Urology Associates
With 35 urologists, Urology Associates is the leader of urological care in Tennessee. We provide comprehensive and compassionate urological care to men and women.

How Do Kidney Stones Form?

Kidney stones are a particularly painful urologic condition, although significant medical advancements give patients more treatment options than ever before. You can hear about some of them when you watch this video, which features a board certified urologist at Urology Associates, P.C.

Dr. Charles Eckstein explains that kidney stones form when there is a high concentration of crystals in the urine. Over time, these crystals can develop into stones, which may remain small or grow larger. Patients who are treated for kidney stones can work with their urologists to manage their risk factors, which can help prevent recurrent stones.

Kidney stones are one of the many medical conditions treated at Urology Associates, P.C. Patients with kidney stones who live in Tennessee can call us at (855) 901-1338 to request a prompt appointment with an experienced urologist.

Signs of Reduced Estrogen Levels in Women

It's natural for women to experience a significant decline in estrogen levels later in life. Some women suffer from early estrogen deficiency, well before they’re expected to go through menopause. Although a decline in estrogen is natural, it can be problematic for a woman’s sexual health and overall health. One common symptom is vaginal dryness and painful sexual intercourse. Women may notice that they get urinary tract infections (UTIs) more readily. This is due to the thinning tissues of the urethra.

Other possible indicators of low estrogen levels include atypical fatigue, problems concentrating, and depressive symptoms. Mood swings, hot flashes, headaches, and breast tenderness can also occur. As women approach menopause, their periods become irregular or periodically absent. Headaches or the worsening of pre-existing migraine headaches are also common.

The Women’s Institute for Sexual Health (WISH) at Urology Associates, P.C. offers specialized care and a sensitive, personalized approach for women experiencing sexual health issues in Tennessee. Call (615)250-9265 for an appointment.

Possible Culprits for Pain During Sex

Sexual health issues are a topic that many women are hesitant to discuss, even with their doctors. Know that sexual dysfunction is quite common among women, and receiving appropriate treatment is a necessary step toward improving quality of life. In some cases, problems such as painful sexual intercourse could indicate an underlying health problem, such as endometriosis. Women who take the first step by talking to a urology provider are being proactive patients.

Vaginal Atrophy

Vaginal atrophy typically occurs after menopause, when a woman has a drastically reduced amount of estrogen. This hormonal shift causes the vaginal walls to become thinner, less lubricated, and inflamed. In addition to painful sex, women with vaginal atrophy may experience urgent, painful urination, urinary incontinence, genital itching, and frequent urinary tract infections (UTIs).


Vaginismus is the involuntary contraction or spasm of the vaginal muscles when penetration is attempted. It can occur when attempting sexual penetration or tampon insertion. In some cases, vaginismus is believed to stem from past sexual abuse.


Normally, the tissue that lines the uterus is shed each month during a woman’s menstrual cycle. In women with endometriosis, uterine tissue grows outside the uterus. This displaced tissue also attempts to shed each month by growing thicker, breaking down, and bleeding. However, the tissue can’t be expelled. Displaced endometrial tissue can cause significant irritation and inflammation, along with the formation of scar tissue, adhesions, and cysts. Women with endometriosis commonly suffer from pain during or after sex, as well as intense pain during menstruation.

Uterine Fibroids

Uterine fibroids are abnormal growths attached to the uterine wall. These are not cancerous, but they can cause medical problems like pain during sex. Fibroids can range widely in size. Some women have just one, while others have many. In some cases, fibroids don’t cause symptoms. Large fibroids can cause painful sex, along with infertility, pelvic pain or pressure, and heavy, prolonged menstruation.

You’ll find sensitive, confidential care for sexual dysfunction in Tennessee at the Women’s Institute for Sexual Health (WISH). WISH, available at Urology Associates, P.C., takes a multidisciplinary approach to coordinate each patient’s care. Call us at (615)250-9265.

A Stage-by-Stage Look at Testicular Cancer Treatment Options

A testicular cancer diagnosis is devastating. Patients may regain a sense of control over their lives by studying their treatment options with the help of a urologist. Like many other cancers, testicular cancer is often treated with multiple types of medical interventions. Urologists carefully develop treatment recommendations based on the stage and specific type of testicular cancer, along with the patient’s overall health.

In Situ

In situ cancer, or stage 0 cancer, is diagnosed when the cancer is confined to the testicle and the patient doesn’t have elevated levels of tumor markers. In some cases, in situ testicular cancer is managed with close surveillance. It may only need treatment if it shows signs of growing or spreading. If in situ cancer is treated, the testicle is usually removed or treated with radiation therapy.

Stage I

Stage I treatments depend on whether the cancer is a seminoma or non-seminoma. Stage I seminomas are treated surgically by removing the spermatic cord and testicle, followed by active surveillance, or either chemotherapy or radiation therapy. The treatment for stage I non-seminomas typically involves the surgical removal of the testicle, followed by one or more of these options:

  • Active surveillance
  • Removal of the lymph nodes at the back of the abdomen
  • Chemotherapy

Stage II

If the patient has a stage IIA seminoma, he will likely have surgery to remove the testicle, followed by radiation treatment directed at the retroperitoneal lymph nodes. Otherwise, the urologist will likely recommend three or four cycles of combination chemotherapy. After the surgical removal of the testicle for patients with stage II non-seminomas, the level of tumor markers will determine the subsequent treatment. It may be chemotherapy, or the removal of lymph nodes, which may possibly be followed with chemotherapy.

Stage III

Although stage III testicular tumors have spread beyond the testicles, they are still highly treatable. Patients can expect the surgical removal of the testicle, followed by aggressive chemotherapy. It’s possible for cancer at this stage to spread to the brain, in which case the preferred treatment is usually radiation therapy. Surgery might also be an option.

Men with testicular cancer in Tennessee need answers and treatment options they feel confident about. That’s why so many patients have turned to Urology Associates, P.C. for cutting-edge care delivered by compassionate, understanding healthcare providers. New and current patients can reach us at (855) 901-1338.

Cystectomies: What to Know and What to Do

Bladder cancer is one of the less common types of cancer diagnosed in the U.S. It usually affects older adults, and it’s typically diagnosed in its earlier stages. Although cancer treatment is more effective when administered as early as possible, this particular disease does have a higher risk of recurrence than most cancers. If the cancer comes back after an initial treatment, or if it isn’t diagnosed until it’s started to spread, then the urologist may recommend a cystectomy.

About the Surgery

The doctor may perform a partial cystectomy, which removes only part of the bladder, or a radical cystectomy, which removes the entire bladder. In men, this latter option also involves the removal of the prostate and seminal vesicles. In women, the removal of the uterus, cervix, ovaries, fallopian tubes, and some of the vaginal may also need to be removed. If you’ll be undergoing a radical cystectomy, your doctor will explain your options for reconstructive surgery. It will be necessary to have an alternative way of storing urine. There are three options:

  • Incontinent diversion: A stoma bag, located outside the body, collects urine for manual emptying.
  • Continent diversion: No bag is located on the outside of the body. Urine is drained by inserting a catheter into the new valve on the front of the abdomen.
  • Neobladder: The newest method of diverting urine, this involves recreating a new bladder from intestine. Patients may still suffer incontinence, but they can urinate normally.

Steps to Prepare

You’ll be given specific instructions to prepare for the cystectomy, based on your unique health factors. You may be asked to:

  • Quit smoking
  • Avoid alcohol
  • Limit or avoid caffeine
  • Make changes to your prescribed and over-the-counter medications

You’ll be placed under general anesthesia for this surgery. To ensure your safety, you’ll need to avoid liquids and food after a certain point—usually midnight the night before the surgery. You should also make arrangements for your recovery. A cystectomy is major surgery, and you can expect to be in the hospital for about five to six days.

At Urology Associates, P.C., you’ll find compassionate care and cutting-edge cancer treatments right here in Tennessee. Our urology team emphasizes the importance of patient education, so you’ll know exactly what to expect and how to prepare for your treatment. Contact our office at (855) 901-1338.

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