Symptoms of Kidney Stones -Beyond the Basics


Kidney stones occur when hard deposits (minerals and salts) form inside the kidney. They vary in size and may travel to other parts of the urinary tract. While small stones may not produce any symptoms, some people complain of severe pain in different parts of the body. The excruciating pain can be likened to that of childbirth. Here is a quick guide on common symptoms of kidney stones.

1. Urge to urinate or frequent urination

Most people with kidney stones feel the urge to urinate. However, this will depend on where the stone is located. Those that are close to the bladder can irritate the walls and make the patient feel an urgent need to use the bathroom. These contractions may even occur when the bladder is empty. Keep in mind that unless the stone has moved to the urethra, there is no trouble when urinating.

2. Pain in the groin, back or side

Patients who experience pain around the groin or the lower abdomen may need a diagnosis for kidney stones. The pain also can occur under the rib cage or on the back side. It starts as a dull ache that escalates to sharp wincing pain. And it’s very episodic – it can be severe one minute and then completely subsides. The pain may be mild or barely noticeable. The patient may need to seek medical attention if the pain is very intense.

3. Nausea and vomiting

These two symptoms occur when the stones interrupt the flow of urine. It’s worth mentioning that stretching of the kidneys can cause gastrointestinal upset. And the worst part is that this pain does not subside even after making changes in body position. When patients vomit, they get dehydrated so additional fluids are recommended.

4. Blood in the urine

In advanced stages, a kidney stone can cause blood in the urine. The blood is only visible with dipstick testing or when examined with a microscope. People who spot pink or reddish urine should see a urologist immediately. Sometimes the urine may look like tea. This could be an underlying symptom to a more serious condition.

5. Fever

While this is not a common symptom for kidney stones, it occurs when patients have an infection in the problem area. According to experts, fever can occur when the stones block the flow of urine, which could be an emergency situation. And because the antibiotics can’t penetrate to an obstructed kidney, the obstruction must be relieved. Fortunately some stones may pass on their own without treatment.

Need the services of a urologist? Visit Advanced Urology Institute for professional treatment. Here you’ll find Dr. David Burday and other practicing urologists. They will do their best to put you at ease. For more information on treatment of kidney stones and other urological problems, visit our “Advanced Urology Institute” site.

Signs and Symptoms of Low Testosterone

Low testosterone (hypogonadism) is increasingly becoming a serious health concern for men. More men are being diagnosed with the condition, with studies indicating that 4 out of 10 men who are 45 and older have low testosterone (low-T). Likewise, 25 percent of men between 30 and 79 have low-T while about 50 percent of men over 80 have the condition. In fact, low testosterone is so common in men of various ages that numerous TV commercials have been created to make money promoting low-T solutions.

So what is low testosterone?

Also known as Testosterone Deficiency (TD), low-T refers to abnormal blood levels of the male hormone testosterone. The condition is characterized by testosterone levels below 300 ng/dl (nanograms per deciliter) in male patients when the measurement is done correctly. While low-T problems primarily occur in adult males, they are not restricted to male adults. However, when the condition occurs in women and young men, its definition and characterization are slightly different and less clear than for male adults.

Symptoms of low testosterone

Although the symptoms of low-T may differ from one man to another, the most common sexual signs are fewer and weaker erections and reduced sex drive, while non-sexual indicators are depression, low iron levels, increased fat around the waist and lack of energy. Other symptoms of low-T are reduced lean muscle mass, erectile dysfunction, irritability, absent or reduced orgasm, reduction or loss of facial, armpit or pubic hair, sleep disturbances, reduction in strength, sweating or hot flashes, breast enlargement or discomfort, reduction in testes size and memory reduction. Other signs observed only in tests or by doctor examination include osteoporosis, anemia, increased body fat and absent or reduced sperm production.

Treatment of low testosterone

While there are several options for treating low-T, the right treatment for any patient depends on various factors, including the severity of the symptoms, cause of the condition and the patient’s preferences. For instance, if the low-T is caused by lifestyle, a change of habits such as losing weight may be an effective and natural way to boost testosterone levels. Similarly, testosterone levels can be enhanced through supplementation. For men having bothersome or worrisome symptoms such as depression, testosterone replacement therapy (TRT) applied as a skin gel or a regimen of regular injections can improve testosterone levels and alleviate the symptoms.

At Advanced Urology Institute, we recognize that low testosterone is a common burden on many men. We endeavor to provide viable solutions including the safest and most effective testosterone replacement therapy for the needs of all our patients. Driven by the belief that every patient is unique and may suffer from serious complications if treatment is generalized, we deliver a highly personalized replacement therapy to our patients. We also follow our patients very closely and ensure we give testosterone therapy the right way. For more information on safe and effective treatment of low-T, visit the “Advanced Urology Institute” site.

What is Da Vinci Robotic Prostatectomy?

The da Vinci system is a revolutionary, minimally-invasive surgical robot for treating prostate cancer. Designed by Intuitive Surgical to help overcome the shortcomings of both the traditional laparoscopic prostatectomy and open prostatectomy, the da Vinci system enables a surgeon to conduct highly precise, nerve-sparing surgery using several dime-shaped incisions. With the da Vinci surgical procedure, entire cancerous tissue or prostate can be removed, cancer completely eradicated and internal repair achieved without interference with sexual function, potency and bladder control.

Also called robotic prostatectomy, the da Vinci uses a finely-controlled robotic apparatus, including micro-surgical instruments and high-resolution cameras, to perform prostate surgery safely, achieving faster patient recovery and better treatment outcomes.

High-Precision Prostatectomy

During da Vinci robotic surgery, urologists use the “motion scaling” feature on the system to convert subtle hand movements made outside the body into extremely precise and accurate movements inside the body. The urologist controls the robotic arms of the da Vinci console by applying natural wrist and hand movements. Through motion scaling, filtration and seamless translation of hand-and-wrist movements, the urologist can achieve greater precision that is normally not achievable during traditional laparoscopic and open surgery procedures. The da Vinci system not only provides urologists with enhanced dexterity, range of motion and flexibility, but also enables surgeons to safely access difficult-to-operate areas of the pelvis, abdomen and closed chest. The robot also filters and eliminates unpredictable hand movements and hand tremors that may occur during the operation.

Computerized 3-D Visualization

The da Vinci system dramatically improves visualization by providing a sharper and brighter view than can be seen during traditional laparoscopic endoscopes and by the eye during open surgery. The robotic system comes with a proprietary camera, enabling the surgeon to zoom in, rotate and even change image visualization. As a result, the 3-D image produced is clearer and brighter, and with no flickers as seen in traditional laparoscopic systems.

Even though the da Vinci robotic prostatectomy is a remote procedure, urologists have the feeling that their hands are fully immersed in the body and are able to complete all the necessary procedures efficiently. With the 3-D visualization and robotic hand simulation, the da Vinci system enables urologists to perform highly complex procedures more effectively than traditional laparoscopic surgery or open surgery.

Getting da Vinci Prostatectomy at Advanced Urology Institute

At Advanced Urology Institute, the da Vinci prostatectomy patients are usually discharged 24 hours after their operation. The system is used at AUI because it has superior benefits to traditional laparoscopic prostatectomy or open prostate surgery. The benefits of the da Vinci prostate surgery include:

  1. Reduced pain and higher nerve-sparing rate.
  2. Shorter hospitalization, with most patients going home the next day.
  3. Minimal blood loss, fewer transfusions and reduced risk of complications (such as impotence and incontinence).
  4. Quicker return to pre-surgery erectile function and urinary continence.
  5. Faster return to routine activities.

Are you looking for a da Vinci urologist near you? You can check out this life-changing technology at Advanced Urology Institute. For more information, visit the “’Advanced Urology Institute” site.

Types of Prostate Cancer

Prostate cancer refers to an uncontrollable accumulation of cells in the prostate gland. When the cancer occurs it means the ability to control the multiplication, growth and death of prostate cells has been lost. The prostate cells form abnormal cells that join into masses known as tumors. Once formed, a tumor can remain at its original location and not spread to any location outside the prostate. Such a tumor is called a primary tumor. But some spread to other areas of the body outside the prostate and are called secondary tumors.

Prostate Cancer Is Generally Slow-Growing

Most prostate cancers are relatively slow-growing. This means that a prostate tumor typically takes many years to grow and reach a size that is detectable. Likewise, it usually takes even a longer time for prostate cancer to spread beyond the prostate. Nevertheless, in a small percentage of men, prostate cancer can grow rapidly and spread aggressively to other areas. Because of this, it is quite difficult to know with certainty which prostate cancers are likely to grow slowly and which ones are likely to grow aggressively. It can be quite difficult to make the right treatment decisions.

Aggressive Versus Indolent Prostate Cancer

While there are many types of prostate cancers, urologists usually break them down into aggressive and indolent categories to make it easier to determine the right treatment and to treat various types of cancers effectively. Aggressive cancer is a high-risk prostate tumor that if not treated remains highly active and very likely to spread to areas outside the prostate gland. The cancer grows quickly, spreads early, rapidly and widely, and causes increased damage in the body. Because aggressive cancer spreads as secondary deposits and can quickly result in widespread damage, it progresses rapidly to advanced stage cancer and can be very difficult to treat. So for aggressive prostate cancers to be treated successfully, they should be diagnosed early and treatment should be started when the tumors are still in their early stages.

On the other hand, indolent prostate cancer is a low-risk, slow-growing and low-volume tumor that can sit in the prostate gland for many years without causing any problems. An indolent cancer is not likely to spread outside the prostate even if not treated. But if it does, the spread will be local and slow. In fact, patients with indolent prostate cancers can live for 10-20 years without the cancer causing any serious effects on their lives.

Identifying Aggressive Prostate Cancer

When a patient is diagnosed with prostate cancer, the urologist will take a biopsy of the prostate gland to make sure the cells are checked under the microscope to determine whether the cancer is aggressive or indolent.

Various cancer cells are examined and their activity graded using the Gleason score. When the microscopic exam returns a Gleason score greater than 7 for cancer that has not spread beyond the prostate, the cancer is classified as aggressive and the patient is given the appropriate treatment. However, if the Gleason score is 7 or below, the prostate cancer may be classified as indolent, depending on other patient factors.

The Gleason score also helps the urologist to decide the appropriate treatment. For instance, if it is an early-stage, slow-growing cancer with a score of 6 or below, the urologist may recommend active surveillance, which means that treatment is postponed and the patient is closely monitored for progress, such as whether the tumor is spreading or worsening. But to determine whether active surveillance is ideal, the urologist also will have to consider factors such as the patient’s life expectancy, overall health and concomitant illnesses. For aggressive cancer, the urologist will work with other doctors to create a treatment plan.

At Advanced Urology Institute in Florida we have a knowledgeable and experienced team of urologists to help diagnose and treat all types of prostate cancers. Our multidisciplinary approach to treatment ensures that even the most aggressive forms of cancer are treated safely and effectively. For more information on the screening, diagnosis, treatment, care and support for prostate cancer, visit the “Advanced Urology Institute” site.

New Treatment Options for Erectile Dysfunction

Statistically, 50 percent of all men experience erectile dysfunction (ED) at some point of their life, with the risk of ED increasing with age. Roughly 30 million men in the United States suffer from ED, a condition that causes frustration and the breakdown of marriages and self-confidence.

Evolution of Erectile Dysfunction Treatments

Over the years, the medical management of erectile dysfunction has evolved greatly. For instance, before oral phosphodiesterase inhibitors (PDESi) like Cialis, Standra, Viagra, Levitra and related medications were introduced, doctors could administer one of only two effective treatments for erectile dysfunction: surgical penile revascularization and implantation of a penile prosthesis.

The emergence of Viagra and related oral drugs for ED ushered in a new age of non-invasive treatment of the condition. These drugs relax the muscles in the penis and increase blood flow, allowing patients to have an erection. However, while these drugs are helpful for many men, they are not safe for men with high blood pressure, severe liver disease, kidney disease, or who take nitrate drugs. The drugs also come with side effects such as a runny or stuffy nose, dizziness, fainting and blurred vision. Because of these limitations, doctors have continuously looked for new treatment options for erectile dysfunction.

New Treatment Options

New treatment options for ED include:

  1. Injection therapy: Drugs such as alprostadil (sold under the names Edex, Caverject and Prostin VR) and the suppository-form of alprostadil (sold as MUSE) are currently available to patients. Alprostadil causes expansion of blood vessels and increased blood flow to the penis, enabling patients to get erections.
  2. Extracorporeal shock-wave therapy (ESWT): Also called acoustical wave therapy or linear shockwave therapy, ESWT uses high-frequency acoustical waves for treatment of the root cause of ED. During treatment, the waves are used to open and repair blood vessels in the penis. The therapy improves blood flow in the penis by creating new blood vessels or rejuvenating existing ones, which in turn increases the patient’s ability to get an erection.
  3. Melanocortin activators: These drugs stimulate erection by acting through the central nervous system. For instance, the drug PT-141 is effective in stimulating erection when given through the nose to men with mild-to-moderate non-medical (emotional or psychological) erectile dysfunction.
  4. Topiglan: This is a cream that is applied to the penis. Topiglan contains alprostadil, the same drug that is injected or applied as suppository by men with ED.
  5. Uprima (apomorphine): Working to stimulate the secretion of the brain chemical dopamine, Uprima heightens sexual interest and increases sensations. It comes in tablet form that easily dissolves under the tongue. However, because of its major side effects of nausea and vomiting, research is still going on to find a nasal spray alternative that causes less nausea but is equally effective.
  6. Gene therapy: The therapy delivers genes that help generate proteins or products that can replace those that are not functioning well in the penile tissues of men with ED. While experimental use of gene therapy has reported tremendous success, regulatory approval and the public’s acceptance of the therapy may still take some time.

If you are suffering from erectile dysfunction, consider your options carefully. Talk to your urologist openly. Effective treatment of ED can improve your quality of life, ability to maintain intimate relationships and boost your self-esteem. At Advanced Urology Institute, we are always improving our range of treatment options to give the very best to our patients. When you visit our urology center in Florida, you can be sure that you will have a broad range of treatment options, including the very latest, for erectile dysfunction. For more information on diagnosis and treatment of erectile dysfunction, visit the “Advanced Urology Institute” site.

Common Treatment Options for Stress Incontinence

The treatment that a urologist may recommend for stress incontinence depends on how troubling the condition is to the woman and on the woman’s general fitness level. Often, the urologist will opt for fairly simple treatment options for a less troubling condition and only recommend surgical treatments when absolutely necessary. For instance, if an overactive bladder is present, the urologist will determine the possible contributing factors and recommend deterrent treatments such as fluid modification and caffeine reduction. Likewise, for women whose body mass index (BMI) is equal to or over 30kg/m2, the urologist will recommend weight loss.

Generally, the most common treatments for stress incontinence are:
  1. Weight loss: For women who are overweight or obese, losing weight helps to reduce urine leakage.
  2. Fluid management: For women who drink large amounts of fluids daily, cutting back on fluids reduces urine leakage. This includes reducing the amount of caffeinated, alcoholic and carbonated drinks. In fact, avoiding fluids 3-4 hours before going to bed helps a lot to prevent frequent nighttime urination.
  3. Avoiding constipation: Since constipation worsens urine leakage, increasing the quantity of dietary fiber to 30 grams or more per day will prevent constipation and reduce incontinence.
  4. Pelvic floor muscle exercises: Exercises for tightening pelvic floor muscles will help control stress incontinence.
  5. Bladder training: Bladder retraining helps affected women to regain bladder control and hold more urine for longer. Bladder training involves going to the bathroom on a specific schedule while awake and applying various strategies to control any sudden urges./li>
When the above options fail, the urologist may recommend:
  1. Bladder control medicines: For example, the drug duloxetine is used to treat stress incontinence in women who are unwilling or whose incontinence is unsuitable for surgical treatment. Collagen injections around the neck of the bladder may also be used when surgery is not ideal.
  2. Topical vaginal estrogen may be recommended for peri-menopausal or post-menopausal women with vaginal atrophy and stress incontinence.
  3. Pessary: A pessary, a stiff ring inserted into the vagina to push up against the wall of the urethra and the vagina, may be applied to reposition the urethra and reduce stress leakage.
  4. Catheterization: This treatment is used in women who are incontinent because the bladder never empties fully (overflow incontinence) or when the bladder cannot empty completely because of a spinal cord injury, past surgery or poor muscle tone.
  5. Biofeedback: The therapist puts an electrical patch over the bladder and urethral muscles, uses a wire to connect the patch to a TV screen where the contraction of these muscles is monitored, then with this information uses electrical stimulation and pelvic floor exercises to control stress incontinence.

As a last resort and depending on the severity of the stress incontinence, the urologist may opt for surgery. Surgery for stress incontinence is the most effective treatment for women who have not been helped by other treatments. Common surgical procedures are anterior vaginal wall repair surgery, colposuspension, surgical tape procedure and laparoscopic (keyhole) surgery. If you have urinary incontinence, speak with your doctor about whether surgery will help you and what type of surgery is perfect for you.

At Advanced Urology Institute, we have a solid track record of helping men and women plagued with urinary incontinence put their lives back on track. We have state-of-the-art facilities and skilled, board-certified urologists to assess, diagnose and treat any type of incontinence. For further help with urological disorders, visit the site, Advanced Urology Institute.

2 Kinds of Incontinence

Urinary incontinence (UI) is the involuntary loss or leakage of urine because of faulty bladder control. Due to pregnancy, structure of the female urinary tract and menopause, women experience urinary incontinence twice as often as men. And according to various studies, 25-45 percent of women in the United States experience some degree of urinary incontinence. In women between 20 and 39 years old, 7-37 percent report some degree of incontinence, while 9-39 percent of women older than 60 report daily incontinence.

Two types of incontinence

Urinary incontinence may result from functional abnormalities in the lower urinary tract or may be caused by other illnesses. There are two types of incontinence, stress incontinence and urge incontinence. Stress urinary incontinence is the involuntary urine leakage from effort, exertion, sneezing or coughing. Stress incontinence occurs because of weakened pelvic floor muscles. It is the most common type of urinary incontinence in young women and the second most common one in older women. This type of incontinence will lead to urine leaks when performing any activity that increases strain on the weakened pelvic floor muscles, such as walking, jumping, exercise, bending, stretching, sneezing, coughing, lifting, and even sex. The amount of leaked urine varies from a few drops up to a tablespoon or more, depending on the severity of the condition.

Urge urinary incontinence is the involuntary urine leakage that is accompanied or immediately preceded by urgency (an abrupt or sudden compelling desire to pass urine that is very difficult to defer). Urge incontinence occurs because of overactivity of the detrusor muscle, with its hallmark being a sudden, overwhelming urge to pass urine, accompanied by leakage or loss of urine. Nighttime urination and frequent urination often occur with urge incontinence. For some women with urge incontinence, even changing a sitting position or hearing running water can trigger bladder contractions and result in urine loss. While urge incontinence may occur in anyone of any age, it is common among older women. Actually, just 9 percent of women ages 40-44 suffer from urge incontinence while at least 31 percent of women 75 and older have the condition.

Seek immediate help

Involuntary leakage of urine is more than a health concern. It affects women on a psychological, social and emotional level. Women with urinary incontinence may avoid certain situations or places for fear of having a leakage accident. In fact, for a significant number of women, the incontinence may be so serious that it calls for changing clothes and avoiding certain tasks and exercises. Some women also may experience mixed incontinence, a condition where urge incontinence and stress incontinence occur at the same time. Therefore, it is important for women experiencing urine leakage of any kind to seek help from a urologist to determine whether they are suffering from urge incontinence, stress incontinence, mixed incontinence or another issue.

At Advanced Urology Institute, we understand that there are a significant number of women living with a lot worse problems than they should. We provide top-notch facilities and experienced board-certified urologists to help such women. For more information, visit the site, Advanced Urology Institute.

Most Common Forms of Prostate Diseases

Located just beneath the bladder and in front of the rectum, the prostate is a tiny gland in men that helps to make semen. It is a walnut-sized gland in young men which is wrapped around the tube carrying urine away from the bladder. The prostate grows larger with age, but when it becomes too large medical problems may arise. For men older than 50, the risk of having prostate related problems is quite high.

The most common prostate diseases are:

  • Prostatitis: Inflammation of the prostate, often caused by bacteria.
  • Enlarged prostate (BPH): Benign prostatic hyperplasia is a frequent problem in older men and is characterized by the frequent urge to urinate (especially at night) and dribbling after urination.
  • Prostate cancer: A common cancer in men which responds well to early treatment.

Benign prostatic hyperplasia (BPH)

This is the most common prostate disease found in men older than 50. BPH occurs when the prostate gland has enlarged to the extent of squeezing the urethra and obstructing the flow of urine from the bladder. Benign prostatic enlargement only means the prostate has enlarged, but there is no cancer. It is treated using active surveillance or watchful waiting when symptoms are not severe, but medications or surgery may be needed in severe cases. Other treatments such as microwaves, radio waves and lasers also may be used.

Prostatitis

Inflammation of the prostate (prostatitis) is frequent in men older than 50. There are three forms of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis and chronic prostatitis. Acute bacterial prostatitis has sudden onset after a bacterial infection and is characterized by chills, fever and pain in addition to other prostate symptoms. A combination of antibiotics and pain medication may relieve the problem.

Chronic bacterial prostatitis is a recurrent bacterial infection of the prostate. It can be relieved by taking certain medications for a long time, but you contact your doctor immediately when symptoms occur. Chronic prostatitis (also known as chronic pelvic pain syndrome) is a common problem which causes pain in the groin, lower back and tip of the penis. It may be treated by a combination of medication, surgery and lifestyle changes.

Prostate cancer

It is the most frequent cancer diagnosed in American men, affecting almost 50 percent of men older than 70. An estimated 200,000 men are diagnosed with the cancer in the U.S. every year, but many men can live with it without problems as it causes few symptoms unless it has spread to other areas of the body. The risk of getting prostate cancer depends on age (men older than 50 are at higher risk), race (African-American men are at higher risk than Native-American), family history (you are at higher risk if your father or brother had it) and diet (more common in men who eat high-fat diets). It is highly curable when detected early. Prostate cancer is diagnosed using a digital rectal exam or prostate-specific antigen (PSA) test. Treatment options include watchful waiting, surgery, radiation therapy and hormone therapy.

Symptoms of prostate disease

You should visit your doctor if you have any of these symptoms:

  • Frequent urge to urinate
  • Painful or burning urination
  • Need to urinate several times at night
  • Painful ejaculation
  • Dribbling of urine
  • Blood in urine/semen
  • Frequent stiffness or pain in lower back, pelvic area, hips, upper thighs or rectal area

At Advanced Urology Institute, we have experienced physicians and state-of-the-art facilities for diagnosis and treatment of prostate diseases. If you have any of the symptoms above, visit us for help. For more information, visit the site Advanced Urology Institute.

Becoming a Urologist – Dr. David E. Burday

Individuals who have a strong interest in caring for patients suffering from urological problems and conditions can find a good career as a urologist.

“A urologist is a physician specialized in diagnosing, treating and monitoring disorders of the urinary tract and reproductive organs, such as the ureters, kidneys, bladder, urethra and prostate,” says Dr. David E. Burday, MD, a board-certified urologist at Advanced Urology Institute.

“Urologists treat men and women for injuries and disorders of the urinary tract, pelvic floor muscle problems in women and male reproductive system disorders, but do not focus on female reproductive issues as those are handled by gynecologists,” he adds.

Urologist Education

“The path to becoming a urologist is quite long,” says Dr. Burday. “You must have a four-year college degree and pass medical college admission tests before you are admitted into medical school. Then there are four years of training in subjects such as embryology, genetics, neuroscience, biochemistry and medical ethics followed by clinical rotations before you graduate from medical school.”

The next step is attending a urology residency, says Dr. Burday. “As a urology resident, you spend a minimum of five years in training, which may be divided into a two-year general surgery residency and a three-year urology residency.”

He adds, “You may spend another one or two years in a post-residency fellowship if you want to pursue a urology subspecialty like pediatric urology or urological oncology. But you must pass an exam after completing the requisite education and training requirements before you can become a board-certified urologist.”

Conditions Treated by Urologists

Urologists diagnose, treat and monitor a broad variety of medical problems, including recurrent urinary tract infections, interstitial cystitis, enlarged prostate, kidney stones, urinary incontinence, overactive bladder, prostatitis, erectile dysfunction, male and female infertility, and cancers of the urinary tract, such as prostate, testicular, kidney, penile and bladder cancers. They also handle pediatric problems such as undescended testicles and enuresis (bedwetting).

“As a urologist, you diagnose and treat many medical conditions,” says Dr. Burday. “We resolve urinary incontinence, weak pelvic floor muscles, recurrent bladder infections and prostate cancer. We also treat kidney stones, erectile dysfunction and male infertility. Some urologists may even narrow their focus into areas such as female urology, oncology urology and pediatric urology.”

In addition to medical history and physical examination, urologists may request tests such as ultrasound before they recommend any treatments. The urologist also may work with specialists such as radiation therapists, radiologists or oncologists to ensure patients get the best treatment.
“The diagnosis and treatment process depends on the condition the urologist is dealing with,” says Dr. Burday. “Typically, the urologist will do a medical history and physical exam then request a few tests before deciding on a suitable treatment. Often, the treatment will be medication, surgery, or both, but that depends on the condition.”

Necessary Skills

Urology is a challenging field that requires determination, patience, eye-hand coordination, critical thinking and good problem-solving skills. Urologists also need excellent communication skills and the ability to make their patients feel at ease and comfortable. They also must be able to work under stress and make effective decisions in emergency situations.

“If you have the right qualities and the desire to improve people’s lives by treating urological problems, then urology is a wonderful profession for you,” says Dr. Burday. “Remember there are many job opportunities for urologists and the pay is above average.”

For more information on urology, visit the site Advanced Urology Institute.

Symptoms of Enlarged Prostate

An enlarged prostate, also called benign prostatic hyperplasia (BPH), is an increase in the size of the prostate. While most men have prostate growth throughout their life, not all men get bothersome symptoms. As the prostate grows it presses on the outside of the urethra and can slow down or even stop the flow of urine. BPH is common in men in their 50’s, with about 1 in 3 men above 50 years of age having urinary symptoms.

It is not clear what causes prostate enlargement. However, the following risk factors are involved:

Age – While prostate gland enlargement hardly causes symptoms in men below age 40, about a third of men in their 60’s and about half of men in their 80’s have BPH symptoms.

Hormone Levels – The balance of hormones in the body changes as men grows older, causing the prostate to grow.

Family History – Those with a blood relative, especially a father or brother, with prostate problems are more
likely to have BPH.

Ethnic Background – BPH symptoms are more common in white and black men than Asian men. Black men tend to experience BPH symptoms at a younger age than white men.

Lifestyle – Regular exercise lowers the risk of BPH while obesity increases the risk.

Diabetes and Heart Disease – The risk of BPH increases in men with diabetes, heart disease and those on beta blockers.

What are the symptoms of an enlarged prostate?

The severity of symptoms in people with BPH varies, but tends to worsen over time. Common symptoms include:

  • urgent or frequent need to urinate
  • nocturia (increased frequency to urinate at night)
  • difficulty starting urination
  • inability to completely empty the bladder
  • weak urine stream or a urine stream that stops and starts
  • straining while urinating
  • dribbling at the end of urination

The less common symptoms of BPH are:

  • inability to urinate
  • urinary tract infection
  • blood in the urine

You may never get all of these symptoms. In fact, some men with an enlarged prostate do not get any symptoms at all. In some men, the symptoms eventually stabilize and may even improve over time, while in others they may get worse. Some of these symptoms may be caused by other conditions, like anxiety, cold weather, lifestyle factors, certain medicines and other health problems. Therefore, if you have any of the above symptoms, visit your physician to find out what could be causing them.

How can a urologist help?

A urologist will take your medical history and conduct a physical exam. Depending on the severity of the symptoms, the urologist will order tests such as digital rectal exam, urine test, blood test for kidney problems, prostate-specific antigen (PSA) blood test or a neurological exam. The doctor may also request additional tests such as urinary flow test, post-void residual volume test, and 24-hour voiding diary. If the problem is more complex, the urologist may recommend a transrectal ultrasound, prostate biopsy, cystoscopy, urodynamic and pressure flow studies, intravenous pyelogram or CT urogram. If an enlarged prostate is diagnosed, the urologist has various treatment options to offer including lifestyle modifications and medicines. In severe cases, the urologist will opt for surgery. For more information and help with BPH, visit Advanced Urology Institute.

4 Common Symptoms of Enlarged Prostate

Prostate gland enlargement occurs in men as they age and is quite common in men above the age of 50. Medically referred to as benign prostatic hyperplasia (BPH), the condition can be completely benign or have serious complications such as bladder blockage, urinary retention, bladder infections, kidney stones or kidney damage. Since the prostate gland is located underneath the bladder, its increased size can block the flow of urine through the urethra, a tube that carries urine from the bladder out of the body via the penis. This in turn results in problems with urination and other complications.

Benign prostate enlargement (BPH) is not prostate cancer.

Even though the complications of an enlarged prostate may be serious, BPH is not prostate cancer. Neither does it imply you have a greater risk of getting prostate cancer. Usually, the growth of prostate tissue associated with BPH starts around the inner prostate (a ring of tissue around the urethra) and progresses inward. In contrast to this, prostate cancer often grows from the outer part of the prostate and continues outward. Therefore, having an enlarged prostate does not increase your risk of prostate cancer because the two conditions typically begin in different areas of the prostate. Nevertheless, men can have prostate cancer and enlarged prostate at the same time, so you should speak with your urologist or GP if you have any concerns about prostate cancer. Keep in mind that BPH does not cause erection problems and does not affect a man’s capacity to father children.

What causes BPH?

Generally, an enlarged prostate is considered a normal part of the aging process in men, believed to result from changes in hormone levels and cell growth. And while the actual cause of benign prostate enlargement is still unknown, studies have shown that changes in the cells of the testicles play a role in the growth of the gland. This is confirmed by the fact that men whose testicles are removed at a young age never develop the condition while those whose testicles are removed after developing BPH experience shrinkage in the size of the prostate. Some studies have also revealed that men with obesity or diabetes, as well as men with a father or brother with the condition, are more likely to develop BPH.

What are the 4 common symptoms of an enlarged prostate?

One of the more common symptoms of BPH is a frequent or urgent need to urinate. Men with BPH will have the urge to urinate more often and particularly at night, a condition known as nocturia. By frequent urination, we mean having to pass urine eight or more times a day. The need to urinate will be urgent because the increased pressure placed on the bladder and urethra by the enlarged prostate make holding urine more difficult.

On the other hand, urinating can be made more difficult by BPH because the increased pressure on the urethra may block urine flow from the bladder out through the penis. You may find it hard to start a urine stream or experience an interrupted or weak urine stream. Depending on the severity of your BPH, you may find it difficult to pass urine, a condition resulting in urine retention. When this happens, you must see your doctor immediately so that a catheter can be inserted into your bladder to drain the urine. Your doctor may recommend you see a urologist for surgery to remove a portion of the enlarged prostate tissue or make cuts on the prostate in order to widen the urethra.

Another symptom is pain during urination or ejaculation caused by pressure on the urinary tract or reproductive system due to BPH. In fact, some men even feel the need to push out urine, which may also cause pain. Remember, pain during ejaculation or urination may also be due to infection.

Other problems associated with an enlarged prostate include urinary tract infections, unusual urine color or smell, blood in urine, bladder stones, and bladder or kidney damage. But not all men with BPH show these symptoms. In fact, some men with enlarged prostate do not get any symptoms at all. If you do have symptoms, you should definitely see your doctor.

How is an enlarged prostate treated?

Your urologist will ask you questions about your symptoms and about your past health. A physical exam, a urine test (urinalysis) and a digital rectal examination will also be performed to aid diagnosis. In some cases, your doctor will request the prostate-specific antigen (PSA) test in order to rule out prostate cancer.

If you only have mild to moderate symptoms, your doctor can recommend “watchful waiting” for lifestyle changes and regular check-ups to monitor symptoms. Your doctor may also prescribe medications such as alpha-blockers or 5-alpha-reductase inhibitors to alleviate the symptoms.

If your condition does not improve after trying recommended lifestyle changes and medications, your doctor may opt for surgery. The type of surgery chosen by the urologist will depend on the size of your prostate, any other medical problems you have and the potential risks and benefits of the operation. For more information about treatments for enlarged prostate, visit an Advanced Urology Institute clinic near you.

Effective Ways To Detect Prostate Cancer

If you are a man, there is a 1-in-6 chance that you will develop prostate cancer at some point in your life. Prostate cancer is basically a tumor of the prostate, the gland located in front of the rectum and just below the bladder. The prostate helps in making the milky fluid called semen, which carries sperm out of the body during ejaculation. Prostate cancer is most common among men over 65 years of age and fairly prevalent in men aged 50-64 years. Still, the cancer can occur in younger men below 50 and screening for it should begin between 40 and 45 years of age.

Risk factors of the cancer include:

  • (Age
  • Obesity
  • Family history
  • Race
  • History of STDs (sexually transmitted diseases)
  • Diets high in fats from red meat

While prostate cancer is a highly treatable condition, many men suffer needlessly because they did not know the symptoms in order to catch it before the advanced stages. And though the cancer typically shows few signs until it has reached advanced stages, knowing the symptoms can be the difference between having to face surgery and just making a few lifestyle changes. The symptoms of prostate cancer include:

In some instances of early prostate cancer, no symptoms occur and the cancer can only be detected through routine screenings.

Effective Ways to Detect Prostate Cancer

Your urologist will start by asking you about your medical history, symptoms and risk factors. A physical examination will also be performed. The doctor will then request a prostate-specific antigen (PSA) test to analyze your blood sample for higher-than-normal levels of the prostate-specific antigen, which is a protein secreted by the prostate gland. Higher PSA levels may indicate presence of cancer. In some cases, your doctor will opt to use the PSA3 test to check for levels of antigen 3 in your urine. When PSA levels are abnormal, the urologist will usually suggest that you return in 6 months for a second PSA test to confirm the presence of the cancer. Other test options that may be used to confirm a diagnosis of prostate cancer are:

(a) Digital rectal exam: The doctor will insert a gloved finger into your lower rectum and prostate gland to check for any abnormalities in size, texture or shape of the prostate.

(b) Targeted biopsy: The doctor removes tissue samples from the prostate by using either MRI fusion-targeted 3D imaging method or the ultrasound high-yield saturation method. Samples taken are analyzed to detect the cancer and determine its severity.

(c) Prostate imaging: Also called perfusion dynamic MRI, prostate imaging uses a special contrast agent inserted into the prostate to precisely identify patients with the risk of prostate carcinoma.
Once prostate cancer is confirmed, the next step is determining its aggressiveness. The aggressiveness of a cancer helps the urologist to choose the best treatment option for the condition. So, after knowing how aggressive the cancer is, the urologist can recommend:

(a) Active surveillance: You are not offered any treatment but kept under careful observation and medical monitoring.

(b) External beam therapy (EBT): The urologist refers you to a radiation oncologist to deliver a beam of high-energy proton beams or x-ray to the tumor location. The oncologist may also use other radiation techniques such as conformal external beam radiation therapy, stereotactic body radiation therapy, proton beam therapy, or image-guided radiation therapy.

(c) Brachytherapy: In this case, radiation is delivered to your prostate by placing radioactive materials inside the prostate. The two forms used are low-dose rate (LDR) and the high-dose rate (HDR) Brachytherapy.

(d) Cryotherapy: This method uses extremely low temperatures (as low as -190 degrees Celsius) to freeze and destroy cancer cells.

(e) Surgery: The urologist makes an incision through the perineum or in the lower abdomen to remove the prostate. A skilled and experienced urologist will perform the surgery without interfering with your sexual function.
At Advanced Urology Institute, we have the best pool of urologists and state-of-the art equipment to help detect and treat prostate cancer. If you want to be screened for the condition, even without symptoms, never hesitate to see a urologist. Remember, early detection is the key to successful prostate cancer treatment. To learn more about prostate cancer screening, prevention and treatment, visit Advanced Urology Institute.