Why Southerners Have a Higher Risk of Kidney Stone

I am Ketan Kapadia. I’m with Advanced Urology Institute and a board certified urologist.

Dr. Ketan Kapadia of St Petersburg, FLObviously the heat is going to play a major role, a lot of it has to do with our diet unfortunately as well. [As with] an American diet, we just don’t eat very well, we’re all a little heavier and that also increases the risk of kidney stones as well.

The interesting thing here in Florida, which isn’t talked about very much and this is sort of the holistic treatment of the patient in urology, which is we get a lot of men who have prostate problems who start cutting back on their fluids because they don’t want to get up at night; And when you start cutting back on fluids and not getting up at night, now you’re at more risk of [getting] stones. We see a lot of older guys who come in with kidney stones for the very first time because they got a prostate problem as well and that hasn’t really been addressed.

Same with women who have overactive bladder. First thing most people do is they start cutting back their fluid so they’re not having to run to the bathroom all the time. Again, you cut back your fluid and now you’re living in Florida in the heat, you’re going to get kidney stones. So a lot of doctors will be more than happy to just get rid of your stone and have the surgery [but] I’m also interested in preventing that next stone. Part of that is getting twenty-four (24) hour urines, seeing why you’re making stones, addressing all the overactive bladder problems and prostate problems because I don’t want you to end up having more stones. I’m happy to operate and take out stones, that’s fun, but it’s my obligation to help prevent [it from happening agan].

Common Urologic Conditions Are Treatable

The urinary system of the human body regulates, manages and eliminates urine waste. The organs in this system are the kidneys, ureters, bladder and urethra. But as with any organ or system of the body, the urinary system can have problems, commonly referred to as urologic diseases or urologic problems.

You can have urologic problems regardless of your age, ethnicity or gender. And when urologic conditions occur, in both men and women they have a direct effect on the urinary tract and how urine is expelled from the body. In men, urologic problems can also affect the reproductive organs.

Signs that you have urinary tract problems:

Urologic conditions are treatable

Urology is a dynamic and advanced field. Urologists know how to treat many urologic diseases, including cancer of the prostate. The first step in any successful treatment is to see a urologist on time. Do not delay. As soon as you experience any problems, visit a urologist for a medical exam.
Mikhail Lezhak, PA-C of Daytona, FL

Common urologic conditions

(1) Urinary Tract Infections (UTIs)

Urinary tract infections (UTIs) are the most frequent type of urologic condition, although they occur more commonly in women than men. Close to 60% of women and 12% of men experience UTIs at some point in their lives. These infections are easily treated with antibiotics, but the treatment should begin as soon as possible to avoid further infection and prevent complications.

(2) Urinary incontinence

Although many people resist seeking help because of embarrassment, urinary incontinence is treatable in most cases. The cause is usually either an overactive bladder (urge incontinence) or stress incontinence. Typically, urge symptoms come from the bladder wall and detrusor muscle and mucosa, while stress symptoms are due to the incompetence of the bladder neck or urethral sphincter.

The diagnosis of urinary incontinence can be reached through a careful patient history, thorough examination and proper tests. You may need bladder retraining, controlled fluid intake, reduction in caffeine intake, or deliberate delayed voiding to treat the symptoms. Your doctor can also recommend medication or perform corrective surgery.

(3) Pelvic Floor Dysfunction

Pelvic floor muscles support the bladder, vagina and rectum. At some point in life, particularly after childbirth, pelvic floor muscles can become irritated or inflamed. Since the pelvic floor has to relax during urination, having pelvic floor dysfunction can cause pain or difficulties. The problem is often treated through pelvic floor exercise, but when the exercises are ineffective, vaginal medications or muscle injections can be used.

(4) Prostatitis

Many urological problems in men are linked to the prostate. Prostatitis is the inflammation or abnormal swelling of the prostate. The most common symptoms of prostatitis are painful urination, fever, chills, abdominal pain, and pain in the lower back or pelvic region. If you are diagnosed with prostatitis, your doctor will recommend antibiotics to reduce the swelling and restore your prostate to normal size.

(5) Bladder and prostate cancer

The PSA test and prostate exam are great ways to check on your prostate health. Should cancer be found in your bladder or prostate, your urologist will offer lifesaving care. Prostate cancer is the second leading cause of cancer-related deaths in men. It results from the abnormal and rapid growth of prostate cells.

Prostate cancer is successfully treated when detected early, which is why men are encouraged to get checked once a year. In fact, the recommended treatment depends on the time of detection, and may include radiation, surgery or regular surveillance. Today, robotic surgery has helped to reduce the hospital stay for kidney, bladder or prostate cancer surgery to just a few days, or just one day.

(6) Prostate enlargement (BPH)

The prostate grows as you age. Over time, you may have to wake up at night to go to the bathroom or you may not be able to produce the stream of urine you once did. When diagnosed with BPH, your urologist will use various techniques to relieve the obstruction caused by the enlarged prostate. These techniques include consistent monitoring, medications, and in some cases surgery.

Your urologist may also recommend the Rezum procedure—which uses heated water vapor to shrink the enlarged prostate tissue—or the green light and thulium laser vaporization techniques, transurethral resection of the prostate, minimally-invasive thermotherapy, or a UroLift. You will likely return home the same day as one of these procedures.

(7) Erectile dysfunction (ED)

This is a common condition as men grow older. When a man in his 40s or 50s notices that his erections are no longer what they used to be, he should talk to a urologist. Erectile dysfunction is the difficulty in achieving or maintaining an erection for sexual intercourse.

Although not fatal, it can cause stress, embarrassment and a strain on your relationship. Urologists will help you determine the underlying conditions and recommend treatments. Your urologist may prescribe medications—such as PDE5 inhibitors Cialis and Tadalafil—penile injections, a penile pump or, as a last resort, penile implant surgery.

(8) Kidney and ureteral stones

Kidney and ureteral stones occur when crystal-like particles in urine develop and grow into larger masses. As the stones pass along the urinary tract, they can get blocked and cause pain. Although most stones are passed naturally, larger stones may require surgery or specific procedures to break them.

One of the most common treatments is the Extracorporeal Shock Wave Lithotripsy (ESWL) technique in which sound waves are used to break up stones into smaller pieces. Also, since kidney stones can recur, patients often need long-term care. Your urologist will advise you on how to prevent kidney stone formation and how to best manage any potentially painful stones that develop.

At Advanced Urology Institute, every day we help people solve problems they may be hesitant to talk about. Since these problems are distressing or awkward to discuss, our goal is to help make you comfortable. We are proud of the long-term relationships we enjoy with our patients. Our knowledgeable urological specialists provide carefully tailored and confidential care. At AUI, patients get a proper diagnosis and the correct treatment, and we are willing to answer any questions you may have about your health.

If you suspect you have a urological problem, we encourage you to make an appointment at one of our many locations. For additional educational resources on urologic conditions, visit the Advanced Urology Institute website.

Types of Prostate Cancer: What You Need to Know

Prostate cancer is a complex disease. It is not easy to predict how any particular prostate tumor will grow, or how rapidly it will spread to areas outside the prostate. After a prostate cancer diagnosis, your urologist will assess various factors to determine the level of risk associated with the disease. Understanding the risk level—low, intermediate or high—will help you and your doctor make decisions to achieve the best survival rate and quality of life.

Types of prostate cancer

While there are many types of prostate cancers, urologists first divide them into two categories—aggressive and indolent—to begin determining the best treatment.

1. Aggressive prostate cancer

Dr. Scott Sellinger of Tallahassee, FLAggressive prostate cancer is the type that grows rapidly, spreads fairly early, quickly and widely, and causes massive body damage. Since it spreads swiftly via secondary deposits, it quickly becomes advanced stage cancer and is very difficult to treat, particularly during the later stages.

For aggressive high-risk prostate cancer, treatment is most effective when it begins while the tumor is still in its early stages. Without early treatment, the cells of the tumor remain highly active, multiplying rapidly. The tumor grows swiftly, spreads rapidly and causes widespread damage.

2. Indolent prostate cancer

Indolent prostate cancer is the type that grows very slowly and is unlikely to spread to areas outside the prostate. Therefore, it is a low-risk, low-volume tumor that can exist in the prostate for several years without causing significant problems. Even if left untreated, it is unlikely to spread outside the prostate; and if it spreads, it only does so slowly and locally.

How are high-risk and low-risk prostate tumors identified?

If you are diagnosed with prostate cancer, your doctor will monitor the disease periodically to see if it is growing and spreading. The primary way for monitoring the growth and spread of the tumor is the prostate-specific antigen (PSA) level in blood. PSA is produced by the prostate and reaches the bloodstream; but larger amounts of PSA in the bloodstream are usually a signal that the prostate is enlarged, infected or malignant.

For instance, the PSA doubling time—the time it takes for a patient’s PSA level to double—predicts how aggressive the cancer is. The faster the PSA level doubles, the more aggressive is the cancer. Likewise, the PSA velocity helps to predict the aggressiveness of a tumor. If the PSA level increases sharply, then the cancer is likely aggressive.

Urologists also use the Gleason score to detect how fast the cancer is growing and spreading. This score is obtained by grading cells in the tumor on the basis of how abnormal or normal the cells look under the microscope. The two most abnormal areas of the tumor are evaluated, each given a score from 1-5, and then the two numbers are added. The higher the score (typically 6 or more), the more aggressive the tumor.

While immediate treatment is called for with aggressive, high-risk tumors, a patient can live with an indolent, low-risk tumor for 20-30 years without the cancer causing any serious effects. For the slow growing tumor, we may recommend observation or a watchful waiting called active surveillance, where we monitor the growth and spread of the tumor without medical intervention.

At Advanced Urology Institute, we offer a wide range of treatment options for prostate cancer, including chemotherapy, hormone therapy, radiotherapy, and surgery. But before we can recommend any treatment, we try to determine the risk of advanced disease. For more information on the diagnosis and treatment of prostate cancer, visit the Advanced Urology Institute website.

Do You Treat People With ED

Well, yes—every day. At Advanced Urology Institute, we treat men with erectile dysfunction (ED) and achieve great results for our patients. Erectile dysfunction is a big issue for men today, regardless of their age. Up to half of all men experience some form of ED in their lifetime, with roughly 10% of men over 40 suffering severe forms of impotence.

What is erectile dysfunction?

Also called impotence, erectile dysfunction is the inability to regularly get or maintain an erection for satisfying sex. In general, an occasional problem should not be a cause for concern. In fact, it is normal to have trouble getting or keeping an erection for up to 20% of sexual encounters. But frequent trouble getting an erection indicates a medical problem. With ED, successful erections either become the exception more than the rule or they never happen.

Treating People with Erectile DysfunctionSome of the causes of ED include:

  • Alcohol use, illicit drug use, or smoking
  • Medications, such as for high blood pressure
  • Diabetes
  • High cholesterol
  • Heart disease
  • Obesity
  • Blocked blood vessels
  • Scar tissue inside the penis
  • Sleep disorders
  • Metabolic syndrome
  • Anxiety, stress, or depression
  • Emotional or relationship issues

Risk factors for erectile dysfunction include advanced age, diabetes, obesity, depression, cardiovascular disease, high blood pressure, low testosterone, high cholesterol and smoking.

What does treatment for ED involve?

Erectile dysfunction is a treatable condition. At Advanced Urology Institute, we offer several treatment options, generally beginning with the least invasive approach. We also give lifestyle advice that may help with overcoming the condition.

For instance, if your ED is due to inactivity, obesity, metabolic syndrome, high blood pressure or cardiovascular disease, we may recommend you engage in regular aerobic exercise to help reduce the symptoms. We may also recommend you quit smoking, minimize your alcohol intake and follow a healthy diet.

Treatments for ED include:

1. Phosphodiesterase type-5 (PDE5) inhibitors

PDE-5 medications are typically the first line of treatment we recommend for men with ED. They include Stendra (avanafil), Viagra (sildenafil), Cialis (tadalafil), and Levitra or Staxyn (vardenafil).

These oral medications work in a similar manner to boost the level of cGMP—a natural chemical in the body that promotes the widening of blood vessels following sexual arousal. In turn, more blood reaches the penis.

At the same time, these medicines enhance the relaxation of muscles of the penis in response to stimulation, hence increasing blood flow to the penis and allowing an erection.

2. Creams and injections

Sometimes we prescribe a topical Alprostadil cream as an alternative to the oral medications. The cream comes with a plunger and is applied to the tip of the penis and the surrounding skin 5-30 minutes before having sex.

At other times, we may prescribe penile injections as a treatment for ED. That is, we teach you how to inject a medicine at the base of your penis 5-20 minutes before sexual intercourse. After the injection, there will be increased blood flow to your penis and an erection will develop within 15 minutes.

3. Penis pumps (vacuum devices)

A penis pump (vacuum erection pump) is a tube that fits over the penis. A plastic container is placed over the penis and the pump draws air from the container to create a vacuum. The change in air pressure when the device is used causes blood to be drawn into the penis and triggers an erection.

Once the vacuum creates an erection, the retaining band is slid down the lower end of the penis and the pump is removed. An erection will typically last long enough for intercourse but the penis may be cold to the touch, and the rubber band may restrict ejaculation.

4. Penile implant (surgery)

We generally recommend surgery only when all other treatment options are not successful or not well tolerated. If that is the case, a penile implant (prosthesis) may help in achieving erections.

A penile implant is a medical device surgically placed into a penis to mimic the look and performance of a natural erection. The prosthesis involves an inflatable rod inserted in the middle of the penis, with a pump hidden in the scrotum. The pump is used to inflate the rod, which in turn causes an erection.

Penis pumps are custom-fit to your anatomy in a procedure that is performed carefully to ensure that the sensitivity of the penis and your ability to ejaculate are not adversely affected, allowing you to have a normal orgasm and great sexual encounters.

At Advanced Urology Institute, we recognize that erectile dysfunction is a common but very sensitive issue. That is why we provide a compassionate, patient-friendly approach to ED treatment to help men tackle it as soon as it starts. And because ED may also be a sign of a more serious medical condition, we encourage you to speak with a urologist as soon as possible to help you address the underlying condition and find the best treatment option.

Remember, the sooner you speak with your doctor about ED, the sooner you can go back to enjoying physical intimacy with your significant other. For more information about the diagnosis and treatment of erectile dysfunction, visit the Advanced Urology Institute website.

Advantages and Disadvantages of Robotic Technology in Urology – Dr. Shaw Zhou

Shaw Zhou, MD of St Petersburg, FL

My name is Shaw Zhou, I am with Advanced Urology Institute.

Robotic surgery is truly precise, for example, the magnify [goes] up to ten times so the doctor can see better and if your doctor has a hand tremor [it’s still] very steady. You got four arms instead of two arms, so you have two arms to grab for you and so on and so forth. And you have three dimensional [view], you can see much better. The traditional labs got surgical screens which are two dimensional so you don’t have that sense of depth. However the drawback is first of all, the doctor sits 10 feet away, so God forbid if something happened, your doctor will have to go in, wash your hands and you are not by your patient

Also you lose the tactile sensation, cause you don’t feel it no more. When you tie a knot or whatever you know, the tactile sensor feed gives how much force you use now, [before] it’s purely by experience. Although the new robot that we’re talking about that has tactile sensationin other words you can visually see it. They see how much force [is needed] if its red or green. So it’s getting better and better, eventually new robots keep on coming out but in the future I think we can overcome all these shortcomings for robot surgery.

Are Medications Effective in Treating Erectile Dysfunction – Dr. Yaser Bassel

My name is Yaser Bassel, I am a board-certified urologist with Advanced Urology Institute.

I would say the vast majority of them, especially if they have not tried medications prior to them being seen in our office, probably 70-80 percent of those men will at least have a response to the medication oftentimes enough to basically be satisfactory to the patient or make them pleased with the way the medication is working. So most of them would actually get a good response to the medication.

Are there other treatment options for ED?

As far as what we have available to us now and what’s on the forefront, [for] those patients that do not want medication there are some newer technologies that are available that utilize shockwave energy to try and create newer vascularity in order to get a better response for that medication and that is something that’s basically come out over the past couple of years that we are starting to utilize in our practice. For those that do not respond to medication and still want to have treatment, the next step oftentimes [is] performing a test called a Penile Doppler where we will inject the penis with a vasoactive medication which will then initiate an erection so that we can measure blood flow and also measure for a venous leak which are two reasons why patients can have issues with erectile dysfunction.

If you are in need of a consultation or have any questions, visit us at our Tampa, FL office or call us at (813) 749-0820.

What Urology Procedures Are Performed in Our Naples Office?

KEY TAKEAWAYS:

  • The Advanced Urology Institute’s Naples office, led by Dr. Rolando Rivera, offers a range of outpatient urology procedures, including prostate procedures, reconstructive surgeries, and stone disease treatment.
  • Complex cases requiring specialized equipment, such as robotic surgery for pelvic organ prolapse, are performed at the hospital.
  • The Advanced Urology Institute is the largest urology practice in Florida, providing comprehensive and personalized care to patients seeking a urologist in Naples, FL.

Introduction

Urology is a specialized field of medicine that focuses on the diagnosis, treatment, and management of various conditions related to the urinary tract and male reproductive system. At the Advanced Urology Institute in Naples, Florida, Dr. Rolando Rivera, is a board-certified urologist who is also specialized in Female Pelvic Medicine and Reconstructive Surgery. In this article, we will discuss the various urology procedures performed at the Naples office and how Dr. Rivera can help you.

Outpatient Urology Procedures in Naples

The surgery center in Naples is designed for primarily outpatient interventions that are fairly uncomplicated. A range of procedures can be performed at this facility, catering to the diverse needs of patients seeking a urologist in Naples, FL.

Prostate Procedures

One of the common procedures performed at the Naples office is the Urolift. This minimally invasive procedure treats benign prostatic hyperplasia (BPH), a condition characterized by an enlarged prostate gland. The Urolift procedure involves the placement of small implants to lift and hold the enlarged prostate tissue out of the way, relieving pressure on the urethra and improving urine flow.

Reconstructive Surgeries

Dr. Rolando Rivera performs simple reconstructive procedures at the Naples office, focusing on pelvic reconstructive surgeries. These surgeries address issues such as pelvic organ prolapse, in which the pelvic organs, like the bladder or uterus, descend due to weakened pelvic floor muscles and ligaments. The reconstructive procedures aim to repair and strengthen the pelvic floor to restore normal function and alleviate symptoms.

Stone Disease Treatment

For patients suffering from kidney stones, the Naples office offers various treatment options. Depending on the size, location, and type of kidney stones, Dr. Rivera may perform minimally invasive procedures like extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy to break up and remove the stones.

Hospital Procedures for Complex Cases

While the Naples office is equipped to handle a variety of urological issues, some complex cases require specialized equipment and hospital facilities. For instance, Dr. Rivera performs robotic surgery for pelvic organ prolapse at the hospital. This advanced technique uses the da Vinci Surgical System to perform precise, minimally invasive procedures that result in shorter recovery times and reduced complications.

Advanced Urology Institute: Comprehensive Urological Care

The Advanced Urology Institute is the largest urology practice in Florida, offering state-of-the-art facilities and a team of highly skilled urologists. With a focus on providing personalized care to each patient, the team at the Advanced Urology Institute works collaboratively to diagnose and treat a wide range of urological conditions. If you are seeking a urologist in Naples, FL, trust the expertise of Dr. Rolando Rivera and the team at the Advanced Urology Institute.

TRANSCRIPTION:

I’m Rolando Rivera and I’m board certified in Urology and Female Public Medicine and Reconstructed Surgery with Advanced Urology Institute.

So the surgery center is designed for primary outpatient interventions that are fairly uncomplicated. So we do do a fair amount of things in the surgery center. We do our prostate procedures, Urolift, we do a fair amount of those. We do simple reconstructive procedures, public reconstructive surgeries, stone disease, those kinds of things. The more complex reconstructive surgeries that require specific equipment, like I do robotic surgery for prolapse, that is a hospital procedure.

REFERENCES:

Urinary Incontinence in Women

The loss of bladder control known as Urinary Incontinence is a normal problem that is more common in women than men. The effects of urinary incontinence range from barely noticeable to severe. As Dr. Amar Raval from the Advance Urology Institute says, “It is a big issue for women out in public.” Incontinence can cause difficult and embarrassing situations.

There are many causes of urinary incontinence. To understand these causes, it is important to remember that urinary incontinence is a symptom, not a disease. Lifestyle choices that can exacerbate the problem include consuming alcohol, caffeine, spicy foods and certain medications. For women, life events that affect women’s bodies in a way that can cause incontinence include pregnancy, childbirth, menopause and aging. Other causes can be found in weight, family history and health.

Dr. Amar Raval of Palm Harbor, FLThe different types of urinary incontinence can exhibit a variety of symptoms. Stress incontinence is characterized by small leaks of urine due to pressure on the bladder while laughing, coughing, sneezing or exerting oneself. The small leaks of overflow incontinence happen when the bladder has not fully emptied during urination. Urge incontinence is the sudden and intense urge to urinate, sometimes resulting in an involuntary loss of urine. Having to urinate frequently through the night is another symptom experienced by women with urge incontinence. It is also common for women to be affected by more than one of these types of incontinence.

Fortunately, a wide range of treatment options is available. Women can work with their urologist to find the best treatment option for their individual situation. In some cases, treatment can be as easy as making slight lifestyle changes or taking an oral medication. Botox and acupuncture can help relieve stress incontinence. For more advanced cases, urethral slings can ease symptoms by lifting the urethra into a normal position, and robotic surgeries can lift the bladder in cases of incontinence caused by a prolapse.

The loss of bladder control can be a lifestyle limiting problem for women when it affects their ability to leave the house and maintain normal activities. The urologists at the Advance Urology Institute work closely with each patient to ensure they can live with freedom and confidence, and without the worries of incontinence. For more information, visit the Advanced Urology Institute website.

How Does UroLift Procedure for BPH Work, According to Dr. David Harris?

KEY TAKEAWAYS:

  • UroLift is a cutting-edge, minimally invasive procedure for treating Benign Prostatic Hyperplasia (BPH), which is the most common prostate problem faced by men over 50. It involves placing a small implant in the urethra to compress the tissue causing blockage, improving urine flow and urination patterns.
  • Compared to previous BPH treatments that required general anesthesia, caused irritation and inflammation, and had a long recovery time, UroLift is well tolerated by patients and has far fewer side effects.
  • UroLift does not cause sexual problems, which were a common side effect of previous BPH treatments. This allows sexually active men to treat their BPH without sacrificing their sex lives.

Benign Prostatic Hyperplasia (BPH) can be described as the blockage of urine as it tries to flow from the bladder, through the urethra, and out of the body. It occurs when an enlarged prostate begins to pinch the urethra, which is the tube that urine flows through as it leaves the bladder. The result is difficulty urinating, weak urine streams, and frequent urgent needs to urinate. BPH is the most common prostate problem faced by men over 50.

Dr. David Harris of Fort Myers, FLFortunately for men who suffer from BPH, medical progress is on their side. According to Dr. David S. Harris, “We now have new tools and less invasive ways of treating guys with blockage.” One of the tools he is referring to is called UroLift. This clever cutting-edge procedure is changing the way the condition is treated and how men live post-BPH.

Before UroLift, in order to open the channel in the urethra a scope would be inserted through the penis to cut and remove tissue from the blocked channel. In other instances, urologists would use a heat method to destroy prostate tissue. Although this procedure would decrease the size of the prostate to relieve pressure on the channel, it required general anesthesia and resulted in a great deal of irritation and inflammation, as well a long recovery time.

UroLift has replaced these invasive procedures. UroLift is a small implant that is placed in the urethra and compresses the tissue that is causing the blockage, opening the channel for the flow of urine. This new implant dramatically improves the strength of urine flow. It also helps create normal patterns of urination, thereby stopping the frequent, strong urges to urinate. It brings men back to normal.

The UroLift procedure is minimally invasive and is well tolerated by patients. Another huge benefit is that UroLift has far fewer side effects than previous BPH procedures. One of the main negative side effects of previous BPH treatments was that they caused sexual problems by affecting a man’s ability to get and maintain an erection for intercourse. Thanks to UroLift, sexually active men do not have to choose between their sex lives and treating their BPH.

UroLift may be the best option for men who wish to take back their lives from the symptoms of BPH without resorting to an invasive procedure. Make an appointment for a consultation with Dr. David Harris or one of the many board certified urology specialists at Advanced Urology Insitute to find out if Urolift will work for you. For more information, visit the Advanced Urology Insitute website.

TRANSCRIPTION:

My name is David Harris and I’m a urologist with Advanced Urology Institute in Fort Myers. We now have tools that have progressed and we have different, less invasive ways of treating many of the guys with blockage. The most recent addition to our armamentarium is a procedure called Urolift and we are very excited to be able to offer Urolift because this is different.

Previously to open that channel there would be a procedure with a scope with the patient asleep and there would either be cutting of tissue in the channel or a heat destruction of prostate tissue and you can imagine that results in a lot of irritation, a lot of inflammation. So Urolift is very clever and the guys that designed this came up with the idea of using a small implant in the channel that compresses the lateral obstructing tissue and makes the channel more open and it is dramatically improving the force of the stream and the urinary pattern with a minimally invasive procedure that is well tolerated, fewer side effects than the medications that have been used, fewer side effects from the bigger operation and excellent outcomes.

Now one of the features, one of the issues that is striking about this is many of the medications that have been used for that will cause sexual problems, will affect the sex act and that also happens with the more significant surgery. It does not change erections and it does not change how a man ejaculates after surgery. So this is becoming very popular very quickly and many of the younger guys 50’s, 60’s that are sexually active that are having obstruction are no longer choosing the medications as the option to avoid surgery. They’re choosing Urolift so they don’t have to take medication, don’t have the side effects. So it’s dramatic.

REFERENCES:

What Causes BPH, and How is it Diagnosed & Treated by Dr. David Harris?

KEY TAKEAWAYS:

  • Benign Prostatic Hyperplasia (BPH) is the most common prostate problem for men over 50, caused by an enlarged prostate that pinches the urethra, leading to symptoms such as trouble starting urination, weak urine stream, and frequent urination.
  • Diagnosis of BPH involves a prostate exam and simple, non-invasive tests at the urologist’s office to determine urine flow and bladder emptying ability. More sophisticated tests, such as fiber optic scope evaluations, may be conducted if needed.
  • Treatment for BPH varies based on the severity of symptoms and can include lifestyle changes, oral medications, and surgical interventions. Urolift, a minimally invasive procedure, is a cutting-edge option that offers fewer side effects than medication and is less invasive than surgery.

Benign Prostatic Hyperplasia (BPH) is a condition in which the male prostate gland interferes with the outflow of urine from the bladder. It is the most common prostate problem for men 50 and older. BPH is caused by an enlarged prostate that blocks the flow of urine. The enlarged prostate pinches the urethra, which is the tube that carries urine out of the body.

The symptoms of BPH are similar to what happens when you step on a running hose. The hose becomes pinched, blocking the flow of water and weakening the stream coming out. People dealing with BPH will have trouble starting to urinate and a weak urine stream. They will strain to urinate, with the flow stopping and starting several times. Another major symptom is frequent urination. Frequent, strong urges to urinate often disrupt sleep and everyday life. This is the symptom that brings men to their urologist.

Dr. David Harris of Fort Myers, FLOnce an appointment is made with the urologist, doctor and patient can begin discussing symptoms and the diagnostic process. If the patient’s complaints are consistent with BPH, the urologist will proceed with a prostate exam. There are also other simple, non-invasive tests that can be completed at the urologist’s office that will indicate the patient’s urine flow and ability to empty his bladder. More sophisticated testing is available if additional data on the patient’s BPH issue is needed. For example, fiber optic scope evaluations give the urologist the most detailed picture of the patient’s BPH, which can then be used to devise the best treatment plan.

Treatment for BPH depends on many factors. For some men, mild symptoms can be managed with slight lifestyle changes and without medical intervention. For men with more severe symptoms, there are a variety of treatment options available. Oral medications can help relax the muscles around the prostate to allow easier urine flow. In serious cases, when medication is not enough, there are surgeries that can treat BPH. One cutting-edge option, that is less invasive than surgery and carries fewer side effects than medication, is Urolift. This minimally invasive procedure implants a stint in the urethra that opens the flow of urine and minimizes the symptoms of BPH.

BPH is a common medical issue that affects men and impacts their lives. As Dr. David S. Harris explains, “In general, many of our guys can tell you every bathroom from Lowe’s to Publix.” Living with BPH means having to plan their lives around the frequent and urgent need to urinate. The urologists at the Advanced Urology Institute work closely with patients to find the best way to solve their BPH-related issues.

TRANSCRIPTION:

My name is David Harris and I’m a urologist with Advanced Urology Institute in Fort Myers. So what you’re talking about is a prostate problem related to obstruction of the outflow of urine from the bladder, a term that many people know and hear is called BPH, Benign Prostatic Hyperplasia. That means the prostate’s enlarged and in general terms people use that term to convey that there’s blockage when that man goes to urinate. And a classic symptom of that is the stream being weaker. But there can be other things. That man may have to urinate more frequently. Many of our guys can tell you every bathroom from Lowe’s to Publix, right? And getting up at night is actually usually one of the complaints that really pushes the guys to come in. They may have to go urgently and if things progress, the bladder may not empty well and we get into other problems related to that.

So if a guy comes in and the complaints are consistent with obstruction, we will do an exam of the prostate. There is other office testing that’s simple, non-invasive, that gives us an idea. Is there a poor flow? Is the patient not emptying? And we can proceed to very sophisticated testing with fiber optic scope evaluations and formal studies of bladder function and urine flow. And we can put together for that patient a picture defining your block, your prostate is this shape, this size and we can lay out the options for that man. And some men tolerate some symptoms that are mild and they prefer to follow that. But as things get worse, we can offer them a variety of medications and many times that can do the job. However, procedures are often needed and this has evolved dramatically over the course of my career.

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Urologists Also Treat Women

Urologists are physicians who specialize in treating the male and female urinary systems, as well as the organs of the male reproductive system. Because men and women can both have problems with their urinary tract systems, many women see urologists for treatment. According to board certified urologist Dr. Howard Epstein, “We usually see women for things like bladder cancer, kidney stones, kidney cancer or incontinence.” Recurring urinary tract infections is another common reason for women to see a urologist.

Although both men and women see urologists, they usually see urologists for different reasons. For instance, women are more prone to urinary incontinence. Urinary incontinence is the loss of bladder control which can cause urine leaks. The degree of the severity of incontinence varies on a case-by-case basis. Some women experience urinary leakage when they laugh, cough or exercise. Urinary incontinence is so common in women that at least half of older women experience some degree of it. Urologists can treat incontinence with a wide range of options, including lifestyle changes, medication, devices, and in some cases surgery.

Urinary tract infections Howard Epstein, MD of St Augustine, FL(UTIs) are another issue that brings many women, especially older women, to their urologist’s office. UTIs are another urinary issue that can affect both men and women, but they are far more common in women than men. About half of all women will have a UTI in their lifetimes, while only 1 in 10 men will. UTIs are infections that happen in the bladder or urethra. Symptoms include burning while urinating, frequent urges to urinate, and pain in the lower back and abdomen. Urologists can prescribe antibiotics to treat the infection.

Kidney stones are another issue for which women seek help from their urologist. These stones, made of salt and mineral deposits in the kidneys, can become lodged in the urinary tract causing a wide range of issues. Symptoms include pain, nausea, vomiting, and even fever. In some cases, the pain can be so severe that some women liken it to childbirth, if not worse. There are several treatment options available for kidney stones, and finding the right one depends on the size and location of the stone. Shock wave lithotripsy can be used as a non-invasive way to break up the stones into small, easily passable pieces. In some cases, more invasive extraction methods might be needed.

All of these urological treatment options, from medications to surgeries, have their side effects. It is important for women to be able to have conversations with their urologist about their health issues and the possible side effects of treatment. For many women with urinary problems, the path to relief begins with a consultation with a urologist at the Advanced Urology Institute.

Becoming a Physician Assistant – Chelsie Ferrell, PA-C

A successful medical team has several positions. One of these positions is the physician assistant. Also referred to as a PA, a physician assistant is a trained medical professional whose education takes less time to complete than a doctor’s. Chelsie Ferrell, PA remembers the first time she shadowed another physician assistant and decided it was the career for her. According to Chelsie, “I met a really great PA and loved her job, and I fell in love with the profession.” After becoming a PA, her career path led her to urology.

Urology is a specialized medical field that focuses primarily on the male and female urinary systems and the male reproductive system. Because of how many different organs are involved in the urinary system, urology covers a wide range of medical issues for both men and women.

Chelsie Ferrell, PA of DeLand, FLOne reason men see a urologist is to check for prostate cancer. Prostate cancer is the most common form of cancer that affects men. As they age and their likelihood of developing the disease increases, regular prostate cancer screenings by a urologist become increasingly important. If cancer is found, the urologist will discuss treatment options with the patient. Some non-aggressive cases can be treated simply by monitoring the cancer. Others cases may need to be treated with surgery or radiation therapy.

For women, urinary tract infections (UTIs) are a common reason to see a urologist. UTIs are infections that flare up in any part of the urinary system, including the kidneys, bladder or urethra. Symptoms can vary between patients, with the most common symptoms being intense pain, frequent need for urination, nausea and vomiting. Although easily treated with antibiotics, UTIs are known to be a recurring problem for some women.

Physician Assistants are important urology team members who help doctors and patients as they work together to achieve the best possible outcome in medical care. They have the satisfaction of knowing that the work they do can make a positive change in a patient’s life. Their work can even be life-saving when it results in the early detection of prostate cancer. The Advance Urology Institute relies on committed staff members like Chelsie Ferrell, PA to provide quality patient care.

What are the different treatment options for kidney stones according to Dr. Samuel Lawindy?

KEY TAKEAWAYS:

  • Shock wave lithotripsy is a non-invasive and relatively pain-free treatment option for kidney stones, where shock waves are used to break the stones into small sand-like particles that can be passed naturally through urine.
  • Ureteroscopy is a more invasive option for kidney stones, involving the use of general anesthesia and a long tool inserted into the urethra to find and remove the stones, with larger stones being broken up using a laser.
  • For the largest stones that sit inside the kidney, a minimally invasive procedure may be required, where the urologist enters the kidney through the patient’s back to break the stone up or remove it through the incision, with recovery involving an overnight stay at the hospital.

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

Dr. Samuel Lawindy of Daytona Beach, FL

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

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

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

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

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

TRANSCRIPTION:

So my name is Samuel Lawindy, I’m a board certified urologist at Advanced Urology Institute.

If you have an acute stone episode where you come in with a lot of pain, nausea, vomiting, fevers, the first step is to place a ureteral stent.
The stent will decompress the kidney, open it up, relieve the pressure, relieve any kind of infection that may be there, and take away the pain most importantly.

Once that’s in, then we have time to figure out what the next best option is in regards to treatment. So when talking about kidney stones, based on the size of the stone, the location of the stone, you can do anywhere from shockwave lithotripsy, where you break up the stone with sound waves, very minimally invasive, very well tolerated.

Next option is something called ureteroscopy, where we go in through the urethra from below all the way up to the location of the stone, and break it up with a laser.

And then we can pull those pieces out so it’s a little bit more definitive, in that we see the stone and remove it with an actual basket, however it’s a little more invasive so there’s a little bit more recovery time.

Lastly there is the larger stones that can sit inside the kidney that would be required to remove through the back, and that’s usually done in an overnight hospital stay, still relatively minimally invasive, but we go in through the back to the kidney, either break up the stone in small pieces and pull them out, or we can just grab the whole thing out and pull it out there.

For PCNL, recovery is usually an overnight stay at the hospital, there is a tube in the back that stays in place overnight, but then you go home with nothing, you go home with no tube in the back, no catheter from below, pain is relatively mild, but well controlled with pain medication.

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Risk Factors of Prostate Cancer

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

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

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

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

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

Becoming a Urologist – Dr. Howard Epstein MD

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

Medical School

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

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

Urology Studies

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

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

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

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

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

Dr. Howard Epstein

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

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