What is Overactive Bladder?

Overactive bladder (OAB) is a common condition defined by a set of urinary symptoms related to the frequency and control of urination. Most cases of overactive bladder are characterized by a sudden, uncontrollable urge to urinate even when the bladder is not full (urinary urgency), passing urine 8 or more times daily without excessive fluid intake (urinary frequency), and involuntary loss of urine immediately after onset of an urgent need to urinate (urge incontinence). In the United States, the condition affects at least 30 percent of men and 40 percent of women, with about 33 million Americans having bothersome overactive bladder.

Annoying and embarrassing problem

Untreated overactive bladder comes with symptoms that can cause serious embarrassment and get in the way of your social life, work, exercise and sleep. For instance, with lots of bathroom trips associated with the condition, you may begin to shy away from social events or everyday activities for fear of not finding a bathroom when you need one. As you refrain from going out with friends or engaging in everyday activities, you start to feel lonely and isolated and may even experience relationship problems with your spouse and family. Overactive bladder also can rob you of a good night’s sleep and leave you tired and depressed. Likewise, frequent leakage of urine can lead to infections or skin problems.

Causes of overactive bladder

At St Pete Urology, we are keen on identifying the underlying causes of an overactive bladder in order to boost treatment outcomes. We recognize that while an overactive bladder is quite common in older adults, it is not a normal part of aging but a treatable condition with various causes. Generally, OAB occurs when bladder muscles begin to contract involuntarily even when the volume of urine in the bladder is low. It is the involuntary contractions that cause the urgent need to pass urine. The most common causes of an overactive bladder include:
Neurological disorders such as multiple sclerosis, Alzheimer’s disease and stroke.

  1. Catheter use.
  2. Obstructions to bladder outflow, such as enlarged prostate.
  3. Pelvic organ prolapse.
  4. Weakened or stretched pelvic muscles.
  5. Weakened or stretched bladder muscles.
  6. Incomplete emptying of bladder.
  7. Excess consumption of alcohol or caffeine.
  8. Structural problems with bladder.
  9. Stroke and Parkinson’s disease.
  10. Hip problems or hip surgery.

When to see a doctor

If your symptoms disrupt your life or cause distress, speak to your doctor about available treatments. While discussing such a private issue with your urologist may not be easy, doing so may be the beginning of restoring your life back to normal. Make sure to see a doctor if the symptoms disrupt your social interactions, work, sleep or everyday activities.

Safe, confidential and effective treatment

If you have overactive bladder, you should not allow the symptoms to weigh you down. Instead of feeling embarrassed, isolating yourself or limiting your work and social life, you should see a urologist for a brief evaluation to reveal the specific cause of your symptoms and help you to get relief. At St Pete Urology, we recognize that you may feel discouraged from seeking treatment because of the sensitive nature of the condition. For this reason, we offer confidential and patient-oriented services to suit your needs. Our candid and private conversations will help us explore your condition, identify the underlying cause and provide the right treatment. We help with all urinary incontinence problems in men and women, but evaluate men with urinary incontinence further to rule out prostate problems. For more information, visit the “St Pete Urology: site.

What does it feel like when you have a kidney stone?

Formed by crystallization of certain substances in urine, kidney stones are hard, pebble-like pieces of materials occurring in one or both kidneys when there are high levels of various minerals such as calcium or uric acid in urine. A kidney stone may be as small as a grain of sand, as big as a pebble or even as large as a golf ball. Generally, the larger the stone the more severe the symptoms. If the stone is very small in size, it can pass through your urinary tract without notice. But a large stone may cause a sharp pain in your side, groin, back or lower abdomen as it passes through the urinary tract.

So what does it feel like when you have a kidney stone?

Typically, kidney stones are formed in the kidney and a stone that remains in the kidney rarely causes pain. But when a kidney stone travels through the tubes of the urinary tract such as the ureter (tube connecting the kidney to the bladder) or the urethra (tube that leads outside the body), it may produce irritation and blockage that result in pain and other symptoms. You may feel the following symptoms depending on the size and location of the stones:

  1. No symptoms, if the stone is very small.
  2. Sudden and severe pain on the side, lower back, groin, abdomen or genitals. The pain gets worse in waves and is often described by people with kidney stones as “the worst pain I have ever experienced.”
  3. Nausea and vomiting, or a persistent stomach ache.
  4. Foul-smelling or cloudy urine
  5. Blood in urine, which occurs whether the stones remain in the kidney or travel through the ureters.
  6. Frequent and painful urination, often occurring when the kidney stone is in the ureter or after the stone has passed the bladder and is located in the urethra. In some cases, painful urination indicates a urinary tract infection occurring concurrently with the stones.

Remember there are other conditions, such as hernias, appendicitis, prostatitis and ectopic pregnancy, which may have the same symptoms. Therefore it is important to see a urologist so your condition is accurately diagnosed.

Abdominal and back pain

Kidney stones may occur in the urinary tract without causing any symptoms. In fact, if you have small stones, they are likely to pass through the urinary tract without causing pain or being noticed. However, this is often only possible before the stones move from your bladder into the ureter. Once inside the ureter or other tube of the urinary tract, kidney stones cause irritation and blockage which may lead to considerable pain and discomfort. The pain may begin while a stone is still in the kidney or after the stone moves into the ureter, urethra or bladder.

If the pain occurs while the stone is still in the kidney, it is felt in the side and on the back, typically on the same side of the body as that of the affected kidney. You also may feel a cramping sensation or a sharp pain in the pelvic area, lower abdomen or in the genitals.When pain is related to the movement of a stone through the urinary tract, it comes in waves and builds in intensity before fading in cycles of every 20-60 minutes.

Physical signs

As kidney stones move through the urinary system, you may feel a strong and frequent urge to urinate. Likewise, the movement of the stone can cause irritation and damage to the lining of the bladder or ureter, causing blood to mix with urine. As a result, you will find yourself passing bloody urine, which appears reddened, pink or rusty in color. The urine also can be cloudy or foul-smelling. Kidney stones may cause gastric distress, nausea and vomiting. If the movement of the stones through the urinary tract triggers an infection, you may experience fever and chills.

Seek prompt treatment

When you feel lasting symptoms or complications due to kidney stones, it is important to seek prompt treatment. At the doctor’s office, you will undergo thorough examination and diagnostic testing to confirm your condition. If you are diagnosed with kidney stones, your treatment will depend on the size and location of the stones. For example, if you have small kidney stones, the urologist may recommend increased fluid intake to enable the stones to pass on their own. But if the stones are large, the doctor may use a scope to remove them. In some cases, surgery may be necessary.

If you suspect that you have kidney stones, visit St Pete Urology for accurate diagnosis, effective treatment and comprehensive care. At St Pete Urology, we have successfully treated kidney stones and other urinary tract problems for several years. For more information, visit the “St Pete Urology” site.

Why Interstim Therapy is For Both Men and Women

For men who suffer from embarrassing and frustrating bladder control problems like retention and overactive bladder, it is typically difficult to control when and how much you urinate. As a result, you may be compelled to cut back on your everyday activities, feeling trapped by the fear of accidental leaks and being unduly preoccupied with your bladder. Unfortunately, you also may find out that common treatments such as behavior modification, drugs, dietary changes, use of catheters to empty your bladder or pelvic floor exercises do not effectively treat your symptoms. What can you do when traditional treatments for bladder problems fail or are intolerable? Never despair. Instead, just visit a competent urologist to administer InterStim therapy.

What is InterStim Therapy?

Also called Sacral Nerve Stimulation (SNS), InterStim is a reversible therapy for treatment of urinary incontinence, urgency (frequency), urinary retention and overactive bladder. It involves implanting an InterStim device (neurostimulator) into the skin in order to send mild electrical pulses to the sacral nerves (nerves located above the tailbone) which control the bladder and muscles associated with urinary function. As a result, the electrical stimulation of the sacral nerves promotes communication between the brain and bladder, improves bladder control functions and eliminates symptoms of overactive bladder and urinary incontinence.

Effective for Both Men and Women

Many people tend to consider InterStim therapy as an exclusive treatment for women with bladder control problems. In truth, however, the therapy is also ideal for men who have failed medications, experience serious adverse effects with bladder medications or do not like using catheters to empty their bladder. Incontinence is a common problem affecting both men and women and any person experiencing the problem can explore InterStim therapy as an effective and convenient option regardless of their sex.

How is the Procedure Performed?

InterStim therapy is a two-stage process involving minimally invasive testing (test stimulation) and the eventual placement of the InterStim device. The urologist conducts the non-invasive test to determine the possible response to the actual device while allowing patients to see if InterStim would be appropriate for them. After successful testing, the InterStim device is placed using a minimally invasive technique in which small and inconspicuous incisions are made on the skin.

InterStim improves the quality of life and will help you to return to your normal life quickly with no more worries of accidental urine leaks. Doctors at St Pete Urology have conducted hundreds of InterStim therapy since the device was approved by the FDA. We help both men and women regain their confidence and dignity. For more information on treatment of bladder control problems, visit the site, St Pete Urology.

Top 3 Questions Frequently Asked by Women about Vasectomy

For couples who have made the decision not to have any more children, vasectomy is a trustworthy and effective birth control method. Though performed on a man, vasectomy is a permanent birth control method with 99.85 percent efficacy and a guarantee that the woman will not have unwanted pregnancies in the future. It does not interfere with a man’s sex drive, erections, orgasm and ejaculation and is only accompanied by temporary discomfort in men. But as with men, many women have worries about the procedure and are concerned whether it can hurt their relationships, sexually and emotionally. Here are the top 3 FAQs women ask about vasectomy.

1. Is vasectomy a perfect form of contraception?

As a permanent means of preventing pregnancy that works through the cutting of the vas deferens, tubes carrying sperm from the testes to the penis, vasectomy ensures sperm does not exit the penis during ejaculation. After the procedure, a man’s body continues to produce sperm, but the secreted sperm die and get reabsorbed by the body. A man cannot make a woman pregnant after vasectomy as long as the couple has used an alternative birth control method for the first 8-12 weeks after the procedure to allow the sperm count in the semen to drop to zero. Once the man has had a follow up test of the semen to confirm there is a zero sperm count, the couple can enjoy sexual activity without any more worries of pregnancy or need for other birth control methods.

2. Is vasectomy easier and more effective than tubal ligation?

Women can have their “tubes tied” surgically by a gynecologist. Tubal ligation is the closing of the fallopian tubes to prevent sperm from reaching an egg (ovum). When not undertaken during a caesarian section (C-section), tubal ligation is a complex procedure requiring a hospital setting, abdominal incisions and general anesthesia, posing a greater risk of complications such as scar tissue, bleeding and longer recovery. On the other hand, vasectomy is a less complex 15-20-minute procedure often performed by a urologist in an ambulatory surgery center (or rarely in the doctor’s office or hospital setting) using local anesthesia and accompanied with minimal to mild discomfort. Vasectomy also can be performed using the no-scalpel technique that requires no incisions, ensuring recovery occurs within a few days. In a sense, vasectomy is easier to perform and more effective in preventing pregnancies than tubal ligation.

3. Can vasectomy be reversed?

For women exploring vasectomy as a permanent birth control method, there is usually the question of what happens when life’s circumstances change after having the procedure and there is a need to conceive naturally. What if we lose all our children or find ourselves in a situation where we need a child after years of having a vasectomy? Well, for such couples, the option of vasectomy reversal can be explored. St. Pete Urology Center has a team of skilled and experienced vasectomy reversal urologists offering reversal services with over 90 percent success rate to couples who wish to have the procedure reversed in order to conceive naturally.

Our team of urologists understands that a vasectomy is a major life decision for couples and provides answers to a broad range of questions on the issue. For more information on vasectomy, visit the site, St Pete Urology.

When Should You Get A PSA Test?

When should you take the Prostate-Specific Antigen (PSA) test? The question of screening is typically a personal and complex issue that requires a consultation with a urologist. Currently, the medical community does not share a unanimous opinion regarding the benefits of prostate cancer screening.

Most physician-led groups, like the American Urological Association and the American Society of Clinical Oncology, insist that PSA screening ought to be considered within the context of a man’s life expectancy and level of risk given other prior or existing medical conditions. Other groups have advised that PSA screening for healthy men under 40 comes with a risk of harm that may outweigh the benefits depending on the patient’s medical history.

When should you start screening?

The decision on when to start screening should depend on your overall health, level of risk, life expectancy, and desire for treatment should you be diagnosed with prostate cancer. While the time to start screening depends on individual factors, the age of 40 years is a reasonable time to begin, particularly for those with genetic predispositions or a family history of cancer. Likewise, for healthy men at high risk, such as African American men with a family history of prostate cancer, starting at age 40 is advisable.

For men at average risk, a urologist may recommend the initial DRE or PSA test at age 40 or 45, while some urologists may recommend starting at age 50. In general, most men have discussed PSA testing with their doctor by the time they reach age 50. This means that men above 40 years should consider discussing PSA screening with their urologist to determine if and when the test is right for them. All men should develop a proactive prostate health plan based on their family history and lifestyle.

When should you visit a urologist?

The above recommendations are specific to prostate cancer screening for healthy men showing no symptoms. If you are diagnosed with prostate cancer and a confirmation is made using a biopsy, your urologist may recommend routine PSA testing for risk assessment and post-treatment monitoring.

The right time to start PSA screening is an individual decision that depends on your risk level and family history. Visit your urologist to discuss the timing of this important medical test for men. For more information on the screening and treatment of prostate cancer, visit St Pete Urology in St Petersburg, Florida.

Promising New Procedure for Men With Enlarged Prostates

A minimally invasive procedure designed to shrink prostate tissue with a series of nine-second blasts of steam offers men a new treatment for urinary symptoms commonly associated with enlarged prostates.

The procedure, called Rezūm (pronounced “resume”) and developed by NxThera Inc. of Maple Grove, Minn., became widely available in the U.S. in the second half of 2016. Thermal energy in the form of steam is applied to the prostate with a needle. As it cools it releases heat energy into the tissue, killing cells and shrinking the prostate overall by about a third, says Bob Paulson, NxThera’s chief executive.

Some 50% of men over the age of 50 have enlarged prostates, which can produce symptoms such as increased urgency to urinate during the day and frequent urination, which disrupts sleep at night. Sufferers often must choose between surgery or medication, both of which have side effects, including sexual dysfunction.

The NxThera therapy is the second major innovation in recent years for men with enlarged prostates. The other, an implanted device called UroLift, was introduced in the U.S. in 2013 by NeoTract Inc. of Pleasanton, Calif.

After years of little improvement in the minimally invasive treatment of enlarged prostates, men now have two new options “that leave your sexual function intact,” says Claus G. Roehrborn, a professor and chairman of the department of urology at the University of Texas Southwestern Medical Center in Dallas and a co-author of published studies on both treatments.

Middle ground

Physicians say Rezūm can be used on a wider range of prostate anatomies than the UroLift implant. The procedure, which costs about $2,000 and generally is covered by insurance, can be done in a doctor’s office in just a few minutes. To dull pain, lidocaine may be injected into the prostate, and most doctors will offer a sedative for patients who want one. After the procedure, most patients need to wear a catheter for two or three days but can return to daily activities immediately.

While the results of a two-year clinical trial published by Dr. Roehrborn and colleagues show that Rezūm provides significant relief from symptoms, it isn’t clear how long the improvement will last.

“The durability issue is what’s going to sink or swim this procedure,” says study co-author Kevin T. McVary, chairman and professor of urology at Southern Illinois University School of Medicine, in Springfield, Ill. Both minimally invasive options are likely less effective than surgery, Dr. Roehrborn says, because surgery removes the most tissue.

Still, for many men, the steam treatment offers an appealing middle ground between the risk of surgery and the hassle and side effects of taking daily medication, which can cause dizziness and fatigue.

“I tried Flomax for about two years but the side effects were too annoying,” says Stephen Gooding, a 60-year-old utility supervisor from Grayson, Ga., who says the drug made him dizzy and constipated. He had the Rezūm procedure in October, and now “I feel like I did 30 years ago.”

In the two-year study of 197 men, funded by NxThera and published online in the Journal of Urology in December, patients who had the Rezūm procedure showed a significantly greater improvement in symptoms at three months compared with patients who had a sham procedure. At the end of two years, patients treated with Rezūm showed a 51% reduction in urinary symptoms (as measured by a seven-question survey), compared with the beginning of the study.

Over the two years, about 4% of the patients who underwent Rezūm had to have a repeat procedure or surgery to treat their condition. Early in the trial, physicians were new at performing the procedure and didn’t always remove enough tissue, says Cindy Ogden, vice president, clinical affairs at NxThera.

So far, Rezūm appears to spare men sexual side effects. In the surgical procedure known as transurethral resection, 70% to 80% of men generally get a condition called retrograde ejaculation, also called dry orgasm, says Dr. McVary.

In the Rezūm study, about 3% of the patients who underwent the procedure experienced no ejaculatory volume afterward, and 5.3% experienced a decrease in ejaculatory volume, according to data provided by NxThera. Ejaculatory volume can fluctuate over time in men with enlarged prostates, so it isn’t clear the reductions were caused by the procedure, Dr. McVary says. Overall in the study, there was no average change in ejaculatory volume, he adds.

Larger prostates

A major advantage of Rezūm is that it can be done on most types of anatomies. UroLift isn’t approved by the Food and Drug Administration to treat the median, or middle lobe of the prostate, which contributes to symptoms in about 10% to 30% of patients, Dr. Roehrborn says.

The FDA hasn’t cleared Rezūm or UroLift for prostates weighing more than 80 grams. So NxThera can’t market its procedure for larger prostates, though doctors can legally use it on such patients if they choose.

Early results in clinical practice on large prostates appear “promising” and a study on prostates up to 150 grams is expected to begin later this year, says Ricardo Gonzalez, a urologist at Texas Medical Center in Houston, who will be a principal investigator on the research. About a quarter of men seeking treatment for prostate-related urinary symptoms have prostates greater than 80 grams, he says.

Business executive Jim Bracke, 69, says that, with just a Tylenol and the lidocaine shot, discomfort from Rezūm’s steam blasts felt no more intense than “warm water spilled on the groin.” He drove himself home after the procedure, and says he’s thrilled that he no longer needs to check out a bathroom the moment he arrives at a restaurant. And as long as he doesn’t overdo it, he adds, “I can have beer, and coffee and chocolate and still sleep through the night.”

Link to original article

Are certain foods helpful in addressing erectile dysfunction (ED)?

It’s possible. Research published in January 2016 found that men who ate foods high in antioxidants called flavonoids had a lower risk of erectile dysfunction (ED) than those who didn’t eat a flavonoid-rich diet.

Flavonoids can be found in certain plant-based foods like citrus fruits, blueberries, strawberries, apples, pears, cherries, blackberries, radishes, and blackcurrant. Some teas, herbs, and wines also have flavonoids in them.

Past studies have shown that consuming flavonoids could reduce a person’s risk for diabetes and heart disease, both of which can lead to ED.

Eating a healthy diet overall, particularly a Mediterranean diet, can go a long way in preserving erectile function, however.

This type of diet includes fruits, vegetables, whole grains, and olive oil. Nuts and fish are good additions.

What does diet have to do with erections?

When a man is sexually-aroused, his penis fills with blood, giving it the firmness it needs for sex. Many men with ED have poor blood flow to the penis. Some medical conditions, like diabetes and heart disease, can damage blood vessels and nerves that are critical for this process.

Eating a healthy diet keeps the body in good working order. It can help men maintain a healthy weight, keep their blood sugar under control, and reduce the risk of blood vessel damage, which can impair blood flow.

Diet isn’t the only path to good erections, however. Other lifestyle habits, like regular exercise, quitting smoking, and managing depression are important too.

A man’s doctor can help him decide which dietary changes to make. However, men who are having trouble with erections should be sure to mention it. Many factors can contribute to ED and it’s best to have a complete medical checkup. [Read Full Article…]

Penile Prosthesis Success Rate, Dr Reid Graves

Penile Implant requires a permanent surgical procedure that cannot be reversed. It is important that men talk to their doctor about the advantages and possible risks of having the procedure.[Read Full Article…]

Dr Reid Graves – Why Choose St Pete Urology

Dr Graves says that the St Pete Urology team of doctors and staff provide compassionate care to patients who often require difficult treatments in sensitive parts of their bodies. In most cases, patients are searching for answers to their medical questions, so the physicians strive to provide them with evidence-based solutions and treat them using the most advanced procedures. [Read Full Article…]

St Pete Urology Patient Care Options

St Pete Urology have successfully treated thousands of patients in the Tampa Bay Area with a focus on achieving the best possible results using the most advanced equipment and procedures. [Read Full Article…]