Becoming A Urologist with Dr David DiPiazza

Intriguing, inspiring and interesting, urology is a great profession for a person in love with solving problems, tackling embarrassing situations, saving lives and relating to the stories of humanity. As a urologist, you see people with awkward urine leaks, inability to get an erection, devastating genitourinary cancer and many other depressing and humiliating conditions every day. Fixing these issues and restoring sparkle, enthusiasm and joy to their lives is tremendously rewarding. It’s a unique position that also provides you with the opportunity of continuous learning and satisfaction. It’s an occupation I dreamed of as a child and which I now cherish as a doctor.

Path to Urology

When I completed my undergraduate studies at Cornell University’s prestigious Ivy College, achieving honors of cum laude, I opted to pursue a urology residency to specialize in a field with so many issues to be tackled but so few medical students turning to it.

For a six-year training span that took me to Princeton Medical Center, The Cancer Institute, New Jersey, and Robert Wood Johnson University Hospital, I honed my skills in all aspects of male and female urology, urologic oncology and robotic surgery. With this extensive training and experience I was able to achieve a double certification in 2006 by Female Pelvic Medicine and Reconstructive Surgery and the American Board of Urology. It took me just 5 years of practice to be honored by my peers for excellent work, being elected the Chief of Surgery at the Medical Center of Trinity, originally the Community Hospital.

Areas of Expertise

I routinely tackle the most common urological problems, such as kidney stones, urologic cancers, UTIs, urinary incontinence, enlarged prostate and overactive bladder. As an expert in no-needle, no-scalpel vasectomy, I also perform quite a number of vasectomies in my office. Likewise, because of my skill and experience in advanced laparoscopic technologies and da Vinci robotic I handle several cases of urogynecology and urologic oncology in Florida.

Some of the procedures I perform routinely include sacrocolpopexy (minimally invasive repair of vaginal prolapse), hysterectomy and sling procedures for urinary incontinence, cystectomy (bladder removal) in those with significant bladder cancer, nerve-sparing prostatectomy (prostate removal) for prostate cancer, nephrectomy (kidney removal) to treat kidney cancer, ureter repair and reconstruction in case of obstruction or injury, adrenalectomy (adrenal gland removal) and pyeloplasty (reconstruction of renal pelvis). I am also a robotic surgery instructor and an expert reviewer with C-SATS certification.

Job Satisfaction

As a urologist, the work hours are often long and I usually find myself in situations that are stressful. But to persevere through them and consistently provide safe, timely and effective remedies to those in great need is incredibly satisfying and keeps me going. The challenges just help bring out the best in me and make my job even more fulfilling. Urology is deeply fascinating as I am not just able to tackle embarrassing problems, but also to examine the urinary system and administer treatment with some of the most advanced and innovative technology.

There’s never a dull moment for a urologist as you see different kinds of people and sort out different issues every day, a guarantee that each day will bring some kind of excitement. You also get the opportunity to know these people, earn their trust and build very close, long-term relationships. I find it quite gratifying to care for patients with often devastating and humiliating issues and to see their situations improve.

Why Advanced Urology Institute

During my training years, I looked forward to an ideal workplace — one that would bring out the best of my talents, skills and experiences and empower me to provide the best possible care. And I found it in Advanced Urology Institute. At AUI, I have no administrative work to trouble me, so I spend most of my time caring for my patients and collaborating, innovating and researching for safe and effective solutions to my patients’ problems. And because AUI brings together a huge pool of skilled, creative, passionate and hard-working medical professionals, it makes it easier for me to perform at my best and to take my career to the heights I desire. I couldn’t have found a better workplace than AUI. For more information on the urological services at AUI, visit the “Advanced Urology Institute”site.

Webb McCanse Becoming a Urologist

Are you blessed with a great sense of humor? Do you have the courage to openly talk about sensitive and awkward issues? Or are you just interested in helping very sick people get better? If so, you are just like me and an ideal person to serve as a urologist. People feel uneasy about seeing urologists because the issues we tackle are in an uncomfortable area of the body. But as a urologist, you are always called upon to make patients open up and speak about their problems honestly. It is a challenging task, but one that is very satisfying. Who would not feel gratified and fulfilled after smashing the barriers that make people suffer silently from genitourinary disorders and help them to find relief from embarrassing symptoms?

Becoming a Urologist

The opportunity to work in the Navy was very attractive to me. So I pursued medicine as a path to serving my country. With the United States
Navy taking care of my fees, I completed my medical school training at the University of Kansas and joined the University of Nebraska’s Medical Center for a six-year urology residency. Upon completion, I served in the United States Naval Hospitals of Pensacola and Guam, with sporadic assignments in Cuba and Okinawa, Japan. Following a satisfying naval service, I moved to Advanced Urology Institute.

Areas of Expertise

My extensive training exposed me to a number of advanced technologies and medical procedures. I am an expert in minimally invasive surgical procedures, particularly laparoscopic surgery and robot-assisted surgery for a wide range of genitourinary disorders. At AUI, I see patients with urologic cancers (bladder, penile, urethral and prostate), kidney stones, benign prostatic hyperplasia (BPH), overactive bladder and urinary incontinence, among other conditions. I no longer serve in the Navy, but I am still proud to serve my country by helping its citizens overcome some of the most painful and embarrassing conditions.

Job Satisfaction

Urology is a very interesting profession, with each day presenting new challenges. We educate patients on living healthy lives, achieving their goals and making informed decisions. The level of engagement with patients is just amazing. We get to know our patients, gain their trust and build enduring relationships with them. It is greatly satisfying to just be there for a person who is suffering but feeling embarrassed to discuss his condition. Then to be able to help him open up, discuss the symptoms freely and find relief just brings incredible joy. As a urologist, I am proud of my specialized role and am deeply contented, satisfied and fulfilled as a person.

Why Advanced Urology Institute

Advanced Urology Institute is a pool of like-minded and experienced professionals working through a collaborative, multidisciplinary, patient-centered approach to deliver the best possible care to patients. Our job is not merely to diagnose and treat, but also to help people be proactive and take control of their lives. We consider the different patient needs, offer tailored consultations and treatments, and are always there for our patients. I love working at AUI because it offers the best opportunity for me to serve my country through timely, safe and effective urological care to its citizens. For more information on urological services offered at AUI, visit the “Advanced Urology Institute” site.

How Did Nicole Szell Become a Urologist?

KEY TAKEAWAYS:

  • Dr. Nicole Szell’s journey to becoming a urologist was driven by her passion for women’s health and her educational background in biology, chemistry, and osteopathic medicine.
  • Urology as a profession is intellectually challenging and rewarding, allowing practitioners to build trust-based relationships with patients and improve their quality of life.
  • Advanced Urology Institute is an ideal place for urologists like Dr. Szell to practice, as it offers a supportive environment with skilled professionals and a patient-centered approach to care.

To be able to dedicate your life to preventing, detecting and intervening in painful and embarrassing situations is an attractive and gratifying undertaking. It may not be for everyone, but for those of us in this profession it just brings incredible joy. As a urologist, you are able to direct your energy and enthusiasm to helping people. You are allowed into the lives of people facing painful conditions and are trusted to inject hope and bring back the joy to living. And as you are diagnosing, treating and educating patients, you make long-term connections and enjoy the thrill of being able to make other people well and happy again. It is a wonderful experience.

My Journey to Urology

Women’s health interested me from a very young age, driving me into many years of service as a volunteer and researcher in various women’s health programs and organizations. So when I went to college, my mind was already made up. I just wanted to pursue female urology and pelvic floor medicine. Being a native of the Midwest and Cleveland, Ohio, I went to Radford University in Radford for my bachelor of science in biology and chemistry. Upon graduation, I joined the College of Osteopathic Medicine, East Lansing, MI, for my medical school degree. Then I went to St. John’s Providence Health System, Detroit, for my urology residency program. I specialized in voiding dysfunction, pelvic floor disorders, sexual dysfunction, urologic reconstruction and pelvic organ prolapse, though I also handle general urology disorders such as kidney stones and bladder cancer.

Job Satisfaction

Urology is a field that challenges the intellect daily. It also inculcates the capacity to develop relationships based on trust. But most importantly, it offers the opportunity to solve women’s health problems, something I have been committed to since I was a young girl. As a urologist, I am able to engage with women in different situations and suffering from various conditions. It is a great privilege to listen to them, help them relax and find hope even in the face of a devastating diagnosis. I love my job because each day offers the chance to relieve discomfort, solve embarrassing conditions and improve the quality of life.

Why Advanced Urology Institute

Advanced Urology Institute is a great place to practice. I call it the urologist’s paradise. You are surrounded by passionate, skilled and talented professionals who are dedicated to a greater purpose. Each member of the pool has an unwavering drive to deliver the best possible care. As a team, we collaborate a lot when handling our patients. Since all administrative work has been centralized, we are left to focus on how to address the issues of our patients. So when patients come, they find us energetic and enthusiastic to serve them. And with our multidisciplinary, compassionate and patient-friendly approach, every patient can be sure of the best possible care. Want to know more about our services? Visit the “Advanced Urology Institute” site.

TRANSCRIPTION: 

Hi, I’m Dr. Nicole Szell. I’m a board certified urologist with Advanced Urology Institute.

I grew up in Cleveland. I am an only child. I moved to Michigan. I did my training at Michigan State for medical school. I did my residency in Detroit, Michigan, and then I went down to Miami for my fellowship in female pelvic medicine and urethral reconstruction. I also did specialized training in chronic pelvic pain, which was in Detroit, and I also did specialized training in female sexual function and dysfunction in San Diego, California, before coming here.

REFERENCES: 

Christopher Sherman Becoming a Urologist

To help a patient overcome an agonizing and upsetting condition brings extraordinary joy. That is the special kind of joy that this profession brings. As a urologist, patients come to you when they are at their worst, trust you with secrets they probably share with no other and put their faith in your ability to find safe and effective solutions for their problems. So whether it is the embarrassing urine leaks, difficulty getting an erection or a devastating genitourinary cancer, you are placed in a position to fix the problem and put a smile on the face of a trusting patient. It is a unique position, but one that brings amazing fulfillment and satisfaction.

The Long Path

Right from childhood, I have had a knack for helping people rise above their limitations. As a native of Florida’s Coral Springs I was often surrounded by people with various medical conditions who had few physicians to attend to them. I made up my mind early that I would pursue medicine to be able to make an impact on these lives. I got my undergraduate degree in health science at the University of Florida, then moved to the College of Medicine, Florida State University, for my medical school degree. After that I took a one-year general surgery training followed by a four-year urology residency at the University of Louisville in Kentucky.

Areas of Expertise

During my training, I became interested in medical technology and in advanced medical procedures. I not only honed my skills in minimally invasive techniques and robot-assisted surgery, but also mastered a number of specialized procedures such as laser surgery for BPH, Botox therapy for overactive bladder, interstim therapy for underactive and overactive bladder, and urethral slings for voiding dysfunction. Through my expertise as a urologist, I have been able to achieve my life’s dream of re-igniting the desire and joy to live in people facing their most uncomfortable, painful or lowest moments. As a urologist, I always feel a sense of peace and fulfillment after making a positive change in the life of a patient.

Job Satisfaction

As urologists, we work for long hours and often face stressful situations. But we take pride in our capacity to persevere and consistently deliver safe, timely and effective treatments. In fact, the challenges just help bring out the best in us and make our job even more interesting. We understand that to have the opportunity to help the sick is very rewarding. We also get to know our patients, win their trust and establish very close relationships. It is so satisfying to take care of patients and be able to make a difference in their lives.

Why Advanced Urology Institute

Every urologist yearns for a workplace that can bring out the best of their skills, talents and experiences and enable them to offer the best possible care. At Advanced Urology Institute, all administrative work has been centralized, allowing physicians to have enough time, tools and drive to collaborate, research, innovate and give the best possible care to their patients. AUI enables us to be in the company of other skilled, passionate, hard-working and creative people, making it easier for us to perform at our best and to take our careers to whatever heights we imagine. At AUI, urologists are living their dreams! For more information, visit the “Advanced Urology Institute” site.

Vasectomy: Easy, Safe, and Effective Birth Control

Vasectomy is a common form of birth control. More than 50 million men have undergone the procedure worldwide. In the United States, around 500,000 men get a vasectomy each year. Vasectomy is an easy, safe and effective surgical procedure carried out in a clinic, doctor’s office or hospital. The outpatient procedure takes 10-20 minutes and the patient can go back home on the same day. While it is still the fourth most preferred method of contraception after oral pills, condoms and tubal ligation, it is one of the cheapest, safest and most effective family planning options.

Vasectomy Procedure

During a vasectomy, the small tubes of the scrotum that transport sperm are blocked or cut off to prevent sperm from leaving the body and causing pregnancy. The name vasectomy comes from the vas deferens, the scrotal tubes that are blocked or cut off during the procedure. Vasectomy is intended for permanent sterilization, so while it can be reversed, only those who are sure they no longer want more children should undergo the procedure.

There are two common vasectomy techniques: the no-cut (no-scalpel) method and the incision method. No-scalpel technique is a lower-risk procedure that minimizes the chance of infection and complications while also taking less time to heal. Nevertheless, whatever method is used, vasectomy is a quick procedure performed with local anesthesia or IV sedation, depending on the patient’s condition and surgeon’s preferences. After numbing, one or two small incisions are used to access the vas deferens so they can be clamped, sealed or cut to disrupt sperm flow. The procedure is performed on both sides.

Recovery from vasectomy

Recovery time after vasectomy varies, but most men are able to return to normal physical activity in 2-3 days. Recovery is quite easy as the patient is able to go home soon after the procedure, rest, apply ice packs for 24-48 hours, watch football over the weekend and be able to resume work the following week. However, it is important to notify your doctor of any severe bruising, swelling, fever, pus or chills. These may indicate internal bleeding or infection and should be dealt with appropriately.

Safety and efficacy

Vasectomy is a highly effective method of preventing pregnancy, guaranteeing almost 100 percent efficacy. It is a safe and low-risk procedure, with just about 1 percent of men reporting side effects such as infection, bleeding and pain. Compared to tubal ligation, vasectomy is faster, less painful and has fewer potential complications. Vasectomy does not significantly change the amount of semen as only sperm will be absent from the ejaculate. It also does not change the way a man ejaculates or feels when having orgasm, so your sex life will remain the same except there will be no worry about pregnancy.

At Advanced Urology Institute, we use the most up-to-date no-scalpel techniques to perform vasectomy and vasectomy reversal quickly, painlessly and effectively. We take great care to review the medical history of every patient, evaluate and counsel our patients, answer all patient questions and ensure that only the right candidates undergo the procedure. We also deliver a safe and effective procedure through a patient-centered, multidisciplinary approach that guarantees the best services for all our patients. At AUI, your health is our number one priority. For more information on vasectomy and vasectomy reversal, visit the “Advanced Urology Institute” site.

Treating Prostate Cancer

Prostate cancer is one of the most common cancers among American men. In fact, it is the most frequently diagnosed non-skin cancer in men, with over 2 million American men currently living with the cancer. Statistically, a new case arises every 3 minutes, one in six American men has prostate cancer, while an American man dies of it every 19 minutes.

Making treatment decisions

At Advanced Urology Institute, we make every effort to deliver world-class treatment and care for patients with prostate cancer. After a diagnosis, our physicians review various treatment options before picking any treatment for the patient. We also conduct further studies, such as biomarker testing and imaging studies, to ensure that we have correctly established the stage or extent of the disease. We use this information to make the right decisions and give prostate cancer patients the most effective treatments. We choose treatment options depending on the cancer itself (high-risk, intermediate risk or low-risk) and patient factors (personal preferences, age and other health issues).

Prostate cancer treatment options

Advanced Urology Institute offers a wide range of innovative and effective diagnostic and treatment procedures for patients with prostate cancer. At the institute, newly diagnosed patients get the opportunity to meet and discuss their condition with renowned and experienced specialists on the same day.

Our treatment options include:

  1. Active surveillance: For a low-risk prostate cancer that may not harm a patient over the course of his lifetime, urologists at AUI usually recommend close observation. It often comes with secondary chemoprevention.
  2. Prostatectomy: Prostatectomy is a surgical procedure to remove the prostate. For localized prostate cancer, radical prostatectomy may be employed. However, at Advanced Urology Institute, we commonly apply the robot-assisted technique, which is a minimally-invasive, laparoscopic procedure.
  3. Radiation: An external beam of radiation is directed at the prostate in order to kill cancerous cells.
  4. Cryotherapy: Probes are inserted into the prostate gland to allow for the introduction of liquid nitrogen into the gland. Once administered, liquid nitrogen produces an ice ball inside the prostate which destroys cancerous cells.
  5. Brachytherapy: A radioactive seed is implanted in the prostate. The procedure involves inserting and removing the needles that are used to place radioactive seeds inside the prostate.
  6. Hormone therapy: Various medications can be administered to reduce or inhibit the secretion of testosterone hormone. Diminished quantities of testosterone means reduced or no growth of the cancer.
  7. Chemotherapy: Certain drugs may be used to boost the effectiveness of the other treatments, both for metastatic and localized disease.

Multi-disciplinary treatment and care

At Advanced Urology Institute, our goal is to cure prostate cancer while also maximizing the quality of life of our patients. We carefully weigh the benefits of every treatment option against the side effects and develop the most practical individualized treatment programs for all patients. We also believe that effective management of prostate cancer needs extensive collaboration. We have implemented a multidisciplinary approach to treatment that allows our various specialists, such as urologists, radiation oncologists, medical oncologists, radiologists, pathologists and clinical trial nurses to deliberate and get diverse, specialized perspectives before making treatment decisions for any patient. During AUI conferences, detailed discussions among experts help to clarify the benefits and risks of various diagnostic tests and treatment options, resulting in better treatment outcomes for our patients.

Advanced Urology Institute uses image-guided targeting, MRI, ultrasound and fusing 3-D guidance to boost the accuracy and usefulness of prostate biopsies. We also apply minimally-invasive, outpatient procedures in most cases. So, with our comprehensive consultation service and multidisciplinary approach that incorporates the latest technologies, research developments and expertise, all our patients can be sure of the best possible prostate cancer treatment. Want help with prostate cancer? Get more information from our “Advanced Urology Institute” site.

Advanced Urology Institute Working Together For You

Advanced Urology Institute is a leading urology practice that excels in the diagnosis and treatment of disorders of the female and male urinary tracts and problems of the male reproductive system. Designed to be a world-class urology center, AUI brings together a huge group of doctors who are specialists in various areas to offer coordinated, effective and top-notch urology services to their patients. From restoring fertility to curing cancer, addressing incontinence to treating kidney stones, the urology services offered by AUI touch every sphere of life and bring back smiles to the faces of all who come to us for help.

Satisfying patient experience

By centralizing the administration of urology services, the doctors are able to concentrate on delivering the highest quality service to patients from initial consultation to follow-up care. The unique partnership and collaboration of many doctors and several care centers ensures that every physician or center in AUI can broaden the scope of expertise and services provided to patients, resulting in a positive experience to meet the unique needs of our patients wherever they are. At Advanced Urology Institute, we invest our time and effort, skills and experiences to make our services better. We are dedicated to delivering life-saving medical and surgical urology care in a prompt, safe and affordable manner. For us, it is not merely our job. The wellbeing and health of our patients is our number one priority.

Innovative and cutting-edge techniques

Advanced Urology Institute is a pool of urologists from multiple subspecialties. We pride ourselves on expertise and ensure that all members of our team continue to undertake training in the latest specialized surgical and medical techniques. Our experienced urologists work collaboratively to deliver highly complex treatment and care individualized to the needs of our patients. And with our exceptional range of specialist urologists, we are able to deliver more complex and innovative surgical services not available anywhere else. As a group, we are able to pool our resources, enabling all our members to have access to better equipment, instruments and tools for managing urologic disorders. Each member of the team has more experts to seek help from and we frequently send patients to other colleagues among us with more expertise and experience. As a result, we do as good a job and deliver as great results as any other premier urology centers in the country.

Unparalleled range of services

At Advanced Urology Institute, we offer a broad range of life-improving, life-extending and life-saving services to patients of all ages. Those who come to AUI have access to every possible treatment option available. In fact, most of the patients we see usually come with issues that other institutions are not able to diagnose or treat. As a team, we are committed to delivering the right care to every patient the first time they come, guaranteeing the highest rate of treatment success. We also endeavor to provide individualized, comprehensive care for all urologic conditions and diseases, giving every patient the opportunity to tap into our collaborative and team approach to have their issues resolved. At AUI, we ensure that all our hospitals, clinics, health care facilities and physicians serve with integrity and unwavering commitment to excellence. We listen to every concern, tailor every evaluation, apply the right treatment and do what is best for the patient. As a team, we deliver beyond the expectations of our clients.

For more information, visit the “Advanced Urology Institute” site.

What are the Symptoms of Low Testosterone

Produced in the testicles (testes), testosterone is the hormone responsible for masculinity and muscular development. It is the hormone that fuels sex drive, creates a deep voice, boosts muscle mass, regulates mood, controls body and facial hair patterns, and regulates bone strength. Testosterone levels usually decrease as men age, with studies showing that a man loses roughly 10 percent of testosterone each decade after reaching the age of 30.

Symptoms of low testosterone levels

Since the reduction in the level of testosterone is typically gradual, the symptoms take longer to occur. Generally, however, about 30 percent of all men will experience symptoms of low testosterone after the age of 50. Andropause is the term used to describe a decrease in the level of testosterone hormone in men. Men experiencing andropause can suffer various symptoms associated with the condition and may be at risk of having other serious health problems like osteoporosis if proper treatment is not administered.

The symptoms of low testosterone include:

  1. Diminished sexual desire (low libido)
  2. Problems getting erections or weak erections
  3. Fatigue and weakness
  4. Hot flashes
  5. Irritable moods
  6. Depression
  7. Increased body fat
  8. Loss of muscle mass or strength

Low testosterone can cause various complications or even change a man’s body. For instance, it can lead to obesity, hair loss, muscular atrophy (less muscle mass), softer testicles, smaller testicles, cardiovascular problems, larger breasts and brittle bones (osteoporosis).

Causes of low testosterone

Even though aging is the most frequent cause of low levels of testosterone in men, several other factors may be involved. Common causes of low-T include:

  1. Kidney disease
  2. Diabetes
  3. Testicular injuries
  4. Liver disease
  5. COPD (chronic obstructive pulmonary disease)
  6. Radiation therapy
  7. Steroid medications
  8. Pituitary gland disorders
  9. Chemotherapy

Men also may be tested for low-T if they have very low sex drive, erectile dysfunction, low sperm count, hair loss, reduced muscle mass or osteoporosis. And because the symptoms of low testosterone are not specific, a doctor may want to first rule out other conditions with similar symptoms before treatment.

Treatment of low testosterone

Testosterone replacement is the most common treatment for men having low-T. The therapy is administered to relieve symptoms and improve quality of life. The testosterone used in the replacement therapy is usually available in various preparations, including gels, capsules, skin patches and injections. The doctor will decide if testosterone replacement therapy is appropriate for a patient. For instance, the treatment is not appropriate for men with prostate cancer and breast cancer. Men with an enlarged prostate, liver disease, kidney disease or who are using blood thinners may or may not undergo replacement therapy depending on their medical history.

At Advanced Urology Institute, we have a long history of treating low testosterone. We put the interest and health of our patients first and always discuss with our patients in great length their conditions and medical history before we administer treatment. For more information, visit the “Advanced Urology Institute” site.

What is an Erectile Dysfunction? with Dr. James E. Renehan

Erectile dysfunction (ED) is a man’s inability or difficulty to get or keep erections that are firm enough to enable sexual intercourse.

While occasional ED is very common in men, particularly during times of stress, depression or fatigue, frequent ED can really ruin a man’s life. For instance, some men with erectile dysfunction may avoid contact with their partners for fear that they will have trouble satisfying them sexually in the bedroom while others may get into a complete emotional and psychological meltdown.

Forms of erectile dysfunction

According to Dr. James E. Renehan of Advanced Urology Institute, erectile dysfunction can take a variety of forms. For example, some men may be unable to get an erection under any circumstance, while other men with ED may occasionally get an erection. In other men, getting an erection is possible but the erections are not strong enough for satisfying sexual intercourse.

“Erectile dysfunction does not mean that you are infertile,” says Dr. Renehan. “In fact, the majority of the men having difficulties with getting an erection are still quite capable of achieving an orgasm and getting children. ED just means that you cannot consistently get or sustain an erection.”

What are the symptoms of erectile dysfunction?

You could be suffering from ED if you frequently have:

  1. Difficulty getting an erection.
  2. Trouble sustaining an erection throughout sexual intercourse or during sexual activities.
  3. Diminished interest in sex.

However, there are also a number of factors related to erectile dysfunction, such as:

  1. Premature ejaculation.
  2. Difficulty achieving orgasm even after ample stimulation (anorgasmia).
  3. Delayed ejaculation.

Experiencing such symptoms for 2 or more months may indicate that you have erectile dysfunction. So it is important to speak with your urologist to determine if you have a sexual disorder.

“Men should know that erectile dysfunction is not in the head,” says Dr. Renehan. “You will not simply get an erection by stimulation, as 80 percent of all cases of ED are usually caused by treatable physical disorders, such as high blood pressure, high cholesterol or diabetes. So make sure you visit your doctor for advice.”

Causes of erectile dysfunction

Erectile dysfunction may have several possible causes, including both physical disorders and emotional problems. The most common causes are:

  1. Diabetes
  2. Obesity (being overweight)
  3. Smoking, alcohol use or drug abuse
  4. Hypertension
  5. Cardiovascular disease
  6. Hyperlipidemia
  7. Injuries
  8. Stress, anxiety or relationship problems
  9. Damage from surgery or cancer treatment
  10. Increased age

Because there are many possible causes of erectile dysfunction, it is important to work with a urologist so that any underlying medical conditions are identified and treated.

Diagnosis of erectile dysfunction

When you visit your urologist, you will be asked questions related to your symptoms, health history, emotional and physical problems. You also should expect a physical examination in which the doctor will listen to your lungs and heart, examine your penis and testicles and measure your blood pressure. The doctor may order various tests to determine whether you have an underlying disorder, such as blood and urine tests. A rectal examination may be requested to check your prostate.

Treatment of erectile dysfunction

The treatment chosen by your doctor will depend on the type of symptoms and any underlying causes for the dysfunction. At times, a combination of treatments may be necessary. The most common treatments for ED include:

  1. Medications: The doctor may prescribe medications to improve blood flow to the penis and improve ED symptoms. The drugs commonly indicated include Alprostadil (Caverject), Avanafil (Stendra), Sildenafil (Viagra), Tadalafil (Cialis), Testosterone (Androderm) and Vardenafil (Levitra).
  2. Talk Therapy: If it is established that the erectile dysfunction is caused by psychological factors such as stress, depression, anxiety or post-traumatic stress disorder, the urologist may recommend that you see a therapist. Working with the therapist, you will attend several sessions in which you will be helped to recover from stress, anxiety, subconscious conflict or negative feelings around sex. A relationship counselor also may be called upon if the ED is affecting your relationship.
  3. Alternative Treatments: Treatments such as prostatic massage, acupuncture, yoga and pelvic floor exercises also may improve your condition. Likewise, lifestyle and diet changes, such as regular exercise, losing weight, lowering your blood pressure and avoiding cigarettes and alcohol can be recommended to help you overcome erectile dysfunction.
  4. Surgery: When medications and exercises fail to work, the urologist may perform a surgery to correct any problems in the penis or to add a penile implant. Penile implants help to generate spontaneous and controlled erections.

Erectile dysfunction is treatable

Most cases of erectile dysfunction are treatable. At Advanced Urology Institute, we have helped thousands of men to improve their symptoms and regain their confidence through compassionate, multidisciplinary, patient-centered treatment approaches. Depending on your condition, we will administer the right medications or treatments to ensure that you achieve an erection and be able to have satisfying sexual intercourse. Come and discuss your symptoms with us so we can fix your problem. For more information on help with erectile dysfunction, visit the “Advanced Urology Institute” site.

What is Da Vinci Robotic Prostatectomy?

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

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

High-Precision Prostatectomy

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

Computerized 3-D Visualization

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

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

Getting da Vinci Prostatectomy at Advanced Urology Institute

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

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

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

Types of Prostate Cancer

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

Prostate Cancer Is Generally Slow-Growing

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

Aggressive Versus Indolent Prostate Cancer

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

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

Identifying Aggressive Prostate Cancer

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

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

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

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

New Treatment Options for Erectile Dysfunction

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

Evolution of Erectile Dysfunction Treatments

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

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

New Treatment Options

New treatment options for ED include:

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

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

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.