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.

Kidney Stones Pain, Symptoms and Treatment

Kidney stone disease is a common issue that affects men and women alike. There are many factors that can be attributed to developing kidney stones. According to Dr. Amar J. Raval, “Kidney stone disease is very prevalent in Florida because of heat and lack of hydration.” The state’s warm climate helps induce sweating and makes it easier to dehydrate, putting people who live there at a higher risk of developing stones.

In addition to climate, there are several other factors that can increase kidney stone likelihood. Family history is one factor. If someone in your family has a history of developing stones, you are at greater risk of developing them as well. Diets high in protein, salt and sugar also increase the risk. Salt especially is known to increase the amount of calcium your kidneys must filter, raising the chances of stone development. Certain conditions like irritable bowel syndrome and urinary tract infections are also known to increase kidney stone risk.

Urologist Dr. Amar Raval of Palm Harbor, FLThere are numerous symptoms associated with kidney stones and they can vary in seriousness and pain level. Doctors often see patients with acute onset pain in the upper abdomen that does not resolve with medication, nausea, fever, chills, difficulty urinating and even blood in the urine. The symptoms of kidney stones may present themselves differently depending on many different factors. It is important to know when something is not right and when it may be best to see a urologist for help.

Luckily for people suffering from kidney stones, there are many treatments doctors can use to help them. Many of the treatments are endoscopic, not requiring incisions and are minimally invasive. For instance, doctors may insert a stint into the urinary tract to allow the patient to pass the stone. Shock waves also can be used to break large stones into smaller more easily passable pieces. The shock wave treatment also is not invasive. Doctors can use lasers to break off a piece of the stone for a biopsy to determine exactly what kind of stone it is and what the best treatment may be.

Consulting a trusted urologist for diagnosis and treatment options for kidney stones is very important. Like many conditions, kidney stone treatment is easiest when caught early. Urologists like Dr. Amar J. Raval at the Advanced Urology Institute help many patients with kidney stones. They are familiar with kidney stone disease as well as the latest medical technology, and can provide the most advanced treatment options for their patients. 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.

How Does Dr. David Harris Diagnose & Treat Bladder Cancer?

KEY TAKEAWAYS:

  • Bladder cancer diagnosis typically begins with identifying blood in the urine, followed by further urinalysis tests, x-rays, and a bladder exam. Most tumors found in the bladder are non-invasive and highly treatable.
  • Treatment plans for bladder cancer often involve surgical intervention, radiation, and chemotherapy. In some cases, a radical cystectomy (removal of the bladder) may be necessary.
  • The prognosis for patients with bladder cancer is generally good, with a 5-year survival rate of 77% and a 15-year survival rate of 65%. Patients may need ongoing regular treatment and should keep all follow-up appointments.

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

How Is Bladder Cancer Diagnosed?

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

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

How Is Bladder Cancer Treated?

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

What Is The Prognosis For Patients With Bladder Cancer?

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

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

TRANSCRIPTION:

My name is David Harris and I’m a urologist with Advanced Urology Institute in Fort Myers. So if a patient comes to us with blood in the urine, and there may be blood that the patient sees, it also may be blood discovered on urine testing, then we’re able to tell by looking at those test results, does that patient need to be worked up for this? And there’s an evaluation that includes urine testing, x-ray imaging, CAT scans, and cystoscopy, which is an exam of the bladder. And if we find a tumor, that tumor would be not just biopsied, but removed from inside the bladder. And most bladder cancers that we find are lower grade and what we call non-invasive. These are tumors of the lining, and fortunately there are good treatments for those. And what we’re doing for those is instilling into the bladder medications that have a good efficacy rate to treat those. So we’re trying to preserve bladders, trying to minimize problems with quality of life, and depending on the different tumor findings, there’s different agents we use and we need to match up the right patient with the right treatment.

REFERENCES:

Screening for Prostate Cancer – Dr. Brian Hale

Urologist Dr. Brian Hale recommends that men over 50 years old be checked regularly for prostate cancer. It is the second most common cause of cancer deaths in men and it increases in likelihood as men age. Tests such as the PSA can help detect prostate cancer in its early stages when treatment is most effective.

The most common way to screen for prostate cancer is the prostate-specific antigen (PSA) test. The PSA test is simple and works like this: Both cancerous and noncancerous prostate tissues create protein, and small amounts of that protein will enter the bloodstream. Prostate cancer cells produce more proteins than noncancerous ones, so if cancer cells are present there will be an increase in the proteins in the blood. The PSA test works by checking the blood for increased protein levels.

Dr. Brian Hale: Board Certified UrologistThere are pros and cons to PSA screening for prostate cancer. PSA tests can show increases in proteins when cancerous tissue is not actually present. This is called a false positive and can cause a great deal of stress for the patient and lead to more invasive tests that may not be necessary. For these reasons, among others, PSA tests were not recommended to patients for a period of time.

A few years after PSA tests stopped being recommended, Dr. Hale began noticing a troubling trend. He began seeing an increasingly large number of patients with prostate cancers that had metastasized, which is when it spreads to other parts of the body. This happens when prostate cancer goes undetected and has time to grow untreated. Dr. Hale noticed a correlation between the time PSA screening stopped being recommended and the up-tick in cases of fast-growing and metastasized cancers.

Because of this finding, Dr. Hale recommends that men continue PSA screening as part of their preventative care. Although it may not be a perfect test, its pros far outweigh its cons. Prostate cancer, when caught early is far easier to treat, and can often be treated with less extreme methods. Prostate cancers that have metastasized can be trickier and far more expensive to treat. Although some men may not like blood tests, it is better to take a simple blood test and catch an issue early than it is to let prostate cancer spread and turn into a much more serious medical problem.

As you age, it is important to take care of yourself and see the right doctors to discuss what is best for you. Dedicated urologists like Dr. Brian Hale at the Advance Institute of Urology have been discussing these issues with their patients for many years and will continue looking out for them. For more information, visit the Advanced Urology Institute website.

Understanding Common Prostate Problems

The prostate gland is a uniquely male body organ. It is small, walnut-shaped and located just under the bladder. The urethra passes through it, carrying both urine and semen. Its main job is to make fluid for the semen.

Many different prostate problems have similar symptoms. If a person experiences these symptoms, it is time to see a urologist. For example, a man may find his urine flow to be too slow or have difficulty urinating. Or he may have the sudden uncontrollable urge to urinate that can cause leaking. Occasional leakage may occur if the urge comes when there is no restroom nearby.

But if such urges happen frequently and too quickly to reach facilities, there may be a problem. If there is a need to struggle or strain to maintain a urine flow, or if the flow is abnormally slow for more than a few days, it is time to talk to your doctor. Pain in the scrotum or penis or a feeling that the bladder is still full after urinating can be indications of a problem. Any combination of these symptoms should be reason to contact a urologist or your primary care doctor as soon as possible.

Some symptoms require prompt attention. You should go to an emergency room if your urine has blood in it or a cloudy appearance, if it develops a very strong unusual smell or if you experience severe pain when urinating. Seek immediate medical attention if you develop a fever, chills or strong body aches in the pelvic region.

Prostate cancer is the most frequently diagnosed cancer in men. Nearly one out of every ten men will develop it in their senior years. Most prostate cancers grow slowly, so quality of life over a long period of time is the issue. There are many effective treatments that, unfortunately, have side-effects men find difficult to discuss. Although prostate cancer is not necessarily a terminal illness, it can be. It is important to see a doctor about symptoms because an early diagnosis increases the likelihood of successfully managing and outliving the condition.

PSA tests are good indicators of the health of the prostate, but slowly increasing levels may mean doing more testing. A PSA test looks for a prostate-specific antigen (PSA) in the bloodstream. Modern medical science is still trying to figure out how quickly and how much to do when PSA tests are abnormal. Your urologist will have the latest information for determining proper treatment.

Benign prostatic hyperplasia (BPH) is one medical condition that, like cancer, often has no clearly known reason for happening. Doctors do know that it often responds to certain types of treatments, albeit not the same way for each person. Any change in the size of the prostate, such as from cancer or from an enlarged prostate, puts pressure on the urethra, affecting urine flow and the ability to properly urinate.

The board-certified urologists at the Advanced Urology Institute are all qualified to diagnose and treat prostate problems with the best options available today. For more information, visit the Advanced Urology Institute website.

What Do Physician Assistants Do? – Mikhail Lezhak, PA

Ask Mikhail Lezhak what physician assistants do and you may be surprised by the answer. In the past, all professional medical care was performed by doctors and nurses. But doctors and nurses often spent a lot of time doing repetitive work that limited the time they had to focus on their specialty.

Mikhail Lezhak, Physician AssistantPhysician assistants, especially those in urology, may be called upon to do any of these things to assist the doctor:

  • Patient history checks, both directly with the patient and with recorded medical records. They will review records and update records. Based on what they learn, they will brief their supervising physicians about anything noteworthy
  • Perform physical exams. They can do the basic exams, but they also are trained to spot symptoms that require more advanced medical care
  • Order and interpret basic laboratory tests
  • For many relatively minor types of injuries, they may be qualified to handle the direct treatment
  • Assist surgeons doing surgical procedures
  • Perform minor surgical procedures, including suturing (making stitches); immunizations and injections; setting up, monitoring and removing intravenous feeds
  • Perform preoperative and postoperative care, including managing infection prevention
  • Prescribe medications as permitted
  • Provide patient counseling on medical issues, including self-care and follow-up
  • Set up health management plans and diets
  • Assist in maintaining a healthy, safe and sanitary healthcare environment, in accordance with health laws, regulations and accepted medical practices
  • Help maintain the proper stocks of medical supplies
  • Work with administrators and administrative staff to assure a more smoothly operating medical care environment

Essentially, PAs perform tasks that free up their supervising doctors for more difficult and complicated health issues. If this job sounds a lot like what nurses do, you are right. There is considerable overlap of responsibilities within medical communities.

In Florida, physician assistants do have a limited ability to prescribe and dispense medications. The ability for PAs to prescribe drugs is based on a written agreement between the PAs and their supervising board-certified doctors. That written agreement must have the following:

  • Effective for only five years, whereupon a new license is required
  • Requires the PA to take 10 continuing medical education credits before each license renewal period, including three hours about safe and effective prescribing of controlled substances
  • Only effective with that one PA-doctor agreement; it must be remade if the supervising doctor changes
  • Filed with the Florida Board of Medicine

There are some drugs that a PA cannot prescribe. For example, a PA working in urology cannot prescribe many of the same drugs that a PA working in psychiatry would prescribe, and vice-versa. Thus, there is local accountability for physician assistants within Florida about how they handle drugs.

Supervising doctors may have their PAs handle such duties as researching new medical device company products and keep the doctors advised on new drug formularies. PAs may be asked to scan medical journals for interesting issues as well as follow interesting and related legal cases involving their profession. They may help in medical research.

Just like nurses and nurse practitioners, PAs help the system run more smoothly by letting those who specialize spend more time on their side of the practice. The doctors can function more professionally as medical experts, and administrators can spend more time working with business management.

When you see Mikhail Lezhak, PA, at Advanced Urology Institute, you are seeing someone who has a wealth of training and experience in many of the same functions performed by a licensed medical doctor. Rest assured that your doctor still has you in good hands when your visit is with a medical professional who is a PA. For more information about physician assistants, visit the Advanced Urology Institute website.

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

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

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

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

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

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

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

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

Erectile Dysfunction Treatment Options

Although it is very common, erectile dysfunction can be an embarrassing subject to discuss even with medical professionals. ED can affect men of all ages and can be caused by a variety of factors, so a wide range of treatment options are available.

How Is Erectile Dysfunction Diagnosed?

According to the Mayo Clinic, ED is the chronic inability to get and maintain an erection. It can be diagnosed by talking with a doctor, ideally a urologist, about the patient’s medical history. The doctor may perform a series of tests, including a physical exam, blood or urine tests, an ultrasound, or even a psychological examination to determine if mental health is a factor in the patient’s erectile dysfunction. Sometimes ED is connected to another underlying issue. All of these factors come into play when determining treatment.

What Are The Treatment Options For Erectile Dysfunction?

Mikhail Lezhak, PA of Daytona Beach, FLThere are many potential steps to be taken in the ED treatment process. The first step, especially when the patient is a younger man, is usually medical management. Doctors may prescribe common medications like Viagra or Cialis. Both medications are taken only when needed. They do not help cause an erection until the patient has already become sexually stimulated. They are safe, commonly prescribed medications; however, they can cause serious side effects in combination with other medicines, especially nitrates.

For many patients, Viagra or Cialis is enough to help solve the problem of erectile dysfunction. If, however, they are not, another option is a penile injection. The initial penile injection may be given at the doctor’s office as a way to introduce the patient to the process. After this introduction, the patient can self-administer the injections at home as needed.

When these medications are not enough to solve a patient’s erectile dysfunction, another option is penile implant surgery. This is only recommended in cases where no other treatment option has been successful and when the patient’s ED has no chance of being reversed. There are a variety of penile implants on the market to accommodate a patient’s lifestyle and needs.

Erectile dysfunction can lead to feelings of embarrassment and shame, relationship difficulties and lowered self-confidence. However, there is no need to worry that these issues will last a lifetime. With the wide range of treatment options available, ED can be managed, allowing patients to resume normal sexual activity after consulting with their doctor. Our team of urologists at Advanced Urology Institute have extensive experience in working with patients experiencing erectile dysfunction. For more information, visit the Advanced Urology Institute website.

How Did Janelle Bunce, PA Become a Physician Assistant?

KEY TAKEAWAYS:

  • Physician assistants play an important and involved role in patient care, and can complete their degree programs in as few as six years.
  • Physician assistants in urology can address a variety of medical issues, such as urinary incontinence, kidney stones, vaginal prolapse, and overactive bladder, assisting doctors in treating a wide range of conditions.
  • Janelle Bunce, PA is a dedicated physician assistant in urology who began assisting doctors within six years of starting her degree program and enjoys working with a team of healthcare professionals to ensure top-notch patient care.

The field of medicine offers many opportunities for people who want to dedicate their lives to helping others. With hard work and study, almost anyone with a desire to work in healthcare can achieve that dream. One growing role in this field is that of the physician assistant who plays an important and involved role in patient care.

Unlike doctors, who spend up to a decade or longer in training, physician assistants can complete their degree programs in as few as six years. This makes earning credentials and beginning a rewarding career less costly and achievable in less time.

Janelle Bunce, PA from Naples, FLAlthough they may not be doctors, physician assistants have some of the most important jobs in healthcare and carry a great deal of responsibility. They assist with surgeries, see patients independently and take an active role in decision making with the doctors. They are an important part of the patient experience and share in the satisfaction of participating in overall patient care.

Physician assistants in the field of urology address a variety medical issues. From urinary incontinence, kidney stones and vaginal prolapse to an overactive bladder, a physician assistant in the specialization of female urology can assist doctors in treating a wide range of conditions while creating lasting relationships with their patients.

One physician assistant who is enjoying a rewarding career in urology is Janelle Bunce, PA. The educational requirements made it possible for her to begin assisting doctors within six years of beginning the required degree program. Janelle enjoys working with a team of nurses and doctors to ensure that her patients receive top-notch care. Her story and success are an inspiration to anyone with a desire to pursue a career in medicine.

Dedicated urology physician assistants, like Janelle Bunce, PA can be found providing excellent patient care every day at the Advanced Urology Institute. For more information, visit the Advanced Urology Institute website or make an appointment for a consultation today.

TRANSCRIPTION: 

My name is Janelle Bunce, I’m a physician assistant with Advanced Urology Institute.

I was a single mother actually and I started college when my daughter was six weeks old and physician assistant field was a place in medicine that you could advance pretty far. We can assist with surgery, we can see patients independently and yet it wasn’t a prolonged education where I needed to be in school ten to twelve years, it was six and a half years. 

I have a masters degree so I started my undergrad degree in biology and then went on to the PA program which was a masters of medical science. I decided to be a physician assistant because this is an area that we can help people from birth to death. In particular urology has a lot to do with quality of life. I like that it’s a nice mix of autonomy but also there’s always a supervising physician that we can bounce ideas against and we work together as a team with our supervising physician.

REFERENCES: 

Becoming a Physician Assistant with Quynh-Dao Tonnu, PA-C

While certified physician assistants (PA-C) are not the same as American Medical Association board-certified medical doctors, they are competent medical professionals. Physician assistants often go into medicine later in life, having already worked in other occupations.

Quynh-Dao Tonnu, PA-CCertified physician assistants go through a rigorous graduate-level training program that takes more than two years to complete. The degree program must be accredited by both the Committee on Allied Health, Education and Accreditation, and the Accreditation Review Commission on Education for the Physician Assistant. After successful completion of the academic portions, the graduates must pass the national Physician Assistant National Certifying Exam. The final stages include formal application with the Florida Board of Medicine and completion of 2,000 hours (about one year) of supervised clinical practice.

Physician assistants are important within medical practices because they relieve the physicians of much of the routine workload. They take medical histories and, because of their medical training and experience, they are able to notice when a patient has a special issue the primary physician should be aware of. They can understand medical histories written by other medical professionals and understand their patients’ backgrounds. For example, some fad diets can seriously affect a person’s digestive system, kidneys, urinary tract and bladder. An experienced PA knows when to ask patients if they have been on such diets.

With a solid understanding of pharmaceutical medicine, physician assistants can prescribe medications or recommend that the physician prescribe certain types of medications. PAs also approve prescription refills according to the physician’s practice and standard medical guidelines. If a patient has questions about how and when to take medications, PAs can give that information.

Quynh-Dao Tonnu, PA-C started her post-secondary education at the University of Florida, where she received her BA in Economics in 2005. Later in 2007, she completed a master’s degree at the University of South Florida in Library and Information Science. After that, she worked in hedge fund accounting, which she found interesting but not very personally fulfilling. In 2014, she changed occupations to become a medical assistant. She realized her most fulfilling job experiences involved working with people, so she went back to school and obtained her Physician Assistant degree in 2017. She has been working in urology for three years and is now fully certified. You can meet this talented PA at the Advanced Urology Institute Oxford office. For more information, visit the Advanced Urology Institute website.

Symptoms & Treatment of Kidney Stones

Kidney stones are a serious and painful medical issue. They cause a wide range of symptoms and can be treated in different ways depending on their size and the patient. Understanding the symptoms of kidney stones and the treatment options available are essential to passing them.

No two people are the same and the symptoms of kidney stones can vary from patient to patient. Some of the most common symptoms are pain in the back or belly, pain or burning during urination, a frequent and urgent need to urinate, urinating in small amounts, and cloudy or bloody urine. Someone experiencing these symptoms most likely has kidney stones and may need to consult a urologist for help.

One of the most troubling symptoms is the pain caused by kidney stones. Some female patients say the pain caused by the stones is worse than being in labor. In many cases, the person with kidney stones may suffer from nausea and vomiting. Although stones can often be passed by the patient on their own, in some cases medical assistance is required.

Treatment for kidney stones is done on a case-by-case basis, with the doctor examining the patient to determine the best treatment method for the individual. For patients experiencing pain, but who may be able to pass the kidney stone, the doctor may prescribe medication to ease the pain and make them comfortable as they wait for the stone to pass. In more serious cases, the doctor may need to surgically remove the stones or bypass them to drain urine and relieve pain.

A new way to remove large painful stones without surgery is Shock Wave Lithotripsy (SWL). With this non-invasive method the stones are broken up by a shock wave of energy focused on the point where the kidney stone is located. This shock wave breaks the kidney stone into a fine powder that is easier for the patient to pass. In severe cases, the doctor will enter with a scope through the urinary tract or kidney and destroy the stones with a laser.

Relief from the pain of kidney stones can be found at the Advanced Urology Institute, where experienced physicians determine the best treatment method available for each patient. For more information, visit the Advanced Urology Institute website.

Kidney stones: What are the treatment options?

If you’ve been diagnosed or suspect you have kidney stones, you will want to know about your options for treatment right away.

Kidney Stones: What are they?

Kidney stones are technically referred to as renal calculi. They are solid entities formed of different types of crystals. When they become large, they are extremely painful. They are called kidney stones because they usually start forming in the kidneys, but they can develop anywhere along the urinary tract, including

  • kidneys
  • ureter
  • bladder
  • urethra

What Causes Kidney Stones?

Kidney stones have several variations, and they originate for different reasons. Some of the causes are:

  • Calcium. Calcium-based stones are the most common type and somewhat preventable by avoiding high oxalate-rich foods like potato chips, peanuts, chocolate, beets and spinach. Ironically, although some kidney stones form from calcium, getting sufficient calcium in your food can prevent these stones.
  • Uric acid. These kidney stones are found more often in men than women. They develop when the urine becomes too acidic due to a diet high in purines (animal proteins) like fish, shellfish and some meats.
    Struvite. Struvite stones are more often found in women who have urinary tract infections or a kidney infection.
  • Cystine. Cystine stones are less common. They are hereditary and caused by leakage of cystine into the urine from the kidneys.

What Treatment is Available for Kidney Stones?

If the stones don’t go away by passing naturally through the urogenital system, you should contact a urologist for treatment. There are several procedures they can employ to remove the stones. The type of treatment depends on the size of the stones and type of stone.

Here are some treatments your urologist might recommend:

  • Medication: The urologist may prescribe pain medications and/or antibiotics in case of an infection. Other medicines also may be prescribed depending on what type of kidney stone is found, including: allopurinol for uric acid stones; diuretics to avoid calcium stones; sodium citrate or sodium bicarbonate, which makes the urine less acidic; or phosphorus solutions which are found to prevent calcium stones from forming.
  • Modern methods of breaking up the stones like lithotripsy, in which sound waves are employed, so stones are more easily passed.
  • Tunnel surgery is a minimally invasive procedure in which the urologist makes a small incision on your back to retrieve the stones.
  • Ureteroscopy: If a kidney stone is lodged in the bladder or ureter your urologist may use a ureteroscope to retrieve it. In this procedure a thin wire with an attached camera is inserted into the urethra and bladder, and then the stones are retrieved. Stones are examined by a lab to give more insight into the type of stones being formed.

Kidney Stone Prevention

If you are prone to kidney stones, try to drink 6 to 8 glasses of water each day to increase urine flow. This preventative measure helps flush out the kidneys. Your urologist may prescribe medication to help prevent future types of stones from forming.

If you think you have kidney stones you will want to speak with a qualified doctor to discuss the best methods to prevent and treat them. If you are in Florida, call the Advanced Urology Institute for an appointment with a board certified urologist.

How Do I Know If I Have a Kidney Stone

Kidney stones is the common term for the medical condition of renal lithiasis or nephrolithiasis. The stones are made up of salts and minerals that form into hard deposits inside your kidneys.

Kidney stones can be caused by many different factors and can show up in different sections of your urinary tract. They may travel from the kidneys to your bladder, and from the bladder to the ureter. Sometimes kidney stones occur when the urine is too concentrated, which allows minerals to coalesce and crystallize. Heeding early signs like painful urination and an irregular urge to pee can help you seek medical help earlier and get treatment.

Pain from Kidney Stones

How can you be sure that kidney stones are causing your pain?
Because there are other maladies that have similar symptoms to kidney stones, a visit to your urologist may save you from uneccesary grief. Some symptoms of kidney stones include:

  • Acute pain below the ribs on the side of your body or in your back. The pain may intensify or shift to various locations as the stones travel along the urinary tract.
  • Pain located in the lower abdomen or groin
  • Pain that fluctuates in severity
  • Painful urination
  • Cloudy or discolored urine (pink, red or brown)
  • Foul-smelling urine
  • Persistent need to urinate or urinating more than usual
  • Urinating in small amounts
  • Nausea and consequent vomiting
  • Chills and fever due to associated infection

You could have just one of these symptoms or several. If you are experiencing severe discomfort along with nausea or blood in your urine, you should seek medical help.

Kidney stones do not usually cause any permanent damage if treated early and correctly. You may be able to drink plentiful amounts of water, take a pain medication, and be able to pass the stone on your own. However, if the stones get lodged in the urinary tract or cause a urinary infection, more aggressive treatment may be in order.

Tests for Kidney Stones

There are several ways your doctor can test for kidney stones that will also reveal their size and precise location. These tests include:

  • Imaging tests: The imaging technology to determine if you have kidney stones includes X-rays, CT scans and ultrasounds.
    CT scans are more thorough than X-rays and result in lucid composite images of kidney stones. Ultrasound is also used to create images of the affected area.
  • Blood tests: Your doctor can determine if your have too much uric acid or calcium in the blood, which can cause kidney stones to form.
  • Urine tests: These lab tests can detect minerals that cause kidney stones in your urine. They can also reveal if you lack elements that prevent stones from forming.

Treatment for Kidney Stones

Your doctor can determine if sound-wave therapy can resolve the problem or if surgery is indicated due to stones being too large to pass, causing infection or other damage. If you are able to pass the stone on your own, saving it for your urologist to examine can help your doctor determine what causes your stones and what can be done to prevent additional ones from forming.

If you would like more information about kidney stones and their treatment, schedule a consultation at the Advanced Urology Institute location nearest you or visit the website.