Mikhail Lezhak, PA C: Why You Should Choose Advanced Urology Institute

Key Takeaways:

  1. Advanced Urology Institute combines geo-strategic accessibility, in-depth expertise, cutting-edge technology and a personal, nurturing approach.
  2. The Institute has the best technology available to offer evidence-based, personalized care.
  3. The Advanced Urology Institute is committed to excellence, striving for better and offering the best available treatment for urological diseases.

As you navigate through the complexities of health, the importance of personal, empathetic, and state-of-the-art care cannot be understated. Florida’s Advanced Urology Institute (AUI) stands at the forefront of patient-focused urological treatments, spearheaded by talented professionals like Mikhail Lezhak, PA-C.

“My name is Mikhail Lezhak. I’m a physician assistant with Advanced Urology Institute in Daytona,” he begins, setting the tone for an intimate dialogue on an often-overlooked field of medicine. At the heart of this discussion is you. You are not just another patient on a long list, but an individual deserving of top-tier medical care. This simple yet transformative principle is at the core of the Institute’s ethos.

Why Choose Advanced Urology Institute?

The answer lies in the convergence of geographic accessibility, in-depth expertise, cutting-edge technology and a personal, nurturing approach. As Mikhail Lezhak notes, “We have locations in many places in Central Florida and not only.” This geo-strategically dispersed presence ensures that no matter where you are in Daytona, FL or the surrounding areas, quality urological care is never far away.

The Institute’s physicians, urologists and Physician Assistants, like Lezhak, bring to the table an unrivaled collective prowess. “We’re very knowledgeable,” he asserts, “and they [the physicians] can help you with any urological problems and treat any kind of urological disease if you have any. And as a PA, I can help them doing that.”

Unparalleled Technological Advancements

AUI impressively aligns human compassion with technological evolution. “We are equipped with the top-of-the-line technology and machines that help to evaluate patients thoroughly,” Lezhak explains, delineating how the Institute is always a step ahead in the evolving medical landscape.

Having the best technology at their disposal allows these capable professionals to offer the best available treatment to the patients. Evidence-based, personalized care is not an abstract concept here, but a daily reality, seamless in execution and delivered with earnest compassion.

A Holistic Approach to Urological Care

AUI’s approach is holistic and patient-centric. The journey from diagnosis to treatment and beyond is mapped out with the utmost sensitivity, taking into account each individual’s unique circumstances.

As Lezhak underscores, his role as a PA enables him to contribute meaningfully to this journey. In this intricate dance of medical intervention, the patient is always at the center, enveloped by a team of experts dedicated to their wellbeing.

A Commitment to Excellence

The largest urology practice in Florida, AUI, has carved out an irreplaceable niche in the landscape of urological care. It is not simply about the cutting-edge technology, the wide-ranging presence across Daytona, FL, or the team of accomplished urologists and Physician Assistants. It is about the commitment to excellence, the relentless striving for better, and the knowledge, as Mikhail Lezhak puts it, “that we can offer the best available treatment currently for urological diseases.”

Choosing the Advanced Urology Institute for your urological care is choosing unparalleled expertise, cutting-edge technology, geographic accessibility, and above all, a compassionate and personalized approach. Dedicate yourself to the best, because your health deserves nothing less.

References:

  1. AUI. (2023, August 17). Brian Hale, MD: Urological Care with AUI. Advanced Urology Institute. https://www.advancedurologyinstitute.com/brian-hale-md-elevating-urological-care-with-advanced-urology-institute/
  2. AUI. (2023, September). Samuel Lawindy, MD: Why Choose AUI. Advanced Urology Institute. https://www.advancedurologyinstitute.com/samuel-lawindy-md-why-choose-advanced-urology-institute/
  3. Watson, S. (2016, May 25). Faces of Healthcare: What Is a Urologist? Healthline; Healthline Media. https://www.healthline.com/health/what-is-a-urologist 
  4. And, D. (2023, September 21). Urologic Diseases – NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases
  5. Urology. (2015, April 7). Urology. Health Careers. https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/surgery/urology ‌

Dr. Samuel Lawindy Talks About How to Treat Urge Incontinence in Women

KEY TAKEAWAYS:

  • Urge incontinence is a condition characterized by a strong, sudden uncontrollable urge to pass urine, which often results in urine leakage. It is often caused by dysfunction of the bladder or pelvic floor muscles due to factors such as pregnancy, childbirth, and hormonal changes around menopause.
  • The treatment for urge incontinence often involves a combination of medications, such as anticholinergics and beta adrenergics, and behavioral treatments like bladder training, pelvic muscle exercises, biofeedback, or urge suppression. If medications don’t work, minimally invasive procedures may be recommended.
  • At Advanced Urology Institute, prompt, reliable, and effective treatment is provided to patients suffering from urge incontinence, emphasizing that it is a treatable medical problem and should not be accepted as a normal part of aging.

At Advanced Urology Institute we see an increasingly high number of women presenting with urge incontinence. Urge incontinence is a condition where you are unable or have difficulty holding urine in your bladder long enough to reach the bathroom.  And so, it is characterized by a strong, sudden uncontrollable urge to pass urine, which often results in urine leakage.

What are the signs that a woman has urge incontinence?

  1. Urine leaks associated with a sudden compelling desire to pass urine
  2. Strong urge to urinate frequently
  3. Changing multiple incontinence pads through the day
  4. Awkward leaks of urine that cause embarrassment
  5. Organizing life and activities around bathroom locations when in new environment

What causes urge incontinence?

Even though up to 50-percent of women may have urge incontinence at some point in their lifetime, roughly 10-20 percent experience extremely bothersome urge-related urine leakage. 

Incontinence may occur as a separate condition, but in some women, it presents alongside other forms of incontinence due to an underlying medical condition. 

Urge incontinence is often caused by dysfunction of the bladder or pelvic floor muscles. 

Generally the dysfunction is due to:

  1. Pregnancy
  2. Childbirth
  3. Hormonal changes just before or after menopause

How is urge incontinence treated?

If you have persistent urge-related urine leaks, consider seeking a board certified urologist for a prompt diagnosis.  During your visit, the doctor will take your medical history and conduct a complete physical examination focused on your urinary system, reproductive organs and nervous system. The doctor will also order various tests which will likely include an analysis of your urine sample.

If urge incontinence is diagnosed, your doctor will prescribe medications to relax your bladder and pelvic muscles as a way of relieving the symptoms. The medications may be used alone or in combination with behavioral treatments, such as bladder training, pelvic muscle exercises, biofeedback, or urge suppression.

The two major classes of medications used for urge incontinence are: anticholinergics and beta adrenergics.  

The anticholinergic drugs include:

  • Darifenacin (Enablex)
  • Fesoterodine (Toviaz)
  • Oxybutynin (Ditropan, Oxytrol, Gelnique)
  • Solifenacin (VESIcare),
  • Tolterodine (Detrol),
  • Trospium (Sanctura). 

The beta adrenergic medications include:

  • Mirabegron (Myrbetriq)
  • Vibegron (Gemtesa)

Your doctor may also recommend vaginal estrogen (creams, pellets or rings) as a form of estrogen replacement therapy to help you if the incontinence is due to menopause, particularly if the incontinence occurs alongside vaginal atrophy (dryness).

If medications don’t work, your urologist may consider minimally invasive procedures. A procedure such as percutaneous tibial nerve stimulation, electrical stimulation, sacral neuro-modulation therapy (Interstim), or Botox bladder injection may be recommended.

Prompt, reliable and effective treatment

At Advanced Urology Institute, we encourage patients to believe that urine leakage does not have to be a normal part of aging.  Incontinence is a medical problem that can be treated effectively to reduce symptoms or eliminate the problem completely.  So we strongly insist that no woman should tolerate or endure this kind of discomfort, especially when it is bothersome and is affecting their quality of life.

If you’re struggling with embarrassing urine leakage, please get in touch with us to schedule your consultation and find out how we can help you. At AUI, we offer some of the latest and best interventions in treating urological disorders.  For more information on the diagnosis and treatment of urinary incontinence and other urologic disorders, visit the site “Advanced Urology Institute.”

TRANSCRIPTION:

So my name is Samuel Lawindy.
I’m a board certified urologist at Advanced Urology Institute.
So there is urgency and urgent incontinence for women.
That occurs when someone feels that they have the desire to go to the bathroom and they
can’t quite make it in time and then they’ll be leaking urine before they get there, wearing
multiple pads throughout the day, always aware of where the bathroom is and that commercial
everyone knows about got to go, go, go to the bathroom.
That’s urgent incontinence.
Very easily treated with medications and multiple different medications can be utilized.
If that doesn’t work, then there is some minimally invasive surgical procedures that can help you.

REFERENCES:

BPH Enlarged Prostate Symptoms & Treatment

Benign prostatic hyperplasia (BPH) is a non-cancerous increase in the size of the prostate gland and surrounding tissue. As the gland enlarges, it squeezes the urethra and causes the bladder wall to become thicker. Over time, the bladder muscles weaken and the bladder loses the ability to empty fully, resulting in urinary symptoms.

The most common complaints in people with BPH include:

  1. Difficulty starting urination
  2. Having to strain or push in order to pass urine
  3. Weak stream due to a weak urine flow
  4. Dribbling at the end of urination
  5. Urgent or frequent need to urinate
  6. Nocturia—increased urinary frequency at night
  7. Intermittency—the need to stop and start many times when passing urine

In some men, rare symptoms may occur, including:

  1. Inability to urinate
  2. Blood in urine
  3. Urinary tract infections

The size of the enlarged prostate gland does not determine the severity of the symptoms. Actually, some men with only a slightly enlarged prostate have significant symptoms while others with a massive enlargement have only minor urinary symptoms. Plus, in some men, symptoms tend to stabilize and even improve with time.

Besides, an enlarged prostate shares urinary symptoms with a number of conditions, including:

  1. Inflammation of the prostate (prostatitis)
  2. Narrowing of the urethra (urethral stricture)
  3. Urinary tract infection
  4. Kidney or bladder stones
  5. Problems with nerves controlling the bladder
  6. Scarred bladder neck after surgery
  7. Bladder or prostate cancer

Therefore, it is advisable that you see a urologist as soon as possible if you are having persistent urinary symptoms. Regardless of whether the urinary symptoms are bothersome or not, seeing a doctor will help to identify or rule out any underlying causes. 

How is benign prostatic hyperplasia treated?

When your urologist is certain that you have benign prostatic hyperplasia, you’re typically started on an alpha blocker—a medication that relaxes your bladder neck muscles and the muscle fibers in the prostate, making urination easier.  

Commonly prescribed alpha blockers include alfuzosin (Uroxatral), tamsulosin (Flomax), doxazosin (Cardura), and silodosin (Rapaflo).  For men with only slightly enlarged prostates, alpha blockers work really quickly and relieve urinary symptoms effectively.

Another option is to prescribe medication that can shrink the prostate by preventing hormonal changes behind prostate enlargement. The medications, called 5-alpha reductase inhibitors, such as Finasteride (Proscar) and Dutasteride (Avodart), can shrink the prostate by as much as 50-percent over a period of six months. You can rely on these drugs to relieve urinary symptoms within a few weeks of usage.

In some cases, your doctor may opt for a combined therapy using an alpha blocker together with a 5-alpha reductase inhibitor. This is done if either medication isn’t effective when used alone.

If your symptoms fail to respond to these medications, your doctor may recommend a minimally invasive surgical procedure. Such a procedure may also be necessary if your symptoms are severe or if you have a urinary obstruction, bladder stones or kidney problem.

Some procedures your doctor may consider include:

  1. Transurethral resection of the prostate (TURP)

This is a minimally invasive procedure that involves inserting a lighted scope into the urethra and using it to guide the removal of all but the outer part of the prostate.

  1. Transurethral incision of the prostate (TUIP)

Just like TURP, this procedure involves inserting a lighted scope into the prostate. The difference is that during TUIP, the surgeon makes 1-2 small incisions in the prostate gland, which enable urine to pass through the urethra.

  1. Transurethral microwave thermotherapy (TUMT)

As opposed to using a lighted scope, this procedure uses a special electrode inserted through the urethra into the prostate. The electrode provides microwave energy that is directed to the inner portion of the enlarged prostate. As a result, the prostate shrinks and urine flow improves.

  1. Transurethral needle ablation (TUNA)

This is another minimally invasive procedure that involves passing a scope into the urethra to allow the surgeon to place needles into the prostate gland. Radio waves are directed through the needles, which help to heat up and destroy excess prostate tissue.

  1. Laser therapy

During this procedure, high-energy laser is used to remove or destroy overgrown prostate tissue. It is preferred in men who are taking blood-thinning medications and who shouldn’t undergo the other minimally-invasive prostate procedures stated above.

  1. Prostate urethral lift (PUL)

This is a minimally invasive procedure that involves using special tags to compress the sides of the prostate in order to enhance urine flow. It is recommended in men who are wary about the impact of treatment on erectile and ejaculatory function. Prostate urethral lift causes minimal adverse effects on ejaculation and sexual function compared with TURP, TUIP, TUMT, and TUNA.

  1. Robot assisted prostatectomy

As a last resort or in cases where the prostate is too much enlarged, the bladder is damaged or there are other complicating factors, the surgeon may opt for da Vinci robot-assisted prostatectomy. The procedure involves making an incision in the lower abdomen to reach the prostate gland, which is then removed.

Reliable, unbeatable care

Are you 50 years or above and are having a frequent urge to urinate, a weak urine stream, leakage or dribbling of urine, or trouble beginning urination? You may be having benign prostatic hyperplasia.

At Advanced Urology Institute, we offer safe, timely and reliable diagnosis and treatment of BPH. Our urologists are skilled in doing physical examination, patient history, symptom evaluation, and ordering tests that form the basis for diagnosing the condition and ruling out other problems, including prostate cancer.

We also make sure that our patients understand the full range of treatment options available to them, and guide them on making an informed decision and on pursuing the treatment that is best for their individual medical situation. For more information on benign prostatic hyperplasia diagnosis and treatment, visit the site “Advanced Urology Institute.”

Common Urologic Conditions Are Treatable

The urinary system of the human body regulates, manages and eliminates urine waste. The organs in this system are the kidneys, ureters, bladder and urethra. But as with any organ or system of the body, the urinary system can have problems, commonly referred to as urologic diseases or urologic problems.

You can have urologic problems regardless of your age, ethnicity or gender. And when urologic conditions occur, in both men and women they have a direct effect on the urinary tract and how urine is expelled from the body. In men, urologic problems can also affect the reproductive organs.

Signs that you have urinary tract problems:

Urologic conditions are treatable

Urology is a dynamic and advanced field. Urologists know how to treat many urologic diseases, including cancer of the prostate. The first step in any successful treatment is to see a urologist on time. Do not delay. As soon as you experience any problems, visit a urologist for a medical exam.
Mikhail Lezhak, PA-C of Daytona, FL

Common urologic conditions

(1) Urinary Tract Infections (UTIs)

Urinary tract infections (UTIs) are the most frequent type of urologic condition, although they occur more commonly in women than men. Close to 60% of women and 12% of men experience UTIs at some point in their lives. These infections are easily treated with antibiotics, but the treatment should begin as soon as possible to avoid further infection and prevent complications.

(2) Urinary incontinence

Although many people resist seeking help because of embarrassment, urinary incontinence is treatable in most cases. The cause is usually either an overactive bladder (urge incontinence) or stress incontinence. Typically, urge symptoms come from the bladder wall and detrusor muscle and mucosa, while stress symptoms are due to the incompetence of the bladder neck or urethral sphincter.

The diagnosis of urinary incontinence can be reached through a careful patient history, thorough examination and proper tests. You may need bladder retraining, controlled fluid intake, reduction in caffeine intake, or deliberate delayed voiding to treat the symptoms. Your doctor can also recommend medication or perform corrective surgery.

(3) Pelvic Floor Dysfunction

Pelvic floor muscles support the bladder, vagina and rectum. At some point in life, particularly after childbirth, pelvic floor muscles can become irritated or inflamed. Since the pelvic floor has to relax during urination, having pelvic floor dysfunction can cause pain or difficulties. The problem is often treated through pelvic floor exercise, but when the exercises are ineffective, vaginal medications or muscle injections can be used.

(4) Prostatitis

Many urological problems in men are linked to the prostate. Prostatitis is the inflammation or abnormal swelling of the prostate. The most common symptoms of prostatitis are painful urination, fever, chills, abdominal pain, and pain in the lower back or pelvic region. If you are diagnosed with prostatitis, your doctor will recommend antibiotics to reduce the swelling and restore your prostate to normal size.

(5) Bladder and prostate cancer

The PSA test and prostate exam are great ways to check on your prostate health. Should cancer be found in your bladder or prostate, your urologist will offer lifesaving care. Prostate cancer is the second leading cause of cancer-related deaths in men. It results from the abnormal and rapid growth of prostate cells.

Prostate cancer is successfully treated when detected early, which is why men are encouraged to get checked once a year. In fact, the recommended treatment depends on the time of detection, and may include radiation, surgery or regular surveillance. Today, robotic surgery has helped to reduce the hospital stay for kidney, bladder or prostate cancer surgery to just a few days, or just one day.

(6) Prostate enlargement (BPH)

The prostate grows as you age. Over time, you may have to wake up at night to go to the bathroom or you may not be able to produce the stream of urine you once did. When diagnosed with BPH, your urologist will use various techniques to relieve the obstruction caused by the enlarged prostate. These techniques include consistent monitoring, medications, and in some cases surgery.

Your urologist may also recommend the Rezum procedure—which uses heated water vapor to shrink the enlarged prostate tissue—or the green light and thulium laser vaporization techniques, transurethral resection of the prostate, minimally-invasive thermotherapy, or a UroLift. You will likely return home the same day as one of these procedures.

(7) Erectile dysfunction (ED)

This is a common condition as men grow older. When a man in his 40s or 50s notices that his erections are no longer what they used to be, he should talk to a urologist. Erectile dysfunction is the difficulty in achieving or maintaining an erection for sexual intercourse.

Although not fatal, it can cause stress, embarrassment and a strain on your relationship. Urologists will help you determine the underlying conditions and recommend treatments. Your urologist may prescribe medications—such as PDE5 inhibitors Cialis and Tadalafil—penile injections, a penile pump or, as a last resort, penile implant surgery.

(8) Kidney and ureteral stones

Kidney and ureteral stones occur when crystal-like particles in urine develop and grow into larger masses. As the stones pass along the urinary tract, they can get blocked and cause pain. Although most stones are passed naturally, larger stones may require surgery or specific procedures to break them.

One of the most common treatments is the Extracorporeal Shock Wave Lithotripsy (ESWL) technique in which sound waves are used to break up stones into smaller pieces. Also, since kidney stones can recur, patients often need long-term care. Your urologist will advise you on how to prevent kidney stone formation and how to best manage any potentially painful stones that develop.

At Advanced Urology Institute, every day we help people solve problems they may be hesitant to talk about. Since these problems are distressing or awkward to discuss, our goal is to help make you comfortable. We are proud of the long-term relationships we enjoy with our patients. Our knowledgeable urological specialists provide carefully tailored and confidential care. At AUI, patients get a proper diagnosis and the correct treatment, and we are willing to answer any questions you may have about your health.

If you suspect you have a urological problem, we encourage you to make an appointment at one of our many locations. For additional educational resources on urologic conditions, visit the Advanced Urology Institute website.

Ways to Pass Kidney Stones

Kidney stones can be a painful and difficult experience for the many men and women who get them. These stones are hard deposits of minerals that build up in the body and cause blockages in the urinary tract. The blockages can make it very painful and difficult to urinate. In addition to difficulty urinating, the stones can cause nausea as well as pain in the groin and abdomen. Luckily, there are many ways that urologists can help speed up the process.

Quynh-Dao Tonnu, PA-C: Physician Assistant in DeLand, FLFinding the best way to help a patient to pass a kidney stone depends on several factors. Not all patients are the same, and the size and difficulty of their kidney stones vary as well. If the stones are smaller than 5 millimeters, the urologist will want the patient to try and pass them naturally. This is the least invasive way to pass kidney stones, although it may not always be possible. Drinking lots of liquids for frequent urination is the key for this method. Urologists may also recommend movement like bicycling and jumping jacks to help dislodge the stones naturally.

If passing naturally is not an option, then medication may be the next step. Urologists will use some of the same medications that are used to treat an enlarged prostate. Medication like Flomax helps relieve pressure on the urinary tract by relaxing the muscles in the prostate. This allows for easier urine flow and can help the patient pass the stones.

Another treatment option that makes passing stones easier is called shock wave lithotripsy. This treatment uses a machine pressed up against the patient’s body that targets water waves directly at the kidney stones. With as many as 2,500 waves per treatment, these waves break the kidney stones into small, sand-like particles. The sandy remnant is then easily passed during urination.

In some cases, a more invasive treatment may be needed to remove the stones from the body. A surgeon may use a scope fitted with a medical laser to enter the patient’s urinary tract through the penis. They can then use the laser to break the stones up into smaller fragments for easier passing. This method is sure to help pass the stones, but a urologist may prefer to try more natural methods first.

There is no single method to passing kidney stones. What matters most is making the process as fast, safe and pain-free as possible. For more information about kidney stones, visit the Advance Urology Institute website.

Surgical Options for Overactive Bladder

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

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

Augmentation Cytoplasty

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

Urinary Diversion Surgery

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

Bladder Removal

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

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

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.

Treatments for Bladder Control Problems in Women

Urinary incontinence happens when the bladder becomes weak and urination happens by accident. Although they seldom want to talk about it, urinary incontinence affects women twice as often as men. The cause may be related to childbirth or menopause, and the structure of the female urinary tract plays a role as well.

If you suffer from this problem, it’s important to realize you are not alone. More than 33 million Americans deal with urinary incontinence or a bladder condition. Unwanted urinary activity occurs in both men and women and increasing age can be a partial cause. Is is estimated that one out of three women in the United States has a bladder problem.

Quynh-Dao Tonnu, PA-C of Daytona Beach, FLBladder control problems can vary, from occasional urine leakage that happens when you cough or sneeze, to having sudden urges to urinate so strong you do not make it to the toilet in time. There are several basic forms of incontinence and you can have more than one condition. There is urge incontinence, where you will feel a need to urinate all of a sudden as the bladder involuntarily contracts, compelling you to urinate immediately. Another form is stress incontinence. This is caused when physical stress from coughing or sneezing, or athletic activity, puts pressure on the bladder and causes leakage.

Some women experience overflow incontinence, which happens when you leak urine because your bladder does not empty all the way.

Assessing Causes of Urinary Leakage

When you make an appointment, your doctor or a physician assistant will ask for a thorough history of the problem, followed by a physical exam. Some simple and painless tests may be taken. Urinalysis is a test in which a urine sample is checked for traces of blood, signs of infection, nitrates, or other indications of a medical problem. You may be asked to create a bladder diary, keeping a record for a few days to track the amount of fluids you drink and the frequency and amount of urine, as well as details of urgency or leakage.

Another test may be a post-void residual measurement. You will urinate into a container, and then your doctor uses ultrasound to measure the amount of urine left in your bladder.

Treating Bladder Control Problems

  • Changing your diet and performing Kegel exercises may help with both urge and stress incontinence. Additional treatments may be recommended ranging from medications to surgery.
  • Medications can be prescribed, including anticholinergics (used to block neurotransmitters), antidepressants, estrogens, or nerve-stimulating drugs.
  • Injection therapy involves the injection of collagen and other compounds to bulk up the urethra.
  • Botox injection is another possibility. Injecting Botox into the bladder partially paralyzes muscles to help reduce overactivity.
  • Surgical options are available for treating bladder control issues. They include urethral slings or mesh tape inserted to support a sagging urethra, or sacral nerve stimulation through an implanted device that calms nerves of the bladder.

It is best to make an appointment with a urologist if you are experiencing bladder control problems. Our doctors at Advanced Urology Institute have years of experience with treating bladder problems and working with patients to find the best solutions. For more information, visit the Advanced Urology Institute website.

What is Dr. Samuel Lawindy’s contemporary approach to treating overactive bladder with InterStim Therapy?

KEY TAKEAWAYS:

  • InterStim therapy is a treatment option for patients with an overactive bladder, serious urine retention, or uncontrollable frequent urge to urinate, who have not responded to other treatments such as medication or physical exercises.
  • The InterStim device is implanted in the upper buttock area through a minor surgical process called Sacral Nerve Stimulation Procedure, aiming to correct the communication patterns between the sacral nerves and the brain for better bladder control.
  • The success rate of the InterStim device is high, with patients reporting relief from their symptoms almost immediately, but it is important to consult an experienced urologist to determine if a patient is a good candidate for the procedure.

InterStim therapy is a treatment option for patients with an overactive bladder, a serious case of urine retention or an uncontrollable frequent urge to urinate for reasons other than an overactive bladder. It gets its name from the InterStim, which is a small implantable device used to administer the therapy. There are other forms of treatment for overactive bladders, including medication and physical exercises. InterStim Therapy is used for patients who have failed to respond to the other treatments or who cannot undergo the treatments.

What is an Overactive Bladder?

Dr. Samuel LawindyAn overactive bladder is a condition characterized by sudden, frequent and uncontrollable urges to urinate. The patient feels the need to go to the bathroom numerous times during the day and the night. Sometimes, due to the uncontrollable nature of the urge, patients may have urine leakage, also known as urinary incontinence.

An overactive bladder may be caused by a neurological condition that interferes with the functioning of nerves that transmit messages between the brain and the bladder. Contributing factors can include diabetes, bladder complications such as tumors or stones, urine retention and an excessive intake of fluids.

InterStim therapy is focused on fixing the disconnect between the nerves in the brain and those that control bladder function.

The Procedure

The InterStim device is implanted in the upper buttock area through a minor surgical process called a Sacral Nerve Stimulation Procedure. Sacral nerves are located around the tailbone and regulate the operation of a person’s urinary function. Bladder movements are determined by the communication between the sacral nerves and the brain.

In patients suffering from an overactive bladder or urge incontinence, an InterStim device is implanted to enhance or correct the communication patterns between the sacral nerves and the brain, ensuring the person has full bladder control. Before the actual InterStim device is implanted, doctors place a temporary stimulator to observe how the patient responds. This helps to project what the efficiency of a permanent stimulator will be. If the patient does not respond at all to the temporary stimulator, then it would not help to implant a permanent one.

The success rate of the InterStim device is high, with patients reporting relief from their symptoms almost immediately. It is important to consult a urologist before having the device implanted because not every person may be a good candidate for the procedure. Since the surgery is a relatively delicate one, a patient should make sure to see an experienced urologist from a reputable institution, such as those from the Advanced Urology Institute. The staff of experts at Advanced Urology Institute can help with any questions, preparations and surgery. For more information, visit the Advanced Urology Institute website.

TRANSCRIPTION:

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

For patients who have significant urge, urinary incontinence and urgency and frequency and medications have not quite treated that, there are a couple other options.

The inner stem is a nerve stimulation test that can not really test but a treatment for overactive bladder that it requires a small implantable device that goes into the upper buttocks that then stimulates the nerves to the spine that goes to the bladder to calm it down so that it gives you complete control over your urinary symptoms with no more leakage and more sleep throughout the night really.

And you don’t really have to think about it, it’s in there, it’s like a little pacemaker for the bladder, you control it with a little phone and you can adjust the settings that way.

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What is the impact of low testosterone on men according to Dr. Samuel Lawindy?

KEY TAKEAWAYS:

  • Low testosterone, or hypogonadism, can lead to reduced sex drive, shrinking testicles, low semen volume, and general fatigue in men.
  • If left untreated, symptoms of low testosterone can increase in severity, potentially causing hair loss, infertility, low bone density, loss of muscle, and weight gain.
  • Regular screening sessions for testosterone levels are important, and men experiencing symptoms should consult a trained urologist for diagnosis and treatment.

Testosterone is the hormone responsible for the development of the male sexual function. Besides being the main force behind a man’s sex drive and production of healthy sperm, testosterone also plays a role in the manufacturing of red blood cells and the distribution of fat in the male body as well as the regulation of muscle mass and bone density.

The production of testosterone drops gradually as men grow older and men over the age of 60 may develop symptoms of low testosterone. There are, however, instances where the production of testosterone slows down and falls below the required levels for reasons other than aging. Such men are said to be suffering from low testosterone. The level of testosterone can be measured through a simple blood test. In a normally functioning male, the level fluctuates between 300 ng/dL to 1000 ng/dL. If the level is below 300 ng/dL, then he may have low testosterone, also called hypogonadism.

Impacts of Low Testosterone on Men

Dr. Samuel Lawindy1. Reduced Sex Drive

A drastic decrease in a man’s urge to have sex may point to low testosterone. Often this will be accompanied by a failure to achieve or maintain an erection, or erectile dysfunction. It is common for men mistakenly to attribute a reduced sex drive to aging. While it is true that the older you are the less interest you may have in sex, this is a gradual process that keeps pace with other bodily changes so when it happens, it is not that much of a surprise. It does not happen abruptly.

2. Shrinking Testicles

Testosterone causes the increase in size of the testicles and the penis during puberty. If the levels go down, it is to be expected that these organs may shrink. The testicles also may feel much softer.

3. Low semen Volume

Testosterone stimulates the production of semen, so low levels of testosterone inhibit the normal production of semen.

4. General Fatigue
Low testosterone levels also may cause a proportionate decrease in energy levels, leading to fatigue. This may be accompanied by a dislike for physical activity and movement.

If left untreated, the symptoms of low testosterone increase in severity and with time may cause hair loss, infertility, low bone density that can develop into osteoporosis, loss of muscle and a marked increase in weight because fat distribution remains unregulated.

The symptoms experienced by patients with low testosterone can mimic symptoms of other conditions. It is therefore necessary for one to undergo diagnostic tests with a trained urologist to determine the cause. Men also should schedule regular screening sessions where their testosterone levels are measured. And it is important to note that hypogonadism is treatable. The Advanced Urology Institute has a highly qualified staff of specialists that can offer a wide variety of treatment options as well as answer any questions. For more information, visit the Advanced Urology Institute website.

TRANSCRIPTION:

So my name is Samuel Lawindy, I’m a board certified urologist at Advanced Urology Institute.
Well low testosterone is a common issue that men may have. It is very important to be evaluated properly for low testosterone. There is a lot of lab values that can be obtained and a lot of information that can be obtained from the proper values and it is important to treat accordingly based on that number.

Not everyone should have testosterone. There are different ways to treat testosterone in regards to treating the hormone that provides testosterone in your body, sometimes blocking the hormone that converts testosterone to estrogen and it’s important to recognize that and treat that accordingly.

Low testosterone symptoms typically include fatigue, low libido, less desire for sex.

You can actually have weight gain, loss of muscle mass and some will actually have decreased outlook in life, somewhat depressed outlook.
Great, they feel wonderful.

If you treat them properly and the testosterone levels come up and they are doing well, tolerating medications well, then they live a normal healthy life.

They just need to be followed again, continually check the testosterone. It’s important to keep checking testosterone and they usually are very happy with the results.

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Dr. Samuel Lawindy: How Prostate Cancer Is Diagnosed

The prostate gland is the part of the male reproductive system that produces seminal fluid. Prostate cancer is the type of cancer that affects this organ. It is the most common cancer in men, with men over the age of 50 being at the greatest risk. It usually does not manifest symptoms in its initial stages. This is unfortunate because it means prostate cancer may not be detected until it is more advanced. Even when it does present symptoms, they might resemble other conditions such as an enlarged prostate. For this reason, before one concludes that they have prostate cancer, it is necessary that they first undergo the specific tests geared toward detecting it.

Diagnosing Prostate Cancer

There are two preliminary tests for prostate cancer. These are:

1. PSA Test. This tests for an antigen produced by and specific to the prostate. It is normal for the antigen to occur in small quantities. An unusually high level of PSA, however, may indicate the presence of prostate cancer or some other inflammation of the prostate.

Dr. Samuel Lawindy from Daytona Beach, FL2. Digital Rectal Exam. This is very commonly used in prostate screening exercises. The doctor inserts a finger into the rectum and physically examines the prostate. If the doctor detects something unusual in the shape, mass or texture of the prostate, then there may be further tests to determine what the problem is.

The two tests are not conclusive. They simply inform the urologist that something might be wrong and that the patient needs further examination. In order to test for cancer of the prostate specifically, the following procedures may be done after either of the initial tests.

A. A biopsy. A prostate cancer biopsy involves the use of a very fine needle inserted through the rectum to collect tissue from the prostate. The tissue is then tested for cancer.

B. Transrectal ultrasound. The doctor inserts a small probe in the rectum. The probe produces high frequency sounds that bounce off the prostate, producing an image of the prostate that can be projected on a screen and observed in greater detail.

C. MRI Fusion biopsy. This combines an MRI and the transrectal ultrasound to produce a clearer image of the prostate. It gives a better view of the part of the prostate that is affected. If a biopsy is to be performed later, it provides a picture of the precise area where tissue should be tested.

Early detection of prostate cancer improves the chances of successful treatment. It is important for men starting about age 50 to have regular screenings so that any cancer can be detected early. Seek out experienced and certified urologists, such as those on staff at the Advanced Urology Institute, to discuss any concerns and set up screening tests. Such examinations should be a regular part of a man’s health care.
For more information, visit the Advanced Urology Institute website.

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