Vaginal Dryness: Causes, Symptoms, and Treatment

Has sex been giving you more discomfort than pleasure lately? Do you experience pain, irritation, burning or dryness? Is there bleeding or spotting during or after sex?

If there is, then you might be experiencing vaginal dryness.

For this condition, you may need to speak with a female pelvic medicine and reconstructive surgery (FPMRS) physician for help. At Advanced Urology Institute, we have FPMRS physicians at our Fort Myers center to ensure you get prompt attention from a location near you.

But first, what is vaginal dryness?

Vaginal dryness refers to a persistent irritating, burning, or itching sensation in the vagina. It is due to inadequate vaginal moisture that makes it feel too dry or too tight. The condition is more noticeable during sexual intercourse as it results in pain and discomfort.

Learn more about vaginal dryness, it’s causes, symptoms and treatment.

Diagnosis and Treatment of Urologic Cancer

Urologic cancers are on the rise and here at Advanced Urology Institute we are seeing more and more cases every year. A urologic cancer is one that occurs in any organ of either the urinary system or the male reproductive system. It is a term that encompasses cancers such as adrenal, bladder, kidney, penile, prostate, testicular and ureter cancer. While a diagnosis with urologic cancer can be devastating and traumatic, the good news here at AUI is that with prompt screening and diagnosis, we can catch the cancers early and partner with our patients throughout their treatment and recovery to follow-up care. We always want our patients to understand that we are in it together and we want to work with them and their families to ensure quick recovery and high quality of life throughout their battle with the disease.

Diagnosis of urologic cancers

Diagnosis of urologic cancers usually starts with symptoms, although some patients don’t show symptoms and their tumors are detected during routine imaging. At AUI, our approach to cancer diagnosis includes patients’ symptoms, personal medical history, family medical history, physical examination, screening and diagnostic testing. The symptoms of urologic cancers tend to vary with the type and location of the tumor, but may include abdominal pain, blood in urine, elevated hormone levels, swollen abdomen and enlarged prostate. In terms of diagnostic tests, we often use biopsy, blood tests for hormone levels, digital rectal exam, liver function tests, pelvic exam, renal arteriography, bone scan, ultrasound, urine test, CT scan and MRI scan.

Care after cancer diagnosis

Dr. Chad Hubsher of Advanced Urology InstituteAt Advanced Urology Institute, we understand that diagnosis with urologic cancer is shattering and distressing. So we speak with our patients soon after diagnosis to bring their emotions under control and give them hope. For us the goal is not just to cure cancer but also to prepare and help our patients to face the challenges that may come with the disease. That’s why we work collaboratively with clinicians, researchers, dieticians, nurses, radiotherapists, radiologists and other medical professionals to ensure optimal outcomes are achieved with minimal impact on our patients’ quality of life.

Treatment of urologic cancers

We follow a multidisciplinary approach when treating urologic cancers. That means a wide-range of certified medical experts evaluate a patient’s condition and develop a comprehensive, personalized treatment plan depending on the type, stage and location of the cancer and the patient’s overall health. In a number of cases, surgery may be the primary treatment for urologic cancer and we provide minimally-invasive laparoscopy, robotic surgery, percutaneous cryosurgery and reconstructive procedures that deliver optimal outcomes with reduced scarring, less pain and shorter recovery time. Every patient’s candidacy for surgery is evaluated after diagnosis or during first appointment, but we are always confident of taking on some of the toughest cancer cases and striving to provide the best surgical outcomes and patient experience.

AUI also provides a number of advanced urologic cancer therapies. We offer current and investigational treatments and provide advanced radiation therapies including prostate brachytherapy (radiation seed implants). Treatment options for urologic cancer may include chemotherapy, hormone therapy, immunotherapy and radiation therapy. For instance, we deliver targeted regimens of radiation that are sculpted to the shape and size of the tumor ensuring that their impact is focused on cancer cells while limiting exposure of adjacent normal tissues. Likewise, urinary diversion techniques, fertility-preserving options and drugs with fewer side effects are prioritized. And with our extensive team of survivorship and supportive care experts, who help patients and their caregivers to attain and maintain a better quality of life before, during and after treatment, we often achieve great outcomes for our patients.

Recognized leader in care for urologic cancers

Advanced Urology Institute has a urology oncology team that is a nationally recognized leader in the management of urologic cancer. We have state-of-the-art equipment, leading urologists in their field and imaging and pathology experts who are good at what they do. What that means is that our patients get the best possible care at every stage of their journey with cancer. We manage urologic cancers in an outpatient setting, allowing our patients to go home the same day. And when they go home early from our day cancer center, we monitor them very closely. We are proud that, in most cases, our cancer patients do really well.

At AUI, our goal is not just to cure cancer but also to prevent it from spreading and from coming back. We are also committed to working with the local communities and spreading the word for people to get tested early. For more information on the prevention, diagnosis and treatment of urologic cancers, visit the “Advanced Urology Institute” site.

Kidney Stone Causes, Symptoms, and Treatments

There are a lot of kidney stone cases in Florida, thanks to dehydration from the extremely hot weather and diets that include a lot of tea, meat, salt and other highly rich foods associated with the stones. While about 10 percent of Americans may expect to have a kidney stone at some point in their lives, the likelihood rises to 15 percent for people living in the South. Stones are formed when minerals and other substances found in urine crystallize, usually in people who are dehydrated or don’t consume enough fluids.

Symptoms of kidney stones

At Advanced Urology Institute, we see a lot of patients with kidney stones. A contributing factor is our location in Florida, with its massive heat and humidity which leads to dehydration and, unfortunately, to the formation of these painful stones in the kidneys. The stones commonly present with severe, intense pain — like something is stabbing you — and you can barely walk. Kidney stones are characterized by sharp pains in the side or back as they make their way to the bladder. Most of our female patients usually say the stones are more painful than labor pain. Other symptoms of kidney stones include vomiting, nausea, a constant urge to pass urine and blood in urine.

Pain from kidney stones is often sudden in onset, though it may get severe over a period of hours in some cases. The pain may be either intermittent (colicky) or steady and, depending on the stone’s location as it moves through to the bladder, it may begin in the back or flank area and radiate slowly downward to your inguinal ligament, urethra, bladder, testicles or penis. Urinary or bladder symptoms, such as frequency of urination and painful urination, may occur if the stone is located in the portion of your urethra found within the bladder wall. Not all stones cause pain and some of them are often discovered “incidentally” during pelvic or abdominal X-rays. But in patients who experience pain, they usually describe it as the worst pain they have ever experienced.

Diagnosis of kidney stones

Diagnosis of kidney stones is almost entirely based on the history of passing the stones or on occurrence of a stabbing pain in the side or back. We usually place emphasis on the patient’s clinical signs, familial disorders, presence or absence of any previous renal stones, or physical exam findings. We also perform a urinalysis to check the presence of white cells (pyuria) or blood (hematuria) in urine, a culture of urine to exclude infection, and use the presence of crystals in urine (crystalluria) to help identify the stone type. Patients are often required to strain their urine to obtain the stone for crystallographic analysis. Analyzing kidney stones for their mineral composition helps us understand your future risk and to recommend the right dietary habits and restrictions for preventing stones. But we also do a CT or CAT scan of the pelvic and abdominal area to evaluate the size, location, degree of hydronephrosis and density of the stone, all of which are important in determing how we treat and manage the stones.


When patients complain of symptoms of kidney stones, we usually do physical exams and run tests to confirm that they actually have stones. But we often begin by getting the pain under control and calming the patients, to enable us to discuss with them available treatment options. The pain due to kidney stones is relieved using pain medication, drinking plenty of fluid to prevent dehydration, and ordering bed rest. In many cases once we have assessed that the stones can pass on their own, we allow about 7 days for them to pass spontaneously. In other instances, however, kidney stones may need to be broken down into tiny pieces or to be removed surgically.

At Advanced Urology Institute, we break up kidney stones using such techniques as percutaneous lithotripsy, cystoscopy or extracorporeal shock-wave lithotripsy. For renal stones less than 2cm in size, we generally treat them using extracorporeal shock-wave lithotripsy. During the procedure, high-intensity ultrasound (shock-waves) are passed through pouches of water placed on the skin and then directed toward the stone. The waves break the kidney stones into tiny pieces that can pass easily through the ureter. For stones located higher in the ureter or in the bladder, we often use cystoscopy to pull them out or break them up with electric energy or laser. During the procedure, the doctor passes a viewing tube with a crushing device into the ureter or bladder to pull the stone out or break it up with electric energy or laser.

For larger stones, percutaneous nephrolithotomy is a safe and reliable technique. For this procedure, you’ll be given medication to sedate you, then a viewing tube will be inserted through an incision made in your side. Once the stone is reached, it’s broken up using electric energy or ultrasound. In cases where this procedure doesn’t work, particularly when the stones are hard to reach or too large, surgery is often the preferred treatment. Surgery to remove kidney stones is performed under general anesthesia with the doctor making an incision into the side and another into the kidney or ureter to remove the stone. After the stone is removed, the incisions are stitched up.

There are many ways of treating kidney stones and the method chosen usually depends on the experience and judgment of the urologist, together with the patient’s preferences. At AUI, we prioritize the comfort of our patients, so we opt for the least invasive procedures before considering surgery. Want to know more about prevention, diagnosis and treatment of kidney stones? Find more information from the “Advanced Urology Institute” site.

How are Kidney Stones Treated?

Kidney stones are a common cause of agonizing and debilitating pain in men and women. In the United States, the stones account for over one million hospital visits and more than 300,000 emergency room visits every year. When patients present with kidney stones, the treatment administered usually depends on the type, size and location of the stone and on the severity of symptoms. Apart from administering treatment, the urologist investigates the underlying cause of the stones and recommends ways of preventing a recurrence.

Spontaneous passage

Kidney stones smaller than 4 mm in diameter are often passed on their own in urine and may be treated at home. While such stones may be painful, the pain often lasts only a few days and usually disappears soon after the stone is passed. So, depending on how bad your symptoms are and how long you’ve had the symptoms, you may not be given any form of treatment and just wait for stones to pass in urine. It usually take up to six weeks to do so.

However, you should only do this if the pain is bearable, there is no sign of infection or kidney blockage and the stone is of a size that can pass on its own. As you wait for it to pass, you’ll need to drink plenty of water and take pain medication to help you manage the discomfort. If you suspect that you have a kidney stone, speak with your doctor to see if you need immediate treatment or if you can wait for it to pass spontaneously.


There are a number of medications that increase the chance of passing kidney stones. For instance, tamsulosin is commonly given to people with kidney stones to help relax the ureter and make it easier for stones to pass. Apart from medications to boost stone passage, your urologist may prescribe anti-emetic (anti-nausea) medication to reduce nausea and vomiting as you wait for the stone to pass. And if you are in severe pain, your doctor may give you 1-2 pain injections and then prescribe some painkillers and anti-emetics for you to take from home.

Surgical procedures

If the pain is so much that you can’t wait for the stone to pass in the urine, you’ll require a surgical procedure to remove it. Surgery is also necessary if the stone is too big to pass on its own or is hampering kidney function. Kidney stones may be removed surgically if they are causing repeated urinary tract infections or are blocking the normal flow of urine.

Surgical procedures to remove kidney stones include extracorporeal shock-wave lithotripsy (ESWL), ureteroscopy and percutaneous nephrolithotomy (PCNL). These procedures are usually chosen by urologists depending on the size, type and location of the stones.

1. Extracorporeal Shock-Wave Lithotripsy (ESWL)

This procedure is the most frequent way of treating stones that can’t pass spontaneously in urine. High-frequency waves (X-rays or ultrasound) are directed at the stone to break it into smaller pieces that can pass in urine. Often the tiny pieces require a few weeks to pass out in urine. While ESWL is 99 percent effective for kidney stones up to 20 mm in diameter, more than one session is usually necessary for the treatment to be successful.

2. Ureteroscopy

For kidney stones that are lodged somewhere in the kidney or ureter, ureteroscopy (also called retrograde intrarenal surgery) may be necessary. The procedure involves directing a long, thin telescope (called ureteroscope) through the urethra, into the bladder, then into the ureter or kidney where the stone is located. If the stone is stuck in the kidney or upper ureter, the urologist uses flexible telescopes for this procedure, but rigid telescopes are ideal for stones stuck in the lower parts of the ureter.

The ureteroscope helps the urologist to reach the stone without making an incision. After reaching the stone, the doctor either can use another instrument to remove it or direct laser energy on it to break it into smaller pieces that can pass naturally in urine. A stent (plastic tube) may be inserted temporarily into the bladder to drain out the stone fragments.

3. Percutaneous nephrolithotomy (PCNL)

For kidney stones that are too large (21-30 mm in diameter), percutaneous lithotripsy is the treatment of choice. During the procedure, a half-inch incision is made in the side or back, just big enough to allow passage of a telescopic instrument (called nephroscope) into the area of the kidney where the stone is located. The nephroscope is used either to pull out the stone or break it up with pneumatic energy (or laser) and suction out the pieces. In fact, it’s the ability to suction out tiny stone pieces that makes this procedure ideal for larger stones.

Kidney stones also can be removed through open surgery, laparoscopic surgery or robotic surgery. But this is only done when the less-invasive procedures fail. Routine surgical procedures for kidney stones require shorter recovery period and you can usually return home the same day after the procedure and resume normal activities in 2-3 days. If the urologist inserts a stent after a procedure, it is removed 4-10 days later. During treatment, you also may be provided with a strainer that you can use to collect stone pieces that pass in urine for laboratory testing and to enable the urologist to recommend appropriate ways of preventing stone recurrence.

At Advanced Urology Institute, we offer shockwave lithotripsy, ureteroscopy and percutaneous nephrolithotomy routinely, and perform robotic and laparoscopic procedures for kidney stones when necessary. We perform blood tests and 24-hour urine analyses for every patient to identify the cause of kidney stones in order to provide the right treatment. We also design prevention strategies tailored to each patient, including personalized dietary recommendations based on results of 24-hour urine analysis. Our aim is to always ensure that our patients properly understand why they have kidney stones and make the necessary lifestyle changes to prevent a recurrence. For more information on kidney stones and how they are managed, visit the “Advanced Urology Institute” site.

Options for Treating Benign Prostatic Hyperplasia

The prostate is a tiny gland situated between the bladder and the penis. But as men get older, the gland grows larger, putting pressure on the urethra and bladder and causing urinary problems. An enlarged prostate is medically called benign prostatic hyperplasia (or BPH), a condition that’s quite common in older men. In the U.S. around 50 percent of men 51-60 years old have BPH while up to 90 percent of men over age 80 are affected by the condition.

The common symptoms of an enlarged prostate are:

  1. Inability to delay urination.
  2. Urge to urinate more than 8 times a day.
  3. Frequently waking up at night to pass urine.
  4. Dribbling after urinating.
  5. Urinary incontinence (urinating accidentally).
  6. Inability to completely empty the bladder (urinary retention).
  7. Having intermittent or weak urine stream.
  8. Straining to pass urine or difficulty starting urination.

So what are the options for treating BPH?

As urologists, the first thing we do when a patient has symptoms is to rule out other possible problems. We talk with our patients to learn the nature and severity of their symptoms, conduct exams, do ultrasound and relevant tests. Once it’s confirmed that it is BPH, we begin treatment starting with the least invasive procedures. Treatment options for BPH include medication, minimally invasive procedures and surgery, although various lifestyle changes also can improve or prevent symptoms.

1. Medications

The urologist may recommend medication to help control prostatic growth and reduce symptoms. For instance, alpha blockers such as alfuzosin (Uroxatral), silodosin (Rapaflo), doxazosin (Cardura), tamsulosin (Flomax) and terazosin (Hytrin) may be used to relax prostate muscles and make it easier to urinate. They quickly increase urine flow and reduce the need to urinate frequently. Another type of medication that may be prescribed is 5-alpha-reductase inhibitors, such as finasteride (Proscar) and dutasteride (Avodart), which limit the growth of the prostate by blocking hormones that promote growth of the gland. It generally takes 3-6 months for 5-alpha reductase inhibitors to relieve symptoms.

Phosphodiesterase-5 (PDE5) inhibitors such as Sildenafil, (Viagra), Tadalfil (Cialis) and Vardenafil (Levitra) may be given to help relax urinary tract muscles and relieve BPH symptoms. However, in some cases, particularly when either a 5-alpha reductase inhibitor or an alpha blocker isn’t effective on its own, urologists may give a combination therapy. This typically involves a combination of a 5-alpha reductase inhibitor and an alpha blocker and usually results in greater symptom relief.

2. Minimally invasive procedures

When medications fail to relieve BPH symptoms, the next step in treatment usually involves minimally invasive interventions. During the procedure, a urologist inserts an instrument into the rectum or urethra to either widen the urethra or destroy excess prostate tissue. For instance, TUMT (Transurethral Microwave Thermotherapy) uses microwaves to heat and destroy excess prostate tissue. TUMT does not cure BPH but makes it easier to pass urine, cuts down urinary frequency and reduces weak flow. Another treatment, TUNA (Transurethral Needle Ablation), uses high-frequency radio waves that are delivered via twin needles to burn a specific area of the prostate. TUNA is an outpatient procedure that relieves BPH symptoms and improves urine flow.

A third minimally invasive option for BPH is water-induced thermotherapy. During the treatment, hot water delivered through a catheter and into a treatment balloon located at the center of the prostate is used to heat up a definite area of the prostate and destroy problematic tissue. Once destroyed, the excess tissue is either reabsorbed in the body or excreted through urine. Another minimally invasive treatment option is the Urolift procedure, which involves inserting small implants into the prostate to retract, hold and lift the enlarged prostate tissue, opening up the passage for urine and relieving bladder blockage. While the Urolift procedure does not involve heating, cutting or removing the excess prostate tissue, it is effective in restoring normal flow of urine and relieving symptoms, and patients usually return home the same day without a catheter.

A revolutionary minimally invasive procedure for treating BPH is the Rezum system. During the treatment, sterile water vapor is injected into the prostate to help destroy overgrown tissue. It takes roughly three months for the body’s healing mechanisms to remove dead prostate cells and shrink the prostate, opening the passage for urine to flow. The Rezum procedure improves urine flow and relieves symptoms without the adverse effect of erectile dysfunction. It’s an ideal option for men who are medically unfit for the other procedures or for those already catheterized.

For prostates that have grown larger than 100 grams, a procedure called aquablation is a good option. It uses a high velocity saline jet to remove the overgrown prostate tissue. After the treatment is planned, the procedure is robotically driven, so its duration and side effects do not depend on prostate size. It does not use heat and postoperative bleeding is prevented by inserting a large catheter and applying a bladder washout (irrigation). The results achieved through aquablation are similar to TURP, except it comes with less dysuria and minimal irritation symptoms because no heat is used.

3. Surgical procedures for treating BPH

If both medication and minimally invasive procedures fail to improve BPH symptoms sufficiently, the urologist may recommend surgery. Surgical interventions also may be necessary if complications develop or symptoms become severe. The most common type of invasive surgery for BPH is TURP (Transurethral Resection of Prostate). In fact, it’s the first surgical option for treating BPH and involves the removal of excess prostate tissue by inserting a resectoscope through the urethra and into the prostate. Or the urologist can opt for TUIP (Transurethral Incision of Prostate) that involves making incisions in the bladder’s neck and into the prostate. The operation is done to widen the urethra and boost urine flow.

In other cases, the urologist may choose to perform laser surgery. This surgical procedure involves inserting a scope into the urethra and using the scope to deliver laser to the prostate tissue. The laser treats enlarged prostate through either enucleation (cutting) or ablation (melting). Both the GreenLight Laser PVP and Holmium laser ablation of prostate (HoLAP) procedures remove the excess prostate tissue by photoselective vaporization while holmium laser enucleation of prostate (HoLEP) uses two instruments, a laser for cutting and removing excess tissue and a morcellator for slicing extra tissue into tiny fragments for removal.

In complicated cases of BPH, such as men with much enlarged prostates or those with bladder damage, urologists may opt for open surgery. During an open simple prostatectomy, the urologist makes an incision just below the navel or numerous small incisions in the abdominal area via laparoscopy. The surgeon then removes the portion of the prostate that’s blocking urine flow.

At Advanced Urology Institute, our choice of treatment usually comes down to patient preferences and their ability to cope with BPH symptoms. We often prefer the least invasive options and give medication in many cases, but other treatment options are considered for patients who aren’t responding well to drugs or who can’t tolerate the adverse effects. As an alternative to TURP and open surgery, we prefer to treat BPH that’s characterized by acute urinary retention, high post-residual volume, recurrent urinary tract infections or bladder stones through the GreenLight Laser PVP or the newer heat treatments like TUNA and microwave. For more information on treatment options for BPH, visit the “Advanced Urology Institute” site.

4 Effective Ways to Treat Kidney Stones

Dreading the agony and pain of kidney stones? You don’t have to because the condition is treatable. And the pain and discomfort disappears as soon as the stones are removed.

The treatment you get depends on the type, size and cause of the stones and on the severity of your symptoms. For instance, if you are having very severe pain, your urologist will give you an injection to relieve the pain. A second injection may be given after 30 minutes if you are still in deep pain. You also may be injected with anti-emetic medication to relieve vomiting and nausea.

Apart from dealing with the symptoms of the kidney stone, your doctor will administer treatment to remove the stone. The 4 effective ways to remove kidney stones include:

1. Spontaneous Passage

If your kidney stones are small (less than 4 mm diameter) and you have minimal symptoms, you won’t require invasive treatment. In fact, once your urologist assesses that you can tolerate the stone, you will be given time so the stone can pass out on its own. In such a case, the urologist will only make the following recommendations:

  • Drrink a lot of water, as much as 1.9-2.3 liters a day, to help you flush out the stone from your urinary tract. In this case, you have to drink enough fluid — until your urine is colorless. So if your urine is still brown or yellow after drinking water, then you know that you aren’t drinking enough fluid.
  • Use pain relievers as you wait for the stone to pass out spontaneously. Since even a very small kidney stone can be really painful, your urologist may recommend pain relievers such as acetaminophen (Tylenol or others), naproxen sodium (Aleve), or ibuprofen (Motrin IB, Advil or others) to relieve the pain. The pain will only last a few days and often disappears soon after the stone is passed.
  • Take medication to help you pass the stone. Such medication, often alpha blockers, help to relax ureter muscles and allow the stone to be flushed out of your urinary system faster and with less pain.

With these recommendations you are expected to wait until the stone passes out and then to collect the stone for analysis by your urologist in order to help determine if there is need for further treatment. To collect the stone, you simply filter your urine through a stocking or gauze as you urinate.

2. Extracorporeal Shock-Wave Lithotripsy (ESWL)

What if your kidney stone is too large to pass out in urine? In that case, your doctor may recommend a procedure called extracorporeal shock-wave lithotripsy. The ESWL procedure uses sound waves to generate strong vibrations (called shock waves), which break the stone into tinier pieces that can easily and less painfully pass through urine.

The high-frequency sound waves (ultrasound) are directed at the stone from a machine for 45-60 minutes. Because this can be a bit uncomfortable, you will undergo the procedure under light anesthesia or sedation to reduce the discomfort. The ESWL procedure is 99 percent effective for kidney stones that are up to 20 mm (0.8inch) in diameter. But you may require one or more ESWL sessions for the kidney stones to be effectively removed.

3. Ureteroscopy

What if the stone is stuck somewhere in your urinary tract, such as the ureter? In that case, your urologist may recommend ureteroscopy, a procedure that’s also called RIRS (retrograde intrarenal surgery). During ureteroscopy your doctor passes a long thin telescope, a ureteroscope, through your urethra, into the bladder and into the ureter, or wherever the stone is stuck.

After locating the stone the urologist uses a special instrument or laser energy to break the stone into tiny pieces that can pass out naturally in urine. The doctor then may place a small plastic tube (stent) temporarily in the ureter to help drain the stone fragments into your bladder, relieve swelling and hasten healing. Ureteroscopy is conducted under general anesthesia, so you shouldn’t operate machinery or drive for up to 48 hours after treatment. It is 50-80 percent effective for kidney stones that are 15 mm (0.6inch) in diameter.

4. Percutaneous Nephrolithotomy (PCNL)

In circumstances where ESWL isn’t appropriate, such as when you are obese, larger stones may require an alternative procedure called percutaneous nephrolithotomy (PCNL). It is a surgical procedure for removing kidney stones using a small thin telescopic instrument known as a nephroscope. The instrument is inserted through a small incision made in your back and guided carefully to your kidney or ureter. Once the stone is located it is either broken into smaller pieces (with pneumatic energy or laser) or pulled out. PCNL has 86 percent efficacy for kidney stones of 21-30 mm in diameter and is performed under general anesthesia.

When should you seek treatment for kidney stones? You need urgent treatment if:

  1. Your pain is sudden, severe or gets worse.
  2. You have a fever of 100.4 F or higher.
  3. You have one or more episodes of shaking or shivering.

At Advanced Urology Institute we have assembled a team of skilled and experienced urologists to help diagnose and treat kidney stones and other urological problems safely and effectively. We offer all 4 effective treatments for kidney stones and have the latest equipment and technology to make the treatment process as painless and comfortable as possible. So don’t try to endure the pain even a day longer before you see us and let us fix it. For more information on kidney stones and other urological disorders, visit the “Advanced Urology Institute’” site.

What are the Symptoms of Low Testosterone

Produced in the testicles (testes), testosterone is the hormone responsible for masculinity and muscular development. It is the hormone that fuels sex drive, creates a deep voice, boosts muscle mass, regulates mood, controls body and facial hair patterns, and regulates bone strength. Testosterone levels usually decrease as men age, with studies showing that a man loses roughly 10 percent of testosterone each decade after reaching the age of 30.

Symptoms of low testosterone levels

Since the reduction in the level of testosterone is typically gradual, the symptoms take longer to occur. Generally, however, about 30 percent of all men will experience symptoms of low testosterone after the age of 50. Andropause is the term used to describe a decrease in the level of testosterone hormone in men. Men experiencing andropause can suffer various symptoms associated with the condition and may be at risk of having other serious health problems like osteoporosis if proper treatment is not administered.

The symptoms of low testosterone include:

  1. Diminished sexual desire (low libido)
  2. Problems getting erections or weak erections
  3. Fatigue and weakness
  4. Hot flashes
  5. Irritable moods
  6. Depression
  7. Increased body fat
  8. Loss of muscle mass or strength

Low testosterone can cause various complications or even change a man’s body. For instance, it can lead to obesity, hair loss, muscular atrophy (less muscle mass), softer testicles, smaller testicles, cardiovascular problems, larger breasts and brittle bones (osteoporosis).

Causes of low testosterone

Even though aging is the most frequent cause of low levels of testosterone in men, several other factors may be involved. Common causes of low-T include:

  1. Kidney disease
  2. Diabetes
  3. Testicular injuries
  4. Liver disease
  5. COPD (chronic obstructive pulmonary disease)
  6. Radiation therapy
  7. Steroid medications
  8. Pituitary gland disorders
  9. Chemotherapy

Men also may be tested for low-T if they have very low sex drive, erectile dysfunction, low sperm count, hair loss, reduced muscle mass or osteoporosis. And because the symptoms of low testosterone are not specific, a doctor may want to first rule out other conditions with similar symptoms before treatment.

Treatment of low testosterone

Testosterone replacement is the most common treatment for men having low-T. The therapy is administered to relieve symptoms and improve quality of life. The testosterone used in the replacement therapy is usually available in various preparations, including gels, capsules, skin patches and injections. The doctor will decide if testosterone replacement therapy is appropriate for a patient. For instance, the treatment is not appropriate for men with prostate cancer and breast cancer. Men with an enlarged prostate, liver disease, kidney disease or who are using blood thinners may or may not undergo replacement therapy depending on their medical history.

At Advanced Urology Institute, we have a long history of treating low testosterone. We put the interest and health of our patients first and always discuss with our patients in great length their conditions and medical history before we administer treatment. 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.