Urologists: What they do and what to expect

A urologist is a medical doctor who specializes in the urinary system, which includes kidneys, bladder, urethra and ureters. Urologists also specialize in issues related to the male reproductive system. Specialization in this field requires a great deal of education. Urologists go through four years of medical school followed by five years of specialized training focusing specifically on urology. By the time a urologist enters a practice they are experts in their field.

There are many reasons why your primary care doctor may recommend a urologist. Urologists help patients with issues like urinary tract infections, stubborn kidney stones, enlarged prostates, incontinence and pelvic prolapses. There are also various forms of cancers that urologists monitor and treat, like prostate cancer. For men, their urologist can be their main point of contact for issues like erectile dysfunction.

Urologists have a variety of tools to help their patients achieve positive outcomes with whatever issue they may be facing. They will consult with their patients to determine what is the best method to treat each individual’s medical issue. Treatment options will vary case to case. Treatments can be both surgical and non-invasive. For example, a urologist may perform surgery to implant stints in the urinary tract to help with kidney stones or perform biopsies on prostates with cancer. Urologists may use new technologies like HIFU, which uses ultrasound waves to break up kidney stones.

A patient seeing a urologist for the first time can expect an experience similar to seeing any other kind of doctor. The appointment might include collecting a urine sample, depending on the reason for the visit. A first visit usually will include a questionnaire about patient’s health history and issues. It is important to answer these questions as truthfully as possible, even though discussing issues regarding incontinence, urinary issues or erectile dysfunction can be embarrassing for many patients. It is helpful to remember that urologists deal with these issues on a daily basis and are accustomed to having these conversations with their patients. There is no issue a patient should be too embarrassed to discuss.

For some patients, seeing a new doctor can be frightening. At St Pete Urology, doctors understand this and work to create an open environment where doctors and patients can achieve positive and sometimes life-changing outcomes. For more information, visit the St Pete Urology website.

What Does the Prostate Gland Do?

The prostate gland is an organ that is part of the male reproductive system. It surrounds the urethra and is located between the bladder and penis. It is relatively small weighing in at a mere three-fourths of an ounce, and can be likened to the size of a walnut or small apricot.

Despite its small size, it does important work for the reproductive system. The primary function of the prostate is to produce and secrete prostate fluid, which is one of the main components of semen. This fluid, which makes up one-third of semen’s volume, contains important enzymes that aid sperm.

The enzymes are referred to as Prostate Specific Antigens (PSA) and help to prevent semen from thickening after ejaculation. The more liquid semen allows sperm to move freely, increasing the chances of its success.

The muscles of the prostate help propel semen. During ejaculation sperm moves from the testicles to the prostate. The prostate then will contract, closing the bladder’s opening to the urethra so the prostate can release the semen through the urethra.

When in good health, the prostate is an important part of the male reproductive system. However, it is prone to a few conditions that are most likely to increase as men age. The most common is enlarging of the prostate. Prostate growth affects virtually all men over age 50. It can cause difficulty urinating and the need for frequent urination. There are medicines that can help treat an enlarged prostate if symptoms get bad enough to warrant treatment.

Another common health issue is prostate cancer. Other than skin cancer, prostate cancer is the most common form of cancer in men. Fortunately, only one in 41 men diagnosed with prostate cancer dies, meaning survival rates are better than in many other forms of cancers. Prostate cancer can be treated with surgery, chemotherapy, radiation and hormone therapy. In some cases, when the cancer is not aggressive or spreading, doctors may recommend leaving the cancer alone and just monitoring it with your urologist.

Given its importance in the human body, good prostate health is important. Having your prostate checked once a year by a urologist should be a part of men’s annual health maintenance as they get older. Having a good relationship with your urologist is important. Urologists like those at St Pete Urology are dedicated to their patients’ best interest and overall health. They are specialists who can help with planning, treatment and any issues that may arise with the prostate. For more information, visit the St Pete Urology website.

Infertility Treatment Options for Men & Women

Infertility Treatment Options for Men & WomenFor couples struggling to conceive a child, life might feel like a carousel, trying for the brass ring, month after month. It can put a lot of pressure on the relationship. But now there are fertility treatments that can put the chances of conception in your favor.

What are the different types of fertility treatments?

Today we have more technology for diagnosing and treating infertility than ever before. Fertility assessments should be done on both partners to determine which treatments can help, and whether it is a male or female infertility issue.

Female Options for Fertility Treatment

Fertility treatments can include medications to regulate hormones and ovulation, which are often combined with minor surgery approaches. Assisted Reproductive Technology, or ART for short, encompasses several procedures to help you conceive. Some ART procedures make it easier for the sperm to fertilize an egg, and others help with getting the egg to implant in the lining of your uterus.

Common ART fertility treatments are:

Intrauterine Insemination (IUI), in which healthy sperm is collected and then inserted directly into the uterus when you are ovulating.

In Vitro Fertilization (IVF), in which eggs are taken from the ovaries to be fertilized by sperm in the lab where they can develop into embryos. Then a doctor implants the embryos into your uterus after they grows for 3 to 5 days.

GIFT, short for Gamete IntraFallopian Transfer, and ZIFT, Zygote IntraFallopian Transfer. In GIFT, the egg and sperm are collected and immediately placed in a fallopian tube. With ZIFT, the egg(s) and sperm are combined in a lab, resulting in a fertilized egg, which then is placed into the tube at 24 hours.

Cryopreservation, which is known as “freezing” your eggs, sperm or embryos, along with donated eggs or embryos, as well as surrogate mothers who carry the embryo to term.

Both fertility drugs and hormones can be used to help determine when the woman is ovulating or ensure proper levels of hormones. Surgery can remove tissue, such as in cases of endometriosis, or be used to open blocked fallopian tubes.

Enlisting donor sperm, eggs or surrogate mothers, is popular with single people and same-sex couples who desire a baby. Donor sperm or eggs can be the solution if either partner has fertility issues.

Male Options for Fertility Treatment

There are various treatment options if the male needs help with sperm counts, quality or motility. Surgery by a qualified urologist is recommended if the cause is a varicocele (widened veins in the scrotum) or for any blockage in the vas deferens, the tubes that carry the sperm. Antibiotics can be used to treat infections in the reproductive organs, and medications can treat problems with ejaculation or erections. Another option is hormone treatment.

If you wish to conceive but are having problems, our team of specialists at St Pete Urology is experienced in working with couples to make assessments and help in achieving your dreams. For more information, visit the St Pete Urology website.

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.

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.

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.

Can a vasectomy fail?

A vasectomy is a form of male contraception that is administered through a minor surgical procedure. During a vasectomy, the patient’s vas deferens are cut and the ends are tied up or seared so they are blocked. The vas deferens is made up of two narrow tubes that transport sperm to the ejaculatory duct during ejaculation. A vasectomy inhibits the transportation of the sperm to the duct, so only seminal fluid is discharged when a man ejaculates. The absence of sperm removes the possibility of conception. A vasectomy is considered to be the most efficient form of birth control. However, there are instances, though very rare, in which pregnancy occurs even after the man has had a vasectomy.

Reasons why a vasectomy may fail

1. Recanalization

This is a medical term for when the cut vas deferens reconnect and revert to something like what they were before the vasectomy. This process happens naturally when tissue from the cut ends gradually grows until the two ends reach one another and reconnect.

Tiny channels also can form in the healing scar tissue of the snipped vas deferens and provide a passageway for sperm from one end of the vas deferens to the other.

2. Surgical error

In very rare cases, surgeons have been known to make an error during the procedure. This might mean either that the vasectomy was not done at all or that it was done in a manner that might cause it to fail.

Such errors could be:

a. Cutting one vas deferens and leaving the other;

b. The surgeon cuts completely different tubes that are not the vas deferens; and

c. In the very rare cases where the patient has duplicated vas deferens, that is to say two vas deferens on each side rather than one on each side as is the normal case, and the urologist cuts only one of the two .

d. Having intercourse too soon

Men who have had vasectomies are always advised to avoid having sex too soon, and if they do, to use another form of contraception. This is because semen does not become clear of sperm immediately after the vasectomy. The standard practice is to wait for three months after the procedure. After the three months, a urologist should conduct a semen analysis and advise accordingly.

Vasectomies are largely successful. Any man considering it has absolutely no reason to fear that it will fail because they rarely do. However, after undergoing the procedure, the patient must take care to observe all guidelines given by the urologist. A little anxiety before the procedure might be expected but the advice of a trained urologist, such as those available at St Pete Urology should dispel the worry. The team of specialists at St. Pete Urology can help with questions, consultation, surgery and follow up steps for a vasectomy. For more information, visit the St Pete Urology website.

How to Prevent Erectile Dysfunction?

Erectile dysfunction is a condition that prevents a man from getting or maintaining an erection firm enough for sexual intercourse. The failure to sustain an erection may happen occasionally in healthy men and this should not be a reason to panic. One is said to have erectile dysfunction only when the inability to sustain an erection is sustained over a period of time. The risk of having erectile dysfunction increases with age, with about 50 percent of men over the age of 40 having the condition. Recent research also indicates an increase in the cases of erectile dysfunction in men in their 30s.Erectile dysfunction is treatable. Even so, it does inhibit a patient’s sexual performance, and in some cases, confidence. It comes as good news, therefore, that the condition is not only treatable, it is also preventable.

Preventing Erectile Dysfunction

The ways in which erectile dysfunction may be prevented fall into two categories:

1. Maintaining good overall health.

The sexual health of an individual is determined by his general health. If his overall health is failing, it will only be a matter of time before this starts to affect one’s sexual ability. One way of preventing erectile dysfunction therefore lies in maintaining good overall health. To this end, the following are recommended:

a. Maintain healthy body weight. A healthy balanced diet and regular exercise go a long way to keep body weight at a desired level. This protects you from obesity and other lifestyle diseases which might cause erectile dysfunction.

b. Avoid excessive use of alcohol, drugs and cigarettes. Taking these may, in the long run, lead to diseases of the heart or interfere with the functioning of blood vessels. Interfering with blood flow may reduce the amount of blood going into the penis, thus causing erectile dysfunction.

2. Managing Underlying chronic diseases

Erectile dysfunction often arises as a result of an underlying illness. For example, obesity, diabetes and cardiovascular illnesses have a tendency of interfering with the flow of blood to the penis. In addition to these, mental issues such as depression or crippling anxiety may cause erectile dysfunction. In such cases, the key to dealing with erectile dysfunction is in fighting the underlying illness. A patient with one of these conditions will be advised to, among other things:

a. Take medication as advised by the attending doctor;

b. Consult with the doctor to see if treatment for erectile dysfunction may be administered independently without affecting the treatment of the underlying illness; and

c. Seek therapy and treatment for mental health conditions.

Erectile dysfunction can be prevented by simply choosing to live a healthy lifestyle. For those already suffering from erectile dysfunction, there is no need to panic as the condition is very treatable. Our team of specialists at St. Pete Urology can help with any questions, consultation, diagnosis and treatment options for erectile dysfunction. For more information, visit the St Pete Urology website.

What to Know About Overactive Bladder

Like the name suggests, an overactive bladder is a bladder that does more than it should. The normal functioning of a bladder is that as urine drains from the kidneys to fill the bladder, nerve signals in the brain communicate the need to discharge the urine. The urge to urinate grows gradually so a person can delay the passage of urine for a while. During the discharge of urine, the bladder contracts, letting out the urine through the urethra.

An overactive bladder contracts suddenly and involuntarily, so a patient cannot hold the urine. It also contracts often, even when it contains just a little urine. This forces the patient to take numerous bathroom breaks. Due to the frequency and suddenness of the contractions, an overactive bladder is known to cause the leaking of urine, otherwise known as urine incontinence. It affects both men and women.

Causes of an Overactive Bladder

An overactive bladder cannot be attributed to one single cause or factor. In most cases, it is caused by a combination of factors. These include:

1. Serious case of a urinary tract infection;

2. A neurological disorder that damages the communication of nerves in the brain and in the bladder;

3. Bladder complications such as bladder stones or tumors;

4. Stroke and multiple sclerosis;

5. Acute urine retention. When urine is retained in the bladder for long, there is no longer space for storage of urine. This may result in an overactive bladder;

6. Pelvic organ prolapse in women and benign prostate hyperplasia in men; and

7. Diabetes.

Social and Emotional Impact of an Overactive Bladder

Patients with an overactive bladder often worry a great deal about stigma. They find the frequent bathroom visits embarrassing and the fear of leaking urine in any social or work environment can be debilitating. These fears affect the normal day to day life of a patient and make it necessary to seek treatment as soon as possible.

Treatment of an Overactive Bladder

A patient can receive treatment in the form of medication, injections and in few cases, minimally invasive surgical procedures. Very often these treatment options are combined with physical therapy and behavioral modifications. Such modifications include:

1. Kegel exercises. These are administered to help strengthen the muscles of the pelvic floor;

2. Exercise aimed at achieving and maintaining a healthy weight;

3. Going on scheduled bathroom visits; and

4. Use of absorbent pads.

An overactive bladder is manageable and treatable. In order to avoid the difficulties that accompany the condition, it is advisable to seek the help of a qualified urologist for a proper diagnosis followed up by efficient treatment. Our team of experts at St. Pete Urology can help with any questions, as well as diagnosis and treatment of an overactive bladder. For more information, visit the St Pete Urology website.

Why Do I Keep Getting UTIs?

Urinary tract infections (UTIs) are caused by bacteria or E.coli in the organs of the urinary tract — the kidneys, ureters, urethra and the bladder. Most UTIs affect the urethra and the bladder alone. While UTIs affect both men and women, the rate of prevalence and recurrence is higher among women, with about 50 percent of all women expected to contract the infection at least once in their life time and 20-30 percent expected to suffer a recurrence.
The high prevalence of UTIs among women is attributed to the fact that the urethra in women is shorter than in men. The urethra in women is placed closer to both the anus and the vagina. Bacteria from the anus and those that enter the vagina during intercourse have only to travel the short length of the urethra to reach the bladder. Besides gender, the other risk factor for UTIs for both genders is advanced age.

Causes of recurrence

A case of UTI is said to be recurrent or persistent if a patient contracts at least four infections in a period of one year. Recurrence of UTIs occurs almost solely among women. Other than the positioning of the urethra in their bodies, this recurrence may be caused by factors such as:

1. Failure to complete a dose of antibiotics. Once the benefits of taking the prescribed antibiotics start to manifest, some patients stop taking the drug because they think the UTI has cleared. Urologists discourage this behavior and advise patients to complete the dose to reduce the chances of any left over bacteria causing a recurrence.

2. Sex is a risk factor. Sexually active women face a higher risk of contracting a UTI because of the transmission of bacteria during intercourse. The risk can be reduced by urinating before and after sex or by taking an antibiotic before or after sex if a doctor prescribes it.

3. Post-menopausal hormonal changes. Menopause lowers estrogen levels in women causing an imbalance in the bacteria in the vagina. This makes women susceptible to infection and recurrence. A urologist can prescribe a vaginal estrogen cream to remedy the problem.

Women are genetically predisposed to contracting UTIs, both because of their anatomy and hormonal changes as they get older. But UTIs in women are highly treatable and are only rarely very serious. If anyone experiences persistent infections, she should seek the advice of expert urologists, such as those found in St. Pete Urology. The experienced specialists at St. Pete Urology can offer consultation, diagnosis and treatment for any UTI problems. For more information, visit the “St Pete Urology” site.