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 is the best medicine for enlarged prostate?

Treatment options for benign prostatic hyperplasia (BPH) have increased significantly in recent years. A few years ago, men suffering from BPH only had surgery as the main treatment option. This has changed as drug-makers have developed a number of drugs to offer more choices for alleviating the symptoms of an enlarged prostate. In fact, medicines now have become the most common treatment method for men with mild-to-moderate BPH. When administered, the drugs can calm bladder and prostate muscles, shrink the prostate, stop prostate growth or relieve symptoms of BPH, such as weak urine streams or the need to urinate several times per day.

Here are some drugs commonly used to treat BPH. Before using any drug, make sure to speak with your doctor to find out which medicine is appropriate for you.

1. Alpha blockers

When diagnosed with an enlarged prostate, your doctor may recommend that you take alpha blockers to ease your symptoms. These drugs relax bladder and prostate muscles and make it easier to pass urine. While they do not alter prostate size, they are effective in promoting urine flow and will prevent the need to urinate frequently or urgently. They work right away so you will not wait too long for the results.
Some alpha blockers that your doctor may suggest include:

  • (a) Doxazosin (Cardura)
  • (b) Alfuzosin (Uroxatral)
  • (c) Tamsulosin (Flomax)
  • (d) Silodosin (Rapaflo)
  • (e) Prazosin (Minipress)
  • (f) Terazosin (Hytrin)

Alpha blockers are very effective for men with both BPH and high blood pressure because they remedy both conditions. However, the drugs should not be taken by men planning to go for cataract surgery as they may cause problems during the surgery.
Side effects of alpha blockers include:

  1. Tiredness/fatigue
  2. Fainting
  3. Dizziness
  4. Lightheadedness
  5. Headaches
  6. Low blood pressure

Alpha blockers also can cause retrograde ejaculation, a condition in which sperm moves backward into the bladder instead of moving forward through the penis. While the condition is not harmful, it means that the fluid ejaculated may not contain sperm. Therefore, men with BPH should keep this in mind particularly if they still desire to have children.

2. 5-Alpha reductase inhibitors

In order to prevent the prostate from growing or just to shrink it, the urologist may recommend that you take a 5-alpha reductase inhibitor. Such drugs stop the body from producing one of the hormones necessary for prostate growth and enlargement. As a result, the drugs improve urine flow and relieve the symptoms of BPH. The 5-ARIs are most effective in men with very large prostates.
The two major 5-alpha reductase inhibitors recommended for BPH are:

  • Dutasteride (Avodart)
  • Finasteride (Proscar, Propecia)

Apart from shrinking or stopping the growth of the prostate and relieving BPH symptoms, the 5-ARIs have two other benefits:

  1. They reduce the chances that BPH will result in other complications, like bladder damage.
  2. They eliminate the need for surgery as treatment for BPH.

The full effects of 5-alpha reductase inhibitors may take up to 6 months to be realized. So you must continue taking the medicines for as long as necessary.

Side effects of 5-ARIs

5-alpha reductase inhibitors are not supposed to be used by women. In fact, pregnant women must never be exposed to the drugs as they can cause birth defects in male fetus. Other side effects of 5-ARIs include:

  • (a) Lower sex drive/libido
  • (b) Erectile dysfunction
  • (c) Retrograde ejaculation

Some of these side effects may improve as the body gets used to the drug.
The 5-ARI drugs also may reduce the levels of prostate-specific antigen (PSA) in the blood. PSA levels are used to screen for prostate cancer, so a drug-induced drop makes it impossible to use the PSA test. It is advisable to have the PSA test done before you start these drugs. The FDA now requires that the labels on 5-ARIs must include a warning that they may increase the risk of having aggressive (high-grade) prostate cancer.

3. Phosphodiesterase-5 inhibitors

In some cases of BPH, the urologist may recommend the use of phosphodiesterase-5 inhibitors, which are drugs that smooth the muscles of the prostate and bladder and help to relieve BPH symptoms. While there are many types of phosphodiesterase-5 inhibitors, only tadalafil (Cialis) has been approved by the FDA for treatment of BPH. Tadalafil is not prescribed as often as other drugs, but when doctors are dealing with cases in which BPH and ED occur together, then it is often a viable option.
The side effects of Tadalafil include:

  • (a) Headaches
  • (b) Muscle and back pain
  • (c) Stomach upset (after eating)
  • (d) A stuffy nose
  • (e) Vision problems
  • (f) Redness, warmth or burning on the neck, face and upper body

4. Combination therapy

When a doctor realizes that a single medication may not effectively relieve BPH symptoms, a combination of two or more drugs may be considered. The most common drug combinations for treating BPH include:

  • (a) Tamsulosin and Dutasteride, comes in one pill called Jalyn
  • (b) Doxazosin and Finasteride
  • (c) Alpha blocker and an antimuscarinic (a drug for treating overactive bladder)

Drug combinations are generally more effective than single drug treatments. However, the combinations also come with greater side effects than those of single drugs.

Are you or your loved one suffering from the symptoms of BPH? Would you like to receive accurate information and effective treatment for an enlarged prostate? Or do you want someone to to talk to about any other urological problem that you may have? If so, then St Pete Urology is the right place for you. For more information on the diagnosis, treatment and care for BPH, 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.

Bladder Control Problems in Women

While there are many types of bladder problems in women, including an overactive bladder and urinary incontinence, one of the most common problems related to the bladder is urinary tract infection (UTI).

Urinary tract infection occurs when a bacteria gets into the urethra and then moves into and multiplies in the bladder. The bacteria may even spread to other parts of the body from the bladder, resulting in complications such as blood poisoning and kidney failure.

Causes of urinary tract infections in women

The urethra is located close to the anus, making it easier for bacteria found in the large intestine (such as E. coli) to move from the anus into the urethra. Once inside the urethra, bacteria can move into the bladder and begin to multiply, resulting in inflammation of the bladder. If the infection is not treated, the bacterial infection may spread into the kidney or the blood.

Women have a higher risk of bladder infection than men because their urethra is shorter, allowing bacteria to gain quick access to the bladder. Bacteria also may be introduced into a woman’s urinary tract during sexual intercourse. Other factors that make women more susceptible to UTIs include diabetes, older age, surgery, catheterization, menopause, immobility and improper hygiene.

Symptoms of urinary tract infection in women

Women with UTIs may have the following symptoms:

  1. Cloudy, bloody, dark or strange-smelling urine.
  2. A burning sensation or feeling when urinating.
  3. An intense or frequent urge to urinate, although very little urine comes out when they do.
  4. Cramping, pressure or pain in the lower abdomen or back.
  5. Feeling shaky or tired.
  6. Low-grade fever or chills (indicating that the infection has reached the kidneys).

Seeking for medical help

Even though most urinary tract infections do resolve on their own, it is important that women seek medical help when having symptoms that are very uncomfortable or when their symptoms last for more than 5 days. Similarly, UTIs may require medical help when there is a sudden worsening of fever or of symptoms. Likewise, women who are diabetic or who are pregnant should seek medical help.

During a visit to a urologist or doctor, a urine test may be ordered to check for offending bacteria before antibiotics are given. In some instances, specialized laboratory testing may be necessary and an intravenous urogram (IVU) may be done to evaluate the urinary tract. Another diagnostic option is cystoscopy, a procedure in which a thin flexible tube is used to look into the bladder.

Treatment of UTIs in women

Generally, most cases of urinary tract infections are easy to treat as long as the diagnosis and treatment begins early. Therefore, it is important to visit a urologist as soon as your UTI symptoms worsen or last longer than expected. Treatment is usually done using antibiotics for about 5 days. However, more complicated cases of UTIs, such as those occurring during pregnancy, may call for administration of antibiotics for a longer duration. Even if you get better soon after starting to take antibiotics, make sure to continue the treatment so that all bacteria are killed and to prevent a recurrence of the infection.

The doctor also will recommend that you drink plenty of water to prevent dehydration and to relieve symptoms. Paracetamol may be prescribed for relieving UTI pain and discomfort, while methenamine hippurate (which is effective in stopping bacterial growth in the urinary tract) may be used as an alternative treatment in women who cannot use antibiotics. More severe cases of UTIs may require hospital admission, where antibiotics are administered through intravenous (IV) drips.

Prevention of urinary tract infections

Because women are at higher risk of getting UTIs than men, they should always take the necessary steps to prevent the infections. Ways of preventing UTIs include:

  1. Urinating soon after sexual activity.
  2. Drinking copious amounts of fluids.
  3. Practicing proper hygiene.
  4. Avoiding fragrant feminine products (not douching).
  5. Wearing cotton underwear.
  6. Avoiding tight-fitting-pants.
  7. Taking showers instead of baths.
  8. Avoiding bladder-irritating fluids such as alcohol and caffeine.

At St Pete Urology in St Petersburg, Fl., we have treated bladder and urinary tract problems in women for decades. Through our skilled, experienced and professional board-certified urologists, we give the most accurate diagnosis and administer the most effective treatments. If you have a bladder problem or have symptoms of UTIs, come see us for quick relief. For more information on the diagnosis, treatment and help with bladder problems, 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.

Common Symptoms of Testicular Cancer

Testicular cancer refers to the cancer of the testes (testicles), which are found within the scrotum, a loose bag of skin located underneath the penis. The principal function of the testes is production of sex hormones and sperm in men. Testicular cancer is relatively rare when compared to other types of cancer, but it is the most frequent type of cancer in American males between 15 and 35 years old. The cancer is highly curable and can effectively be treated even after it has spread outside the testicle. Nevertheless, a man may need to receive several treatments or a combination of treatments, depending on the stage and type of testicular cancer.

Testicular cancer symptoms

Testicular cancer is usually unclear from the symptoms because it shares many symptoms with other problems such as epididymitis and hydrocele. Therefore, it is important to see a doctor as soon as possible to have your condition diagnosed so that testicular cancer can either be detected or ruled out. Do not wait.

The most common symptom of testicular cancer is a lump in or on one or both testicles. The testicle may become larger or swollen, and it is normal for one of the testicles to be larger or to hang lower than the other. Testicular cancer may cause pain, but most often the condition is painless. Men having the cancer also may experience a heavy feeling, pressure or aching in the scrotum or in the lower belly.

Symptoms of advanced testicular cancer

If testicular cancer is not diagnosed early, it may spread (metastasize) beyond the testicles and reach other parts of the body, including regional lymph nodes and organs. The type of symptoms caused by the spread of testicular cancer depends on the area of the body that has been affected. In fact, even after spreading to various parts of the body, testicular cancer may still show no symptoms. Symptoms that may occur after the cancer has spread include:

  1. Lower back pain: May occur when testicular cancer has spread to lymph nodes found in the back of the abdomen (belly).
  2. Belly pain: May occur when testicular cancer has spread to the liver or when affected lymph nodes have enlarged.
  3. Coughing, chest pain or shortness of breath: May occur when testicular cancer has spread to the lungs.
  4. Headaches or confusion: May occur when the cancer has spread to the brain.
  5. Sweating for no apparent reason, fever, lack of energy, or a general feeling of sickness.
  6. Breast swelling or nipple tenderness: Occurs rarely but may be caused by the production of hormones due to the cancer.

When should you see a doctor?

Make sure to see a urologist as soon as you detect swelling, lumps or pain in your testicles or in the groin area, particularly if these signs last longer than 2 weeks. Remember that these signs and symptoms may be caused by other conditions that are not testicular cancer. So it is always important to have your doctor check them and advise you accordingly. At St Pete Urology in St Petersburg, Fl, we have treated testicular cancer for many years and have the experience and expertise to diagnose and treat the cancer effectively. We cure most testicular cancers regardless of whether or not they have spread to other areas of the body. For more information on testicular cancer, 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.

4 Effective Treatments for Urinary Incontinence in Men

There is no single treatment for urinary incontinence that works for all men. The treatment that your urologist recommends will depend on the type of urinary incontinence you are having and the severity of the symptoms on your life. At St Pete Urology in St Petersburg, Fl, urologists may even consider your lifestyle and your treatment preferences, beginning with the simpler treatment options before going for the complex ones.

In fact, many men usually regain urinary control after changing a few of their habits and engaging in exercises to strengthen their bladder muscles. But if the behavioral treatments fail to yield desirable results, the urologist may choose to apply a continence device or prescribe medications. In some men, surgery is the right treatment for their urinary incontinence.

If there is no cancer, infection or other underlying cause of urinary incontinence that can only be cured by surgery, the urologist will complete the treatment in stages, starting with behavioral changes and performing surgery only as a last resort. Here are the 4 treatments that are effective for urinary incontinence in men.

1. Behavioral treatments

For some men, treatment of urinary incontinence is as simple as planning for regular bathroom trips or limiting fluid intake to certain times of the day. This type of therapy for UI is called bladder training or timed voiding. So at St Pete Urology in St Petersburg, Fl, the urologist may recommend some changes in your urinary habits, diet or lifestyle to help you gain control over your bladder. As you regain control, you will be able to extend the time you take between bathroom trips. Bladder training (timed voiding) also includes Kegel exercises for strengthening pelvic muscles to enable the bladder to hold urine longer.

2. Medicines

Urologists prescribe medicines that can help to improve bladder control in men with urinary incontinence. The medicines work in different ways, with some blocking abnormal nerve signals sent at the wrong time while others slow down urine production. Still other medications help relax bladder muscles or shrink an enlarged prostate. The most common drugs used for urinary incontinence in men include:

(a) Alpha-blockers: Drugs such as Doxazosin (Cardura), Terazosin (Hytrin), Alfzosin (Uroxatral) and Tamsulosin (Flomax) are used to relieve urinary incontinence caused by bladder outlet obstruction and prostate enlargement. These drugs relax the smooth muscles of the bladder neck and prostate, encouraging the normal flow of urine and preventing abnormal contractions of the bladder, which may cause incontinence.

(b) Imipramine: The drug Tofranil, which belongs to the tricyclic antidepressants class, works by relaxing muscles and blocking nerve signals that might lead to bladder spasms. This helps to relieve urinary incontinence in men.

(c) Antispasmodics: Drugs such as tolterodine (Detrol LA), trospium chloride (Sanctura), solifenacin succinate (VESIcare), darifenacin (Enablex), oxybutynin (Ditropan XL) and Finasteride (Proscar) work by relaxing bladder muscles and relieving muscle spasms, which in turn helps to relieve urinary incontinence.

(d) 5-alpha reductase inhibitors: Drugs such as dutasteride (Avodart) and finasteride (Proscar) inhibit the production of DHT, a male hormone believed to be responsible for prostatic enlargement. When administered, the 5-alpha reductase inhibitors relieve urinary incontinence through the shrinking of an enlarged prostate.

3. Self-catheterization

Urologists at St Pete Urology in St. Petersburg may recommend self-catheterization for men having overflow incontinence due to a weak bladder or a blockage. The catheter (a thin, hollow tube) is inserted through the urethra to reach the bladder and help drain the bladder in men having urinary incontinence. In some cases, urologists may recommend self-catheterization when their evaluations have established that surgery is not ideal for their patients.

4. Surgical treatments

If you are suffering from urinary incontinence because of a nerve-damaging event, such as radical prostatectomy or spinal cord injury, then surgery is the best treatment for the condition. The surgery performed may be a urinary diversion, male sling or artificial sphincter.

(a) Urinary diversion surgery: If all the bladder function has been lost or the bladder must be removed after nerve damage, the urologist may consider an operation to create a urinary diversion. During this procedure, the surgeon will create a reservoir by removing a small piece of your small intestine and then redirecting the ureters to the reservoir. A stoma (an opening in the lower abdomen that is used to drain urine into a bag or through a catheter) also may be created by the surgeon.

(b) Male sling surgery: In the sling procedure, the surgeon boosts the support for the urethra by wrapping it with a strip of material and then attaching the ends of the strip to your pelvic bone. The sling will ensure there is constant pressure on the urethra and that the urethra does not open unless the patient consciously decides to release the urine.

(c) Artificial sphincter surgery: At other times, the urologist may decide to implant a device (artificial sphincter) that can keep the urethra closed until the patient reaches the bathroom and is ready to pass urine. This operation helps men with urinary incontinence due to weak sphincter muscles or nerve damage that has impaired the functioning of the sphincter muscle.

At St Pete Urology in St Petersburg, Fl, we know that urinary incontinence in men is an underreported and under-diagnosed problem, as many patients are too embarrassed to seek treatment. We apply a personalized, friendly, compassionate and multidisciplinary approach in the screening, diagnosis and treatment of urological problems. This approach ensures that all types of urinary incontinence are correctly diagnosed and treated promptly. If you suspect that you or your loved one is suffering from urinary incontinence, visit St Pete Urology for effective treatment. For more information on urological disorders, 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.