General Practitioners

• Osteoporosis
• Warts
• Cryotherapy
  Cryotherapy: During an operation probes are placed in the prostate. The probes are then frozen which kills the prostatic cells.
• Pediatric Care
  A urologist is a physician with specialized training to treat disorders of the male and female urinary tract (bladder, ureter, kidney and urethra) and the male reproductive system. Urology is classified as a surgical subspecialty, but since a wide variety of clinical problems are encountered when treating urological conditions, knowledge of internal medicine, pediatrics, gynecology, and other specialties is required.
• Primary Care
  Dr. Bauer went on active duty to Tripler Army Medical Center, Honolulu, Hawaii, for his transitional/surgical internship, which he completed in 1988. Waiting for his residency, he served as a primary care provider for the 7th Special Forces Group (Airborne), better known as the "Green Berets," from 1988 to 1992 in Central and South America.
• Family Practice
  Please bring a copy of your current medical problem list from you primary care physician (family medicine/internist).
• Male Infertility
  Dr. John Bauer brings effective male sexual dysfunction diagnosis and treatment to the forefront of the practice. He established the Center for Male Sexuality to provide specialized comprehensive services for the treatment of erectile dysfunction, male infertility, male sterilization and other categories of male sexual dysfunction.
• Emergency Care
  In case of emergency, call our number at 810-230-2280. After hours and on weekends, our phones are answered by an answering service, which relays a message to our on call physician automatically. If the situation is critical, call an ambulance or go immediately to the nearest Emergency Department at Hurley, McLaren or Genesys Regional Hospitals or the nearest facility to you if you are traveling.
• Erectile Dysfunction
• Urinary Incontinence
  Loss of bladder control affects at least one of every 10 adults. Half of all women experience urinary incontinence (the accidental loss of urine) at some point in their lives. It is most common in women, however, children and men also experience urinary incontinence. You may feel like you are the only one that suffers from this condition. However, in the U.S., approximately 10 million people suffer from incontinence. This includes older people, women who have had children, anyone who exercises, and men who have had prostate surgery. Incontinence can leave you exhausted, robbed of a good night's sleep, and make travel uncomfortable or even impossible. It can keep you from enjoying a full life. Only 50% of those with some form of incontinence ever tell their physicians. Yet, despite these frustrations, only about one in 12 people seek relief. Most don't realize help is available - and it doesn't always mean surgery.
• Diarrhea
• Pneumonia

Gynecologists

• Gynecology
• Female Infertility
• Pelvic Pain
  In most cases, Acute and the bacterial varieties of Orchitis can be treated very effectively and most men can be relieved of their symptoms. However, if the pain does not respond to these treatments it may be the first encounter with a chronic pain syndrome or myofascial syndrome. These syndromes occur in both male and females. Chronic Low Back Pain (CLBP) occurs in both the sexes. Chronic pelvic pain syndrome and pelvic inflammatory disease (PID) in females is well known. Males also have these syndromes, however, are not as well known to the public. Chronic pain syndromes of the prostate, epididymis and the testicles are some of the male specific myofascial syndromes. These chronic pain syndromes are very difficult to treat symptomatically and they are rarely cured. The patient must be reassured that they do not have a disease process that will end in their demise. A physician must especially reassure the patient that the condition is not caused by a cancer of the specified organ. If initial attempts to treat the pain have failed, the patient must be educated on the disease entity and made aware of the chronicity of the disease. They must realize that they now have a new baseline of pain that is considered normal for them. Any other acute increase in the pain must be treated as an Acute on Chronic disease.
• Pregnancy
• Labor and Delivery
  Stress incontinence usually occurs because of weakening of the support structures in the pelvis that hold up the bladder and urethra. Childbirth and menopause are two factors that may increase a woman's chance of developing stress incontinence.

Internists

• Internal Medicine
• Bladder Cancer
  These intravesical agents are used to treat recurrent or high-grade superficial bladder cancer. These agents prevent or decrease the recurrence of the disease. Superficial Bladder Cancer has a propensity to recur in up to 65-85% of patients. This is why bladder surveillance using cystoscopy is a life long protocol to prevent the progression of these lesions into a more aggressive deadly form of bladder cancer. Bladder instillation treatments are given in various regimens, the typical course is weekly instillations for six weeks, a three-week break and then an additional three weekly treatments. A cystoscopy is completed about 3-6 weeks after the treatment cycle to determine the effectiveness of the treatments.
• Urology
  Dr. Bauer continued his postgraduate studies in urology at the premier military medical facility, Walter Reed Army Medical Center, Washington, D.C., from 1992 to 1997. From 1997 to 1999, he remained as a staff attending at Walter Reed and received additional postgraduate training in urodynamics and female urology. During this time, he participated in a part-time urology research fellowship at Johns Hopkins University, Baltimore, Maryland, with emphasis in medical informatics, tele-surgery and medical robotics. Dr. Bauer managed over $50 Million in advanced surgical research funding as the Director of Advanced Surgical Technology for the U.S. Army. He continued in this capacity until leaving the military December 2000.
• Kidney Stones
  Chemolysis: Certain types of kidney stones can be dissolved with the application chemicals. Uric acid stones, for example, can be dissolved with a solution of sodium bicarbonate in saline. Cystine stones may be treated successfully with a combination of acetylcysteine and sodium bicarbonate in saline. Struvite and carbon apatite stones can be treated with an acidic solution of hemiacidrin. The procedure involves infusing the chemical solution into the affected area by means of a ureteral catheter in a series of treatments over time until the stone is dissolved. The patient's urine must be cultured regularly throughout the course of treatment to guard against urinary infection and prevent the buildup of excessive chemical levels, particularly magnesium, which can cause other health problems.
• Testicular Cancer
  A. No, overall, the weight of the evidence suggests that there is no consistent association between vasectomy and prostate cancer, testicular cancer, or heart disease.
• Interstitial Cystitis
  There is no scientific link between interstitial cystitis and diet, but many IC patients find that modifying their diet helps to control their symptoms and avoid flare-ups. The following is a list of foods by food group that many IC patients have trouble with and that the Interstitial Cystitis Association recommends avoiding...
• Urinary Tract Infection
  If you are getting a procedure in the office, we use this to make sure that we are not putting you at risk by proceeding in the face of a urinary tract infection (symptomatic or asymptomatic). If you were to get a procedure while infected you could become very ill with infection in the blood stream, which could be fatal if not treated immediately with IV antibiotics. Those patients that have a urine dipstick test that is positive for white blood cells (infection) or red blood cells (blood, infection, cancer or renal disease), our office will examine the urine under the microscope to confirm and quantify the finding. Sometimes the dipstick can be in error, some tests turn falsely positive for other reasons. If your urine is suspicious for infection, we will cancel your procedure, send your urine for culture, and treat you for 7-10 days with oral antibiotics. If your urine is infected, we will require you to take another urine analysis and urine culture to make sure the infection was adequately treated. We will have you reschedule the visit after we have worked through this problem.
• Prostate Cancer
  PSA is made by normal prostate cells, enlarged prostate cells and cancerous prostate cells. In fact, it is made at the same rate by all of these cells, or slightly more so by normal cells rather than by cancerous cells. The amount of PSA found in the blood stream, however, may be different and tends to be higher in patients with prostate cancer. Normally, PSA, which is formed by the prostate cells, is secreted by these cells into the prostatic fluid. In prostate cancer, the cancer often forms microscopic spheres and these spheres do not connect to the duct system. Thus, since the PSA can not get out, it "leaks" back into the bloodstream resulting in a higher level of detectable PSA in patients with prostate cancer than in patients without cancer.
• Lung Cancer
  After lung cancer, cancer of the prostate is the second most common cause of cancer deaths in men in the United States. It is estimated that up to 350,000 men are diagnosed with prostate cancer annually. Adenocarcinoma of the prostate is the clinical term for cancer that begins as a tumor on the outside of the prostate gland. As it grows, it may spread to the inner part of the prostate. If identified early enough in its development and treated before the malignancy spreads too far into the gland or out into surrounding tissues, lymph nodes or bones, it can be treated successfully with a variety of medical procedures. If not, the cancer cells will spread through the bloodstream, infecting other parts of the body, and the disease will claim the patient as one of its estimated 40,000 victims annually.

Psychiatrists

• Depression
• Anxiety

Endocrinologist

• Diabetes Care

Radiologist

• Ultrasound
  Inflammation of the testicle can occur due to a variety of causes, some of which include urinary infection, viral illness elsewhere in the body, minor physical trauma and reaction to medication. In many cases, the exact cause of an episode of orchitis may not be identified. During examination, the physician checks to make sure other problems are not present which can also cause scrotal pain, such as testicular tumor, hernia, or varicoceole. In some cases, a scrotal ultrasound may be recommended.
• Radiology
  Myofascial syndrome is a term used to describe the type of pain some men experience in their testicles, groin and prostate. Prior to this diagnosis, a thorough history, physical exam, urine tests, and occasionally, radiology tests are performed.
• X-Rays
• Computed Tomography
  Prostate cancer is the most common type of cancer in adult men. The prostate is a gland, which is part of the reproductive system. It makes a portion of the semen, which is the fluid that comes out at the time of ejaculation. The prostate wraps around the urethra, which is the urinary channel that drains urine from the bladder to the outside through the penis. The prostate begins to enlarge in a benign or non-cancerous fashion in almost all men beginning at the age of 40. As it does, it can compress the urethra and cause a change in the pattern of urination. While normal growth of the prostate affects most men, approximately 1 out of 11 men will develop cancer of the prostate. Every man should have an annual exam for prostate cancer with a combination of digital rectal exam and a PSA blood test. A digital rectal exam is carried out when a physician inserts a gloved finger into the rectal area to feel the surface of the prostate to determine if there are any areas of nodule formation or irregularity. The PSA level is checked by a blood test. PSA stands for prostate specific antigen, which is a protein made only in the prostate and not anywhere else in the body. If the PSA is elevated it may be a sign of prostate cancer. Other conditions can cause elevation of the PSA such as the normal enlargement of the prostate or inflammation of the prostate. If there is an abnormality on either digital rectal exam or PSA, a prostate ultrasound with biopsy can determine if prostate cancer is present. When prostate cancer is identified by biopsy, staging studies are carried out next to determine the extent of the prostate cancer. Prostate cancer can spread to the lymph nodes, the bones and the lungs. These areas are checked with a CT scan of the pelvis, a bone scan and a chest X-Ray. If there are abnormal areas on the bone scan, followup X-Rays and evaluation may be needed.
• Chemotherapy
  There are many causative agents that may decrease fertility some of these are nicotine, alcohol, marijuana, opiates, anabolic steroids, prescription medications, estrogen compounds (e.g. DES), chemotherapy, toxins in the workplace, lead, DBCP (soil fumigant), radiation therapy, hyperthermia, and sexual dysfunction.
• Iontophoresis
  Many forms of therapy have been enthusiastically endorsed for this condition and included: observation, Vitamin E, diathermy, ultrasound, histamines, estrogen, iontophoresis, dimethylsulfoxide, radiation, steroids either orally or injected into the plaque, Tamoxifen, potassium para-amino-benzoate (Potaba), and resection of the plaque with or without insertion of a penile prosthesis.
• Radiation Therapy
  Radiation therapy involves the application of x-ray treatment to the prostate in an effort to eradicate the cancerous cells or at least arrest their growth. Radiation can be delivered in two different forms: external beam radiotherapy or brachytherapy, (the insertion of radioactive seeds into the prostate). External radiation is typically given over a course of 30 to 40 treatments. It is usually given 5 days a week for a 6 to 8 week treatment total. Complications of radiation can include damage to the urinary bladder or the rectum. This can result in urinary frequency and urgency. It can also cause diarrhea and rectal pain. Incontinence, which is the loss of urinary control, develops in less than 1% of men. Impotence, the inability to get an erection, may develop on a delayed basis in up to 1/3 of patients. Radiation therapy has very effective treatment results at 5 and 10 years. The results are not as favorable at the 15 year mark. Radiation is a good choice for men in their 70's without other significant health troubles. It may at times be appropriate for men in their 60's who have other health troubles or who have a type of cancer with low biologic potential. If cancer remains in the prostate after radiation, a later attempt to remove the prostate through surgery is not a favorable option.

Surgeons

• General Surgery
  The male procedures for these problems are located in the surgical services section in the Center for Urinary Control.
• Vasectomy
  Vasectomy has been considered a safe and effective means for permanent surgical contraception for many years, and indeed, world-wide, millions of men have had this minor operation. Despite the excellent results, and the fact that the operation is really easy for the patient, many men are still reluctant to undergo a vasectomy. There is no doubt that one of the reasons for men not to have vasectomy is the fear of pain and their perception that it may alter their sexual function.
• Laparoscopy
  Laparoscopy: Surgery using an laparoscope to visualize internal organ through a small incision. Generally less invasive than traditional surgeries requiring a shorter recovery period.
• Reconstructive Surgery
  This prosthesis will often fit in fibrotic corpora when no other device will and there is less risk of erosion with it than with a rod prosthesis. For these reasons, the AMS 700CXM is the prosthesis of choice for reconstructive surgery.

Plastic Surgeons

• Laparoscopic Surgery
  The surgery is usually done through a groin incision or by laparoscopic surgery under general anesthesia as an outpatient. If there is testicular atrophy, this will usually cease and the testicular size will increase to the same size as the normal opposite side.
• Gynecomastia
  Clinical manifestations of testosterone deficiency depend on the age at onset and duration of deficiency. Prepubertal hypogonadism is generally characterized by infantile genitalia and lack of virilization, while the development of hypogonadism after puberty can result in a variety of complaints, including diminished libido, erectile dysfunction, infertility, gynecomastia, impaired masculinization, muscle weakness, reductions in body and facial hair, and osteoporosis. Lethargy, depression, and other negative mood and energy parameters have also been reported in some testosterone-deficient men.

Dermatologists

• Cyst
• Ulcer
  Chancre: A hard, syphilitic primary ulcer, the first sign of syphilis, appearing approx. 2 to 3 weeks after infection. The ulcer begins as a painless lesion or papule that ulcerates. Occurs generally singly, but sometimes may be multiple.
• Lesions
  Adult circumcision is completed for multiple reasons; it is best to do it for medical reasons rather than pure cosmetic reasons in the adult. The medical reasons are usually chronic irritation, infection, phimosis, paraphymosis, penile cancer, penile lesions, condyloma (venereal warts), and some other less common conditions. Our office will do an adult circumcision for pure cosmetic reasons, however, the patient must be aware that there is a significant recovery period in which the male is sore. Return to work is not immediate, usually after the pain has resolved in one week. You will be mildly sore for the next two weeks and the sutures will continue to bother you until they dissolve.

Physical Therapists

• Back Pain