What is Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS)?

Bladder pain syndrome (BPS), medically known as interstitial cystitis (IC), is not easy to diagnose. It is a chronic health issue that causes pain and pressure in the bladder region and usually lasts at least six weeks without an infection or other clear cause. The pain may be mild, moderate or severe.

Symptoms

Pain, pressure, or tenderness may occur around the bladder, urinary tract, pelvic area and/or genitals and worsen during sexual intercourse. The pain may be either intermittent or constant, and may intensify as the bladder becomes full.

People with IC/BPS may find themselves urinating more frequently than normal. As the condition worsens, the urgency for urinating will increase. Sometimes even after urinating, there is still a feeling of not having finished. As a result, social life, sleep and concentration at work can all be impacted depending on the severity of IC/BPS.

Causes

Although there are theories about what may cause IC/BPS, the causes are not clearly understood or proven, and therefore treatments vary. It could be that IC/BPS symptoms are due to a combination of conditions. There may be a bladder tissue problem. Mast cells may cause inflammation. A chemical in the urine may damage the bladder. Some nerve cells may change. It is even possible there is an immune system response involved. In this sense, IC/BPS is like the term cancer; it has some definite symptoms, but the possible causes are many. Thankfully, while uncomfortable, unless IC/BPS in a patient is caused by cancer, it is rarely a serious medical problem.

Diagnosis

To treat IC/BPS, your urologist will want to know your medical history, symptoms, diet, prescriptions and over-the-counter supplements. Because it is difficult to pinpoint a particular cause, diagnosis is more a matter of ruling problems out. Typically, there are two aspects to this approach to medicine. The tests that are inexpensive, non-invasive and easy are usually done first.

Typical physical and neurological exams will check pain levels and the ability to urinate completely (a voiding test). Commonly used invasive tests include urodynamic evaluations and cystoscopy. A urodynamic evaluation is when the bladder is filled with a small catheter to check the bladder and patient responses. Cystoscopy requires the insertion of a special tube with a camera to visibly examine the urethra and bladder. If the urologist notices an ulcer, or a stone, or something that can be worked on, the doctor can do the procedure through the tube.

Treatments

IC/BPS can often be minimized or eliminated through some simple lifestyle changes. Diet can be an issue for some types of the condition and minimizing acidic foods might help. Some types of physical therapy, including manipulative physical therapy, may work and reducing stress can bring about an improvement.

A number of prescription drugs have been found useful. But one of them, pentosan polysulfate, may take up to six months of treatment before symptoms are relieved. A bladder ulcer can be cauterized or given steroid injections. Botox© may be effective, but these treatments usually wear off and may need to be repeated.

In most cases, it is best to assume IC/BPS is in remission, not cured. The best plan is to keep the changes that work and continue to avoid activities that may have aggravated the condition in the past. If you have pain in the pelvic or bladder area, visit St Pete Urology for a diagnosis and treatment plan that could put you on a path to resuming your normal, pain-free lifestyle.

What Causes Bladder Incontinence

Urinary incontinence is basically the loss of bladder control or leaking urine. Women experience urinary incontinence twice as frequently as men. One reason for this difference is that childbirth and pregnancy, as well as menopause, can contribute to making urinary incontinence more likely. There are two common types that affect women, stress incontinence or urge incontinence (or overactive bladder, also known as OAB).

Urine is made by the kidneys and is stored in the bladder. There are muscles in the bladder that tighten, causing a need to urinate. When these muscles tighten, urine is forced out of the bladder through the urethra. Urination happens when the sphincter muscles surrounding the urethra relax, letting urine out of your body. Urinary incontinence can make you leak small amounts of urine, or release larger amounts of urine suddenly.

For women, urinary incontinence may happen regardless of age, but it’s most likely to occur in older women. Almost half of women 65 and older have some type of urinary incontinence.

Signals that you have an incontinence issue that merits seeing a urologist include spasms or pressure in the pelvic area, causing an urgent need to urinate. Also frequent trips to the bathroom, for example, more than eight times per day or more than two per night while you sleep.

Your doctor will give you a plan of treatment, starting with steps that you can do at home. If these activities don’t improve symptoms, your doctor might recommend seeing a urologist or recommend other treatments, depending on whether you have urge incontinence or stress incontinence, or both.

What You Can Try at Home

Your doctor, nurse or urologist may suggest exercises that you can do at home. These preventative activities may stop urinary incontinence, or help you leak less.

Here are some of the activities that may be prescribed:

  • Kegel exercises. Kegel exercises targeted to strengthen the pelvic floor can help. However, some women’s pelvic floor muscles remain tightened all the time. In those cases, Kegel exercises not only will not help your urinary symptoms but they may cause more problems.
  • Bladder training. Going to the bathroom at regular times can help control an overactive bladder and help urge incontinence. You will be asked to keep a bladder diary to track how often you make a trip to the bathroom. You then will add 15 minutes to the intervals between bathroom visits. You should urinate each time, regardless of whether or not you feel an urge to go. You will be incrementally increasing the time between visits. Eventually your can train your bladder to retain more urine before it needs to be emptied.
  • Losing weight. Having extra pounds adds pressure to the bladder and surrounding muscles, which can cause bladder control problems.
  • Changing eating habits. Drinks with carbonation, alcohol or caffeine may aggravate incontinence.
  • Treating Constipation. Try eating more fiber because constipation can worsen urinary incontinence.

Urinary incontinence does not need to be a normal part of aging. It is sometimes a signal of another health problem, such as weak pelvic floor muscles. There are different types of treatment available to help ease the problem. Our team of specialists at Advanced Urology Institute have years of experience working with patients with urinary incontinence and can develop the best plan for the individual’s needs. For more information, visit the Advanced Urology Institute website.

BPH: What Is It and What Causes It?

BPH: What is it and What Causes it?BPH is the abbreviation for benign prostatic hyperplasia, also called prostate gland enlargement, a condition commonly found in men as they age. Enlarged prostate glands can cause serious urinary issues such as blocked urine flow, urinary tract issues and kidney problems. The treatments for BPH include medications and minimally invasive surgery.The most common symptom is an urgent and frequent need to urinate. These may be accompanied by a difficulty beginning urination, a weak and interrupting stream, extended dribbles at the end of urination, or an inability to completely empty the bladder during urination. Urinary tract infections and bloody urine are other less common symptoms.

It is important to note that the size of the prostate does not necessarily correlate to the enlargement of the prostate. For instance, some men may have prostates that are only slightly enlarged and still suffer from symptoms worse than men with far greater enlarged prostates.

The prostate gland is found just below the bladder, and the tube that allows urine to exit the body runs directly through it. This is why urine flow is affected when the prostate enlarges. The primary cause of BPH is not fully known, but it may be related to changing sex hormone levels in men as they age.

The main risk factor for BPH is aging. Although BPH rarely affects men under 40, one-third of men between the ages of 40 and 60 experience it. And half of men experience it by age 80. Family history also plays a role in your chances of developing these problems. Men with a blood relative with BPH are more likely to develop it themselves. Diabetes, heart disease and obesity all increase the risk factors as well, while exercise helps lower them.

There are several complications that can result from BPH. The most common one is the inability to urinate, which may require a catheter if severe enough. Urinary tract infections can occur as well. Bladder stones and bladder damage may occur when the bladder cannot be fully emptied, which is more likely to happen to someone with BPH. Kidney damage is another complication that occurs when pressure that has built up in the bladder directly damages the kidneys.

Although common, BPH is a serious condition that can negatively affect quality of life and well being. But with many treatment options available, men can find relief by promptly seeking medical help. The doctors at St Pete Urology specialize in treating these issues and improving the lives of men as they age. For more information, visit the St Pete Urology website or make an appointment for a consultation.

How soon can I have sex after a vasectomy?

Men have a vasectomy in order to not have to worry about conception when they are making love. A vasectomy is one of the few ways men can have control over their reproductive capacity. It’s also one of the most reliable ways to prevent an unwanted pregnancy.You may have questions before or right after having a vasectomy. Here are some answers to the most frequent questions.

What is a Vasectomy?

Considered a minor surgery, a vasectomy is when the vas deferens is cut and the two ends are seal and tied together. Depending on factors that your urologist can discuss with you, you will either have a conventional vasectomy or a “no-scalpel” vasectomy.

During a conventional vasectomy, the surgeon will make one or two small incisions in the skin of the scrotum to access the vas deferens. The surgeon may remove a small piece of the vas deferens before searing the ends and tying them off with a suture. The procedure is repeated on both sides. The small cuts in the scrotum may be closed with dissolvable stitches or simply left to close on their own.

For a no-scalpel vasectomy, your urologist will locate the vas deferens by feeling for it under the skin of your scrotum and place a small clamp on the vas. A minute hole is made in the skin, which is stretched open so the vas deferens can be lifted out to cut, and then the ends are tied or seared, and replaced.

What will sex be like?

A vasectomy is a fairly simple procedure without long-term effects on sexual activity. Your surgeon may recommend abstaining from sex for a short time afterward. This is to allow the incisions and sutures time to heal.

Normally the recommendation is to wait for any pain or swelling to resolve before having sex. The reason you should wait to have sex is because if it is too soon, you could reopen the site of the incisions and infection-causing bacteria might enter the incision.

Most men can resume sexual activity within a week or two. During the time shortly after your vasectomy you should use an alternative form of birth control because it takes a little while before all the sperm is cleared from your ejaculate. Your doctor will test your semen sometime after surgery, usually around six to twelve weeks.

Having a vasectomy rarely changes anything about ejaculation or orgasm. There are a few cases of post-vasectomy pain syndrome. But most patients have only the following post-surgical inconveniences which generally go away on their own:

  • mild to moderate pain or discomfort
  • bruising or soreness of the scrotum
  • blood clots in the scrotum
  • swelling in your genital area or scrotum
  • blood in the semen

Having the peace of mind that a vasectomy delivers sometimes can enhance sex life, with better arousal and erections. About three months after your surgery, you can have unprotected sex without fear a possible pregnancy. However, it is always wise to use protection with a new partner.
To find out more about the vasectomy procedure, visit St Pete Urology’s websit.

Facts About Stress Urinary Incontinence in Women

What Is Urinary Incontinence?

Many women have a silent concern due to urinary incontinence. It somehow seems taboo to talk about the problem, even with a regular doctor or gynecologist. There are approximately 25 million Americans who suffer from some type of urinary incontinence and as many as 80 percent of them are women. Pregnancy, giving birth, going through menopause and even the unique structure of the female urinary anatomy contribute to the disparity between male and female sufferers.

Urinary incontinence is defined as the unintentional loss or leakage of urine. The term “stress incontinence” means that when the body is under exertion it puts pressure on your bladder and the bladder leaks. Some triggers for stress incontinence include running, coughing, sneezing, bending or heavy lifting.

Bladder Retraining

The bladder is controlled by muscles and it can be trained. You may wish to keep a voiding diary, noting things like times of urination, duration between bathroom trips, types of food or beverages that seem to trigger urgency or frequency of bathroom trips. This journal describing your symptoms and potential causes can help if you need to visit a urologist for treatment.

As you establish baselines for your urinary problem, you can start behavior modification and training your bladder. Here’s how to do it:

  • Schedule Your Bathroom Breaks

Start by scheduling bathroom visits. Increase the time periods between those breaks by adding 15-minute increments. Visit the bathroom even if you don’t feel you need to go. You will be working toward longer and longer stretches of time between breaks.

  • Perform Kegel Exercises

When you learn to isolate the muscles that control urine flow, you can practice having more control by performing Kegel exercises while sitting, standing or during urination.

Other Tips to Prevent Overactive Bladder:

  • In addition to bladder retraining, you may want to eliminate or limit beverages that increase the need for urinating, like coffee, tea or caffeinated sodas.
  • Drink fewer fluids before bedtime.

Treating Overactive Bladder With Behavioral Modifications

You needn’t feel alone when you have urinary incontinence. Make an appointment with a urologist who is trained to deal with your condition. Your doctor may take any of the following approaches beyond what you can do on your own:

  • Recommend biofeedback,
  • Send urine or drawn blood to the lab to determine how completely you empty your bladder.
  • Prescribe medicine to address bladder function or tighten muscles.
  • Employ a medical device, such as a urethral insert or a pessary.
  • Try nerve stimulation, using a mild electric current to nerves in the bladder that help control urination.
  • Suggest surgery if indicated.

If you have stress incontinence, you may be limiting yourself from fully participating in life events. Seek treatment from experts like those at St Pete Urology, where surgeons perform hundreds of successful sling surgery procedures every year. For more information, visit the St Pete Urology website.

How to tell if your prostate is enlarged?

The prostate gland is an integral part of the male reproductive system. It secretes seminal fluid, which nourishes sperm as they grow and facilitates their transportation during ejaculation. It is located between the bladder and the rectum and surrounds the base of the urethra. Due to its location next to key parts of the urinary system, the health of the prostate gland tends to have a direct impact on the health of a man’s urinary system.

The prostate gland grows larger as a man ages. While this gradual enlargement is normal, by the time a majority of men turn 50, the prostate has reached a size where it may start to affect the normal functioning of the urinary organs near it. It is at this point that a man is said to have an enlarged prostate, or clinically speaking, benign prostate hyperplasia (BPH).

Signs and Symptoms of an Enlarged Prostate

An enlarged prostate presses, pinches or causes a blockage in the urethra. The urethra carries urine from the bladder to outside the body. The direct effects of an enlarged prostate are manifested by difficulty in the discharge of urine. These difficulties could be in the form of:

1. Frequent and sudden urges to discharge urine;

2. Difficulty starting a urine stream;

3. Weak urine stream; and

4. Dribbling urine.

If left untreated, the effects of an enlarged prostate can cause the following complications:

1. Acute Urine retention. This is a complete inability to pass urine. Medical attention must be sought immediately if this occurs;

2. Urinary tract infections;

3. Blood in the urine;

4. Pain when passing urine; and

5. Pain in the lower abdomen.

Sometimes an enlarged prostate does not produce symptoms. When this occurs in some men, it may not even be possible to diagnose the condition because it gives them no trouble at all.

The key to diagnosing and treating an enlarged prostate lies with frequent prostate monitoring by a qualified urologist. Men approaching age 50 should get tested or at least keep a watch out for any of the symptoms listed above. The good news is there are many successful treatment options for the condition. Our specialists at St Pete Urology are experienced and well qualified to help with any questions, concerns and treatment. If you think you may have an enlarged prostate, or are experiencing any problems, by all means contact us. For more information, visit the St Pete Urology website.

Can a vasectomy fail?

A vasectomy is a form of male contraception that is administered through a minor surgical procedure. During a vasectomy, the patient’s vas deferens are cut and the ends are tied up or seared so they are blocked. The vas deferens is made up of two narrow tubes that transport sperm to the ejaculatory duct during ejaculation. A vasectomy inhibits the transportation of the sperm to the duct, so only seminal fluid is discharged when a man ejaculates. The absence of sperm removes the possibility of conception. A vasectomy is considered to be the most efficient form of birth control. However, there are instances, though very rare, in which pregnancy occurs even after the man has had a vasectomy.

Reasons why a vasectomy may fail

1. Recanalization

This is a medical term for when the cut vas deferens reconnect and revert to something like what they were before the vasectomy. This process happens naturally when tissue from the cut ends gradually grows until the two ends reach one another and reconnect.

Tiny channels also can form in the healing scar tissue of the snipped vas deferens and provide a passageway for sperm from one end of the vas deferens to the other.

2. Surgical error

In very rare cases, surgeons have been known to make an error during the procedure. This might mean either that the vasectomy was not done at all or that it was done in a manner that might cause it to fail.

Such errors could be:

a. Cutting one vas deferens and leaving the other;

b. The surgeon cuts completely different tubes that are not the vas deferens; and

c. In the very rare cases where the patient has duplicated vas deferens, that is to say two vas deferens on each side rather than one on each side as is the normal case, and the urologist cuts only one of the two .

d. Having intercourse too soon

Men who have had vasectomies are always advised to avoid having sex too soon, and if they do, to use another form of contraception. This is because semen does not become clear of sperm immediately after the vasectomy. The standard practice is to wait for three months after the procedure. After the three months, a urologist should conduct a semen analysis and advise accordingly.

Vasectomies are largely successful. Any man considering it has absolutely no reason to fear that it will fail because they rarely do. However, after undergoing the procedure, the patient must take care to observe all guidelines given by the urologist. A little anxiety before the procedure might be expected but the advice of a trained urologist, such as those available at St Pete Urology should dispel the worry. The team of specialists at St. Pete Urology can help with questions, consultation, surgery and follow up steps for a vasectomy. For more information, visit the St Pete Urology website.

How to Prevent Erectile Dysfunction?

Erectile dysfunction is a condition that prevents a man from getting or maintaining an erection firm enough for sexual intercourse. The failure to sustain an erection may happen occasionally in healthy men and this should not be a reason to panic. One is said to have erectile dysfunction only when the inability to sustain an erection is sustained over a period of time. The risk of having erectile dysfunction increases with age, with about 50 percent of men over the age of 40 having the condition. Recent research also indicates an increase in the cases of erectile dysfunction in men in their 30s.Erectile dysfunction is treatable. Even so, it does inhibit a patient’s sexual performance, and in some cases, confidence. It comes as good news, therefore, that the condition is not only treatable, it is also preventable.

Preventing Erectile Dysfunction

The ways in which erectile dysfunction may be prevented fall into two categories:

1. Maintaining good overall health.

The sexual health of an individual is determined by his general health. If his overall health is failing, it will only be a matter of time before this starts to affect one’s sexual ability. One way of preventing erectile dysfunction therefore lies in maintaining good overall health. To this end, the following are recommended:

a. Maintain healthy body weight. A healthy balanced diet and regular exercise go a long way to keep body weight at a desired level. This protects you from obesity and other lifestyle diseases which might cause erectile dysfunction.

b. Avoid excessive use of alcohol, drugs and cigarettes. Taking these may, in the long run, lead to diseases of the heart or interfere with the functioning of blood vessels. Interfering with blood flow may reduce the amount of blood going into the penis, thus causing erectile dysfunction.

2. Managing Underlying chronic diseases

Erectile dysfunction often arises as a result of an underlying illness. For example, obesity, diabetes and cardiovascular illnesses have a tendency of interfering with the flow of blood to the penis. In addition to these, mental issues such as depression or crippling anxiety may cause erectile dysfunction. In such cases, the key to dealing with erectile dysfunction is in fighting the underlying illness. A patient with one of these conditions will be advised to, among other things:

a. Take medication as advised by the attending doctor;

b. Consult with the doctor to see if treatment for erectile dysfunction may be administered independently without affecting the treatment of the underlying illness; and

c. Seek therapy and treatment for mental health conditions.

Erectile dysfunction can be prevented by simply choosing to live a healthy lifestyle. For those already suffering from erectile dysfunction, there is no need to panic as the condition is very treatable. Our team of specialists at St. Pete Urology can help with any questions, consultation, diagnosis and treatment options for erectile dysfunction. For more information, visit the St Pete Urology website.

What Can You Do To Reduce The Risk of Having Kidney Stones

Kidney stones are hard, crystallized minerals that form in the kidneys that may spread to other organs in the urinary tract such as the bladder and the ureter. They form when urine becomes so concentrated with minerals that the minerals crystallize and harden. Often stones are formed from a fusion of calcium and oxalate or phosphorus. Symptoms of kidney stones include trouble passing urine, excruciating pain when passing urine, pain in the groin, below the ribs and in the abdomen, blood in the urine and frequent urination. While reports indicate that the prevalence of kidney stones has grown in modern times, the condition still remains a preventable one.

Ways of preventing Kidney Stones

1. Cut down on sodium intake
A heavy sodium intake causes a proportionate increase in the amount of calcium in urine, creating a good chance of kidney stone formation. Processed and canned foods are known to contain high amounts of sodium. It is advisable to reduce one’s consumption of such foods.

2. Staying hydrated
Drinking enough water and other fluids is one of the best and easiest ways to prevent kidney stones. Water dilutes urine, making it less concentrated. A shortage of fluid in the body translates into just a little concentrated urine. Urine salts are more likely to crystallize and form stones because there is insufficient water to dissolve them.

3. Consumption of foods rich in calcium
Even if most stones have aspects of calcium, calcium rich foods such as milk and cheese prevent the likelihood of kidney stone recurrence. This is because the levels of oxalate, which is a stone forming mineral, increase with decreasing levels of calcium. Calcium should be maintained at a good level.

4. Cut down on the intake of animal proteins and fructose
Organ meats, red meat, seafood and poultry contain a compound known as purine which contributes to the formation of kidney stones, specifically uric acid stones. The same goes for foods with high fructose, with corn syrup specifically being one to avoid. Managing the intake of these foods should go a long way in preventing stones from forming.

In addition to watching one’s diet, medical professionals advise that people should obtain a good amount of exercise to prevent weight related disorders such as obesity.

Kidney stones are very painful and, in this instance, there is no question that prevention is much better than cure. If you discover that you have kidney stones, you should seek medical attention immediately. For those interested in prevention only, reading up on the subject can offer practical ways to avoid having kidney stones. The staff of specialists at St. Pete Urology also are able to help with diagnosis, prevention and treatment of kidney stones. For more information, visit the St Pete Urology website.

What is a Varicocelectomy?

An apt introduction to varicocelectomy would be to describe the relatively common condition known as varicose veins. Varicose veins occur with the swelling and enlargement of the veins in a patient’s legs to the point that the veins become easily visible under the skin. This condition sometimes occurs in the scrotum and the enlargement is known as a varicocele. Varicocelectomy is a surgical procedure that is performed to remove varicoceles from the scrotum. The main cause of varicoceles is a malfunctioning of the valves inside the veins, which causes an accumulation of blood in the veins and causes them to expand. Upon a physical examination, a varicocele is said to feel like a bag of worms.

When to go for a Varicocelectomy

Having a varicocele is not in itself reason to have a varicocelectomy. In most instances, the varicocele does not manifest any symptoms. It does not cause pain or interfere with the sexual or reproductive function. In such cases, a urologist will advise that the varicocele be left undisturbed. However, if the varicocele causes any of the following, then a varicocelectomy should be performed.

  1. Reduced sex drive;
  2. Reduced sperm production resulting in inability to conceive
  3. Pain and swelling of the scrotum;
  4. When the varicocele is on the right side — ordinarily varicoceles occur on the left side of the scrotum. When it occurs on the right side, it is likely that it is the result of a tumor. The urologist will remove the tumor and the varicocele.
  5. Testicular atrophy — where the testes shrink or fail to develop normally because of a varicocele.

Procedure of Varicocelectomy

A varicocelectomy is a minor surgical procedure that allows the patient to leave the hospital the same day. It is a procedure involving cutting or sealing off the affected vein to restore normal blood flow. A surgeon can choose to do it in either of two ways:

1. laparoscopic varicocelectomy — a surgeon makes several small incisions in the lower abdomen and inserts the laparoscope, which projects an image of your anatomy on a screen. He also inserts other small tools which he uses to cut the affected vein.

2. Open Surgery — The surgeon makes incisions large enough to access the affected veins and cut them or seal them off.

Even though self examination can reveal a varicocele, the question of whether to undergo a varicocelectomy can only be answered by a urologist. A urologist who has specialized in the treatment of varicoceles, such as those in St. Pete Urology, should be contacted if a patient finds any of the symptoms listed above. For more information on prevention, diagnosis and treatment, visit the “St Pete Urology” website.