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.

Becoming a Physician Assistant with Quynh-Dao Tonnu, PA-C

While certified physician assistants (PA-C) are not the same as American Medical Association board-certified medical doctors, they are competent medical professionals. Physician assistants often go into medicine later in life, having already worked in other occupations.

Quynh-Dao Tonnu, PA-CCertified physician assistants go through a rigorous graduate-level training program that takes more than two years to complete. The degree program must be accredited by both the Committee on Allied Health, Education and Accreditation, and the Accreditation Review Commission on Education for the Physician Assistant. After successful completion of the academic portions, the graduates must pass the national Physician Assistant National Certifying Exam. The final stages include formal application with the Florida Board of Medicine and completion of 2,000 hours (about one year) of supervised clinical practice.

Physician assistants are important within medical practices because they relieve the physicians of much of the routine workload. They take medical histories and, because of their medical training and experience, they are able to notice when a patient has a special issue the primary physician should be aware of. They can understand medical histories written by other medical professionals and understand their patients’ backgrounds. For example, some fad diets can seriously affect a person’s digestive system, kidneys, urinary tract and bladder. An experienced PA knows when to ask patients if they have been on such diets.

With a solid understanding of pharmaceutical medicine, physician assistants can prescribe medications or recommend that the physician prescribe certain types of medications. PAs also approve prescription refills according to the physician’s practice and standard medical guidelines. If a patient has questions about how and when to take medications, PAs can give that information.

Quynh-Dao Tonnu, PA-C started her post-secondary education at the University of Florida, where she received her BA in Economics in 2005. Later in 2007, she completed a master’s degree at the University of South Florida in Library and Information Science. After that, she worked in hedge fund accounting, which she found interesting but not very personally fulfilling. In 2014, she changed occupations to become a medical assistant. She realized her most fulfilling job experiences involved working with people, so she went back to school and obtained her Physician Assistant degree in 2017. She has been working in urology for three years and is now fully certified. You can meet this talented PA at the Advanced Urology Institute Oxford office. For more information, visit the Advanced Urology Institute website.

Prostate Cancer Recurrence: What You Need To Know

Cancer of the prostate affects a small gland that is situated just in front of the rectum and around the base of the urethra in men. It is the most common type of cancer in men, with those over age 50 facing the greatest risk. The good news is that prostate cancer is treatable. Treatment options include surgical removal of the prostate gland, radiation therapy, hormone therapy and chemotherapy. A combination of various treatment methods may be applied for full effect.Sometimes, however, even after treatment has been administered successfully, the prostate cancer returns. This is called a recurrence and it occurs with other types of cancer too.

Causes of Prostate Cancer Recurrence

Prostate cancer can recur for two main reasons.

1. A small clump of cancer cells left behind during the earlier course of treatment can grow into a larger number.

2. The cancer initially was diagnosed as being less advanced than it actually was. For instance, a patient might be diagnosed with cancer that is limited only to the prostate while in fact, the cancer might have advanced to the surrounding lymph nodes.

Diagnosis of Recurrent Prostate Cancer

Dr. Jonathan Jay with patientA major indicator of recurring prostate cancer is a rise in Prostate Specific Antigen (PSA) levels. PSA is a protein produced by the prostate. A PSA test is always conducted as part of the preliminary work in the diagnosis of prostate cancer, whether initial or recurrent. Ideally, after successful treatment, PSA levels should go down and should stay consistently low. If the level starts to rise again, that is a red light that should be followed up with further testing.

Another test, which doctors agree is very effective in checking for recurrent prostate cancer, is the PET/CT imaging scan. Dr. Jonathan Jay, who has an office in Naples, Fl., says the scan is effective because it has the ability to localize the cancer and map out its extent with great accuracy. Treatment of cancer usually depends on being able to tell exactly what part is affected. If this can be done, then it becomes easy to direct treatment at that specific area, which is what a PET/CT imaging scan does.

Treatment of Recurring Prostate Cancer

The form of treatment depends on what was initially administered. The following options are available:

1. If the prostate was surgically removed the first time, radiation therapy may be administered to treat the recurrent cancer;

2. If radiation therapy was administered the first time, a surgical removal of the prostate may be recommended. That decision depends on whether or not the cancer has spread outside of the prostate.

3. Cryotherapy. This treatment involves freezing the cancer cells to kill them.

4. Hormone Therapy. This may be used in combination with other methods. It is also used as a last option when the cancer has spread very far.

The management of recurrent prostate cancer depends on finding the cancer, which most likely would be detected in a post treatment screening. Men who have undergone successful prostate cancer treatment should attend regular screenings after the treatment is finished. Followup screening and checkups are important, and it is important to seek out a comfortable, patient centered treatment center, such as the Advanced Urology Institute. The staff at Advanced Urology Institute is very experienced in working with patients and helping with questions, diagnosis and treatment. They have the knowledge and technology to work with the patient through every step of the process. For more information, visit the Advanced Urology Institute website

What Urology Procedures and Treatment are Performed at AUI?

Advanced Urology Institute offers a wide-range of services to prevent, diagnose, treat and care for patients with different urological conditions. Our team of urologists are surgical and medical specialists who treat patients dealing with urinary incontinence, kidney stones, urinary tract infections, sexual dysfunction, premature ejaculation, urethral stones, pelvic floor problems, kidney, prostate and bladder cancer, kidney transplants, vasectomies and traumatic urinary tract injuries. We are involved in the assessment of the structure, function and problems of the prostate, kidney, bladder, testes, penis, urethra and their associated glands.

A typical day at AUI

The consultations each day range from patients with voiding and sexual difficulties to victims of knife and gun violence with injuries to their genitourinary organs. We document and review the medical histories of these patients, order appropriate diagnostic tests, such as the PSA for screening prostate cancer, interpret results of the tests, make accurate diagnosis and develop individualized treatment plans. We typically use a wide range of equipment and instruments, including radiographic (X-ray) machines, MRI scans, CT scans, ultrasounds, fluoroscopes, catheters, cystoscopes, radium emanation tubes, and diathermy machines.

We administer treatment depending on the type of condition, severity of symptoms, area affected and patient preferences. Routinely, we perform brachytherapy, high-intensity focused ultrasound (HIFU), photodynamic therapy, laser-based procedures, extracorporeal shock-wave lithotripsy, robot-assisted surgery and abdominal, pelvic and retroperitoneal surgery. We also may prescribe medication for certain conditions or recommend lifestyle and behavioral changes to improve treatment outcomes.

Treating kidney and urethral stones

For patients who come to our emergency department with excruciating flank pain or stone-related pain, we usually run various tests to diagnose the stone. A CT scan typically is used to confirm the presence, location and size of the stone. For small stones, patients are often discharged with pain medication and guided on fluid intake and what to do to ensure the stone is seamlessly passed. The patients also are given instructions on what to do with the stone once passed. For instance, we direct patients to bring the stones to AUI for analysis of chemical composition and determination of metabolic risk factors. With that information, we are able to recommend appropriate dietary measures for preventing stone recurrence, such as avoiding excess salt and animal protein and increasing fluid intake. For larger stones, we may opt to use more invasive treatments to break down or remove them from the urinary tract. The treatment approach depends on the type, size and location of the stone.

Prostate procedures

In men, the diagnosis and treatment of prostate-related conditions, such as BPH and prostate cancer, require various procedures. At AUI, we frequently administer the PSA (prostate-specific antigen) test to assess if there is a prostate problem in men with urinary symptoms such as pelvic pain, voiding problems and blood in urine. Through PSA screening, we are able to reduce the likelihood of advanced disease and the chances of prostate cancer death. But to maximize the benefits of the test and prevent undue harm, we are always careful to use the test in the right patients and at the right time.

We often use rectal and prostate ultrasound to examine the shape and size of the prostate gland. When a tumor is suspected, we may pass a flexible cystoscope or use CT or MRI scan to assess the nature and extent of the malignancy. To check for abnormal prostate cells or confirm prostate cancer, a prostate biopsy is commonly the go-to procedure. During the procedure, the patient is placed under a local anesthetic. The doctor extracts systematic biopsy cores from the area with the suspicious lesion or growth and sends them to the laboratory for diagnosis. Once BPH or cancer has been confirmed, appropriate treatment such as brachytherapy, TURP (transurethral resection of prostate) or prostatectomy (via laparoscopy or robot-assisted surgery) is set up.

Fertility procedures

At AUI, we see patients with a broad range of fertility issues, including those who want to prevent pregnancy permanently and those who have difficulty becoming pregnant. For men who can’t ejaculate healthy sperm, we offer sperm retrieval procedures like surgical sperm extraction and sperm aspiration to harvest their healthy sperm from the testes. These procedures are usually carefully timed to coincide with in-vitro fertilization (IVF) cycles or with the harvesting of the female partner’s eggs. And for men who can’t ejaculate because of spinal cord injuries and other problems, we offer procedures such as electro-ejaculation or the penile vibratory stimulation. The procedures use electro-stimulation and vibration to prompt ejaculation and enable collection of healthy sperm.

For patients who want to avoid pregnancy, we offer vasectomy and vasectomy reversal procedures. Conducted in the urologist’s office with only a local anesthetic, vasectomy is a quick, safe and effective way in which men can stop getting their partners pregnant. It is generally a permanent sterilization method and offers higher efficacy than tubal ligation performed in women. But for men who change their minds after they have undergone a vasectomy, we offer the reversal procedure as a way to try and restore fertility or to help a smaller fraction of men for whom vasectomy triggers ongoing pain.

Urologic oncology procedures

We have skilled and experienced oncologists at AUI who use a combination of equipment and procedures to diagnose and treat different urologic cancers. At AUI, our medical team offers a comprehensive assessment of all available cancer treatments and their expected outcomes, paving the way for their quick integration in our practice. For that reason, we are often the first cancer center in Florida to adopt the latest innovative cancer treatment and care approaches as soon as they are devised. When making cancer treatment decisions at AUI, urologists typically consider a number of psychological and clinical factors, including type and stage of the cancer, anticipated life expectancy, level of risk, overall health of the patient and personal preferences of the patient.

So whether we are dealing with kidney, prostate or bladder cancer, or with genital and pelvic cancers such as scrotal, penile and urethral malignancies, we ensure that the timing of treatment is just as precise and important as the treatment chosen. In some patients, we may opt for active surveillance (watchful waiting) to delay treatment and avoid related side-effects and risks. But to treat cancer, the options include local topical therapies, genital-preserving surgeries, genital reconstruction surgeries, radiation therapy, chemotherapy or hormone therapy.

Pediatric urology procedures

At AUI, we also offer treatment for a number of childhood conditions, particularly congenital ones. For example, children with undescended testes — where one or both testes haven’t descended into the scrotum — may benefit from our minimally-invasive robotic or laparoscopic procedures to correct the disorder. Surgery is our primary treatment option for most pediatric conditions and the da Vinci robotic surgery and laparoscopic surgery have become the standards of care at AUI. The minimally-invasive approaches are preferred for children because they are generally less painful, come with a shorter hospital stay, and require a shorter recovery time. We also offer circumcision to children in their first few days after birth as an elective procedure to remove the foreskin of the penis.

At Advanced Urology Institute, we offer multidisciplinary, patient-friendly, excellent urology care for our patients. So whether you are interested in seeing a urologist for conditions such as prostatitis, stress incontinence, pelvic organ prolapse, recurrent urinary tract infection or urologic cancer, or for procedures like penile implant surgery, vasectomy and cystoscopy, you can rest assured of having a urologist you can trust at AUI. And we are not only focused on innovative, exceptional and superior treatments, services and outcomes, but also satisfactory patient experiences and sound, long-term patient-physician relationships. With our state-of-the-art facilities, advanced equipment, experienced medical professionals and a responsive, compassionate institutional culture, we guarantee top-notch, exceptional care to our patients in an environment where they feel comfortable and treasured.

For more information urological problems and how to prevent, diagnose and treat them, visit the Advanced Urology Institute website.

Robotic Surgery Effective in Partial Nephrectomy


Robotic partial nephrectomy involves using an advanced surgical robot to remove part of the kidney, usually the portion with a tumor. Initially, robotic surgery enjoyed tremendous success with surgical removal of the prostate (prostatectomy), but in recent years its usage in kidney operations also has yielded remarkable results. In fact, robotic partial nephrectomy has become the preferred treatment option for most patients with benign kidney tumors, small renal masses and early-stage cancer. During the procedure, tumors are removed with the least possible disruption of the rest of the kidney — a nephron-sparing approach that maximizes post-operative kidney function.

Why is the da Vinci surgical system suited for partial nephrectomy?

The da Vinci surgical robot provides superior maneuverability that is suited for the delicate slicing, cutting and stitching involved in the removal of a portion of the kidney. The surgical robot offers a three-dimensional view of the targeted area, allowing for a broader range of motion of the surgical devices. Urologists using the robot find it much easier to make the complex maneuvers required during the procedure.

Since it uses smaller incisions and doesn’t involve making cuts through bone or muscle, the da Vinci partial nephrectomy causes less scarring and minimal trauma to patients. The recovery time is typically only 2 weeks compared to the 6-8 weeks recovery time after open kidney surgery. Likewise, blood supply to the kidney is blocked for a shorter duration, leading to less overall blood loss and quicker recovery compared to laparoscopy.

How is the robotic partial nephrectomy performed?

During robotic partial nephrectomy, the surgeon makes a series of tiny incisions in your abdomen. The camera and robotic surgical instruments are inserted through these incisions. To create enough room for manipulation of the surgical instruments and enable easy access to the cancerous tissue, the abdomen is inflated with gas (carbon dioxide gas). The doctor then moves the colon away from the kidney and trims off the fat covering the kidney to expose the kidney surface.

With the kidney exposed, the surgeon halts the blood flow to the kidney temporarily to prevent potential bleeding as the tumor is cut and the remaining portion of the kidney sutured together. At the end of the procedure, the urologist reconstructs the kidney, restores blood flow and then inspects the kidney carefully to make sure there is no bleeding.

Who should undergo robotic partial nephrectomy?

The da Vinci partial nephrectomy is the surgical treatment of choice for patients with smaller kidney tumors, usually not bigger than 4 cm in size. However, even patients with tumors ranging from 4 cm-7 cm also may undergo the procedure if they are to be treated in certain areas. Similarly, robotic partial nephrectomy is appropriate in cases where removing the whole kidney could trigger kidney failure or the need for dialysis.

At Advanced Urology Institute, we perform hundreds of robotic partial nephrectomy every year with amazing results for our patients. The procedure takes a short time, reduces the problems caused by benign or small kidney tumors and is effective in helping patients recover from kidney cancer. The minimally-invasive nature of the procedure guarantees less scarring, minimal trauma and quicker recovery for our patients. But we always ensure that patients are closely monitored for post-operative pain and complications, accomplishing cancer-free and happier lives for our patients. For more information on treatment of kidney cancer and other urological problems, visit our “Advanced Urology Institute” site.

Advanced Urology Institute Working Together For You

Advanced Urology Institute is a leading urology practice that excels in the diagnosis and treatment of disorders of the female and male urinary tracts and problems of the male reproductive system. Designed to be a world-class urology center, AUI brings together a huge group of doctors who are specialists in various areas to offer coordinated, effective and top-notch urology services to their patients. From restoring fertility to curing cancer, addressing incontinence to treating kidney stones, the urology services offered by AUI touch every sphere of life and bring back smiles to the faces of all who come to us for help.

Satisfying patient experience

By centralizing the administration of urology services, the doctors are able to concentrate on delivering the highest quality service to patients from initial consultation to follow-up care. The unique partnership and collaboration of many doctors and several care centers ensures that every physician or center in AUI can broaden the scope of expertise and services provided to patients, resulting in a positive experience to meet the unique needs of our patients wherever they are. At Advanced Urology Institute, we invest our time and effort, skills and experiences to make our services better. We are dedicated to delivering life-saving medical and surgical urology care in a prompt, safe and affordable manner. For us, it is not merely our job. The wellbeing and health of our patients is our number one priority.

Innovative and cutting-edge techniques

Advanced Urology Institute is a pool of urologists from multiple subspecialties. We pride ourselves on expertise and ensure that all members of our team continue to undertake training in the latest specialized surgical and medical techniques. Our experienced urologists work collaboratively to deliver highly complex treatment and care individualized to the needs of our patients. And with our exceptional range of specialist urologists, we are able to deliver more complex and innovative surgical services not available anywhere else. As a group, we are able to pool our resources, enabling all our members to have access to better equipment, instruments and tools for managing urologic disorders. Each member of the team has more experts to seek help from and we frequently send patients to other colleagues among us with more expertise and experience. As a result, we do as good a job and deliver as great results as any other premier urology centers in the country.

Unparalleled range of services

At Advanced Urology Institute, we offer a broad range of life-improving, life-extending and life-saving services to patients of all ages. Those who come to AUI have access to every possible treatment option available. In fact, most of the patients we see usually come with issues that other institutions are not able to diagnose or treat. As a team, we are committed to delivering the right care to every patient the first time they come, guaranteeing the highest rate of treatment success. We also endeavor to provide individualized, comprehensive care for all urologic conditions and diseases, giving every patient the opportunity to tap into our collaborative and team approach to have their issues resolved. At AUI, we ensure that all our hospitals, clinics, health care facilities and physicians serve with integrity and unwavering commitment to excellence. We listen to every concern, tailor every evaluation, apply the right treatment and do what is best for the patient. As a team, we deliver beyond the expectations of our clients.

For more information, visit the “Advanced Urology Institute” site.

8 Easy Ways to Cleanse Your Kidneys

The kidneys are amazing little organs. Each day, they process about 200 quarts of blood, getting rid of excess water and waste products, removing toxins and keeping the body functioning smoothly. If the kidneys are not able to remove toxins and waste from the body, they will build up in the body and hinder the normal function of kidneys, liver and other organs, resulting in exhaustion, stomach pain, headaches, water retention and other problems. Buildup of toxins and waste also may lead to kidney stones, a mass of crystals or unprocessed minerals which can grow to the size of a golf ball. Kidney stones affect 10-15 percent of American adults, but also may be found in children as young as five.

Kidney stones causes and symptoms

There are many causes of kidney stones, such as dehydration, excessively acidic urine, urinary tract infections, buildup of waste and toxins in the kidneys, among others. The symptoms of kidney stones include excessive lower back, abdominal or urinary tract pain which may be sharp, mild or excruciating, severe vomiting or feeling nauseated, persistent urge to pass urine, and constant chills or sweating. While the symptoms vary depending on the size of the stones, unceasing pain and discomfort on the sides is a good reason to see a urologist. Kidney stones are easily curable if diagnosed early.

Why you should cleanse your kidneys

There are several reasons why you should flush out toxins and waste from your body. For instance, cleansing your kidneys improves their function and reduces bloating. Likewise, cleansing your kidney improves your ability to process certain foods, absorb nutrients and convert food to energy, preventing fatigue. Flushing out waste and toxins prevents potential infection and reduce the risk for bladder problems. Similarly, cleansing the kidneys reduces the chances of having painful kidney stones, corrects hormonal imbalances and prevents skin breakouts such as acne, eczema and rashes.

Below are 8 easy ways to cleanse your kidneys

1. Apple Cider Vinegar

Apple cider vinegar is effective in preventing oxidative stress of the kidneys. It increases the levels of antioxidants in the body, balances blood sugar levels and reduces blood pressure, creating optimum conditions for kidney health. Apple cider vinegar contains citric acid which dissolves kidney stones. Frequent intake of apple cider vinegar also flushes out toxins from the kidneys.

2. Kidney Beans

Kidney beans not only resemble the kidneys but also remove waste and toxins from the kidney and flush out kidney stones effectively. Kidney beans are rich in Vitamin B, fiber and several minerals which help to clean the kidney and boost the function of the urinary tract.

3. Lemon Juice

Lemon juice is naturally acidic and increases citrate levels in urine, hence discouraging the formation of kidney stones. Lemon juice also filters blood and flushes out wastes and other toxins. Daily intake of diluted lemon juice reduces the rate of kidney stone formation and dissolves calcium oxalate crystals, which is the most common constituent of kidney stones. For people with kidney stones, combining lemon with olive oil ensures smooth passage of the stones.

4. Watermelon

Watermelon is a mild diuretic. It hydrates and cleanses the kidneys. It is also rich in lycopene, which improves cardiovascular health and ensures well-functioning kidneys. Watermelon also has large quantities of potassium salts which regulate acidity of urine and prevents stone formation. In fact, eating watermelon regularly is great for kidney health.

5. Pomegranate

Both the juice and seeds of pomegranate contain large amounts of potassium and therefore are effective in removing kidney stones. Potassium lowers acidity of urine, prevents stone formation because of its astringent properties, curtails crystallization of minerals, and flushes out toxins and waste from the kidneys.

6. Basil

Basil is an effective diuretic. It removes kidney stones and improves kidney functioning. Basil also lowers the level of uric acid in blood and improves kidney health. Its ingredients such as essential oils and acetic acid break down kidney stones and allow for smooth removal. Basil is also a pain killer.

7. Dates

When dates are soaked in water for 24 hours and then consumed after seeds are removed, they are effective in dissolving and flushing out kidney stones. Dates are rich in fiber, helping to reduce the risk of kidney stones. The magnesium ingredient in dates also cleanses the kidneys.

8. Dandelion

Consuming tea made using dried organic dandelion or fresh dandelion root (pulled from the ground) helps to cleanse the kidneys. Dandelion is a kidney tonic, but also stimulates bile production to improve digestion and minimize the waste reaching the kidneys.

Another effective cleansing agent for the kidneys is cranberry juice which supports the urinary tract, fights urinary tract infections and removes excess calcium oxalate. Beets and their juices contain Betaine which increases urine acidity, prevents build-up of struvite and calcium phosphate and reduces the chances of kidney stone formation. Other effective cleansing agents are coconut water, cucumber juice and cherries. For more information on preventing and treating kidney problems, visit the site, Advanced Urology Institute.

5 Most Common Signs of Urinary Tract Infection

Urinary tract infections (UTIs) are infections of any part of the urinary system, such as kidneys, bladder, ureters and urethra. UTIs typically occur when bacteria access the urinary tract via the urethra and start to multiply in the bladder. While the urinary system is equipped to keep out the bacteria, the system’s defenses may sometimes fail and allow bacteria to take hold and multiply, resulting in a full-blown urinary tract infection. Abnormalities in the urinary tract that interfere with drainage of urine (such as enlarged prostate or kidney stones), foreign bodies in the bladder (such as tubes and catheters), diabetes, and immune-suppressing drugs and disorders increase the risk of urinary tract infections.

How common are urinary tract infections?

Urinary tract infections (UTIs) are the most common bacterial infections in humans. In the United States, over 8.6 million hospital visits and more than 1 million hospital admissions are due to these infections. Women are at higher risk of having a UTI than men and account for more than 84 percent of all UTIs annually. In fact, every woman has over a 50 percent chance of developing at least one UTI in her lifetime, with the risk of recurrent UTI increasing significantly with each infection. Women have greater risk of getting UTIs because the urethra is shorter in women than in men, allowing bacteria to enter the bladder more easily and multiply. Sexually active women also have higher risk of UTI because anything placed inside the vagina increases the risk of infection.

5 most common signs of urinary tract infection

Urinary tract infections are easy to treat when detected early, but untreated or undiagnosed UTI may lead to kidney damage. To help detect UTIs and seek early treatment, it is important to familiarize yourself with their most common signs.

Often, the most frequent sign of a urinary tract infection is a noticeable change in urination, such as frequent urination, burning sensation when passing urine or strong-smelling urine.

The most common signs of a UTI include:

  1. Change in urine color
    Normal urine is clear and pale yellow in color. But when having a urinary tract infection, the urine may appear cloudy, red, cola-colored, bright pink or just darkened. When you see these changes, you should suspect a urinary tract infection and visit your urologist immediately for help.
  2. Strong-smelling urine
    Urine has its characteristic smell, but when you have a urinary tract infection the smell may be unusually strong. Make sure to speak with your doctor if your urine smells stronger than usual.
  3. Abdominal or back pain
    Along with a burning sensation when urinating, urinary tract infections may cause abdominal or pelvic pain, particularly around the pubic bone and in the center of the pelvis. Abdominal, upper back and flank (side) back pain also can indicate infection of the kidney. Speak with your urologist about the pain as soon as possible.
  4. Fever and chills
    In some cases, a urinary tract infection may cause a fever and chills. For instance, when having a catheter, fever may be the only sign of infection, but when the fever increases and is accompanied by fatigue, chills or mental problems, then a severe kidney infection may be suspected. Visit your doctor immediately if you experience these symptoms.
  5. Nausea and vomiting
    Because the urinary tract is closely associated with the digestive system, a urinary tract infection may cause nausea and vomiting. Make sure to talk to your doctor immediately, especially if the nausea and vomiting is accompanied by other UTI symptoms.Urinary tract infections cause relatively little harm, but they can be dangerous when left untreated. If you are diagnosed with an infection, the doctor will prescribe antibiotics taken for 2-3 days. Severe infections may require longer treatment, but antibiotics resolve most cases of UTIs.

It is also important to take steps to prevent or reduce the risk of UTI. The steps include:

  1. Drinking plenty of water daily.
  2. Using underwear made of absorbent cotton.
  3. Wiping from the front to the back.
  4. Urinating immediately after sexual intercourse.
  5. Avoiding birth control or feminine products that are inserted into the vagina.

When you have to use such inserts, wash your hands and the vaginal area thoroughly before inserting a device.
Work closely with your urologist to prevent complications that may be caused by urinary tract infections. Remember doctors can help by prescribing appropriate antibiotics, but you also can take steps to prevent UTIs in the first place.

Vasectomy Poses Minimal Risk of Prostate Cancer

For men who are done having children, vasectomy is an effective method for birth control. As a surgical procedure that involves the cutting, blocking or sealing off tubes that transport sperm out of the testicles, vasectomy prevents the release of sperm during sex and is therefore a long-term form of birth control. About 1 in 7 men undergoes vasectomy after the age of 35 years. However, while the procedure is fairly simple and generally safe, it has sparked controversy about various long-term risks, particularly its link to prostate cancer (PCa). The prostate gland is located just behind the tubes and adds essential fluids to semen, so there has been a longstanding fear that vasectomy may cause prostate cancer.

Does vasectomy increase the risk of prostate cancer?

A 2014 Harvard research generated panic when it associated vasectomy with a 10 percent increase in the risk of prostate cancer and a 20 percent increased risk of the aggressive form of the cancer. But according to a recent report published online in the JAMA Internal Medicine, those numbers were probably overblown. Based on a comprehensive review and meta-analysis drawing on more than three decades of epidemiologic literature, the researchers in this study demonstrated that any risk posed by vasectomy, if at all existent, is too small to be of clinical importance.

The researchers reviewed and analyzed 53 studies, including 33 case-control studies involving 44,536 men, 4 cross-sectional studies involving 12,098,221 men, and 16 cohort studies involving 2,563,519 men. The analysis revealed no significant link between vasectomy and aggressive prostate cancer, whether high-grade cancer (Gleason score of 8 or more), advanced (normally T3-4, positive nodes or metastasis), or fatal prostate cancer (PCa). And when data from 6 case-control studies and 7 cohort studies considered to be of low risk according to the Newcastle-Ottawa Scale were analyzed, a non-significant 6 percent increased risk of prostate cancer was noted in the 6 case-control studies while the 7 cohort studies gave a weak but noteworthy 5 percent increased risk of prostate cancer.
From the data, the researchers calculated the absolute increase in lifetime risk of prostate cancer for those who have undergone vasectomy. It was found that vasectomy has an absolute lifetime risk of prostate cancer of just 0.6 percent and may only be responsible for 0.5 percent of prostate cancer cases in the population. This led to the conclusion that the association between vasectomy and prostate cancer is at most trivial, clinically insignificant and should not stop the use of the procedure for long-term contraception.

Vasectomy is Safe

This study affirms that vasectomy is unlikely to substantially increase the risk of having any type of prostate cancer. It also affirms that there is no difference in development of prostate cancer between those who undergo vasectomy and those who do not. In fact, the small risk of low-intermediate tumors reported is attributed to the fact that men who get vasectomies also tend to take PSA tests for prostate cancer, which can detect early-stage disease.

If you are looking for a safe and effective form of birth control, do not let fears of prostate cancer discourage you. Vasectomy does not increase your risk of the cancer. And while more research on the causes of prostate cancer is still ongoing, you can lower your risk by maintaining a healthy weight, regular exercise, eating a low-fat diet, increasing vegetable intake, decreasing dairy intake, and quitting smoking. Talk to your urologist about what is right for you depending on your medical history.

The Truth About Testicular Cancer

Testicular cancer develops when abnormal cells grow out of control in a man’s testes (testicles), which are found inside the scrotum. The testes are male sex organs that produce hormone testosterone and make and store sperm. Compared to other cancers, testicular cancer is quite rare occurring in 1 man per 100,000. Nevertheless, it is the most frequent cancer among American males ages 15 to 35 and is more frequently found in white males than Asian or African men. It is important to note that not all testicular lumps are cancer and a man may have other conditions such as testicular microlithiasis, epididymal cysts and appendix testis, all of which may be painful but are non-cancerous. Testicular cancer is very much treatable and can be treated even after spreading beyond the testicle.

Causes

While the exact causes of testicular cancer are not known, the cancer generally occurs when healthy cells of the testicle become altered. Testicular cells usually multiply in a systematic manner to keep the body functioning normally. However, abnormalities in some cells may abruptly cause uncontrollable multiplication, resulting in a surplus of new cells in the testicle. The accumulation of new cells results in a testicular mass or lump. Almost all testicular cancers start in germ cells (testicular cells producing immature sperm).

Risk factors for testicular cancer include:

  • Cryptorchidism (undescended testicles): Development of the testicles occurs in the fetal abdomen and the developed testes move down into the scrotum before birth. A man whose testicles never descended in this manner is at greater risk of having testicular cancer than those whose testes descended normally. The risk is still high even if the testes have been surgically relocated into the scrotum.
  • Abnormal testicle development: Disorders that hinder normal development of testicles, like Klinefelter syndrome, increase the risk of this cancer.
  • Age: Testicular cancer is common in teens and young men (ages 15 to 35). Nevertheless, it may still occur in older men.
  • Family history: If your father or brother has had the cancer, you have an increased risk.
  • Personal history of testicular cancer: If you have had the cancer treated in one testicle, you may develop it in the other testicle.
  • Race: The cancer is more frequent in white males than in black or Asian males.
  • Infertility: Men who do not produce sperm when ejaculating have a greater risk.

Signs and symptoms

Knowing the symptoms of testicular cancer can help you to seek treatment when the cancer is still at an early stage. The most common indicators are:

  • An enlargement or lump in either testicle.
  • Accumulation of fluid in your scrotum.
  • A dull pain or ache in the groin or abdomen.
  • The scrotum becomes increasingly heavy.
  • Discomfort or pain in the testes or on the scrotum.
  • Tenderness or enlargement of male breasts.
  • Lower back pain.
  • In rare cases, testicular cancer can spread and affect other organs resulting in coughing, difficulty swallowing, breathing difficulties and swelling in the chest.

Diagnosis of testicular cancer

A man may detect enlargement or lumps in his testicles through self-examination. A doctor can notice a lump in a testicle during routine physical examination. When an enlargement or a lump is detected, the doctor will suggest a few tests to confirm or rule out testicular cancer. The tests commonly requested are a testicular ultrasound and blood tests for tumor markers. Surgery to remove a testicle for analysis and classification of the cancer also may be performed.

Removal of a testicle is usually done to classify the cancer since it is the type and stage of cancer that determines treatment and prognosis. Testicular cancer is divided into two types, seminoma and nonseminoma. Seminoma cancer can be found in all age groups, but is more frequent in older men. The cancer is less aggressive than nonseminoma. Nonseminoma cancer tends to develop in younger men and teens and is characterized by rapid growth and spread.

Testicular cancer stages

When testicular cancer has been diagnosed, it is then important to determine the stage (extent) of the cancer. For a doctor to assess how far the cancer has spread in or outside a testicle, blood tests and computer tomography (CT) scan are requested. The results of these tests help the doctor to categorize the cancer in stages and to offer appropriate treatment. The stages include:

Stage I: Cancer that is restricted to the testicle.
Stage II: Cancer that has spread out of the testicle into the lymph nodes of the abdomen.
Stage III: Cancer that has spread to various body parts, such as liver, bones, brain and lungs.

Testicular cancer treatment

The appropriate treatment for the cancer depends on many factors, including your general health, stage and type of cancer, and your preferences. For instance the doctor may opt for surgery to remove the affected testicle or nearby lymph nodes. Alternatively, the doctor may use radiation, high-powered beams of energy, like X-rays, to treat the cancer. Another option is chemotherapy, where specific drugs are used to destroy cancer cells. For more information on testicular cancer, visit the site, Advanced Urology Institute.