Tonight we’re going to talk about bowel and bladder control primarily, so Dr. Graves and I both actually trained together at the University of Pennsylvania in Philadelphia. And we’ve been each practicing for close to ten years and we’ve had five years of urology training in residency and med school before that. And the topic tonight is something that we do have a lot of focus in and enjoy taking care of and have specialty in.
So bladder control is something we’ll discuss about the pathophysiology and how that works. So your kidneys filter your blood and make urine and then it goes into the bladder where it’s stored and then you pee that out. And you’re supposed to be able to control that and the bladder’s in muscle. And when the bladder gets full basically it’ll send a signal and you’ll get relaxation of the external sphincter, which is a sphincter control to control the urine. And then allow the sphincter to open and then the bladder squeezes down and drains the bladder. But this is a complex system and it does require basically the brain and its ability to inhibit the need to urinate and the ability to control relaxation. The sphincter and the spinal cord so it’s a pretty exquisite and very detailed system, but it’s something that different areas of that process can have an issue that could be fixed or could be the cause of the incumbents. And then the bowel control is very similar instead of a bladder you have intestines and a colon and a rectum where a stool is stored. And there is a sphincter as well that controls your ability to hold the stool in place and again that involves the brain the spinal cord and the the muscle of the rectum and the colon involved for bowel control you
May is the World Bladder Cancer Awareness Month—a time to reflect on the burden of the cancer across the globe and to improve on the fight against the disease.
Being the tenth most common cancer worldwide with over 550,000 cases diagnosed annually and more than 1.7 million people living with the condition, bladder cancer is increasingly posing a heavy morbidity and mortality burden.
Currently, it is the sixth most common cancer in men and the seventeenth most common cancer in women—one in 100 men and one in 400 women are diagnosed with the cancer globally. It is also the thirteenth most common cause of death from cancer worldwide.
So there is every reason to up the battle against the disease. And the Bladder Cancer Awareness Month is a critical time to do that.
Why raise awareness?
Raising awareness is a major weapon in fighting bladder cancer. You may not know it, but it is true that most people have never heard of bladder cancer. In fact, most people diagnosed with the cancer had never heard of it until it stormed into their lives.
Likewise, bladder cancer is one of the most forgotten and least talked about conditions globally. Thanks to symptoms such as blood in urine and its occurrence in an intimate area of the body, many people tend to feel embarrassed speaking about it or seeking professional help.
With less talk about it follows less awareness. And with inadequate information follows limited action to prevent the cancer or to seek early diagnosis. So as a consequence, most cases of bladder cancer are detected too late, which diminishes the chances of successful treatment.
The lack of awareness also causes people to think it is a very rare cancer, which is quite far from the truth. In the United States, bladder cancer is the sixth most common cancer, with at least 81,000 new cases reported every year.
Equally, many people are unaware of the main symptoms of the cancer, and how serious the disease can be. Neither are they aware that it can affect anyone, male or female, young or old.
Moreover, since early diagnosis is critical in beating the cancer, it is essential the more people know about the cancer, its signs and symptoms, and why the need to seek medical attention as soon as they have the symptoms.
Help spread the message
The World Bladder Cancer Awareness Month provides an opportunity to spark conversations that can drive awareness and help overcome the feelings of embarrassment about the symptoms. Plus, it provides the opportunity to raise our voices for those affected by the condition.
At St Pete Urology, we take the Bladder Cancer Awareness Month seriously. It is a period when the world’s attention is on the cancer and we consider it the best time to intensify our efforts on bladder cancer awareness, early detection, and successful treatment.
We also take it a as a crucial time when everyone—you included—can play a part in combating the cancer. This month, we call on you to join us in raising awareness.
So what practical things can you do to help raise awareness about bladder cancer?
Check if your hospital has information posters and leaflets for bladder cancer patients. And if they are available, find out if they are giving them to the patients. If not, please do let them know.
Speak with your physician and get them to display bladder cancer awareness posters or distribute awareness leaflets. Plus, you can request for bladder cancer awareness posters to display on various spaces, in your home or office.
Speak openly about bladder cancer with your friends and relatives. Encourage them to also talk to others about the disease. Remember, if you tell two people, and then those two people tell another two, a chain of information is created that can have a huge impact.
Make some posts about bladder cancer on social media. Of course, you can easily do that by sharing, liking, or commenting on our posts. You may never know just how many people you might help learn more about the cancer.
Thank medical professionals involved in bladder cancer care. It may appear like a small effort, but in the larger scheme of things, it goes a long way in encouraging them to do their best for cancer patients.
Take part in a fundraising to help the fight against bladder cancer.
Wear orange and tell people the reason why you are doing so. Dressing up in orange for a day or more can be a striking way of drawing people’s attention towards the disease.
At St Pete Urology, we believe that making more people aware of bladder cancer is a potent weapon in the fight against the disease. That is why every year in May we line up various activities to help us take advantage of the Bladder Cancer Awareness Month in getting the message out there.
We also believe that increased awareness can help to drive more people to seek prompt medical attention. For in combating the cancer, nothing is more critical than early detection, which often leads to successful treatment.
So help us spread this message of awareness and let others know more about the cancer. For more information on bladder cancer, signs and symptoms, risks and prevention, diagnosis and treatment, visit the site “St Pete Urology.”
Tonight we’re going to talk about bowel and bladder control primarily, so Dr. Graves and I both actually trained together at the University of Pennsylvania in Philadelphia. And we’ve been each practicing for close to ten years and we’ve had five years of urology training in residency and med school before that. And the topic tonight is something that we do have a lot of focus in and enjoy taking care of and have specialty in.
So really we’re going to be dealing with two main things: that’s problems with number one and number two, so issues with urinary control and bowel control today. And actually I still remember one of the main reasons I went into urology was because I wanted to help people with quality of life issues. And often having issues controlling either urination or your bowels can be embarrassing and difficult to talk about. And a lot of patients I’ll even deal with for other reasons and they just don’t want to talk about it because they’re just embarrassed. But it’s very common and as patients even young patients can have issues but as we get older they can become more prevalent, but we want to create awareness about it and let you know that you can talk to your physicians, doctors and urologists about it and there are solutions and it’s not something you have to live with.
So just a quick outline of what we want to talk about today is understanding the bladder and bowel control better today, the care pathway for these different treatment options. And then we can also talk about how medtronic has different treatment options such as inner stem, another type of treatment called neuro, and we’ll discuss those in detail and then we’ll open it up for some questions. So if you’re having bowel and bladder issues you’re not alone, it’s very common and one in six adults can have an overactive bladder. And we’ll discuss what that means so OAB is often referred to as overactive bladder.
So you have about 37 million Americans who have an overactive bladder and that’s where you have urinary frequency, urgency, difficulty with controlling urination when you want to, and that can even have incontinence where you actually can have urinary incontinence and lose control of your urine. And then one in 12 adults can have fecal incontinence and that’s loss of control of having a bowel movement so that can be very distressing for patients. And this is quite common just to compare there’s 12 million patients in the U.S with vision problems and 17 million patients with asthma so it’s even more prevalent than that.
Why is pelvic organ prolapse so complicated and distressing?
With pelvic organ prolapse, one of the organs in the pelvic region—such as the uterus, rectum or bladder—drops downwards and bulges into the vagina.
What follows is a number of bothersome symptoms, such as:
A persistent feeling that something foreign is inside you. The feeling worsens walking standing or during bowel movements.
A persistent pressure or pain in the pelvis and lower back.
Troublesome urinary problems such as the need to constantly pass urine or the leaking of urine.
Painful sex or urination
In some cases, the uterus and vagina may bulge through the vaginal opening. For many, this can be embarrassing and make sex uncomfortable, difficult and in some instances impossible.
Does pelvic organ prolapse go away?
Unfortunately, pelvic organ prolapse will not go away without surgery. Untreated pelvic organ prolapse will remain the same and in many cases simply deteriorate over time.
There is one exception.
If you have a mild prolapse after childbirth, it will in many cases resolve itself one year or so after delivery. In other words, the prolapse will follow the normal recovery trend after childbirth.
Otherwise, apart from pelvic organ prolapse after childbirth, prolapses tend to stabilize if managed with conservative treatments or get worse.
Why is surgery often necessary if you have pelvic organ prolapse?
An organ prolapse is not a life-threatening condition so you may choose to leave it untreated.
Of course, there are measures that can improve the condition and relieve the symptoms. For instance, pelvic floor exercises (kegel exercises) can strengthen your pelvic floor, improve the support for the prolapsed organ, and relieve the symptoms—though it won’t resolve the prolapse completely or reverse it..
In some instances, you may use vaginal pessaries. These are medical devices inserted in the vagina to provide support. In general, they will hold up the vaginal or uterus walls and push back the prolapse.
However the most effective way to comprehensively treat a pelvic organ prolapse is surgery that is tailored to repair the prolapse. Ideally your doctor will restore the organ to its place, tighten your pelvic floor muscles, and restore necessary support in your pelvic region so the prolapse is successfully eliminated.
The type of surgery required will depend largely on the organ involved and the specific degree of prolapse. Hence, your doctor will customize the procedure to meet your specific condition and needs.
At St Pete Urology, we help women recover from mild, moderate or severe pelvic organ prolapse. Speaking with one of our experienced urologists will enable you to make an informed decision on how to manage a prolapse.
You’ve heard of prostate cancer, and you’re scared you might have it.
Perhaps, that’s why you’re reading this post—to confirm your worries.
At St Pete Urology, we want our clients to be involved in decisions about their health. And to make the most informed health choices.
So we strive to provide our clients with the most accurate and trustworthy information. And direct them to where they’ll get helped.
We hope to help you overcome your worries. And make the right decisions.
Prostate cancer—a slow-growing cancer
Though prostate cancer is one of the most common types of cancer, it generally grows slowly and tends to be confined to the prostate. And as long as it remains in the prostate, it does not usually cause serious harm. In fact, slow-growing types of prostate cancers may need minimal or no treatment.
Still, there are few types of prostate cancer that are aggressive, spread quickly, and need timely treatment. Such types of the cancer need to be detected early, particularly when still confined to the prostate, so that they can be treated successfully.
It is due to these types of the cancer that you should know the early warning signs of the cancer and seek prompt treatment.
Yet, with prostate cancer, there are a number of challenges when it comes to warning signs.
Different men have different symptoms.
Some men do not show symptoms at all.
The cancer grows slowly, so it takes time for symptoms to occur.
Only aggressive, rapidly spreading types of the cancer may need treatment.
The cancer doesn’t show any signs or symptoms when in the early stages. So it needs to grow for a while before you can notice any signs.
Signs and symptoms that appear as the cancer advances aren’t specific, and could be due to other non-cancerous conditions.
Nevertheless, any signs are still valuable in early detection of the disease as long as you consult your doctor as soon as you have worrying or persistent symptoms.
The five warning signs of prostate cancer are:
Pain or a burning sensation when urinating. Pain may also occur when ejaculating
Frequent urination especially at night
Blood in urine or semen
Sudden erectile dysfunction
Difficulty starting or stopping urination
Most of these warning signs are related to urination. That is because the prostate is situated beneath the bladder. So an increased mass or size of the prostate immediately affects the bladder and hinders urination.
When prostate cancer has spread beyond the prostate, other warning signs may appear.
They include:
Lower body swelling
Bone pain
Abnormal urinary or bowel habits
Sudden, inexplicable weight loss
Pain in the back, pelvis, or hips that doesn’t go away
Difficulty emptying the bladder completely
When to see a doctor
Since the warning signs of prostate cancer aren’t specific, you should make an appointment with your doctor if you have any symptoms that worry you or if any signs are persistent. Your doctor will take your history, conduct exams, and order for tests that will help to rule out other conditions.
Besides, even if you are diagnosed with prostate cancer, it is much easier to treat when detected early.
At St Pete Urology, we offer a full-range of diagnostic testing for prostate cancer. Our multidisciplinary team of urologic oncologic experts is devoted to evaluating, detecting and treating prostate cancer. Book your consultation now if you have any of the above warning signs. For more information on the diagnosis and treatment of prostate cancer, visit the site “St Pete Urology.”
Urine is your body’s liquid waste. A larger part of it is water, but it also contains salts, urea, uric acid, and other chemicals. The contents of urine indicate how healthy your body is and an analysis of your urine sample can help your doctor to figure out if you’re healthy or not.
What is the color of healthy urine?
Normal urine is pale yellow to deep amber. The color is due to the pigment urochrome that is a byproduct of the breakdown of hemoglobin. So if your urine is any color ranging from yellow to gold, then it is healthy. Also, if your urine color is a pale shade of yellow or clear, then it is a good sign for your health.
Of course, when your urine is bright yellow or a neon liquid, you may think it isn’t normal. But that is still the color of harmless urine and it may only show you’re taking a lot of vitamins or supplements—you may cut down on them if necessary.
Dark yellow urine is normal, but may indicate you need to drink more water. Actually, a darker shade of yellow implies low urine volume, which tends to come from dehydration, strenuous exercise, working for several hours in a hot place, or not drinking enough fluids.
Besides, a dark yellow color may mean that your urine is more concentrated and needs some diluting through increased fluid intake. But a continuous low volume of urine that has a darker shade of yellow, amber or is honey-colored is a major risk of kidney stones and you’ll need to correct it quickly by drinking more water to dilute and make it clearer.
Clear or somewhat transparent urine is healthy, too. It often means that you’re drinking a lot of water. Increased water intake dilutes the yellow pigment found in urine, so that the more you drink the clearer your urine becomes.
A little reduction of your fluid intake will restore the yellow color of your urine, especially if it is persistently clear or transparent. Reducing your fluid intake also helps to minimize the number of trips you make to the bathroom.
What are the colors of unhealthy urine?
Brown urine
Brown urine color does not always mean you’re unhealthy. The color may occur when you consume large quantities of fava beans, aloe or rhubarb. It may also be due to severe dehydration, which you can correct by drinking plenty of water. Plus, it can be due to medications like metronidazole (Flagyl), chloroquine, primaquine, nitrofurantoin, methocarbamol, and laxatives such as senna or cascara.
But brown urine may equally imply you have medical conditions such as a kidney disorder or a liver condition. Some urinary tract infections may also turn urine brown. Therefore, if you have brown urine that doesn’t go away with increased fluid intake, visit your doctor to find out the cause.
Red, pink or bloody urine
Your urine may be red or pink if you’ve recently eaten beets, rhubarb or blueberries; or if you have engaged in a strenuous exercise. Medications such as rifampin, phenazopyridine, and laxatives like senna can also cause a red color.
But red color may also mean blood in urine (hematuria), which is a common indicator of urinary tract infections, enlarged prostate, cancerous or non-cancerous tumor, kidney cyst, bladder or kidney stones. Likewise, a deep red to brown color may indicate porphyria—a rare, inherited disorder of the red blood cells.
Visit your doctor if you experience blood in your urine, particularly if you have no recent history of medication or foods that can turn your urine red.
Orange urine
Orange color of urine may mean you’re eating large quantities of carrots, carrot juice or food with an orange dye. It may also imply you took medications such as phenazopyridine, sulfasalazine, isoniazid, riboflavin, a chemotherapy drug, or a laxative.
But your urine may also be orange because you are dehydrated and need water, or due to a liver or bile duct condition. If the orange color in your urine lasts a few days, you need to see your urologist.
Blue or green urine
It is quite rare to have urine that is blue or green in color. But you can have blue urine due to a food dye or medications such as the pain reliever indomethacin, the anti-acid cimetidine, the anesthetic propofol, or the antidepressant amitriptyline.
Children with a rare genetic condition called familial benign hypercalcemia (blue diaper syndrome) have blue urine. Your urine may be green due to asparagus or because of infection by the bacteria Pseudomonas. Get in touch with your doctor if a blue or green urine color occurs for more than a day.
Purple urine
It is very unusual to have purple urine. But one of the conditions known to cause purple urine color is the purple bag urine syndrome, which occurs due to the use of a urinary catheter by a patient who also has a co-existing urinary tract infection.
Cloudy or foamy urine
You can have foam in your urine if you love steak and eat a lot of red meat or are on a ketogenic diet (high fat and low carbohydrate diet). But cloudy urine may also indicate dehydration or excess mineral intake. Disorders like urinary tract infection, Chron’s disease, kidney disease, or diverticulitis also cause cloudy urine.
When should you see your doctor?
Changes in the color of your urine may be temporary and harmless, particularly due to food, vitamins or medication. But when the changes persist, you should be concerned.
You should see your doctor anytime you have blood in your urine as this usually indicates urinary tract infections, kidney stones or other condition. Seeing your doctor is even more urgent if the blood is accompanied by pain—although a painless bleeding may be due to a more serious condition such as cancer.
You should see a doctor if your urine is green, brown or orange and comes with a back pain, side pain, fever, burning sensation with urination, vomiting, discharge or thirst.
Remember, green urine may be due to bacterial infection, orange urine may indicate liver problem, and brown urine may signal kidney or liver disorder. Visiting your doctor will help you know what is causing the change. For more information on various urologic disorders, visit the site “St Pete Urology.”
You’re suddenly in an excruciating pain. You have a sharp, cramping pain in your back and side that comes in waves. And the overwhelming feeling moves to your lower abdomen or groin, and hurts badly.
Well, you probably have kidney stones. And you need to give it a quick fix. You can do that without medical intervention, especially if you can find something that will dissolve the stones fast.
Types of kidney stones
Generally, up to 80 percent of kidney stones are calcium stones—usually either calcium oxalate or calcium phosphate. These types of stones occur if you have too much calcium in your urine, though they could also form for other reasons.
Another type of stones, struvite stones, is related to chronic urinary tract infections, makes up 10 percent of all kidney stones and often forms when urine is alkaline. Uric acid stones make up 5-10 percent of kidney stones, and require acidic urine to form; while cystine stones that are less than 1 percent of all stones form when you have cysturia—too much cystine in urine.
Apple cider vinegar as kidney stones remedy
If you’re looking to dissolve kidney stones fast, you can rely on apple cider vinegar. Made from fermenting apples and endowed with phosphoric, citric and acetic acids, apple cider vinegar makes urine acidic and helps to dissolve most types of kidney stones quickly.
The acids in the apple cider vinegar react rapidly with compounds forming stones, especially calcium and struvite stones. As the reactions occur, the stones reduce in size and eventually dissolve.
Once the stones are dissolved or their size significantly reduced, they are easily flushed out in urine. Equally, as the stones break down, their obstruction of the urinary tract is reduced. Hence the pain caused by the stones is relieved.
Besides, apple cider vinegar reduces the risk of stone formation by dissolving minerals that may form stones. It also has an alkalizing effect that boosts the digestion process and increases the production of hydrochloric acid. The acid dissolves various minerals and helps prevent the formation of new kidney stones.
To prepare apple cider vinegar as remedy for kidney stones, mix two tablespoons of apple cider vinegar with 6-8 ounces of water and drink the mixture frequently throughout the day, but mostly before mealtime. You should not consume more than one 8-ounce glass of this mixture per day as excess apple cider vinegar can reduce potassium levels and cause osteoporosis.
Lemon juice remedy for kidney stones
Apart from apple cider vinegar, you can use lemon juice to dissolve kidney stones. Usually, a mixture of lemon juice with olive oil is preferred as the lemon juice provides citrate that breaks up or prevents calcium stones from forming while the olive oil helps to flush out the stones.
Mix a quarter of a cup of olive oil with equal amount of lemon juice and drink. Follow it with a glass of water. Repeat this in the afternoon, but making sure to drink plenty of water and plenty of lemon juice throughout the day.
Alternatively, you can just squeeze some lemon into your drinking water as often as you can. Unfortunately, this will require a great deal of lemon juice if it has to produce the effect you desire.
Other natural options that help with kidney stones include:
Celery juice
Pomegranate juice
Basil juice
Dandelion root juice
Horsetail juice
Wheatgrass juice
These juices help eliminate waste, enhance digestion, and increase urination. They are also packed with a lot of nutrients and can relieve inflammatory issues.
But as you go for the juices, also remember that drinking plenty of water is necessary. Drinking enough water prevents dehydration, dilutes urine, and hinders formation of kidney stones. Water also helps stones to pass through the urinary tract. As a rule, you should drink 6-8 ounces of water per day.
When should you see a urologist?
When kidney stones are too large and cause severe symptoms, visiting a urologist for treatment is the right option. Your doctor may prescribe medication such as tamsulosin (Flomax) to relax your ureter and make it easier for the stone to pass.
You may also be given pain and anti-nausea medicine to help you cope. Plus, your doctor may consider procedures such as extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, percutaneous nephrolithotomy (PCNL), laparoscopy, and robotic surgery to help remove the stones.
You should see a urologist if your symptoms are becoming severe after using apple cider vinegar or lemon juice remedy for a few weeks. Indicators of worsening kidney stones include nausea, blood in urine, painful urination, severe pain in the lower back or abdomen, vomiting, fever, and chills. In fact, if you’re not able to pass the stone for six weeks then you should see your doctor to determine whether you need therapy.
At St Pete Urology, we see many patients with kidney stones on a regular basis and know exactly what to do in every situation. Our team of urologists has the skill, expertise, and experience to give effective treatments for the stones, particularly if you’re not able to pass the stones naturally.
Our range of treatments includes medication and procedures like lithotripsy (ESWL), ureteroscopy, percutaneous nephrolithotomy (PCNL), laparoscopy, and robotic surgery. Schedule your appointment with us if your symptoms have lasted more than six weeks. For more information on the diagnosis and treatment of urologic disorders, visit the site “St Pete Urology”.
Have you and your partner been experiencing challenges conceiving a child ? There are many potential reasons for this but one obvious is basic health issues connected with fertility
What treatment options are available for male infertility?
Surgery
In cases where infertility is due to obstructions in the sperm transport pathway, surgical correction can help to restore fertility.
For example, if the vas deferens is blocked in a manner that prevents sperm from reaching the urethra, a qualified urologist can conduct an operation to remove the blockage. Likewise, a varicocele can lead to lower sperm production but often be repaired surgically within the spermatic cord leading to an enhancement to your fertility.
Surgery may also be performed to retrieve sperm directly from the testicles or epididymis using a sperm retrieval surgical technique.
Your doctor may do a transurethral resection of the ejaculatory duct to help eliminate an obstruction in your ejaculatory duct, improving the chances of any inflamed or chronically dilated areas in your ejaculatory duct to normalize.
A similar procedure—the transurethral resection of the seminal vesicles—may also be an option to help eliminate an obstruction in the seminal tract or in a strategic area, enhancing fertility.
Hormone therapy and medications
You may need hormone medications or hormone replacement therapy if your infertility is due to high or low levels of certain hormones or problems with how your body synthesizes hormones.
In men with mild sperm abnormalities, the drug clomiphene citrate can in many cases help to boost semen quality, improve sperm count and enhance sperm motility.
If the infertility is due to problems in the pituitary gland or hypothalamus, human chorionic gonadotropin (hCG) may be administered, usually combined with recombinant human follicle-stimulating hormone (rhFSH). When prescribed, the treatment can help achieve normal blood hormone levels so that your body can better produce sperm.
For many protocols, human chorionic gonadotropin (hCG) is injected three times per week under the skin for between six months and one year. Then blood tests will be run and the dose adjusted as necessary.
After six months of treatment, typically your urologist will check and inspect your semen. If sperm is still absent, doctors will in some cases add recombinant human FSH to the injected hCG.
Assisted reproductive techniques (ARTs)
Assisted reproduction involves obtaining sperm by normal ejaculation, surgical extraction, or donor individuals, depending on the specific case.
The sperm can then be inserted into the female genital tract or used to conduct in vitro fertilization or intra-cytoplasmic sperm injection.
The sperm collected from ejaculated semen or obtained using a needle inserted into the testicle is processed and introduced to the eggs by intrauterine insemination (IUI), in-vitro fertilization (IVF), or intra-cytoplasmic sperm injection (ICSI).
Intrauterine insemination (IUI) is done during ovulation with sperm injected directly up the uterus. The woman is first prescribed targeted medications to increase the number of eggs she releases.
In-vitro fertilization (IVF) involves mixing sperm with multiple eggs collected from your partner in a plastic dish (“test-tube”). The fertilized eggs are then inserted into the uterus. Of course, IVF requires viable sperm.
In intracytoplasmic sperm injection, a single sperm is injected via a tiny needle into an egg. The fertilized egg is then implanted in the uterus. The procedure is appropriate when the sperm count is extremely low or abnormal.
At St. Pete Urology, we work with couples to optimize their reproductive health.
Contact us today if you have issues conceiving and for more information on the diagnosis and treatment of infertility and other urological problems.
A vasectomy is one of the safest and most effective birth control methods. But like other medical procedures, it isn’t foolproof.
There is a possibility that a vasectomy can fail to prevent pregnancy in extremely rare cases with roughly a 1-percent chance of failure.
Though vasectomy failures can be due to various reasons, several cases are due to a reversal of the procedure over time.
How can a vasectomy reverse itself?
In rare instances, a vasectomy can reverse itself and is known to occur in about 0.025 percent of cases, equivalent to 1 reversal in 4,000 vasectomies. Such a reversal involves reconnection of the vas deferens after successful surgery and an effective post-vasectomy plan.
Remember that during a vasectomy, the vas deferens—the two tubes that carry sperm from the testicles to the urethra—are cut and sealed off to block sperm from reaching semen. The channel in the vas deferens is broken at the point where it is cut to eliminate the passageway of the sperm to combine with the semen.
However, in some cases, the vas deferens grow back several years after the procedure. The growth may continue until a connection is recreated, allowing the free flow of sperm to the urethra.
An extremely rare and successful reconnection can occur after 10 to 14 years or more and is usually almost impossible to notice.
Most men only realize that their vas deferens have reconnected after their sexual partners get pregnant.
What can make a vasectomy reverse itself?
After a vasectomy, sperm may leak from the vasectomy site or a rupture and directly into the epididymis. Since sperm have immune system stimulating properties (antigenic qualities), it recognizes sperm as foreign and attacks them.
The sperm leakage triggers an inflammatory reaction that causes the body to develop pockets to trap the sperm in scar tissues and inflamed cells.
With time, spheres of cells called sperm granulomas form and produce nodules in the vas deferens that may grow and result in the reconnection of the vas deferens.
The risk of a reversal increases with the presence of sperm tissue at the vasectomy site.
Another reversal mechanism is scar tissue.
With cells present after a vasectomy forming tiny channels that allow sperm to squirm their way through the tiny tears in the scar tissue, small drainage channels appear in the tissue on the ends of the severed vas deferens. Over time, these channels may reconnect to the divided vas deferens, providing a pathway for sperm to the seminal vesicles. The risk of a reversal via scar tissue increases with open-ended vasectomy, where only one end of the vas deferens is closed.
However, you shouldn’t be overly concerned if you consider a vasectomy or have already undergone the procedure.
The chances of a reversal are pretty rare—almost negligible—and extremely unlikely in most cases.
At St. Pete Urology, we are proud of our excellent record of successful vasectomies. Our skilled and experienced urologists understand the factors that may lead to vasectomy failure, including non-severance of the vas deferens, non-observance of a period of sperm-free ejaculate, reconnection of the vas deferens, and duplication of the vas deferens. So we tailor and conduct every vasectomy under strictest adherence to best practices.
Call St. Pete Urology today for more information on vasectomy and vasectomy reversal.
Prostate cancer starts in the prostate gland, but can spread outside of it if not detected and treated early.
To confirm a diagnosis of prostate cancer and assess the stage of the cancer, doctors will use tests such as the PSA test and DRE, as well as a biopsy, ultrasound, MRI, and CT scans.
The cancer is staged based on the size and spread of the tumor, with Stage I being the least advanced and having a high survival rate.
Prostate cancer starts and grows in the prostate gland, but may spread outside the prostate, particularly when not detected and treated early. As it grows and spreads away from the prostate, the tumor may invade nearby tissues and consequently get carried via lymph nodes and lymph vessels traveling to distant tissues.
Grading of prostate cancer
Prostate cancer is primarily screened using the prostate-specific antigen (PSA) test and the digital rectal exam (DRE). And when screening tests give abnormal results, your physician will run further tests to confirm the diagnosis, grade the cells, and then assess the stage of the cancer.
To confirm the diagnosis, your doctor will order a prostate biopsy. The test involves obtaining a sample of tissue from the most affected areas of the prostate and having the cells examined by a pathologist to determine if they are cancerous. And since cancerous cells appear different from healthy cells, the biopsy helps to confirm the diagnosis.
The appearance of cells is also used to grade the cancer. Usually, the cells are classified using the Gleason system, which uses the numbers 1 to 5 to grade the patterns of cells seen in the tissue sample as the most common (primary) and the second most common (secondary) patterns of cells.
Cells that look much similar to normal cells are given a score of 1, and then the scores 2-4 are given an increasing order of difference from normal ones. Therefore a score of 4 represents cells that are more different and have a higher chance of uncontrolled replication than a score of 2. And a score of 5 is given to cells that are completely different from normal prostate cells.
The total Gleason score is obtained by adding the primary and secondary scores, with the least tally that indicates cancer being 6—a score that shows a low-grade, least aggressive cancer. A Gleason score of 7 indicates a medium-grade cancer, while tallies of 8, 9 or 10 show a high-grade cancer.
Generally, the higher the score, the more the cancer cells appear different from normal prostate cells, and the more aggressive the cancer. Aggressiveness of a cancer means it has more chances of spreading to other areas of the body.
Today, the Gleason score is used alongside the grade group score to help stage prostate cancer. Other tests that help assessing the stage of prostate cancer include Transrectal ultrasound, prostate-specific antigen (PSA), MRI of the prostate, abdominal and pelvic CT scan to detect the potential spread of the cancer, nuclear scans to detect spread to bones, and surgical biopsy to check lymph nodes of your pelvis for the tumor.
So what are the stages of prostate cancer?
Staging of a prostate cancer means classifying the cancer according to how far it has spread and its effects on the prostate. The staging system helps in tailoring treatment to properly address the tumor.
To determine the stage of a cancer, your doctor will use a number of indicators. For instance, your doctor will use the TNM system, which has three different aspects. Tumor (T) describes the size of the main area of the cancer, nodes (N) identifies whether the cancer has spread to the lymph nodes and to what extent, while metastasis (M) describes how far from the prostate the cancer has spread.
Similarly, your physician will use the Gleason score and the grade group score to stage the cancer. The higher the Gleason or grade group score, the more aggressive and widely spread the cancer. Plus, your doctor will use the PSA level, ultrasound, MRI, CT scans, nuclear scans, and surgery to correctly stage the cancer.
Stage I Prostate Cancer
The least advanced prostate cancer, usually small and not yet spread beyond the prostate, is called stage I prostate cancer. It is characterized by a PSA level that’s less than10 ng/mL, a Gleason score of 6, and a grade group score of 1. The cancer has a 5-year survival rate of almost 100 percent.
Stage I prostate cancer is managed by active surveillance for nearly all patients with a Gleason score of 6, unless the patient is unwilling or unable to undergo additional biopsies or has high-volume disease.
Active surveillance means your doctor monitors the tumor over time to check whether further treatment is necessary. Apart from active surveillance, stage I cancer may be treated using radical prostatectomy—the surgical removal of the prostate; or radiation therapy, either alone or with prostate removal.
State II Prostate Cancer
The cancer is still restricted to the prostate and has not spread to the lymph nodes or other parts of the body. Also, it may or may not be felt during a prostate exam, though it may appear on ultrasound imaging.
Stage II prostate cancer has a PSA score of less than 20ng/mL, but is further divided into three phases depending on Gleason scores and grade group scores. Stage IIA has a Gleason score of 6 or less and grade group score of 1, stage IIB has a Gleason score of 7 (3+4) and grade group score of 2, while stage IIC has a Gleason score of 7 or 8 and grade group score of 3 or 4.
For stages IIA and IIB, active surveillance may be adequate. But, in some cases, doctors recommend removing the prostate together with the surrounding lymph nodes in order to prevent further spread of the cancer. Your doctor may also consider radiation therapy, in the form of external beam or brachytherapy.
For stage IIC, a combination of hormone therapy with radiation therapy in select patients—group grade 3 or those with more than 50-percent positive biopsy cores, usually gives great results.
Stage III prostate cancer
At this stage, the cancer may or may not have spread outside the prostate. If the tumor hasn’t spread outside the prostate, the 5-year survival rate still remains close to 100-percent. But when the tumor has spread, the survival rate is reduced.
Stage III prostate cancer is divided into three sub-groups: IIIA, IIIB and IIIC. In stage IIIA, the cancer hasn’t spread outside the prostate, has a PSA level of 20ng/mL or higher, a Gleason score of 8 or less, and grade group score of 1 to 4.
Stage IIIB has spread outside the prostate and may have reached the seminal vesicles or the surrounding tissue, but it hasn’t reached the lymph nodes or other parts of the body. It may have any PSA level, but a Gleason score of 9 or 10, and grade group score of 5.
Stage IIIC prostate cancer may or may not have spread to the lymph nodes or other nearby organs. It has any PSA level, but a Gleason score of 9 or 10 and a grade group score of 5.
Stage III prostate cancer is treated through a combination of external beam radiation and hormone therapy. In some cases, brachytherapy or radical prostatectomy—with removal of pelvic lymph nodes—is considered. Active surveillance isn’t used for stage III prostate cancer because there is a higher risk of disease progression if not treated.
Stage IV prostate cancer
This is the most advanced form of prostate cancer. The cancer has typically spread to distant parts of the body and affected several organs. Stage IV prostate cancer is divided into IVA and IVB. Stage IVA tumor has spread to nearby lymph nodes but hasn’t reached other areas of the body. Stage IVB tumor has reached distant lymph nodes and many other areas including bones or organs.
The treatments for stage IV prostate cancer include hormone therapy, chemotherapy, external beam radiation, targeted radiation and potentially prostate surgery.
Effective, state-of-the-art treatment
Successful treatment of prostate cancer depends on regular screening to increase the chances of early detection, correct grading of the cancerous cells, and proper staging of the cancer. Early detection ensures a higher survival rate just as the right staging ensures that the treatment administered is safe and effective.
At St Pete Urology, after a diagnosis, our skilled and experienced urologists select the right tests to determine the stage of the cancer. Then through a multidisciplinary approach, we provide a tailored treatment with the highest potential of achieving the best possible outcomes.
Call us today to book your screening, diagnosis and treatment of prostate-related problems. For more information on prostate cancer and other urological disorders, visit https://stpeteurology.com/
May is the World Bladder Cancer Awareness Month—a time to reflect on the burden of the cancer across the globe and to improve on the fight against the disease.
Tonight we’re going to talk about bowel and bladder control primarily, so 
With 
You are experiencing some terrifying symptoms.
Urine is your body’s liquid waste. A larger part of it is water, but it also contains salts, urea, uric acid, and other chemicals. The contents of urine indicate how healthy your body is and an analysis of your urine sample can help your doctor to figure out if you’re healthy or not.
You’re suddenly in an excruciating pain. You have a sharp, cramping pain in your back and side that comes in waves. And the overwhelming feeling moves to your lower abdomen or groin, and hurts badly.
Have you and your partner been experiencing challenges conceiving a child ? There are many potential reasons for this but one obvious is basic health issues connected with fertility
Prostate cancer starts and grows in the prostate gland, but may spread outside the prostate, particularly when not detected and treated early. As it grows and spreads away from the prostate, the tumor may invade nearby tissues and consequently get carried via lymph nodes and lymph vessels traveling to distant tissues.