Can a vasectomy reverse itself after 14 years?

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.

What are the 4 stages of prostate cancer?

Key takeaways

  • 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.

  1. 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.

  1. 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.

  1. 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.

  1.     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/

References

What are the key signs of prostate cancer?

Key takeaways

  • Prostate cancer occurs when prostate cells grow and multiply uncontrollably, and can be malignant and life-threatening if it spreads to other parts of the body.
  • Early-stage prostate cancer does not have any unique signs or symptoms and is difficult to detect, making regular screening and testing important for early detection.
  • Common screening tests for prostate cancer include the PSA test and the DRE, and men who are 55-69 years old, African-American, or have a family history of prostate cancer should consider getting screened.

The prostate is a tiny, walnut-shaped gland in the pelvis. Located near the bladder and felt through a digital rectal exam, the prostate produces the fluid that transports and nourishes sperm. The fluid—called seminal fluid—is squeezed out via the urethra during ejaculation.

What is prostate cancer?

Prostate cancer occurs in the prostate when prostate cells grow and multiply non-stop. The growth of the prostate can either be benign or malignant. Benign growth of the prostate, also called benign prostatic hyperplasia, is rarely a threat to life as it doesn’t invade tissues around your prostate, doesn’t spread, and can be removed or shrink back.

On the other hand, prostate cancer is a malignant growth that can spread to nearby organs like the bladder or rectum and is, therefore, a threat to life. This cancer can spread to other parts of your body and may grow back after removal.

When prostate cancer cells break away from the prostate, they can spread through lymph nodes or blood vessels to other parts of your body. 

Upon spreading, the cancer cells attach to other tissues and grow to form new tumors that cause damage in the areas where they land.

Prostate cancer is one of the most common types of cancer. 

Although most cases of prostate cancers grow slowly and are restricted to the prostate gland, where they tend to cause little harm, some types of cancer are aggressive, spread quickly, and are life-threatening.

What are the key signs of prostate cancer?

Early-stage prostate cancer doesn’t have any unique signs or symptoms. It starts in the outer areas of the prostate and grows slowly. These areas are away from the urethra, so the growing tissue mass does not press against the tube and affects your urination.

There are no early urinary signs of prostate cancer. When symptoms occur, they are usually related to the non-cancerous condition called enlarged prostate or another health condition.

Nevertheless, as the tumor grows and spreads, it begins to affect the organs around the prostate. So with time, it will eventually show signs as it breaks out of the gland (locally advanced prostate cancer) or spreads to other areas of the body (advanced prostate cancer).

Unfortunately, even late-stage prostate cancer shares signs with other urological disorders, making it difficult to tell whether it is due to cancer or other conditions, such as prostatitis or benign prostate enlargement (BPH). 

That is why the key to establishing if you have prostate cancer is seeing a urologist, who will order tests to help find out what is causing the symptoms.

When they occur, the symptoms of prostate cancer include:

  1. Dull pain in the lower pelvic area
  2. Trouble starting to urinate or to empty your bladder
  3. Interrupted or weak urine flow
  4. Dribbling of urine after urinating or a feeling that the bladder hasn’t emptied properly
  5. Frequent urination, particularly at night
  6. Pain or burning sensation when urinating
  7. Difficulty having an erection, painful ejaculation, or decrease in the amount of ejaculate
  8. Blood in urine or semen
  9. Pain or pressure in the rectum
  10. Persistent pain in the back, hip, or pelvis
  11. Unexplained weight loss
  12. Bone pain
  13. Loss of appetite

Diagnosis of prostate cancer

Prostate cancer is highly treatable when detected early. But for the condition to be discovered early, frequent screening is necessary. 

Screening means you undergo testing even though you have no symptoms. The prostate-specific antigen (PSA) test and the digital rectal examination (DRE) are the most commonly used screening tests. Both help detect cancer early, although they aren’t perfect tests.

Speak with your urologist about whether or not you should undergo screening. Your doctor will assess your degree of risk and decide whether you should have the PSA test and the DRE. Generally, you should be screened if you are 55-69 years or older, African-American male, or have a family history of prostate cancer.

If the screening tests show that you might have cancer, your doctor will recommend a biopsy for confirmation. The decision to have a biopsy is based on the PSA and DRE results. Your doctor will also consider family history, ethnicity, and other health factors.

At St Pete Urology, we offer screening, diagnosis, and treatment of prostate cancer. Through our patient-centered, compassionate approach to care, we have ensured that most of our at-higher-risk clients are enrolled in screening.  

We have employed a collaborative, multidisciplinary approach that ensures all our patients get the best possible care. 

Call us today for more information on prostate cancer and other urology disorders.

References

Can you still have Orgasm after Vasectomy?

Men, we all desire to be good husbands and partners. Many of you may have seen your wife or partner experience the adverse effects of some contraception. Some will want to help alleviate this unfortunate circumstance.

The option of undergoing vasectomy may come up. This procedure is one big step to take a lead role in family planning and protect your partner. However, you may also have concerns about how it will affect your sex life afterward.

The good news is, vasectomy will not adversely affect your sex life.

It will neither reduce your sex drive nor affect your ability to have an erection. It will not affect your ability to ejaculate or have any difference in the amount of semen you ejaculate.

No effect on testosterone production

Your male characteristics depend on the hormone testosterone. Produced in your testicles and responsible for secondary sexual characteristics, testosterone is the hormone that maintains your libido (sex drive), sensation, and ability to have an erection and an orgasm.

An average testosterone level after vasectomy means you maintain the same level of sexual performance and satisfaction after the procedure.

So does a vasectomy affect your testosterone level? No. Your testicles continue to produce testosterone after the procedure, just as they did before the surgery. The operation is done on the vas deferens and not on your testicles, which means there are no effects on testosterone production. Plus, it means you continue to have normal erections, ejaculations, and orgasms.

If you experience a drop in testosterone after vasectomy, the reduction may be unrelated to the procedure. Such a reduction is often due to diminished function of the testes (hypogonadism), which is linked to age.

Hypogonadism affects 1 in 50 men aged 40-79 years. It is more common in men with diabetes, kidney disease, heart disease, or those taking certain medications, such as steroids. It may also be due to stress, depression, or too much alcohol.

If you notice any drop in your sex drive after vasectomy or feel you might have symptoms of low testosterone, speak with your doctor for help.

Normal ejaculations

A vasectomy does not significantly affect the quantity of the ejaculate. While the procedure ensures that the sperm made in the testicles do not pass through the vas deferens to reach the urethra, it doesn’t noticeably change the quantity of fluid you ejaculate.

In a typical ejaculation, the semen produced in your seminal vesicles and prostate gland forms 95-98 percent of the ejaculate. And so, since sperm only makes 2-5 percent of the ejaculate, preventing sperm from being included in the semen doesn’t make a big difference in the volume of the ejaculate. You will not even realize the difference in your ejaculations.

Remember that the procedure does not stop sperm production. Your testicles will continue to secrete sperm throughout your life; only that the sperm will not reach the urethra to be added to the semen before ejaculation.

During a vasectomy, your vas deferens is cut and blocked to stop sperm and make it impossible for them to travel to the urethra. The sperm dies and is absorbed by the lining (membrane) of the epididymis, where they dissolve naturally. The absorption process doesn’t interfere with testosterone production, erections, or orgasms.

Enhanced orgasms

With a vasectomy, you will feel relieved from the anxiety or stress of an unplanned pregnancy. And, with that freedom, your lovemaking will be more spontaneous, sensual, frequent, and intense.

Recent studies have shown that the procedure isn’t only reliable but boosts sex drive in men and ensures stronger erections and better orgasms without the risk of pregnancy.

Safe, effective vasectomy

Want to have a vasectomy but have questions before the procedure?

At St Pete Urology, we do vasectomies every week and guide men to make the right family planning decisions. We will listen to your concerns, give you the right advice, and help you make an informed decision.

Over the years, we have seen our clients undergo vasectomy procedures and report results that make us proud. We are happy that our patients retain the highest level of sex drive, firmer erections, unchanged ejaculation, and regular orgasms after the procedure.

If you’re considering having a vasectomy at St Pete Urology, you shouldn’t fear it would affect your sex drive or orgasms. We can guarantee that your sexual performance and satisfaction will only get better. 

What is sex like with a penile prosthesis

There is no such thing as “normal” when it comes to sex. What you like isn’t necessarily what another person likes. How important it is to you and how often you want it is also a personal preference, but what is common for everyone is the desire to have a pleasurable sexual encounter.

Men with erectile dysfunction who intend to have a penile implant inserted into their penis often want to know how it would impact their sexual pleasure.

Strong, reliable erection

A penile prosthesis enables you to have an erection that is strong enough for satisfactory sex. You will have an erection similar to a natural erection and will not have problems keeping it throughout sexual intercourse.

At St Pete Urology, we offer both inflatable and non-inflatable penile implants. An inflatable implant has two rods filled with fluid from a reservoir near the bladder. As the rods fill, the penis becomes erect. When there is no fluid in the rods, the penis is fully deflated and unnoticeable.

With the non-inflatable implant, a single rod is surgically implanted within the erection chamber of your penis. The rod keeps the penis in a semi-rigid state so that you merely need to lift it into position or adjust it by hand for sexual intercourse.

Regardless of whether the implant is inflatable or in a semi-rigid state, it will support your penis without making it larger or affecting the shape of its head. Expect your penis to be erect to about the same size as before you got the implant, and provide enough hardness for penetration and satisfying sex.

Unhindered sensitivity

A penile prosthesis does not affect the sensitivity of the penis, its glans, or its skin. You will not lose sensitivity and will generally respond to sexual stimulation. You will also have no limitations such as axial effort, traction, or your partner tightening the penis during sexual intercourse.

You can still enjoy different positions and enjoy normal orgasm and ejaculation—deriving maximum pleasure from your sexual encounters. The penis stays rigid even after orgasm, and it is up to you to choose to release the valve to remove the fluid from the rods and end the erection. You should also make sure to have good lubrication during intercourse.

Once you have a penile prosthesis, it may destroy your natural erection reflex. You should have the implant only when recommended by your urologist.

Hidden and unnoticeable

Due to the small incision made for the procedure, the healed scar after penile implant surgery is subtle and hidden to casual observers. The implant will be fully concealed and remain private. You can freely enjoy sex without worrying about your partner knowing you have an implant.

No one will be able to tell that you have a penile prosthesis until they see the small scar at the bottom of your penis. Even in the shower or locker room, it will remain undetectable.

Do you have erectile dysfunction? Would you like to restore your sexual function? At St Pete Urology, we understand that erectile dysfunction can severely impact your relationships and your quality of life. We offer various solutions that can help you with this predicament.

We typically recommend a penile prosthesis for patients who have not found the other ED treatments effective. After the implant surgery, patients can expect to enjoy healthy sex lives, enhanced self-esteem, and more satisfying relationships.

Schedule a consultation with one of our skilled and experienced surgeons at St Pete Urology to find out if a penile implant could be an excellent option for you

ST PETE UROLOGY IS FIRST TO OFFER NEW MEDICAL TECHNOLOGY FROM MEDTRONIC TO TREAT PEOPLE SUFFERING FROM INCONTINENCE

 

Contacts:

Phone: (727) 822–9208
Fax: (727) 822–9211

StPeteUrology@gmail.com

ST PETE UROLOGY IS FIRST TO OFFER NEW MEDICAL TECHNOLOGY FROM MEDTRONIC TO TREAT PEOPLE SUFFERING FROM INCONTINENCE 

The New FDA Approved InterStim™ Micro is the Smallest and Fastest Rechargeable Bladder and Bowel Control System with Conditional Full-Body MRI

Full-Body MRI Conditional InterStim™ II and InterStim™ Micro Systems Give Patients a Choice Between Sacral Neuromodulation Devices to Suit Their Lifestyle

ST PETERSBURG, FL – JUNE 28, 2021 –  St Pete Urology is one of the only medical providers in St. Petersburg, FL to offer new solutions to the millions  of people who suffer from incontinence thanks to technology advancements from Medtronic — the world’s leading provider of therapy for bladder and bowel control issues. 

More than 37 million adults in the United States – almost one in six – suffer from overactive bladder (OAB) and nearly 18 million Americans – about one in 12 – have fecal incontinence (FI).1-4 It is life-altering because many sufferers limit their lives socially, professionally, and personally,5 but it is  treatable. The new InterStim™ II and InterStim Micro systems provide patients with safe, effective relief from OAB and FI. The InterStim™ II recharge-free system offers patients freedom from a recharging routine, the hassle of recharging components, and a reminder they have a disease. The rechargeable InterStim™ Micro system, the smallest device available in the sacral neuromodulation (SNM) market, benefits patients who want a smaller, longer lasting device. Both systems are full-body* conditional MRI and deliver the same therapy with long-term relief.

“Effective long-term bladder and bowel control is an unmet medical need by many in the St. Petersburg area who experience regular accidents and/or frequency issues associated with OAB and FI. It can significantly impact all aspects of a person’s quality of life – self-confidence, exercise, activities and even intimacy,” said Adam Oppenheim, DO. “By partnering with Medtronic, the trusted leader in SNM therapy, my goal is to help give patients a life without limits.” 

Known as sacral neuromodulation (SNM), the therapy is delivered by the InterStim™ system – an implanted medical device that provides gentle stimulation to the sacral nerve and is thought to normalize the brain-bladder connection to alleviate symptoms. Medtronic developed SNM therapy more than 25 years ago in partnership with physicians who specialize in treating incontinence. Recent technology advancements from Medtronic now gives patients lifestyle-friendly choices in the type of InterStim system they choose; improved battery technology; conditional full-body MRI; and the smallest and fastest charging device on the SNM market.

“I must say, I was very impressed with EVERY aspect of my visit with Dr. Oppenheim. His knowledge goes without saying. Top notch. I was taken aback, though, by his patience and kindness. He took the time to listen patiently to the questions I had. I didn’t feel rushed. He answered those questions in a way that was very easy for me to understand. The staff that I encountered were friendly and assistive. I was also glad that any procedures/tests that he recommended I need are done right there at the office, not a hospital. His office and the building in which it’s in is very easy to find. Overall, a great experience. Should the need arise for anyone I know to need a urologist, I’m definitely recommending Dr. Oppenheim and his staff.”

“For much too long, my life revolved around where I would find the next bathroom,” said Wes Linkovich. “I’m so glad I finally sought help and was open-minded about sacral neuromodulation. My therapy fits well with my lifestyle and, finally, I can focus on the things I love. To anyone suffering in silence, please ask your doctor or urologist about the InterStim™ system from Medtronic. I wish I done this sooner.”  

Not every patient receives the same benefit, and there are potential risks, which may include surgical, device and stimulation risks.6   St Pete Urology will explain the benefits and risks and help each patient find their best treatment. 

About St Pete Urology

Drs. Reid Graves, Nicholas Laryngakis and Adam Oppenheim are dedicated to serving the urological needs of the Tampa Bay and surrounding communities. We strive to provide state-of-the-art diagnosis and treatment and believe in rendering the least invasive, most efficacious treatment of urological disorders in a kind, empathetic, manner. We treat each patient as a partner in his or her medical care and make patient education a central component of our care. Because many urological conditions are accompanied by social discomfort or embarrassment, we emphasize sensitivity and discretion when dealing with all of our patients’ concern

-end-

*Under certain conditions; see approved labeling for details. Patients with InterStim™ SureScan™ MRI leads only
References:

  1. Stewart WF, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003 May;20(6):327-336.
  2. United Nations, Department of Economic and Social A airs, Population Division (2011). World Population Prospects: The 2010 Revision, CD-ROM Edition.
  3. United States Quick Facts. United States Census Bureau Web site. Available at: https:// www.census.gov/quickfacts/table/ PST045215/00. Accessed July 19, 2016.
  4. Whitehead WE, Borrud L, Goode PS, et al. Fecal Incontinence in US adults: epidemiology and risk factors. Gastroenterology. 2009;137(2):512- 517.
  5. Dmochowski RR, Newman DK. Impact of overactive bladder on women in the United States: results of a national survey. Current Medical Research and Opinion. 2007;23:65-76.
  6. Link to Important Safety Information

What is the fastest way to cure erectile dysfunction

For a man, erectile dysfunction can be a serious issue. When sex stops, your relationship problems may begin or worsen.The occasional inability to have an erection that is firm enough for sexual intercourse is normal. However, when the problem persists for a while, it points to a deeper issue that should be addressed immediately. Without treatment, ED can make sexual intercourse impossible.

So what is the fastest way to cure erectile dysfunction?

1. Make lifestyle changes
If you have erectile dysfunction, you can get quick results by making a few lifestyle changes that ensure enhanced blood flow to the penis and help achieve harder erections.

For example, if you quit smoking, lose weight, or exercise regularly, you may see an improvement in your sexual function. You may also need to speak with your doctor if you suspect that a medication you are taking contributes to your ED. Your doctor may change or withdraw the medication.

2. Using oral medication
You can get quick results through oral medications such as Viagra, Cialis, Levitra, Staxyn, or Stendra. These pills boost blood flow to the penis during sexual arousal, making it possible to achieve an erection that is firm enough for satisfactory sexual intercourse.

These pills require a doctor’s prescription to guarantee safety and should not be taken more than once per day. They are taken 30-60 minutes before sexual activity. Cialis can be taken up to 36 hours before sexual activity and comes with a lower daily dose.

3. Injectable drugs
If you don’t like pills, injectable medications for ED can help you achieve a stronger erection. They are injected directly into the penis and work by widening the blood vessels, making the penis engorged with blood.

Alternatively, you can use a medicated pellet that you insert into your urethra to trigger an erection within a few minutes.

If you are considering injectable drugs as an option, please make sure to discuss the details with your urologist.

4. Vacuum devices
Also called pumps, vacuum devices provide an alternative to medication. To use the pumps, you place your penis inside a cylinder connected to the pump. The pump draws out air from the cylinder to create a partial vacuum around the penis. As a result, blood rushes into and fills your penis, causing an erection.

You will have an elastic band around the base of your penis to maintain the erection during intercourse. But if you are considering using a vacuum device, it is important to discuss its proper use with your urologist because the elastic band must be used correctly to avoid potential penile damage.

5. Penile implant surgery
If you have tried pills and other less invasive options without success, you may need to undergo penile implant surgery. This option is ideal if your penile blood vessels have been damaged by severe diabetes or during radical prostatectomy. You may also need to undergo penile implant surgery if you have structural problems that make erections difficult or impossible.

There are two basic types of penile implants: inflatable and non-inflatable. The non-inflatable (malleable) implant is a single rod that can be shaped by hand to create an erection. The inflatable implant has two rods filled with fluid from a reservoir located near the bladder.

When you desire an erection, you use the pump to fill the rods with pressurized fluid. As the rods fill, the penis becomes erect and broader. The prosthesis leaves the penis completely deflated when there is no fluid in the rods, making the penis implant unnoticeable.

Want to overcome erectile dysfunction fast?

At St Pete Urology, we offer various safe, effective treatments for erectile dysfunction, including medications, injections, vacuum devices, and penile implants.

We are proud of what we have been able to achieve for our patients. In most cases, our patients have the same level of sexual satisfaction and ability to ejaculate that they had before the erectile dysfunction.

If you have trouble with erections, speak with our skilled urologists and begin your journey to a life of renewed self-esteem, confidence, and optimum sexual function. For more information about effective treatments for erectile dysfunction, visit the St Pete Urology website.

What Foods Are Good For Kidneys?

Kidneys play a significant role in the overall health of the body. They filter out waste products from blood and send them out of the body as waste through urine. The kidneys also balance fluid and electrolyte levels in the body while making hormones that regulate the function of other organs of your body. But to keep your kidneys healthy, you need to watch what you eat and drink because some foods boost the performance of the kidneys while others stress, degrade and damage them.

What foods support healthy kidneys?

Kidney-friendly foods are those that enhance kidney function and protect them from damage. Generally, a good balance of quality protein, calories, vitamins, and minerals are great for the kidneys. Very high dietary levels of some mineral ions such as sodium, potassium, phosphorus and calcium may in the long run endanger your kidneys. Foods linked to heart problems and high blood pressure may put additional pressure on the kidneys.

For healthy kidneys, consider the following:

1. Stay Hydrated

Water helps to flush out toxins from the body. In fact, the body relies on water to assist transporting toxic wastes into the bloodstream, then to the kidneys where they are filtered and removed through urine. This process helps reduce the risk of bacterial infection, kidney stones, and kidney disease, which is why water is crucial for the critical salt-fluid balance in the body.

Ideally, you should drink 6-8 glasses of water per day, but of course you can drink more if you are active during the day. In addition to the many other benefits of staying hydrated, drinking water when thirsty helps to support your kidneys.

2. Apples and mushrooms

Apples are rich in fiber. One of the fibers, called pectin, helps to reduce various risk factors for kidney disease, such as high blood sugar and cholesterol levels. Apples also have anti-inflammatory constituents, prevent constipation, protect against heart disease, and lower the risk of cancer. You might also consider eating mushrooms for their high levels of vitamin D, which boosts kidney function.

3. Sweet potatoes

Sweet potatoes have a robust fiber profile. They break down very slowly in the body which helps to support low insulin levels. Sweet potatoes also have a healthy amount of vitamins and minerals, such as potassium which helps to balance sodium levels in the body and reduce the effect of sodium on the kidneys. However, since they contain high levels of potassium, sweet potatoes are not ideal for those with chronic kidney disease (CKD).

4. Berries

Dark berries, such as strawberries, raspberries and blueberries are a great source of nutrients and antioxidants and for most people protective for the kidneys.

5. Dark leafy vegetables

Leafy vegetables such as kale, spinach and chard contain a wide variety of vitamins, fibers, and minerals that support kidney function. While they do supply a number of protective compounds, dark leafy vegetables are highly rich in potassium and therefore less suitable for those with chronic kidney disease (CKD), restricted diet, or patients on dialysis.

6. Kale and cauliflowers

Kale is a terrific source of vitamins A and C which reduce inflammation, boost the immune system and protect the kidneys. Kale is also lower in potassium compared to other greens, and contains lots of iron. Like kale, cauliflower is rich in vitamin C and also has plenty of fiber and folate that are crucial for kidney function. Likewise, cauliflower contains compounds that improve the liver’s ability to neutralize toxic substances and reduce the stress on the kidneys.

7. Fatty fish and egg whites

Tuna, salmon and other cold-water, fatty fish have high omega-3 fatty acids. The omega-3 fatty acids in these fish are heart protective and also healthy for the kidneys. Since high blood pressure is a risk factor for kidney disease, fatty fish is a great way to improve your cholesterol profile and protect your kidneys.

Foods to avoid include:

1. High salt

Elevated salt levels raise blood pressure making the heart and kidneys work extremely hard. You can control your salt intake by cooking at home and avoiding most fast foods which are sky high in sodium.

You can also try substituting new spices and herbs in place of salt and by avoiding packaged and pre-cooked foods, such as soups, frozen dinners, and boxed meals that usually have extra salt. Similarly, you should avoid table salt and high-sodium seasonings like soy sauce, garlic salt and sea salt.

2. Foods rich in potassium

While potassium helps your nerves and muscles to work properly, too much of it can lead to serious heart problems and eventually to kidney issues. Potassium is found in most fruits and vegetables, such as bananas, oranges, avocadoes, raw carrots, cooked broccoli, potatoes, greens, tomatoes, and melons.

Instead of these high potassium foods, try alternatives such as apples, cranberries, blueberries, raspberries, and strawberries. Other good options are pineapples, peaches, plums, asparagus, cabbage, cucumber, and beans (green and white).

3. Limit phosphorus and calcium

Phosphorus and calcium are great minerals for keeping your bones healthy and strong. But high levels of phosphorus may increase the risk of long-term kidney disease. Since most foods that contain phosphorus are also equally rich in calcium, the body’s levels of the two minerals can be controlled by similar mechanisms.

If your doctor suggests limiting phosphorus, avoid foods such as red meat, dairy products, nuts, fish, most grains, and legumes. Consider replacing these foods with healthy foods that are lower in phosphorus, such as fresh fruits and veggies, rice, corn and fish.

At St Pete Urology, we encourage our patients to take care of their kidneys through healthy behaviors—exercise, drinking plenty of water and eating a balanced diet. We also perform surgeries and treat urination problems such as incontinence, tumors, cysts, growth and stones of the urinary system, as well as problems of the male reproductive system. For more information on kidney disorders and their treatment, visit the St Pete Urology website.

Overcoming an Overactive Bladder

Overactive bladder (OAB) is an uncomfortable and stressful condition. Characterized by a sudden involuntary bladder contraction that triggers a compelling urge to pass urine, OAB may lead to urine leakage or the need to pass urine several times during the day or night. As a result, having an overactive bladder makes it difficult to go through the day without several visits to the bathroom.

Bothersome Symptoms

While the symptoms of OAB may be less troublesome when you are at home, they can be a problem in a public or unfamiliar place. No one wants to rush out of meetings with important clients or friends for fear of not making it to the restroom in time.

The fear instilled by overactive bladder can interfere with your ability to go out with friends, work, exercise, and even sleep. It can also disrupt your sex life, leave you tired and short-tempered, or cause rashes or infection due to the leaks. And the whole experience may leave you feeling unhappy and hopeless.

Strategies for Overcoming Overactive Bladder

The good news is that overactive bladder can be controlled. In fact, many patients overcome OAB without the need for invasive medical and surgical procedures. The key to successful treatment is seeing a urologist early to assess your condition and identify steps to help you manage the symptoms and regain control over your bladder.

Lifestyle measures may include changing what you eat or drink, pelvic floor exercises, and pre-planned bathroom visits. When lifestyle changes are unsuccessful, medical and surgical interventions may be necessary.

Behavioral Changes

1. Reducing fluid intake

Restricting fluid intake reduces your urinary output and helps control OAB symptoms. Since the symptoms of overactive bladder usually occur after a certain critical urinary volume is reached in the bladder, limiting fluid intake ensures it takes longer to reach this critical volume.

By consuming most of your fluid before 7 PM, you can lessen your nocturnal frequency. If you are on diuretic medications, you can check with your urologist to see whether they can be changed.

2. Limiting foods and drinks that trouble your bladder

Alcohol and caffeine (present in coffee, tea, colas, chocolate and some energy drinks) irritate the bladder and increase urinary output. By reducing the intake of these beverages and foods, you can improve your bladder control.

Foods such as fruits and vegetables have hidden water content, so you can limit additional beverages when eating healthy fresh produce. You might also want to reduce or abstain from spicy foods, citrus fruits, and artificial sweeteners, foods made with tomatoes, soda, and other fizzy drinks.

Because the chemical constituents of tobacco constrict blood vessels, impair blood flow, decrease oxygenation, and promote inflammation—affecting the bladder, urethra and pelvic floor muscles—quitting cigarette smoking will improve your OAB symptoms.

3. Keep a bladder diary

Writing down the time and triggers for your trips to the bathroom can help you understand your body better. After a few days, your diary will show you the things that make your symptoms worse. For instance, you may realize that your symptoms get worse after you eat or drink a certain food. This helps you to decide what changes to make in your diet.

4. Weight loss and regular exercise

Excess weight puts pressure on the urinary bladder and worsens overactive bladder. Even modest weight loss may improve your overactive bladder symptoms.

Lower impact exercises, such as yoga, cycling, Pilates, and swimming, can help to alleviate pressure on the urinary bladder by boosting core muscle strength and tone. As a result, OAB symptoms improve.

Due to the proximity of the rectum to the bladder, a full rectum can put pressure on your bladder, resulting in worsening of urgency, frequency and incontinence. Taking steps to avoid constipation will improve bladder control.

Voiding Measures and Bladder Retraining

You can overcome overactive bladder by managing how and when you void. Ways to manage voiding include delayed (inhibited) voiding, timed voiding, and double voiding. Bladder retraining gradually imposes increased intervals between voids and establishes a more normal pattern of urination.

Delayed voiding means you practice waiting before you can go into the bathroom, even when you feel the urge. At the beginning, you may try waiting a few minutes, then gradually increase your waiting time to achieve a delay of up to 2-3 hours.

By timed voiding, you follow a daily pre-planned bathroom schedule. That is, instead of going to the bathroom every time you feel the urge, you go at set times during the day. For example, you may try to pass urine every 2-4 hours regardless of whether you have the urge to go or not. The goal of doing this is to prevent an urgent uncontrollable feeling and to regain control over your bladder.

Double voiding (emptying your bladder twice) helps if you have trouble emptying your bladder. After you go to the bathroom, try again a minute later.

Pelvic Floor Muscle Training

Pelvic floor muscle exercises, also called Kegel exercises, help to stimulate inhibitory reflexes between the bladder and the pelvic floor muscles. By exercising your pelvic floor muscles rhythmically, you can inhibit involuntary contraction before and after it begins.

Kegel exercises target muscles that relax the bladder. To perform the exercises, you should begin by mastering the presence, location, and nature of the pelvic floor muscles. A simple means of identifying the muscles is to start urinating and then, when about halfway completed, to abruptly stop the urine stream.

Once you locate the muscles, squeeze them just before and during the trigger for urgency or incontinence. This will diminish the urgency and help avoid the incontinence. When performing Kegel exercises, always squeeze and relax the muscles repeatedly when you feel the urge to pass urine.

Medications

Bladder relaxant medications can help you suppress overactive bladder symptoms, although you may need several trials of different medications or combinations of medications to achieve optimal results.

Your urologist will prescribe medication either in conjunction with behavioral modification or after behavior modification has been tried unsuccessfully. The drugs prevent involuntary contractions of the bladder muscles by relaxing and stabilizing them.

Biofeedback and Botox injections

Biofeedback is an adjunct to training pelvic floor muscles in which electronic instrumentation is used to transmit feedback information about pelvic floor muscle contractions. It enhances awareness and strength of pelvic floor muscles.

In other cases, your urologist may opt for Botox—a simple procedure usually done in the doctor’s office—where it is injected directly into the bladder muscle to help reduce OAB symptoms. Once injected, Botox helps to relax areas of the bladder where it is injected. Botox injections generally last 6-9 months and are covered by Medicare and most insurance companies.

Percutaneous Tibial Nerve Stimulation (PTNS) and Interstim

PTNS is a minimally invasive form of neuro-modulation. A tiny acupuncture-style needle is inserted near the tibial nerve in the ankle and a hand-held stimulator used to generate electrical stimulation with the intent of improving OAB symptoms. The procedure is performed once every week for 12 weeks.

In some cases, your urologist may opt for the more invasive form of neuro-modulation, called interstim. During the interstim procedure, electrical impulses are used to stimulate and modulate the sacral nerves in the effort to relieve OAB symptoms. A battery-powered neuro-stimulator (bladder “pacemaker”) is used to provide the mild electrical impulses that are carried by a small lead wire to the stimulated sacral nerves affecting bladder function.

Surgery for Overactive Bladder

Treating OAB with surgery is not common and is usually reserved for cases where other treatment plans have failed. Surgery may increase the physical size of the bladder by using portions of the bowel to replace and expand a section of the bladder.

At St Pete Urology, our approach to helping you overcome overactive bladder includes lifestyle changes and medical treatments such as prescription drugs, bladder Botox treatment, nerve stimulation, and surgery. Our specialist team of urologists is experienced at dealing with overactive bladder through proper diagnosis and treatment. You can be sure your consultation will lead to a recommendation of the best possible treatment options for you. Schedule your appointment with us and begin your journey to freedom from overactive bladder. For more information on overcoming overactive bladder and other urologic conditions, visit the St Pete Urology website.

What Causes Low Sperm Count?

Low sperm count, which means having fewer than normal sperm in the ejaculate, decreases the likelihood that your sperm will fertilize your partner’s ovum and result in pregnancy. But it may also be related to your overall health, as it is often characterized by symptoms such as pain, swelling or a lump in the testicle area, low sex drive, erectile dysfunction, or decreased facial or body hair. Your sperm count is lower than normal if you have fewer than 15 million sperm per milliliter of semen.

What are the causes of low sperm count?

1. Emotional stress and inadequate sleep

Prolonged or severe emotional stress may interfere with the hormones needed to produce sperm, while depression lowers sperm concentration. Inadequate sleep makes it difficult to maintain a healthy weight and may lead to obesity. Obesity impairs fertility by directly impacting sperm and causing changes in the hormones that promote sperm production.

2. Overexposure to harmful chemicals

Chronic exposure to pesticides and other harmful chemicals can lead to low sperm count. For instance, prolonged exposure to industrial chemicals, such as xylene, toluene, benzene, herbicides, pesticides, organic solvents, BPA, perfluorinated chemicals, lead, and painting materials may lead to low sperm count. Likewise, when exposure to radiation or x-rays lowers sperm production, it can take years for sperm production to normalize.

3. Lack of exercise

Exercise plays a huge role in the health of your sperm. Men who sit for longer periods tend to have a lower sperm count than those who are active in their daily life. This means you can improve your numbers through moderate routine exercise every day, such as a daily walk for lunch or daily yoga in the evenings. Frequent exercise will increase your circulation, boost your mood, and increase your sperm count.

4. Overheating of the testicles

Exposure to high temperatures impairs sperm production and function. This is why frequent use of hot tubs or saunas temporarily lowers sperm count. Similarly, wearing tight clothing, sitting for long periods or working on a laptop for a long period of time may raise the temperature around the scrotum and reduce sperm production.

5. Drug and alcohol use

Anabolic steroids that are taken to stimulate muscle growth and can cause testicular shrinkage and decreased sperm production. Use of cocaine or marijuana also lowers sperm number and quality, while excessive drinking of alcohol lowers testosterone levels and hampers sperm production. Men who smoke tend to have a lower sperm count than those who do not.

6. Infection, medications and prior surgery

Some infections interfere with sperm production and sperm health. They include epididymitis (inflammation of epididymis), orchitis (inflammation of testicles), sexually transmitted infections (like gonorrhea, Chlamydia and HIV), and mumps infection. Also, long-term anabolic steroid use, cancer medications, testosterone replacement therapy, some ulcer medications, some antifungal and antibiotic medications, and other medications can hinder sperm production and lower sperm count.

Prior surgeries such as a vasectomy, scrotal or testicular surgery, inguinal hernia repair, prostate surgery, and large abdominal surgery for testicular or rectal cancer may affect sperm production. Similarly, tubes that carry sperm may be blocked by injury from surgery, trauma, prior infections, or abnormal development such as cystic fibrosis. Spinal cord injuries, diabetes and surgeries can block the normal flow of sperm and lead to retrograde (backward) ejaculation.

7. Certain medical conditions

A varicocele, the swelling of veins that drain the testicle, impairs testicular temperature regulation and causes low sperm count. Anti-sperm antibodies, which are immune cells that mistakenly identify sperm as harmful invaders, may destroy sperm and lead to low sperm count.

Undescended testicles, Peyronie’s disease, sperm duct problems, vas deferens blockages, unhealthy prostate, high blood pressure, diabetes, peripheral vascular disease, tumors that affect male reproductive organs directly, and hormonal imbalances may impair sperm production and lower sperm count.

What should you do to improve your sperm count?

  1. Eat healthy
  2. Exercise regularly and minimize your sitting time
  3. Don’t smoke
  4. Reduce or abstain from alcohol
  5. Avoid illicit drugs
  6. Use protection (condoms) during sexual intercourse
  7. Manage stress
  8. Get enough sleep
  9. Maintain a healthy weight
  10. Avoid exposure to pesticides, heavy metals, and other toxins
  11. Keep your laptop away from your lap
  12. Speak with your doctor about medications that can affect your sperm count
  13. Avoid frequent hot showers or hot tubs.
  14. Avoid tight pants

Maintaining a high sperm count is not necessarily difficult. All you need is some good habits such as healthy eating, regular exercise, comfortable clothes, and avoiding toxins. You should also speak with your urologist about possible remedies.

At St Pete Urology, we offer a variety of treatments for low sperm count, including lifestyle changes and minimally invasive procedures. We make sure to conduct thorough physical exams, medical history, and diagnostic tests to establish the underlying cause of the low sperm count before we recommend treatment. Meet with one of our urologists and start your journey to healthy fertility. For more information on male fertility, erectile dysfunction and other urologic issues, visit the St Pete Urology website.