What to know about Erectile Dysfunction

Erectile dysfunction, also commonly referred to as ED, is the inability for a man to maintain an erection for sexual activity. Although it can be an embarrassing subject to talk about, it is very common. Fifty percent of men over the age of 50 experience some degree of ED. It is important to know that there are plenty of treatment options available. As Luis Camacho, PA explains, “We have several patients with erectile dysfunction, and we can be very helpful with treatment and procedures.”

Luis Camacho, PA of Fort Myers, FLA man experiencing the symptoms of erectile dysfunction can make an appointment to discuss the issue with his urologist. A conversation about the patient’s medical history and symptoms can usually lead to an in-office diagnosis. Once diagnosed, and it is determined that the patient is healthy enough for sexual activity, the urologist and patient can discuss treatment options. Many patients find themselves surprised by the number of treatment options available to them.

The most common and familiar treatment for ED is medication. Pills are easy to take and highly effective in many cases. For this reason, most urologists start treating ED by prescribing one of the many pill options available. Another simple option is the vacuum erection device. For this treatment, a man inserts his penis into the cylindrical pump that works like a vacuum to draw blood to the penis resulting in an erection. A band then goes around the base of penis in order to maintain the erection. Yet another option is injection therapy. A patient using this therapy will give himself a small, nearly painless injection into the base of the penis. The injection stimulates an erection for a certain amount of time.

Some cases call for more invasive treatments. With a penile prothesis, an implant is surgically inserted into the penis. A pump in the scrotum that is attached to the prosthesis is used to create the erection.

When facing erectile dysfunction, it is important to know that you are not the only person dealing with this issue, and there are plenty of treatment options available that help men lead normal and satisfying sexual lives. All it takes is a conversation with a urologist at the Advanced Urology Institute to find the best ED treatment for you.

How common is erectile dysfuntion?

Erectile dysfunction, also known as ED, is the inability of a man to get or maintain an erection firm enough for intercourse. ED is a very common issue that can negatively affect a man’s self-confidence and his relationship with his partner. Many men see urologists for help with ED when this happens.

Dr. David Harris of Fort Myers, FLThe primary symptom of ED is trouble getting and maintaining an erection, and reduced sexual desire is often associated with it. There are many factors that can cause ED, and they can be divided into two categories: mental and physical. Depression, anxiety and stress are mental factors that can cause ED. There are also physical factors, including heart disease, diabetes, high blood pressure and substance abuse. There are plenty of cases when it is a combination of mental and physical factors that cause ED.

All men are at risk for erectile dysfunction; however, there are some factors that increase the likelihood of developing it. Heart disease and diabetes are key risk factors that increase the likelihood of ED. Tobacco use causes damage to arteries, restricting blood flow and raising the chances of ED. Drug and alcohol use are risk factors as well. Men who are overweight, and especially those who are obese, are also at greater risk of developing erectile dysfunction.

A urologist can diagnose ED by performing a physical exam and asking a few questions. Once diagnosed, urologists can consider a variety of options for treatment, depending on the patient. The first option is usually oral medication. Urologists will try different medications to help patients maintain erections. If none are effective, then the urologist may prescribe injections. Small injections can be made to the shaft of the penis that dilate the blood vessels in the penis, allowing better blood flow and erections. The patient can administer these injections himself as needed.

Erectile dysfunction is not uncommon and as Dr. David Harris says about treating it, “As urologists, we are the leading authority.” Urologists see cases of ED on a daily basis and are accustomed to having conversations about it and finding the best way to solve the issue with their patients. In most cases a patient who is motivated to work with his urologist on finding the best treatment will eventually find a solution that works. The Advanced Urology Institute helps many patients explore their options and treat their ED so they can continue their normal lives and activities. For more information, visit the Advanced Urology Institute website.

Kidney Stones: Who is at Risk

Kidney stones are a common medical issue that arises when hard deposits of minerals form in the kidney and can affect the urinary tract. These stones can cause severe pain in the abdomen and groin, nausea, and pain during urination. Kidney stones have no single or set cause. Anyone is at risk of developing kidney stones at some point in life.

Dr. David Harris of Fort Myers, FLAlthough anyone can develop stones, there are certain factors that can indicate who gets them and how they occur. As urologist Dr. David S. Harris states, “There are certain features of a person’s stone history that are predictors to us if they’re going to have more stones.” A patient suffering from kidney stones will want to consult a urologist to see what can be done to limit the chances of developing kidney stones in the future.

A urologist may want to do a urine or blood analysis to see if there are any reasons for a patient to develop kidney stones. A urologist also may want to address some common risk factors for kidney stones. For instance, dehydration is a very common cause of kidney stones. For this reason, people who live in warm climates and are at greater risk of dehydration are also at greater risk of developing kidney stones. A urologist may recommend that someone living in a warm climate like Florida drink plenty of fluids every day.

People with diets high in salt, protein and sugar are also at increased risk of developing kidney stones. Too much salt especially increases the amount of calcium a person’s kidneys must filter, increasing the chances of stone development. Obesity also increases the risk of developing kidney stones, so weight management is something a urologist will strongly recommend if that is a factor.

Beside dehydration and dietary choices, genetics can play an important role in an individual’s risk of developing kidney stones. If someone in your family has kidney stones, then you are more likely to develop them as well. And once you develop kidney stones you are at a greater chance of developing stones in the future. For this reason, in addition to adjustments in water intake and diet, urologists sometimes will recommend medications.

Just because someone has had kidney stones before doesn’t mean they will have to suffer with them the rest of their lives. At the Advanced Urology Institute, doctors work with their patients to find and correct root causes for kidney stones. For more information, visit the Advanced Urology Institute website.

Bladder Cancer Diagnosis and Treatment – Dr. David Harris

If you or a loved one have been diagnosed with bladder cancer, you probably have a lot of questions. The physicians at Advanced Urology Institute are experts in treating this type of cancer and will be there to guide you from diagnosis to recovery.

How Is Bladder Cancer Diagnosed?

One of the most common signs of bladder cancer is blood in the urine. You may notice this at home on your own, or a doctor might notice trace amounts during routine urine testing. The doctor will be able to determine if further testing is necessary, the next round of which includes more urinalysis tests, x-rays and a bladder exam.

Urologist Dr. David Harris of Fort Myers, FLDr. David Harris with AUI Fort Myers explains, “If we find a tumor, that tumor would be removed from inside the bladder and biopsied.” Dr. Harris reassures patients that most tumors found in the bladder are non-invasive and highly treatable.

How Is Bladder Cancer Treated?

Surgical intervention is used in most treatment plans for bladder cancer, either alone or along with another form of treatment. For patients whose tumors have grown into the muscle of their bladder, radical cystectomy (removal of the bladder) may be necessary. This procedure may also be recommended for patients who have a fast-growing tumor in the early stages of bladder cancer to prevent a future recurrence. Radiation and chemotherapy are often part of the treatment, especially for patients who are in the later stages of bladder cancer.

What Is The Prognosis For Patients With Bladder Cancer?

Compared to other cancers, the prognosis for patients with bladder cancer is good. The general 5-year survival rate for bladder cancer patients is 77 percent; the 15-year survival rate is 65 percent. Patients may need ongoing regular treatment to keep the cancer in check. It is important to keep all follow-up appointments to monitor recovery and make sure the cancer has not returned. Patients who have undergone a cystectomy will be fitted with a device to help them urinate; the exact solution varies depending on the type of surgery performed, but patients are commonly fitted with a urostomy bag. Although this does introduce new challenges, patients are able to resume most normal daily routines and enjoy a high quality of life.

Whatever your diagnosis, remember that you are not alone in your journey to recovery. Dr. Harris reassures patients that at AUI, “we’re trying to preserve bladders, trying to minimize problems with quality of life.” For more information on how our team of urology experts can help, visit the Advanced Urology Institute website.

How are Urinary Problems Treated?

Because urinary problems can be a sensitive and potentially embarrassing subject, many people are nervous about discussing these issues with their medical provider, even though they are very common conditions. Experts estimate that around a third of the U.S. population suffers from urinary incontinence. Luckily, these issues are treatable, according to Luis Camacho, PA, a physician assistant with the Advanced Urology Institute.

“If the patient has prostate problems, bladder problems, for the most part, the patient can be treated with oral medications,” Camacho explains. “If that is not effective, then we can incorporate different procedures or surgeries in order to improve the patient’s symptoms.”

Urinary Incontinence

Urinary incontinence is the most common problem. There are five different types of incontinence, but one of the most common types is stress urinary incontinence, or SUI. SUI occurs when a patient’s pelvic muscles are weakened, allowing urine to escape during normal everyday movements, such as sneezing, coughing or bending over. This condition is particularly common with older women, especially those who have had children. SUI can be managed with lifestyle changes or pelvic floor strengthening exercises like kegels.

Another common type of incontinence is overactive bladder, or OAB. Patients dealing with OAB feel an urge to go to the bathroom frequently throughout the day and night, even though their bladder isn’t full. This urge can be difficult to ignore and can lead to a lot of stress for patients in their daily lives. OAB and SUI can occur together in a condition known as mixed incontinence.

Other Urinary Problems

Other common urinary problems that should be discussed with a doctor include urinary tract infections, also known as UTIs; hematuria, or blood in the urine; and urinary retention or frequent urination. These problems are often signs of a larger issue that should not be ignored, such as diabetes, kidney stones, or prostate or bladder cancer. It’s important to bring up any issues like these with a doctor to ensure that the underlying issues can be treated promptly.

Getting Help

Although urinary problems are common, that does not mean they should be ignored, especially when they could potentially be signs of a more serious problem. Medical professionals know how wide-ranging both the symptoms and causes of urinary problems can be. “It’s important to listen to the patient and then establish a course of assessments, so we can help the patient effectively,” Camacho says. He and the other experts at the Advanced Urology Institute understand the sensitive nature of urinary problems and are well-prepared to help patients deal with these issues and get back to living their lives with confidence. For more information, visit the Advanced Urology Institute website.

Prostate Cancer Treatment: How to Choose What’s Best for You

Prostate cancer is one of the most common types of cancer that affects men. The prostate is a small gland, similar in shape to a walnut, that produces the seminal fluid that helps transport sperm. Although anyone can get prostate cancer, it becomes more common as men age.

It can be difficult to detect prostate cancer as it has little to no symptoms in its early stages. For this reason, it is important for men to have their prostate routinely checked by their doctor. Only after the cancer advances do symptoms occur like trouble urinating, blood in semen, bone pain, erectile dysfunction and discomfort in the pelvic area.

Advanced Urology Institute Doctor: Dr. David HarrisSome prostate cancers grow slowly and, in some cases, need little to no treatment. Other cancers can be aggressive and spread quickly. It is important to see your urologist often to monitor your cancer, as the best treatment for you will depend on the type of prostate cancer you have and how it reacts to treatment.

Treatments for prostate cancer vary depending on multiple factors. Urologists will look at a patient’s age, health and the type of prostate cancer when deciding on the best treatment. In a healthy young patient, a urologist may recommend robotic surgery or a radical prostatectomy. These are well-tested and invasive treatments that can produce very good outcomes.

For patients who may be a little older and not in the best of health, radiation therapy may be their best option. Having access to quality radiation therapy can be a game changer in prostate cancer treatment and can create excellent outcomes. It also will be easier on a patient with other health issues.

There are also newer advances that can be used to treat prostate cancer. For example, cryotherapy uses extremely cold temperatures to destroy cancerous tissues in the prostate by freezing them. Another example is HIFU therapy. This stands for stands for High Intensity Focused Ultrasound and uses an intense ultrasound, focused on the prostate, to treat the cancer and is minimally invasive.

Prostate cancer is a serious and often frightening prospect. Many men will suffer from this cancer, but they are not alone. Along with their urologist, men can combat their cancer in a way that produces the best outcomes. Dedicated urologists, like David S. Harris, MD at Advanced Urology Institute, have an arsenal of treatment options and are ready to help men live healthy lives. For more information, visit the Advanced Urology Institute website.

Becoming a Physician Assistant – Luis Camacho P.A.

Luis Camacho, P.A. is a physician assistant in urology with more than 14 years of experience. Physician assistants in Florida are highly trained professionals who can perform many of the same medical diagnoses and treatments as medical doctors. They first have to enter an accredited graduate medical program that is recognized by the Commission on Accreditation of Allied Health Programs.

Luis Camacho, PA of Fort Myers, FLEntrance into these programs is highly competitive. Students must first take all prerequisites for any of the required graduate classes before admission. Students are also admitted based on their ability to work with people, their understanding of the PA occupation, their prior health care experience and prior academic performance, and their life experiences. They also must pass the Graduate Record Exam.

Physician assistant graduate medical programs run about 27 months with more than a thousand hours of classroom and laboratory experience. They must complete two thousand hours of supervised clinical experience, which can take up to a year. The program culminates by passing the Physician Assistant National Certifying Exam, a grueling 300-question exam that takes five hours to complete. Overall, that means a physician assistant has had at least three years of training before passing the certifying exam.

PAs must renew their license annually to continue practicing medicine. During every two-year period, they must obtain at least 100 hours of continuing medical education, which assures patients their PAs understand the most current medical thinking and practices.

Physician assistants must also work under the direct supervision of a board certified medical doctor. While PAs are fully capable of handling most common medical issues, this supervision assures the patients that their PAs are part of a medical team, always working together to provide the best in medical treatment.

Luis Camacho, P.A. works within a large practice at Advanced Urology Institute in Fort Myers, Florida, where he and all his colleagues work as a team under the supervision of a board certified urologist. He is a knowledgeable and experienced physician assistant who is dedicated to caring for patients. For more information, visit the Advanced Urology Institute website.

Why Women Should See a Urologist

Urologists are doctors who specialize in the treatment of diseases and complications of the urinary system. They also treat conditions of the male reproductive system, a function which, in women, is performed by a gynecologist. Urologists treat more male conditions than female ones, and men therefore are advised to visit urologists more often than women. The result is that women suffer from conditions of the urinary system in silence or they try to self treat. In almost all cases, this approach makes the condition worse.

Reasons Why Women Avoid Urologists

The main reason women avoid urologists is that female urological conditions carry social stigma. A lot of women are afraid that if they reveal they have a serious urinary tract infection, it will say something about their personal hygiene. Conditions such as incontinence and pelvic organ prolapse are looked upon as shameful. This kind of social stigma prevents many women from going to urologists.

Lauren Masters, ARNPMost women also confuse a problem of the urinary system with a condition of the reproductive system. They visit gynecologists for most of their medical problems, even when they are of the urological system.

Women should be taught from a very early age to feel confident about seeking treatment for any part of their bodies. They also should be made aware that problems of the urinary system are extremely common and that treatment options are readily available from most urologists’ offices.

Common Problems of the Female Urinary System

There are several conditions that women suffer from and which should always be referred to a urologist. These include:

1. Urinary Tract Infections. These are more common in women than men. They have a tendency to recur and may be simple infections or serious ones related to another health problem. Urologists are well trained to treat these.

2. Urinary Incontinence. This is also referred to as urine leakage. It can get very complicated if left untreated.

3. Kidney stones. These are very painful and should be treated at the earliest stages.

4. Pelvic Organ Prolapse. This occurs when the bladder, the upper roof of the vagina or even the rectum droops into the vagina. It affects a lot of women but it is not widely discussed. It makes all aspects of a woman’s existence very uncomfortable. Urologists are uniquely qualified to treat it.

Women should understand that a urologist is as important to their health as a gynecologist. They also should know that urologists understand the need to make female patients comfortable. And women should know that female urological problems are treatable and that most urologists, such as the Advanced Urology Institute, have invested heavily in the treatment of these problems. Their team of specialists can answer your questions, help with diagnosis and treatment of problems with the urinary system. For more information, visit the Advanced Urology Institute website.

Treatment Options for Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is the clinical term for an enlarged prostate. An enlarged prostate presses on the urethra which passes through its middle. This causes difficulties with the passing of urine, such as urine retention, weak urine stream or a frequent and sudden urge to urinate. If left untreated, it may lead to urinary tract infections and bladder complications. Benign Prostatic Hyperplasia is not cancerous and it is normal for men over age 40 to start manifesting symptoms. The condition is highly treatable.

Treatment Options for Benign Prostatic Hyperplasia

The treatment is determined by the age and general health of the patient, the size of the patient’s prostate and the severity of the symptoms. After making an evaluation based on those factors, a urologist will recommend either of the following options:

1. Oral Medication
Mild cases of benign prostate hyperplasia respond extremely well to medication. The available medication falls into two categories. There are alpha blockers that relax bladder and prostate muscles, making urination easier. The other choice may be the 5-alpha reductase inhibitors to prevent hormonal changes that cause prostate enlargement. These work to gradually reduce the size of the prostate. In some cases, a doctor may prescribe both alpha blockers and 5-alpha reductase inhibitors.

2. Minimally invasive Procedures
The variety of treatment options that fall under minimally invasive procedures include:

  1. Laser therapy. This is where a high powered laser beam is used to destroy the excess prostatic tissue.
  2. Transurethral incision. With the help of a lighted scope inserted through the urethra, the surgeon makes two incisions on the prostate to ease the passage of urine.
  3. Transurethral resection. This one is administered in the same way as a transurethral incision, except the surgeon removes the inner tissue of the prostate and leaves just the outer parts.
  4. Prostatic Urethral Lift. This is a relatively new procedure. It involves placing small implants that lift and hold the excess prostatic tissue so it no longer presses on the urethra. This procedure is widely recommended because it eliminates the irritation or discomfort that may be caused by the other procedures that involve laser therapy or cutting tissue away.
  5. Open prostatic surgery. This option is used only where the prostate is very large or the symptoms are extremely severe. It is not commonly done.

When symptoms of benign prostate hyperplasia begin to manifest, a patient should consult a urologist immediately so the condition can be managed well from the outset. There are many platforms for obtaining more information and help, such as the Advanced Urology Institute. At Advanced Urology Institute, a team of experts can help with diagnosis and treatment of benign prostate hyperplasia and answer any questions you may have. For more information, visit the Advanced Urology Institute website.

Recent Advances in Prostate Cancer Treatment

Prostate cancer is cancer of the gland that produces seminal fluid for the nourishment of sperm. Some cases are slow developing and do not affect the patient significantly. These can be managed by watchful waiting and constant monitoring. Others are aggressive and must be addressed immediately. As with most cancers, early diagnosis increases the chances of successful treatment.

Developments in the treatment of prostate cancer

1. Multiparametric MRI (MpMRI) in diagnosis

Determining which cancer is life threatening and which one is not is a critical issue. In order to carry out a more efficient diagnosis, doctors now are using an MRI guided biopsy instead of the more traditional transrectal ultrasound guided biopsy. The MpMRI provides better results determining if the prostate is infected and if the cancer has spread outside the prostate. It can help a doctor decide whether or not a patient should undergo a biopsy. And the MpMRI can be used to monitor the cancer growth, making it a very useful tool when watchful waiting is adopted.

2. Use of immunotherapy in treatment

Until recently, it was thought that immunotherapy was ineffective against prostate cancer. Prostate cancer treatment was primarily limited to surgery, hormone therapy and radiotherapy. In recent years, however, researchers have found that immunotherapy, specifically a drug called pembrolizumab, may be effective in treating aggressive cases of prostate cancer that have advanced beyond the other forms of treatment.

3. Robotic surgery

Like most other areas of surgery, the treatment of prostate cancer has benefited from the use of robotic or the da vinci surgical system that is guided by a surgeon operating from a console. Patients who undergo prostatectomy to remove the prostate may avoid open surgery by opting for robotic surgery. Benefits of robotic surgery include reduced bleeding, reduced pain, low risk of post surgery infections and fast recovery rates.

Medical advancements have improved cancer treatment outcomes and changed lives for the better. At Advanced Urology Institute, the team of specialists uses the latest techniques and technology for treating prostate cancer. They are available to offer consultation, diagnosis and treatment best suited for the individual patient.

For more information, visit the Advanced Urology Institute website.