How Can You Effectively Treat Female Urinary Incontinence?

Key Takeaways:

  1. The mid-urethral sling procedure is a surgical solution to female urinary incontinence that is minimally invasive and has a high success rate.
  2. Benefits of the mid-urethral sling procedure include a quick recovery time and return to normal activities within two to four weeks.
  3. The experienced urologists at St Pete Urology in St Petersburg, Florida, are dedicated to helping patients address urinary incontinence and regain control of their lives.

Introduction

Urinary incontinence is a health concern that affects many women throughout their lives. It is a problem that can lead to a loss of self-esteem and can impact daily activities. However, there is hope for those who suffer from this condition. In this article, we will explore the mid-urethral sling procedure, a surgical solution to female urinary incontinence. As Dr. Adam Oppenheim, a urologist with St. Pete Urology, explains, “the mid-urethral sling is a procedure that we offer for stress urinary incontinence in females.”

Understanding Female Urinary Incontinence

Before delving into the mid-urethral sling procedure, it is essential to understand the underlying condition it addresses. Stress urinary incontinence occurs when pressure is placed on the bladder, causing unintentional leakage of urine. This can happen during everyday activities such as coughing, sneezing, laughing, or exercising. Additionally, it is often a result of weakened pelvic floor muscles, which can be caused by childbirth, obesity, or aging.

The Mid-Urethral Sling Procedure: A Solution for Stress Urinary Incontinence

For women who have bothersome stress urinary incontinence, a surgical procedure known as the mid-urethral sling is often the recommended treatment. This outpatient procedure takes under an hour to complete. Additionally, it shows promising results in addressing the issue of urinary incontinence. According to Dr. Oppenheim, “the patient is then sent home and follows up in the office within a few days.”

How Does the Mid-Urethral Sling Procedure Work?

The mid-urethral sling is a minimally invasive procedure that provides support to the urethra. A small incision is made in the vagina. Then, a synthetic mesh material is inserted to create a “sling” around the mid-portion of the urethra. This sling provides support to the weakened pelvic floor muscles. Furthermore, it helps prevent urine leakage during activities that put pressure on the bladder.

Benefits and Risks of the Mid-Urethral Sling Procedure

There are several benefits to the mid-urethral sling procedure, including:

1. The minimally invasive technique of the mid-urethral sling allows patients to return home the same day as the surgery since it’s an outpatient procedure. They typically have a follow-up appointment in just a few days.

2. The mid-urethral sling has demonstrated a high success rate in treating stress urinary incontinence, contributing significantly to many women regaining their quality of life.

3. The procedure boasts a relatively short recovery time, with most patients resuming normal activities within two to four weeks.

However, like any surgical procedure, the mid-urethral sling carries certain risks, which may encompass infection, bleeding, pain, or difficulties in urination. It’s crucial to discuss these potential risks and benefits with your urologist to determine if the mid-urethral sling procedure is the right choice for you.

Seek Help from Expert Urologists at St Pete Urology

If you are experiencing stress urinary incontinence, it is essential to know that there are effective treatments available, such as the mid-urethral sling procedure. The experienced urologists at St Pete Urology in St Petersburg, Florida, are dedicated to helping patients regain control of their lives by addressing urinary incontinence and providing exceptional care. Let the expert team at St Pete Urology help you take back your life and enjoy every moment without the worry of urinary incontinence.

References:

Transcription:

I’m Dr. Adam Oppenheim. I’m a urologist with St. Pete Urology. Generally, a surgical procedure known as a mid-urethral sling is offered for women who have bothersome stress urinary incontinence. So the mid-urethral sling is a procedure that we offer for stress urinary incontinence in females. It’s an outpatient procedure that takes usually less than an hour or so to complete. The patient is then sent home and follows up in the office within a few days.

What Are the Different Types of Prostate Problems? – Dr. Adam Oppenheim

Key Takeaways:

  1. There are two main types of prostate problems: Benign Prostatic Growth and Prostate Cancer.
  2. Early detection is key in managing and treating prostate cancer and should begin at age 50 (or 45 for those with a family history or higher risk factors).
  3. Treatment for both benign prostatic growth and prostate cancer depends on various factors and should be personalized to meet each patient’s unique needs.

Getting to Know Your Prostate

As the wise Dr. Adam Oppenheim says, “I’m a urologist with St. Pete Urology.” And who better to enlighten us on the different types of prostate problems than a seasoned professional? So, sit back and let’s delve into the world of prostate health.

First, let’s begin with some basics. The prostate is a walnut-sized gland located just below the bladder in men. Its primary function is to produce the fluid that nourishes and transports sperm. While this may seem like a small and insignificant part of the male anatomy, it can cause significant problems if not properly cared for.

Two Main Types of Prostate Problems

Dr. Oppenheim outlines two main issues in urology related to the prostate:

  1. Benign Prostatic Growth
  2. Prostate Cancer

Let’s take a closer look at each of these issues.

Benign Prostatic Growth: When Nature Takes Its Course

As Dr. Oppenheim explains, benign prostatic growth occurs when “patients have trouble urinating and they’re very bothered and often have to urinate very frequently or have a blocked stream.” This condition is known as Benign Prostatic Hyperplasia (BPH) and is a natural part of the aging process for men.

However, the symptoms of BPH can be quite bothersome, including:

  • Frequent urination
  • Difficulty starting and stopping urination
  • Weak urine stream
  • Dribbling of urine

While BPH is not life-threatening, it can significantly impact a man’s quality of life. Treatment options vary depending on the severity of symptoms and may include medications, minimally invasive procedures, or surgery.

Prostate Cancer: The Silent Threat

The second issue, prostate cancer, is a more sinister problem. Dr. Oppenheim informs us that “it doesn’t usually cause symptoms, but it can cause life-threatening cancer down the road if not treated.” This type of cancer occurs when malignant cells begin to grow uncontrollably in the prostate gland, often without any noticeable symptoms.

Early detection is key in managing and treating prostate cancer. Dr. Oppenheim suggests that men should begin screening for prostate cancer at age 50 (or 45 for those with a family history or higher risk factors). Regular screening tests, such as a prostate-specific antigen (PSA) blood test and digital rectal exam (DRE), can help identify any abnormalities in the prostate gland.

Choosing the Right Path: Customized Treatment Options for Prostate Problems

The course of treatment for both benign prostatic growth and prostate cancer depends on various factors, including the severity of the condition, age, overall health, and personal preferences. Dr. Oppenheim and the experts at St. Pete Urology offer personalized treatment plans designed to meet each patient’s unique needs.

For BPH, treatment options may include medication management, minimally invasive procedures, or surgery. For prostate cancer, treatment options can range from active surveillance (monitoring) to radiation or surgery, depending on the stage and aggressiveness of the cancer.

Conclusion: Trusting Your Prostate Health to St Pete Urology

Dr. Adam Oppenheim and the team at St Pete Urology in St Petersburg, Florida, understand the importance of early detection and customized treatment plans for men dealing with prostate problems. As Dr. Oppenheim says, “prostate health is a vital component of overall well-being, and we are here to help you navigate the complexities of this often-misunderstood aspect of men’s health.”

Don’t leave your prostate health to chance. Trust the urology professionals at St Pete Urology to provide the expertise and compassionate care you need. Schedule an appointment today and take control of your prostate health.

References:

Transcription:

I’m Dr. Adam Oppenheim, I’m a urologist with St. Pete Urology.
So the prostate, there’s kind of two main issues in urology with the prostate.
There’s benign prostatic growth where patients have trouble urinating and they’re very bothered and often have to urinate very frequently or have a blocked stream.
And then there’s prostate cancer which is different and that doesn’t usually cause symptoms but it can cause life threatening cancer down the road if not treated.

What is a PSA Test, and When is the Right Time to Get It? – Dr. Adam Oppenheim

Key Takeaways:

  1. The PSA Test measures the levels of prostate-specific antigen (PSA) in a man’s blood and is used to screen for prostate cancer.
  2. When to get tested depends on your age and risk factors. For men aged 55-70 without high-risk factors, it is recommended to consider getting a PSA test.
  3. Early detection of prostate cancer is key to successful treatment, so speaking to your doctor about when to get tested is important in safeguarding your health.

Understanding the PSA Test

Ranked as the second leading cause of cancer deaths in men, prostate cancer demands serious attention. Yet, with early detection, many men can successfully overcome this potentially deadly disease. So, what precisely is a PSA test, and when should you consider undergoing one? Dr. Adam Oppenheim is a distinguished urologist at St. Pete Urology. He offers valuable insights into the significance of this vital diagnostic tool.

“A PSA is a blood test, it stands for the prostate-specific antigen, and it’s a blood test used in the screening of men for prostate cancer.” – Dr. Adam Oppenheim

Unveiling the PSA Test: How it Works

The PSA test measures the levels of prostate-specific antigen (PSA) in a man’s blood. This protein is produced by the prostate gland and is vital for the normal functioning of the prostate. However, elevated levels of PSA can be a red flag, indicating the possible presence of prostate cancer. It is important to note that other factors, such as age, medication, and inflammation, can also affect PSA levels.

When to Get Tested: Age and Risk Factors

The right time to start considering a PSA test largely depends on your age and risk factors. According to Dr. Oppenheim:

“Well, the guidelines recommend that screening for prostate cancer happen between the ages of 55 and 70 unless the patient has significant high-risk factors for prostate cancer, which are family history or being an African American.”

If you fall into this age range and have no high-risk factors, it’s time to think about getting a PSA test. However, if you have a family history of prostate cancer or are of African-American descent, consult your doctor. You should discuss the possibility of earlier screening to ensure proactive health management.

Treatment Options: Surgery vs. Radiation

When your PSA test reveals an elevated level of PSA, your doctor will probably recommend additional tests to confirm the presence of cancer. If cancer is indeed detected, the recommended treatment plan hinges on various factors. These factors include your age, as well as the stage of the cancer. It’s a comprehensive assessment that guides the most appropriate course of action.

“So it largely depends on how old the patient is, a younger patient is likely to be counseled to undergo surgery and have the prostate removed, whereas an older patient is probably more likely to be counseled to undergo radiation where they don’t have to have an inpatient setting of an operation and they can do treatments as an outpatient.” – Dr. Adam Oppenheim

Ultimately, whether you choose surgery or radiation treatment will be a personal decision made in consultation with your doctor.

Taking Control: The Importance of Early Detection

Prostate cancer is a serious medical condition, but with early detection, it can often be successfully treated. By understanding the PSA test and speaking to your doctor about when to get tested, you take an active role in safeguarding your health.

At St Pete Urology, a leading urology practice in St. Petersburg, Florida, their expert team is dedicated to helping you navigate your prostate health journey. From discussing your risk factors to offering guidance on treatment options, St Pete Urology accompanies you every step of the way. Their presence ensures that you receive the best possible care throughout your journey. Don’t leave your prostate health to chance. Reach out to the professionals at St Pete Urology today.

References:

Transcription:

I’m Dr. Adam Oppenheim, I’m a urologist with St. Pete Urology.
A PSA is a blood test, it stands for the prostate specific antigen, it’s a blood test used in the screening of men for prostate cancer.
Well the guidelines recommend that screening for prostate cancer happen between the ages of 55 and 70, unless the patient has significant high risk factors for prostate cancer, which are family history or being an African American.
So it largely depends on how old the patient is, a younger patient is likely to be counseled to undergo surgery and have the prostate removed, whereas an older patient is probably more likely to be counseled to undergo radiation where they don’t have to have an inpatient setting of an operation and they can do treatments as an outpatient.

What is a PSA Test and When Should You Get It?

The PSA test measures the level or amount of PSA (prostate-specific antigen) in blood. The prostate-specific antigen is a protein synthesized by both non-cancerous and cancerous tissue in the prostate — a tiny gland found below the bladder in men. After it is produced, the PSA finds its way into semen and in small quantities in the blood. But since cancerous cells produce more PSA than non-cancerous cells, the test is carried out to detect high levels of PSA in blood, which may indicate the existence of prostate cancer.

What are the benefits of the PSA test?

Early detection of certain types of prostate cancer is critical for successful treatment and recovery. When the PSA test shows elevated levels of the antigen in blood, it may help to identify prostate cancer that is likely to grow quickly or spread to other parts of the body. In turn, the test helps to catch and treat such cancers early before they begin causing serious symptoms or become life-threatening. Also, by enabling early detection of prostate cancer when the necessary treatment is less aggressive, the test reduces the risk of certain adverse effects of treatment, such as urinary incontinence and erectile dysfunction.

What are the risks associated with the PSA test?

Carrying out the test itself comes with very little risk. It requires only a simple drawing of blood used to run the test in a laboratory. However, once the results of the test are out, there are a number of potential downsides involved. For instance, since false positives are quite common and elevated PSA results may have other causes other than prostate cancer, including prostate infection (prostatitis) and enlarged prostate (BPH), the test results may expose some patients to unnecessary or inappropriate treatments.

Some types of prostate cancer don’t produce much PSA, which means that a test may incorrectly indicate that you don’t have the cancer (a false negative). And follow-up tests for checking out the underlying causes of an elevated PSA test are often stressful, invasive, time-consuming or expensive. Furthermore, living with a localized or slow-growing prostate cancer — one that doesn’t require treatment — can cause stress and anxiety.

When should you get your first PSA test?

Before you get the first PSA test, it is recommended that you discuss the benefits and risks of the test with your doctor. During the discussion, a comprehensive review of your risk factors and preferences is done. For example, the urologist will consider your age, race, size of your prostate, medications you are taking (dutasteride and finasteride affect PSA levels), and how frequently your PSA levels change when making a decision about getting the test.

At St. Pete Urology, we advise men who are at higher risk of the disease, such as African American men and those with a brother or father who have had the cancer, to get their first test at the age of 40-45. Having the test before you reach 50 helps us to establish your PSA baseline and thereafter monitor the changes in your PSA levels to determine whether or not you’ll need annual PSA screening and prostate biopsy. If your blood PSA level is very low, we’ll put off any further PSA tests. But if you are a man of moderate to low risk of the disease, we recommend you get your first PSA test at age 50 or older (generally between 55 and 70).

What happens if your first PSA test result is high?

If you don’t have symptoms of prostate cancer, another PSA test may be recommended if your first test showed an elevated PSA level. The second test is used to confirm the validity of the original finding. But if the second PSA test still gives elevated PSA level, the urologist may direct that you continue with more PSA blood tests and digital rectal exams (DREs) at frequent intervals to monitor any changes in your prostate over time.

If your blood PSA level continues to rise over time or the urologist finds a suspicious lump in your prostate during a DRE, additional tests may be suggested to establish the nature of the problem. For example, a urine test may be run to find out if you have a UTI (urinary tract infection). Imaging tests like X-rays, cystoscopy or transrectal ultrasound also may be recommended. Then if prostate cancer is suspected, the urologist carries out a prostate biopsy — collecting multiple samples of tissue from your prostate by inserting hollow needles into the gland and withdrawing tissue. The tissues are examined under a microscope by a pathologist to confirm the cancer.

Treatment of prostate cancer

The type of treatment recommended for prostate cancer usually depends on whether it is early-stage or advanced-stage disease. For early-stage cancer the options include watchful waiting, radical prostatectomy, brachytherapy, conformal radiotherapy and intensity-modulated radiation therapy. At St Pete Urology, watchful waiting means no immediate treatment is offered but the cancer is closely monitored through regular PSA tests. Prostatectomy involves surgically removing part of or the entire prostate; brachytherapy involves implantation of radioactive seeds into the prostate to deliver specific amounts of radiation to the tumor. Conformal and intensity modulated radiotherapies deliver targeted amounts of radiation to the tumor with minimal damage or exposure of healthy tissues.

For advanced-stage prostate cancer, which is typically a more aggressive tumor that grows quickly and spreads faster to other areas of the body, treatment includes chemotherapy and androgen deprivation therapy. Chemotherapy can eliminate cancer cells that have spread to other parts of the body. Likewise, androgen deprivation therapy (androgen suppression therapy or ADT) is used to reduce the effect of androgens — male hormones that stimulate cancer growth — thereby slowing down or stopping cancer growth.

At St Pete Urology, we talk to our patients openly and candidly about the risks and benefits of the PSA test before we can advise them to get it. We also discuss the results of the tests, give our recommendations for those with positive results and typically repeat the PSA test for those with negative results. Our patients have always told us that our attention to detail, quality of interactions and efficiency during their visits is unmatched. If you would like to know more about the PSA test, visit the “St Pete Urology” site.

Urge Incontinence Treatment for Women

Urge incontinence is often a symptom of an unstable or overactive bladder. Characterized by a sudden strong desire to pass urine that can’t be postponed (urgency), urge incontinence usually comes with frequency (more often than normal) during the day and several times at night. Some women may even experience urine leakage during sex, particularly during orgasm. Although many women may avoid leakage by urinating frequently, they find the continual need to visit a bathroom quite restrictive to their lifestyles.

How do you know you have urge incontinence?

With urge incontinence, you will have urine loss because bladder muscles squeeze or contract at the wrong times. These contractions occur repeatedly, regardless of how much urine is in the bladder. There are 3 main indicators that you have urge incontinence:

  1. Inability to control when you urinate
  2. Having to pass urine frequently during the day and night
  3. Needing to pass urine suddenly and urgently

Causes of urge incontinence

There are two principal causes of urge incontinence. Irritation within the bladder may trigger incontinence. Or it may be loss of the nervous system’s inhibitory control on bladder contractions. For example, neurological conditions such as multiple sclerosis, spinal cord injuries, Parkinson’s disease and stroke may diminish bladder control and cause urge incontinence. Likewise, cardiovascular disorders, diabetes, bladder cancer, bladder stones, alcohol consumption, infections, diuretic medicine and inflammation that irritate the bladder or damage its nerves may cause incontinence. Urge incontinence also may indicate a more serious problem. For instance, when the urgency to pass urine is accompanied by blood in urine, recurrent urinary tract infections (UTIs) or an inability to empty the bladder completely, these may be red flags for a more serious issue than just urinary incontinence.

How is urge incontinence treated?

Generally a few lifestyle adjustments may help a woman cope with urge incontinence. For instance, making it as easy as possible to get to the bathroom, avoiding caffeine (tea, cola and coffee), avoiding alcohol, reducing amount of fluid intake per day and losing weight can help relieve symptoms. Secondly, bladder training (also called bladder drill) and pelvic floor muscle exercises can be combined to treat urge incontinence. A third solution may be treating urge incontinence with medicines called anticholinergics (antimuscarinics) such as oxybutynin, solifenacin, tolterodine, trospium chloride, propiverine, darifenacin and fesoterodine fumarate. And if the urge incontinence is associated with the lining of the vagina after menopause, applying estrogen cream directly inside the vagina may help.

Urge incontinence is also treated using Botulinum Toxin A (Botox), a prescription-only medication that relieves the incontinence when other options such as bladder training and other medication have failed. When these treatments are not successful, the urologist may suggest surgery. Surgical procedures for treating urge incontinence include sacral nerve stimulation, percutaneous posterior tibial nerve stimulation, augmentation cystoplasty and urinary diversion.

At St Pete Urology, our doors are open to all women troubled by incontinence. We are a recognized name in the urological community and boast of a team of highly innovative, experienced and certified physicians who deliver leading-edge urology and patient-centered care. We know there are many women who live with severe urological problems and we do our best to help those who come to us. We are good at treating these disorders. For more information, visit the St Pete Urology website.

What is the best treatment for urinary incontinence?

The sling procedure is the best, safest and most effective surgical operation for treating urinary stress incontinence. During the procedure, the urologist creates a sling using an artificial mesh, animal tissue or human tissue and places it under the urethra to support the urethra and bladder neck and to prevent unintentional urine loss.

What is stress incontinence?

Unintentional urine leakage (loss) occurs when you engage in physical activities or movements, such as running, sneezing, heavy-lifting, coughing or any action that puts stress (pressure) on your bladder. The condition is triggered by the weakening of pelvic floor muscles (the muscles supporting your bladder) and urinary sphincter muscles (muscles that control the release of urine).

Normally, as the bladder fills with urine and expands, the valve-like muscles in the urethra remain closed to prevent leakage of urine until you have reached the bathroom. However, if those muscles weaken and are not able to withstand pressure, then anything that exerts pressure on your pelvic and abdominal muscles can cause unintentional loss of urine.

Your sphincter and pelvic floor muscles may weaken because of:

  1. Type of childbirth/delivery.
  2. Previous pelvic or abdominal muscle surgery.
  3. Obesity/increased body weight.
  4. Smoking, which may trigger frequent coughing.
  5. Prolonged involvement in high-impact activities, such as running and jumping for several years.
  6. Age — the muscles weaken with increasing age.

You have stress urinary incontinence if you frequently leak urine when you:

  1. Sneeze
  2. Cough
  3. Stand up
  4. Laugh
  5. Have sex
  6. Get out of your car
  7. Exercise
  8. Lift something heavy

While stress incontinence does not imply that you will lose urine every time you do these things, you will most likely experience frequent leakage of urine when you engage in pressure-increasing activities.

Why should you undergo the sling procedure for stress urinary incontinence?

Having stress incontinence can be really awkward and embarrassing. In fact, with frequent leakage of urine, you may begin isolating yourself and limiting your social and work life. For instance, you may find it difficult to engage in exercise and in different leisure activities for fear of urine leakage. But with treatment, you can manage the incontinence and improve your overall quality of life and well-being. The sling procedure is ideal for you if you’ve tried other measures and still find urine leakage disruptive to your life.

How does the sling procedure work?

The sling procedure is aimed at closing your urethra and the neck of your bladder. For the procedure, your surgeon uses strips of synthetic mesh, animal tissue, donor tissue or your own tissue to develop a sling (hammock) that is inserted under your urethra or bladder neck. Once the sling is placed, it supports the urethra and ensures it remains closed — particularly when you are engaged in pressure-increasing activities such as coughing, laughing, sneezing or exercise — preventing the leakage of urine.

How is the sling procedure performed?

Before the procedure begins, you are placed under either general or spinal anesthesia. With general anesthesia, you will remain asleep throughout the procedure and will feel no pain. With spinal anesthesia, you are completely awake except that the area of your body from the waist down is numb and you don’t feel pain as the procedure is performed. Following application of anesthesia, the urologist places a tube (catheter) into your bladder to drain any urine already inside it.

The surgeon then proceeds to place the sling in any of the following ways:

1. Retropubic Method (Tension-Free Vaginal Tape/TVT Method): The surgeon makes a tiny incision inside your vagina, just under the urethra. Two other cuts are then made above your pubic bone — large enough to allow needles through. The surgeon uses a needle to place the sling beneath the urethra and behind the pubic bone. Using stitches or skin glue that is easily absorbed by the body, the surgeon closes off the cuts.

2. Single-Incision Mini Method: The surgeon makes a single tiny incision in the vagina, then passes the sling through it. No stitches are used to attach the sling, but over time the scar tissue grows and forms around it, keeping it in place.

3. Transobturator Method: The surgeon makes a tiny cut inside the vagina, just under the urethra. Two more cuts are made, one on each side of the labia (folds of skin on either side of the vagina). Using the incisions, the surgeon inserts the sling under the urethra.

At St Pete Urology, we perform hundreds of sling surgery procedures every year with remarkable results for our patients. The sling procedure is an outpatient operation that takes about one hour to complete and the patient is free to go home the same day. After the procedure, we arrange for follow-up sessions with our patients in the doctor’s office to assess the efficacy of the procedure and help with any complications that may arise. So if you are feeling embarrassed by stress urinary incontinence or have tried other measures without success, check with us to find out if the sling procedure can help you overcome the condition. For more information, visit the “St Pete Urology” site.

How can I prevent recurrent kidney stones

Kidney stones occur when tiny crystals form and stick together as solid masses in urine. Often, due to increased concentration of various chemicals in urine, crystals form and then grow into larger masses that move through the urinary tract. As they move, the stones may get stuck somewhere along the tract and block urine flow, causing pain. Most kidney stones are a combination of calcium with either oxalate or phosphate, but stones also may form when uric acid levels increase in urine as a result of protein metabolism.

Preventing kidney stone recurrence

For many people who have had a kidney stone, it is not a one-time thing. In fact, in about 50 percent of those who have had a stone, another one will appear within 7 years if no preventive measures are in place. At St Pete Urology, we ensure that our patients take the necessary steps to prevent a recurrence. That is why, after treatment, we conduct a special urine test on our patients to find out why the stone formed in the first place. Using the results of the test, we guide our patients on how best they can avoid a recurrence.

Some of the measures we recommend to avert kidney stone recurrence include:

1. Drinking enough water

Water dilutes urine, reduces the concentration of substances in it and prevents kidney stones. To prevent recurrent kidney stones, you should endeavor to drink enough fluid to pass at least 2 liters of urine per day. Increased fluid intake that is distributed throughout the day decreases kidney stone recurrence by about 50 percent and with virtually no adverse effects.

For better results, you may add orange juice or lemonade to the water so there is increased citrate in the fluid to block stone formation. Medication such as allopurinol, citrate or a thiazide diuretic can be taken with the fluid to minimize the chance of kidney stone recurrence. However, if you are already drinking that much fluid before your kidney stones, you should not increase your fluid intake.

2. Making dietary changes

Once you are treated for kidney stones, we will recommend that you reduce your intake of eggs, seafood, poultry, red meat and other animal protein. These foods increase uric acid levels while also reducing citrate levels in the body, which can trigger a recurrence of kidney stones. That is why after treatment for kidney stones, we recommend that you should cut down your daily meat portions to a size no larger than a pack of playing cards. Likewise, you should avoid foods such as chocolate, strawberries, wheat bran, beets, spinach, tea, rhubarb and most nuts that contain oxalate or the phosphate containing colas that may trigger kidney stone recurrence.

3. Increasing calcium intake

Oxalate levels may rise and trigger kidney stones if the level of calcium in the diet is low. So after treatment, it is important to ensure that you increase your calcium intake to match your age. For example, if you are a man 50 and older, you should get 1,000 milligrams of calcium every day, together with 800-1000 IU (international units) of vitamin-D to ensure your body absorbs the calcium properly. With increased dietary calcium, you can prevent a recurrence of kidney stones.

4. Reduced sodium intake

Kidney stones may recur if there is a lot of sodium in your diet because increased sodium leads to high concentration of calcium in urine. So after treatment for kidney stones, we usually recommend that you lower the amount of sodium in your diet, limiting your total daily sodium to 2,300 mg. But if sodium was responsible for your previous kidney stones, then we recommend that you should take at most 1,500 mg of sodium per day. Such a low level of sodium also will be good for your heart and your blood pressure.

Those are some of our most common recommendations for averting kidney stone recurrence. As you might have noticed, they are not complicated things to do, but they do require some commitment. For more information on prevention and treatment of kidney stones, visit the “St Pete Urology” site.

How To Treat Kidney Stones?

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

Stones come in different sizes

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

Pain due to kidney stones

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

Treatment of kidney stones

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

Types of treatments

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

1. Extracorporeal Shockwave Lithotripsy (ESWL)

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

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

2. Ureteroscopy (URS)

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

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

3. Percutaneous nephrolithotomy (PCNL)

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

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

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

Meet Dr. Adam Oppenheim

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

Becoming a urologist

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

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

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

What do we do as urologists?

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

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

Job Satisfaction

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

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

Why St Pete Urology

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

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