the exact cause of prostatitis is the first step toward effective treatment. If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 17

Will Pain Go Away After Kidney Stone Removal Surgery? What to Expect

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

It is understandable that you may be experiencing significant concern due to the sudden onset of flank pain and discomfort, which can interfere with daily activities. It appears that you are carefully considering whether natural passage is possible or which treatment option is most appropriate for urinary stone removal.

When a stone obstructs the ureter, it can cause severe pain due to swelling of the kidney.

If the stone is larger than 5 mm, the likelihood of spontaneous passage decreases, making it important to accurately determine the size and location through proper evaluation. Based on these findings, treatment options such as extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic surgery may be recommended. We advise visiting a urology clinic for appropriate diagnosis and treatment planning.

The symptoms of urinary stones may vary depending on the size and location of the stone.

Typically, sharp, stabbing flank pain that lasts from minutes to hours and then subsides is one of the most common symptoms.

Early diagnosis and treatment are essential. If left untreated, urinary stones may lead to complications such as reduced kidney function, so prompt treatment is strongly recommended.

✅ What is a urinary stone?

Urinary stones are formed when substances in the urine crystallize and harden into stone-like structures in the kidney. As these stones move along the urinary tract, they can cause severe pain.

Reduced fluid intake increases the risk by allowing crystals to remain in the urine longer. A family history, dietary habits, and lifestyle factors can also contribute. One of the main challenges of urinary stones is both the intensity of pain and the high recurrence rate.

✅ Common symptoms

✔ Severe, stabbing pain in the flank or lower abdomen

✔ Hematuria (visible or microscopic blood in the urine)

✔ Urinary frequency, painful urination, or a sensation of incomplete emptying (especially when bladder stones are present)

✔ Fever and chills (may indicate infection and require urgent care)

✅ Causes and risk factors

✔ Insufficient fluid intake leading to reduced urine volume

✔ Dietary habits such as high salt intake or excessive animal protein consumption, increasing the risk of uric acid or calcium stones

✔ Metabolic conditions such as obesity, hypertension, and diabetes

✔ Genetic predisposition, especially with a family history of urinary stones

✅ Diagnosis and treatment based on stone size

To accurately assess the condition, tests such as urinalysis, X-ray imaging, ultrasound, or intravenous pyelography may be used to determine the exact location of the stone.

✔ ≤ 5 mm: natural passage may be attempted with hydration and medication

✔ ≥ 6 mm: lower likelihood of passage → procedural removal such as ESWL is recommended

✔ ≥ 1 cm: larger or harder stones may require ureteroscopic surgery

✔ Extracorporeal Shock Wave Lithotripsy (ESWL)

A non-invasive method that uses high-energy shock waves to break stones into smaller fragments. It can be performed without anesthesia or hospitalization, and newer devices help reduce discomfort during treatment.

✔ Ureteroscopy and robotic-assisted surgery

An endoscope is inserted into the ureter to directly fragment and remove stones. This approach allows complete removal even in cases where ESWL is not effective.

Advanced systems such as the AI-based Zamenix robotic system enhance precision, safety, and overall treatment efficiency.

✅ Lifestyle management and prevention

✔ To prevent recurrence, it is important to drink at least 2 liters of water per day to dilute urine and reduce stone formation

✔ Reduce salt and animal protein intake

✔ Maintain regular physical activity such as walking, jogging, or light jumping exercises to support urinary tract health and help the passage of small stones

The newly introduced AI-assisted kidney stone surgical robot (Zamenix) improves surgical precision, safety, and efficiency through advanced features such as respiratory compensation, stone size guidance, and pathway tracking.

Maintaining adequate hydration, controlling dietary habits, and engaging in regular exercise are essential for preventing urinary stones.

Because urinary stones can cause sudden and severe pain, our clinic operates a 24-hour emergency care system across all branches to ensure prompt treatment whenever needed.

At Goldman Urology Clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing an accurate diagnosis and personalized treatment plan.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 18

How Are Kidney Stones Removed with Endoscopic Surgery? Procedure Explained

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

I understand that you may be experiencing significant discomfort in your daily life due to the sudden and severe pain caused by urinary stones. It appears that you are carefully considering the most appropriate treatment option, including endoscopic stone removal, based on your current condition.

If the pain is recurring and not adequately controlled with medication, it is important to focus on active treatment to prevent complications such as deterioration of kidney function.

When a stone blocks the ureter, it can cause severe pain due to swelling of the kidney.

If the stone is larger than 5 mm, the likelihood of spontaneous passage decreases, making it necessary to accurately determine its size and location through proper evaluation.

Depending on the size and composition of the stone, treatment options such as extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic surgery may be recommended. We advise visiting a urology clinic for appropriate diagnosis and treatment planning.

The symptoms of urinary stones may vary depending on the size and location of the stone.

Typically, sharp, stabbing flank pain that lasts from minutes to hours and then subsides is one of the most common symptoms.

Early diagnosis and treatment are essential. If left untreated, urinary stones may lead to complications such as reduced kidney function, so prompt treatment is strongly recommended.

✅ What is a urinary stone?

Urinary stones are formed when substances in the urine crystallize and harden into stone-like structures in the kidney. As these stones move along the urinary tract, they can cause severe pain.

Reduced fluid intake increases the risk by allowing crystals to remain in the urine longer. A family history, dietary habits, and lifestyle factors can also contribute. One of the main challenges of urinary stones is both the intensity of pain and the high recurrence rate.

✅ Common symptoms

✔ Severe, stabbing pain in the flank or lower abdomen

✔ Hematuria (visible or microscopic blood in the urine)

✔ Urinary frequency, painful urination, or a sensation of incomplete emptying (especially when bladder stones are present)

✔ Fever and chills (may indicate infection and require urgent care)

✅ Causes and risk factors

✔ Insufficient fluid intake leading to reduced urine volume

✔ Dietary habits such as high salt intake or excessive animal protein consumption, increasing the risk of uric acid or calcium stones

✔ Metabolic conditions such as obesity, hypertension, and diabetes

✔ Genetic predisposition, especially with a family history of urinary stones

✅ Diagnosis and treatment based on stone size

To accurately assess the condition, tests such as urinalysis, X-ray imaging, ultrasound, or intravenous pyelography may be used to determine the exact location of the stone.

✔ ≤ 5 mm: natural passage may be attempted with hydration and medication

✔ ≥ 6 mm: lower likelihood of passage → procedural removal such as ESWL is recommended

✔ ≥ 1 cm: larger or harder stones may require ureteroscopic surgery

✔ Extracorporeal Shock Wave Lithotripsy (ESWL)

A non-invasive method that uses high-energy shock waves to break stones into smaller fragments. It can be performed without anesthesia or hospitalization, and newer devices help reduce discomfort during treatment.

✔ Ureteroscopy and robotic-assisted surgery

An endoscope is inserted into the ureter to directly fragment and remove stones. This approach allows complete removal even in cases where ESWL is not effective. Advanced systems improve precision, safety, and treatment efficiency.

✅ Lifestyle management and prevention

✔ To prevent recurrence, it is important to drink at least 2 liters of water per day to dilute urine and reduce stone formation

✔ Reduce salt and animal protein intake

✔ Maintain regular physical activity such as walking, jogging, or light jumping exercises to support urinary tract health and help the passage of small stones

Maintaining adequate hydration, controlling dietary habits, and engaging in regular exercise are essential for preventing urinary stones.

Because urinary stones can cause sudden and severe pain, our clinic operates a 24-hour emergency care system across all branches to ensure prompt treatment whenever needed.

At Goldman Urology Clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing an accurate diagnosis and personalized treatment plan.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 19

What Should I Expect After Circumcision? Recovery and Care Guide

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

It is possible to remove pearly penile papules (PPP) at the same time as undergoing circumcision. Performing both procedures together has the advantage of managing anesthesia and recovery in a single process. Pearly penile papules are a benign condition with no health risk, but many patients choose removal for cosmetic reasons.

It is generally possible to drive or perform light office work the day after surgery, but it is recommended to avoid excessive physical activity. If your work involves mostly sitting, there should be minimal difficulty. However, if your job requires a lot of movement, friction may cause some discomfort.

Pain levels can vary from person to person, but in most cases, discomfort lasts for about 2 to 3 days after surgery and gradually improves.

Full recovery of the surgical site typically takes approximately 4 weeks. During this period, it is important to avoid intense exercise and sexual activity. If you are concerned about pain, it can be effectively managed with prescribed medication, so there is no need for excessive worry. Following the provided post-operative care instructions will help support proper healing and prevent complications.

At our clinic, we carefully evaluate each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If discomfort persists, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 20

Is Cystitis a Sexually Transmitted Disease? Differences Between UTI and STD

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

If you are experiencing symptoms of cystitis but no inflammation or bacteria are detected in a standard urinalysis, additional testing may be necessary to identify the underlying cause.

Certain microorganisms or sexually transmitted infections (STIs) that are not detected in routine tests can cause symptoms similar to cystitis. If the exact cause is not identified and symptoms persist, it may lead to significant discomfort in daily life.

Even if your condition has been considered functional or stress-related, if urinary symptoms such as frequency or a sensation of incomplete emptying continue, it would be advisable to visit a urology clinic. More advanced tests, such as PCR testing, can help detect a wider range of pathogens, including those not found in standard tests.

In cases where the bacterial concentration in urine is low or when infection involves atypical organisms, routine tests may not be sufficient for diagnosis. If left untreated, these conditions may progress to chronic pain or persistent symptoms.

Once the causative organism is identified, appropriate antibiotic treatment can be initiated, often leading to rapid improvement. Therefore, rather than worrying excessively, we recommend seeking accurate diagnosis and appropriate care.

At our clinic, we carefully evaluate each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 21

I Think I Have Premature Ejaculation—What Should I Do? Causes and Treatment

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

Concerns about ejaculatory control during adolescence are quite common and can occur due to physical changes and hormonal influences during this stage of development. The sensation of ejaculation experienced during masturbation can differ from that during actual sexual activity due to environmental and psychological factors, so it is not necessary to prematurely assume a diagnosis of premature ejaculation.

Maintaining overall physical health through regular exercise and balanced nutrition is also important. As you are still a student, it is generally more appropriate to focus on psychological stability and developing healthy sexual habits, rather than considering medication or surgical treatment at this stage.

If these efforts do not improve your symptoms and the issue continues to cause significant stress or disruption in daily life, it would be advisable to visit a urology clinic for further evaluation.

At our clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 22

Can Teenagers Have Blood in Urine? Causes of Hematuria in Adolescents

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

Hematuria (blood in the urine) can occur even during adolescence due to various causes. If your urine appears reddish compared to usual, it may indicate inflammation in the urinary tract or a temporary physical change.

Certain foods containing strong pigments can also affect urine color and may cause what is known as pseudo-hematuria, where the urine appears red without actual blood. Therefore, it is important to undergo proper medical evaluation for an accurate diagnosis.

If the discoloration is caused by food, the urine color typically returns to normal over time. However, if you experience pain during urination or discomfort in the flank area, it may not be a simple pigment-related change. Additionally, temporary hematuria can occur after intense physical activity or fatigue.

A urine test is necessary to determine whether red blood cells are actually present. Based on the results, appropriate treatment can be provided, and recovery is usually prompt. There is no need for excessive concern, but it is advisable to visit a urology clinic for proper evaluation.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully assess each patient’s symptoms and overall health to provide an accurate diagnosis and a personalized treatment plan.

Identifying the exact cause is the first step toward effective treatment. If your symptoms persist, we strongly recommend visiting a urology clinic. We hope this information is helpful. Thank you.

Question 23

How Is Herpes Type 2 Transmitted? HSV-2 Infection Routes Explained

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

The incubation period for herpes typically ranges from 2 to 20 days. However, it is also common for individuals to remain asymptomatic for months or even years before experiencing their first outbreak. In your case, it is possible that a previously acquired virus has reactivated and presented as blisters due to a weakened immune system.

Additionally, herpes can be transmitted through sexual contact even when a partner is an asymptomatic carrier. Therefore, even if your girlfriend does not currently have symptoms, it is difficult to rule out the possibility of infection. It is important for both of you to visit a clinic together and undergo appropriate testing, such as antibody tests, to confirm your status.

During the period when blisters are present, the risk of transmission is high, and sexual activity should be avoided. Even after symptoms resolve, the virus can remain dormant in the body, so continued caution is necessary.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully evaluate each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment. If your symptoms persist, we strongly recommend visiting a urology clinic. We hope this information is helpful. Thank you.

Question 24

Is This Blood in My Urine? Causes of Hematuria and When to Seek Care

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

Experiencing visible blood in the urine (hematuria) can be alarming, especially when it occurs outside of the menstrual period. Hematuria that is clearly noticeable to the naked eye may indicate inflammation or abnormalities in the urinary tract, such as the bladder or kidneys.

Although it is uncommon for hematuria to be caused solely by diet, certain foods or excessive fatigue may contribute to conditions like cystitis or temporarily alter urine color. Therefore, it is important to seek accurate medical evaluation.

A urinalysis is necessary to determine whether there is actual blood in the urine or simply a change in color due to other factors. If symptoms such as pain during urination or a sensation of incomplete emptying are present, there is a possibility of acute cystitis.

The treatment approach for hematuria varies depending on the underlying cause. Even if it appears to be temporary, it is important to evaluate the condition of internal organs rather than ignoring the symptom.

Once an accurate diagnosis is made, symptoms can often be rapidly improved with appropriate treatment, such as antibiotic therapy. There is no need for excessive concern, but we strongly recommend visiting a urology clinic for proper evaluation.

At our clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 25

Why Does My Urethra Sting? Causes of Urethral Pain in Men

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

You may be understandably concerned about persistent urethral discomfort and frequent urination after sexual intercourse. Even if your PCR urine test results came back normal, there are several possibilities to consider if symptoms continue.

First, the test may have been performed too early, during the incubation period, which means the causative organism may not have been detected yet. In such cases, repeat testing after a certain period may be necessary. Additionally, symptoms such as a heavy sensation and urinary frequency can occur not only from common sexually transmitted infections but also from prostatitis or inflammation of the surrounding urethral tissues.

If you have a history of Gardnerella infection, it is possible that the previous treatment was incomplete, or that a similar nonspecific inflammatory condition has recurred due to a weakened immune system. Therefore, if symptoms persist, further evaluation beyond urine testing—such as prostate fluid or semen analysis—may be required.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully assess each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans. Identifying the exact cause is the first step toward effective treatment, so if your symptoms persist, we recommend visiting a urology clinic for further evaluation.

We hope this information is helpful. Thank you.

Question 26

Can Epididymitis Recur? Causes and Prevention of Recurrence

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

You may be concerned about the possibility of recurrence, given that you are experiencing pain again 7 years after being treated for epididymitis.

Mild pain felt during activities such as showering or getting dressed may be due to a recurrence of chronic epididymitis or increased nerve sensitivity around the epididymis. In addition, the cramp-like pain in the prostate area that occurs during physical exertion is similar to symptoms seen in prostatitis.

In men in their 30s, such symptoms are far more commonly associated with chronic prostatitis or pelvic muscle tension rather than benign prostatic hyperplasia (BPH). The epididymis and prostate are anatomically connected, so inflammation in the prostate can cause referred pain to the epididymis, and vice versa. Therefore, it is important to evaluate both areas together.

While this could be a temporary symptom related to fatigue, if the pain recurs, it is advisable to undergo further evaluation, such as ultrasound or urine testing, to assess your condition.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully assess each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment, so if your symptoms persist, we recommend visiting a urology clinic for proper evaluation.

We hope this information is helpful. Thank you.

Question 27

Should I Get Circumcision? Benefits, Risks, and When It Is Recommended

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

You may be concerned about whether circumcision is necessary and about hygiene management. Based on your description—where the glans is partially exposed during erection and the foreskin can be fully retracted manually without pain—it is unlikely that you have true phimosis or paraphimosis that would medically require surgery.

When the foreskin covers the glans, residual urine and secretions can accumulate, forming what is known as smegma, which can lead to odor.

If you prefer not to undergo surgery, it is important to develop proper hygiene habits. During showering, fully retract the foreskin to thoroughly clean around the glans and the inner foreskin, and make sure to dry the area completely afterward. A moist environment can promote bacterial growth.

However, if odor persists despite proper hygiene or if inflammation recurs, there may be structural limitations that make hygiene difficult. In such cases, circumcision can be considered as a treatment option.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully assess each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment, so if your symptoms persist, we recommend visiting a urology clinic for proper evaluation.

We hope this information is helpful. Thank you.

Question 28

Could This Be Testicular Torsion? Symptoms That Require Emergency Care

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

You mentioned that you have previously experienced testicular torsion that resolved on its own, and now you are feeling a different type of discomfort, which understandably raises concern. Testicular torsion is an emergency condition in which blood flow to the testicle is compromised. Even if the pain is not severe, any change in the position or shape of the testicle compared to usual should be carefully evaluated.

The reason your current pain may not be severe could be that this is not a complete torsion, but rather a partial torsion, or that blood flow is temporarily maintained.

However, if you feel as though the testicle is twisted in multiple directions, this may indicate that the supporting structures of the testicle are weakened, making it more susceptible to torsion at any time.

Repeated episodes of torsion can lead to damage of the testicular tissue, so it is important to assess blood flow through imaging studies such as ultrasound when symptoms occur. Especially in adolescents, testicular health is very important, so it is safer to undergo evaluation for any structural issues regardless of the level of pain.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully evaluate each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment, so if your symptoms persist, we recommend visiting a urology clinic for proper evaluation.

We hope this information is helpful. Thank you.

Question 29

Is This a Serious STD? When to Be Concerned About Sexually Transmitted Infections

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

You may be quite concerned about the blister-like lesion on your boyfriend’s genital area. Without a direct examination, it is difficult to make a definitive diagnosis. However, a clear blister on the genital area can be caused by various conditions, including herpes virus infection, genital warts (condyloma), or simple dermatitis.

In particular, herpes often begins as small blisters and may be accompanied by pain or itching. Over time, these blisters can rupture and develop into ulcers.

Since it can be transmitted through sexual contact, it is safest to avoid sexual activity until an accurate diagnosis is made. Even if there is only a single blister, it may still be a viral condition, so it is advisable to visit a clinic for proper evaluation.

Although it could be a simple skin issue, the possibility of a sexually transmitted infection cannot be ruled out. Therefore, consulting a specialist is the most accurate way to determine the cause.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully assess each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment, so if your symptoms persist, we recommend visiting a urology clinic for proper evaluation.

We hope this information is helpful. Thank you.

Question 30

Erectile Dysfunction in Your 20s: Causes and Treatment Options

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

You may be very concerned about the cola-colored urine and visible blood in your urine after heavy drinking. Visible hematuria (blood in the urine) should always be carefully evaluated to determine the underlying cause.

In middle-aged men, painless hematuria can raise concern for urinary tract tumors, including bladder cancer. However, there are also various other possible causes, such as temporary inflammation after excessive alcohol intake, severe fatigue, or urinary stones. In particular, the presence of small clots in the urine and changes in urine color depending on fluid intake may indicate ongoing bleeding somewhere in the urinary tract.

Although you may be worried about cancer, there is also a significant possibility that the bleeding is due to inflammation or stones. Therefore, it is important to visit a clinic for proper evaluation. Hematuria itself is an important signal from the body, and even if the symptoms appear to improve, the underlying cause should always be identified.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully assess each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment, so if your symptoms persist, we strongly recommend visiting a urology clinic for proper evaluation.

We hope this information is helpful. Thank you.

Question 31

Blood in Urine for Several Days—Is It Serious? Causes and When to See a Doctor

Accepted Answer

Hello, this is Dr. Ryu Kyung-ho from Goldman Urology Clinic, Gangnam Branch.

You may be very concerned about the cola-colored urine and visible blood in your urine after heavy drinking. Visible hematuria (blood in the urine) requires careful evaluation to determine its cause.

In middle-aged men, painless hematuria may raise concern for urinary tract tumors, including bladder cancer. However, there are also various other possible causes, such as temporary inflammation after excessive alcohol intake, severe fatigue, or urinary stones. In particular, when small clots are present in the urine and the color changes depending on fluid intake, it may indicate ongoing bleeding somewhere in the urinary tract.

Although concern about cancer is understandable, there is also a significant possibility that the bleeding is due to inflammation or stones. Therefore, it is important to visit a clinic for proper evaluation. Hematuria itself is an important signal from the body, and even if symptoms seem to improve, the underlying cause should always be identified.

At our urology clinic, each branch is equipped with extensive clinical experience. We carefully evaluate each patient’s symptoms and overall health to provide accurate diagnoses and personalized treatment plans. Identifying the exact cause is the first step toward effective treatment, so if your symptoms persist, we strongly recommend visiting a urology clinic for proper evaluation.

We hope this information is helpful. Thank you.

Question 32

Is itching normal after circumcision?

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

The change from pain to itching after surgery can be a normal part of the healing process. As the anesthesia wears off, you may initially feel stronger pain, but over time, as sensation returns and the body begins its inflammatory healing response, itching can occur.

However, if the itching feels more intense than the pain, it may also be caused by skin irritation or an allergic reaction to the gauze or adhesive dressing covering the surgical site. Itching can also occur as new tissue forms during wound healing, but in the early post-operative period, it is important to check the condition of the dressing and whether there is excessive pressure from the bandage.

Intermittent, brief pain may be due to swelling or minor stimulation of the surgical area, so monitoring your symptoms is recommended. It is important to avoid scratching or touching the area despite the itching, as this may increase the risk of infection.

If the symptoms are difficult to manage and interfere with daily life, you may take the prescribed medication or revisit the clinic where the surgery was performed for further evaluation.

At our clinic, we carefully assess each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 33

Could white discharge and painful urination after sex be urethritis?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

The presence of white discharge and pain during urination after an incubation period of about one week following sexual activity may suggest the possibility of urethritis.

If the discharge was initially minimal but has progressively increased to the point of staining your underwear, and is accompanied by pain during urination, there is a high likelihood that inflammation has developed within the urethra.

Although it can be alarming to experience these symptoms while traveling abroad, urethritis requires accurate diagnosis, as treatment varies depending on the causative organism. If left untreated, the infection may spread to conditions such as prostatitis or epididymitis, and symptoms may worsen.

It is important to visit a urology clinic and undergo tests such as a urinalysis or discharge PCR test to identify the exact pathogen. Based on the results, appropriate treatment can be initiated.

At our clinic, we carefully evaluate each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 34

Is circumcision safe for adults, and does it reduce sensitivity?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

Many men in their late 20s consider circumcision due to changes in sensitivity or functional concerns. Even if you have a natural foreskin, if the opening is tight or hygiene is difficult to maintain, circumcision can help improve these issues.

There is no problem with undergoing circumcision as an adult. Regarding sensitivity, while some people are concerned about reduced sensation, the outcome can vary depending on the individual. In many cases, improved hygiene after the procedure leads to greater comfort and psychological confidence.

As for procedures related to penile length or enlargement, the possibility depends on each individual’s anatomy. A proper evaluation is necessary to determine whether such procedures are appropriate.

If you have concerns about size or function, it is recommended to visit a urology clinic to assess your current condition and discuss suitable treatment options.

At our clinic, we carefully evaluate each patient’s condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist or concerns continue, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 35

Why does it hurt when I urinate and touch the tip of my penis?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

The pain during urination and tenderness at the tip of the penis that started a few days ago may indicate an inflammatory response in the urinary tract or external mucosal tissue.

Even if there are no visible changes, mild inflammation inside the urethra or at the glans can cause discomfort, including pain when touched or a burning sensation during urination.

In cases of urethritis, visible redness is not always clearly noticeable. It can vary depending on an individual’s natural skin color, making it difficult to identify changes visually.

If pain occurs during urination, it is important to consider the possibility of bacterial infection or inflammation, and to also evaluate the condition of the prostate if necessary.

If left untreated, the inflammation may worsen or spread to other areas. Therefore, it is recommended to visit a urology clinic and undergo a urinalysis to determine the exact cause and receive appropriate treatment.

At our clinic, we carefully evaluate each patient’s symptoms and overall condition to provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 36

Is it normal to have a scab after frenulum removal in circumcision?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

If it has been about one month since your circumcision and frenulum removal, the healing process is generally well underway.

The black scab you are seeing at the surgical site is most likely a normal part of the healing process, specifically a dried blood clot. If there is no pain, swelling, or discharge, it is generally safe to leave the area uncovered without a bandage.

However, until the tissue has fully healed, erections may cause the skin to stretch, which can irritate the scab. In some cases, the scab may come off and cause minor bleeding, but at this stage of recovery, this is usually not a major concern.

It is important not to forcibly remove the scab, and instead allow it to fall off naturally.

If you notice increased swelling, pain, or signs of infection, it would be advisable to visit a urology clinic for further evaluation.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 37

Do I need circumcision if my glans is fully exposed during erection?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

If your glans is fully exposed during erection, circumcision is generally not medically necessary.

As long as there is no pain, no difficulty with urination, and no discomfort in daily life, you can maintain your current condition without undergoing surgery.

However, with a natural foreskin, smegma or debris can accumulate, which may lead to odor or inflammation if proper hygiene is not maintained. If you are able to manage hygiene well and do not experience recurrent inflammation, circumcision is not required.

On the other hand, if the foreskin becomes tight, causing pain during erection, or if there is significant buildup leading to itching or irritation, it would be advisable to visit a urology clinic for evaluation and possible treatment.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 38

Can dissolvable stitches after circumcision heal faster or be removed early?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

At 5 days after circumcision, even if the wound appears healed on the surface, the deeper tissues are still in the process of recovery.

Dissolvable stitches are designed to naturally break down and fall off over time, and attempting to remove or dissolve them prematurely may irritate the wound or cause it to reopen.

The stinging sensation you are experiencing is common during the healing process and may occur when the stitches pull on the surrounding skin or lightly irritate the tissue.

In most cases, dissolvable stitches begin to fall off naturally within 2 to 3 weeks, although this may vary depending on the individual.

It is important not to pull on the stitches, as doing so may lead to wound separation or delayed healing.

If the discomfort becomes severe or if you notice redness, swelling, or signs of infection around the stitches, it is recommended to visit a urology clinic for further evaluation.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 39

Why is my urine color unusual?

Accepted Answer

Hello, this is Dr. Kyungho Ryu from Goldman Urology Clinic, Gangnam.

I understand that you may be concerned about the sudden change in urine color and the sound during urination. In many cases, urine appearing light green or greenish is more often caused by external factors rather than an internal medical issue.

Commonly, multivitamins, supplements, or certain food colorings can affect urine color as their components are excreted through the urine. If you are taking any medications, their ingredients may also temporarily cause a greenish discoloration of urine.

However, in rare cases, urine color changes may be associated with a urinary tract infection caused by specific bacteria. Therefore, it is important to check whether you have accompanying symptoms such as pain during urination or a sensation of incomplete emptying.

While this may be a temporary condition, if the symptoms persist or recur, it would be advisable to undergo a urinalysis to determine the exact cause.

At our clinic, we carefully evaluate each patient’s symptoms and overall health condition based on extensive clinical experience, providing accurate diagnosis and personalized treatment plans.

Identifying the exact cause is the first step toward effective treatment.

If your symptoms persist, we recommend visiting a urology clinic for further evaluation.

Thank you, and we hope this information was helpful.

Question 40

Is smegma buildup normal in teenagers and how should it be cleaned safely?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

It is understandable to feel concerned after discovering a large amount of white material under the foreskin.

What you are describing is most likely smegma, which is a combination of natural secretions and shed skin cells. This is a common and normal finding, especially in areas that have not been regularly exposed or cleaned.

Washing it gently with water was a very appropriate and correct step.

Rather than trying to remove everything forcefully at once, it is better to soften the area with warm water and clean it gently, as excessive rubbing may irritate the skin.

If the foreskin is not regularly retracted and cleaned, smegma can accumulate and may lead to odor or inflammation such as balanitis.

Going forward, it is recommended to gently retract the foreskin during showering and maintain proper hygiene.

If you notice redness, swelling, or persistent itching after cleaning, it would be advisable to visit a urology clinic for further evaluation.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 41

Severe itching 2 weeks after circumcision—is this normal after stitch removal?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

Severe itching around the surgical site about 2 weeks after circumcision, especially after stitch removal, is commonly part of the natural healing process.

As the wound heals, nerve endings begin to recover, and new skin forms. This process can cause increased sensitivity and itching, particularly in areas where stitches were previously holding the tissue together.

Since there was mild inflammation near the frenulum, the skin in that area may be even more sensitive during the regeneration phase, leading to stronger itching sensations.

However, it is important to avoid scratching or rubbing the area, as this may cause micro-injury or secondary infection.

In most cases, the itching will gradually improve over time as healing progresses.

If you notice increasing redness, swelling, discharge, or worsening pain, it would be advisable to visit a urology clinic for further evaluation.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 42

Do I need circumcision if I cannot retract my foreskin and feel pain as a teenager?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

At your age, difficulty retracting the foreskin during erection, along with pain when attempting to pull it back, may indicate that the foreskin opening is relatively tight, a condition often referred to as phimosis.

The strong sensitivity you feel when touching the inner area is also normal, as the glans has likely not been regularly exposed and is therefore more sensitive to stimulation.

If you experience pain even when retracting the foreskin in a non-erect state, it suggests that the foreskin may be constricting the glans, which can make hygiene more difficult and may cause discomfort in the future.

Masturbating without retracting the foreskin is not immediately harmful, but over time it may lead to poor hygiene and could potentially cause pain during sexual activity later in life.

If the foreskin cannot be easily retracted or if pain persists, it is advisable to visit a urology clinic to evaluate your condition and determine whether circumcision or other treatment may be appropriate.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 43

Is yellow discoloration and bumps normal 4 days after circumcision or a sign of infection?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

At 4 days after circumcision, it is common to experience various changes as the wound begins to heal.

A yellowish discoloration around the surgical area may be part of the normal healing process, such as resolving bruising or dried wound discharge.

The small bumps or lump-like structures you are noticing are often due to temporary swelling at the stitch sites or mild tissue reaction from the procedure or anesthesia.

If there is no severe pain, these findings are generally considered part of the normal recovery process.

However, if you notice foul-smelling discharge, increasing redness, warmth, significant swelling, or worsening pain, these could be signs of infection and should be evaluated by a urology specialist.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist or worsen, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 44

How can Gardnerella be detected in men after years without sexual activity? (Latency explained)

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

It is understandable to feel confused when Gardnerella is detected despite no recent sexual activity.

Gardnerella is commonly associated with bacterial vaginosis in women, but it can also be found in men. Importantly, it is not strictly classified as a typical sexually transmitted infection, as it can behave like part of the normal microbial flora (commensal bacteria).

In men, Gardnerella may persist in small amounts within the urethra or prostate, especially if conditions such as changes in the local environment, decreased immunity, or urinary flow issues allow the bacteria to remain or multiply.

Even after a long period without sexual activity, it is possible that the bacteria were previously present at low levels (latent colonization) and were only detected during a detailed test like PCR.

In most cases, Gardnerella does not cause serious problems in men. However, if it is associated with symptoms such as urethral discomfort or prostatitis, further evaluation and treatment may be necessary.

We recommend visiting a urology clinic for a comprehensive assessment based on your current condition.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If symptoms persist, medical evaluation is recommended.

Thank you, and we hope this information was helpful.

Question 45

Is hypersensitivity normal 3 days after circumcision and when can I wear clothes comfortably?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

At 3 days after circumcision, it is very common to experience increased sensitivity.

The glans, which was previously covered by the foreskin, is now directly exposed to air and friction, making it highly sensitive. This is a normal part of the healing process.

Over time, the glans undergoes a process called keratinization, where the surface gradually adapts to external exposure, reducing discomfort.

During the first week after surgery, even light contact with clothing may feel painful or irritating.

It is recommended to wear loose, breathable clothing rather than tight-fitting pants to minimize friction and support healing.

In most cases, sensitivity improves within 1 to 2 weeks, and normal clothing can be worn comfortably afterward.

However, if the sensitivity does not improve over time or if you notice increasing redness, swelling, or worsening pain, it is advisable to visit a urology clinic for further evaluation.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 46

Penile bumps without sexual activity—could this be an STD or HIV?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

It is understandable to feel concerned after noticing new changes.

The episode of pus during middle school, especially without sexual activity, was more likely due to balanitis (inflammation of the glans and foreskin) caused by hygiene issues rather than a sexually transmitted infection.

Regarding the bumps you are currently seeing, in individuals without sexual experience, these are far more likely to be benign conditions such as pearly penile papules or Fordyce spots, which are normal anatomical variations.

HIV is typically transmitted through sexual contact or blood exposure, and penile bumps are not a primary or typical symptom of HIV. Therefore, based on your history, the likelihood of HIV is extremely low.

However, if the bumps change in appearance, increase rapidly in number, or cause discomfort, it would be advisable to visit a urology clinic for proper evaluation and reassurance.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 47

Post-Operative Exercise Guidelines: When can I return to the gym after circumcision?

Accepted Answer

Light upper-body training is generally permitted after stitches are removed (around 2 weeks). However, high-intensity workouts, leg days, or exercises that increase abdominal pressure should be avoided for at least one month. Excessive movement before the site fully heals can cause dehiscence (wound opening) or bleeding. Gradually increasing intensity after a professional follow-up check is the safest approach.

Question 48

Clinical Indications for Circumcision: Managing Severe Phimosis and Intercourse Pain

Accepted Answer

If the foreskin cannot be retracted, it is likely a case of 'True Phimosis.' This not only interferes with sexual activity but can also lead to hygiene issues or infections. In such cases, circumcision is a medically effective solution. While you can return to light daily activities almost immediately, we recommend 2-3 days of rest, and sexual intercourse should be avoided for at least 4 weeks to ensure full healing of the surgical site.

Question 49

Identifying Abnormal Spots on the Urethral Meatus: Pigmentation or Pathology?

Accepted Answer

While a black spot without pain may be simple melanin pigmentation (a freckle-like spot on the mucosa), it could also represent a small hematoma (bruise) or a rare dermatological condition. It's important to monitor for any changes in size, shape, or color. To rule out any pathological issues, a visual inspection by a urologist is recommended. Early detection is key to peace of mind.

Question 50

Post-Circumcision Swelling: Understanding the 'Doughnut' Effect During Recovery

Accepted Answer

This 'doughnut' swelling is a very common and normal part of the recovery process after circumcision. It occurs as the lymphatic and blood vessels re-establish themselves. Swelling typically peaks between the first and second weeks. As long as the swelling is gradually decreasing and involves no severe pain or heat (signs of infection), you should continue following your post-op care instructions. It will eventually be absorbed by the body.

Question 51

When is it safe to masturbate after circumcision (9 days post-surgery)?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

At 9 days after circumcision, although the outer wound may appear to be healing, the internal tissues and blood vessels are still in recovery.

Engaging in masturbation or any physical stimulation at this stage—especially before stitch removal—can increase the risk of wound reopening, bleeding, or delayed healing.

In general, it is recommended to wait at least 4 weeks after surgery before resuming masturbation or sexual activity.

Even erections alone can place tension on the surgical site, and premature stimulation may lead to larger scars or prolonged recovery time.

After the stitches are removed, additional time is still needed for the tissue to fully stabilize.

If you notice redness, swelling, or pain at the surgical site, it is advisable to visit a urology clinic for evaluation.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 52

Is it normal to not have wet dreams (no ejaculation during sleep) as a male?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

Not having wet dreams does not indicate any health problem.

Wet dreams (nocturnal emissions) are a natural way for the body to release semen, but they are not a necessary or universal process for all males.

Even without ejaculation through masturbation or wet dreams, sperm does not continue to accumulate indefinitely. Instead, it is naturally broken down and reabsorbed in the body, particularly in the epididymis, or may be released in small amounts during urination.

In some cases, wet dreams may occur during sleep without being noticed, so the absence of conscious awareness does not necessarily mean they never happen.

Therefore, the presence or absence of wet dreams should not be used as a measure of male health or function.

If you experience other symptoms or concerns, it is always a good idea to consult a urology clinic for proper evaluation.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Question 53

Is HoLEP surgery covered by health insurance? (BPH in Gangnam)

Accepted Answer

You inquired about HoLEP surgery among prostate hyperplasia treatment methods. First, if there is no improvement despite taking medication for a long time, you can consider procedures or surgery for prostate hyperplasia.

There are various treatment methods such as HoLEP surgery, Urolift, and Rezum therapy, so it is important to choose the best treatment method for each individual patient.

Among these, HoLEP surgery uses a Holmium laser to completely separate the hyperplastic prostate tissue between the outermost membrane and the enlarged tissue and remove it from the body. HoLEP (Holmium Laser Enucleation of the Prostate) is a frequently chosen surgery recently because it allows for rapid recovery and less bleeding among prostate hyperplasia surgeries.

Many patients worry about 'cost' first when they hear about surgery. This is especially true for those in professional life or families caring for elderly parents. Many people eventually decide on surgery because their urine stream is not refreshing even after taking medicine for a long time and they wake up frequently at night.

The cost of HoLEP surgery is relatively low compared to other surgeries because health insurance applies.

The total cost of HoLEP surgery is usually formed in the 2-3 million won range. Of course, if you have private insurance, some items may be coverable, so it is good to check with your insurance company in advance.

As explained earlier, HoLEP surgery, unlike conventional laser surgery that burns away tissue, completely removes the hyperplastic prostate tissue and takes it out of the body, so it can see an effect similar to open surgery. The advantage is that since the surgery is performed with an endoscope, there is almost no pain or bleeding caused by the surgery.

If you are considering choosing a treatment method for prostate hyperplasia, I recommend you consult with a urologist at a hospital where all treatment methods, including HoLEP surgery, Rezum therapy, and Waterjet robotic surgery, are possible before making a decision.

Since the size and location of prostate hyperplasia vary from person to person, it is important to choose a treatment method that fits the individual.

Also, since the appropriate treatment method can vary depending on the degree of individual symptoms, duration of illness, and presence of complications, you must choose the best method for you to be effective in treatment.

I hope my answer was helpful in researching HoLEP surgery. Thank you.

Question 54

Do I need to see a urologist for frequent urination?

Accepted Answer

It must be very uncomfortable for you to visit the bathroom so many times during a short outing and even before going to sleep. Urinating 6-7 times during a 2-hour outing is significantly higher than the average frequency.

These symptoms can be caused by various factors such as benign prostatic hyperplasia (BPH) or overactive bladder, and it is necessary to check for symptoms like urgency or a feeling of residual urine.

Rather than visiting a tertiary (large) hospital right away, I recommend visiting an urology clinic first for basic tests. Most urinary discomforts can be diagnosed and managed effectively at urology clinics equipped with proper diagnostic systems, so do not worry too much.

For now, try to reduce beverages that irritate the bladder, such as caffeine or alcohol, and if symptoms persist, it is important to find where the irritation is coming from—whether it's the bladder muscle or nerves—to regain a comfortable daily life.

At our urology clinic, we identify each patient's symptoms and health status based on rich clinical experience at each branch and provide customized treatment plans.

Since finding the cause is the first step in treatment, I recommend seeing a urologist if symptoms continue. I hope this helps. Thank you.

Question 55

Will Aquablation surgery for BPH be effective? (Gangnam Station BPH)

Accepted Answer

I believe you must be suffering a lot in your daily life due to urinary discomfort caused by prostate hyperplasia. The Aquablation treatment you inquired about is a robotic surgical method that removes enlarged prostate tissue using a high-pressure waterjet.

The characteristic is that since it does not use thermal energy, it can reduce damage to surrounding tissues and the possibility of sexual function side effects is lower compared to conventional surgical methods. Also, since the robot system removes tissue as much as the pre-planned range, the surgery time is shortened and the recovery is relatively fast.

However, it is necessary to check if it is a medical institution equipped with the equipment, and the appropriate treatment method can vary depending on the size or shape of your prostate. Therefore, a consultation process is necessary to see if this method is suitable for you through an examination.

After Aquablation surgery, you can expect results such as an improvement in the thickness of the urine stream and residual urine sensation, and an overall improvement in the quality of life.

If you neglect symptoms, it can also affect bladder function, so I hope you visit early and receive necessary measures. It is helpful to check your urination status carefully and manage it through regular checkups.

Choosing the treatment that is essential for you through sufficient consultation is the shortcut to regaining a healthy daily life.

At our urology department, based on rich clinical experience at each branch, we identify the symptoms and health status of each patient in detail, make an accurate diagnosis, and provide a tailored treatment plan accordingly.

Finding the exact cause is the first step in treatment, so if uncomfortable symptoms persist, I recommend you receive an examination at a urology clinic.

I hope the answer was helpful. Thank you.

Question 56

BPH Symptoms - Weak Urine Stream (Gangnam Station BPH Symptoms)

Accepted Answer

Hello, this is Dr. Kyung-ho Ryu, a Doctalk-Naver KnowledgeiN consulting physician.

You're considering tests for BPH symptoms. First, benign prostatic hyperplasia is a very common condition where the prostate tissue gradually enlarges as aging progresses, compressing the urethra and causing various urinary dysfunction symptoms.

Generally, the prevalence rate increases rapidly after the 50s, but recently, due to various environmental factors such as westernized eating habits, stress, and prolonged sedentary lifestyle, symptoms can also appear in relatively younger age groups.

BPH Symptoms

✔️ Weak stream: The urine stream becomes thin and weak.

✔️ Hesitancy: It's difficult to start urinating and requires straining.

✔️ Intermittency: The urine flow stops and starts.

✔️ Delayed urination: It takes a long time to urinate.

✔️ Frequency: You go to the bathroom frequently.

✔️ Nocturia: You wake up multiple times at night to urinate.

✔️ Urgency: Sudden urge to urinate that's hard to hold.

✔️ Residual urine sensation: Feeling like urine remains in the bladder after urinating.

BPH Tests

Diagnosing BPH is a comprehensive process that goes beyond simply checking the size of the prostate, including the severity of symptoms the patient experiences, bladder function status, and ruling out other serious conditions.

✔️ Interview and symptom questionnaire: Check how often you urinate, how urgent it is, how many times you wake up at night, etc., based on the International Prostate Symptom Score (IPSS).

✔️ Digital rectal examination (DRE): A test where the prostate is directly felt through the anus. It's a necessary basic examination that can simply check size, firmness, and abnormalities.

✔️ Uroflowmetry + residual urine measurement: Measures urine stream strength, urination time, and how much urine remains in the bladder after urination to identify functional problems.

✔️ Urinalysis and blood test (PSA): Checks for infection or prostate cancer possibility through basic urinalysis and prostate-specific antigen (PSA) levels.

BPH patients can effectively control symptoms through medication. However, if symptoms don't improve despite long-term medication, or if complications such as acute urinary retention, recurrent urinary tract infections, bladder stones, or kidney function decline occur, surgical treatment is considered.

Currently, surgical treatments for BPH range from relatively minimally invasive procedures like UroLift to highly effective HoLEP surgery.

It's important to comprehensively consider the patient's prostate size, symptom severity, and preferences to select the most suitable treatment that will yield the best results for the individual.

BPH Surgical Treatments

✔️ Waterjet robotic surgery: Can be performed regardless of prostate size or shape, using high-pressure spray to precisely and consistently ablate prostate tissue with micro-level minimal invasion without heat energy generation.

✔️ HoLEP surgery: Uses holmium laser to separate between hyperplastic tissue and capsule, removing hyperplastic tissue entirely like peeling an orange, leaving no hyperplastic tissue with minimal bleeding, side effects, and low recurrence rate.

✔️ UroLift: Instead of ablating or burning the prostate with laser, this surgical method simply binds and fixes the left and right sides of the enlarged prostate tissue to widen the urethra. No hospitalization needed and can be easily performed under local anesthesia, making it suitable for those with heart disease or other conditions where anesthesia is burdensome.

✔️ Plasma TURis: Surgery that uses low-temperature plasma to instantly vaporize and remove blood vessels and hyperplastic tissue.

✔️ Rezum procedure: Transurethral prostate ablation using steam, can proceed under local anesthesia, making it possible even for elderly or those with underlying conditions. Also gaining attention as a promising procedure with low possibility of retrograde ejaculation while having treatment effects comparable to surgery.

✔️ iTind surgery: Surgical method that widens narrowed prostate urethra area with a stent, removed within 5-7 days after surgery. Even after device removal, the prostate urethra area remains in an expanded state, allowing normal urination. Same-day discharge is possible with minimal retrograde ejaculation and low possibility of long-term complications.

I recommend seeing a urologist for diagnosis if BPH symptoms persist. Thank you.

Question 57

Question about Balanitis!

Accepted Answer

Hello, this is Dr. Kyung-ho Ryu, a Doctalk-Naver KnowledgeiN consulting physician.

You've been diagnosed with balanitis. To conclude first, just because you've been diagnosed with balanitis doesn't necessarily mean you must have circumcision.

The current inflammation can be sufficiently treated through antibiotic or anti-inflammatory prescriptions and appropriate ointment application.

However, if inflammation repeatedly recurs despite thorough hygiene management, or if the foreskin is too tight to expose the glans smoothly, making it difficult to maintain cleanliness, circumcision can be a fundamental solution.

This is because frequent inflammation can cause the foreskin to harden (adhesion) or lead to chronic pain.

If the foreskin naturally retracts well, the priority should be to calm the inflammation through medication. If the same symptoms continue to recur afterward, causing inconvenience in daily life, it's not too late to carefully decide on surgery after consulting with a urology specialist.

At our urology clinic, based on abundant clinical experience at each branch, we carefully assess each patient's symptoms and health status to make an accurate diagnosis and provide a customized treatment plan accordingly.

Finding the cause is the first step in treatment, so if uncomfortable symptoms persist, I recommend seeing a urologist.

I hope this answer helps. Thank you.

Question 58

Sudden Hematuria and Burning Sensation in Women: Is it Cystitis or Urethritis?

Accepted Answer

Even without sexual history, women can experience acute cystitis (bladder infection) or urinary tract infections. Hematuria at the end of urination suggests significant irritation of the bladder mucosa. While water intake helps flush some bacteria, it may not completely eliminate the infection. If the root cause is not treated, it can recur or lead to a more serious kidney infection. I strongly advise a formal evaluation and a course of antibiotics to ensure a full recovery.

Question 59

Erectile Dysfunction in Young Men: The Impact of High-Intensity Overtraining

Accepted Answer

Excessive high-intensity training without adequate recovery can lead to systemic fatigue and a temporary drop in cortisol and testosterone balance, often resulting in psychogenic erectile dysfunction. Physical exhaustion prevents adequate blood flow to the pelvic region during intimacy. Adjust your training intensity to focus on recovery and reduce psychological pressure. If symptoms persist, a hormonal and blood flow evaluation is recommended.

Question 60

Hematuria Following Initial Sexual Intercourse: Distinguishing Cystitis from Pregnancy Concerns

Accepted Answer

The symptoms of hematuria, frequency, and abdominal pain after initial intercourse are classic signs of 'honeymoon cystitis,' where bacteria enter the urethra during intimacy. While it doesn't immediately suggest pregnancy or an STD, a urinalysis and potentially a culture test are necessary to confirm the diagnosis and rule out other infections. You can visit either a urology or a gynecology clinic for this.

Question 61

Chlamydia Treatment Duration: Why am I still in pain after medication?

Accepted Answer

It typically takes about 3 to 7 days for the bacteria to be eradicated and for the inflammation to subside enough for symptoms to disappear completely. It is likely that the medication is still working or your tissue is recovering. If symptoms persist beyond a week, a follow-up visit is necessary. Remember to avoid sexual contact until you have been cleared and ensure your partner is also treated.

Question 62

Is it erectile dysfunction if I can get erections alone but not during sex? Treatment options?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

It is understandable to feel frustrated when an erection does not occur at an important moment.

If you are able to achieve normal erections during morning erections or masturbation, but experience difficulty only during intercourse, this is more likely due to psychological factors, commonly referred to as psychogenic erectile dysfunction.

Erectile dysfunction is generally defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual activity. When symptoms occur only in specific situations, factors such as performance anxiety, stress, or pressure to perform well are often involved.

In such cases, treatment may include short-term use of erectile dysfunction medications, which help improve blood flow and restore confidence during intercourse.

Addressing psychological factors alongside medical support can significantly improve symptoms.

We recommend visiting a urology clinic for proper evaluation and guidance tailored to your condition.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, medical evaluation is recommended.

Thank you, and we hope this information was helpful.

Question 63

I have difficulty holding urine both day and night. Is it overactive bladder?

Accepted Answer

Overactive bladder (OAB) is a condition where, unlike cystitis, there is no inflammation in the bladder, but symptoms of frequent urination and inability to hold urine occur. Normally, people do not feel significant discomfort until the bladder holds about 400-500ml of urine. However, for those with OAB, the bladder muscles contract even with small amounts of urine, creating a strong urge that is difficult to suppress.

If you find yourself going to the bathroom more than 8 times a day, experiencing urgency where it's hard to hold it, or waking up during the night to urinate (nocturia), you may suspect an overactive bladder.

Finding the cause is the first step in treatment, so if uncomfortable symptoms persist, I recommend seeing a urologist. I hope this helps. Thank you.

Question 64

Popping sound during erection—could this be penile fracture or corpus cavernosum injury?

Accepted Answer

Hello, this is Dr. Changki Lee from Goldman Urology Clinic, Incheon.

Hearing a popping sound during intercourse followed by sudden loss of erection can indicate that mechanical stress was applied to the penile tissues, including the tunica albuginea or the corpus cavernosum.

A complete penile fracture typically presents with severe pain, rapid swelling, and visible deformity. However, in some cases, there may be minor or partial injury, which may not show obvious external signs but can still lead to reduced erection quality or rigidity.

Based on your symptoms—especially the change in erection strength and maintenance—it is difficult to rule out a subtle injury to the erectile tissue or vascular structures.

If left unexamined, such conditions may contribute to long-term erectile dysfunction.

We recommend visiting a urology clinic for further evaluation, which may include penile ultrasound or blood flow assessment, to determine the exact cause and guide appropriate treatment.

At our clinic, we carefully assess each patient’s condition and provide accurate diagnosis and personalized treatment plans.

Identifying the cause is the first step toward effective treatment.

If your symptoms persist, we strongly recommend seeking medical evaluation.

Thank you, and we hope this information was helpful.

Health Q&A

What tests are needed for benign prostatic hyperplasia (BPH) in older adults?

Sudden Scrotal Discomfort in Adolescence: Differentiating Torsion from Positional Pain

Will self-medicating with antibiotics affect the accuracy of STD testing?

Experiencing Sensation of Ejaculation Without Fluid: Understanding Retrograde Ejaculation

Why does my urine turn bright yellow after taking cold medication?

Could recent changes in ejaculation timing be a sign of Premature Ejaculation?

Overcoming Psychogenic Urinary Frequency: When Stress Affects Bladder Control

Could it be Male Menopause at 41? Symptoms of Fatigue and Low Libido

What Happens During a Urology Visit for Cystitis? Diagnosis and Treatment Process

How often should adults urinate per day?

Is foamy urine normal in teenagers?

What causes pain during urination?

Diagnosis and Treatment Options for Anal Condyloma (Genital Warts)

Is HoLEP Surgery Safe and Effective for Benign Prostatic Hyperplasia (BPH)?

Do I Need Surgery for Kidney Stones? When Severe Pain Requires Treatment

Bacterial vs Non-Bacterial Prostatitis: Do Treatment Methods Differ?

Will Pain Go Away After Kidney Stone Removal Surgery? What to Expect

How Are Kidney Stones Removed with Endoscopic Surgery? Procedure Explained

What Should I Expect After Circumcision? Recovery and Care Guide

Is Cystitis a Sexually Transmitted Disease? Differences Between UTI and STD

I Think I Have Premature Ejaculation—What Should I Do? Causes and Treatment

Can Teenagers Have Blood in Urine? Causes of Hematuria in Adolescents

How Is Herpes Type 2 Transmitted? HSV-2 Infection Routes Explained

Is This Blood in My Urine? Causes of Hematuria and When to Seek Care

Why Does My Urethra Sting? Causes of Urethral Pain in Men

Can Epididymitis Recur? Causes and Prevention of Recurrence

Should I Get Circumcision? Benefits, Risks, and When It Is Recommended

Could This Be Testicular Torsion? Symptoms That Require Emergency Care

Is This a Serious STD? When to Be Concerned About Sexually Transmitted Infections

Erectile Dysfunction in Your 20s: Causes and Treatment Options

Blood in Urine for Several Days—Is It Serious? Causes and When to See a Doctor

Is itching normal after circumcision?

Could white discharge and painful urination after sex be urethritis?

Is circumcision safe for adults, and does it reduce sensitivity?

Why does it hurt when I urinate and touch the tip of my penis?

Is it normal to have a scab after frenulum removal in circumcision?

Do I need circumcision if my glans is fully exposed during erection?

Can dissolvable stitches after circumcision heal faster or be removed early?

Why is my urine color unusual?

Is smegma buildup normal in teenagers and how should it be cleaned safely?

Severe itching 2 weeks after circumcision—is this normal after stitch removal?

Do I need circumcision if I cannot retract my foreskin and feel pain as a teenager?

Is yellow discoloration and bumps normal 4 days after circumcision or a sign of infection?

How can Gardnerella be detected in men after years without sexual activity? (Latency explained)

Is hypersensitivity normal 3 days after circumcision and when can I wear clothes comfortably?

Penile bumps without sexual activity—could this be an STD or HIV?

Post-Operative Exercise Guidelines: When can I return to the gym after circumcision?

Clinical Indications for Circumcision: Managing Severe Phimosis and Intercourse Pain

Identifying Abnormal Spots on the Urethral Meatus: Pigmentation or Pathology?

Post-Circumcision Swelling: Understanding the 'Doughnut' Effect During Recovery

When is it safe to masturbate after circumcision (9 days post-surgery)?

Is it normal to not have wet dreams (no ejaculation during sleep) as a male?

Is HoLEP surgery covered by health insurance? (BPH in Gangnam)

Do I need to see a urologist for frequent urination?

Will Aquablation surgery for BPH be effective? (Gangnam Station BPH)

BPH Symptoms - Weak Urine Stream (Gangnam Station BPH Symptoms)

Question about Balanitis!

Sudden Hematuria and Burning Sensation in Women: Is it Cystitis or Urethritis?

Erectile Dysfunction in Young Men: The Impact of High-Intensity Overtraining

Hematuria Following Initial Sexual Intercourse: Distinguishing Cystitis from Pregnancy Concerns

Chlamydia Treatment Duration: Why am I still in pain after medication?

Is it erectile dysfunction if I can get erections alone but not during sex? Treatment options?

I have difficulty holding urine both day and night. Is it overactive bladder?

Popping sound during erection—could this be penile fracture or corpus cavernosum injury?

Could this be a symptom of urethritis?

Prostatitis

Does STD panel testing detect non-gonococcal urethritis and what are the symptoms?

Cystitis, Acute Pyelonephritis Symptoms - Frequency and Urgency