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.

Prostate Cancer Types of Treatment

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

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

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

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

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

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

What is the best treatment for enlarged prostate?

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

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

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

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

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

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

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

What are the treatment options for erectile dysfunction?

Erectile dysfunction is a common disorder that affects men of all ages. It is a man’s inability to get and maintain an erection. There are many different causes of ED and in many cases there is more than one underlying cause. All a urologist needs is a physical exam and a few questions answered in order to diagnose erectile dysfunction in a patient.

Dr. Brian Hale - Urologist at Palm Harbor, FLFor urologists like Dr. Brian Hale, treatment for erectile dysfunction begins with trying three different medications. The medications are generally oral and easy to take. The urologist will monitor the results of the oral drugs with the patient. Very often, at least one of the oral drugs prescribed will resolve the issue. For these cases, the urologist will write a prescription for the drug and continue to monitor its effectiveness through routine appointments.

If the urologist and the patient are unable to find an oral medication that works effectively, there are other options to consider. One possibility is injection therapy. Small injections into the shaft of the penis are used to dilate the penile arteries, helping increase blood flow, causing an erection. For most men who do not see results with the oral medication, injection therapy is their next best option.

For many men, injection therapy can seem a bit overwhelming at first, maybe even frightening. But in reality, the injections are easy to administer and are relatively painless. The urologist and the patient will begin the injection therapy with a teaching session at the urologist’s office. The urologist may use an ultrasound to monitor the reaction of the blood vessels to the injection to help determine the right dosage for the patient. The patient is also taught how to administer the injection on his own.

Patients are generally pleased after they start injection therapy. The teaching session at the office helps the patient see that the injections are not painful and can easily be done at home. It is very rare that a patient cannot do the injection therapy himself. For those who did not respond positively to the oral drugs, injection therapy is an ideal treatment to produce the desired results and overcome the erectile dysfunction.

Treating erectile dysfunction is an important part of a patient’s well being, both personally and within his relationships. The urologists of the Advanced Urology Institute offer many options for treatment and remain committed to finding the best one for each patient. For more information, visit the Advanced Urology Institute website.

Discussing a Sensitive Topic: Erectile Dysfunction

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

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

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

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

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

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

What is the Prevalence of Erectile Dysfunction, According to Dr. Harris?

KEY TAKEAWAYS:

  • Erectile dysfunction (ED) is a common issue that can result from both mental and physical factors, such as depression, anxiety, stress, heart disease, diabetes, high blood pressure, and substance abuse.
  • Certain risk factors, including heart disease, diabetes, tobacco use, drug and alcohol use, and being overweight or obese, increase the likelihood of developing ED.
  • Urologists can diagnose ED through a physical exam and questioning, and treatment options typically start with oral medications, followed by injections if medications prove ineffective.

Erectile dysfunction, also known as ED, is the inability of a man to get or maintain an erection firm enough for intercourse. ED is a very common issue that can negatively affect a man’s self-confidence and his relationship with his partner. Many men see urologists for help with ED when this happens.

Dr. David Harris of Fort Myers, FLThe primary symptom of ED is trouble getting and maintaining an erection, and reduced sexual desire is often associated with it. There are many factors that can cause ED, and they can be divided into two categories: mental and physical. Depression, anxiety and stress are mental factors that can cause ED. There are also physical factors, including heart disease, diabetes, high blood pressure and substance abuse. There are plenty of cases when it is a combination of mental and physical factors that cause ED.

All men are at risk for erectile dysfunction; however, there are some factors that increase the likelihood of developing it. Heart disease and diabetes are key risk factors that increase the likelihood of ED. Tobacco use causes damage to arteries, restricting blood flow and raising the chances of ED. Drug and alcohol use are risk factors as well. Men who are overweight, and especially those who are obese, are also at greater risk of developing erectile dysfunction.

A urologist can diagnose ED by performing a physical exam and asking a few questions. Once diagnosed, urologists can consider a variety of options for treatment, depending on the patient. The first option is usually oral medication. Urologists will try different medications to help patients maintain erections. If none are effective, then the urologist may prescribe injections. Small injections can be made to the shaft of the penis that dilate the blood vessels in the penis, allowing better blood flow and erections. The patient can administer these injections himself as needed.

Erectile dysfunction is not uncommon and as Dr. David Harris says about treating it, “As urologists, we are the leading authority.” Urologists see cases of ED on a daily basis and are accustomed to having conversations about it and finding the best way to solve the issue with their patients. In most cases a patient who is motivated to work with his urologist on finding the best treatment will eventually find a solution that works. The Advanced Urology Institute helps many patients explore their options and treat their ED so they can continue their normal lives and activities. For more information, visit the Advanced Urology Institute website.

TRANSCRIPTION:

My name is David Harris and I’m a urologist with Advanced Urology Institute in Fort Myers. That’s very common. And I think one reason men come into us is I think they understand that as urologists we’re the authority. And we have the literature, we have the established urological associations, understanding and framework from which to address this. And you’ll find ads in the paper, ads on the radio, a lot of quick easy ways to treat this. And patients come to us because they want to know that it’s safe and that they’re going to get an expert to tell them what to do. So yes, we see a lot of patients, it’s a daily thing, and I see in this day and age men much more comfortable coming in the office and saying, you know, Doc, I need a little help. You know, I’m not terrible, but I’m not where I was. Please help me with erections. And I think if you look back 15 years ago, there was less of that. So I think men are much more comfortable coming in and talking about it. And we have a variety of options. Okay. And that’s the same kind of thing. You have to talk to that patient about what their comfort level is, and their health issues, and help define for them the way you want to approach that. I think a fair statement, it doesn’t mean everybody’s got a fix for everything. But I think a guy that is very motivated can find an option to treat ED that will be successful.

REFERENCES:

Kidney Stone Surgery and Removal Procedures

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

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

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

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

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

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

Kidney Stones: Who is at Risk

Kidney stones are a common medical issue that arises when hard deposits of minerals form in the kidney and can affect the urinary tract. These stones can cause severe pain in the abdomen and groin, nausea, and pain during urination. Kidney stones have no single or set cause. Anyone is at risk of developing kidney stones at some point in life.

Dr. David Harris of Fort Myers, FLAlthough anyone can develop stones, there are certain factors that can indicate who gets them and how they occur. As urologist Dr. David S. Harris states, “There are certain features of a person’s stone history that are predictors to us if they’re going to have more stones.” A patient suffering from kidney stones will want to consult a urologist to see what can be done to limit the chances of developing kidney stones in the future.

A urologist may want to do a urine or blood analysis to see if there are any reasons for a patient to develop kidney stones. A urologist also may want to address some common risk factors for kidney stones. For instance, dehydration is a very common cause of kidney stones. For this reason, people who live in warm climates and are at greater risk of dehydration are also at greater risk of developing kidney stones. A urologist may recommend that someone living in a warm climate like Florida drink plenty of fluids every day.

People with diets high in salt, protein and sugar are also at increased risk of developing kidney stones. Too much salt especially increases the amount of calcium a person’s kidneys must filter, increasing the chances of stone development. Obesity also increases the risk of developing kidney stones, so weight management is something a urologist will strongly recommend if that is a factor.

Beside dehydration and dietary choices, genetics can play an important role in an individual’s risk of developing kidney stones. If someone in your family has kidney stones, then you are more likely to develop them as well. And once you develop kidney stones you are at a greater chance of developing stones in the future. For this reason, in addition to adjustments in water intake and diet, urologists sometimes will recommend medications.

Just because someone has had kidney stones before doesn’t mean they will have to suffer with them the rest of their lives. At the Advanced Urology Institute, doctors work with their patients to find and correct root causes for kidney stones. For more information, visit the Advanced Urology Institute website.

Kidney Stones Pain, Symptoms and Treatment

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

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

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

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

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

Becoming a Urologist with Amar Raval, MD

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

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

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

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

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

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

KEY TAKEAWAYS:

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

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

How Is Bladder Cancer Diagnosed?

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

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

How Is Bladder Cancer Treated?

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

What Is The Prognosis For Patients With Bladder Cancer?

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

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

TRANSCRIPTION:

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

REFERENCES:

Screening for Prostate Cancer – Dr. Brian Hale

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

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

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

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

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

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

What Do Physician Assistants Do? – Mikhail Lezhak, PA

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

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

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

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

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

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

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

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

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

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

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.