How Does the Bladder Sphincter Work?

The bladder sphincter is made up of two muscles that control the release of urine from the bladder through the urethra. If the bladder were a reservoir, then the bladder sphincter would be the dam that holds back water and controls when it is released. The bladder sphincter is made up of two muscles, the internal and external sphincter muscles.

  • The internal sphincter muscle is located at the opening of the bladder to the urethra. It is a smooth, involuntary muscle. Because of its location, it is also primary muscle prohibiting the release of urine.
  • The external sphincter muscle surrounds the area of the urethra outside the bladder. It is the secondary muscle in control of urine flow. It is made of skeletal muscle and is a voluntary muscle.

Both muscles function in a similar fashion. When one relaxes the voluntary muscle, the involuntary muscle relaxes as well. When these muscles are relaxed, they open up allowing for urine to flow out of the bladder through the urethra and out the body. When these muscles are contracted, they keep urine in the bladder. Given the functions of the bladder sphincter, it is understandable the important role it plays in urinary continence. Damage or weakening of these muscles can also be a main cause for urinary incontinence.

Urinary IncontinenceUrinary incontinence is the loss of bladder control. It is a common yet embarrassing problem. It can be as mild as releasing a small amount of urine when you laugh or sneeze, or as serious as having the urge to urinate come on so strong and fast that you don’t have time to get to a bathroom. Problems with the bladder sphincters can cause several different forms of incontinence.

One form of urge incontinence occurs when the urethra can’t hold back urine in the bladder and the bladder sphincters relax uncontrollably.

Stress urinary incontinence is another common issue. In this case, stress or damage to the sphincters or surrounding muscles can cause urinary incontinence. This is common in women after childbirth, or in men after prostate surgery or radiation therapy. Neurogenic bladder dysfunction occurs when trauma or disease of the central nervous system causes a person to lose control of their bladder sphincter muscles.

Although issues caused by malfunctioning bladder sphincters can be embarrassing, there are a variety of treatment options available. The option that works best–whether it be lifestyle changes, medication, or surgery–depends on the patient and their overall medical history. Urologists work to understand their patient’s unique needs and develop the best plan to treat their bladder problems. For more information, visit the Advanced Urology Institute website.

Surgical Options for Overactive Bladder

If you feel frequent, sudden urges to urinate that you cannot control, you might be suffering from overactive bladder. This condition can lead to feelings of embarrassment or shame, but it’s a common problem and can be treated in a variety of ways. For many people, overactive bladder can be treated with lifestyle changes such as special diet, weight loss, regularly timed trips to the bathroom, and exercises to strengthen the pelvic floor. Dealing with symptoms by using absorbent pads is also an option.

However, for some people, these methods are not enough to ensure they can live a healthy, fulfilling life. In these situations, surgical intervention is an option to correct overactive bladder problems.

Augmentation Cytoplasty

One of the options for treating overactive bladder is called augmentation cytoplasty. This procedure increases the size of the bladder. The surgeon accomplishes this by removing a small part of the intestine and using it to replace parts of the bladder in order to increase its capacity. For some people, this procedure allows them to resume normal bladder function. For others, the use of a catheter may be necessary for the rest of their life.

Urinary Diversion Surgery

Another surgical treatment option for overactive bladder is urinary diversion surgery. This procedure involves diverting urine from the bladder. One option for bypassing the bladder involves linking the ureters, which normally connect the kidneys to the bladder, to an ostomy bag outside of the body. Another option involves the creation of a new bladder inside of the patient’s body, which means they will be able to continue normal urinary function.

Bladder Removal

Bladder removal surgery, or a cystectomy, is the last resort option for patients with overactive bladder for whom no other treatment has been successful. For men, bladder removal surgery also involves the removal of part of the prostate; for women, it involves removal of the uterus, ovaries and part of the vagina. Because this is a risky procedure that involves multiple organs, it is usually only used for more serious urological conditions such as bladder cancer or birth defects. Removal of the bladder necessitates the use of a urinary diversion such as an ostomy bag or a stoma.

An overactive bladder can be a debilitating condition, but there are many options for treatment. If you are dealing with this issue, the physicians at Advanced Urology Institute are here to help you reach a diagnosis and find a treatment to restore your quality of life.

Prostate Cancer Types of Treatment

Prostate cancer is one of the most prevalent types of cancer men face. According to board certified urologist Dr. Arash Rafiei, “One in nine men will have prostate cancer in their lifetime.” Although somewhat common, not all cancers in the walnut-shaped prostate gland are the same. Every case of prostate cancer is different and affects men differently. Urologists work with their patients to find the most effective treatment option based on each patient’s individual needs.

Dr. Arash Rafiei: Urologist in Orange City, FLUrologists will consider their patient’s health, age, and the type cancer when deciding how to proceed. For some cases, the best treatment is none at all. When a patient has slow growing prostate cancer that is not spreading, a urologist may suggest holding off on treatment while monitoring the growth through routine appointments. The cancer needs to be taken seriously and watched closely, but invasive treatment is not always necessary for the patient’s health.

When treatment for the prostate cancer is needed, there are two main options: radiation and surgery. Both options offer the same level of prostate control and urologists will discuss the pros and cons of each with their patients. For surgical options the urologist may suggest a radical prostatectomy or robotic surgery. Both are well-tested invasive options that produce very good patient outcomes.

Radiation therapy is another common cancer treatment option. The radiation is centered on the prostate to kill cancer cells. The radiation will also kill some healthy cells as well, causing side effects. This is a non-invasive option that, like surgery, has its pros and con that a patient and doctor will want to discuss. Follow-up appointments to determine if the cancer responded to the treatment will also be necessary.

In addition to radiation and surgery, there are also some newer options that can be utilized in prostate cancer treatment. For instance, cryotherapy uses very cold temperatures to kill cancerous tissues and cells in the prostate by freezing them. There are also treatments using intense ultrasound waves centered on the prostate to destroy the cancer cells. These procedures are newer and there is less data on when they are the most effective, but they are options to consider.

All cancer is serious and can be a stressful and frightening prospect. Having a dedicated urologist who will listen and suggest the best treatment for each patient is key to success. Whether the best option is observation, radiation, surgery or a newer procedure, the Advance Urology Institute is a team of dedicated urologists with an array of treatment options for their patients.

What is the best treatment for enlarged prostate?

All men can experience difficulties caused by an enlarging prostate. As Board Certified Urologist Dr. Arash Rafiei says, “All men have prostates, and as we age our prostates enlarge, some more than others.” Yet each man’s situation and health is different. The symptoms of an enlarged prostate will differ greatly between individuals and the best treatment option for one may not be the best option for another.

Urologist in DeLand, FL: Dr. Arash RafieiFor most men, the symptoms of an enlarging prostate include the slowing of their urine stream, pushing to urinate, and having to go to the bathroom frequently. Many men also have the feeling of not fully emptying their bladder after urination. In many cases, men will find that they need to wake up multiple times in the night to go to the bathroom.

Because the symptoms of an enlarging prostate differ for everyone, the first thing a urologist will ask is if the symptoms are bothering the patient. For some men, the symptoms, especially in their early stages, are not a problem. Men may notice that they urinate a little more often. It may also take a bit longer for them to urinate when they do. They may have to get up once or twice at night when they did not have to before. A lot of men see these symptoms as inconveniences that they can adapt to and live easily with. In these cases, the urologist and their patient will just want to continue to watch the situation and may not need to take any action.

For men with more severe prostate enlargement the symptoms may be causing issues that are negatively affecting their lives. In these cases, their urologist may recommend medical therapy. Urologists will recommend medication that will help slow the growth of the prostate and relax the muscles around the bladder. This treatment will help make urination easier for men you have been experiencing difficulties. Slowing prostate growth will also give the patient more time before more invasive treatment options become necessary.

For cases where medication does not produce successful outcomes there are plenty of procedures that can help. One common procedure is a transurethral resection of the prostate. For this procedure a resectoscope in inserted through the tip of the penis and into the urethra. The urologist uses this device to trim away excess tissue on the prostate, relieving pressure on the urethra. This is an outpatient procedure and often helps relieve the patient’s urinary problems.

Another procedure that is new and becoming more common for treating enlarged prostates is Urolift. For this cutting-edge treatment, a urologist separates and lifts the prostate from the urethra using a suture, relieving pressure on the urethra and allowing better urine flow. A plus side to Urolift is that, unlike in a transurethral resection, no prostate tissue is removed allowing for quicker recovery. Most patients return home the same day as the procedure.

Having plenty of treatment options is the key to successfully managing prostate enlargement. The urologists at Advance Urology Institute get to know and understand their patients in order to find the best option for each individual. For more information, visit the Advanced Urology Institute website.

Talk With Your Doctor About Erectile Dysfunction

The first step in treating erectile dysfunction is talking to your doctor about it. Unfortunately, for many men this can be difficult as erectile dysfunction is often a sensitive subject for those experiencing it. However, the issue is far more common than most men realize. As Chelsea Ferrell , physician assistant, states, “Fifty percent of men over 50 have some degree of erectile dysfunction, so you do not have to be embarrassed to speak to your doctor about it.” Urologists and PAs discuss erectile dysfunction with patients on a daily basis.

Chelsie Ferrell, Physician Assistant at DeLand, FLUrologists can usually diagnose erectile dysfunction during the appointment by asking a few questions about medical history and having a conversation with the patient. Once diagnosed, urologists try to discuss erectile dysfunction with the patient by reassuring him that even in the most severe cases there are still plenty of treatment options available. Because there are so many options available, the decision really is up to the patient working with his urologist to decide the best treatment for a successful outcome in his case.

There are plenty of different treatments available for erectile dysfunction and, in many cases, if one does not work another will. The most common options are pills like Viagra and Cialis, or generic versions of these pills that offer the same effects at a lower price. Others prefer the vacuum erection device. This is a cylindrical pump that the penis goes into and works like a vacuum to draw blood to the area, with a band that goes around the base of the penis to keep the erection.

Many men respond to at least one of these treatments. However, for those who do not there are still plenty of options. The urologist may want to try injection therapy. Men can give themselves small, relatively pain-free injections of a treatment into the base of the penis that will stimulate an erection. If injection treatment does not help, then the urologist may suggest a penile prosthesis. An implant is surgically inserted into the penis attached to a pump in the scrotum that can be used to give the patient an erection. This treatment will correct the patient’s erectile dysfunction for life.

Talking to your doctor about an issue as common as erectile dysfunction does not have to be an uncomfortable experience. And with the many options available now to treat erectile dysfunction, the right option is just a conversation away. Chelsea Ferrell PA at the Advanced Urology Institute is one of the many friendly and intelligent professionals helping patients find their best treatment option. For more information, visit the Advanced Urology Institute website.

Discussing a Sensitive Topic: Erectile Dysfunction

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

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

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

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

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

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

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 Stone Surgery and Removal Procedures

Kidney stones can be stubborn and painful. In many cases, patients rely on a urologist for help removing these painful obstructions. Kidney stones are hard deposits of minerals that form in the body and can cause blockage in the urinary tract. Urologists will decide how to treat the stone based on factors like its size, the patient’s health and the amount of pain it’s causing.

Dr. Brian Hale of Palm Harbor, FLOne cutting-edge and noninvasive method for treating kidney stones is called shock wave lithotripsy. Board-certified urologist Dr. Brian D. Hale describes it as using water waves to break up the stone. A machine is put against the patient’s body and creates small explosions. The water waves from the explosions target the stone. As many as 2,500 water waves are directed at the stone during a single treatment.

These waves break the stone into small pieces similar to sand. The patient will be able to pass these much smaller pieces with greater ease. The whole treatment takes about 25 minutes. The procedure is mostly pain free but does require the patient to go under general anesthesia. In the early 2000s, patients were not required to go under anesthesia for this procedure. However, it was found that natural movements from the patient made it difficult to concentrate the water waves on the stone, so putting patients under anesthesia is now the general practice.

Each case of kidney stones is different, and noninvasive measures are not always an option. An alternative procedure for stone removal is to use a scope to go up the patient’s penis through the urethra to the kidney and then use a medical laser to break up the stone and pull out the fragments. This is the preferred method for some of the smaller stones that cannot be broken up with shock wave lithotripsy.

For larger stones in the kidney, urologists may recommend a more invasive form of surgery called percutaneous nephrolithotomy. In these cases, the urologist will make a small incision in the patient’s back to reach the kidney directly. The urologist then will use a scope and either a laser or ultrasound energy to break up the stone. This procedure also requires general anesthesia and the patient may need to stay in the hospital for one to two days to recover.

There are many options for patients suffering from painful kidney stones. The many urologists of the Advanced Urology Institute have committed to finding the best options to relieve the pain of kidney stones. 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.

Becoming a Urologist with Amar Raval, MD

A urologist plays an important role in healthcare. The field of urology encompasses many issues that people face throughout their lives, especially as they start to age. As urologist Dr. Amar Raval notes, urology allows him the opportunity to “provide a service to others.” As a urologist he gets to make a positive impact on his patients’ lives by helping them with many of the common issues that prompt people to seek medical help.

Dr. Amar Raval from Palm Harbor, FLOne common problem is kidney stone disease. Kidney stones form for a variety of different reasons. They are particularly common in warm climates, like Florida. Symptoms can vary, but they include severe abdominal pain, nausea, fever, chills, difficulty urinating or blood in the urine. Kidney stones can be very painful and some people need assistance to pass them. A urologist can assess the stones and determine the best way to remove them. In some cases, experienced urologists can break up the stones using a shock wave treatment that is totally noninvasive.

Urologists also frequently see cases of prostate cancer, one of the most common cancers for men. The disease comes in many different forms, making each case unique. While some need to be treated with surgery, chemotherapy or radiation, other forms are non-aggressive and can be left alone. Urologists also may recommend cutting-edge technologies like HIFU. Whatever the diagnosis, it is important to work with your urologist to monitor your prostate and find the best treatment plan for you.

Urinary incontinence is a common problem that many patients are embarrassed to discuss with their doctor. A urologist deals with many patients experiencing urinary incontinence and is accustomed to having in-depth conversations with their patients about incontinence. They know how to discuss the problem with patients so they feel comfortable while also finding the underlying issue causing the incontinence. Whether it is caused by stress, infection, lifestyle or another issue, a urologist can find the best solution and help a patient maintain a healthy and confident life.

There are countless other issues that bring patients to see a urologist for help. Dr. Amar Raval at the Advanced Urology Institute is one of many dedicated urologists improve their patients’ quality of life. For more information, visit the Advanced Urology Institute website.