Dr. Rolando Rivera of Advanced Urology Institute Re-designated as a UroLift Center of Excellence

Dr. Rolando Rivera of Advanced Urology Institute Re-designated as a UroLift Center of Excellence

About Dr. Rolando Rivera

Rolando Rivera, MD, FACS is an established Urologist in Naples, Florida, who features over two decades of experience in his field. Dr. Rivera’s acclaimed career in medicine began in 1996, when he graduated from the University of Puerto Rico School of Medicine in San Juan. Upon earning his Medical Degree, he completed an internship at Brooke Army Medical Center in San Antonio, Texas, before undertaking his residency at the University of Florida Shands Medical Center in Gainesville. Pursuing advanced medical training, Dr. Rivera then completed a fellowship in Female Urology, Pelvic Surgery and Urodynamics at the University of Miami.

About Advanced Urology Institute

As one of the largest full-service urology groups Florida, our 37 locations offer comprehensive urology services, from evaluation and pre-surgical preparation, to surgery and rehabilitation. We have evaluated numerous patients and performed thousands of urologic surgical and cancer procedures in the last decade with excellent outcomes. We are dedicated to combining clinical excellence, advanced technology, and patient- and family-centered care.

For more information contact AUI at: 855-977-4888

Congratulations to Dr. Jonathan Jay for being selected as Top Doctor in 2021 for Naples Illustrated Magazine

Congratulations to Dr. Jonathan Jay for being selected as Top Doctor in 2021 for Naples Illustrated Magazine

About Dr. Jonathan Jay

Dr. Jay received his Bachelor of Science degree in Physiology from Michigan State University, graduating with Honors. He went on to complete his medical education at the University of Michigan, Ann Arbor. He completed his residency training at Henry Ford Hospital before entering and completing his fellowship training at Beth Israel Deaconess Medical Center, Harvard Medical School in Boston. He received numerous honors and awards throughout his training, including Outstanding Resident Training Award and Lansing School District Distinguished Alumni Award.

He has made national presentations on various urological topics and has published multiple scientific papers in peer-reviewed journals as well as book chapters. He is involved in clinical research, including clinical trials for the minimally invasive correction of bladder control problems.

About Advanced Urology Institute

As one of the largest full-service urology groups Florida, our 37 locations offer comprehensive urology services, from evaluation and pre-surgical preparation, to surgery and rehabilitation. We have evaluated numerous patients and performed thousands of urologic surgical and cancer procedures in the last decade with excellent outcomes. We are dedicated to combining clinical excellence, advanced technology, and patient- and family-centered care.

For more information contact AUI at: 855-977-4888

Congratulations to Dr. David Wilkinson for being selected as Top Doctor in 2021 for Naples Illustrated Magazine

Congratulations to Dr. David Wilkinson for being selected as Top Doctor in 2021 for Naples Illustrated Magazine

About Dr. David Wilkinson

Dr. Wilkinson’s areas of special interest include laparoscopic surgery, robotic surgery, and minimally invasive treatment of prostatic diseases. He joins our group with significant training and experience in da Vinci® robotic prostatectomy as well as other applications of the da Vinci® surgical system.

About Advanced Urology Institute

As one of the largest full-service urology groups Florida, our 37 locations offer comprehensive urology services, from evaluation and pre-surgical preparation, to surgery and rehabilitation. We have evaluated numerous patients and performed thousands of urologic surgical and cancer procedures in the last decade with excellent outcomes. We are dedicated to combining clinical excellence, advanced technology, and patient- and family-centered care.

For more information contact AUI at: 855-977-4888

Janelle Bunce, PA-C of Advanced Urology Institute Re-designated as a UroLift Center of Excellence

Congratulations to Janelle Bunce, PA-C on having been re-designated as a UroLift Center of Excellence in May 2021.

About Janelle Bunce, PA-C

Janelle Bunce PA-C is a nationally certified Physician Assistant who earned her Masters of Medical Science and Physician Assistant studies degrees at Nova Southeastern a University in Davie, FL in 2004. She is a member of the American Academy of Physician Assistants, Florida Urological Society and the American Urological Association. She has participated in multiple medical mission trips. Her specialties include adult and pediatric urology. She is currently a practicing physician assistant in Naples, FL.

About Advanced Urology Institute

As one of the largest full-service urology groups Florida, our 37 locations offer comprehensive urology services, from evaluation and pre-surgical preparation, to surgery and rehabilitation. We have evaluated numerous patients and performed thousands of urologic surgical and cancer procedures in the last decade with excellent outcomes. We are dedicated to combining clinical excellence, advanced technology, and patient- and family-centered care.

For more information contact AUI at: 855-977-4888

Dr. David Wilkinson of Advanced Urology Institute Re-designated as a UroLift Center of Excellence

Congratulations to Dr. David Wilkinson on having been re-designated as a UroLift Center of Excellence in May 2021.

About Dr. David Wilkinson

Dr. Wilkinson’s areas of special interest include laparoscopic surgery, robotic surgery, and minimally invasive treatment of prostatic diseases. He joins our group with significant training and experience in da Vinci® robotic prostatectomy as well as other applications of the da Vinci® surgical system.

About Advanced Urology Institute

As one of the largest full-service urology groups Florida, our 37 locations offer comprehensive urology services, from evaluation and pre-surgical preparation, to surgery and rehabilitation. We have evaluated numerous patients and performed thousands of urologic surgical and cancer procedures in the last decade with excellent outcomes. We are dedicated to combining clinical excellence, advanced technology, and patient- and family-centered care.

For more information contact AUI at: 855-977-4888

Advances in Prostate Cancer Research

Prostate cancer is one of the most common types of cancer in men. However, it might not show any symptoms until it reaches an advanced stage. A considerable number of men only realize they have the disease when it is already adversely affecting their lives.“This cancer is a big thing, with huge effects on the lives of patients,” says Dr. Jonathan Jay, a board certified urologist at Advanced Urology Institute in Naples, Florida. “The condition can cause urinary incontinence, reduced sexual desire, erectile dysfunction, changes in orgasm, and infertility, among other problems,” he adds.

Treatable Condition

The good news is that there are various treatments and management options for prostate cancer, even if it is found at a later stage. When detected early, the cancer is highly treatable, and most men with the disease survive.

“Prostate cancer is quite complex, which makes it difficult to predict how fast or slow it will grow and the risk associated with it,” says Dr. Jonathan Jay. “That is why, during diagnosis, we evaluate several factors to determine the aggressiveness of the tumor. After we determine the risk associated with the cancer, we are better placed to recommend the right treatment for our patients, which can yield great results,” he affirms.

The cancer is categorized as low risk, intermediate risk, or high risk depending on its ability to grow and spread to other areas of the body. Low risk prostate cancer is slow-growing and unlikely to spread quickly. In contrast, a high risk cancer is likely to spread rapidly outside the prostate.

Improved PSA Screening

One recent advance in prostate cancer research is the proper use of the prostate-specific antigen (PSA) test. Although the PSA test has had its limitations, it is still valuable for identifying and categorizing cancer as high risk or low risk, aggressive or indolent. When correctly used, it shows with accuracy those patients who have the aggressive type of cancer. This finding effectively guides the doctor to develop a more targeted treatment plan.

“The PSA got a bad reputation because it was used wrongly,” says Dr. Jonathan Jay. “But today, urologists understand that the PSA is still a very valuable tool in prostate cancer diagnosis and treatment. And it is now known that the significance of the PSA is not in whether it is elevated relative to the average, but in how it changes over time,” he asserts.

Studies have shown that the PSA is not abnormal just because it is elevated compared to the average. If the PSA of a man is stable over time, it doesn’t show prostate cancer, let alone an aggressive type of the disease. But if the PSA of a man has been stable for a prolonged period and then changes suddenly, it shows that something is wrong.

“If your PSA is one over the years, but changes to 3, then something is wrong, regardless of the fact that 3 is still within the normal range,” explains Dr. Jonathan Jay. “And if you’ve had a PSA of 6 over the past many years, then it’s not abnormal since it remains stable, regardless of the fact that it’s not within the normal range,” he adds.

Enhanced Precision with Molecular Biology

Significant progress has been made in prostate cancer research in the area of biopsies. Traditionally, prostate cancer has been confirmed and graded through a biopsy. To confirm a diagnosis, a urologist takes 8-12 needle biopsies along the prostate in a random sample and examines the cells under a microscope. However, while a biopsy tends to provide more accuracy than a typical PSA, it doesn’t give a perfect picture of the cancer.

“It is difficult to detect an aggressive cancer through the way cells look or behave,” says Dr. Jonathan Jay. “Besides, a biopsy may miss the specific areas of the prostate that would help to distinguish an aggressive from an indolent cancer,” he adds.

Advances in this area have ensured more accuracy and reduced the risk of misdiagnosis. For instance, abnormal prostate cancer genes can now be used to identify high risk cancer. The look of genes, occurrence of virulence factors, behavior, and other features are studied to better understand how likely it is that a cancer will grow and spread.

“Nowadays, we look at genes to determine the aggressiveness of prostate cancer,” says Dr. Jonathan Jay. “For example, genes of cancer cells may contain virulence factors or show how fast the cells will multiply and spread to other areas. This helps determine which cancer should be treated faster, and which categories of patients may benefit from therapeutic interventions,” he adds.

Apart from genomics, urologists can now use magnetic resonance imaging (MRI) technology before a biopsy to look for areas in the prostate that are suspicious of the cancer. This is possible thanks to new technology that fuses MRI images with real-time ultrasound to guide prostate needle biopsies to areas of specific concern.

Why Seek Prostate Cancer Treatment At Advanced Urology Institute?

At Advanced Urology Institute, we understand that prostate cancer is highly treatable when detected early and accurately.

We offer comprehensive prostate cancer care that includes the use of the latest research knowledge and techniques. With the advances in prostate cancer research, we can know who has aggressive or indolent cancer with greater accuracy, minimizing the chances of overtreatment and unnecessary biopsies.

Moreover, our urologists are acquainted with up-to-date prostate cancer knowledge, tools, and techniques. All of this helps guide treatment and enables us to develop more targeted treatment plans for our patients.

When you come to see us at our Naples, Florida office for diagnosis or treatment, we will consider your unique situation from a point of knowledge and recommend the best possible treatment for you.

For more information on prostate cancer treatment and diagnosis, visit the Advanced Urology Institute website.

Why Nursing Is Still a Great Career Choice for Women – Donna Irving ARNP

Donna Irving, APRN of Naples, FLHi, My name is Donna Irving and I’m a Nurse Practitioner with Advanced Urology Institute.

I would say nursing, in general, [is] for women that get bored easily or they want some opportunity that will expand through a lifetime. You could still work into your sixties (60s) and still be able to do something in nursing and if you become a Nurse Practitioner you can have several specialties. You don’t have to rely on one specialty, you can go to another if you so choose so it gives you a wide variety of jobs within a job.

Diagnostic Tools and Urodynamic Testing for Urinary Problems

Donna Irving, APRN of Naples, FLHi, my name is Donna Irving and I am a Nurse Practitioner with Advanced Urology Institute.

I think [with] the tool sets that we use, we have good ways to evaluate just with blood withdrawal, looking at the PSAs [etc.]. Then we have what’s called urodynamic studies, where we can put catheters in people’s bladder and we can actually tell them how well their bladder is working because we have men that will come in and we’ll say “We’re not sure if its your prostate or is it actually your bladder that’s not working”. [With Urodynamic Testing] we can actually measure both of them or we can do the cystoscopies, look up inside their bladder and tell them how big of a prostate that they have, how much is it impinging on their urethra and we can also measure their bladder so that we can tell them if they have a little bit of both, [and] so we’ll know how to treat them afterwards.