- With Mayo Clinic urologist
Erik P. Castle, M.D.
read biographyclose windowBiography of
Erik P. Castle, M.D.
Erik P. Castle, M.D.
Dr. Erik Castle is a board-certified urologist who joined the Mayo Clinic staff in Arizona in 2007.
Dr. Castle is an associate professor of urology at College of Medicine, Mayo Clinic, and a senior associate consultant in the Department of Urology, where he also is assistant residency coordinator.
He was an assistant professor in the Department of Urology at Tulane University in New Orleans from 2004 to 2006 after serving as a clinical instructor/fellow at Mayo Clinic in Arizona for one year.
Dr. Castle's research interests include prostate cancer, bladder cancer and kidney cancer. He is the director of the Desert Mountain Prostate Cancer Research Fund and is the principal investigator of Castle labs housed at the Samuel C. Johnson Medical Research Building at Mayo Clinic in Arizona. His basic science research is focused on novel secondary hormonal therapies of prostate cancer as well as genomics of prostate and bladder cancers.
His surgical expertise includes laparoscopic urology, robot-assisted radical prostatectomy with nerve sparing, robot-assisted radical cystectomy with neobladder, robot-assisted retroperitoneal lymph node dissection, robot-assisted partial nephrectomy and other robotic urologic oncology procedures. He has performed many of these procedures as demonstrations internationally. He is a member of the American Association of Clinical Urologists, the American Urological Association, the Endourological Society, and the Society of Laparoendoscopic Surgeons. He is past president of the international Society of Urologic Robotic Surgery. He is also the director of the international laparoscopic nephrectomy courses throughout Mexico on behalf of the American Urologic Association.
Complications (1)
- Bladder outlet obstruction: Causes in men?
Treatments and drugs (1)
- PSA levels: Can they rise after prostate removal?
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Question
Bladder outlet obstruction: Causes in men?
My doctor says I may have bladder outlet obstruction. What does that mean?
Answer
from Erik P. Castle, M.D.
Bladder outlet obstruction in men is a blockage that slows or stops urine flow out of the bladder.
Chronic bladder outlet obstruction causes urine to back up in your system, leading to difficulty urinating and other bothersome urinary symptoms. If it isn't treated, bladder outlet obstruction can lead to bladder stones, infection and damage to the bladder and kidneys.
There are a number of possible underlying causes of bladder outlet obstruction, including:
- Enlarged prostate, also known as benign prostatic hyperplasia (BPH) — this is a common cause of bladder outlet obstruction in men
- Bladder stones
- Certain medications, including antihistamines, decongestants or drugs to treat overactive bladder
- Scarring of the urinary channel (urethra) or bladder neck, as a result of injury or surgery
- Prostate cancer
Treatment options are based on the underlying cause of bladder outlet obstruction. If the cause is unclear, your doctor will take some steps to help determine the origin of your symptoms. Your doctor or other medical professional may:
- Perform a physical examination. This may include a digital rectal examination. During this test, your doctor will insert a lubricated, gloved finger into your rectum. This allows your doctor feel the surface of your prostate gland to look for signs of prostate enlargement or prostate cancer.
- Conduct a bladder ultrasound. This can help determine how much urine remains in your bladder after you urinate.
- Use a visual scope to look inside your urinary system (cystoscopy). This allows the doctor to examine your prostate, urinary channel (urethra) and bladder for signs of problems.
- Do other tests, such as blood tests or tests to measure urine flow.
Prompt diagnosis and treatment of bladder outlet obstruction is important to prevent serious problems caused by urine backing up into your system.
- Seek emergency treatment if you can't pass any urine and it feels like you have to. In the emergency room, a tube (catheter) will be inserted through the tip of your penis and into your bladder to drain urine.
- Go to the doctor if you can still urinate but have other signs or symptoms of bladder outlet obstruction — especially if your symptoms are accompanied by fever and chills.
PSA levels: Can they rise after prostate removal?
- Gerber GS, et al. Evaluation of the urologic patient: History, physical examination, and urinalysis. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/145142932-3/0/1445/6.html?tocnode=54299532&fromURL=6.html#4-u1.0-B978-0-7216-0798-6..X5001-8--section2_95. Accessed April 11, 2011.
- McVary KT, et al. Lower urinary tract symptoms in men. http://www.uptodate.com/home/index.html. Accessed April 11, 2011.
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