How To Treat Kidney Stones?

When certain minerals are in excess in the body, they accumulate in urine. The urine becomes more concentrated as the levels of minerals and salts increase, particularly when the body is not well hydrated. As a result, hard masses of minerals and salts called kidney stones — often made of uric acid or calcium — form inside the kidney and can travel to other areas of the urinary tract. About 1-in-11 Americans will have a kidney stone at some point in their lifetime, but stones occur more often in men, people with diabetes and those who are obese.

Stones come in different sizes

Kidney stones vary in size. While some may be as small as a fraction of an inch and others only a few inches across, some stones can be very large and may take up the whole kidney. Smaller stones tend to remain in the kidney and rarely cause pain as they pass out of the body. In most cases they are not noticed until the kidney stones pass into the ureter. But larger stones may block urine flow, cause pain and result in urinary tract problems. Fortunately, the stones rarely cause permanent damage, and there are effective treatments for them.

Pain due to kidney stones

Pain is the most common characteristic and frequent symptom of kidney stones. Although the pain associated with stones varies from person to person, it can be quite intense and agonizing when it occurs — accounting for over 1 million visits to the emergency room every year. Many women who have had the condition attest that the pain is worse than the cramps and spasms of childbirth; others say it’s like being stabbed with a knife. The pain is felt along the side and back and below the ribs, though it may radiate to the belly and groin area with the movement of the stone along the urinary tract. It also generally occurs in waves, each wave lasting a few minutes, before disappearing and coming back.

Treatment of kidney stones

At St Pete Urology, we admit many patients in our emergency department because of painful kidney stones. Some patients also present with symptoms such as nausea, vomiting and hematuria (blood in urine). We determine how to manage kidney stone disease depending on the location and severity of the stones. For patients with small stones — several millimeters in size — we may allow time for the stones to pass without intervention. In that case, a patient is given pain medication, advised to drink plenty of water and waits for the stones to pass, under our close observation. But for large stones or complex ones causing problems such as severe pain, infection or kidney failure, we usually intervene to remove the stones.

Types of treatments

We often intervene to remove kidney stones that fail to pass spontaneously, are affecting kidney function, are accompanied by too much pain to wait for their passage, are blocking the flow of urine or are causing repeated infections. The interventions involve tiny or no incisions, minimal pain and a short time off work. At St Pete Urology, the treatments we commonly provide for kidney stones are extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy and ureteroscopy.

1. Extracorporeal Shockwave Lithotripsy (ESWL)

ESWL (Extracorporeal Shockwave Lithotripsy) is the use of highly-focused sound waves released and focused from outside the body to crush kidney stones. The intense waves are able to reduce the stones into sand-like granules that can pass normally in urine over a few weeks. Before ESWL, patients are given a sedative or placed under regional or general anesthesia and ultrasound or X-rays used to pinpoint the location of the stones.

The procedure takes about 1 hour, but larger or more complex stones may need several ESWL treatments. Patients return home the same day and are able to resume normal activities in 2-3 days. Shockwave lithotripsy is not used for hard stones, such as cystine, struvite, and some types of calcium phosphate and calcium oxalate stones. It’s also not ideal for stones larger than 1 inch in diameter and for pregnant women.

2. Ureteroscopy (URS)

For some kidney stones, especially those located in the kidney and ureter, ureteroscopy is the preferred treatment. The treatment involves passing a small fiber-optic instrument called ureteroscope into the urethra and bladder, then into the ureter. The telescopic instrument enables the urologist to see the stone and to use a small, basket-like device to pull out a smaller stone. For larger stones that can’t be removed in one piece, the urologist uses laser or a similar stone-breaking tool to shatter the stone into smaller pieces.

Flexible ureteroscopes are used for stones located in the kidney and upper ureter while rigid ones are used when stones are located in the lower ureter near the bladder. During the procedure, you are placed under general anesthesia to keep you comfortable. A stent (or small tube) is left in the ureter to keep it open and drain urine from the kidney and into the bladder, but it’s completely within your body and doesn’t require an external urine collection bag. You can return home the same day and resume normal activities in 2-3 days, but the stent must be removed in 4-10 days to avoid infection and potential loss of kidney function.

3. Percutaneous nephrolithotomy (PCNL)

Percutaneous nephrolithotomy (PCNL) is the most appropriate treatment for larger or more complex kidney stones. It’s also the best treatment if several small stones are bundled up in one kidney. During the procedure, the surgeon makes a half-inch incision in the side or back and then guides a nephroscope (rigid telescope) through the incision and into the area of the kidney where the stone is located. Using the nephroscope, the urologist reaches the stone with instruments that fragments it into pieces that are then suctioned out. The ability to suction tiny pieces of stone from the urinary tract makes PCNL the best treatment option for larger stones.

PCNL is performed with the patient under general anesthesia. The procedure requires hospitalization and you are discharged after 24 hours but resume normal activities after 1-2 weeks. Usually at the end of the procedure a tube is placed in the kidney to help drain urine into a bag outside the body. The tube remains for a few days or just overnight. Before you are discharged from hospital, the urologist may do X-rays to check if any pieces of stone remain. The nephroscope may be inserted again if any stone fragments are detected to remove the leftover fragments and to make sure you are completely free of the condition.

At St Pete Urology, we have experienced urologists, specialized equipment and highly-skilled support personnel to help us deliver excellent outcomes for patients with kidney stones. We use both surgical and non-surgical methods to tackle this painful condition, including the minimally-invasive procedures of shockwave lithotripsy, percutaneous nephrolithotomy and ureteroscopy, robotic surgical procedures, advanced imaging technology, medications and dietary changes. For us, the goal is not only to cure kidney stones but also to prevent a recurrence — striving to make your first stone surgery your last. So if you have symptoms of kidney stones or want advice on how to avoid this painful condition, come see us for help. For more information on prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

Meet Dr. Adam Oppenheim

Urology is a great blend of surgery and medicine and a specialty that provides an amazing work-life balance. It also brings profound satisfaction from the excellent outcomes with most cases. It is a wonderful opportunity to help people with embarrassing conditions and a chance to provide life-saving and life-extending treatments. Being passionate about making a difference in the lives of people, I found urology the perfect specialty for me.

Becoming a urologist

I was born and grew up in Yorktown, Va., and went to Virginia Tech for my Bachelor of Science in Biology. I went to the Nova Southeastern University, College of Osteopathic Medicine for my medical education. While a lot of factors were involved in choosing to become a doctor, my dad was a big influence. He was an ophthalmologist who spoke fondly about the joy of caring for patients — both in his office and in the operating room. My dad made medicine such a noble career that I was inspired to follow in his footsteps.

But it was when I was a third year medical student that I chose to become a urologist. My general surgery rotations allowed me to interact closely with many urologists. During those sessions I spent with them, I saw the enthusiasm the urologists brought to their work and it inspired me. They really appreciated their work and their passion and commitment translated into great care and excellent outcomes for their patients. They instilled that love for urology in me — a love that has continued to flourish ever since.

I completed my general surgery and urology residency at the Einstein Medical Center in Philadelphia. During those years in Philadelphia I also received urology oncology training at the Fox Chase Cancer Center — one of the nation’s top centers in cancer care. My urology training included working with the country’s leading doctors in penile implant surgery, enabling me to be solidly grounded in knowledge, skill and experience in penile prosthesis. Likewise, I took extra-curricular courses in mid-urethral sling insertion for stress incontinence in women, urologic prosthetics, GreenLight laser therapy and InterStim sacral neuromodulation for BPH.

What do we do as urologists?

We are specialists in treating medical problems of the urinary tract and the male reproductive system. The problems are found in organs such as kidneys, uterus, urethra, urinary bladder and male reproductive organs. When necessary, we perform surgeries to remove kidney stones, genital abnormalities present at birth, urinary tract obstructions, and other issues causing problems for patients. We diagnose and treat enlarged prostate, erectile dysfunction, urinary problems, urologic cancers, overactive bladder, urethritis, prostatitis and interstitial cystitis, among other conditions. We see patients of all ages, from babies and children to seniors.

Urology is a specialized field with a lot of things that I like. We do many procedures to improve the quality of life of our patients. For instance, we do prostate procedures to help patients pass urine, treat erectile dysfunction which is quite embarrassing to those who struggle with it, treat kidney stones that can cause agonizing pain, and tackle life-threatening conditions such as prostate cancer and kidney cancer. I practice every aspect of general urology but I have a special interest in erectile dysfunction, kidney stones, urinary problems, enlarged prostate, prosthetics and men’s health, spending the better part of each day doing exams on the male genitalia and performing a lot of surgeries on balls and penises.

Job Satisfaction

As a urologist, I always feel that I’m in a unique position. I am able to have a lasting relationship with my patients, which is something I find really gratifying. And after almost every successful diagnosis and treatment, my patients improve quickly and are able to enjoy life again — something that fills me with joy and satisfaction.

During our work, the most difficult part is usually for patients struggling with embarrassing and awkward conditions to walk in, sit down and discuss sensitive issues openly and honestly. With every encounter I try to provide a caring and compassionate environment that allows for frank and open conversations. The goal for me is to craft a personalized treatment plan that suits the goals and lifestyle of each patient. A plan may be as simple as changing medications or as complex as conducting surgery with sophisticated equipment.

Why St Pete Urology

St Pete Urology is a wonderful place with great professionals and state-of-the-art equipment. Working here always fills me with pride because of the excellent outcomes we achieve for our patients and the unwavering commitment to improving the standards of care through innovative and advanced techniques. It’s always buzzing with people sharing jokes and smiling, and that positive attitude is contagious. It also helps because we have to perform tests and procedures in an uncomfortable area of the body and there are often times we have to deliver news about diagnoses that patients may not want to hear. It has been an amazing time being here and I have only good things to say about urology — I would choose urology if I had to do so again.

For more information on our urologists and range of services, visit the “St Pete Urology” site.

What is BPH

Benign Prostatic Enlargement (BPH) is an age-related, non-cancerous growth of the prostate. BPH is a common condition, particularly in older men. In fact, almost every man will suffer from the symptoms of the condition at some point after the age of 40; with more than 70 percent of men over 60 having symptoms of BPH while 90 percent of men over 85 years have the condition. As the prostate gets larger, it presses hard on the urethra causing urethra blockage and bothersome urinary symptoms. However, BPH is not cancer and does not make a man more likely to get prostate cancer.

Phases of prostate growth

Located in front of the rectum and between the penis and the bladder, the prostate is a small, walnut-sized gland that secretes the prostatic fluid, one of the key components of semen. Typically, the prostate goes through two major growth phases during a man’s lifetime. The first growth phase takes place during puberty when the prostate usually doubles in size. Beyond puberty, often at around the age of 25, the prostate begins to grow again and continues to do so for the rest of life in many men. This continuous growth is what leads to BPH and makes the condition quite frequent in older men. BPH does not occur in men until the second phase of prostate growth when the gland begins to press on the urethra and causes urinary problems.

Causes of BPH

As a man gets older, the balance between self-proliferation of cells and cell-death becomes harder to maintain due to changes in hormone levels (androgens), cell-to-cell communication (cell signaling pathways) and growth factors. The cells of the prostate multiply rapidly and form microscopic nodules, which then continue to grow. The abnormal and uncontrolled increase in the number of prostate cells is called hyperplasia. The microscopic nodules increase in mass and volume, resulting in an enlarged prostate. This abnormal growth occurs in the transitional zone around the urethra and is characterized by increase in size without becoming cancerous.

Symptoms of BPH

As the prostate increases in size, it begins to squeeze more tightly on the urethra. This makes it difficult for the bladder to fully compensate for the resulting pressure and reduces its ability to empty completely. Urine flow problems may result, including:

  1. Difficulty starting urination.
  2. Dribbling of urine, often after urinating.
  3. Weak urine stream (peeing in stops and starts).

As the urethra is squeezed by the enlarged prostate, it becomes difficult for the bladder to push out urine. Over time, the bladder muscles are weakened as they push harder to empty urine. This in turn makes it more difficult for the bladder to empty, resulting in:

  1. Frequency, urinating too often, typically eight or more times per day.
  2. Incontinence, lack of control over when to pass urine.
  3. Urgency, sudden need to urinate.
  4. Nocturia, waking up several times each night to pass urine.
  5. Urinary retention, a sense that you are not fully emptying your bladder.
  6. Urine leakage.

In some cases, BPH may lead to backing up and stagnation of urine, which may in turn result in bladder stones, recurring urinary tract infections, bladder divericulae and kidney or bladder damage. The condition also may lead to a sudden inability to pass urine (acute urinary retention), a very painful medical emergency requiring urgent drainage.

When Should You See a Doctor?

Symptoms of BPH vary from person to person. Some men with the condition have few or no issues while others experience severe symptoms. Generally, treatment for BPH may be optional when the symptoms are mild and no complications exist. So if the symptoms do not bother you enough to take medications or go through a procedure for it, then you may only need to speak with your doctor to make sure that your symptoms are stable and your bladder empties well. However, if you experience complications such as a burning sensation when urinating, bladder pain when urinating, blood in urine accompanied by chills and fever or nausea and vomiting, acute urinary retention or lower back pain, then you must seek immediate medical attention.

Treatment for BPH

There are many treatment options for BPH. If you are diagnosed with this condition, talk to your doctor to find out the right treatment for you. The most common treatments include medications (such as alpha reductase inhibitors), UroLift System treatment, thermotherapies (using heat energy such as radiofrequency or microwave), laser resection and transurethral resection. The treatment recommended by your doctor will depend on the severity of your symptoms, the extent to which the symptoms affect your life and the presence of other medical disorders.

Looking for the best urology center for safe and effective treatment? At St Pete Urology, we have built a reputation for exceptional and excellent diagnosis and treatment of BPH and other urological conditions using medical and surgical interventions. Through our skillful and experienced urologists, nurses and technicians, we deliver comprehensive, compassionate and patient-centered treatment and care to all our patients. We use state-of-the-art surgical and medical techniques to deliver timely, safe and effective treatment. For more information on the diagnosis and treatment of BPH and other urological disorders, visit the “St Pete Urology” site.

Prostate Enlargement BPH

Prostate enlargement (Benign Prostatic Hyperplasia) is a medical condition characterized by increase in the size of the prostate gland without becoming cancerous. So the prostate grows bigger but the cells do not become cancerous. The prostate is an essential organ in the male reproductive system, secreting the prostate fluid that forms part of semen. In childhood, the prostate is a small, walnut-sized gland and maintains this size up to puberty. During early puberty, the prostate undergoes the first phase of growth which doubles its size. Later on, at about age 25, the prostate starts to undergo a second phase of growth which continues for the rest of a man’s life. It is during this second phase of growth that benign prostatic enlargement (BPH) occurs.

How prostate size varies with age

By the age of 20, average males have a walnut-sized prostate and very few prostate-related health concerns. However, around 40, many men begin to experience issues related to prostate enlargement. By the age of 50, around 50 percent of all men have health concerns related to BPH. And at 60 and beyond, the prostate continues to grow and press against the urethra, reducing the size of the urethra and obstructing the flow of urine. Men in their 60s may experience mild inconvenience or serious lifestyle disruptions such as lack of sleep due to difficult or frequent nighttime urination as pressure is applied on the bladder and urethra by the inflamed prostate. By the age of 80, around 80 percent of men experience symptoms of prostate enlargement. In fact, the symptoms are so common beyond the age of 80 that almost all men will experience them if they live long enough.

Symptoms of prostate enlargement

As the prostate increases in size, it presses against the urethra and causes the size of the urethra to reduce. The narrowing of the urethra causes the bladder to thicken, weaken and lose the ability to empty fully, resulting in urinary retention. The urinary retention in the bladder and the tightening of the urethra causes several urinary tract problems, such as:

  1. Difficulty in starting a urine stream.
  2. Difficulty emptying the bladder.
  3. Urinary urgency, being unable to delay urination.
  4. Urinary frequency, passing urine eight or more times per day.
  5. Nocturia, passing urine during periods of night sleep.
  6. Interrupted or weak urine stream.
  7. Dribbling after passing urine.
  8. Pain during urination or after ejaculation.
  9. Urinary incontinence, accidental loss of urine.
  10. Unusual smell or color of urine.

Treatment of prostate enlargement

The right treatment for benign prostate enlargement varies from patient to patient depending on the severity of the symptoms, the extent to which the symptoms affect a man’s life, presence of other medical conditions and the patient’s preferences. A man may not need treatment for a mild prostate enlargement unless he has bothersome symptoms that are affecting the quality of his life. However, in cases where no treatment is administered, regular checkups are recommended.

If the benign prostatic hyperplasia is causing severe, bothersome symptoms or presents a serious health risk, then the urologist would recommend treatment, such as medications (using alpha blockers, 5-alpha reductase inhibitors, phosphodiesterase-5 inhibitors or combination medications), minimally-invasive procedures (like transurethral needle ablation, transurethral microwave thermotherapy, high-intensity focused ultrasound, transurethral electro-vaporization, water-induced thermotherapy or prostatic stent insertion) and surgery (transurethral resection, laser surgery, transurethral incision or prostatectomy) for long-term treatment.

Are you a man age 40 or older who is worried about your risk of prostate enlargement? Would you like a session with some of the best, world-renowned urologists to help you find relief from your prostate enlargement symptoms? At St Pete Urology, we have tailored our urology services to meet the diverse needs of our patients. We have assembled a great team of urologists, nurses and technologists to help us deliver prompt, safe and effective treatment of urological disorders. We use the latest technology and techniques to guarantee utmost convenience, safety, comfort and efficacy of all our procedures. Visit us today for help with your BPH symptoms. For more information on the diagnosis, treatment and care for prostate enlargement, visit the “St Pete Urology” site.

How Are Kidney Stones Formed?

Kidney stones are hard mineral or salt deposits formed in the kidney when urine is concentrated. Originating as microscopic crystals or particles that develop over time into pebble-sized calculi or larger deposits as minerals crystallize and fuse together, kidney stones can affect any section of the urinary tract (the kidney, bladder, ureters and urethra). The kidneys filter and remove wastes from blood, add them in urine and concentrate the urine as it flows from the cortex into the renal pelvis. However, if the minerals and other wastes fail to dissolve completely in urine, microscopic particles may develop which may grow into larger stones.

Why Stones Form

Formation of urine crystals is a common occurrence even in those who never form stones. The natural existence of substances promoting crystal development in all urine means that everyone can have urine crystals. Substances that promote crystal development in urine include oxalate,calcium, phosphorus, uric acid, sodium and cystine (for those with cystinuria). Nevertheless, urine also has natural inhibitors of crystal formation such as magnesium, citrate, phytate, pyrophosphate, proteins, total urine volume and other byproducts of normal metabolism. These inhibitors promote elimination of crystals before they can attach to the kidney and develop into larger stones.

How are kidney stones formed?

Kidney stones typically form from soluble salts found in urine. For example, the soluble salt calcium oxalate is commonly found in urine in a dissolved or crystalline form. Soluble salts are usually formed when various chemical elements found in urine combine. When the urine concentration of these soluble salts is very high, solid crystals may be formed. While there is usually a high concentration of salts in urine, the presence of inhibitors makes it more difficult for crystals to develop.Therefore, urine must become supersaturated for the balance between stone-promoters and inhibitors to be broken and allow larger stones to form. Supersaturation of urine may be caused by low urine volume, very low quantities of inhibitors or very high concentration of stone-promoters.

Processes of stone formation

Kidney stone formation begins by the process of nucleation, an association of free ions into microscopic particles. Nucleation can occur in the kidney nephron and on the surfaces of the extracellular matrix and cells. Once tiny crystals are formed, they can undergo secondary nucleation or aggregation, the processes through which the crystals formed in solution form into bigger multi-component particles. Larger crystals then can grow into giant single crystals which can be retained in the kidney by further aggregation and attachment to specific intra-renal structures.

Passing kidney stones

Once kidney stones are formed, they move down the urinary tract from the kidneys through the ureter and to the bladder. Small stones can pass out on their own without causing problems. However, larger stones can become lodged in the ureter and cause severe, agonizing pain that starts in the lower back and spreads out to the groin. When a stone is lodged in the ureter, it can block urine flow, causing increased pressure build-up in the affected ureter or kidney and resulting in severe pain and spasms. Larger kidney stones (called starghorn stones) also may be problematic to the entire urinary tract, resulting in symptoms such as:

  1. Severe pain in the back, in the side or below the ribs.
  2. Excruciating pain radiating to the groin and lower abdomen.
  3. Red, pink or brown urine.
  4. Pain when urinating.
  5. Pain that fluctuates in intensity or comes in waves.
  6. Frequent urination, urinating small amounts or persistent urge to pass urine.
  7. Nausea and vomiting.
  8. Foul-smelling or cloudy urine.
  9. Chills and fever if an infection is present.

While kidney stones can cause severe pain and discomfort, they usually do not cause permanent damage when recognized early and treated promptly. In fact, depending on the situation, passing the stones may require nothing more than just taking pain medication and drinking plenty of water. In situations where the stones are lodged, obstructive or linked with urinary infections or complications, other removal mechanisms may be necessary, including surgery. The urologist also may recommend effective preventive measures to minimize the risk of recurrent stones.

At St Pete Urology, we have made a difference in many lives by helping patients get relief from the pain and discomfort caused by kidney stones. We have assembled a skilled and experienced team of urologists committed to the best practices in health care and delivering world-class urological care to all. We also have put together the latest diagnostic and treatment tools to ensure that our patients receive the very best care. With our patient-centered, collaborative approach to management of kidney stones and other urological problems, you can be sure that you will not leave our doors without getting the relief you seek.

For more information on prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.

Vasectomy Animation Overview

Sperm production occurs in the male testis (testicle). Each testis contains seminiferous tubules, which are tiny coiled tubes lined with spermatogonia (sperm stem cells) and sertoli cells (sperm nurse cells) for sperm production. Around the tubes are testosterone-producing cells called Leydig cells, which produce hormones that stimulate the nurse cells and regulate sperm production. It takes roughly 70 days for sperm to develop in the testis and be ready for action.

Movement of Sperm

Newly formed sperm cells move into the epididymis (a tightly coiled duct located above the testis), where special proteins are added to the sperm membrane resulting in highly specialized cells capable of swimming, binding and penetrating the ovum (female egg). Since sperm cells only form a small portion of the ejaculated fluid, the cells are typically mixed with fluids from glands such as prostate, seminal vesicles and Cowper’s gland as they are pushed through the ducts. In fact, a big part of the fluid making up semen comes from the prostate gland and the seminal vesicles. From the epididymis, sperm cells move into the vas deferens and then into the urethra.

Sperm after vasectomy

During a vasectomy, the sperm duct (vas deferens) is cut and its ends sealed to prevent passage of sperm into the urethra. So sperm cells are still produced and moved into the epididymis to mature but are not able to pass into the vas deferens because of the blockage at the ends of the vas. After a vasectomy, sperm is still produced but does not get into the ejaculated fluid due to the blockage of the vas deferens. And since the sperm cells cannot move out, they naturally dissolve and are absorbed by the lining (membrane) of the epididymis. Vasectomy does not reduce a man’s ability to have orgasms. In fact, you still have the same mind-blowing experience but without the possibility of a pregnancy.

Does vasectomy have complications?

Vasectomy is one of the most effective and safest methods of birth control. However, like every other surgical procedure, a vasectomy may have complications. Therefore, it is important to discuss this with your doctor before undergoing the procedure.

Whenever complications occur after a vasectomy, they are usually minor and very easy to treat. For instance, after the procedure a man may experience a dull ache or pain due to pressure on the tiny tubes of the epididymis. This pain is treated with medication, though removal of epididymis sometimes may be recommended. Other possible complications are a risk of infection, fluid accumulation, temporary swelling, transient bruising or bleeding. Vasectomy does not increase the risk of prostate cancer.

Looking for a surgical and medical center where you can have the safest vasectomy procedure? At St Pete Urology, you can be sure of getting one of the most skilled and experienced pool of urologists, latest medical and surgical equipment, and patient-friendly, multidisciplinary services that guarantee the best outcomes. For more information, visit the “St Pete Urology” site.

What happens to the sperm when you have a vasectomy?

Vasectomy is an effective way of sterilizing men permanently. The surgical procedure involves partially removing (cutting) or blocking both sides of the vas deferens to stop sperm from getting into the semen. A vasectomy is not intended to stop the production of sperm; it just ensures that the sperm produced in the testes does not reach the ejaculate and no longer reaches the female reproductive tract to trigger pregnancy.

So what is the fate of the sperm that is still produced after a vasectomy?

After a vasectomy, your ejaculations remain much the same as before the procedure. You will still produce as much ejaculatory fluid as before and will experience the same feeling and pleasure as before the operation. The only change is that your semen will no longer have sperm. However, since sperm is just around 2-5 percent of the ejaculate volume, there is no significant difference in ejaculate volume after a vasectomy.

Continued production of sperm

The testicles continue to produce sperm even after a vasectomy. The testicles are made up of small, coiled tubes known as seminiferous tubules, which produce sperm. In the tubules are sperm nurse cells that regulate sperm stem cells. The tubules are also surrounded by testosterone-generating cells, which promote sperm development by stimulating the nurse cells and in turn controlling the sperm stem cells. It takes around 70 days for sperm cells to develop fully and be ready for action. After sperm cells are produced, they move into the duct where some proteins are added to improve sperm performance. The sperm then gets into the vas deferens (tubes) for transportation to the ejaculation point.

Fate of sperm after a vasectomy

For sperm to mature, it is usually stored in a tube called the epididymis. The epididymis is a tightly-coiled tube measuring 15-18 feet long where sperm usually leaves to the vas deferens to take part in fertilizing an ovum (egg). After undergoing a vasectomy, the sperm cannot move out of the epididymis. Therefore, most of the sperm is absorbed by the lining (membrane) of the epididymis and dissolves naturally into the body.

Open-ended vasectomy

At St Pete Urology, we use the open-ended vasectomy procedure as part of our no-scalpel, no-needle technique to improve sperm drainage after vasectomy. We understand that a man’s testicles age and the sperm machinery may be less efficient with time. Therefore, instead of leaving our patients to rely solely on the epididymis for sperm disintegration and absorption, we apply the open-ended technique to ensure the bottom end of the tubes (vas deferens) is left open (uncauterized) while cauterizing the end leading to the penis, providing a reliable way for drainage of sperm after a vasectomy. The open-ended technique ensures that sperm is naturally reabsorbed back into the testes without any pain, discomfort or pressure.

Are you planning to have a vasectomy? At St Pete Urology, we perform the procedure using a simple, safe and effective method. Our no-scalpel, no-needle technique ensures quick recovery and a return to work in as soon as 2 days. Want an appointment with our vasectomy experts? Visit the “St Pete Urology” site.

Vasectomy vs Tubal Ligation

Are you done having children or just feel sure you never want kids? If so, then you may consider having a permanent birth control (sterilization) procedure. For couples, sterilization can be performed on either a man or woman, with the procedure for men called a vasectomy while for women it is known as tubal ligation (getting your tubes tied). Sterilization is a common method of birth control, with more than 23 percent of all couples in the United States relying on it to stop having children.

What is tubal ligation? What is vasectomy?

Tubal ligation is a sterilization option for women. During the procedure, the fallopian tubes are sealed off or blocked to prevent ova (eggs) moving from the ovary via the fallopian tubes, preventing them from meeting with male sperm. A vasectomy is a sterilization option for men in which a man’s vas deferens tubes are blocked or tied and cauterized to prevent the transportation of sperm during ejaculation. While both vasectomy and tubal ligation are viable options, only one of the two procedures may be necessary when a couple chooses sterilization as a method of birth control. And often, vasectomy is the most preferred method of sterilization for couples because it is simpler, safer, cheaper, more reversible and more effective than tubal ligation.

Safety of vasectomy and tubal ligation

Both tubal ligation and vasectomy are extremely safe. However, tubal ligation involves hospitalization of women as the procedure is performed under general anesthesia. Tubal ligation is a more complex and lengthier procedure. On the other hand, a vasectomy, particularly the no-scalpel procedure, can be performed in as little as 10 minutes with the patient allowed to go home soon after operation. Vasectomy is less invasive and the doctor barely scores the scrotum skin. So when as a couple you are choosing between a vasectomy and tubal ligation, then the safety, convenience, minimal complications and short recovery time should make vasectomy the better option.

Risks of vasectomy and tubal ligation

Tubal ligation is typically a laparoscopic procedure that requires many hours or days of recovery. There also may be serious complications associated with general anesthesia, perforation of intestines or even infection. Tubal ligation also may cause long term side effects such as painful menstrual cycles and pelvic pain, though this occurs rarely. A vasectomy is a simple, minimally invasive outpatient procedure which takes less than one hour. It also does not have scientifically proven long-term risks or complications.

Efficacy of vasectomy and tubal ligation

Both vasectomy and tubal ligation are very effective. Studies examining the failure rates of vasectomy and tubal ligation have rated them among the most effective methods of birth control, with less than 1 in 100 chance of pregnancy after sterilization. However, because tubal ligation is more invasive and women have to stop using all forms of contraception after attaining a certain age, vasectomy is more appropriate.

Cost of vasectomy and tubal ligation

The costs associated with vasectomy and tubal ligation is quite different. A tubal ligation costs four times as much as a vasectomy. The average cost of a tubal ligation procedure is $2,000 or more while the average cost of a vasectomy procedure is $500, though the exact price varies from one surgeon to another. Nevertheless, if you have to pay for sterilization straight from your pocket, then a vasectomy may be more preferable as it is less expensive.

Reversibility of vasectomy and tubal ligation

Vasectomy and tubal ligation are considered permanent procedures. While a reversal of either is possible, the reversal procedures are quite expensive and without guarantee of success. While at least half of couples have reported successful pregnancy after a reversal of either type of sterilization, success rates depend on a number of factors, including the age, time since sterilization and type of surgery. So if you are not really sure that you do not want children, you should consider other birth control methods such as the implant (IUD) instead of sterilization.
Birth control is not the sole responsibility of women and their male partners should work with them to choose safer and more effective methods of birth control. A vasectomy has lower risks of complications, lower costs and more convenience than tubal ligation. However, before making a decision, it is important to speak with your doctor to obtain all the crucial information necessary for making an informed decision. At St Pete Urology, we help couples to make the right birth control decisions and to have access to safe and effective procedures. For more information, visit the “St Pete Urology” site.

Should You Screen for Prostate Cancer?

A visit to St Pete Urology to screen for prostate cancer is also an opportunity to have a variety of health issues resolved. St Pete Urology operates according to the principle that most health issues affecting men are interconnected and can only be treated effectively through a comprehensive and multidisciplinary approach. When you visit our urologists for prostate cancer information, screening, diagnosis and treatment, we extend our role to include screening for signs of mental health disorder, make efforts to influence behavior change and speak with you candidly about psychological and medical care beyond our direct involvement in treatment of urologic disease.

At St Pete Urology, we are committed to safe, holistic and effective care for all our patients. We handle diagnosis and treatment of prostate cancer using the latest technological, medical and psychosocial approaches.

Tackling mental health issues during prostate cancer screening

Helping patients with mental health problems is a familiar territory for urologists at St Pete Urology, Fl. For instance, during prostate cancer screening, the urologists also screen for signs of distress, educate patients on their diagnosis, treatment and potential side effects, and provide support through referral to psychosocial services or rehabilitation programs. For men experiencing urinary tract symptoms, the urologist may conduct a functional analysis to assess the effect of the symptoms on everyday activities, recommend practical solutions such as Kegel exercises, and provide psychosocial referrals to help deal with issues related to interpersonal relationships and self-esteem. Working with our urologists not only provides the opportunity to detect and treat urological problems like prostate cancer, but also for early detection and treatment of mental health disorders.

Should you undergo prostate cancer screening?

Prostate cancer is a very common cancer so it is very important to get checked for its presence. While screening tests will not show with certainty that you have cancer, they help to find warning signs and help to detect the cancer when it is still at an early stage, making treatment easier and more effective. If one of the screening tests gives an abnormal result, you will need a biopsy of prostate tissue to confirm whether or not you have cancer. Men who want to be checked are tested using the PSA (prostate-specific antigen) blood test and the DRE (digital rectal exam).

1. PSA (Prostate-specific antigen) blood test

PSA (Prostate-specific antigen) is an essential substance made by the cells of the prostate, typically by both normal and cancerous cells. It is predominantly found in semen. However, it also may be found in small quantities in blood. The majority of men with no prostate cancer do have PSA levels below 4 nanograms-per-milliliter [abbreviated as ng/mL] of blood. Those with higher PSA readings have a greater likelihood of developing cancer of the prostate.

While the PSA usually goes up beyond 4ng/mL as prostate cancer develops, a reading below 4 is not a guarantee that you do not have the cancer. In fact, about 15 percent of men whose PSA is under 4ng/mL are found to have the cancer upon a biopsy. Similarly, men with PSA between 4 and 10 have 25 percent chance of having the cancer, while those with PSA above 10 have a 50 percent chance of developing prostate cancer. If you have elevated PSA, your urologist may indicate that you either wait for a period of time and you repeat the test or take a prostate biopsy to confirm the cancer.

2. DRE (Digital Rectal Exam)

During a DRE (digital rectal exam), your urologist will insert a gloved and lubricated finger into your rectum in order to feel or detect any hard areas, nodules or bumps on your prostate, which may be due to cancer. Prostate cancer usually starts at the back of the prostate and this can be felt through a rectal exam. The DRE may be a bit uncomfortable, particularly for men with hemorrhoids, but it is not usually painful and often takes a very short time. Although the DRE is less accurate than PSA in screening or detecting prostate cancer, its ability to occasionally find cancer in men whose PSA values are normal makes it a vital component of prostate cancer screening.

Making screening decisions

It is important to work closely with your doctor in order to make informed screening decisions. At St Pete Urology, we recommend that men should screen for prostate cancer at:

  1. Age 50 for those men who are at average risk of getting prostate cancer and are still expected to live for more than 10 years.
  2. Age 45 for men who are at high risk of developing prostate cancer, such as African Americans and men whose first-degree relative [father, son or brother] had the cancer before the age of 65 years.
  3. Age 40 for men with even greater risk, especially those who have had more than one first-degree relative get prostate cancer at a very early age.

For more information, visit the “St Pete Urology” site.

Treating Low Testosterone Properly

St Pete Urology in Florida offers a comprehensive and compassionate patient-centered approach to men with urological problems. We also listen and respond to the mental health problems related to the conditions we treat. Our experienced doctors know their work and efficiently diagnose and treat ailments with a focus on restoring and improving the overall health of the patients. For an all-inclusive, focused, safe and effective treatment of men’s issues, St Pete Urology leads the way.

How do we deal with men’s health and mental health problems?

At St Pete Urology we recognize that mental health problems can be closely interlinked with urological problems such as erectile dysfunction, low testosterone and enlarged prostate. We have tailored our screening, diagnostic and treatment procedures to also respond to the mental health needs of our patients. We take a leadership role in men’s health by treating a patient’s visit to our clinic as an opportunity to comprehensively assess his overall health.

For men suffering from the effects of low testosterone, we follow a biopsychosocial approach that goes beyond testosterone replacement therapy. For instance, we engage in distress screening and ask brief questions on relevant life domains such as work, substance use, relationship and sexual function to help us identify men with mental health problems. We also endeavor to build close and cordial relationships with our clients, which enable us to treat their urological problems while also acting as their gateway to mental care services through appropriate referrals.

Excellence in treating low testosterone

At St Pete Urology, we strive to ensure that your visit is as convenient as possible. We keep all the procedures for diagnosis and treatment of urologic disorders, from urologic consultation to testing and treatment, under the same roof. The availability of the latest diagnostic tools such as ultrasound, Ureteroscopy and cytoscopy, urodynamic studies, PSA, blood tests, urinalysis with culture, among others, makes us a reliable clinic for all types of urological issues. And because of our capacity to deliver accurate and timely results for testosterone tests, we offer a safe and more effective place to treat low testosterone.

What are the symptoms of low testosterone?

Also called Andropause or Hypogonadism, low serum testosterone is a condition affecting about 39 percent of all men who are 45 years old or older. Its prevalence increases with age and studies have shown that its incidence increases from roughly 20 percent in men older than 60 to 30 percent of men older than 70 and to 50 percent of men older than 80. When serum testosterone drops below the normal range, the following symptoms may occur:

  1. Diminished energy levels or fatigue.
  2. Reduced libido or a drop in sex drive.
  3. Sexual dysfunction characterized by weak erections or fewer erections.
  4. Increased body fat or weight gain.
  5. Reduced muscle mass.
  6. Decreased bone strength.
  7. Loss of body hair.
  8. Depressed mood.
  9. Hot flushes and sweats.

Low-T is diagnosed based on the symptoms and on blood tests measuring the amount of testosterone. This is why it is important to go to a clinic managed by a urologist and where low-T levels can be measured correctly.

At St Pete Urology, we are proud of our comprehensive and innovative diagnostic and treatment options for low testosterone. We follow a guideline approach to ensure that we have correctly identified patients with low-T and to guarantee that we do not miss a diagnosis. We also monitor our patients closely enough to be able to check for other related issues, including mental health problems. And when we find a patient whose testosterone is low, we order more tests to check for any underlying causes. So when you visit St Pete Urology, you can be sure that your diagnosis and treatment of low testosterone will be safe, effective and the best you can possibly get. For more information, visit the “St Pete Urology” site.