Different Treatment Options for Kidney Stones

Kidney stones are hard deposits of salts and minerals that form in the kidneys. They are a common and sometimes acutely painful occurrance that affects both men and women. Sometimes these stones can pass from the kidneys and become lodged in the tubes that connect the kidney to the bladder, called ureters. When this happens, kidney stones can become a big problem, causing painful symptoms that may require medical treatment.

Dr. Samuel Lawindy of Daytona Beach, FLAcute kidney stone symptoms include pain, nausea, vomiting and fever. When a patient experiencing an acute kidney stone episode sees their urologist, the first thing the urologist will do is insert a stint into the urethra. This will open it up and take pressure off the kidney, easing any pain that is present. With the pain subdued, the urologist can move on to assessing the kidney stone’s size and location in order to decide the best treatment option.

One of the best and newest treatment options is shock wave lithotripsy. For this treatment, shock waves are used to break the stone, or stones, into small sand-like particles. These much smaller particles are easier for the patient to pass naturally through their urine. Lithotripsy is a non-invasive and relatively pain free treatment option that is generally well tolerated by the patient.

Ureteroscopy is a slightly more invasive option for kidney stones. General anesthesia is used for this procedure in which a urologist uses a long tool inserted into the urethra to find and remove the kidney stone. In cases of larger stones, a laser is used to break up the stone so it can be scooped out with the tool. With this procedure, the urologist can see the stones as they are removed. Since this is a more invasive option than the shock wave lithotripsy, there is a slightly longer recovery time.

For the largest stones that sit inside the kidney, urologists may need to remove them through the patient’s back. Although still minimally invasive, it is the most invasive option listed here. The urologist will enter the kidney through the back and then either break the stone up or pull the whole thing out through the incision. Recovery for this procedure usually involves an overnight stay at the hospital and some mild pain that can be helped with pain medication.

Patients experiencing the pain and discomfort of kidney stones should be reassured that there are several established procedures for removing the stones. Dr. Samuel Lawindy of the Advance Urology Institute knows the importance of finding the right kidney stone treatment for each patient. For more information about kidney stones, visit the Advanced Urology Institute website.

Risk Factors of Prostate Cancer

Prostate cancer is a health challenge that many men will face in their lifetime. What makes prostate cancer unique is the many forms it can take, with each form requiring a different treatment method and affecting men differently. According to board certified urologist Dr. Brian Hale, “Prostate cancer is extremely common and most men with prostate cancer will probably never have a problem from it.”Prostate cancer is so common that up to 80% of men who live to age 80 will have some form of it. Fortunately, for most of these men the illness will not be terminal. However, prostate cancer is still deadly enough to be the second leading cause of death for men in the United States. In other words, prostate cancer is often harmless; but when it isn’t, it can be deadly. This makes a proper and timely prostate cancer diagnosis essential.

Dr. Brian Hale of Palm Harbor, FLFor many men, their prostate cancer will not be aggressive and the symptoms will be manageable. In these cases, urologists rely on active surveillance as the best first treatment option. Rather than risk possibly harmful treatments on a non-aggressive cancer, the urologist will monitor the cancer with routine checkups. Other treatment options will be considered if the cancer becomes more aggressive.

If the prostate cancer is aggressive and immediate treatment is needed, urologists and their patients have a wide range of treatment options to choose from. The treatment option that works best will depend on a number of factors such as the cancer’s size and growth, and the patient’s age and health. Surgery to reduce the size of the cancer is often preferred for slow growing cancers. For more aggressive cancers, urologists may choose chemotherapy or radiation to kill the cancer cells as quickly as possible.

Although there are many possible causes of prostate cancer, there are certain factors that are known to raise the risk of its occurance. The first risk factor is age. As men get older, their likelihood of developing prostate cancer increases. African-American men have a greater genetic risk for developing an aggressive prostate cancer, while family history and obesity are also factors.

Early detection is the key to a successful treatment. Because prostate cancer is age related, it is recommended to most men that they begin having annual prostate checkups at age 50. African-American men and those with a family history of this cancer should be checked annually starting at age 40. Life saving screenings and successful treatments of prostate cancer happen every day at the Advanced Urology Institute, where trusted urologists like Brian C. Hale, MD guide their patients from diagnosis to recovery.

Becoming a Urologist – Dr. Howard Epstein MD

To become a urologist, one must really be committed to both people and study! First, students have to be top high school students. Then they go to a college or university to study the subjects needed before attending a graduate-level medical school.

Medical School

After completing the required subject courses, students take the Medical College Admission Test (MCAT) and complete medical school applications. Applicants then must pass face-to-face interviews with professors who are medical doctors and have just one question: “Would I want this person to be my doctor?”

Once admitted to medical school, the future urologist can look forward to a program that will last at least four years, including grueling residency requirements and more exams. Upon completing exams, the student is a doctor, but merely graduating from medical school does not make a urologist!

Urology Studies

Howard Epstein, MD of St Augustine, FLThere is yet another exam called the American Board of Urology (ABU) Qualifying Examination, Part 1. Then the future urologist must complete five more years of schooling and residency practice. During this time, the new doctor must learn general surgery, surgical critical care, trauma, colorectal surgery, transplantation and plastic/reconstructive surgery. Also during this time, at least four years of clinical urology training are required. After all of that has been completed, the doctor must pass the ABU Certifying Exam (Part II) to become an ABU certified urologist.

There are a few medical programs that can shorten this process of nine years of graduate school, but they are not accepted in every state.

Re-certification as a urologist must occur every ten years. To continue as a licensed medical doctor, one must do a certain amount of continuing education credits each year. The learning never ends.

Urologists must learn how to examine and treat a large number of different disorders. They work with all kinds of diseases and injuries related to the urinary tract. The urinary tract includes the kidneys, ureters, the adrenal glands, the related arteries and veins, the bladder and the urethra. Urology also includes the male reproductive system, which means urologists also treat issues concerning erectile dysfunction.

The urinary tract is one of the most important parts of the body. It regulates which chemicals, vitamins, minerals and gasses go to every part of the body. While the urinary tract does not regulate what goes into the body, it does regulate what comes out, at least as urine, and ensures that blood composition is just right.

Dr. Howard Epstein

Dr. Howard Epstein did not have a traditional course of undergraduate studies for medical school. His first university degrees were a dual-major in electrical engineering and business administration. From friends who were in medical school, he discovered that he was more interested in their work than in the fields for which he had degrees, so he went back to school.

Dr. Epstein has been practicing medicine since 1984. He is a board certified urologist with the American Board of Urology, a fellow of the American College of Surgeons and a member of the American Urological Association. He is also with the Florida Urologic Association. Serving as the chief of urology at the Gainesville Veteran Administration Medical Center increased his awareness of the unique needs of American veterans. He currently practices medicine at the Advanced Urology Institute’s two offices in St Augustine, Florida at the Southpark and Tuscan locations. To contact Dr. Epstein or for more information, visit the Advanced Urology Institute website.

5 Reasons for Women to See a Urologist

A urologist isn’t just a doctor for men. There are many reasons why a woman would need to see a doctor who treats the urinary system. The urinary system is a collection of organs that involved the kidneys and bladder, as well as the organs involved in the reproductive process.

Here are five common reasons why a woman may need to see a urologist

1. Kidney Stones

When minerals in the urine combine, they can sometimes stick together and create kidney stones that get lodged in the urinary tract. These stones vary in size and create a variety of symptoms. The most common symptoms are pain and difficulty urinating. Some women may also experience fever or chills.

Treatment for kidney stones varies depending on patient and stone type, but urologists have plenty of treatment options on hand. In some cases, drinking lots of water can flush the stones out. In other cases, high-intensity focused ultrasounds can break the stones into smaller, more easily passable pieces.

2. Urinary Tract Infection

Commonly referred to as UTI, this a common infection that many women will develop at some point in their lives. It occurs when bacteria enter the urinary tract and cause pain and burning during urination. UTI’s can become serious, so treatment with antibiotics is important.

3. Bladder/Pelvic Prolapse

This painful condition occurs when the bladder begins to drop down into the vagina. There are a few reasons why this may happen. Some women develop this condition after childbirth, but for others it occurs as a part of the aging process. Correcting this problem usually requires surgery performed by a urologist.

4. Bladder Control Problems

Bladder control problems are twice as common for women, and the medical term for these problems is Urinary Incontinence. Urinary incontinence takes many forms. Some women experience dripping when they sneeze, cough or laugh. Some women have an overactive bladder that creates a sudden and urgent need to use the bathroom. No matter what form it takes, women can work with a urologist to find the best treatment, or combination of treatments, to help with their incontinence.

5. Cancer

There are certain cancers for which a woman would be treated by a urologist. These include cancers of the bladder, kidneys or urethra. Lower back pain, pain during urination, and blood in the urine can be signs of one or more of these cancers. Treatment varies depending on the type of cancer, how aggressive it is, and the overall health of the patient.

Women in Florida who need a urologist for treatment of one or more of these problems have many options. The Advance Urology Institute is a team of highly skilled medical professionals who practice at locations throughout the state and with a commitment to achieving the best possible outcomes for their male and female patients. For more information about women’s urological issues, visit the Advance Urology Institute website.

Why Would You Need to See a Urologist

The urinary system is your body’s way of getting rid of urine. If there is something wrong with your urinary system, you may need to see a urologist. A urologist is a doctor trained and certified in treating issues with the many components of the male and female urinary systems and male reproductive organs.

Urologists treat a wide range of urological issues, including problems with the bladder, kidneys or urethra. If you are a man experiencing issues with your reproductive organs—penis, testes, scrotum, and prostate—it is a urologist you will need to see. And for women, issues with the bladder and pelvis are reasons to visit this kind of specialist.

Common bladder problems that send patients to the urologist are kidney blockages, kidney stones, and urinary tract infections (UTIs.) Treatment for these issues vary from patient to patient. For instance, some patients might be able to pass a kidney stone by drinking water and moving around to dislodge it, while others may need a more advanced treatment like a high frequency ultrasound, which is an ultrasound focused on the stone to break it down into smaller, easily passable pieces, similar to sand.

For men’s reproductive health, urologists can treat Erectile Dysfunction (ED). In most cases, this condition is easily treated with oral medication, though in some patients injection therapy may be necessary. Prostate cancer, the most common cancer that affects men, is another reason that men seek out a urologist for treatment. Again, for this issue, treatment varies by diagnosis. While some men’s prostate cancer can be monitored and treated with active surveillance, others may need surgery or chemotherapy depending on the aggressiveness of the cancer.

Women are more likely to see a urologist for bladder problems, often for changes in urination after pregnancy. Pelvic organ prolapse is another potential medical issue for women. Usually caused by age, this is when either the uterus or bladder begins to drop and press into the vagina. A urologist can treat this condition to relieve the discomfort and pain it causes.

Residents of Florida have access to a leading center for the medical specialization of urology with locations throughout the state. The Advanced Urology Institute is an exceptional team of medical professionals who treat their patients’ urological issues with compassion and a commitment to the highest quality care. For more information, visit the Advanced Urology Institute website.

Fort Myers Office: Working Together For You

Collaboration between medical staff and patients is one of the most important aspects of medical care. Achieving successful outcomes happens when everyone involved works together. Medical offices that create spaces for this to happen are laying the groundwork for the best treatment possible. In describing the medical office he works in, Luis Camacho PA says, “Patients feel they are in a good atmosphere, where they can be treated respectfully.” A place like this is where patients and staff can work together.

Urology offices, like other medical offices, benefit from this collaboration. Each patient has unique needs based on their ailment, medical history, age, and many other factors. In a comfortable atmosphere, patients who feel at ease describing their medical issues can give urologist a clearer picture of their patients’ unique situations and the best approach to treatment. Whether the patient is suffering from problems with their prostate, kidneys, urinary track, erectile dysfunction, or any other issue, working together helps lead to a better outcome.

Luis Camacho PA of Fort Myers, FLFor instance, many men suffer from the negative side effects of an enlarging prostate as they age, and yet the best treatment for this is not the same for every patient. For some, diet and lifestyle adjustments may be all they need to treat their side effects, while some may need medication as well. For men with a more serious issue, their urologist may want to perform a transurethral resection of the prostate. For this procedure, a small device is used to trim away excess tissue from the prostate to shrink its size. There are other options, but what is important is tracking progress with your urologist.

Another common issue that patients and urologists work together on is treating kidney stones. Treatment will be determined by the size of the kidney stones, patient’s health, and pain level. If possible, the urologist may recommend non-invasive options like shock wave lithotripsy where water waves are directed at the stone, breaking it up into small pieces like sand that are easier to pass. For larger, more stubborn stones, the urologist may have to use an invasive option. An example of this would be making a small incision in the patient and inserting a scope to break up the stones.

No matter the issue that brings a patient into a urologist’s office, collaboration between patient and doctor is essential. A comfortable atmosphere, free of judgment, language barriers, or miscommunication is the best start to treatment. The Advance Urology Institute in Fort Myers understands the importance of creating this kind of atmosphere and does so every day.

Immunotherapy for Cancer

Immunotherapy

Cancer comes in many forms and choosing the right treatment options depends heavily on the patient, their health, and the type of cancer present. For patients with metastatic cancer (cancer that has spread to other parts of the body from where it started), chemotherapy has been a long-standing choice. However, for some patients, immunotherapy is the more effective treatment with fewer side effects.

Immunotherapy works by working with the patient’s body. The human body is designed to fight against infections and diseases, including cancer cells that grow and spread unchecked as they avoid the body’s natural defenses. Immunotherapy boosts the natural immune system, making it more effective in fighting cancer cells. It helps the body identify which cells should be left alone and which cells are cancerous and need to be attacked and eradicated. Immunotherapy utilizes the immune system to better recognize and target cancer cells, even after treatment has ended.

Dr. Amar Rava of Palm Harbor, FL l discusses ImmunotherapyOne of the biggest benefits of immunotherapy is its less severe side effects. Chemotherapy is known for its harsh side effects that can be devastating to patients. Side effects such as severe fatigue, hair loss, nausea and vomiting diminish quality of life for cancer patients. While immunotherapy is not without its side effects, most patients find that muscle aches, shortness of breath and headaches are easier to endure.

Immunotherapy can be used to treat many types of cancers. Urologists have been using it to treat bladder and prostate cancers, and typically for patients who have asymptomatic, castrate-resistant prostate cancer. Having more treatment options for prostate cancer—the most common form of cancer found in men—means a successful outcome is more likely.

Immunotherapy is less toxic than chemotherapy and its less intense side effects allow for a better quality of life for patients with prostate and bladder cancer. According to Dr. Amar J. Patel, Board Certified Urologist, immunotherapy is also shown to increase life expectancy for cancer patients by up to three months. Advance Urology Institute achieves better outcomes for patients by utilizing all of the tools available in the fight against cancer, including the patient’s very own immune systems. For more information about immunotherapy, visit the Advanced Urology Institute website.

Should You Be Screened for Prostate Cancer

Prostate cancer is a common cancer that affects the walnut-shaped male prostate gland. As with most cancers, early detection is an important part of any successful treatment. The most common way prostate cancer is detected is through prostate cancer screenings during a patient’s appointment with a urologist. According to Dr. Amar Raval, “Screenings are important, along with a digital rectal exam, because prostate cancer continues to be the number one cancer found in men.”

Should you be screened for prostate cancer? If you can answer yes to one or more of the following conditions, then you may need to be screened:

• If you are between the ages of 55 and 69.
• If there is a history of prostate cancer in your family.
• If you are African-American.
• If you have a pre-existing medical condition that makes treatment difficult.

Dr. Amar Raval of Palm Harbor, FLThese factors are known to increase the risk of developing prostate cancer, and it is recommended that someone who has one or more of these conditions is screened at least once a year.

There are two main types of prostate cancer screening tests that a patient may receive. The most common is a digital rectal examination (DRE). For this exam, the health care provider puts on a glove and inserts a finger into the patient’s rectum to feel for any abnormalities on the prostate that can be attributed to cancer. The other screening is a prostate specific antigen (PSA) blood test. This blood test checks the PSA level in the blood, as someone with prostate cancer will have an elevated PSA level.

If one of these tests leads to a prostate cancer diagnosis, the urologist will want to identify what kind of prostate cancer it is in order to develop the best treatment plan. Non-aggressive cancers may not necessarily need treatment and can be monitored with active surveillance, which means watching the cancer to make sure it doesn’t turn aggressive and spread. In cases where the cancer is of intermediate or high risk, early identification from a screening test can help make sure that the treatment used on the cancer has the best chance for success.

If you believe it is time for you to start being screened for prostate cancer, then you should have a conversation with your urologist. Early detection can be a life saver. For men who are concerned about prostate cancer, the Advance Urology Institute is an excellent place to begin screening.

What to know about Erectile Dysfunction

Erectile dysfunction, also commonly referred to as ED, is the inability for a man to maintain an erection for sexual activity. Although it can be an embarrassing subject to talk about, it is very common. Fifty percent of men over the age of 50 experience some degree of ED. It is important to know that there are plenty of treatment options available. As Luis Camacho, PA explains, “We have several patients with erectile dysfunction, and we can be very helpful with treatment and procedures.”

Luis Camacho, PA of Fort Myers, FLA man experiencing the symptoms of erectile dysfunction can make an appointment to discuss the issue with his urologist. A conversation about the patient’s medical history and symptoms can usually lead to an in-office diagnosis. Once diagnosed, and it is determined that the patient is healthy enough for sexual activity, the urologist and patient can discuss treatment options. Many patients find themselves surprised by the number of treatment options available to them.

The most common and familiar treatment for ED is medication. Pills are easy to take and highly effective in many cases. For this reason, most urologists start treating ED by prescribing one of the many pill options available. Another simple option is the vacuum erection device. For this treatment, a man inserts his penis into the cylindrical pump that works like a vacuum to draw blood to the penis resulting in an erection. A band then goes around the base of penis in order to maintain the erection. Yet another option is injection therapy. A patient using this therapy will give himself a small, nearly painless injection into the base of the penis. The injection stimulates an erection for a certain amount of time.

Some cases call for more invasive treatments. With a penile prothesis, an implant is surgically inserted into the penis. A pump in the scrotum that is attached to the prosthesis is used to create the erection.

When facing erectile dysfunction, it is important to know that you are not the only person dealing with this issue, and there are plenty of treatment options available that help men lead normal and satisfying sexual lives. All it takes is a conversation with a urologist at the Advanced Urology Institute to find the best ED treatment for you.

I’ve got prostate cancer. Now what?

Being diagnosed with prostate cancer is a painful reality that can happen to any man. As Dr. Paul Arnold states, “Being diagnosed with prostate cancer is a very alarming, shocking, and scareful diagnosis.” A patient diagnosed with prostate cancer may experience a flood of thoughts, emotions and questions. For men recently diagnosed with cancer, the first step to a successful outcome will be having a trusted urologist answer questions and suggest treatment options.

Men recently diagnosed with prostate cancer will find there are many treatment options available to them. A trained and experienced urologist will be able to offer a number of treatment options tailored to their patient’s specific cancer type and circumstance. In some cases, when a cancer is not aggressive, a urologist may recommend staying away from treatment and instead monitor the cancer with the patient using active surveillance.

In cases where the cancer is more aggressive and the patient is healthy, a urologist may recommend surgery. Depending on how far the cancer has spread, the surgery could remove the entire prostate or just the prostate tissue where the cancer is found. In some cases, robotic surgery can be used for more precise procedures that cause less pain and quicker recovery times. Some of the common side effects of surgery are bladder incontinence and erectile dysfunction, although both usually go away with time.

Radiation therapy is an option for older patients, those who have other health problems, and patients who may have difficulty recovering from a surgery. For this treatment, radiation is used to kill the cancer cells. It also targets cancer that may have spread to bone. Although effective, the side effects of radiation therapy can be strenuous.

One newer option for prostate cancer treatment is High Intensity Focused Ultrasound (HIFU). This is a cutting-edge treatment option has been approved by the FDA since 2016 with exciting success. HIFU works by sending intense ultrasound waves directly to the area of the prostate that has cancer cells and these waves destroy the cancer cells. This is a minimally invasive treatment option with few side effects; however, only certain sizes and types of cancers can be treated in this way.

The fear and uncertainty caused by a cancer diagnosis is serious. Fortunately, experienced urologists at Advanced Urology Institute can help men find treatment options and guide them through this difficult time. For more information about prostate cancer, visit the Advanced Urology Institute website.