When Should You Get A PSA Test?

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

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

When should you start screening?

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

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

When should you visit a urologist?

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

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

Why is InterStim Therapy Effective against Overactive Bladder?

Overactive Bladder (OAB) is characterized by an uncontrollable urge to urinate, a frequent need to pass urine during the day and night, accidental urine leakage, and inability to get to the bathroom in time due. This condition greatly affects quality of life by having life revolve around uncontrollable urination problems. Those afflicted avoid social functions due to fear of urine leaks, foul smell and embarrassment, wake up too many times at night to urinate, stay home to avoid public shame, or reduce food and liquid consumption to avoid triggering bladder spasms. While there are several treatment options for OAB that include medications and pelvic floor exercises, a number of patients either do not respond to these treatments or find them intolerable. For such patients, InterStim therapy offers the best hope for controlling the bladder, relieving symptoms and improving quality of life.

How Does the InterStim Procedure Relieve Overactive Bladder?

InterStim therapy is a proven, minimally invasive treatment for overactive bladder. It helps to relieve the symptoms of OAB by delivering electrical impulses to the sacral nerves (found in the tailbone area), modifying abnormal reflexes in the pelvic and sacral nerves of the pelvic floor and bladder, and altering abnormal communications between the brain and bladder. The InterStim device is implanted under the skin around the location of the sacral nerves (upper buttock) so that mild electrical impulses are generated for stimulating the sacral nerves, correcting malfunctioning nerves and improving bladder control. In fact, InterStim therapy interrupts the abnormal signals transmitted in people with overactive bladder and reduces episodes of urinary incontinence.

Why is InterStim Therapy Effective against Overactive Bladder?

Unlike other therapies, the effectiveness of InterStim therapy can be assessed by physicians and patients through a test evaluation stage before commitment to long-term therapy. Roughly 80% of patients who undergo test evaluation have a successful response and can proceed to have the InterStim device implanted. According to studies, patients with successful trial stimulation will experience 50%-90% improvement in overactive bladder symptoms after the implant has been placed. In fact, people with overactive bladder have reported significant improvements in the number of incontinence episodes per week, with the majority of patients being completely free of incontinence after InterStim therapy. There is also a major reduction in the number of times patients urinate per day after treatment, while almost all patients report improvement in quality of life after InterStim procedure.

InterStim therapy is minimally invasive in nature and completely safe and reversible. Therefore, the patient can discontinue it any time it fails to meet expectations. It also does not prevent the use of alternative treatments and can easily be combined with any other treatment for a better outcome. If you or your loved one is suffering from overactive bladder and find other treatments ineffective or intolerable, do not hesitate to ask your urologist about InterStim therapy. For more information on treating urological problems, visit St Pete Urology.

7 Common Symptoms of Kidney Stone and Treatment Options

The symptoms of kidney stones are largely determined by the size of the stones. For small kidney stones, the symptoms may be mild. In fact, small stones may go undetected and pass out of the body painlessly during urination. The most common symptom of kidney stones is pain which begins as a vague sensation then becomes sharp and severe as ureter muscles contract and relax around the stones. Initially, the pain is felt on the flanks or on the sides of the body, between the pelvis and ribs, including the lower back and upper abdomen. Later it moves to the groin or testicles as the kidney stone moves through the urinary tract.

Generally, the symptoms of kidney stones follow the migration of the stone across the urinary tract. The symptoms will depend on whether the stone gets stuck in the kidney, begins to travel down the ureter, or causes an infection.

Therefore, depending on the size of the stone, symptoms may include:

  • Sharp, persistent and severe ache in the side and back, often below the ribs
  • Pain which spreads to the groin and lower abdomen
  • Pain occurring in waves and with fluctuating intensity
  • Pain when passing urine
  • Restlessness and inability to lie still
  • Nausea and vomiting
  • Red, pink or brown urine
  • Foul smelling or cloudy urine
  • Urge to pass urine more often than usual
  • Urinating small quantities of urine
  • Chills and fevers if there is an infection

Blood in urine, often caused by the stone scratching the ureter or kidney
A kidney stone may cause an infection when it has blocked the ureter, preventing waste products from passing the blockage and resulting in bacterial build-up. It is the infection that causes symptoms such as fever, chills and shivering, diarrhea, foul smelling and cloudy urine, and fatigue.

Symptoms of Kidney Stone and Treatment OptionsIf you have these symptoms, it is important to see a physician, preferably a urologist. The doctor will perform a medical and symptomatic history, give a physical exam and order the necessary tests to confirm the presence of kidney stones and determine their size, location and appropriate treatment. The tests may include blood tests (like uric acid, calcium and phosphorous), tests for stone-forming salt crystals, infections, blood cells and stone factors, kidney function tests, and imaging tests (kidney ultrasounds, CT scans, MRI scans, abdominal X-rays and intravenous pyelograms). The urologist will recommend appropriate treatment after confirming the presence of stones.

If small, less-troublesome stones are detected, the urologist may recommend drinking 8-16 cups of water to flush them out. Along with the recommendation to drink plenty of fluid, the urologist may prescribe pain relievers such as ibuprofen, naproxen sodium or acetaminophen. In some cases, the urologist may offer a medication to help pass small stones from the kidney. The medication, called an alpha blocker, helps to relax ureter muscles and allows the stones to move quickly and painlessly out of the urinary tract.

Large stones are accompanied by various symptoms and should be treated using stronger measures. The urologist may use sound waves to break up the stones, a procedure called extracorporeal shock wave lithotripsy (ESWL). In some cases, the urologist will use a scope (a thin lighted tube equipped with a camera) to remove the stones. The urologist may also opt for percutaneous nephrolithotomy to surgically remove large stones, or even parathyroid gland surgery when necessary.

At St Pete Urology, we have experienced urologists and state-of-the-art facilities to ensure prompt diagnosis and effective treatment of kidney stones. If you have questions about this condition, visit St Pete Urology in St Petersburg for quality medical care.

3 Main Causes of Erectile Dysfunction and Treatment Options

Erectile dysfunction (ED) occurs when a man is incapable of having an erection firm enough for sexual intercourse. While occasional inability to have an erection is considered normal, frequent or prolonged difficulty to get or keep an erection, along with reduced sexual desire, is classified as erectile dysfunction. The condition often leads to an unsatisfactory sex life and may result in other problems such as low self-esteem, embarrassment, anxiety, depression and relationship problems.

Causes of Erectile Dysfunction

Erectile dysfunction is caused by physiological (physical) factors, psychological (mental) factors, or a combination of both. Generally, psychological problems are more likely to cause ED in younger men while physical problems are often the cause in older men.

The major psychological causes of ED are:

1. Depression

2. Stress at work or home

3. Worries about sexual performance with a new sexual partner or new situation

4. Unresolved relationship conflicts

5. Fatigue

6. Temporary issues such as loss of a job, studying for exams or financial concerns

7. Deep-rooted negative attitudes about sex, intimacy, or strict religious beliefs

8. History of sexual abuse

For a man to have a normal functioning erection, it helps to have self-confidence and arousing behavior or thoughts while being free of anxiety. If at least one of these conditions is chronically absent, a man’s inability to perform sexually can become a lasting issue.

The major physiological causes of ED are:

1. Diseases such as diabetes, liver disease, kidney disease, multiple sclerosis, high blood pressure, atherosclerosis, chronic alcoholism, neurological disease, and vascular disease.

2. Drugs for treating hypertension (high blood pressure), depression, anxiety and psychosis, and regular consumption of alcohol, marijuana, cigarettes and other recreational drugs.

3. Injuries such as spinal cord injury and nervous system injury (like pinched nerves due to slipped vertebral discs).

4. Atherosclerosis (hardening of arteries due to a buildup of fat/cholesterol deposits inside arterial walls).

5. Hormonal imbalances such as low testosterone levels or due to diseases of the pituitary, adrenal or thyroid gland.

6. Cigarette smoking.

The main risk factors for erectile dysfunction are:

1. Age over 50

2. Lack of exercise

3. Diabetes (high blood sugar)

4. High cholesterol

5. High blood pressure

6. Smoking

7. Obesity

8. Cardiovascular disease

9. Drug and alcohol abuse

10. Cancer radiation therapy

11. Prostate surgery

12. Medicines such as antihistamines, antidepressants and blood pressure drugs.

Men spending a lot of time bicycling are also at risk of ED because bicycle seats can damage the nerves and blood vessels involved in erections.

Treatments for Erectile Dysfunction

The treatment for erectile dysfunction depends on the cause. Often, the urologist will suggest a change of certain habits or recommend that you stop smoking, using drugs or stop alcohol use. The urologist may also recommend treatments for emotional problems, depression, performance anxiety or relationship conflicts.

The most common treatments for ED are:

1. Oral medications (erection pills) such as Cialis (tadalafil), Levitra (vardenafil), Stendra (avanafil) and Viagra (sildenafil).

2. Counseling and psychotherapy if your ED is related to psychological problems.

3. Injection of drugs in the penis: If oral medications fail, the urologist may recommend the injection of Caverject (alprostadil) in the penis. Suppositories of the same drug may also be placed in the urethra as an alternative to injection.

4. Vacuum erection devices: These devices create a low-pressure vacuum around erectile tissue, resulting in erection.

5. Testosterone replacement therapy may be recommended for a man with below-normal testosterone hormone.

6. Surgery: Surgery is usually recommended by a urologist when other treatments fail to improve the ED. The operation is performed to either fix blood vessel issues or for penile implants (like inserting penile prostheses, bendable implants or inflatable implants).

7. Penile arterial revascularization: A surgery for men under 45 years of age who have pelvic or penile injuries, helping to fix blocked or injured blood vessels in the penis.

8. Venous ligation surgery: Aimed at improving the firmness of the penis, this surgery corrects leaky penile vessels that cause softening of the penis during an erection. This technique is rarely used for correcting ED due to its low success rate of around 5%.

Are you having difficulties with sexual performance? Talking with an experienced urologist at St Pete Urology might help you solve the problem. For more information on dealing with erectile dysfunction, visit the website of St Pete Urology in St Petersburg, Florida.

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.

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