What Causes Bladder Incontinence

Urinary incontinence is basically the loss of bladder control or leaking urine. Women experience urinary incontinence twice as frequently as men. One reason for this difference is that childbirth and pregnancy, as well as menopause, can contribute to making urinary incontinence more likely. There are two common types that affect women, stress incontinence or urge incontinence (or overactive bladder, also known as OAB).

Urine is made by the kidneys and is stored in the bladder. There are muscles in the bladder that tighten, causing a need to urinate. When these muscles tighten, urine is forced out of the bladder through the urethra. Urination happens when the sphincter muscles surrounding the urethra relax, letting urine out of your body. Urinary incontinence can make you leak small amounts of urine, or release larger amounts of urine suddenly.

For women, urinary incontinence may happen regardless of age, but it’s most likely to occur in older women. Almost half of women 65 and older have some type of urinary incontinence.

Signals that you have an incontinence issue that merits seeing a urologist include spasms or pressure in the pelvic area, causing an urgent need to urinate. Also frequent trips to the bathroom, for example, more than eight times per day or more than two per night while you sleep.

Your doctor will give you a plan of treatment, starting with steps that you can do at home. If these activities don’t improve symptoms, your doctor might recommend seeing a urologist or recommend other treatments, depending on whether you have urge incontinence or stress incontinence, or both.

What You Can Try at Home

Your doctor, nurse or urologist may suggest exercises that you can do at home. These preventative activities may stop urinary incontinence, or help you leak less.

Here are some of the activities that may be prescribed:

  • Kegel exercises. Kegel exercises targeted to strengthen the pelvic floor can help. However, some women’s pelvic floor muscles remain tightened all the time. In those cases, Kegel exercises not only will not help your urinary symptoms but they may cause more problems.
  • Bladder training. Going to the bathroom at regular times can help control an overactive bladder and help urge incontinence. You will be asked to keep a bladder diary to track how often you make a trip to the bathroom. You then will add 15 minutes to the intervals between bathroom visits. You should urinate each time, regardless of whether or not you feel an urge to go. You will be incrementally increasing the time between visits. Eventually your can train your bladder to retain more urine before it needs to be emptied.
  • Losing weight. Having extra pounds adds pressure to the bladder and surrounding muscles, which can cause bladder control problems.
  • Changing eating habits. Drinks with carbonation, alcohol or caffeine may aggravate incontinence.
  • Treating Constipation. Try eating more fiber because constipation can worsen urinary incontinence.

Urinary incontinence does not need to be a normal part of aging. It is sometimes a signal of another health problem, such as weak pelvic floor muscles. There are different types of treatment available to help ease the problem. Our team of specialists at Advanced Urology Institute have years of experience working with patients with urinary incontinence and can develop the best plan for the individual’s needs. For more information, visit the Advanced Urology Institute website.

What Causes a Urinary Tract Infection?

Urinary tract infections, or UTIs, can be diagnosed based on either symptoms or a urine sample test. The good news is that most urinary tract infections can be cleared up in 2 or 3 days of treatment. When the bacteria of the genitourinary tract are out of balance, there is more opportunity for micro organisms like E. coli to thrive. Here are some causes of UTIs:

  • Difficulty with being able to empty the bladder completely
  • Bowel incontinence
  • Kidney stones
  • Diabetes
  • Poor personal hygiene
  • Some types of birth control, including spermicides
  • Use of tampons
  • Frequent and/or intense sexual intercourse, especially with new partners
  • Pregnancy or menopause
  • Having a catheter
  • Long-term immobility
  • Suppressed immune system
  • Prolonged use of antibiotics

If you believe you have a urinary tract infection, you should see a doctor as soon as possible for treatment. While most UTIs aren’t serious, they can be very painful and they can also develop into more serious problems such as kidney infections.

Symptoms that might indicate a UTI include:

  • frequent or strong urges to urinate
  • cloudy, smelly or bloody urine
  • burning pain when urinating
  • nausea and vomiting
  • muscle aches in the lower back and abdominal pains

Prevention is preferable to treatment, and these practices can reduce your risk of developing a UTI:

  • Drink plentiful amounts of water and urinate frequently.
  • Avoid alcohol and caffeine, as they can irritate your bladder.
  • Urinate before and shortly after sex.
  • After using the toilet, remember to always wipe front to back.
  • Shower instead of taking baths.
  • Consume cranberries. While cranberry extracts don’t actually treat UTIs, they are effective in reducing your risk of recurrent UTIs. Try cranberry extract tablets, which can be twice as effective as drinking cranberry juice.
  • Regularly taking probiotics, especially after completing a course of antibiotics, may lower your risk of UTIs.
  • Be vigilant about keeping the genital area clean.
  • Choose cotton underwear and loose-fitting clothing.

Diagnosis and Treatment

Consult with your doctor if you develop symptoms of a urinary tract infection. Diagnosis includes assessing symptoms and following up with testing a sample of urine to analyze counts of bacteria, white blood cells and red blood cells. Since UTIs happen due to an imbalance of bacteria, the most common treatment is antibiotics or antimicrobials.

Prescription or over-the-counter pain relief meds can alleviate pain. You also can try putting a heating pad on the abdomen or back.

If you think you have a UTI, you may wish to contact St Pete Urology for a consultation. For more information, visit the St Pete Urology website or make an appointment with one of our board-certified physicians.

BPH: What Is It and What Causes It?

BPH: What is it and What Causes it?BPH is the abbreviation for benign prostatic hyperplasia, also called prostate gland enlargement, a condition commonly found in men as they age. Enlarged prostate glands can cause serious urinary issues such as blocked urine flow, urinary tract issues and kidney problems. The treatments for BPH include medications and minimally invasive surgery.The most common symptom is an urgent and frequent need to urinate. These may be accompanied by a difficulty beginning urination, a weak and interrupting stream, extended dribbles at the end of urination, or an inability to completely empty the bladder during urination. Urinary tract infections and bloody urine are other less common symptoms.

It is important to note that the size of the prostate does not necessarily correlate to the enlargement of the prostate. For instance, some men may have prostates that are only slightly enlarged and still suffer from symptoms worse than men with far greater enlarged prostates.

The prostate gland is found just below the bladder, and the tube that allows urine to exit the body runs directly through it. This is why urine flow is affected when the prostate enlarges. The primary cause of BPH is not fully known, but it may be related to changing sex hormone levels in men as they age.

The main risk factor for BPH is aging. Although BPH rarely affects men under 40, one-third of men between the ages of 40 and 60 experience it. And half of men experience it by age 80. Family history also plays a role in your chances of developing these problems. Men with a blood relative with BPH are more likely to develop it themselves. Diabetes, heart disease and obesity all increase the risk factors as well, while exercise helps lower them.

There are several complications that can result from BPH. The most common one is the inability to urinate, which may require a catheter if severe enough. Urinary tract infections can occur as well. Bladder stones and bladder damage may occur when the bladder cannot be fully emptied, which is more likely to happen to someone with BPH. Kidney damage is another complication that occurs when pressure that has built up in the bladder directly damages the kidneys.

Although common, BPH is a serious condition that can negatively affect quality of life and well being. But with many treatment options available, men can find relief by promptly seeking medical help. The doctors at St Pete Urology specialize in treating these issues and improving the lives of men as they age. For more information, visit the St Pete Urology website or make an appointment for a consultation.

What is Peyronie’s Disease?

Peyronie’s disease can cause several problems with your penis. One symptom may be that you notice your penis is not as straight as it used to be. If you think the reason is Peyronie’s disease, here are some answers to questions about the condition.

What is Peyronie’s Disease?

Peyronie’s disease is a problem that is caused by scar tissue (fibrous plaque) inside the penis. Besides resulting in a curvature of the penis, it sometimes causes pain or erectile dysfunction. Most cases occur in middle-aged men but both older and younger men can develop this problem. The likelihood of developing Peyronie’s disease does increase with age, especially in men over 55.

What Causes Peyronie’s Disease?

Doctors don’t always know the cause of Peyronie’s disease. It is believed that the plaque starts forming after some type of trauma (hitting or bending) that causes bleeding inside the penis. Peyronie’s disease is often caused by a minor injury to the penis or “penile trauma.” The trauma can be a result of vigorous sex that bends the penis during penetration. Sports mishaps or other accidents can also result in trauma that leads to Peyronie’s disease. When Peyronie’s disease develops gradually, it might be due to genetic causes.

Symptoms of Peyronie’s Disease?

One of the baffling things about Peyronie’s disease is that symptoms can appear slowly over time or may happen suddenly. When the penis is soft, the condition is not visible. It’s when the penis is erect that the bending and associated pain can happen. This is because the area with hardened plaque becomes scar tissue lacking the ability to stretch, so your penis appears bent and may be painful.

At times, men who have Peyronie’s disease also have scar tissue elsewhere, such as in their hands or feet, which may help signal that the penile problem is Peyronie’s disease.

How Do I Get a Diagnosis for Peyronie’s Disease?

If you think you may have Peyronie’s disease, make an appointment with a qualified urologist. The doctor will manually examine you, looking for hardened tissue, or you may get an injection to cause your penis to get hard to help with diagnosis. Your urologist may order an ultrasound or X-ray of your penis. For cases that occurred rapidly, your urologist may take a biopsy for the lab.

How is Peyronie’s Disease Treated?

In most cases, the pain eases over time and you may not need treatment. But if the bend in your penis gets worse, seek an appointment. Mild cases don’t require treatment. If it doesn’t cause issues with your sex life, you may not need treatment. Your doctor may prescribe an oral medication as the first recourse. Sometimes your doctor can give an injection of collagenase, which reduces curvature and pain.

If pills or injections don’t work and your sex life is greatly impaired, there are surgical recourses that might be recommended. Learn more about Peyronie’s disease and surgical treatment at St Pete Urology’s website. You needn’t suffer alone with Peyronie’s disease.

How soon can I have sex after a vasectomy?

Men have a vasectomy in order to not have to worry about conception when they are making love. A vasectomy is one of the few ways men can have control over their reproductive capacity. It’s also one of the most reliable ways to prevent an unwanted pregnancy.You may have questions before or right after having a vasectomy. Here are some answers to the most frequent questions.

What is a Vasectomy?

Considered a minor surgery, a vasectomy is when the vas deferens is cut and the two ends are seal and tied together. Depending on factors that your urologist can discuss with you, you will either have a conventional vasectomy or a “no-scalpel” vasectomy.

During a conventional vasectomy, the surgeon will make one or two small incisions in the skin of the scrotum to access the vas deferens. The surgeon may remove a small piece of the vas deferens before searing the ends and tying them off with a suture. The procedure is repeated on both sides. The small cuts in the scrotum may be closed with dissolvable stitches or simply left to close on their own.

For a no-scalpel vasectomy, your urologist will locate the vas deferens by feeling for it under the skin of your scrotum and place a small clamp on the vas. A minute hole is made in the skin, which is stretched open so the vas deferens can be lifted out to cut, and then the ends are tied or seared, and replaced.

What will sex be like?

A vasectomy is a fairly simple procedure without long-term effects on sexual activity. Your surgeon may recommend abstaining from sex for a short time afterward. This is to allow the incisions and sutures time to heal.

Normally the recommendation is to wait for any pain or swelling to resolve before having sex. The reason you should wait to have sex is because if it is too soon, you could reopen the site of the incisions and infection-causing bacteria might enter the incision.

Most men can resume sexual activity within a week or two. During the time shortly after your vasectomy you should use an alternative form of birth control because it takes a little while before all the sperm is cleared from your ejaculate. Your doctor will test your semen sometime after surgery, usually around six to twelve weeks.

Having a vasectomy rarely changes anything about ejaculation or orgasm. There are a few cases of post-vasectomy pain syndrome. But most patients have only the following post-surgical inconveniences which generally go away on their own:

  • mild to moderate pain or discomfort
  • bruising or soreness of the scrotum
  • blood clots in the scrotum
  • swelling in your genital area or scrotum
  • blood in the semen

Having the peace of mind that a vasectomy delivers sometimes can enhance sex life, with better arousal and erections. About three months after your surgery, you can have unprotected sex without fear a possible pregnancy. However, it is always wise to use protection with a new partner.
To find out more about the vasectomy procedure, visit St Pete Urology’s websit.

Prostate Cancer: Symptoms and Signs

What is Prostate Cancer?

Prostate cancer only affects men because it occurs in the prostate, a small gland located below the bladder that produces the male seminal fluid to nourish and transport sperm.

What Are The Symptoms of Prostate Cancer?

Some cases of prostate cancer are silent. However, there are signs that might indicate the condition:

  • Urinary and Other Problems:
  • difficulty starting or maintaining a steady stream of urine
  • frequent urination and leakage of urine
  • excessive nighttime urination urge
  • leaking small amounts of urine
  • weak urination stream or straining to empty the bladder
  • blood in the urine or seminal fluid
  • onset of erectile dysfunction
  • discomfort when sitting

Risk factors

Factors that may increase your risk of prostate cancer include:

  • Age
  • Family history
  • Race
  • Obesity

Prostate cancer is one of the most common types of cancer affecting men. When detected early and still contained to the prostate gland, it usually grows slowly. When initially confined to the prostate gland, it may not cause major harm. Prostate cancer that has been detected early has a better chance of successful treatment.

Treatment and Diagnosis

If you or your loved one is experiencing the signs or potential risk factors, it is best to make an appointment with a urologist. The urologist can take a biopsy, which is the only sure way to know if you have cancer. Additional steps that your doctor may employ include:

  • A PSA test
  • A DRE (this is a manual exam)
  • Biomarker tests

Like any cancer, early detection and intervention are key to resolving it. If not caught and treated early, the cancer can metastasize or spread.

Untreated, prostate cancer can spread to nearby organs such as the bladder, or to the bones or other organs, through your bloodstream or lymphatic system. If prostate cancer reaches the bones, it can cause pain and broken bones. As prostate cancer advances, it can be treated and somewhat controlled but it is unlikely to be cured at a later stage.

Prostate Cancer Prevention

Doctors recommend the following changes to prevent prostate cancer. These recommendations are healthy lifestyle changes for all individuals:

  • Choose a healthy diet full of fruits, vegetables and whole-grain foods.
  • Avoid high-fat foods.
  • Exercise at least 3 to 4 times a week.
  • Maintain a weight that is healthy for your body mass.

Men who face a higher risk of prostate cancer may consider medications or other treatments. Your urologist may prescribe 5-alpha reductase inhibitors. Not only do these drugs reduce the overall risk of developing prostate cancer through controlling prostate gland enlargement, they also may reduce hair loss.

Many men would rather avoid prostate exams and knowing if they have prostate cancer. They may fear that if cancer is detected they will experience impotency or incontinence because of treatment. However, recent medical developments have made such concerns unnecessary. To learn more about prostate problems, visit the St Pete Urology website or make an appointment for a consultation.

Facts About Stress Urinary Incontinence in Women

What Is Urinary Incontinence?

Many women have a silent concern due to urinary incontinence. It somehow seems taboo to talk about the problem, even with a regular doctor or gynecologist. There are approximately 25 million Americans who suffer from some type of urinary incontinence and as many as 80 percent of them are women. Pregnancy, giving birth, going through menopause and even the unique structure of the female urinary anatomy contribute to the disparity between male and female sufferers.

Urinary incontinence is defined as the unintentional loss or leakage of urine. The term “stress incontinence” means that when the body is under exertion it puts pressure on your bladder and the bladder leaks. Some triggers for stress incontinence include running, coughing, sneezing, bending or heavy lifting.

Bladder Retraining

The bladder is controlled by muscles and it can be trained. You may wish to keep a voiding diary, noting things like times of urination, duration between bathroom trips, types of food or beverages that seem to trigger urgency or frequency of bathroom trips. This journal describing your symptoms and potential causes can help if you need to visit a urologist for treatment.

As you establish baselines for your urinary problem, you can start behavior modification and training your bladder. Here’s how to do it:

  • Schedule Your Bathroom Breaks

Start by scheduling bathroom visits. Increase the time periods between those breaks by adding 15-minute increments. Visit the bathroom even if you don’t feel you need to go. You will be working toward longer and longer stretches of time between breaks.

  • Perform Kegel Exercises

When you learn to isolate the muscles that control urine flow, you can practice having more control by performing Kegel exercises while sitting, standing or during urination.

Other Tips to Prevent Overactive Bladder:

  • In addition to bladder retraining, you may want to eliminate or limit beverages that increase the need for urinating, like coffee, tea or caffeinated sodas.
  • Drink fewer fluids before bedtime.

Treating Overactive Bladder With Behavioral Modifications

You needn’t feel alone when you have urinary incontinence. Make an appointment with a urologist who is trained to deal with your condition. Your doctor may take any of the following approaches beyond what you can do on your own:

  • Recommend biofeedback,
  • Send urine or drawn blood to the lab to determine how completely you empty your bladder.
  • Prescribe medicine to address bladder function or tighten muscles.
  • Employ a medical device, such as a urethral insert or a pessary.
  • Try nerve stimulation, using a mild electric current to nerves in the bladder that help control urination.
  • Suggest surgery if indicated.

If you have stress incontinence, you may be limiting yourself from fully participating in life events. Seek treatment from experts like those at St Pete Urology, where surgeons perform hundreds of successful sling surgery procedures every year. For more information, visit the St Pete Urology website.

Nephrolithotomy for Treating Kidney Stones

What is nephrolithotomy? The complete surgical procedure name is called percutaneous nephrolithotomy (PNL). It is a procedure used to remove kidney stones. If the stone is too large to go through the tube, the surgical procedure is called percutaneous nephrolithotripsy, because the surgeon must first break the stone into pieces small enough to be removed from the body. So far as the patient is concerned, there are no differences between the two procedures.

PNL is done:

  1. When the stones are stuck in the ureter (which is the urine tube between the kidney and the bladder)
  2. The stones are blocking more than one branch of the kidney’s collecting system
  3. The stones are nearly an inch in diameter (2 cm or larger)
  4. The patient has other types of infections at the same time
  5. When other treatments have failed, such as the use of an external ultrasound lithotripsy (SWL)

PNL requires general anesthesia. The urologist surgeon will make a small incision in the patient’s back, through which a nephroscope tube will be inserted in the patient’s back and into the kidney. The scope tube has a camera and other tools as needed to remove the stone, including a small vacuum.

During that procedure, the doctor will usually place a ureteral stent to prevent certain types of pain for the time of the operation and the first two days afterward while the kidney is healing. A foley catheter also will be inserted to drain the bladder. Another drain will be placed through the surgical incision area to help to directly drain the kidney of urine. Because it takes time for basic healing to take place, the procedure typically requires a three-day inpatient stay.

The risks may include bleeding, temporary holes in the kidney, injury to other organs, such as the bladder or the colon, and other types of damage to normal kidney function. However, PNL has less than a 10 percent recurrence rate for kidney stones, making it one of the most effective approaches for treating them. In rare cases, there may be incomplete stone removal. As with all surgeries, infection may occur.

There will be several follow-up visits to the urologist. Patients usually can be back to work within one or two weeks.

St Pete Urology has the urologists who know how to compassionately work with patients throughout the treatment process. From early diagnosis, through the surgery, and by effective follow-up visits, the patents can know they are in the care of competent urological specialists. For more information, visit the St Pete Urology website.

Treating Voiding Dysfunction in Women

Voiding dysfunction is a problem that affects women in increasing numbers, and it can be an embarrassing condition that curtails daily activities. Voiding dysfunction can take several forms, including urinary incontinence, painful urination and interstitial cystitis. Women over 40 are especially susceptible and it can be uncomfortable subject to bring up in conversations with doctors.

Preliminary Diagnosis

Although your primary care doctor can perform simple testing for a urinary tract infection, you may save time and discomfort by seeing a qualified urologist first. Some urological procedures for diagnosis include:

  1. Urinalysis
  2. Uroflow electromyogram (EMG)
  3. Abdominal X rays (KUB)
  4. Cystoscopy
  5. Uroflowmetry

Initial Care for Voiding Dysfunction

Your primary care doctor may recommend dietary changes such as reducing the amount of alcohol and caffeine you consume. Your doctor may even warn you about the use of tobacco if you are a smoker.

Kegel Exercises

Kegel exercises are often effective at improving voiding dysfunction in the form of bladder leakage in women. Kegel exercises (or Kegels) simply increase the strength of the pelvic floor, and can be done in bed or while emptying the bladder. However, there are instances when the woman’s pelvic floor is too tight and Kegels are not recommended. A urologist can diagnose and recommend the appropriate treatment for the various types of voiding dysfunction.

Additional treatments for voiding dysfunction include muscle relaxants, pelvic floor therapy, self-catheterization and insertion of a neuromodulation device.

Painful Urination and Treatment

Besides being unable to control bladder flow, painful urination is another dysfunction associated with voiding. You may be diagnosed with interstitial cystitis. Some refer to the condition as BPS (bladder pain syndrome). Interstitial cystitis is associated with bladder pain, overactive bladder, bladder distention and, at times, bladder stones.

Once your physician has isolated the source of the problem, he or she may recommend a medication that allows the bladder to relax.

Why Get Diagnosed and Treated for Voiding Dysfunction

Successful treatment of voiding dysfunction will allow you to enjoy life better, with:

  1. Fewer accidents
  2. More control over where and when you void your bladder
  3. Longer intervals between needing to urinate

For those who live in the St Petersburg, Tampa or Clearwater areas, St Pete Urology offers treatment and relief of this condition. Schedule a consultation today to learn how our experienced team offers the most advanced technology, minimally invasive surgery options and compassionate care.

How to tell if your prostate is enlarged?

The prostate gland is an integral part of the male reproductive system. It secretes seminal fluid, which nourishes sperm as they grow and facilitates their transportation during ejaculation. It is located between the bladder and the rectum and surrounds the base of the urethra. Due to its location next to key parts of the urinary system, the health of the prostate gland tends to have a direct impact on the health of a man’s urinary system.

The prostate gland grows larger as a man ages. While this gradual enlargement is normal, by the time a majority of men turn 50, the prostate has reached a size where it may start to affect the normal functioning of the urinary organs near it. It is at this point that a man is said to have an enlarged prostate, or clinically speaking, benign prostate hyperplasia (BPH).

Signs and Symptoms of an Enlarged Prostate

An enlarged prostate presses, pinches or causes a blockage in the urethra. The urethra carries urine from the bladder to outside the body. The direct effects of an enlarged prostate are manifested by difficulty in the discharge of urine. These difficulties could be in the form of:

1. Frequent and sudden urges to discharge urine;

2. Difficulty starting a urine stream;

3. Weak urine stream; and

4. Dribbling urine.

If left untreated, the effects of an enlarged prostate can cause the following complications:

1. Acute Urine retention. This is a complete inability to pass urine. Medical attention must be sought immediately if this occurs;

2. Urinary tract infections;

3. Blood in the urine;

4. Pain when passing urine; and

5. Pain in the lower abdomen.

Sometimes an enlarged prostate does not produce symptoms. When this occurs in some men, it may not even be possible to diagnose the condition because it gives them no trouble at all.

The key to diagnosing and treating an enlarged prostate lies with frequent prostate monitoring by a qualified urologist. Men approaching age 50 should get tested or at least keep a watch out for any of the symptoms listed above. The good news is there are many successful treatment options for the condition. Our specialists at St Pete Urology are experienced and well qualified to help with any questions, concerns and treatment. If you think you may have an enlarged prostate, or are experiencing any problems, by all means contact us. For more information, visit the St Pete Urology website.