Symptoms of Kidney Stones -Beyond the Basics


Kidney stones occur when hard deposits (minerals and salts) form inside the kidney. They vary in size and may travel to other parts of the urinary tract. While small stones may not produce any symptoms, some people complain of severe pain in different parts of the body. The excruciating pain can be likened to that of childbirth. Here is a quick guide on common symptoms of kidney stones.

1. Urge to urinate or frequent urination

Most people with kidney stones feel the urge to urinate. However, this will depend on where the stone is located. Those that are close to the bladder can irritate the walls and make the patient feel an urgent need to use the bathroom. These contractions may even occur when the bladder is empty. Keep in mind that unless the stone has moved to the urethra, there is no trouble when urinating.

2. Pain in the groin, back or side

Patients who experience pain around the groin or the lower abdomen may need a diagnosis for kidney stones. The pain also can occur under the rib cage or on the back side. It starts as a dull ache that escalates to sharp wincing pain. And it’s very episodic – it can be severe one minute and then completely subsides. The pain may be mild or barely noticeable. The patient may need to seek medical attention if the pain is very intense.

3. Nausea and vomiting

These two symptoms occur when the stones interrupt the flow of urine. It’s worth mentioning that stretching of the kidneys can cause gastrointestinal upset. And the worst part is that this pain does not subside even after making changes in body position. When patients vomit, they get dehydrated so additional fluids are recommended.

4. Blood in the urine

In advanced stages, a kidney stone can cause blood in the urine. The blood is only visible with dipstick testing or when examined with a microscope. People who spot pink or reddish urine should see a urologist immediately. Sometimes the urine may look like tea. This could be an underlying symptom to a more serious condition.

5. Fever

While this is not a common symptom for kidney stones, it occurs when patients have an infection in the problem area. According to experts, fever can occur when the stones block the flow of urine, which could be an emergency situation. And because the antibiotics can’t penetrate to an obstructed kidney, the obstruction must be relieved. Fortunately some stones may pass on their own without treatment.

Need the services of a urologist? Visit Advanced Urology Institute for professional treatment. Here you’ll find Dr. David Burday and other practicing urologists. They will do their best to put you at ease. For more information on treatment of kidney stones and other urological problems, visit our “Advanced Urology Institute” site.

Robotic Assisted Laparoscopic Radical Prostatectomy


Robotic-Assisted Laparoscopic Prostatectomy is a viable option for treating prostate cancer. It is a minimally invasive method for accessing both seminal vesicles and prostate glands during treatment of prostate cancer. Robotic prostatectomy is performed by an experienced surgical team with the help of advanced surgical robotic technology.

What is Robotic-Assisted Radical Prostatectomy?

Robotic prostatectomy involves the use of a laparoscopic system and Robotic Surgery System called da Vinci® Surgical System. This is a sophisticated robotic system designed to enable the surgeons to operate with enhanced vision, precision and control.

With the help of the surgical system, it is possible to pass miniaturized robotic instruments through keyhole incisions and remove the prostate and other nearby tissues with greater accuracy. During a robotic-assisted radical prostatectomy, it is able to create an incision that extends from the belly button to the pubic bone.

In the Robotic-Assisted Laparoscopic Radical-Prostatectomy, an image processing machine and a three-dimensional endoscope are used to achieve a clear and magnified view of structures around the prostate gland. This makes it possible to extract affected parts with optimal preservation of critical body parts such as blood vessels, nerves and muscles.

During the procedure, the surgeon operates the surgical system using a computer console that enables him to control tiny flexible instruments. This makes it possible to achieve higher precision and mobility. The whole process is done without the surgeon’s hand entering the area of the surgery in the patient’s body.

Advantages of Robotic-Assisted Laparoscopic-Radical Prostatectomy:

Robotic prostatectomy has some benefits compared to the traditional open surgical methods. Here are some of the advantages:

  1. Less pain
  2. Less loss of blood during the operation
  3. Shorter stay in the hospital.

Possible risks of Robotic-Assisted Prostatectomy:

The following are possible risks associated with the Robotic Assisted Laparoscopic-Radical Prostatectomy, although they are very unlikely:

  1. Damage to adjacent tissue or organ
  2. Infection of surgical site
  3. Bleeding

Laparoscopic Radical Prostatectomy:

As with all surgical methods, the robotic-assisted radical prostatectomy has a number of potential side effects, which include:

  1. Urinary incontinence or inability to control urine. However, this problem will reduce over time.
  2. Erectile dysfunction or impotence: Depending on the age of the patient, erectile function is likely to be affected.

Advanced Urology Institute is a patient-centered institute that works to minimize the possible side effects of a procedure. They research and partner with the best board-certified urologists, among them Dr. David Burday, to make sure that patients have a good experience during the operation and heal well afterward. For further information, visit the “Advanced Urology Institute” website.

Treatment Options for Urge Incontinence

Urge incontinence is not an inescapable consequence of aging. In fact, a huge majority of women with the condition have been effectively treated or helped. The trick is simply not staying at home and giving up, but visiting a urologist as soon as possible for help.

Factors that affect the treatment decision

Effective treatment of urge incontinence in women depends on the kind of incontinence, personal preferences, underlying causes and severity of the symptoms. Where the condition has more than one underlying cause, the most serious cause will be dealt with first. Likewise, your urologist most likely will opt for the least invasive treatments first before moving on to invasive ones.

Treatments for urge incontinence include:

1. Behavioral techniques

These treatments include making certain lifestyle changes to improve bladder control. They include:

  • (a) Bladder training: Entails delaying urination once the urge to pass urine comes. You can begin by holding off urine for as short as 10 minutes and then extending the holding time to hours. The goal of holding off urine each time the urge comes is to lengthen the duration between your trips to the toilet by up to 2.5 hours to 3.5 hours.
  • (b) Double voiding: Means that you urinate and then wait for only a short duration (a few minutes) then try again to pass urine. The goal of double voiding is to achieve complete emptying of the bladder to avoid overflow incontinence.
  • (c ) Scheduled toilet visits: Planning your toilet trips so that you urinate every 2-4 hours instead of waiting for the urge to come, will help you improve bladder control.
  • (d) Diet and fluid management: To improve your bladder control, you may have to cut back or avoid acidic foods, alcohol and caffeinated drinks. By increasing physical activity, reducing liquid consumption or losing weight you can ease urge
    incontinence.

2. Pelvic floor exercises

Also called Kegel exercises, pelvic floor exercises can strengthen the muscles responsible for bladder control and urination. To help you learn and perform these exercises, your doctor may recommend that you work with a physical therapist or to try using biofeedback techniques.

3. Electrical stimulation

The urologist may choose to insert electrodes into the vagina to strengthen and stimulate your pelvic floor muscles. With gentle stimulation, urge incontinence may resolve. However, you may need several treatments over many months to be successfully treated.

4. Medications

There are several common medications that are effective in treating urge incontinence. They include:

  • (a) Anticholinergics: Include solifenacin (Vesicare), trospium (Sanctura), tolterodine (Detrol), fesoterodine (Toviaz), oxybutynin (Ditropan XL) and darifenacin (Enablex).
  • (b) Alpha blockers: These drugs relax bladder muscles and make bladder emptying easier. They include alfuzosin (Uroxatral), doxazosin (Cardura), silodosin (Rapaflo) and tamsulosin (Flomax).
  • (c) Topical estrogen: Application of a low dose of a topical estrogen, such as a vaginal patch, cream or ring can rejuvenate and tone the tissues of the vagina and urethra, helping treat urge incontinence.
  • (d) Mirabegron (Myrbetriq): This drug relaxes the muscles of the bladder, increases the quantity of urine that the bladder can hold and increases the amount of urine that can be passed at any one time. As a result, it helps to empty the bladder more completely and treats urge incontinence.

5. Medical devices and interventions

Devices such as urethral inserts and pessaries can help to treat or relieve urge incontinence. Interventional therapies such as using a sacral nerve stimulator,bulking material injections, botulinum toxin (Botox) injections and nerve stimulators also can be used to treat urge incontinence.

6. Surgery

The doctor or urologist also may use surgery to correct the underlying cause of urge incontinence. Common surgical procedures include bladder neck suspension, prolapse surgery, artificial urinary sphincter and the sling surgery procedure.

7. Catheters and absorbent pads

If the urologist finds that no medical treatment can completely eliminate the incontinence, various products can be recommended to help ease the problem, minimize discomfort and reduce the inconvenience caused by urine leakage. The most commonly used products are catheters, absorbent pads and absorbent garments.

Urge incontinence is a treatable condition. As a woman, you should not continue living with this problem since there are solutions to help you. At Advanced Urology Institute,we have helped thousands of women with urge incontinence recover from it. Come see us so we can fix the problem. For more information,
visit the “Advanced Urology Institute” site.

Common Treatment Options for Stress Incontinence

The treatment that a urologist may recommend for stress incontinence depends on how troubling the condition is to the woman and on the woman’s general fitness level. Often, the urologist will opt for fairly simple treatment options for a less troubling condition and only recommend surgical treatments when absolutely necessary. For instance, if an overactive bladder is present, the urologist will determine the possible contributing factors and recommend deterrent treatments such as fluid modification and caffeine reduction. Likewise, for women whose body mass index (BMI) is equal to or over 30kg/m2, the urologist will recommend weight loss.

Generally, the most common treatments for stress incontinence are:
  1. Weight loss: For women who are overweight or obese, losing weight helps to reduce urine leakage.
  2. Fluid management: For women who drink large amounts of fluids daily, cutting back on fluids reduces urine leakage. This includes reducing the amount of caffeinated, alcoholic and carbonated drinks. In fact, avoiding fluids 3-4 hours before going to bed helps a lot to prevent frequent nighttime urination.
  3. Avoiding constipation: Since constipation worsens urine leakage, increasing the quantity of dietary fiber to 30 grams or more per day will prevent constipation and reduce incontinence.
  4. Pelvic floor muscle exercises: Exercises for tightening pelvic floor muscles will help control stress incontinence.
  5. Bladder training: Bladder retraining helps affected women to regain bladder control and hold more urine for longer. Bladder training involves going to the bathroom on a specific schedule while awake and applying various strategies to control any sudden urges./li>
When the above options fail, the urologist may recommend:
  1. Bladder control medicines: For example, the drug duloxetine is used to treat stress incontinence in women who are unwilling or whose incontinence is unsuitable for surgical treatment. Collagen injections around the neck of the bladder may also be used when surgery is not ideal.
  2. Topical vaginal estrogen may be recommended for peri-menopausal or post-menopausal women with vaginal atrophy and stress incontinence.
  3. Pessary: A pessary, a stiff ring inserted into the vagina to push up against the wall of the urethra and the vagina, may be applied to reposition the urethra and reduce stress leakage.
  4. Catheterization: This treatment is used in women who are incontinent because the bladder never empties fully (overflow incontinence) or when the bladder cannot empty completely because of a spinal cord injury, past surgery or poor muscle tone.
  5. Biofeedback: The therapist puts an electrical patch over the bladder and urethral muscles, uses a wire to connect the patch to a TV screen where the contraction of these muscles is monitored, then with this information uses electrical stimulation and pelvic floor exercises to control stress incontinence.

As a last resort and depending on the severity of the stress incontinence, the urologist may opt for surgery. Surgery for stress incontinence is the most effective treatment for women who have not been helped by other treatments. Common surgical procedures are anterior vaginal wall repair surgery, colposuspension, surgical tape procedure and laparoscopic (keyhole) surgery. If you have urinary incontinence, speak with your doctor about whether surgery will help you and what type of surgery is perfect for you.

At Advanced Urology Institute, we have a solid track record of helping men and women plagued with urinary incontinence put their lives back on track. We have state-of-the-art facilities and skilled, board-certified urologists to assess, diagnose and treat any type of incontinence. For further help with urological disorders, visit the site, Advanced Urology Institute.

2 Kinds of Incontinence

Urinary incontinence (UI) is the involuntary loss or leakage of urine because of faulty bladder control. Due to pregnancy, structure of the female urinary tract and menopause, women experience urinary incontinence twice as often as men. And according to various studies, 25-45 percent of women in the United States experience some degree of urinary incontinence. In women between 20 and 39 years old, 7-37 percent report some degree of incontinence, while 9-39 percent of women older than 60 report daily incontinence.

Two types of incontinence

Urinary incontinence may result from functional abnormalities in the lower urinary tract or may be caused by other illnesses. There are two types of incontinence, stress incontinence and urge incontinence. Stress urinary incontinence is the involuntary urine leakage from effort, exertion, sneezing or coughing. Stress incontinence occurs because of weakened pelvic floor muscles. It is the most common type of urinary incontinence in young women and the second most common one in older women. This type of incontinence will lead to urine leaks when performing any activity that increases strain on the weakened pelvic floor muscles, such as walking, jumping, exercise, bending, stretching, sneezing, coughing, lifting, and even sex. The amount of leaked urine varies from a few drops up to a tablespoon or more, depending on the severity of the condition.

Urge urinary incontinence is the involuntary urine leakage that is accompanied or immediately preceded by urgency (an abrupt or sudden compelling desire to pass urine that is very difficult to defer). Urge incontinence occurs because of overactivity of the detrusor muscle, with its hallmark being a sudden, overwhelming urge to pass urine, accompanied by leakage or loss of urine. Nighttime urination and frequent urination often occur with urge incontinence. For some women with urge incontinence, even changing a sitting position or hearing running water can trigger bladder contractions and result in urine loss. While urge incontinence may occur in anyone of any age, it is common among older women. Actually, just 9 percent of women ages 40-44 suffer from urge incontinence while at least 31 percent of women 75 and older have the condition.

Seek immediate help

Involuntary leakage of urine is more than a health concern. It affects women on a psychological, social and emotional level. Women with urinary incontinence may avoid certain situations or places for fear of having a leakage accident. In fact, for a significant number of women, the incontinence may be so serious that it calls for changing clothes and avoiding certain tasks and exercises. Some women also may experience mixed incontinence, a condition where urge incontinence and stress incontinence occur at the same time. Therefore, it is important for women experiencing urine leakage of any kind to seek help from a urologist to determine whether they are suffering from urge incontinence, stress incontinence, mixed incontinence or another issue.

At Advanced Urology Institute, we understand that there are a significant number of women living with a lot worse problems than they should. We provide top-notch facilities and experienced board-certified urologists to help such women. For more information, visit the site, Advanced Urology Institute.

Becoming a Urologist – Dr. David E. Burday

Individuals who have a strong interest in caring for patients suffering from urological problems and conditions can find a good career as a urologist.

“A urologist is a physician specialized in diagnosing, treating and monitoring disorders of the urinary tract and reproductive organs, such as the ureters, kidneys, bladder, urethra and prostate,” says Dr. David E. Burday, MD, a board-certified urologist at Advanced Urology Institute.

“Urologists treat men and women for injuries and disorders of the urinary tract, pelvic floor muscle problems in women and male reproductive system disorders, but do not focus on female reproductive issues as those are handled by gynecologists,” he adds.

Urologist Education

“The path to becoming a urologist is quite long,” says Dr. Burday. “You must have a four-year college degree and pass medical college admission tests before you are admitted into medical school. Then there are four years of training in subjects such as embryology, genetics, neuroscience, biochemistry and medical ethics followed by clinical rotations before you graduate from medical school.”

The next step is attending a urology residency, says Dr. Burday. “As a urology resident, you spend a minimum of five years in training, which may be divided into a two-year general surgery residency and a three-year urology residency.”

He adds, “You may spend another one or two years in a post-residency fellowship if you want to pursue a urology subspecialty like pediatric urology or urological oncology. But you must pass an exam after completing the requisite education and training requirements before you can become a board-certified urologist.”

Conditions Treated by Urologists

Urologists diagnose, treat and monitor a broad variety of medical problems, including recurrent urinary tract infections, interstitial cystitis, enlarged prostate, kidney stones, urinary incontinence, overactive bladder, prostatitis, erectile dysfunction, male and female infertility, and cancers of the urinary tract, such as prostate, testicular, kidney, penile and bladder cancers. They also handle pediatric problems such as undescended testicles and enuresis (bedwetting).

“As a urologist, you diagnose and treat many medical conditions,” says Dr. Burday. “We resolve urinary incontinence, weak pelvic floor muscles, recurrent bladder infections and prostate cancer. We also treat kidney stones, erectile dysfunction and male infertility. Some urologists may even narrow their focus into areas such as female urology, oncology urology and pediatric urology.”

In addition to medical history and physical examination, urologists may request tests such as ultrasound before they recommend any treatments. The urologist also may work with specialists such as radiation therapists, radiologists or oncologists to ensure patients get the best treatment.
“The diagnosis and treatment process depends on the condition the urologist is dealing with,” says Dr. Burday. “Typically, the urologist will do a medical history and physical exam then request a few tests before deciding on a suitable treatment. Often, the treatment will be medication, surgery, or both, but that depends on the condition.”

Necessary Skills

Urology is a challenging field that requires determination, patience, eye-hand coordination, critical thinking and good problem-solving skills. Urologists also need excellent communication skills and the ability to make their patients feel at ease and comfortable. They also must be able to work under stress and make effective decisions in emergency situations.

“If you have the right qualities and the desire to improve people’s lives by treating urological problems, then urology is a wonderful profession for you,” says Dr. Burday. “Remember there are many job opportunities for urologists and the pay is above average.”

For more information on urology, visit the site Advanced Urology Institute.