What Urology Procedures Are Performed in Our Naples Office?

KEY TAKEAWAYS:

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

Introduction

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

Outpatient Urology Procedures in Naples

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

Prostate Procedures

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

Reconstructive Surgeries

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

Stone Disease Treatment

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

Hospital Procedures for Complex Cases

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

Advanced Urology Institute: Comprehensive Urological Care

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

TRANSCRIPTION:

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

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

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Urinary Incontinence in Women

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

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

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

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

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

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

KEY TAKEAWAYS:

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

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

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

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

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

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

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

TRANSCRIPTION:

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

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

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

REFERENCES:

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

KEY TAKEAWAYS:

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

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

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

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

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

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

TRANSCRIPTION:

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

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

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Urologists Also Treat Women

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

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

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

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

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

Advanced Urology Institute Names Scott B. Sellinger, MD as AUI President

PRESS RELEASE

FOR IMMEDIATE RELEASE
October 30, 2020

PRESS CONTACT:
NAME: Miriam Williams, CAO
PHONE: (850) 348-2944
EMAIL: miriam.williams@auihealth.com

ADVANCED UROLOGY INSTITUTE NAMES SCOTT B. SELLINGER, MD AS AUI PRESIDENT

Michael S. Grable, MD will step down at the end of 2020

OXFORD, FL, October 30, 2020 — Advanced Urology Institute is proud to announce that Dr. Scott B. Sellinger will become president in 2021.

He brings a wealth of experience and accomplishments to the position. Raised in upstate New York, Dr. Sellinger graduated from Syracuse University in 1982 with a Bachelor of Science degree in chemistry. After moving to Gainesville, he attended the University of Florida School of Medicine and graduated with honors in 1986.He completed his surgical internship and urological residency at UF. In 1987, he was named as Surgical Intern of the Year and in 1989 received the prestigious Harris Award for the outstanding urology resident.

He replaces Dr. Michael S. Grable, who is transitioning out of his role at the end of 2020 to spend more time away from the practice. Dr. Grable became president of Advanced Urology Institute in 2013 during the formative stages of the practice. His vision and leadership skills helped transform AUI into the successfully and highly respected practice it is today.

The AUI board of directors unanimously voted Dr. Sellinger as his replacement.

“It is my honor and privilege to serve as your next AUI president effective January 1, 2021,” says Dr. Sellinger. “Please help me thank Dr. Mike Grable for his six plus years of service as president of our organization. Under his strong guidance and leadership, AUI has become one of the largest independent urology groups in the country. I look forward to many more years of growth and prosperity, and most importantly, standing tall on our commitment to world-class, patient-centered care.”

Dr. Sellinger was president of Capital Medical Society in 2003 and served as president of the Florida Urological Society in 2005. He is past president of the Southeastern Section of the American Urological Association and is immediate past president of the American Association of Clinical Urologists (AACU). In addition, he has served on the board of directors for the Large Urology Group Practice Association (LUPGA) for the past six years. Dr. Sellinger has developed a special interest in risk management and prevention of medical errors and has lectured extensively on these subject matters during the past several years.

“Dr. Grable has kept our AUI organization consistently focused on our AUI mission of patient-centered care throughout his presidency, which has been the linchpin of our success,” says AUI CEO Richard Wooten. “I am certain that Dr. Sellinger will continue to guide our AUI organization to greater heights. We welcome Dr. Sellinger as our second AUI president.”

About Advanced Urology Institute:
Headquartered in Oxford, FL, Advanced Urology Institute (AUI) is a professional corporation of medical doctors (M.D.’s) who are board-certified and qualified in the surgical sub-specialty of urology. In addition to Oxford, AUI specialists are located throughout Florida in Ocala, Panama City, Tallahassee, Daytona Beach, St. Petersburg, Clearwater, Fort Meyers, and Naples. AUI was founded in 2014 as a single-specialty, physician led organization to respond more efficiently and effectively to the ever-mounting changes in healthcare and government regulations. This allows AUI to provide and dedicate the highest level in patient-centered care with over 600 providers, clinical and front office staff. Learn more at https://www.advancedurologyinstitute.com/

Becoming a Physician Assistant – Chelsie Ferrell, PA-C

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

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

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

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

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

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

KEY TAKEAWAYS:

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

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

Dr. Samuel Lawindy of Daytona Beach, FL

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

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

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

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

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

TRANSCRIPTION:

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

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

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

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

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

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

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

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Risk Factors of Prostate Cancer

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

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

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

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

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

Becoming a Urologist – Dr. Howard Epstein MD

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

Medical School

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

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

Urology Studies

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

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

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

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

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

Dr. Howard Epstein

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

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

5 Reasons for Women to See a Urologist

A urologist isn’t just a doctor for men. There are many reasons why a woman would need to see a doctor who treats the urinary system. The urinary system is a collection of organs that involved the kidneys and bladder, as well as the organs involved in the reproductive process.

Here are five common reasons why a woman may need to see a urologist

1. Kidney Stones

When minerals in the urine combine, they can sometimes stick together and create kidney stones that get lodged in the urinary tract. These stones vary in size and create a variety of symptoms. The most common symptoms are pain and difficulty urinating. Some women may also experience fever or chills.

Treatment for kidney stones varies depending on patient and stone type, but urologists have plenty of treatment options on hand. In some cases, drinking lots of water can flush the stones out. In other cases, high-intensity focused ultrasounds can break the stones into smaller, more easily passable pieces.

2. Urinary Tract Infection

Commonly referred to as UTI, this a common infection that many women will develop at some point in their lives. It occurs when bacteria enter the urinary tract and cause pain and burning during urination. UTI’s can become serious, so treatment with antibiotics is important.

3. Bladder/Pelvic Prolapse

This painful condition occurs when the bladder begins to drop down into the vagina. There are a few reasons why this may happen. Some women develop this condition after childbirth, but for others it occurs as a part of the aging process. Correcting this problem usually requires surgery performed by a urologist.

4. Bladder Control Problems

Bladder control problems are twice as common for women, and the medical term for these problems is Urinary Incontinence. Urinary incontinence takes many forms. Some women experience dripping when they sneeze, cough or laugh. Some women have an overactive bladder that creates a sudden and urgent need to use the bathroom. No matter what form it takes, women can work with a urologist to find the best treatment, or combination of treatments, to help with their incontinence.

5. Cancer

There are certain cancers for which a woman would be treated by a urologist. These include cancers of the bladder, kidneys or urethra. Lower back pain, pain during urination, and blood in the urine can be signs of one or more of these cancers. Treatment varies depending on the type of cancer, how aggressive it is, and the overall health of the patient.

Women in Florida who need a urologist for treatment of one or more of these problems have many options. The Advance Urology Institute is a team of highly skilled medical professionals who practice at locations throughout the state and with a commitment to achieving the best possible outcomes for their male and female patients. For more information about women’s urological issues, visit the Advance Urology Institute website.

Why Would You Need to See a Urologist

The urinary system is your body’s way of getting rid of urine. If there is something wrong with your urinary system, you may need to see a urologist. A urologist is a doctor trained and certified in treating issues with the many components of the male and female urinary systems and male reproductive organs.

Urologists treat a wide range of urological issues, including problems with the bladder, kidneys or urethra. If you are a man experiencing issues with your reproductive organs—penis, testes, scrotum, and prostate—it is a urologist you will need to see. And for women, issues with the bladder and pelvis are reasons to visit this kind of specialist.

Common bladder problems that send patients to the urologist are kidney blockages, kidney stones, and urinary tract infections (UTIs.) Treatment for these issues vary from patient to patient. For instance, some patients might be able to pass a kidney stone by drinking water and moving around to dislodge it, while others may need a more advanced treatment like a high frequency ultrasound, which is an ultrasound focused on the stone to break it down into smaller, easily passable pieces, similar to sand.

For men’s reproductive health, urologists can treat Erectile Dysfunction (ED). In most cases, this condition is easily treated with oral medication, though in some patients injection therapy may be necessary. Prostate cancer, the most common cancer that affects men, is another reason that men seek out a urologist for treatment. Again, for this issue, treatment varies by diagnosis. While some men’s prostate cancer can be monitored and treated with active surveillance, others may need surgery or chemotherapy depending on the aggressiveness of the cancer.

Women are more likely to see a urologist for bladder problems, often for changes in urination after pregnancy. Pelvic organ prolapse is another potential medical issue for women. Usually caused by age, this is when either the uterus or bladder begins to drop and press into the vagina. A urologist can treat this condition to relieve the discomfort and pain it causes.

Residents of Florida have access to a leading center for the medical specialization of urology with locations throughout the state. The Advanced Urology Institute is an exceptional team of medical professionals who treat their patients’ urological issues with compassion and a commitment to the highest quality care. For more information, visit the Advanced Urology Institute website.

Immunotherapy for Cancer

Immunotherapy

Cancer comes in many forms and choosing the right treatment options depends heavily on the patient, their health, and the type of cancer present. For patients with metastatic cancer (cancer that has spread to other parts of the body from where it started), chemotherapy has been a long-standing choice. However, for some patients, immunotherapy is the more effective treatment with fewer side effects.

Immunotherapy works by working with the patient’s body. The human body is designed to fight against infections and diseases, including cancer cells that grow and spread unchecked as they avoid the body’s natural defenses. Immunotherapy boosts the natural immune system, making it more effective in fighting cancer cells. It helps the body identify which cells should be left alone and which cells are cancerous and need to be attacked and eradicated. Immunotherapy utilizes the immune system to better recognize and target cancer cells, even after treatment has ended.

Dr. Amar Rava of Palm Harbor, FL l discusses ImmunotherapyOne of the biggest benefits of immunotherapy is its less severe side effects. Chemotherapy is known for its harsh side effects that can be devastating to patients. Side effects such as severe fatigue, hair loss, nausea and vomiting diminish quality of life for cancer patients. While immunotherapy is not without its side effects, most patients find that muscle aches, shortness of breath and headaches are easier to endure.

Immunotherapy can be used to treat many types of cancers. Urologists have been using it to treat bladder and prostate cancers, and typically for patients who have asymptomatic, castrate-resistant prostate cancer. Having more treatment options for prostate cancer—the most common form of cancer found in men—means a successful outcome is more likely.

Immunotherapy is less toxic than chemotherapy and its less intense side effects allow for a better quality of life for patients with prostate and bladder cancer. According to Dr. Amar J. Patel, Board Certified Urologist, immunotherapy is also shown to increase life expectancy for cancer patients by up to three months. Advance Urology Institute achieves better outcomes for patients by utilizing all of the tools available in the fight against cancer, including the patient’s very own immune systems. For more information about immunotherapy, visit the Advanced Urology Institute website.

Should You Be Screened for Prostate Cancer

Prostate cancer is a common cancer that affects the walnut-shaped male prostate gland. As with most cancers, early detection is an important part of any successful treatment. The most common way prostate cancer is detected is through prostate cancer screenings during a patient’s appointment with a urologist. According to Dr. Amar Raval, “Screenings are important, along with a digital rectal exam, because prostate cancer continues to be the number one cancer found in men.”

Should you be screened for prostate cancer? If you can answer yes to one or more of the following conditions, then you may need to be screened:

• If you are between the ages of 55 and 69.
• If there is a history of prostate cancer in your family.
• If you are African-American.
• If you have a pre-existing medical condition that makes treatment difficult.

Dr. Amar Raval of Palm Harbor, FLThese factors are known to increase the risk of developing prostate cancer, and it is recommended that someone who has one or more of these conditions is screened at least once a year.

There are two main types of prostate cancer screening tests that a patient may receive. The most common is a digital rectal examination (DRE). For this exam, the health care provider puts on a glove and inserts a finger into the patient’s rectum to feel for any abnormalities on the prostate that can be attributed to cancer. The other screening is a prostate specific antigen (PSA) blood test. This blood test checks the PSA level in the blood, as someone with prostate cancer will have an elevated PSA level.

If one of these tests leads to a prostate cancer diagnosis, the urologist will want to identify what kind of prostate cancer it is in order to develop the best treatment plan. Non-aggressive cancers may not necessarily need treatment and can be monitored with active surveillance, which means watching the cancer to make sure it doesn’t turn aggressive and spread. In cases where the cancer is of intermediate or high risk, early identification from a screening test can help make sure that the treatment used on the cancer has the best chance for success.

If you believe it is time for you to start being screened for prostate cancer, then you should have a conversation with your urologist. Early detection can be a life saver. For men who are concerned about prostate cancer, the Advance Urology Institute is an excellent place to begin screening.

How Has Prostate Cancer Biopsy Advanced with Dr. Jonathan Jay?

KEY TAKEAWAYS:

  • GPS Guided Biopsies offer greater accuracy in detecting and determining the type of prostate cancer, as they can pinpoint the growth more precisely than a regular biopsy.
  • High-quality T3 MRIs, molecular biopsies, and patient follow-up allow urologists to monitor the cancer closely and make better-informed decisions about the need for aggressive treatment.
  • Urologists use tools like rectal exams and prostate-specific androgen (PSA) tests to monitor the progression of prostate cancer and recommend surgery or radiation therapy if the cancer becomes aggressive.

Prostate cancer is one of the most common forms of cancer found in men. The likelihood of it forming in the walnut-shaped prostate organ increases with age. Luckily, there have been many major advances in how prostate cancer is diagnosed and treated. When it comes to diagnosing, board-certified urologist Dr. Jonathan Jay says, “First we must define where it is, how much of it exists within your prostate, and then what its behavior is like.”

Answering the where, how, and what is key to determining the type of prostate cancer and how to watch or treat it. Urologists are using advanced technologies to answer these questions. Urologists want to know how aggressive a cancer is when determining how aggressively they need to treat it. They can use a molecular biopsy and a high-quality T3 MRI to pick up on aggressive cancers. If an aggressive cancer is found, urologists can perform a more focused biopsy.

Dr. Jonathan Jay - Naples, FLThis focused biopsy is called a GPS Guided Biopsy and it has some very important advantages over a regular biopsy. The cancer may exist in a very small portion of the prostate, especially early on. This small cancer can be missed during a biopsy just by a sampling error, leading to a diagnosis that may not give a completely accurate picture of the cancer. But with a high-quality MRI, a guided biopsy can pinpoint the growth and the urologist can detect and determine the type of cancer with greater accuracy.

When the cancer is detected with greater accuracy, the urologist can now follow it more closely and understand what type the doctor and patient are dealing with. The urologist can perform a biopsy on the cancer to look at and understand its genetics. If the genetics show that it is not very aggressive or growing, then the urologist may decide to watch the cancer, as treatment may not be necessary. MRI’s and patient follow up can be used to watch the growth to see if there are any changes that may require more aggressive treatment.

Along with MRI’s, the cancer can be monitored with rectal exams and prostate-specific androgens (PSA) tests. These tools offer insight into the patient’s specific prostate cancer and its progression. If it becomes aggressive, the urologist can recommend surgery or radiation therapy.

A diagnosis is the beginning of a patient’s cancer treatment. At the Advance Urology Institute, urologists like Dr. Jonathan Jay utilize recent advancements in prostate cancer biopsies to provide their patients with the most accurate diagnosis and best treatment options.

TRANSCRIPTION: 

I’m Jonathan Jay, I’m a board certified urologist with Advanced Urology Institute.

One thing I’ve always said about prostate cancer, one you’ve got to be able to define where it is, how much of it exists within your prostate and then what its behavior is like.

So if we take that molecular biology and now we have MRI, T3 weighted MRI that can pick up aggressive prostate cancers and we do what we call GPS guided biopsy, a Euronav biopsy. So for instance, if I were sitting in this room and I’m the cancer, so this room is the prostate and I’m the cancer in the prostate, I could pass a needle through this room 15 times and miss me or just catch my baby toe. So I can miss the cancer just by sampling error. But if I had an MRI that said in this part of the room where I sit is an abnormality and it looks different than the other parts of the prostate and I focus on that, my ability to define and detect that cancer within that room is much higher. So we have the ability to do that. So not only did I detect the cancer in a much better way, but I have the ability now to follow the cancer. So if I biopsy that, look at the genetics of that cancer and it’s not very virulent, I can watch that cancer.

I got MRI which I can use to plot whether it changes in size or character. I can use the molecular biology to tell how fast it multiplies if it’s a virulent cancer. I’ve got PSA and I’ve got my rectal exam. So I’ve got three or four clinical tools for which I can follow that patient. We always talk about risk and benefit of treating any disease and we can watch this disease. If it shows that it’s being virulent or changing its character, then we can take the risk of having surgery or radiation. But we would not take that risk if it’s unnecessary if we saw something that was not changing much over time and a threat to the patient.

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