How Does the Bladder Sphincter Work?

The bladder sphincter is made up of two muscles that control the release of urine from the bladder through the urethra. If the bladder were a reservoir, then the bladder sphincter would be the dam that holds back water and controls when it is released. The bladder sphincter is made up of two muscles, the internal and external sphincter muscles.

  • The internal sphincter muscle is located at the opening of the bladder to the urethra. It is a smooth, involuntary muscle. Because of its location, it is also primary muscle prohibiting the release of urine.
  • The external sphincter muscle surrounds the area of the urethra outside the bladder. It is the secondary muscle in control of urine flow. It is made of skeletal muscle and is a voluntary muscle.

Both muscles function in a similar fashion. When one relaxes the voluntary muscle, the involuntary muscle relaxes as well. When these muscles are relaxed, they open up allowing for urine to flow out of the bladder through the urethra and out the body. When these muscles are contracted, they keep urine in the bladder. Given the functions of the bladder sphincter, it is understandable the important role it plays in urinary continence. Damage or weakening of these muscles can also be a main cause for urinary incontinence.

Urinary IncontinenceUrinary incontinence is the loss of bladder control. It is a common yet embarrassing problem. It can be as mild as releasing a small amount of urine when you laugh or sneeze, or as serious as having the urge to urinate come on so strong and fast that you don’t have time to get to a bathroom. Problems with the bladder sphincters can cause several different forms of incontinence.

One form of urge incontinence occurs when the urethra can’t hold back urine in the bladder and the bladder sphincters relax uncontrollably.

Stress urinary incontinence is another common issue. In this case, stress or damage to the sphincters or surrounding muscles can cause urinary incontinence. This is common in women after childbirth, or in men after prostate surgery or radiation therapy. Neurogenic bladder dysfunction occurs when trauma or disease of the central nervous system causes a person to lose control of their bladder sphincter muscles.

Although issues caused by malfunctioning bladder sphincters can be embarrassing, there are a variety of treatment options available. The option that works best–whether it be lifestyle changes, medication, or surgery–depends on the patient and their overall medical history. Urologists work to understand their patient’s unique needs and develop the best plan to treat their bladder problems. For more information, visit the Advanced Urology Institute website.

Ways to Pass Kidney Stones

Kidney stones can be a painful and difficult experience for the many men and women who get them. These stones are hard deposits of minerals that build up in the body and cause blockages in the urinary tract. The blockages can make it very painful and difficult to urinate. In addition to difficulty urinating, the stones can cause nausea as well as pain in the groin and abdomen. Luckily, there are many ways that urologists can help speed up the process.

Quynh-Dao Tonnu, PA-C: Physician Assistant in DeLand, FLFinding the best way to help a patient to pass a kidney stone depends on several factors. Not all patients are the same, and the size and difficulty of their kidney stones vary as well. If the stones are smaller than 5 millimeters, the urologist will want the patient to try and pass them naturally. This is the least invasive way to pass kidney stones, although it may not always be possible. Drinking lots of liquids for frequent urination is the key for this method. Urologists may also recommend movement like bicycling and jumping jacks to help dislodge the stones naturally.

If passing naturally is not an option, then medication may be the next step. Urologists will use some of the same medications that are used to treat an enlarged prostate. Medication like Flomax helps relieve pressure on the urinary tract by relaxing the muscles in the prostate. This allows for easier urine flow and can help the patient pass the stones.

Another treatment option that makes passing stones easier is called shock wave lithotripsy. This treatment uses a machine pressed up against the patient’s body that targets water waves directly at the kidney stones. With as many as 2,500 waves per treatment, these waves break the kidney stones into small, sand-like particles. The sandy remnant is then easily passed during urination.

In some cases, a more invasive treatment may be needed to remove the stones from the body. A surgeon may use a scope fitted with a medical laser to enter the patient’s urinary tract through the penis. They can then use the laser to break the stones up into smaller fragments for easier passing. This method is sure to help pass the stones, but a urologist may prefer to try more natural methods first.

There is no single method to passing kidney stones. What matters most is making the process as fast, safe and pain-free as possible. For more information about kidney stones, visit the Advance Urology Institute website.

Surgical Options for Overactive Bladder

If you feel frequent, sudden urges to urinate that you cannot control, you might be suffering from overactive bladder. This condition can lead to feelings of embarrassment or shame, but it’s a common problem and can be treated in a variety of ways. For many people, overactive bladder can be treated with lifestyle changes such as special diet, weight loss, regularly timed trips to the bathroom, and exercises to strengthen the pelvic floor. Dealing with symptoms by using absorbent pads is also an option.

However, for some people, these methods are not enough to ensure they can live a healthy, fulfilling life. In these situations, surgical intervention is an option to correct overactive bladder problems.

Augmentation Cytoplasty

One of the options for treating overactive bladder is called augmentation cytoplasty. This procedure increases the size of the bladder. The surgeon accomplishes this by removing a small part of the intestine and using it to replace parts of the bladder in order to increase its capacity. For some people, this procedure allows them to resume normal bladder function. For others, the use of a catheter may be necessary for the rest of their life.

Urinary Diversion Surgery

Another surgical treatment option for overactive bladder is urinary diversion surgery. This procedure involves diverting urine from the bladder. One option for bypassing the bladder involves linking the ureters, which normally connect the kidneys to the bladder, to an ostomy bag outside of the body. Another option involves the creation of a new bladder inside of the patient’s body, which means they will be able to continue normal urinary function.

Bladder Removal

Bladder removal surgery, or a cystectomy, is the last resort option for patients with overactive bladder for whom no other treatment has been successful. For men, bladder removal surgery also involves the removal of part of the prostate; for women, it involves removal of the uterus, ovaries and part of the vagina. Because this is a risky procedure that involves multiple organs, it is usually only used for more serious urological conditions such as bladder cancer or birth defects. Removal of the bladder necessitates the use of a urinary diversion such as an ostomy bag or a stoma.

An overactive bladder can be a debilitating condition, but there are many options for treatment. If you are dealing with this issue, the physicians at Advanced Urology Institute are here to help you reach a diagnosis and find a treatment to restore your quality of life.

Prostate Cancer Types of Treatment

Prostate cancer is one of the most prevalent types of cancer men face. According to board certified urologist Dr. Arash Rafiei, “One in nine men will have prostate cancer in their lifetime.” Although somewhat common, not all cancers in the walnut-shaped prostate gland are the same. Every case of prostate cancer is different and affects men differently. Urologists work with their patients to find the most effective treatment option based on each patient’s individual needs.

Dr. Arash Rafiei: Urologist in Orange City, FLUrologists will consider their patient’s health, age, and the type cancer when deciding how to proceed. For some cases, the best treatment is none at all. When a patient has slow growing prostate cancer that is not spreading, a urologist may suggest holding off on treatment while monitoring the growth through routine appointments. The cancer needs to be taken seriously and watched closely, but invasive treatment is not always necessary for the patient’s health.

When treatment for the prostate cancer is needed, there are two main options: radiation and surgery. Both options offer the same level of prostate control and urologists will discuss the pros and cons of each with their patients. For surgical options the urologist may suggest a radical prostatectomy or robotic surgery. Both are well-tested invasive options that produce very good patient outcomes.

Radiation therapy is another common cancer treatment option. The radiation is centered on the prostate to kill cancer cells. The radiation will also kill some healthy cells as well, causing side effects. This is a non-invasive option that, like surgery, has its pros and con that a patient and doctor will want to discuss. Follow-up appointments to determine if the cancer responded to the treatment will also be necessary.

In addition to radiation and surgery, there are also some newer options that can be utilized in prostate cancer treatment. For instance, cryotherapy uses very cold temperatures to kill cancerous tissues and cells in the prostate by freezing them. There are also treatments using intense ultrasound waves centered on the prostate to destroy the cancer cells. These procedures are newer and there is less data on when they are the most effective, but they are options to consider.

All cancer is serious and can be a stressful and frightening prospect. Having a dedicated urologist who will listen and suggest the best treatment for each patient is key to success. Whether the best option is observation, radiation, surgery or a newer procedure, the Advance Urology Institute is a team of dedicated urologists with an array of treatment options for their patients.