The following program
presents principles designed
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to promote good
health and is not intended
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to take the place of
personalized professional care.
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The opinions and ideas expressed
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are those of the speaker.
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Viewers are encouraged to
draw their own conclusions
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about the information presented.
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Urogenital pain
although sometimes uncomfortable
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to talk about is
an important issue
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to discuss with your physician,
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if you are
experiencing symptoms.
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As we continue on
our series on pain today,
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we'll discuss some
of the common causes
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and treatments on
this difficult topic.
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I'm Dr. James Marcum.
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Are you interested in
discovering the reason why?
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You want solutions to
your healthcare problem?
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Are you tired of
taking medications?
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Well, you're about to be
given the ultimate prescription.
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Welcome to the program today,
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you're watching the
Ultimate Prescription
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and I'm your host Nick Evenson.
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On this series of
programs, we're discussing pain
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throughout the body.
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And today's topic
is urogenital pain.
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Sometimes this can be a
difficult topic Dr. Marcum
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but thank you for taking
this on as it's important.
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Yeah, a lot of
people have problems
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with the urogenital pathways,
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and the
specialists that deal with this
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are the gynecology specialists.
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Right.
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And urologists, that
they spend their whole life
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talking about this
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and these are
causes of pain that's real.
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And
unfortunately a lot of people
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when they have urogenital pain
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that they don't
want to talk about it,
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they don't want to
they sort of put it off.
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Now let's talk
about that for a second
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because you know as
Bible believing Christians,
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God made the entire body
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and he made it to
function in a certain way
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that doesn't know have pain,
weren't designed to have pain.
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Right.
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So we shouldn't feel embarrassed
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to talk about these
things with our physicians,
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why do you think that is?
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I don't know, but you know,
we're gonna talk about males,
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you know, when they have
problems with their penis,
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or scrotum, or that they just
don't like to talk about it.
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Now women, I don't know,
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'cause I don't deal
with this type of pain,
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but I guess it's
the same thing too,
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it is something that's private.
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You know, we've always
talked about this, you know,
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private parts but we
want to give people a feel
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for the different types of pain,
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pains it could be
dangerous, what's causing them,
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because I think at one point
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we pointed out
in this pain series,
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is pain means something's wrong.
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That's right,
and you can't ignore
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something that's wrong.
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Of course, and as we
get back to God's plan,
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that's the best
plan to prevent pain,
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but when pain's happening,
if it's a right away pain,
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we want to get that evaluated
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and if we can get over the hump,
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maybe we can prevent
that from happening again.
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And of course we don't want
to have chronic pain as well.
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So I guess a good place to
start for everybody would be
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understanding the
anatomy, what's the parts,
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because of the
parts that we understand,
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that we could understand
where the pain's coming from.
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But uro means urological,
okay, that's the urine, okay,
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that's getting
rid of the wastes.
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The kidneys do that okay,
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and the kidneys get
rid of our waste products
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and then it
comes out these tubes
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called the ureters, okay.
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And then the ureters go down
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and they put it into a
reservoir called the bladder,
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which stores that and
then eventually comes out
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through either the
penis or in the women
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it comes out of uterus too
and then you go to the bathroom
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and get the waste out of you.
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So sometimes those
parts can have problems, okay.
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So that's one part
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and then also we have
our reproductive parts, okay.
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That's right, yeah.
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Okay, in the man it
happens to be that the scrotum,
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the epididymis,
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the tubes that connect
into the reproductive organs,
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the testis,
those type of things.
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In the women they have
the reproductive parts too.
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You know, we talk about
that the ureters, the ovaries.
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We have the uterus in that area
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and all along the line
of the reproductive track
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and the ureter that
makes up the urogenital system.
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Okay.
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And all of those
can have problems,
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not only can the
parts leading to it,
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but the parts that
support it have problems.
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Right.
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There's muscles
around these parts
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that support it.
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Frequently people
have bladder problems,
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it's because the
muscles get weak overtime.
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And unfortunately in women,
if you have lots of babies,
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okay, sometimes babies
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that pull can put
trauma on the system,
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can weaken muscles and
there's different things
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that can do that and sometimes
some of this can lead to pain,
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and when pain happens,
if we know what's causes it,
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we can deal
with it a lot better.
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So this is something
that we need to talk about
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and that's just
understanding the parts
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I think is a
good place to start.
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Yeah, it is a good
description of the anatomy.
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Now what types of pain
might someone experience?
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So let's talk
about some of the most
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common causes of
pain in all these parts.
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Yeah. Okay.
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And I guess
probably the most common one
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that I hear about
is infections, okay.
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We heard about infections
in the urinary tract...
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Right. That can cause pain.
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So any time the
urine doesn't move
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there could be an infection.
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Okay.
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So you know the
bladder doesn't move,
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there can be infection...
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Sometimes you can get
it by introducing bacteria
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into the tract.
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Sometimes there
could be connections
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that we're not supposed to have.
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So if the urine is not
moving, is that because
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there is a state of
dehydration causing that,
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or because of a blockage?
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Either one of that,
you're right on top of that.
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The doctor will
describe what is it,
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they're not getting
enough water, is that it,
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are they
introducing an infection
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into the organ systems,
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and sometimes
during reproduction
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we introduce bacteria,
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you know, is it because
of an anatomical abnormality.
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Right.
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And the doctor will
evaluate that infection.
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So infections in women,
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women have more
urine inspections
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than men do, but
men can get them too.
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It's a lot a lot
rare, sometimes the urine
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can't get out of the men
if the prostate gets enlarged,
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sometimes the
urine can't get out,
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sometimes the
prostate gets infected,
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we call that prostatitis.
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Another big causes of
problems is infections
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in the reproductive organs.
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Okay.
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Especially people that
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they have illicit relationships,
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multiple partners, sometimes
that can lead to infections.
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Right.
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There are other
different types of infections.
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So that's probably the
most common causes of pain
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in the urogenital
system is infections,
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urinary as well as
reproductive infections.
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What cause...
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What do we do we
have when we have it?
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Yeah, yeah. Okay.
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Well, this is the
time to go see your doctor,
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if you're having pain,
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either in the
reproductive organ,
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or when you go to the bathroom,
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pain means something's abnormal,
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one of the top
things on the list
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is to make sure you're
not having an infection.
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Right. Okay.
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Now another
terrible cause of pain is
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if the tubes get
blocked up or something,
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okay, especially the
tubes that lead to the kidneys,
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to the ureters.
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Sometimes the body makes this,
the metabolism makes stones.
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Like kidney
stones. Yeah, exactly.
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And the stones can
travel out into the ureters,
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and you can have a kidney stone.
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Now what causes
the kidney stone,
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what is a kidney
stone made up of,
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because it's not
a stone like a rock?
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No, no, it is stone like a rock,
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but it can be made up
of different chemicals.
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Sometimes it could be calcium,
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another type of
crystal as oxalate crystal.
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But it's usually in air,
in metabolism in the body.
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So the kidneys we
get too much of something
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and then too much of
something turns into a stone,
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and sometimes this
is the diets we eat,
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sometimes it's genetics,
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sometimes it's not
drink enough water.
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So if you're a stone
former, your urologist
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would want to see
what type of stone it is,
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so he can guide you on
things that you can do.
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But if you get a stone in there,
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it's very painful.
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Yeah.
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So you have pain when
you go to the bathroom,
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they say it's some of
the worst pain in your life.
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Sometimes you can
feel it in your plank,
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and they can do
some simple X-ray test
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to see if you have a stone,
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and then
depending on the size of it,
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sometimes people pass the stone.
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Okay. Sometimes people...
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The stones are too big,
and they can't pass the stone.
00:07:59.21\00:08:02.54
And the
treatment for that stone,
00:08:02.58\00:08:04.38
if you can't pass it as
they can now do ultrasound,
00:08:04.41\00:08:07.22
which can sometimes break it up,
00:08:07.25\00:08:09.28
they can, of
course, cut the stone out,
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sometimes they
can put a stent in it.
00:08:11.49\00:08:14.32
So stones happen in
both males and females,
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it's very, very painful.
00:08:17.49\00:08:18.83
So in the urogenital tract,
00:08:18.86\00:08:20.63
if you're having pain
evaluate for an infection,
00:08:20.66\00:08:23.53
sometimes you have
evaluate for a stone.
00:08:23.57\00:08:26.77
Those are the things you can do.
00:08:26.80\00:08:28.14
So if it's not an infection,
not a urinary tract infection
00:08:28.17\00:08:31.94
and it's not kidney
stones, or anything like that.
00:08:31.97\00:08:34.78
Actually, I
understand, does that occur
00:08:34.81\00:08:36.38
anywhere besides the kidneys?
00:08:36.41\00:08:37.75
Yeah, you can
have stones, of course,
00:08:37.78\00:08:39.11
we hear of gallstones you can...
00:08:39.15\00:08:41.35
other parts of the
body, it gets stuck in a tube
00:08:41.38\00:08:44.92
and the tube
can't get the material
00:08:44.95\00:08:46.72
that supposed to move
to that tube through it,
00:08:46.76\00:08:48.96
whether that be
there's the bile ducts
00:08:48.99\00:08:51.23
or whether it'd be ureters
00:08:51.26\00:08:52.63
and that
eventually causes a problem.
00:08:52.66\00:08:54.86
But lots of tubes in
the body can get clogged up.
00:08:54.90\00:08:58.03
And they usually
get passed through?
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Well, sometimes they
pass, sometimes it's too large,
00:08:59.97\00:09:02.50
and they can't pass through.
00:09:02.54\00:09:03.87
Okay.
00:09:03.91\00:09:05.24
So of those are
probably some of the two most
00:09:05.27\00:09:06.61
common causes of pain
in this part of the body,
00:09:06.64\00:09:08.91
then there is the pain
when we have relations.
00:09:08.94\00:09:11.58
Okay, and that
gives dyspareunia,
00:09:11.61\00:09:13.98
painful intercourse.
00:09:14.02\00:09:16.35
In a female probably the most
common cause of that pain is
00:09:16.38\00:09:20.42
atrophy of that vaginal area.
00:09:20.46\00:09:23.46
Okay.
00:09:23.49\00:09:24.83
And that's usually
caused by a lack of estrogen.
00:09:24.86\00:09:27.06
Okay.
00:09:27.10\00:09:28.43
And if this is
happening sometimes,
00:09:28.46\00:09:29.93
an estrogen cream
can be very helpful.
00:09:29.96\00:09:32.73
Another part that can
cause pain on relations
00:09:32.77\00:09:35.97
is vaginitis or infections,
and that can present as a pain
00:09:36.00\00:09:39.81
that's
inflammatory, itchy, burning
00:09:39.84\00:09:43.24
and a very common infection
in that area is Candida.
00:09:43.28\00:09:46.51
Candida is a
very common infection,
00:09:46.55\00:09:48.35
so if a females
having pain with relations,
00:09:48.38\00:09:51.99
the first thing they want
to do is see their doctor,
00:09:52.02\00:09:54.42
and their doctor will evaluate
00:09:54.46\00:09:55.79
to see if they
might be lacking estrogen,
00:09:55.82\00:09:57.73
or there's some other
type of infectious processes
00:09:57.76\00:10:00.33
going on that might be
contributing to that pain.
00:10:00.36\00:10:03.30
Men can also have pain as well,
00:10:03.33\00:10:05.47
and the same
process would go on.
00:10:05.50\00:10:07.44
You make sure there
is not an infection,
00:10:07.47\00:10:08.94
make sure there's no...
00:10:08.97\00:10:10.31
the tissue is not doing well,
and that can help quite a bit.
00:10:10.34\00:10:14.18
Now one pain that
we have to talk about
00:10:14.21\00:10:16.18
in the urogenital
area is dysmenorrhea
00:10:16.21\00:10:19.08
that's pain during
the menstrual cycle.
00:10:19.11\00:10:20.98
Okay.
00:10:21.02\00:10:22.65
Unfortunately this is
the major issue. Okay.
00:10:22.68\00:10:25.65
In fact in women
that are menstruating
00:10:25.69\00:10:27.82
10% of the time they describe
that pain is incapacitating,
00:10:27.86\00:10:32.39
they can't even function
00:10:32.43\00:10:34.16
and
unfortunately 80% of the time
00:10:34.20\00:10:36.73
when they're
evaluated by their gynecologist,
00:10:36.77\00:10:39.43
80% of time
there's no pathology,
00:10:39.47\00:10:42.30
we don't know why.
00:10:42.34\00:10:43.91
Just happens...
It just happens...
00:10:43.94\00:10:45.27
And understood cause.
00:10:45.31\00:10:46.64
Yeah, but a couple
things that are reassuring
00:10:46.68\00:10:48.01
usually it
lessens after pregnancies,
00:10:48.04\00:10:50.95
it seems it go away overtime
and if it gets really bad,
00:10:50.98\00:10:55.92
there's some
medicines that can help it.
00:10:55.95\00:10:57.45
And what happens is that
the chemistry of the body,
00:10:57.49\00:11:00.56
you have a
process called myometrium
00:11:00.59\00:11:03.02
that's where the
muscles don't work as well.
00:11:03.06\00:11:05.73
And the contractions caused
by increased prostaglandins
00:11:05.76\00:11:09.96
in the body during
this whole process,
00:11:10.00\00:11:11.83
so sometimes just
blocking prostaglandins,
00:11:11.87\00:11:14.70
help on this dysmenorrhea
or painful period cycle
00:11:14.74\00:11:18.44
and the thing
that helps with that
00:11:18.47\00:11:20.71
probably the most as anything
that blocks prostaglandin.
00:11:20.74\00:11:23.75
And non-steroidals or medicines,
00:11:23.78\00:11:27.05
Advil and Motrin
that block prostaglandins,
00:11:27.08\00:11:29.75
that might help him a lot.
00:11:29.78\00:11:32.49
Now tell me again
what is prostaglandin,
00:11:32.52\00:11:34.32
is this a...
00:11:34.36\00:11:35.69
Yeah, it's a
chemical that the body makes
00:11:35.72\00:11:37.13
and we know that it's increased,
00:11:37.16\00:11:40.26
increased prostaglandins
00:11:40.30\00:11:41.63
cause the muscles to cramp more.
00:11:41.66\00:11:43.47
Okay.
00:11:43.50\00:11:44.87
Some reasons the women
make more prostaglandins
00:11:44.90\00:11:47.60
during their
periods, the hormonal changes,
00:11:47.64\00:11:50.17
but the good news is,
00:11:50.21\00:11:51.54
it seems to get
better after pregnancy.
00:11:51.57\00:11:54.18
And we have to talk about it,
because 10% is incapacitating
00:11:54.21\00:11:57.81
and if you're out there
and having this problem,
00:11:57.85\00:11:59.95
go and see your
gynecologist, you're not alone.
00:11:59.98\00:12:02.78
A lot of people
have this problem
00:12:02.82\00:12:04.59
that needs to be looked at.
00:12:04.62\00:12:06.52
Well, men also
have infections too.
00:12:06.55\00:12:08.96
That was going to
be my next question.
00:12:08.99\00:12:10.33
Yeah and prostatitis,
infections of the prostate
00:12:10.36\00:12:13.83
are probably the most common.
00:12:13.86\00:12:15.56
Usually in older men,
the prostate gets bigger,
00:12:15.60\00:12:19.13
we can tell what
happens because it hurts
00:12:19.17\00:12:20.90
when you go to the bathroom.
00:12:20.94\00:12:22.27
Okay.
00:12:22.30\00:12:23.64
When it's examined,
the prostate feels big,
00:12:23.67\00:12:25.47
it feels warm, it's
hurting when you're touching.
00:12:25.51\00:12:28.54
And usually when
they look at their urine,
00:12:28.58\00:12:31.75
and they have a urine infection,
00:12:31.78\00:12:33.11
they have a fever,
00:12:33.15\00:12:34.78
it's interesting
because heavier set men
00:12:34.82\00:12:37.12
have more problems with this
00:12:37.15\00:12:38.49
because same like fat increases
00:12:38.52\00:12:40.36
the different
hormonal environments,
00:12:40.39\00:12:42.42
and a lot of
people, as you gain weight,
00:12:42.46\00:12:44.53
you become more estrogenic,
man has more estrogen in them
00:12:44.56\00:12:47.86
than more fat they have in them.
00:12:47.90\00:12:49.36
The more estrogen have in them
and guess what it turns down,
00:12:49.40\00:12:51.70
testosterone.
00:12:51.73\00:12:53.07
Right.
00:12:53.10\00:12:54.44
So one of the treatments for men
00:12:54.47\00:12:55.80
that have lots
infection is to lose weight,
00:12:55.84\00:12:58.27
so that's just sort
of an overview Nick,
00:12:58.31\00:13:01.34
of many of the
causes of urogenital pain.
00:13:01.38\00:13:04.11
The reason we have to
talk about it is because
00:13:04.15\00:13:06.21
if you're having this symptom,
00:13:06.25\00:13:07.95
then you need to
get it evaluated.
00:13:07.98\00:13:09.32
That's right.
00:13:09.35\00:13:10.69
And then we
talked about infections,
00:13:10.72\00:13:12.05
urinary tract infections on
reproductive type infections
00:13:12.09\00:13:16.49
and the
gynecologists and urologists
00:13:16.52\00:13:18.86
can help you through this
and maybe give you some tips
00:13:18.89\00:13:21.76
'cause chronic
pain, Nick, is not good.
00:13:21.80\00:13:23.67
That's right.
00:13:23.70\00:13:25.03
Because chronic pain
causes chemicals in the body,
00:13:25.07\00:13:27.37
hurts us, damages
long-term and creates...
00:13:27.40\00:13:30.47
damage our immune system,
00:13:30.51\00:13:31.94
it makes us
unpleasant to be with,
00:13:31.97\00:13:33.61
when you're in chronic pain.
00:13:33.64\00:13:35.11
And there's some
simple things that we can do,
00:13:35.14\00:13:37.58
medical profession can
help you get over the hump
00:13:37.61\00:13:39.95
and also guide you
at the cause of pain,
00:13:39.98\00:13:42.32
so maybe you
cannot have it anymore.
00:13:42.35\00:13:44.29
Right.
00:13:44.32\00:13:45.65
Well, Dr. Marcum, thank you for
00:13:45.69\00:13:47.02
getting us
started on this topic,
00:13:47.06\00:13:48.39
like it's a difficult one
to talk about for some folks,
00:13:48.42\00:13:49.96
but we thank you
for the advice so far.
00:13:49.99\00:13:51.93
We're gonna be
back in just a moment.
00:13:51.96\00:13:53.80
People were
written into our website at
00:13:53.83\00:13:55.16
heartwiseministries.org.
00:13:55.20\00:13:56.90
And we invite you
to visit the website,
00:13:56.93\00:13:58.27
where you can ask
your health questions.
00:13:58.30\00:14:00.34
And Dr. Marcum will
be back in just a moment
00:14:00.37\00:14:02.27
to answer some of
those, so stay with us.
00:14:02.30\00:14:04.17