What are the Symptoms of Pelvic Organ Prolapse?

In general terms, the pelvic region of a human body is the area between the abdomen and the thighs. The pelvic region primarily comprises the bowels and the organs of the reproductive and urinary systems. In both men and women, pelvic organs are held in place and supported by strong muscles which collectively form the pelvic floor. Pelvic organ prolapse is a condition that results from a weakening of the pelvic floor muscles in women, causing the pelvic organs, chiefly the uterus, the bladder and the small intestines, to droop or descend and press on or even through the vagina. Common causes of pelvic organ prolapse include pregnancy, vaginal childbirth, sustained and prolonged pressure on the abdomen, aging, heavy lifting, hysterectomy, obesity and prolonged chronic coughing. Some women are also genetically predisposed to pelvic organ prolapse.

Symptoms of a Pelvic Organ Prolapse

The symptoms are usually determined by the organ that is affected. The symptoms listed here do not all occur together, although they may manifest in a combination of two or three.

1. A feeling of heaviness, pressure or fullness in the pelvic area. The descending organs put pressure on the lower parts of the pelvis, causing the sensation of heaviness and fullness.

2. Seeing or feeling something coming through the vagina. With time, small parts of the descending organs or the surrounding tissue may be seen through the vagina. Even if not seen, a patient might feel a bulging at the vaginal opening.

3. Urinary incontinence. Pressure on the bladder may cause leaking of urine or a frequent urge to urinate.

4. Painful intercourse and trouble inserting tampons. The displaced organs occupy spaces and put pressure on channels that are usually open to facilitate intercourse and to allow the insertion of tampons, thus making these activities uncomfortable and even painful.

5. Trouble having a bowel movement or constipation. This is common in patients with a rectal prolapse.

6. Lower back ache. This is common with patients who have a prolapse of the bowel.

Most patients report that symptoms worsen late in the day and after standing for a long period of time or taking part in an intense physical activity.

Any of these symptoms should be reported to a urologist so tests can be conducted and treatment administered as early as possible. In addition to finding a competent urologist, a patient also should seek a treatment platform that she is comfortable with. One way to find such a platform is to study the online profiles of urology professionals, such as the one created by St Pete Urology, so as to make an informed choice. For more information, visit the St Pete Urology website.

What is Urinary Diversion?

Urinary diversion is a solution to any urological problem that prevents the passage of urine in the ordinary way. It is basically a rerouting of the urinal path through surgery.Ordinarily urine flows from the kidneys to the bladder through the ureter. It is stored in the bladder until the individual lets it out by urinating. The tube that drains urine out of the bladder is called the urethra. Sometimes the bladder can no longer function as a storage for urine or it has to be removed. This is common when a patient has cancer of the bladder or has suffered serious injury to the bladder. Urine flow is rerouted to follow another path out. Sometimes the procedure may be performed to provide temporary relief while in other instances it is permanent.

Types of Urinary Diversions

1. Continent Diversion

A continent urinary diversion is created by making a urine reservoir from parts of the bowel, mostly the small intestine. A surgeon can choose to attach the ureters and the urethra to the new reservoir, placing it in the position of the bladder that has been removed. That reservoir is referred to as a neobladder or a continent urinary diversion. A patient who has a neobladder is able to pass urine the normal way.

The alternative for a neobladder is creating a stoma as an outlet for the reservoir. A patient has to connect a catheter to drain urine from the stoma a number of times a day. This form of reservoir is also referred to as a continent catheterizable diversion.

2. Incontinent or Non-continent Diversion

An incontinent diversion connects the ureters that drain urine out of the kidney into an opening of the abdominal wall. The patient then is required to wear an ostomy bag into which the ureters drain the urine.

Performing a urinary diversion is a precise procedure and its complexity depends on the reasons why it is performed. A patient requires strict medical attention both before and after undergoing the procedure. Even after one has recovered, the advice of a urologist is necessary in the management of the various forms of diversions. A patient should insist on receiving the attention of a specially trained urologist if they require a urinary diversion. St. Pete Urology over the years has developed an outstanding staff of specialists in the area and it is a good place to start. For more information, visit the St Pete Urology website.

What is a Varicocelectomy?

An apt introduction to varicocelectomy would be to describe the relatively common condition known as varicose veins. Varicose veins occur with the swelling and enlargement of the veins in a patient’s legs to the point that the veins become easily visible under the skin. This condition sometimes occurs in the scrotum and the enlargement is known as a varicocele. Varicocelectomy is a surgical procedure that is performed to remove varicoceles from the scrotum. The main cause of varicoceles is a malfunctioning of the valves inside the veins, which causes an accumulation of blood in the veins and causes them to expand. Upon a physical examination, a varicocele is said to feel like a bag of worms.

When to go for a Varicocelectomy

Having a varicocele is not in itself reason to have a varicocelectomy. In most instances, the varicocele does not manifest any symptoms. It does not cause pain or interfere with the sexual or reproductive function. In such cases, a urologist will advise that the varicocele be left undisturbed. However, if the varicocele causes any of the following, then a varicocelectomy should be performed.

  1. Reduced sex drive;
  2. Reduced sperm production resulting in inability to conceive
  3. Pain and swelling of the scrotum;
  4. When the varicocele is on the right side — ordinarily varicoceles occur on the left side of the scrotum. When it occurs on the right side, it is likely that it is the result of a tumor. The urologist will remove the tumor and the varicocele.
  5. Testicular atrophy — where the testes shrink or fail to develop normally because of a varicocele.

Procedure of Varicocelectomy

A varicocelectomy is a minor surgical procedure that allows the patient to leave the hospital the same day. It is a procedure involving cutting or sealing off the affected vein to restore normal blood flow. A surgeon can choose to do it in either of two ways:

1. laparoscopic varicocelectomy — a surgeon makes several small incisions in the lower abdomen and inserts the laparoscope, which projects an image of your anatomy on a screen. He also inserts other small tools which he uses to cut the affected vein.

2. Open Surgery — The surgeon makes incisions large enough to access the affected veins and cut them or seal them off.

Even though self examination can reveal a varicocele, the question of whether to undergo a varicocelectomy can only be answered by a urologist. A urologist who has specialized in the treatment of varicoceles, such as those in St. Pete Urology, should be contacted if a patient finds any of the symptoms listed above. For more information on prevention, diagnosis and treatment, visit the “St Pete Urology” website.

What are 5 warning signs of testicular cancer?

Testicular cancer is cancer of the testes, the male organ responsible for producing male hormones and sperms. It is understood to be one of the rarer cancers, especially when compared to the prevalence of prostate cancer. In addition to its rarity, testicular cancer is also distinguished by the fact that it is one of the most treatable. Research estimates indicate that up to 95 percent of those diagnosed with it are treated successfully. This success rate holds even for cases in which the cancer has spread outside of the testes. Testicular cancer is most common among men of 15-35 years old.

Symptoms of testicular cancer

Testicular cancer does not always exhibit any symptoms and when it does, its symptoms are similar to those of non-cancerous conditions or inflammations. For these reasons, testicular cancer is often diagnosed at a late stage.

Any one or a combination of the following symptoms should serve as warning signs:

1. Lump and swelling in the testicle

A painless lump or a swelling, or a general change in the size of the testes is one sign of testicular cancer. It is not unusual for one testicle to seem larger than the other. However, a noticeable change from what is usually the normal size of either testes should be treated as a warning sign.

2. Pain or discomfort in the scrotum

Ordinarily a lump or swelling does not cause pain. In some cases of testicular cancer, however, patients report an ache in the scrotum holding the affected testes. It also could be a feeling of heaviness in the scrotum causing discomfort.

3. Enlargement and tenderness of breasts

In rare instances, the presence of testicular tumors encourages the development of breast tissue. This is a condition known as gynecomastia.

4. Accumulation of fluid in the scrotum

A sudden and perceptible collection of fluid in the scrotum should be treated as a red flag.

5. Pain in the groin area, abdomen or lower back

This occurs as an extension of the pain in the testes, if any. It also occurs if the cancer has spread from the testes to the lymph nodes around the groin and the abdomen.

It is noteworthy that the symptoms described above could arise from a non-cancerous condition. That may be reassuring news, but any symptoms also should be considered with caution, because they make testicular cancer that much harder to detect. It is advisable to see a urologist if you have experienced any of the above symptoms, if only to eliminate the presence of testicular cancer. Experienced urologists at St Pete Urology can offer help and treatment for urological problems. Their pool of trained urologists can offer consultation and guidance with any questions and concerns you may have. For more information about testicular cancer, visit the St Pete Urology website.

What is a PSA Test and When Should You Get It?

The PSA test measures the level or amount of PSA (prostate-specific antigen) in blood. The prostate-specific antigen is a protein synthesized by both non-cancerous and cancerous tissue in the prostate — a tiny gland found below the bladder in men. After it is produced, the PSA finds its way into semen and in small quantities in the blood. But since cancerous cells produce more PSA than non-cancerous cells, the test is carried out to detect high levels of PSA in blood, which may indicate the existence of prostate cancer.

What are the benefits of the PSA test?

Early detection of certain types of prostate cancer is critical for successful treatment and recovery. When the PSA test shows elevated levels of the antigen in blood, it may help to identify prostate cancer that is likely to grow quickly or spread to other parts of the body. In turn, the test helps to catch and treat such cancers early before they begin causing serious symptoms or become life-threatening. Also, by enabling early detection of prostate cancer when the necessary treatment is less aggressive, the test reduces the risk of certain adverse effects of treatment, such as urinary incontinence and erectile dysfunction.

What are the risks associated with the PSA test?

Carrying out the test itself comes with very little risk. It requires only a simple drawing of blood used to run the test in a laboratory. However, once the results of the test are out, there are a number of potential downsides involved. For instance, since false positives are quite common and elevated PSA results may have other causes other than prostate cancer, including prostate infection (prostatitis) and enlarged prostate (BPH), the test results may expose some patients to unnecessary or inappropriate treatments.

Some types of prostate cancer don’t produce much PSA, which means that a test may incorrectly indicate that you don’t have the cancer (a false negative). And follow-up tests for checking out the underlying causes of an elevated PSA test are often stressful, invasive, time-consuming or expensive. Furthermore, living with a localized or slow-growing prostate cancer — one that doesn’t require treatment — can cause stress and anxiety.

When should you get your first PSA test?

Before you get the first PSA test, it is recommended that you discuss the benefits and risks of the test with your doctor. During the discussion, a comprehensive review of your risk factors and preferences is done. For example, the urologist will consider your age, race, size of your prostate, medications you are taking (dutasteride and finasteride affect PSA levels), and how frequently your PSA levels change when making a decision about getting the test.

At St. Pete Urology, we advise men who are at higher risk of the disease, such as African American men and those with a brother or father who have had the cancer, to get their first test at the age of 40-45. Having the test before you reach 50 helps us to establish your PSA baseline and thereafter monitor the changes in your PSA levels to determine whether or not you’ll need annual PSA screening and prostate biopsy. If your blood PSA level is very low, we’ll put off any further PSA tests. But if you are a man of moderate to low risk of the disease, we recommend you get your first PSA test at age 50 or older (generally between 55 and 70).

What happens if your first PSA test result is high?

If you don’t have symptoms of prostate cancer, another PSA test may be recommended if your first test showed an elevated PSA level. The second test is used to confirm the validity of the original finding. But if the second PSA test still gives elevated PSA level, the urologist may direct that you continue with more PSA blood tests and digital rectal exams (DREs) at frequent intervals to monitor any changes in your prostate over time.

If your blood PSA level continues to rise over time or the urologist finds a suspicious lump in your prostate during a DRE, additional tests may be suggested to establish the nature of the problem. For example, a urine test may be run to find out if you have a UTI (urinary tract infection). Imaging tests like X-rays, cystoscopy or transrectal ultrasound also may be recommended. Then if prostate cancer is suspected, the urologist carries out a prostate biopsy — collecting multiple samples of tissue from your prostate by inserting hollow needles into the gland and withdrawing tissue. The tissues are examined under a microscope by a pathologist to confirm the cancer.

Treatment of prostate cancer

The type of treatment recommended for prostate cancer usually depends on whether it is early-stage or advanced-stage disease. For early-stage cancer the options include watchful waiting, radical prostatectomy, brachytherapy, conformal radiotherapy and intensity-modulated radiation therapy. At St Pete Urology, watchful waiting means no immediate treatment is offered but the cancer is closely monitored through regular PSA tests. Prostatectomy involves surgically removing part of or the entire prostate; brachytherapy involves implantation of radioactive seeds into the prostate to deliver specific amounts of radiation to the tumor. Conformal and intensity modulated radiotherapies deliver targeted amounts of radiation to the tumor with minimal damage or exposure of healthy tissues.

For advanced-stage prostate cancer, which is typically a more aggressive tumor that grows quickly and spreads faster to other areas of the body, treatment includes chemotherapy and androgen deprivation therapy. Chemotherapy can eliminate cancer cells that have spread to other parts of the body. Likewise, androgen deprivation therapy (androgen suppression therapy or ADT) is used to reduce the effect of androgens — male hormones that stimulate cancer growth — thereby slowing down or stopping cancer growth.

At St Pete Urology, we talk to our patients openly and candidly about the risks and benefits of the PSA test before we can advise them to get it. We also discuss the results of the tests, give our recommendations for those with positive results and typically repeat the PSA test for those with negative results. Our patients have always told us that our attention to detail, quality of interactions and efficiency during their visits is unmatched. If you would like to know more about the PSA test, visit the “St Pete Urology” site.

Urge Incontinence Treatment for Women

Urge incontinence is often a symptom of an unstable or overactive bladder. Characterized by a sudden strong desire to pass urine that can’t be postponed (urgency), urge incontinence usually comes with frequency (more often than normal) during the day and several times at night. Some women may even experience urine leakage during sex, particularly during orgasm. Although many women may avoid leakage by urinating frequently, they find the continual need to visit a bathroom quite restrictive to their lifestyles.

How do you know you have urge incontinence?

With urge incontinence, you will have urine loss because bladder muscles squeeze or contract at the wrong times. These contractions occur repeatedly, regardless of how much urine is in the bladder. There are 3 main indicators that you have urge incontinence:

  1. Inability to control when you urinate
  2. Having to pass urine frequently during the day and night
  3. Needing to pass urine suddenly and urgently

Causes of urge incontinence

There are two principal causes of urge incontinence. Irritation within the bladder may trigger incontinence. Or it may be loss of the nervous system’s inhibitory control on bladder contractions. For example, neurological conditions such as multiple sclerosis, spinal cord injuries, Parkinson’s disease and stroke may diminish bladder control and cause urge incontinence. Likewise, cardiovascular disorders, diabetes, bladder cancer, bladder stones, alcohol consumption, infections, diuretic medicine and inflammation that irritate the bladder or damage its nerves may cause incontinence. Urge incontinence also may indicate a more serious problem. For instance, when the urgency to pass urine is accompanied by blood in urine, recurrent urinary tract infections (UTIs) or an inability to empty the bladder completely, these may be red flags for a more serious issue than just urinary incontinence.

How is urge incontinence treated?

Generally a few lifestyle adjustments may help a woman cope with urge incontinence. For instance, making it as easy as possible to get to the bathroom, avoiding caffeine (tea, cola and coffee), avoiding alcohol, reducing amount of fluid intake per day and losing weight can help relieve symptoms. Secondly, bladder training (also called bladder drill) and pelvic floor muscle exercises can be combined to treat urge incontinence. A third solution may be treating urge incontinence with medicines called anticholinergics (antimuscarinics) such as oxybutynin, solifenacin, tolterodine, trospium chloride, propiverine, darifenacin and fesoterodine fumarate. And if the urge incontinence is associated with the lining of the vagina after menopause, applying estrogen cream directly inside the vagina may help.

Urge incontinence is also treated using Botulinum Toxin A (Botox), a prescription-only medication that relieves the incontinence when other options such as bladder training and other medication have failed. When these treatments are not successful, the urologist may suggest surgery. Surgical procedures for treating urge incontinence include sacral nerve stimulation, percutaneous posterior tibial nerve stimulation, augmentation cystoplasty and urinary diversion.

At St Pete Urology, our doors are open to all women troubled by incontinence. We are a recognized name in the urological community and boast of a team of highly innovative, experienced and certified physicians who deliver leading-edge urology and patient-centered care. We know there are many women who live with severe urological problems and we do our best to help those who come to us. We are good at treating these disorders. For more information, visit the St Pete Urology website.

What is the best treatment for urinary incontinence?

The sling procedure is the best, safest and most effective surgical operation for treating urinary stress incontinence. During the procedure, the urologist creates a sling using an artificial mesh, animal tissue or human tissue and places it under the urethra to support the urethra and bladder neck and to prevent unintentional urine loss.

What is stress incontinence?

Unintentional urine leakage (loss) occurs when you engage in physical activities or movements, such as running, sneezing, heavy-lifting, coughing or any action that puts stress (pressure) on your bladder. The condition is triggered by the weakening of pelvic floor muscles (the muscles supporting your bladder) and urinary sphincter muscles (muscles that control the release of urine).

Normally, as the bladder fills with urine and expands, the valve-like muscles in the urethra remain closed to prevent leakage of urine until you have reached the bathroom. However, if those muscles weaken and are not able to withstand pressure, then anything that exerts pressure on your pelvic and abdominal muscles can cause unintentional loss of urine.

Your sphincter and pelvic floor muscles may weaken because of:

  1. Type of childbirth/delivery.
  2. Previous pelvic or abdominal muscle surgery.
  3. Obesity/increased body weight.
  4. Smoking, which may trigger frequent coughing.
  5. Prolonged involvement in high-impact activities, such as running and jumping for several years.
  6. Age — the muscles weaken with increasing age.

You have stress urinary incontinence if you frequently leak urine when you:

  1. Sneeze
  2. Cough
  3. Stand up
  4. Laugh
  5. Have sex
  6. Get out of your car
  7. Exercise
  8. Lift something heavy

While stress incontinence does not imply that you will lose urine every time you do these things, you will most likely experience frequent leakage of urine when you engage in pressure-increasing activities.

Why should you undergo the sling procedure for stress urinary incontinence?

Having stress incontinence can be really awkward and embarrassing. In fact, with frequent leakage of urine, you may begin isolating yourself and limiting your social and work life. For instance, you may find it difficult to engage in exercise and in different leisure activities for fear of urine leakage. But with treatment, you can manage the incontinence and improve your overall quality of life and well-being. The sling procedure is ideal for you if you’ve tried other measures and still find urine leakage disruptive to your life.

How does the sling procedure work?

The sling procedure is aimed at closing your urethra and the neck of your bladder. For the procedure, your surgeon uses strips of synthetic mesh, animal tissue, donor tissue or your own tissue to develop a sling (hammock) that is inserted under your urethra or bladder neck. Once the sling is placed, it supports the urethra and ensures it remains closed — particularly when you are engaged in pressure-increasing activities such as coughing, laughing, sneezing or exercise — preventing the leakage of urine.

How is the sling procedure performed?

Before the procedure begins, you are placed under either general or spinal anesthesia. With general anesthesia, you will remain asleep throughout the procedure and will feel no pain. With spinal anesthesia, you are completely awake except that the area of your body from the waist down is numb and you don’t feel pain as the procedure is performed. Following application of anesthesia, the urologist places a tube (catheter) into your bladder to drain any urine already inside it.

The surgeon then proceeds to place the sling in any of the following ways:

1. Retropubic Method (Tension-Free Vaginal Tape/TVT Method): The surgeon makes a tiny incision inside your vagina, just under the urethra. Two other cuts are then made above your pubic bone — large enough to allow needles through. The surgeon uses a needle to place the sling beneath the urethra and behind the pubic bone. Using stitches or skin glue that is easily absorbed by the body, the surgeon closes off the cuts.

2. Single-Incision Mini Method: The surgeon makes a single tiny incision in the vagina, then passes the sling through it. No stitches are used to attach the sling, but over time the scar tissue grows and forms around it, keeping it in place.

3. Transobturator Method: The surgeon makes a tiny cut inside the vagina, just under the urethra. Two more cuts are made, one on each side of the labia (folds of skin on either side of the vagina). Using the incisions, the surgeon inserts the sling under the urethra.

At St Pete Urology, we perform hundreds of sling surgery procedures every year with remarkable results for our patients. The sling procedure is an outpatient operation that takes about one hour to complete and the patient is free to go home the same day. After the procedure, we arrange for follow-up sessions with our patients in the doctor’s office to assess the efficacy of the procedure and help with any complications that may arise. So if you are feeling embarrassed by stress urinary incontinence or have tried other measures without success, check with us to find out if the sling procedure can help you overcome the condition. For more information, visit the “St Pete Urology” site.

Treating Erectile Dysfunction with Inflatable Penile Prosthesis

Prescription medications are typically the first treatment offered for men with erectile dysfunction. But for those who don’t respond well or are unable to be treated with these pills, a penile implant is a useful alternative. The penile implant (also called penile prosthesis) is a medical device that is placed surgically into the penis to generate a natural-feeling and natural-looking erection.

Simple, outpatient procedure

The operation to place a penile prosthesis is a quick and simple procedure that takes about 1 hour to complete. The device is inserted into the penis and custom-fitted to help with erection. After it is placed, a man can go home the same day and is ready to enjoy sex after a 4-6 week recovery period.

What is a penile prosthesis?

An inflatable penile implant is a self-contained, fluid-filled, supple and durable system designed to mimic both the look and performance of the penis during a natural erection. It has three components: a reservoir that is placed in the abdomen, two cylinders inserted in the penis and a pump located in the scrotum. The two cylinders situated in the penis are connected to the saline reservoir using a tubing. Because of the three components, the penile prosthesis is known as the three-piece inflatable penile implant.

How does the penile implant work?

To inflate the penile prosthesis, a man presses the pump to transfer the saline from the reservoir into the cylinders located in the penis. The cylinders are then inflated and the penis becomes erect. When the deflation valve found at the base of the pump is pressed, the fluid moves back to the reservoir, deflating the penis and making it flaccid. So the penile implant is capable of producing erections that are satisfactory for sexual intercourse.

Why should men with ED consider penile implants?

Once placed surgically by a urologist, an inflatable penile prosthesis helps a man to regain control of his body. Unlike other ED treatment options which require a slightly longer waiting period before use, the implant can be used at any time. Penile implants are an ideal option for men whose ED has not been resolved by other treatment options. It is a cost-effective option that achieves 98 percent satisfaction rate with patients and is not noticeable in a flaccid penis. In fact, even your sex partners will not know that you have the implant unless you inform them.

If you are looking for something to make you a confident, self-assured man again, a penile prosthesis may be just what you need. It effectively mimics the look and performance of a natural penis and will enable you to begin enjoying sex as soon as you are recovered from the surgery. Unlike remembering to take your medication every time you want to have sex, a penile prosthesis offers a more permanent and natural solution. For more information on treatment of erectile dysfunction, visit the “St Pete Urology” site.

What kinds of prostate problems are common in men over 50?

The prostate is a tiny walnut-sized gland that surrounds the urethra. But with hormonal changes that come with age, men of all ages usually experience changes in their prostate. As a result of these changes, prostate issues are quite common in men, particularly older ones. For example, the prostate often grows and swells with age, compressing the urethra and causing urinary issues.

Benign Prostatic Hyperplasia

With the prostate, there are usually two main issues: benign prostatic hyperplasia and prostate cancer. For men older than 50, benign prostatic hyperplasia (BPH) is the most frequent prostate issue. BPH, also called an enlarged prostate, means a non-cancerous increase in the number and size of prostate cells — so basically, it is an unhealthy increase in prostate size. While what triggers BPH isn’t well understood, it is believed that factors such as aging, inflammation, fibrosis and hormonal changes are the causes of the condition.

An enlarged prostate presses hard on the urethra and makes urination difficult. In men with the condition, symptoms include:

  1. Frequent urination, particularly at night.
  2. Difficulty starting a urine stream.
  3. Dribbling after passing urine.
  4. Weak urine stream, or a stream that starts and stops.
  5. Inability to empty the bladder completely.

But BPH also may have rare and more severe symptoms like:

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

Prostate cancer

Prostate cancer is another frequent condition in men. In fact, it is the most common cancer after skin cancer, with about 1-in-6 American men being diagnosed with the disease during his lifetime. And like BPH, the cancer is most common in older men, with two-thirds of men diagnosed with the condition usually over age 65.

The cause of prostate cancer isn’t clear, but risk factors include age, family history, race and diet. The cancer grows slowly and rarely shows symptoms, so most men may never know that they have developed the disease until it is in advanced stage. But that also means only around 1-in-35 men with the cancer dies of the disease. Nevertheless, while some prostate cancers grow slowly and often require no or minimal treatment, there are other types that are quite aggressive and spread really quickly.

When caught early, there is a better chance of successfully treating the cancer. However, since it has similar symptoms to BPH, the condition is quite difficult to diagnose and by the time men see blood in their urine or feel chronic pain in their thighs, hips or lower back, it is often quite late. That is why it is critical for men of average to high risk of the cancer to have annual screening as early as appropriate.

Actually, for men of average risk of prostate cancer, the discussion to begin screening should start at the age of 50. While for those of higher risk, it is prudent to begin this discussion a little earlier, though not earlier than 40. But before screening, it is vital to discuss the risks and benefits of the testing with the doctor so the test offered meets the personal preferences and values of the patient.

For more information on prostate problems and how to prevent, diagnose and treat them, visit the “St Pete Urology” site.

How can I prevent recurrent kidney stones

Kidney stones occur when tiny crystals form and stick together as solid masses in urine. Often, due to increased concentration of various chemicals in urine, crystals form and then grow into larger masses that move through the urinary tract. As they move, the stones may get stuck somewhere along the tract and block urine flow, causing pain. Most kidney stones are a combination of calcium with either oxalate or phosphate, but stones also may form when uric acid levels increase in urine as a result of protein metabolism.

Preventing kidney stone recurrence

For many people who have had a kidney stone, it is not a one-time thing. In fact, in about 50 percent of those who have had a stone, another one will appear within 7 years if no preventive measures are in place. At St Pete Urology, we ensure that our patients take the necessary steps to prevent a recurrence. That is why, after treatment, we conduct a special urine test on our patients to find out why the stone formed in the first place. Using the results of the test, we guide our patients on how best they can avoid a recurrence.

Some of the measures we recommend to avert kidney stone recurrence include:

1. Drinking enough water

Water dilutes urine, reduces the concentration of substances in it and prevents kidney stones. To prevent recurrent kidney stones, you should endeavor to drink enough fluid to pass at least 2 liters of urine per day. Increased fluid intake that is distributed throughout the day decreases kidney stone recurrence by about 50 percent and with virtually no adverse effects.

For better results, you may add orange juice or lemonade to the water so there is increased citrate in the fluid to block stone formation. Medication such as allopurinol, citrate or a thiazide diuretic can be taken with the fluid to minimize the chance of kidney stone recurrence. However, if you are already drinking that much fluid before your kidney stones, you should not increase your fluid intake.

2. Making dietary changes

Once you are treated for kidney stones, we will recommend that you reduce your intake of eggs, seafood, poultry, red meat and other animal protein. These foods increase uric acid levels while also reducing citrate levels in the body, which can trigger a recurrence of kidney stones. That is why after treatment for kidney stones, we recommend that you should cut down your daily meat portions to a size no larger than a pack of playing cards. Likewise, you should avoid foods such as chocolate, strawberries, wheat bran, beets, spinach, tea, rhubarb and most nuts that contain oxalate or the phosphate containing colas that may trigger kidney stone recurrence.

3. Increasing calcium intake

Oxalate levels may rise and trigger kidney stones if the level of calcium in the diet is low. So after treatment, it is important to ensure that you increase your calcium intake to match your age. For example, if you are a man 50 and older, you should get 1,000 milligrams of calcium every day, together with 800-1000 IU (international units) of vitamin-D to ensure your body absorbs the calcium properly. With increased dietary calcium, you can prevent a recurrence of kidney stones.

4. Reduced sodium intake

Kidney stones may recur if there is a lot of sodium in your diet because increased sodium leads to high concentration of calcium in urine. So after treatment for kidney stones, we usually recommend that you lower the amount of sodium in your diet, limiting your total daily sodium to 2,300 mg. But if sodium was responsible for your previous kidney stones, then we recommend that you should take at most 1,500 mg of sodium per day. Such a low level of sodium also will be good for your heart and your blood pressure.

Those are some of our most common recommendations for averting kidney stone recurrence. As you might have noticed, they are not complicated things to do, but they do require some commitment. For more information on prevention and treatment of kidney stones, visit the “St Pete Urology” site.