Women’s Health: Do Women See A Urologist?

It is a common mistake to believe that only men see urologists. In fact, women are more likely than men to have a urinary problem at some stage of life. When it comes to a condition affecting the urinary tract, bladder or kidneys, a urologist is the expert who can offer the best treatment. Urologists see women, men and children to treat common disorders of the urinary system.

Women’s Urological Conditions

(a) Overactive bladder: A woman with an overactive bladder experiences a sudden, frequent or hard-to-control urge to urinate, wakes up more than once at night to urinate, or urinates eight or more times in 24 hours. A urologist will perform various tests to diagnose the disorder and then recommend treatment according to the cause.

(b) Urinary incontinence: Characterized by a loss of bladder control that often results in accidental leakage of urine, urinary incontinence affects up to 57% of women between 40-60 years and requires the attention of a urologist.

(c) Urinary tract infections (UTIs): Urinary tract infections can cause serious complications if they spread to the kidney. They require prompt and effective treatment. Since women are more susceptible than men to UTIs because of their anatomy, they should see a urologist if they have frequent or persistent infections.

(d) Fallen bladder: Because the bladder is held in position by the pelvic floor, it may drop onto the vagina when the pelvic floor is weakened or stretched due to obesity, menopause, aging or prior pelvic surgery. A woman should see a urologist with experience in female urology to correct a fallen bladder.

(e) Painful bladder syndrome (interstitial cystitis): Interstitial cystitis (IC) comes with lower belly and bladder discomfort, a feeling that the bladder is always full, and a sudden and severe urge to urinate (even up to 60 times per day), which can interfere with everyday activities. Some women have been forced to skip social events or avoid travelling away from home, while some find sex uncomfortable or painful due to the condition. Women who have the disorder need to see a urologist.

(f) Urinary stones: Urinary stones are hard masses that form in the kidneys, bladder or ureters. While drinking 2-4 quarts of water in 24 hours may help to move a urinary stone, a urologist can break them apart with ultrasound-based treatment or remove them surgically.

(g) Cancer: Women can have cancer in the bladder, bladder lining, kidneys or urethra. The cancer may show signs such as pain during urination, lower back pain, blood in urine and frequent visits to the bathroom. Seeing a urologist may help to detect and treat the cancer early.

Ideally, women should see a urologist when experiencing:

  • Pelvic pain
  • Burning sensation or discomfort when urinating.
  • Frequent urination
  • Blood in urine
  • Pain in the back or sides
  • Leaking urine

At St Pete Urology, we have specialized urology services that cater to the unique needs of women. We deal with many urological conditions affecting women, including incontinence, pelvic organ prolapse, bladder infection, overactive bladder, kidney stones and cancer. Male or female, feel free to contact St Pete Urology when you have a urine or bladder issue.

Debunking 4 Myths about Urinary Incontinence

Urinary incontinence is an embarrassing condition affecting more than 200 million people globally. Characterized by bladder leakage, painful urination, strong urge to urinate and incomplete emptying of the bladder, the condition can negatively impact the quality of life of affected individuals by restricting their ability to participate in various activities. Riddled with several misconceptions and accompanied by considerable stigma, bladder leakage is a highly misunderstood condition that even those affected do not want to talk about. Yet by debunking some of the myths associated with the condition and establishing a clearer understanding of the problem, affected individuals can get on the right track for healthy and happy bladder management. Here are four of the more common myths about urinary incontinence:

Myth 1: Only the elderly experience urinary incontinence.

Even though the risk of urinary incontinence increases with age, virtually any person can experience incontinence at any stage of life. For instance, bladder weakness typically affects 1 in every 3 women above the age of 18 with many young women experiencing sensitive bladder symptoms after pregnancy and labor. Urinary incontinence can also result from an enlarged prostate, nerve damage, weakened pelvic muscles, medical conditions such as obesity, onset of menopause in women due to a drop in estrogen levels, infection, and as a side effect of certain medications.

Myth 2: Reducing fluid intake reduces urinary incontinence.

Limiting fluid intake may sound like a brilliant idea since drinking plenty of water increases the frequency and urgency of urination. However, it has been shown that drinking adequate amounts of fluid in small doses throughout the day helps to prevent leakage. In fact, severe limitation of fluid intake can make urine more concentrated, increasing the risk of bladder irritation and worsening urinary incontinence. Drinking enough water also helps to reduce odors. Doctors recommend that you sip water between meals, avoid fluids for two hours before bed, and reduce or avoid citrus juices, caffeine, carbonated beverages and alcohol.

Myth 3: Surgery is a necessary treatment for urinary incontinence.

While surgery is one effective treatment for incontinence, it comes with more risks than other treatment options. For instance, invasive surgical procedures such as sling surgery and retropubic suspension have associated risks such as difficulty urinating and worsened incontinence. Therefore, affected individuals should always be offered the option of trying nonsurgical treatment first and only opt for surgery when nonsurgical options fail. In fact, for most people, simple lifestyle changes, medications for relaxing the bladder and treating urinary infections, medical devices like pessaries, weight loss, dietary changes, and pelvic floor muscle exercises provide considerable improvement in symptoms. Surgery should only be considered as a last resort.

Myth 4: Delaying urination strengthens the pelvic floor.

While many think that delaying going to the bathroom can help to strengthen the pelvic floor, the truth is that this can overstretch the bladder, resulting in a flaccid and dysfunctional bladder. Therefore, for a person living with urinary incontinence, it is important to avoid actions that may weaken your bladder and instead seek immediate medical treatment. Remember, urinary incontinence may be a symptom of an underlying medical condition that requires a prompt visit to a urologist. So stop living quietly with urinary incontinence and thinking that you can crudely wish it away. Talk to your doctor about what could be causing the problem and what might be the best individual treatment option for you. For more information on managing urinary incontinence, visit the St Pete Urology website or make an appointment for a consultation with a urologist.

Technological Innovations in Urology

Technological innovations in urology have resulted in far-reaching improvements in patient care. At St Pete Urology, the implementation of new technologies and innovations has improved diagnostic accuracy, enhanced the safety and quality of treatments, and streamlined patient information systems. For example, the use of advanced imaging technologies has enabled urologists to visualize and diagnose different conditions more precisely while minimally invasive surgery results in significantly reduced pain and quicker recovery and convalescence.

Laparoscopic Surgery

Our urology specialists use laparoscopic surgery when applying miniature instruments inserted using a small tube (known as a laparoscope) through small incisions in the patient’s body. We use novel biological sensors, techniques and instruments to ensure less pain, faster recovery and better outcomes for urologic problems. For example, we offer minimally invasive laparoscopic surgery for kidney stones, pelvic organ prolapse, live donor nephrectomy, uretal stricture, uretopelvic junction obstruction, renal cysts, renal cell carcinoma, prostate cancer and more. Our urologists in St Petersburg have also refined laparoscopic surgery for use in children to remove dysfunctional or malformed kidneys, correct blocked ureters and treat undescended testicles.

Robotic Surgery

At St Pete Urology, every urologist is trained in the use of robotic surgery to perform operations with more precision. Robot-assisted surgery is a minimally-invasive operation similar to laparoscopy (performed through smaller incisions than open surgery), but in which small surgical tools are mounted on a robotic arm controlled by the surgeon using a computer. The urologist makes tiny incisions for inserting the instruments into the body then uses an endoscope to view enlarged 3-D images of the affected area during the operation. Our urology clinic boasts of the da Vinci machine, the world’s most advanced surgical robot, enabling our specialists to conduct operations with better vision, precision and control.

External Beam Radiation Therapy (EBRT)

Also called Image Guided Radiation Therapy (IGRT), this form of treatment has been implemented at St Pete Urology with great success for prostate patients. Our state-of-the-art imaging enables urologists to direct radiation with more precision to the area of the prostate that requires treatment. With better preparation and planning, this technology ensures more accuracy and allows the urologist to target the same area of the prostate for all additional treatments. In fact, EBRT ensures less radiation and pinpoint accuracy for better outcomes and reduced side effects associated with radiotherapy.

Cryosurgery and Cryosurgical Ablation

We have implemented new cryosurgical technologies for treating prostate cancer, making it easier for our urologists to map cancerous cells more precisely, and freezing and killing cells not reachable by means of radical prostatectomy surgery. Similarly, we use cryosurgical ablation to destroy diseased tissues and eradicate prostate cancer in patients who decline radical surgery (involving prostate removal). Our cryosurgical procedures can be performed on an outpatient basis and without incisions, ensuring minimal blood loss or side effects.

Selecting the Best Technologies

In a world with seemingly endless urology innovations and technologies, we have carefully selected and implemented only those that are effective and appeal to both patients and doctors. This means that all technologies at St Pete Urology have a proven efficacy, cause the least discomfort to patients, and can easily be performed by every urologist. For more information on safer and effective use of the latest technological innovations in the treatment of urological conditions, make an appointment at St Pete Urology in St Petersburg, Florida.

3 Essential Facts About Surgery For Prostate Cancer

When prostate cancer is detected early enough, before it has spread beyond the prostate gland, surgery is often recommended as the cure. Also known as prostatectomy, surgery for prostate cancer involves removal of the entire prostate and nearby lymph nodes. The surgery not only aims to remove the cancer but also to provide a close look at the pathology of the cancer. It ensures that treatment is completed within a shorter period of time compared to other options such as radiotherapy. Surgery also has immediate psychological benefits in patients who take comfort in knowing that the cancer has been removed.

3 Essential Facts About Prostate Cancer Surgery

1. There are two basic approaches: Open and Laparoscopic.

To remove the cancer, the urologist gains access to the prostate and associated lymph nodes either by open radical prostatectomy or laparoscopic prostatectomy (either manually or robot-assisted). Open radical surgery for prostate cancer is the procedure whereby an incision, roughly 10 centimeters in length, is made in the patient’s lower abdomen (belly button to pubic bone) or in the skin between anus and scrotum (perineum) in order to access the prostate and affected lymph nodes. In laparoscopic surgery the urologist may use either a small camera and instruments (laparoscope) to make several small incisions or perform the surgery with robotic equipment that provides 3-D vision and dexterity.

2. Robot-assisted prostatectomy gives better precision and outcome.

Robotic prostatectomy is performed using a robotic interface (the da Vinci System), with the surgeon sitting at a control panel and moving robotic arms to operate via several minute incisions made in the patient’s abdomen. The da Vinci system ensures less pain, minimal blood loss and shorter recovery time than open surgery. For surgeons, robotic surgery ensures more maneuverability and greater precision in the movement of surgical instruments.

3. The success of the operation depends on the surgeon’s skill and experience.

Like any surgery, prostate surgery is associated with risks regardless of the approach used. Therefore, whether you opt for open or laparoscopic surgery, you must find an experienced and highly skilled urologist capable of conducting operations with minimal risks. The surgeon should be capable of performing operations that ensure that nerves near the prostate are not harmed. Remember, in some cases, the urologist will have to remove small amounts of tissue that contain lymph nodes near your prostate or will remove the prostate gland together with the seminal vesicles and vas deferens. So the more skilled and experienced the surgeon, the higher the chance of success.

For more information on successful surgery for prostate cancer, visit the website of St Pete Urology in St Petersburg, Florida.

Should You Take Medicine for Treating Enlarged Prostate?

As a man ages, his prostate may become larger, a disorder known as Benign Prostatic Hypertrophy (BPH). While an enlarged prostate is neither a serious nor a life-threatening condition, it can cause urinating problems in men aged 50 years and older. Men with urinary problems should immediately see their doctor for a prompt and accurate diagnosis because symptoms of BPH are similar to those of prostate cancer. A patient should also see a doctor immediately when experiencing fever, chills, back pain, side pain, abdominal pain, bloody or cloudy urine, or pain when urinating.

Treatment of Enlarged Prostate

After a diagnosis of prostate enlargement, the urologist evaluates the severity of symptoms before recommending treatment. You are expected to participate in the decision making process to ensure you get the best treatment possible. Generally, no medications are prescribed for enlarged prostate unless the symptoms are severe, bothersome or accompanied by problems such as bladder stones or bladder infection. In fact, around 4 out of 10 men usually have no symptoms or have their symptoms improve without medications or surgery and only require lifestyle changes to manage BPH. Conversely, 1 in 4 men in their late 50s, 1 in 3 men in their late 60s, and 1 in 2 men in their late 70s and beyond can expect to have bothersome symptoms that require medications or even surgery.

Watchful Waiting

Should you take medications for treating enlarged prostate? After the diagnosis of BPH, you will have to choose either watchful waiting or medicine as your primary treatment, though surgery is sometimes necessary for serious symptoms. The best treatment option for men with minimal and less bothersome symptoms is watchful waiting. It involves combining lifestyle measures that prevent or relieve symptoms of BPH with visits to the urologist at least once a year for physical examination, testing and symptom status review.

Men managing BPH through watchful waiting must limit the amount of fluid they consume at any given time, avoid drinking fluids after 7 p.m., avoid beverages containing caffeine, avoid delaying urination, cut back on salty or spicy foods, limit alcohol intake, engage in regular physical activity and Kegel exercises, avoid cold weather and keep themselves warm, control their weight, control their blood sugar level, eat diets rich in vegetables, and avoid over-the-counter antihistamines (decongestants).

You should opt for watchful waiting if:

  • (a) You experience mild and less bothersome BPH symptoms.
  • (b) The side effects of the medicine may bother you more than the mild symptoms of BPH.
  • (c) You can attend regular medical checkups (at least once a year).
  • (d) You can effectively use special bathroom techniques, cut back on your fluid intake and change your lifestyle.

Medicines

If your symptoms are severe or worsen during watchful waiting, you should consider taking BPH medications. The three types of drugs commonly used for treating enlarged prostate are alpha-blockers, 5-alpha reductase inhibitors and phosphodiesterase-5 inhibitors. Alpha-blockers are fast-acting drugs that relax prostate muscles and relieve urination problems within a few days or weeks. They include terazosin (Hytrin), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), Alfuzosin (UroXatral) and tamsulosin (Flomax). Drugs called 5-alpha reductase inhibitors such as dutasteride (Avodart) and finasteride (Proscar) cause shrinkage of the prostate and improve symptoms, albeit after several months. Phosphodiesterase-5 inhibitor called tadalafil (Cialis for daily use) has also been approved for use in treating BPH.

When using a prescription for managing enlarged prostate, you will take the pills every day for life, have regular medical checkups, and use special bathroom techniques such as relaxation and double voiding. The medicines will reduce the risk of urinary retention, relieve symptoms and minimize risks of future surgery. However, prescriptions are often expensive and come with certain side effects such as trouble getting an erection, diminished sex drive, tiredness, dizziness, and stuffy nose.

Conclusion

When you have problems urinating, you should immediately see a doctor as you may have an enlarged prostate. At the urology clinic, the doctor will perform a physical exam and run a few tests to find out if you have BPH. If BPH is confirmed, the urologist will explain to you the treatment options available, such as watchful waiting, medications and or surgery for serious cases. The treatment option chosen will depend on the severity of symptoms and your desire to improve the quality of your life. You should consider watchful waiting if you have mild symptoms and want to avoid the adverse effects of drugs. However, in case of severe BPH symptoms, you should take medications to relieve symptoms and possibly prevent the need for surgery in the future. For more information on treating an enlarged prostate, visit St Pete Urology in St Petersburg, Florida.

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Urology Patient Testimonial

Dr. Graves is the kindest, most thoughtful, genuinely caring doctor I have ever encountered in my entire life; and my brother had cancer when we were three and mom had a triple by-pass at twelve. I grew up in hospitals, but I have not spent much time in them for myself since very recently. I would rather pass a stone at home-and have twice- than have the kidney stone blasted at the hospital because of the pain afterward from endometriosis. Dr Graves called me HIMSELF to check on me. Choose him. – Kendra Burke

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