Discussing a Sensitive Topic: Erectile Dysfunction

Erectile Dysfunction, also called ED, is the inability for a man to get or maintain an erection firm enough for sexual activity. It is a very personal and sensitive issue that can be difficult to talk about. Although ED is a common issue that affects many men, it can still cause feelings of embarrassment and shame. This makes open conversations, even with a trusted urologist, difficult in some cases.

Dr. Billy Vanasupa of St Augustine, FLA urologist is a doctor who specializes in the urinary tract and male reproductive system. They are the doctor a patient will most likely to go to about his ED. Urologists see countless cases of ED on a regular basis, and to them it is not a major issue at all. However, good urologists understand that ED can be an embarrassing issue for their patients and they immediately begin their visits by creating a comfortable environment where doctor and patient feel at ease discussing it.

One such urologist who works to create a comfortable environment is Dr. Billy Vanasupa. When talking about his approach with patients who see him for ED, Dr. Vanasupa says, “I always try to make my visits light, make some jokes here and there, and make them feel comfortable.” His goal is to make his patients laugh so they are less nervous and feel they can easily talk to him. Dr. Vanasupa removes the stigma of ED so he and his patient can openly discuss this sensitive topic.

Once everyone is comfortable discussing the topic, the urologist will ask background questions like whether the ED occurred slowly or abruptly. The patient will be asked if he has tried any medications. The doctor’s questions are to help determine root causes for the issue and will include asking about diet, alcohol and drug use, and stress factors. Finding possible causes for ED is an important first step in treating it.

The urologist and patient will discuss best treatment options for ED. In many cases, oral medication, possibly along with some minor lifestyle adjustments, will fix the issue and allow healthy men to return to their normal sexual activity. For some men, oral medication does not help. The urologist may suggest injections. Patients will learn in the office how to administer a very low-pain injection at the base of the penis. There are very few cases where neither the oral or injected medication solves the issue.

Outcomes are best when the patient feels comfortable talking to his urologist about sensitive issues. The Advanced Urology Institute has urologists who can treat erectile dysfunction in a way that puts a patient at ease. For more information, visit the Advanced Urology Institute website.

Kidney stones: What are the treatment options?

If you’ve been diagnosed or suspect you have kidney stones, you will want to know about your options for treatment right away.

Kidney Stones: What are they?

Kidney stones are technically referred to as renal calculi. They are solid entities formed of different types of crystals. When they become large, they are extremely painful. They are called kidney stones because they usually start forming in the kidneys, but they can develop anywhere along the urinary tract, including

  • kidneys
  • ureter
  • bladder
  • urethra

What Causes Kidney Stones?

Kidney stones have several variations, and they originate for different reasons. Some of the causes are:

  • Calcium. Calcium-based stones are the most common type and somewhat preventable by avoiding high oxalate-rich foods like potato chips, peanuts, chocolate, beets and spinach. Ironically, although some kidney stones form from calcium, getting sufficient calcium in your food can prevent these stones.
  • Uric acid. These kidney stones are found more often in men than women. They develop when the urine becomes too acidic due to a diet high in purines (animal proteins) like fish, shellfish and some meats.
    Struvite. Struvite stones are more often found in women who have urinary tract infections or a kidney infection.
  • Cystine. Cystine stones are less common. They are hereditary and caused by leakage of cystine into the urine from the kidneys.

What Treatment is Available for Kidney Stones?

If the stones don’t go away by passing naturally through the urogenital system, you should contact a urologist for treatment. There are several procedures they can employ to remove the stones. The type of treatment depends on the size of the stones and type of stone.

Here are some treatments your urologist might recommend:

  • Medication: The urologist may prescribe pain medications and/or antibiotics in case of an infection. Other medicines also may be prescribed depending on what type of kidney stone is found, including: allopurinol for uric acid stones; diuretics to avoid calcium stones; sodium citrate or sodium bicarbonate, which makes the urine less acidic; or phosphorus solutions which are found to prevent calcium stones from forming.
  • Modern methods of breaking up the stones like lithotripsy, in which sound waves are employed, so stones are more easily passed.
  • Tunnel surgery is a minimally invasive procedure in which the urologist makes a small incision on your back to retrieve the stones.
  • Ureteroscopy: If a kidney stone is lodged in the bladder or ureter your urologist may use a ureteroscope to retrieve it. In this procedure a thin wire with an attached camera is inserted into the urethra and bladder, and then the stones are retrieved. Stones are examined by a lab to give more insight into the type of stones being formed.

Kidney Stone Prevention

If you are prone to kidney stones, try to drink 6 to 8 glasses of water each day to increase urine flow. This preventative measure helps flush out the kidneys. Your urologist may prescribe medication to help prevent future types of stones from forming.

If you think you have kidney stones you will want to speak with a qualified doctor to discuss the best methods to prevent and treat them. If you are in Florida, call the Advanced Urology Institute for an appointment with a board certified urologist.

What Causes Kidney Stones

What causes kidney stones? This is a question that Dr. Howard Epstein hears often when he meets patients suffering from the symptoms, pain and problems caused by this common urological condition.

It is important to first know what the kidneys are and what is their normal function. The kidneys are often described as fist-sized, bean-shaped organs. They are located below the ribs, behind the stomach. Their main function is to filter the blood and maintain the proper balance of necessary salt, water and various minerals in the blood. Excess salt and minerals and other wastes are removed and sent to the bladder as urine. The filtered blood is sent to the heart, where it can carry oxygen and necessary nutrition to the rest of the body. Because the kidneys essentially make sure the blood is clean and healthy, they are critical for life.

Dr. Howard EpsteinFor a normal person, the kidneys will filter around 200 quarts of blood each day, and they will remove about two quarts of liquid each day in the form of urine. Since a healthy person of around 160 pounds has only five quarts of blood, that means the blood will flow through the kidneys around 40 times per day.

Of all the various ailments a person can have, kidney stones can be among the most painful. The stones are formed when the kidneys filter out an excessive amount of minerals, such as salt or calcium, and those minerals remain in the kidney long enough to start crystallization. It’s the same kind of process that can create rock candies. Over time, the crystals become larger, forming kidney stones. If they are small, they can often be flushed out (passed out) of the kidneys and the body without creating any problems. But if at any stage they get stuck in the body, they will continue to grow in that spot. The most common spot is in the kidneys, where they first start growing. As they grow, they hinder normal kidney function, reducing the flow of blood and reducing the kidney’s ability to produce and pass urine. A kidney stone can move and completely stop the flow of urine, which is really bad news.

If a person consumes too much salt, too many calcium-containing foods, takes certain medications or drinks far too little water, kidney stones can develop. There is evidence that genetics also can can cause stone-making kidney disorders. The end result can be very painful.

Drinking water every day is essential to good health. The citrate in lemon juice can be beneficial in small amounts. Artificially colored sodas and food, as well as too much coffee, can cause problems because of the types of chemicals that enter the body. The body also gets rid of excess water through perspiration, so it is important to drink enough water to urinate at least four times a day, with an average above that.
Anyone experiencing symptoms such as strong pains in the stomach area or on the side down to the groin should immediately see a doctor. There are numerous problems that can cause excessive side or abdominal pain and it is advisable to see a specialist. If you are concerned about the possibility of having kidney stones, schedule a consultation with Dr. Howard Epstein MD or one of the many highly skilled urologists at an Advanced Urology Institute location near you.

Why Urology? with Dr. Bill Vanasupa

Becoming a doctor in any field of medicine requires a great deal of dedication and determination. Students wishing to become physicians put in long hours studying for tests and preparing for classes and internships. After graduating, many new doctors find their profession leaves little time for a personal life with friends and family. Their dedication to patient care can cause a difficult work-life balance.

Dr. Billy VanasupaDr. Bill Vanasupa thought he wanted to be a family practice doctor, seeing and growing with the same patients throughout his career. However, when he was an intern he discovered that although family practice is rewarding in its own way, it was not the right choice for him. When he assisted in surgery as part of his training, he discovered an aspect of medical care that he felt was his calling.

However, Dr. Vanasupa also knew about the challenges of practicing in certain fields of surgery, and he found himself considering where he could best serve patients with both surgical and non-surgical treatments.
As luck would have it, Dr. Vanasupa had a friend in college whose father was a urologist. He spoke to his friend’s father and a career in urology seemed like a good fit for him. Urology would allow him to create lifelong relationships with patients while also performing surgeries and keeping a desired work-life balance. By assisting patients with their urology problems, Dr. Vanasupa has the opportunity to create great patient relationships that last for years.

Today, Dr. Vanasupa is living his dream at Advanced Urology Intstitute by helping people by offering the most advanced medicine and surgical techniques available in the medical field of urology.