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.

Prostate Cancer: Early Detection and Screening

Prostate cancer screening means conducting tests to find the cancer in people with no symptoms. Screening helps in early detection of the cancer when it is still easier to treat. To detect prostate cancer before symptoms appear, urologists recommend either measuring the amount of prostate-specific antigen (PSA) in blood or doing a digital rectal exam (DRE), when the urologist inserts a gloved, lubricated finger into the rectum. If the results of a PSA or DRE are abnormal, the urologist will request further tests. Finding prostate cancer via a PSA or DRE screening means the disease is probably still at an early stage and will respond well to treatment.

PSA Screening

Prostate Cancer: Early Detection and ScreeningThe prostate-specific antigen (PSA) test measures the amount of the protein (PSA) released in blood by prostate cells. Even though both normal and cancerous (abnormal) prostate cells produce the protein, higher blood levels of PSA indicate the possibility of cancer. The PSA test is one of the best indicators of prostate cancer and is recommended by urologists because it is widely available, relatively inexpensive and is a low-risk blood test for patients.

Digital Rectal Exam (DRE)

To perform a digital rectal exam, the urologist inserts a gloved and lubricated finger into the rectum in order to feel the state of the prostate gland. Since prostate cancer often begins in the back of the prostate, DRE helps to assess the texture of this area and checks for hard areas and bumps (nodules) which might indicate cancer. DRE is also effective in detecting whether the cancer has spread to nearby tissues or has reoccurred after treatment.

Confirming Prostate Cancer

After a digital rectal exam (DRE) or PSA blood test, the urologist may request a biopsy to confirm the cancer. But before the doctor can decide whether biopsy is necessary, a number of supplementary tests and considerations must be made, including family history, ethnicity, prior biopsy findings and different forms of PSA. A biopsy means the doctor takes out a small portion of the prostate tissue to be examined under a microscope for cancerous cells. Since cancerous cells appear different from normal prostate cells, a close exam of biopsy cells will help to confirm the cancer.

When to Start Screening

The age of beginning or stopping prostate cancer screening depends on individual risk. Men with a higher risk of having prostate cancer should start screening at age 40. This includes African American men and all men with first and second degree relatives with a history of prostate cancer. Men with average risk should start screening at 50, but only after discussing it with their doctors to reduce the rate of unnecessary biopsies. Men age 75 and older or those with limited life expectancy (less than 10 years) should be discouraged from early detection testing for prostate cancer because they may not benefit much from screening. Nevertheless, a decision to go for prostate cancer screening must be made with the help of a urologist or GP and should depend on a man’s lifestyle, family history, overall health and life expectancy. For more information on screening, diagnosis and treatment of prostate cancer, visit the site, Advanced Urology Institute.

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.


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.

Where is the best place to get a vasectomy reversal in Florida?

All men who undergo a vasectomy are counseled to consider the procedure a permanent form of male sterilization. However, a number of factors such as loss of child or remarriage may call for vasectomy reversal. If you are a man who had a vasectomy in the past but are now considering a reversal, it is important to remember that the procedure is complex and requires specialized expertise and experience to perform successfully.

Where is the best place to get a vasectomy reversal in Florida?

While there are many qualified vasectomy reversal doctors and facilities in Florida, one of the best places to undergo the procedure is Advanced Urology Institute. This multi-dimensional urology practice has locations throughout Florida, including well-equipped clinics in Panama City, Daytona Beach, Blountstown, Perry, St Augustine, Daytona Beach, Port Orange, Tallahassee, Carrabelle, Orange City, Palm Coast, Oxford and other towns, bringing highly qualified and board certified urologists closer to those in need of their medical care. Advanced Urology Institute surgeons perform hundreds of vasectomy reversals every year with a remarkable success rate. The urologists are highly trained in their surgical technique and perform all procedures in accredited clinics with board-certified anesthesiologists who ensure maximum comfort during surgery.

Initial Consultation

A vasectomy reversal at Advanced Urology Institute means access to exceptional treatment and care at a center with an international reputation that offers vasectomy reversal as a specialization. You can schedule surgery over the phone, have your pre-operative appointment with a urologist the first day, and undergo the operation the next day. During the initial consultation, the urologist will review your history, personally perform a complete examination, and request any necessary tests such as blood studies, semen analysis and ultrasound exam. The urologist will discuss all options currently available, and the relative success rate of each, and will help you make the right choice.

Affordable Cost

The total cost for a vasectomy reversal at Advanced Urology Institute is less than $7,000. These charges include hospital, surgical and anesthesia fees, but exclude post-op semen analysis. You may have a secondary blockage in the epididymis (where sperm is stored behind the testicle) in which case the urologist will examine the fluid coming out of the proximal vas for sperm to rule out a blockage. When there is no blockage, the urologist will proceed with vasovasostomy, a simple vasectomy reversal procedure in which the vas deferens is sewn back together. In case of a blockage, there will be no sperm and the vas deferens will have to be connected directly to the epididymis at the point above the obstruction. This is done through vasoepididymostomy, a more complex vasectomy reversal procedure in which the doctor attaches the vas deferens straight to the back end of the testicles. There will be no additional charges for the complex reversal as the urologist will decide on the appropriate type of reversal at the time of surgery.

Book Your Appointment

Vasectomy reversal at Advanced Urology Institute is an outpatient procedure that is completed in one day. Follow-up appointments may be scheduled the day after the operation and you will return to routine work after 3-4 days. Sexual activity may be resumed after 2 weeks. If you have been considering a vasectomy reversal, be sure to call Advanced Urology Institute and request an appointment for more information.

3 Effective Ways to Treat Peyronie’s Disease

Peyronie’s disease is a type of erectile dysfunction that leads to both physical and emotional scarring. It is caused by penile tissue damage resulting in the formation of scar tissue called plaque. Depending on the location and size of the plaque, the penis may bend downward or upward or become indented. The bending may occur suddenly (almost overnight) or happen gradually, beginning with soreness and lumps that develop into a hardened scar. While Peyronie’s disease is most often found in middle-aged men, it can occur at any age.
Here are 3 effective ways to treat Peyronie’s disease:


Drug therapy is helpful for most men who are affected by Peyronie’s disease, especially during the acute phase. For instance, oral Vitamin E will make the plaques smaller and help to straighten the bent penis. Potassium Amino-Benzoate (Potaba), Tamoxifen, PABA, Colchicine and Carnitine are also effective during the acute phase of the disease. Likewise, during the early stages of the condition, drugs for erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra), may be beneficial.

As an alternative to oral medications, injecting certain drugs directly into the plaque can bring relief, particularly for men in the acute phase of the disorder who are not sure whether they want to undergo surgery. For example, verapamil injections disrupt the protein responsible for the formation of lesions in Peyronie’s disease, thus helping to relieve acute symptoms. Interferon injections prevent swelling and control scarring, while collagenase injections break down the plaque and are recommended for treating men with a penis curve of more than 30 degrees. Injection therapy may be administered using a combination of above drugs plus hyaluronidase, betamethasone or prostaglandin E1. Another method of applying these drugs is iontophoresis (electromotive administration/EMDA), where the drug is applied on the penile skin and then pushed through the skin using a low electric current.

Radiation Therapy

During radiation therapy, high-energy rays are targeted at the plaque to relieve the pain. The disadvantage of radiation therapy is that it relieves the pain on the bent penis without having a direct effect on the plaque which causes erectile dysfunction. Instead of radiation therapy, a man may opt for shockwave therapy, a form of mechanical treatment that uses a lithotripter device (such as those used for breaking up kidney stones) to break down calcified plaques or scarring. Other mechanical devices that can be used to treat the disease are low-dose radiotherapy and vacuum-based machines.


Surgery for Peyronie’s disease is reserved for men suffering from severe, disabling penile disorder that makes it difficult to have sex. Before the surgery, the urologist will check the blood flow in the penis by injecting a drug to make it stiff and also examining the penis using ultrasound. The tests are used to assess the penis before deciding the type of surgery that is ideal. There are three basic ways through which the urologist will fix the disorder surgically. First, the urologist can remove the plaque and replace it with a tissue patch, helping to stretch the penis and restore its original length. Secondly, the surgeon may change or remove part of the tunica albuginea from the penis area opposite the plaque, an operation known as the Nesbit procedure. Lastly, the urologist may perform penile prosthesis implantation, a procedure recommended for men having both Peyronie’s disease and erectile dysfunction.


Since Peyronie’s disease varies extensively in how it affects patients, the treatment chosen should be carefully selected according to an individual’s condition. Most importantly, treatment should aim to preserve sexual function. If you are suffering from the disease, it is important to work closely with a urologist in order to get the right resources, prompt diagnosis and correct treatment, and to prevent the disease from turning into a crisis. For more information on dealing with Peyronie’s disease and erectile dysfunction, visit Advanced Urology Institute.

Why Walnuts Make Men More Fertile

Are you a man struggling to have children and looking for a way to boost your fertility? If so, consider eating a handful of walnuts every day. According to a study conducted by the University of Delaware, eating a walnut-enriched diet boosts sperm quality and aids in preventing male infertility. Working with two groups of mice, one fed on a walnut-enriched diet and the other fed on a control diet for 9 weeks, the researchers found that the group fed walnuts had a significant improvement in sperm quality.

How Do Walnuts Work?

Walnuts reduce lipid peroxidation, a form of cell damage that interferes with sperm membranes and harms sperm cells. Sperm is made of polyunsaturated fatty acids which are liable to damage by lipid peroxidation. Walnuts are the only tree nut made of mostly polyunsaturated fatty acids and will therefore effectively replenish sperm cells. In fact, just 1 ounce of walnuts contains 13 grams of polyunsaturated fatty acids (PUFAs) in 18 grams of total fat. By preventing sperm damage and replenishing sperm cells, walnuts help to improve sperm morphology, motility and vitality.

First Study on Walnut Efficacy

The study by the University of Delaware was based on a previous study by the UCLA Fielding School of Public Health and School of Nursing. According to the first study, which was based on a randomized control trial at UCLA, eating 2.5 ounces of walnuts each day (about 30 walnut halves) significantly improves the motility, morphology and vitality of sperm in men. During the research, more than 100 healthy young men eating their usual Western-style diet participated in monthly calls to share what they ate throughout the study. At the end of the study, it was clear that walnuts improved sperm quality, though more research was necessary to verify the role of the nuts.

Second Research Study by the University of Delaware

When the University of Delaware conducted its study, it was designed to reveal the mechanism by which walnuts had improved sperm quality in the UCLA study. Two groups of male mice, one consisting of healthy male mice and the other of genetically predetermined infertile male mice, were fed on either a walnut-enriched diet or a controlled diet for 9 to 11 weeks. At the end of the study, significant improvements in sperm morphology and motility were observed in mice consuming 20% of their daily calories from walnuts (equivalent to 2.5 ounces daily in humans). Most interestingly, even infertile mice had a remarkable boost in sperm morphology and both groups showed noteworthy reduction in peroxidative damage. The researchers concluded that walnuts improve sperm quality by reducing peroxidative sperm cell damage, though recommending further studies to determine which specific nutrients in walnuts are responsible for this improvement.

Walnuts are Beneficial for Sperm Health

Fertility in men is determined largely by sperm quality and quantity. For instance, if the number of sperm ejaculated is very low or the sperm are of poor quality, it may be difficult or even unlikely for pregnancy to occur. Since one-in-five infertility cases are solely due to the male partner and about one-in-twenty men suffer from some form of fertility problem related to low numbers of sperm ejaculated, using a healthy and proven method of improving sperm morphology, vitality and motility is a good way to begin addressing fertility problems. Enriching your diet with walnuts can be an effective first step in resolving your fertility issues and, if needed, there are many other treatments for infertility using medications or surgery. For more information on dealing with male infertility, visit Advanced Urology Institute.

3 Easy Ways to Prevent Kidney Stones

3 Easy Ways to Prevent Kidney Stones


Kidney stones are formed when certain chemicals present in the urine solidify and turn into hard crystals. Over time, these crystals grow in size and eventually leave the body through urine. Sometimes, the crystals get stuck in the urinary tract, blocking the flow of urine and causing enormous pain. In nearly 50% of patients with this problem, the stones reappear within 5 to 7 years if no preventive measures are taken. In most cases, these stones form when calcium reacts with phosphorus or oxalate. A physician first determines the cause of this condition and will likely suggest reducing the intake of sodium or protein, both of which cause kidney stone formation. With some determination and care, the risk of kidney stones can be significantly reduced. The following are three simple preventive methods:

1. Increase Calcium

Calcium deficiency causes an increase in the body’s oxalate levels which directly contributes to the formation of stones. Find out how much calcium you should consume for your age to ensure that your body is not deficient in this essential mineral. Generally, men older than 50 years of age need 1,000 mg of calcium every day in addition to 800 to 1,000 IU of vitamin D to help the body absorb calcium. Getting your calcium from food is preferable since studies show that calcium supplements may increase the risk of stone formation.

2. Reduce Animal Protein

Your body produces uric acid while breaking down proteins. Higher levels of this compound increase the acidity of urine, which may cause the formation of kidney stones in the long run. For this reason, keep a check on protein-rich foods, especially red meat, seafood, poultry, and eggs. Eating too much protein also reduces the content of citrate in your urine, and this may also lead to stone formation. If you are prone to kidney stones, you should also follow a low-sodium meal plan. Nutritionists suggest a daily maximum sodium intake of 2,300 mg, but people who already have kidney stones due to high sodium levels should consume less than 1,500 mg of sodium per day.

3. Drink Plenty of Fluids

Drinking plenty of water is the simplest home remedy for kidney stones because water dissolves the unwanted substances in urine. As a rule of thumb, drink at least 2 liters of water per day. You may substitute with citrus beverages such as fresh orange juice or lemonade.

In addition to the above measures, avoid stone-forming foods such as chocolate, beets, tea, nuts, rhubarb and spinach, all of which are rich in oxalate. Colas are high in phosphate, a substance to avoid if you have a history of kidney stones due to high phosphate levels. Also, our bodies turn vitamin C into oxalate, so individuals taking this vitamin in supplement form can be at a slightly higher risk. Overall, with proper treatment and some changes to your diet, kidney stones can easily be prevented.

7 Types of Bladder Control Problems in Women

Bladder control problems are common for many women. They are characterized by urine leakage, a progressively weaker urine stream, inability to empty the bladder or the frequent urge to urinate and rush to a bathroom. Bladder issues often restrict a woman’s range of physical activities and may cause withdrawal from social interactions, resulting in a diminished quality of life. Causes may include weakness of the pelvic fascio-muscular supports, nerve damage, various medications for neurologic conditions and underlying medical disorders like kidney disease and diabetes. While these problems differ according to cause and contributing factors, urologists can help women regain bladder control by identifying the type of bladder problem and administering the right treatment.
The 7 most common types of bladder control problems in women are:

1. Temporary or transient incontinence

This is a short-lived episode of loss of bladder control that commonly affects more than half of hospitalized women and at least a third of community-dwelling elderly women. It is often a side effect of medications (such as sleeping pills and diuretics) that lower cortical control over the urinary bladder or stimulate overproduction of urine. They may also be caused by surgery, pregnancy, urinary infections, severe constipation, or an inflamed or irritated bladder, vagina or urethra. In all cases, temporary incontinence will resolve on its own as soon as causative factors are identified and corrected.

2. Stress incontinence

This is the involuntary loss of bladder control associated with activities that increase physical pressure and stress in the abdomen and bladder. Affected women report having urine escapes when they laugh, cough, sneeze, have sex, exercise or engage in heavy lifting. It is the most common type of incontinence among women, occurring at any stage of life due to the physical changes of pregnancy, childbirth or menopause, all of which weaken the pelvic floor and reduce the effectiveness of bladder supporting ligaments.

3.Urge incontinence

Urge incontinence is the loss of bladder control commonly resulting from abnormal nerve signals or nerve damage due to a cerebrovascular accident, an infection or diabetes mellitus. It is characterized by a strong, abrupt and urgent need to urinate without prior warning, followed by the escape of a considerable amount of urine almost at once. Women affected by this bladder problem report leaking urine on their way to the restroom, urinate more than eight times per day and usually have to get to the bathroom more than two times overnight.

4. Mixed incontinence

This type of incontinence represents a combination of the characteristics of both urge and stress incontinence, with affected women experiencing episodes of sudden, urgent and uncontrollable urge to urinate together with urine leakage after a sudden cough, sneeze or laughter. All the factors that trigger urge and stress incontinence also cause mixed incontinence, including abnormal nerve signals, nerve damage, weakened pelvic floor muscles and connective tissue abnormalities.

5. Functional incontinence

Unlike the other types of incontinence, functional incontinence is not caused by abnormalities in the urinary system, nerves or muscles, but it occurs when a woman is unable to reach the bathroom in time to void because of mental and physical limitations. For example, a woman who is handicapped (such as having arthritis, a broken leg, Parkinson’s disease or Alzheimer’s disease) may not be able to move to the bathroom to urinate as soon as her bladder capacity is far exceeded, urinating where she is. Therefore, functional incontinence is a side effect of a mental or medical health issue.

6. Overflow incontinence

Characterized by the involuntary leakage of small amounts of urine when the amount of urine in the bladder exceeds the bladder’s maximum capacity, overflow incontinence occurs in women with weak bladder muscles, blocked urethra, kidney stones, scar tissue, pelvic organ prolapse, diabetes and multiple sclerosis. In overflow incontinence, the bladder has a substantial amount of residual urine and tends to overfill rapidly, resulting in the overflow of urine within a very short time. When not promptly treated, overflow incontinence can lead to bladder infection.

7. Overactive bladder

In some women, the inability to control the bladder is characterized by a sudden and unstoppable need to urinate, passing urine eight or more times per day and having to wake up two or more times every night to pass urine. In women with overactive bladder, detrusor muscles contract unpredictably and the inability to control the bladder can be so embarrassing that the affected person may want to isolate herself and limit her work and social life.
For women having bladder control problems, the good news is that a brief evaluation by an experienced urologist can quickly identify the type of bladder problem and pave the way for immediate treatment. If you have bladder control problems, inform your doctor and ask for help. Do not let your embarrassment keep you from getting the help you need. For more information, visit the site Advanced Urology Institute.

Why do I have a curved penis, Could it be a symptom of Peyronie’s disease?

The penis tends to bend slightly when it is erect because human anatomy is rarely perfectly symmetrical. The direction of bending of an erect penis depends on the ratio of the crus (portion of penis under the skin) to the exposed penis. Hence, a man with a shorter crus and longer exposed penis tends to have an erection pointing downward while one with a longer crus and shorter exposed penis has an erect penis pointing straight up or outward. In some men, the penis may curve slightly to the right or to the left. However, when the bend is more extreme and accompanied by painful erections, it may be a symptom of Peyronie’s disease.

What Is Peyronie’s Disease?

Peyronie’s disease (PD) is the most common cause of a curved penis. As a collagen disorder characterized by scar tissue (plaques) that develops under the skin, Peyronie’s disease is typified by a bend of the penis during erections. Other deformities, such as penis shrinkage, loss of girth, hourglass narrowing and indentation may also occur. The resulting bend makes penetrative sex painful or difficult, culminating in physical and psychological distress that causes difficulties in relationships.While the actual cause of Peyronie’s disease is not known, genetic defects, damage to blood vessels of the penis and low levels of testosterone hormone are believed to cause the disorder. And although the number of men who develop the condition is not known—given that most men are too embarrassed to see a doctor about the disorder—it is estimated that between 3-9 men out of 100 are affected. The disease is common among men in their fifties, though a small number of teenagers may also develop it.

Diagnosis and Treatment of Peyronie’s Disease

Typical symptoms such as painful erections, bending, deformity of the shaft and angulation are indicative of the disease. Given these indications, the urologist will measure the bend or distortion of an erect penis using photographs taken by a patient at home, a vacuum pump, or an injection to stimulate an erection. In some cases, the urologist may find it necessary to order a duplex ultrasound test in order to have a more accurate assessment of blood circulation in the penis.

Treatment options for the disease include stretching (external penile traction), vacuum devices, oral medicines (such as para-aminobenzoate, propoleum and colchicines), topical medicines (applied on the surface of the penis, like topical verapamil), injections into scar tissue (such as interferon, verapamil and clostridium hystolyticum (Xiaflex)), electrical currents (iontophoresis) and surgery.

So, is it normal to have a curved penis or could it be a symptom of Peyronie’s disease? Well, a mild curvature may be normal, but a severe curvature accompanied by painful erections requires immediate medical attention as it may, in fact, be a symptom of a curable disease. Presently, urologists have several treatment options for handling the condition in a personalized manner. Don’t suffer in silence. For more information, visit Advanced Urology Institute.

Life Changing Treatment At Advanced Urology Institute

What I Do as a Physician Assistant – Lisa Cunningham



Driven by an unwavering commitment to excellence in urology, Advanced Urology Institute offers a complete range of innovative, specialized and high quality medical services for male and female urological conditions. We have assembled a multidisciplinary team of specialists who work together for you, including preoperative nurses, urologists, pathologists, radiation oncologists, dedicated robotic surgeons, postoperative recovery specialists and nurse navigators who coordinate urologic cancer care. Our board certified experts will work with you to identify the most effective treatment that meets your individual needs, ensuring a minimal disruption of your lifestyle.

Better Outcomes

At Advanced Urology Institute, we recognize that the most effective treatment for urologic conditions requires close collaboration between urologists, oncologists and other medical specialists. We have therefore created an environment in which the interactions between different specialists result in better patient care and improved outcomes. Our specialists work together managing each case jointly right from the start because we have removed all artificial boundaries between specialties, thus ensuring that transitions are seamless. In fact, we can deliver comprehensive treatment from one location by combining surgical expertise, on-site pathology and clinical laboratories, imaging services such as radiation therapy and CT scan, leading-edge robotic technology and synchronized care, resulting in unmatched personalized patient experience.

Comfort and Convenience

As experts on the conditions of the female and male urinary tract and the male reproductive system, we endeavor to help patients navigate sensitive health issues with a focus on their comfort and convenience. Every urologist at our center is open, friendly and willing to listen to the unique story of each patient in order to correctly recognize the symptoms and provide proper diagnosis. This extends to the use of the most recent diagnostic tools and the development of personalized treatment programs for conditions such as kidney cancer, bladder cancer, prostate cancer, male erectile dysfunction, renal pelvic obstructions, adrenal disease and female urologic disorders.

Are you looking for the highest quality urology services? Visit our site ‘Advanced Urology Institute‘ for more information.

What Are The Types of Hematuria?

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Hematuria is a health condition that is characterized by the presence of blood in the urine. There are two main types of hematuria: microscopic and macroscopic.

In microscopic hematuria, there is no visual evidence of the presence of blood, unless the urine is view under a microscope. Macroscopic hematuria, on the other hand, is evident immediately with red discoloration of the urine.

Hematuria can also be classified according to the cause of the blood in the urine. Both of these types are detailed further below.

Microscopic Hematuria

The concentration of blood in the urine is not visible to the naked eye in microscopic hematuria and can only be detected under a microscope.

Some individuals are affected by microscopic hematuria without an identifiable cause, which is referred to as idiopathic hematuria. This is thought to result from an increased excretion of red blood cells in respect to what is considered to be normal, although may not be associated with adverse effects on the individual.

Macroscopic Hematuria

Also known as frank or gross hematuria, macroscopic hematuria involves visible discoloration of the urine as a result of a greater concentration of blood in the urine. The color is usually described as pink, red or dark brown. Additionally, there may also be evidence of small or large blood clots in some cases.

It is not necessary for a large volume of blood to be present for the color of the urine to be altered. In fact, 1 mL of blood is sufficient to precipitate a change in color. Additionally, the volume of blood may not be an accurate indicator of the severity of the underlying cause, and even a small quantity of blood may have serious repercussion and vice versa.

Joggers Hematuria

“Joggers hematuria” is a specific type of hematuria that occurs as a result of recurrent damage to the bladder during activities such as jogging and long-distance running.

Classification by Cause

Hematuria can also be classified according to the cause of the condition, as follows:

  • Infective hematuria: due to pyelonephritis, cystitis or urethritis
  • Stones-related hematuria: due to staghorn calculi, calcium stones or uric acid stones
  • Trauma-related hematuria: due to pelvic trauma, renal injuries or foreign bodies
  • Renal hematuria: due to IgA nephropathy, hereditary nephritis, medullary sponge kidney or thin basement membrane diseases
  • Iatrogenic hematuria: due to recent endoscopic procedure, trans-rectal ultrasound, traumatic catheterization, radiation, indwelling ureteric stents, renal biopsy or extracorporeal shockwave lithotripsy
  • Benign hematuria: due to strictures, renal masses or benign prostatic hypertrophy
  • Malignant hematuria: due to prostate acinar adenocarcinoma or renal cell, transitional cell, squamous cell or urothelial cell carcinoma

Other Causes of Red Discoloration

While red discoloration is the most distinctive feature of hematuria, there are various other causes of this discoloration, which can result from numerous factors. These may include the presence of pigments such as:

  • Myoglobin (indicative of myoglobinuria)
  • Porphyrins (indicative of porphyria)
  • Betanin (in beets)

Additionally, some drugs can have a similar effect, including rifampicin, phenazopyridine, sulphonamides and non-steroidal anti-inflammatory drugs (NSAIDs).

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