New Treatment Options for Erectile Dysfunction

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

Evolution of Erectile Dysfunction Treatments

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

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

New Treatment Options

New treatment options for ED include:

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

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

Common Treatment Options for Stress Incontinence

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

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

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

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

Thanksgiving is The Best Time To Get A Vasectomy

Considered the easiest and safest form of surgical sterilization, vasectomy is an outpatient procedure in which the tubes (vas deferens) that carry sperm from a man’s testicles to the urinary tract are cut to stop the release of sperm during sexual intercourse. During a vasectomy, a small cut made through the skin on the front surface of the scrotum is used to bring the vas deferens to the skin level, allowing the vas to be cut or cauterized (burned) before being tied or clipped off and then dropped back into the scrotum.

After a vasectomy, a man is encouraged to rest for a few days. During the first 24 hours after the procedure, it is recommended that he apply an ice pack on the scrotum or use a package of frozen peas to reduce discomfort. The ice pack should be wrapped in a towel and should not be placed directly on the skin. Recovery takes a few days and the man can resume routine work within 3 days, but should avoid exercise and heavy lifting for at least one week.

Choosing to undergo a vasectomy is a big step in your life, and like most big life decisions, the timing of the procedure is critical. In fact, while the procedure is typically an outpatient routine, the recovery period requires ample rest, which makes it important to carefully choose the time to have the procedure. Even for a really tough guy who would like to go back to work soon after a vasectomy like it is no big deal, recovery still means a few days of soreness and discomfort which need to be properly timed to minimize inconvenience as much as possible.
So when is the best time to have a vasectomy?

1) March Madness

For sports fans, March offers lots of good entertaining TV watching, particularly during the first weekend of the NCAA Basketball Tournament. It is also a perfect time to schedule the procedure because it allows you to rest on your couch and enjoy the games on TV while your body recovers from the operation. In fact, many urologists across the United States have reported that there is a massive increase in the number of vasectomies scheduled in the period leading to the NCAA tournament (as many as 50 percent more procedures during this season than at any other time of the year). So if you are thinking about having a vasectomy, the Thursday and Friday of the first weekend of the NCAA tournament is a good time to undergo the procedure and then kick back for the entire weekend with your ice pack and great games involving your favorite players and teams.

2) A Four-day Weekend

Due to the down time involved in recovering from a vasectomy, a four-day weekend is ideal for the procedure. In this case, you can take a Friday off from work if there is a holiday the following Monday, such as Labor Day or Memorial Day. The time is adequate for you to relax and enjoy quiet activities as you recover from the operation. Scheduling the procedure on a Thursday or Friday also will reduce the amount of time you will miss from work.

3) Thanksgiving Weekend

After a vasectomy, it is recommended that you get enough rest and avoid activities that may require exertion. There is no better time of the year that you can find complete rest from exertion than during the Thanksgiving weekend. Thanksgiving weekend provides four days for you to enjoy delicious food, watch football, spend time with family members and engage in other activities that you desire. So you can schedule your operation just before the big day’s feast in order to have enough time to recover. Of course, you should avoid traveling over that weekend and stay away from the traditional annual touch football family game.

Have you decided to undergo a vasectomy or have questions about planning for a vasectomy? Advanced Urology Institute is the place for you to find the best information and get the safest and most effective vasectomy. As a leader in vasectomy in Florida, Advanced Urology Institute offers top-notch vasectomy techniques such as the no-needle no-scalpel procedure that is less invasive and causes minimal discomfort, fewer complications and requires a shorter recovery time. For more information on how to find the best urologist for treatment of urological problems and for the vasectomy procedure, visit the “Advanced Urology Institute” site.

Prostate Cancer: Early Detection and Screening

Prostate cancer screening means conducting tests to find the cancer in people with no symptoms. Screening helps in early detection of the cancer when it is still easier to treat. To detect prostate cancer before symptoms appear, urologists recommend either measuring the amount of prostate-specific antigen (PSA) in blood or doing a digital rectal exam (DRE), when the urologist inserts a gloved, lubricated finger into the rectum. If the results of a PSA or DRE are abnormal, the urologist will request further tests. Finding prostate cancer via a PSA or DRE screening means the disease is probably still at an early stage and will respond well to treatment.

PSA Screening

Prostate Cancer: Early Detection and ScreeningThe prostate-specific antigen (PSA) test measures the amount of the protein (PSA) released in blood by prostate cells. Even though both normal and cancerous (abnormal) prostate cells produce the protein, higher blood levels of PSA indicate the possibility of cancer. The PSA test is one of the best indicators of prostate cancer and is recommended by urologists because it is widely available, relatively inexpensive and is a low-risk blood test for patients.

Digital Rectal Exam (DRE)

To perform a digital rectal exam, the urologist inserts a gloved and lubricated finger into the rectum in order to feel the state of the prostate gland. Since prostate cancer often begins in the back of the prostate, DRE helps to assess the texture of this area and checks for hard areas and bumps (nodules) which might indicate cancer. DRE is also effective in detecting whether the cancer has spread to nearby tissues or has reoccurred after treatment.

Confirming Prostate Cancer

After a digital rectal exam (DRE) or PSA blood test, the urologist may request a biopsy to confirm the cancer. But before the doctor can decide whether biopsy is necessary, a number of supplementary tests and considerations must be made, including family history, ethnicity, prior biopsy findings and different forms of PSA. A biopsy means the doctor takes out a small portion of the prostate tissue to be examined under a microscope for cancerous cells. Since cancerous cells appear different from normal prostate cells, a close exam of biopsy cells will help to confirm the cancer.

When to Start Screening

The age of beginning or stopping prostate cancer screening depends on individual risk. Men with a higher risk of having prostate cancer should start screening at age 40. This includes African American men and all men with first and second degree relatives with a history of prostate cancer. Men with average risk should start screening at 50, but only after discussing it with their doctors to reduce the rate of unnecessary biopsies. Men age 75 and older or those with limited life expectancy (less than 10 years) should be discouraged from early detection testing for prostate cancer because they may not benefit much from screening. Nevertheless, a decision to go for prostate cancer screening must be made with the help of a urologist or GP and should depend on a man’s lifestyle, family history, overall health and life expectancy. For more information on screening, diagnosis and treatment of prostate cancer, visit the site, Advanced Urology Institute.

2 Kinds of Incontinence

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

Two types of incontinence

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

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

Seek immediate help

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

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

8 Easy Ways to Cleanse Your Kidneys

The kidneys are amazing little organs. Each day, they process about 200 quarts of blood, getting rid of excess water and waste products, removing toxins and keeping the body functioning smoothly. If the kidneys are not able to remove toxins and waste from the body, they will build up in the body and hinder the normal function of kidneys, liver and other organs, resulting in exhaustion, stomach pain, headaches, water retention and other problems. Buildup of toxins and waste also may lead to kidney stones, a mass of crystals or unprocessed minerals which can grow to the size of a golf ball. Kidney stones affect 10-15 percent of American adults, but also may be found in children as young as five.

Kidney stones causes and symptoms

There are many causes of kidney stones, such as dehydration, excessively acidic urine, urinary tract infections, buildup of waste and toxins in the kidneys, among others. The symptoms of kidney stones include excessive lower back, abdominal or urinary tract pain which may be sharp, mild or excruciating, severe vomiting or feeling nauseated, persistent urge to pass urine, and constant chills or sweating. While the symptoms vary depending on the size of the stones, unceasing pain and discomfort on the sides is a good reason to see a urologist. Kidney stones are easily curable if diagnosed early.

Why you should cleanse your kidneys

There are several reasons why you should flush out toxins and waste from your body. For instance, cleansing your kidneys improves their function and reduces bloating. Likewise, cleansing your kidney improves your ability to process certain foods, absorb nutrients and convert food to energy, preventing fatigue. Flushing out waste and toxins prevents potential infection and reduce the risk for bladder problems. Similarly, cleansing the kidneys reduces the chances of having painful kidney stones, corrects hormonal imbalances and prevents skin breakouts such as acne, eczema and rashes.

Below are 8 easy ways to cleanse your kidneys

1. Apple Cider Vinegar

Apple cider vinegar is effective in preventing oxidative stress of the kidneys. It increases the levels of antioxidants in the body, balances blood sugar levels and reduces blood pressure, creating optimum conditions for kidney health. Apple cider vinegar contains citric acid which dissolves kidney stones. Frequent intake of apple cider vinegar also flushes out toxins from the kidneys.

2. Kidney Beans

Kidney beans not only resemble the kidneys but also remove waste and toxins from the kidney and flush out kidney stones effectively. Kidney beans are rich in Vitamin B, fiber and several minerals which help to clean the kidney and boost the function of the urinary tract.

3. Lemon Juice

Lemon juice is naturally acidic and increases citrate levels in urine, hence discouraging the formation of kidney stones. Lemon juice also filters blood and flushes out wastes and other toxins. Daily intake of diluted lemon juice reduces the rate of kidney stone formation and dissolves calcium oxalate crystals, which is the most common constituent of kidney stones. For people with kidney stones, combining lemon with olive oil ensures smooth passage of the stones.

4. Watermelon

Watermelon is a mild diuretic. It hydrates and cleanses the kidneys. It is also rich in lycopene, which improves cardiovascular health and ensures well-functioning kidneys. Watermelon also has large quantities of potassium salts which regulate acidity of urine and prevents stone formation. In fact, eating watermelon regularly is great for kidney health.

5. Pomegranate

Both the juice and seeds of pomegranate contain large amounts of potassium and therefore are effective in removing kidney stones. Potassium lowers acidity of urine, prevents stone formation because of its astringent properties, curtails crystallization of minerals, and flushes out toxins and waste from the kidneys.

6. Basil

Basil is an effective diuretic. It removes kidney stones and improves kidney functioning. Basil also lowers the level of uric acid in blood and improves kidney health. Its ingredients such as essential oils and acetic acid break down kidney stones and allow for smooth removal. Basil is also a pain killer.

7. Dates

When dates are soaked in water for 24 hours and then consumed after seeds are removed, they are effective in dissolving and flushing out kidney stones. Dates are rich in fiber, helping to reduce the risk of kidney stones. The magnesium ingredient in dates also cleanses the kidneys.

8. Dandelion

Consuming tea made using dried organic dandelion or fresh dandelion root (pulled from the ground) helps to cleanse the kidneys. Dandelion is a kidney tonic, but also stimulates bile production to improve digestion and minimize the waste reaching the kidneys.

Another effective cleansing agent for the kidneys is cranberry juice which supports the urinary tract, fights urinary tract infections and removes excess calcium oxalate. Beets and their juices contain Betaine which increases urine acidity, prevents build-up of struvite and calcium phosphate and reduces the chances of kidney stone formation. Other effective cleansing agents are coconut water, cucumber juice and cherries. For more information on preventing and treating kidney problems, visit the site, Advanced Urology Institute.

What is Prostate and Prostate Cancer?

The prostate gland is a chestnut-shaped male reproductive organ located below the urinary bladder and surrounding the upper portion of the urethra, the duct that allows passage of semen and urine. It is a conglomerate of secretory ducts that emit fluids into the urethra and ejaculatory ducts. The prostate produces a thick, white fluid which mixes with sperm from the testicles to create semen, contributing 15-30 percent of the semen secreted by a man. The gland also produces a protein known as prostate-specific antigen (PSA), which turns semen into liquid. While the prostate matures into a small, walnut-sized gland at puberty, usually between 10-14 years old, it will still grow slowly with age. However, prostate enlargement after age 50 may lead to urinary problems, often occurring as a result of inflammation or malignancy.

Prostate Cancer: What is it?

Prostate cancer is a disease that occurs when changes in prostate cells make them grow uncontrollably or abnormally. The abnormal or cancerous cells then may continue to multiply non-stop and even spread outside the prostate into nearby or distant areas of the body. Prostate cancer is rare before age 50, but is common among older men and is the second most frequent cause of all cancer-related deaths in American men. The disease is typically slow growing, often showing no symptoms until it reaches advanced stage. Hence, most men with the cancer will never know it and will just die of other causes. Nevertheless, when prostate cancer starts to grow and spread quickly, it can be very lethal and requires prompt treatment.

Causes of Prostate Cancer

Prostate cancer occurs mainly in older men, with more than 80 percent of cases seen in men older than 65 and less than 1 percent observed in men younger than 50. Men who eat lots of high-fat diets such as red meat have a higher risk of getting the disease. Studies have shown that the disease is more common among men who consume meat and dairy products regularly than in those who eat vegetables, rice and soybean products. Fats increase the amount of testosterone in the body and in turn speed up the growth and spread of prostate cancer. Men from families with a history of the cancer are at a higher risk, as are welders, rubber workers, battery manufacturers and men frequently exposed to metal cadmium. Failure to exercise regularly also may make the cancer more likely.

Symptoms of Prostate Cancer

Prostate cancer tends to show no symptoms in the early stages, but will show some symptoms in the later stages. Common symptoms include sudden or frequent urge to urinate, trouble starting a urine stream or knowing when to urinate, pain or discomfort when urinating, blood in urine or semen, and pain in the upper thighs, lower back or hips. While these symptoms may not necessarily mean you have prostate cancer, you should see a urologist or GP when you have any of them.

Diagnosis and Treatment

When you visit a urologist, a medical history and physical examination will be performed followed by a digital rectal exam (DRE) and PSA test. If the doctor detects that you are at risk of prostate cancer, a biopsy will be requested to confirm it. There are several treatment options for prostate cancer including active surveillance (watchful waiting), surgery, radiation therapy, cryotherapy, hormone therapy, chemotherapy and bone-directed treatment. Remember that early diagnosis and treatment of prostate cancer improves your chances of survival. For more information on treatment of prostate diseases, visit the site, Advanced Urology Institute.

Most Common Forms of Prostate Diseases

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

The most common prostate diseases are:

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

Benign prostatic hyperplasia (BPH)

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

Prostatitis

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

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

Prostate cancer

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

Symptoms of prostate disease

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

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

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

Vasectomy Poses Minimal Risk of Prostate Cancer

For men who are done having children, vasectomy is an effective method for birth control. As a surgical procedure that involves the cutting, blocking or sealing off tubes that transport sperm out of the testicles, vasectomy prevents the release of sperm during sex and is therefore a long-term form of birth control. About 1 in 7 men undergoes vasectomy after the age of 35 years. However, while the procedure is fairly simple and generally safe, it has sparked controversy about various long-term risks, particularly its link to prostate cancer (PCa). The prostate gland is located just behind the tubes and adds essential fluids to semen, so there has been a longstanding fear that vasectomy may cause prostate cancer.

Does vasectomy increase the risk of prostate cancer?

A 2014 Harvard research generated panic when it associated vasectomy with a 10 percent increase in the risk of prostate cancer and a 20 percent increased risk of the aggressive form of the cancer. But according to a recent report published online in the JAMA Internal Medicine, those numbers were probably overblown. Based on a comprehensive review and meta-analysis drawing on more than three decades of epidemiologic literature, the researchers in this study demonstrated that any risk posed by vasectomy, if at all existent, is too small to be of clinical importance.

The researchers reviewed and analyzed 53 studies, including 33 case-control studies involving 44,536 men, 4 cross-sectional studies involving 12,098,221 men, and 16 cohort studies involving 2,563,519 men. The analysis revealed no significant link between vasectomy and aggressive prostate cancer, whether high-grade cancer (Gleason score of 8 or more), advanced (normally T3-4, positive nodes or metastasis), or fatal prostate cancer (PCa). And when data from 6 case-control studies and 7 cohort studies considered to be of low risk according to the Newcastle-Ottawa Scale were analyzed, a non-significant 6 percent increased risk of prostate cancer was noted in the 6 case-control studies while the 7 cohort studies gave a weak but noteworthy 5 percent increased risk of prostate cancer.
From the data, the researchers calculated the absolute increase in lifetime risk of prostate cancer for those who have undergone vasectomy. It was found that vasectomy has an absolute lifetime risk of prostate cancer of just 0.6 percent and may only be responsible for 0.5 percent of prostate cancer cases in the population. This led to the conclusion that the association between vasectomy and prostate cancer is at most trivial, clinically insignificant and should not stop the use of the procedure for long-term contraception.

Vasectomy is Safe

This study affirms that vasectomy is unlikely to substantially increase the risk of having any type of prostate cancer. It also affirms that there is no difference in development of prostate cancer between those who undergo vasectomy and those who do not. In fact, the small risk of low-intermediate tumors reported is attributed to the fact that men who get vasectomies also tend to take PSA tests for prostate cancer, which can detect early-stage disease.

If you are looking for a safe and effective form of birth control, do not let fears of prostate cancer discourage you. Vasectomy does not increase your risk of the cancer. And while more research on the causes of prostate cancer is still ongoing, you can lower your risk by maintaining a healthy weight, regular exercise, eating a low-fat diet, increasing vegetable intake, decreasing dairy intake, and quitting smoking. Talk to your urologist about what is right for you depending on your medical history.

Becoming a Urologist – Dr. David E. Burday

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

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

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

Urologist Education

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

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

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

Conditions Treated by Urologists

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

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

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

Necessary Skills

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

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

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

How Percutaneous Nephrolithotomy Works?

Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure for removing upper ureteral stones and kidney stones larger than 2 centimeters in diameter. Historically, larger stones were removed in open surgery, which required a larger flank incision. Percutaneous nephrolithotomy (nephrolithotripsy) is a more refined alternative to open surgery, using a 1-centimeter skin incision. The procedure reduces blood loss, pain and hospital stay and has an increased success rate.

During PCNL, the patient is given general anesthesia before a needle is inserted through the skin to puncture the kidney and create a channel through which a nephroscope is passed into the kidney to break the stone into fragments for easy extraction. The entire procedure takes 3-4 hours.

During percutaneous nephrolithotomy:

  • The patient receives general anesthesia to make the procedure less painful. The patient then lies face down on the abdomen.
  • The surgeon performs cystoscopy (telescopic exam of the bladder) and instills X-ray dye or carbon dioxide into the kidney using a small catheter through the ureter of the affected kidney. This helps the surgeon to locate the stone more precisely.
  • After locating the stone, the urologist makes a small incision on the back and passes a tiny needle through the skin (under X-ray guidance) into the kidney to directly access the stone.
  • The needle tract is dilated to about 1-centimeter to enable placement of a plastic sheath and telescope for visualizing the stone.
  • Using a laser or mechanical lithotripsy device, the surgeon breaks the stone into smaller fragments and extracts the pieces through the sheath.
  • At the end of the operation, temporary catheters, a nephrostomy tube for the kidney and a stent tube for the bladder, are used to drain urine. The catheters are removed before discharge from hospital, usually after 2-4 days.

Percutaneous nephrolithotomy is recommended when:

  • Urine flow is blocked.
  • Kidney stones obstruct several branches of the collecting system of the kidney (also called staghorn kidney stones).
  • Kidney stones are bigger than 2 centimeters (0.8 inch) in diameter.
  • Urine leakage is occurring inside the body.
  • There is severe pain even after treatment for a kidney stone.
  • Kidney stone is causing damage to the kidney.
  • Other treatment options have failed.
  • The urologist will request several tests before the operation. Blood and urine tests check for infection and other problems, while a computerized tomography (CT) scan helps to determine the location of the stones.

Advantages of PCNL:

  • Minimally-invasive procedure, with less pain, quick recovery, shorter hospital stay (2-4 days) and quick return to work (7-10 days).
  • No surgical scar or complications associated with large incision operations.
  • Less risk of postoperative infections compared to open surgery.
  • Minimal harm to kidney function.
  • Limits residual stones, as the surgeon has the opportunity to look inside the renal calyx and ureter.
  • Percutaneous nephrolithotomy is effective for most people with stones in the ureter or kidney. Its stone free rate is greater than 90 percent and is the highest of all procedures.

For more information on treatment of kidney stones, visit Advanced Urology Institute.

The Truth About Testicular Cancer

Testicular cancer develops when abnormal cells grow out of control in a man’s testes (testicles), which are found inside the scrotum. The testes are male sex organs that produce hormone testosterone and make and store sperm. Compared to other cancers, testicular cancer is quite rare occurring in 1 man per 100,000. Nevertheless, it is the most frequent cancer among American males ages 15 to 35 and is more frequently found in white males than Asian or African men. It is important to note that not all testicular lumps are cancer and a man may have other conditions such as testicular microlithiasis, epididymal cysts and appendix testis, all of which may be painful but are non-cancerous. Testicular cancer is very much treatable and can be treated even after spreading beyond the testicle.

Causes

While the exact causes of testicular cancer are not known, the cancer generally occurs when healthy cells of the testicle become altered. Testicular cells usually multiply in a systematic manner to keep the body functioning normally. However, abnormalities in some cells may abruptly cause uncontrollable multiplication, resulting in a surplus of new cells in the testicle. The accumulation of new cells results in a testicular mass or lump. Almost all testicular cancers start in germ cells (testicular cells producing immature sperm).

Risk factors for testicular cancer include:

  • Cryptorchidism (undescended testicles): Development of the testicles occurs in the fetal abdomen and the developed testes move down into the scrotum before birth. A man whose testicles never descended in this manner is at greater risk of having testicular cancer than those whose testes descended normally. The risk is still high even if the testes have been surgically relocated into the scrotum.
  • Abnormal testicle development: Disorders that hinder normal development of testicles, like Klinefelter syndrome, increase the risk of this cancer.
  • Age: Testicular cancer is common in teens and young men (ages 15 to 35). Nevertheless, it may still occur in older men.
  • Family history: If your father or brother has had the cancer, you have an increased risk.
  • Personal history of testicular cancer: If you have had the cancer treated in one testicle, you may develop it in the other testicle.
  • Race: The cancer is more frequent in white males than in black or Asian males.
  • Infertility: Men who do not produce sperm when ejaculating have a greater risk.

Signs and symptoms

Knowing the symptoms of testicular cancer can help you to seek treatment when the cancer is still at an early stage. The most common indicators are:

  • An enlargement or lump in either testicle.
  • Accumulation of fluid in your scrotum.
  • A dull pain or ache in the groin or abdomen.
  • The scrotum becomes increasingly heavy.
  • Discomfort or pain in the testes or on the scrotum.
  • Tenderness or enlargement of male breasts.
  • Lower back pain.
  • In rare cases, testicular cancer can spread and affect other organs resulting in coughing, difficulty swallowing, breathing difficulties and swelling in the chest.

Diagnosis of testicular cancer

A man may detect enlargement or lumps in his testicles through self-examination. A doctor can notice a lump in a testicle during routine physical examination. When an enlargement or a lump is detected, the doctor will suggest a few tests to confirm or rule out testicular cancer. The tests commonly requested are a testicular ultrasound and blood tests for tumor markers. Surgery to remove a testicle for analysis and classification of the cancer also may be performed.

Removal of a testicle is usually done to classify the cancer since it is the type and stage of cancer that determines treatment and prognosis. Testicular cancer is divided into two types, seminoma and nonseminoma. Seminoma cancer can be found in all age groups, but is more frequent in older men. The cancer is less aggressive than nonseminoma. Nonseminoma cancer tends to develop in younger men and teens and is characterized by rapid growth and spread.

Testicular cancer stages

When testicular cancer has been diagnosed, it is then important to determine the stage (extent) of the cancer. For a doctor to assess how far the cancer has spread in or outside a testicle, blood tests and computer tomography (CT) scan are requested. The results of these tests help the doctor to categorize the cancer in stages and to offer appropriate treatment. The stages include:

Stage I: Cancer that is restricted to the testicle.
Stage II: Cancer that has spread out of the testicle into the lymph nodes of the abdomen.
Stage III: Cancer that has spread to various body parts, such as liver, bones, brain and lungs.

Testicular cancer treatment

The appropriate treatment for the cancer depends on many factors, including your general health, stage and type of cancer, and your preferences. For instance the doctor may opt for surgery to remove the affected testicle or nearby lymph nodes. Alternatively, the doctor may use radiation, high-powered beams of energy, like X-rays, to treat the cancer. Another option is chemotherapy, where specific drugs are used to destroy cancer cells. For more information on testicular cancer, visit the site, Advanced Urology Institute.

Symptoms of Enlarged Prostate

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

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

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

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

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

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

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

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

What are the symptoms of an enlarged prostate?

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

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

The less common symptoms of BPH are:

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

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

How can a urologist help?

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

Where is the best place to get a vasectomy reversal in Florida?

All men who undergo a vasectomy are counseled to consider the procedure a permanent form of male sterilization. However, a number of factors such as loss of child or remarriage may call for vasectomy reversal. If you are a man who had a vasectomy in the past but are now considering a reversal, it is important to remember that the procedure is complex and requires specialized expertise and experience to perform successfully.

Where is the best place to get a vasectomy reversal in Florida?

While there are many qualified vasectomy reversal doctors and facilities in Florida, one of the best places to undergo the procedure is Advanced Urology Institute. This multi-dimensional urology practice has locations throughout Florida, including well-equipped clinics in Panama City, Daytona Beach, Blountstown, Perry, St Augustine, Daytona Beach, Port Orange, Tallahassee, Carrabelle, Orange City, Palm Coast, Oxford and other towns, bringing highly qualified and board certified urologists closer to those in need of their medical care. Advanced Urology Institute surgeons perform hundreds of vasectomy reversals every year with a remarkable success rate. The urologists are highly trained in their surgical technique and perform all procedures in accredited clinics with board-certified anesthesiologists who ensure maximum comfort during surgery.

Initial Consultation

A vasectomy reversal at Advanced Urology Institute means access to exceptional treatment and care at a center with an international reputation that offers vasectomy reversal as a specialization. You can schedule surgery over the phone, have your pre-operative appointment with a urologist the first day, and undergo the operation the next day. During the initial consultation, the urologist will review your history, personally perform a complete examination, and request any necessary tests such as blood studies, semen analysis and ultrasound exam. The urologist will discuss all options currently available, and the relative success rate of each, and will help you make the right choice.

Affordable Cost

The total cost for a vasectomy reversal at Advanced Urology Institute is less than $7,000. These charges include hospital, surgical and anesthesia fees, but exclude post-op semen analysis. You may have a secondary blockage in the epididymis (where sperm is stored behind the testicle) in which case the urologist will examine the fluid coming out of the proximal vas for sperm to rule out a blockage. When there is no blockage, the urologist will proceed with vasovasostomy, a simple vasectomy reversal procedure in which the vas deferens is sewn back together. In case of a blockage, there will be no sperm and the vas deferens will have to be connected directly to the epididymis at the point above the obstruction. This is done through vasoepididymostomy, a more complex vasectomy reversal procedure in which the doctor attaches the vas deferens straight to the back end of the testicles. There will be no additional charges for the complex reversal as the urologist will decide on the appropriate type of reversal at the time of surgery.

Book Your Appointment

Vasectomy reversal at Advanced Urology Institute is an outpatient procedure that is completed in one day. Follow-up appointments may be scheduled the day after the operation and you will return to routine work after 3-4 days. Sexual activity may be resumed after 2 weeks. If you have been considering a vasectomy reversal, be sure to call Advanced Urology Institute and request an appointment for more information.

4 Common Symptoms of Enlarged Prostate

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

Benign prostate enlargement (BPH) is not prostate cancer.

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

What causes BPH?

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

What are the 4 common symptoms of an enlarged prostate?

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

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

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

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

How is an enlarged prostate treated?

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

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

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