Treatment Success for Overactive Bladder

Successful treatment of overactive bladder can relieve annoying urinary symptoms and inject new enthusiasm and confidence into your life. While successful treatment may mean different things, it is typically defined by a reduction or an end to annoying and embarrassing bathroom visits that force you to approach everyday activities with fear and anxiety. It is important to know that an overactive bladder is not a disease but a group of urinary symptoms. Knowing this will help you to assess your disease, the range of symptoms and underlying causes and find the right treatment.

Targeted treatment

Treatment results for overactive bladder vary depending on the state of the condition and underlying causes of the symptoms. At St Pete Urology, the urologist will conduct a comprehensive medical history though an open, warm and private conversation to establish the state of your condition and identify potential causes. A physical examination is followed by relevant medical tests to help find the cause of the disorder in order to tailor treatment. The doctor also will create a record of the symptoms to be used later to monitor the success of the treatment.

Patient-oriented goals

Before choosing a treatment or combination of treatments that is ideal for you, the doctor will discuss all the options with you. The treatment chosen will target both the underlying cause and the symptoms. For example, if the underlying cause is a urinary tract infection, the urologist will offer antibiotics to combat the infection as well as provide the medications or recommend the exercises to alleviate the symptoms. The urologist will help you to identify your treatment goals to enable you to find relief as soon as possible. For example, voiding 6-8 times and getting up just once at night may be normal if you are an older adult. So if you have been voiding 12 times a day and 3 times a night, you may set your goal at 6 times a day and 1-2 times a night. When setting your goals, the doctor will explain what is normal and what is not so you can set goals that boost your treatment success..

In many cases, treatment success may be marked by:

  1. Decreased urinary urgency.
  2. No dribbling.
  3. Remaining dry all night.
  4. Sleeping all night or waking up just once to urinate.
  5. Remaining dry all day.
  6. Passing urine every couple of hours.

For instance, if you have been voiding 16 times a day, going down to 3 times a day means your treatment is successful. Likewise, if you previously woke up 3-4 times a night, going down to 1-2 times a night means your treatment is successful. Similarly, if the treatment can help you to stop dribbling on your way to the bathroom and significantly reduce your urinary urgency, then it can be classified as successful. With goals that are specific to your overactive bladder symptoms, you can easily monitor your treatment and increase success.

Tracking your symptoms

Overactive bladder is usually characterized by a sudden and uncontrollable urge to pass urine and the tendency to visit the bathroom several times (8 or more times) during the day and night. Urine also may leak immediately after you experience the urge. With treatment, the urgency and frequency of passing urine may begin to change, while urine leakage may reduce or stop. In order to monitor any improvements as soon as you begin treatment, it is important to record all your symptoms before treatment. At St Pete Urology, the urologist will help with taking your bladder records before treatment begins. The data then is used as treatment progresses to monitor your improvement and evaluate success.

Success rates vary with type of treatment

Outcomes vary from one treatment to another. For example, Botox can provide 80-90 percent success rate when chosen correctly. Likewise, a combination of bladder training, kegel exercises for pelvic floor muscles and anticholinergic drugs can produce a success rate of 70-90 percent when properly deployed. It is important to work with a urologist who has been treating overactive bladder on a regular basis and is knowledgeable and experienced to customize treatments for your condition. At St Pete Urology, we have a pool of skilled urologists who have been treating overactive bladder symptoms for decades. We will help you overcome embarrassing symptoms and get your life back to normal quickly. For more information, visit the “St Pete Urology” site.

How long should it take to pass a kidney stone?

Most kidney stones will pass through the ureter to the bladder and out of the body when given time. In fact, with ample fluid intake, nearly all kidney stones will pass through the urinary tract on their own within 48 hours. Nevertheless, the time it takes for a stone to be passed depends on its size and location in the urinary tract. For instance, smaller stones and those located in the lower portion of the urinary tract (closer to the bladder than the kidneys), have a higher likelihood of passing on their own and tend to pass more rapidly. Larger stones and those located in the kidneys are less likely to pass on their own and tend to pass more slowly.

How long does it take to pass a kidney stone?

According to the American Urological Association, the length of time required to pass a kidney stone located in the ureters (tube that connects kidneys to the bladder), is an average of 8 days if the stone is less than 2mm, about 12 days for a stone between 2mm and 4mm, and 22 days if the stone is between 4mm and 6mm. Generally, however, most kidney stones will pass on their own in 40 days. But when a medical expulsive therapy is applied, a kidney stone (2mm to 6mm) will pass within a few days or weeks provided the patient is in good health. Medications called antispasmodics can be used to accelerate the process of passing a stone. The drugs relax the ureters and increase the speed of passing a stone by up to 5-7 days. A urologist may allow for up to 6 weeks for a kidney stone to pass on its own, but earlier intervention may be necessary if the stone is causing severe pain, gastric discomfort or urinary problems.

Factors affecting the ability to pass a kidney stone

There are several factors that affect the ability to pass a kidney stone. They include:

  1. Prostate enlargement.
  2. Size of the person.
  3. Prior stone passage.
  4. Pregnancy.
  5. Size of the stone.
  6. Location of the stone.

For instance, a kidney stone that is 4mm in size has an 80 percent chance of passing while a stone that is 5mm in size has only a 20 percent chance. Kidney stones that are larger than 9mm-10mm can hardly pass without a doctor’s intervention and require timely treatment to avoid complications. To increase the passage rate of kidney stones, a urologist may recommend certain medications. The medications include alpha blockers such as tamsulosin (Flomax) and calcium channel blockers such as nifedipine (Procardia, Nifediac, Adalat or Afeditab).

Dealing with the symptoms of a kidney stone

Since most kidney stones will eventually pass through the urinary tract and out of the body when given time, treatment is usually directed toward controlling the symptoms. When the stones are passed at home, appropriate interventions usually include increased fluid intake and taking anti-inflammatory drugs such as Ibuprofen. If over-the-counter pain medications are ineffective, stronger drugs such as Ketorolac (an injectable anti-inflammatory drug) and narcotic pain medications are used. In case of severe nausea and vomiting, the doctor may give intravenous medications.

When do kidney stones require removal?

Waiting for kidney stones to pass is not ideal for every case. According to the American Urological Association, kidney stone removal should be considered if a stone fails to pass on its own within 2 months. Likewise, stone removal is necessary if complications arise due to the stone. Complications that require stone removal include ureter blockage or irritation, urinary tract infection, decreased kidney function and uncontrolled pain, nausea or vomiting.

To remove kidney stones, a procedure called lithotripsy is often used. During the procedure, kidney stones are subjected to shock waves, resulting in the breakdown of larger stones into smaller pieces that can easily pass through the urinary tract. When lithotripsy is not effective, surgical techniques may be necessary to remove kidney stones. This may be done either by making a tiny incision in the skin (percutaneous nephrolithotomy) or via an instrument (called ureteroscope) passed through the urethra and bladder into the ureter.

Effective treatment at St Pete Urology

At St Pete Urology, we provide a multidisciplinary approach to treating and managing kidney stones of all sizes. We have assembled a highly integrated team of nephrologists, urologists, radiologists and dietary and metabolic specialists to ensure comprehensive diagnosis, treatment and proper assessment of the risks leading to the formation of kidney stones. By applying the latest technology in treating kidney stones (including state-of-the-art lasers) and a broad range of noninvasive and minimally-invasive procedures for removing small and large stones, we guarantee only the highest quality and successful treatment to all our patients. For more information, visit the St Pete Urology site.

4 Best Treatments for Overactive Bladder

Overactive bladder (OAB) is not just an embarrassing and annoying condition. It can have serious impact on every aspect of your life. For instance, it can compel you to avoid vacations, dinner outings and other social events, miss out on valuable time with friends and family, or lose out on many hours of sleep. Fortunately, there are safe and effective ways to treat the condition and restore your life back to normal. Minor cases of OAB can be effectively treated with pelvic muscle exercises, bladder training and absorbent pads, while severe cases can be successfully treated with medication and surgery.

The 4 best treatments for overactive bladder are:

1. Bladder training

As a non-drug remedy with almost no side effects, bladder training helps to change how you use the bathroom and allows you to gain control over your bladder. Through scheduled voiding (urinating at set times of the day), you can learn to control the urge and gradually overcome embarrassing symptoms. Bladder training should begin with waiting for a few minutes before voiding and progressively increase to one hour or more between your bathroom visits.

2. Pelvic floor exercises

Carefully selected exercises can strengthen muscles that control urination and in turn relieve overactive bladder symptoms. During pelvic exercises, such as biofeedback and kegel exercises, you voluntarily tighten, hold and relax muscles responsible for starting and stopping urine flow and gradually regain control over your bladder.

3. Medications

If a specific cause is identified, overactive bladder can effectively be treated using appropriate drugs. For instance, if a urinary tract infection is the underlying cause, antibiotics can be used to alleviate the symptoms. Likewise, topical application of estrogen vaginal cream can be used to relieve OAB symptoms associated with atrophic urethritis.

Drugs commonly used to treat overactive bladder include:

  • (a) Anticholinergics: This group of drugs relieves symptoms by blocking nerve signals associated with involuntary contraction of bladder muscles. The drugs also reduce the urge to go to the bathroom and increase bladder capacity. Examples of anticholinergics are Darifenacin (Enablex), Tolterodine (Detrol), Fesoterodine (Toviaz), Trospium (Sanctura), Oxybutynin (Oxytrol) and Solifenacin (Vesicare).
  • (b) Antidepressant imipramine hydrochloride (Tofranil), which relaxes the muscles of the bladder and relieves symptoms.
  • (c) Botox: When injected into the bladder muscles, Botox causes them to relax and minimizes involuntary muscle contractions. Botox also boosts bladder capacity. However, Botox is only recommended when oral medications, bladder training and exercises have failed.

4. Surgery

Urologists opt for surgery as a last resort when medications and behavioral therapy have failed. There are many surgical options available for treating overactive bladder, including sacral nerve neuromodulation and percutaneous tibial stimulation, which typically are used for severe overactive bladder symptoms. For successful treatment of OAB, urologists often combine two or more treatments such as combining behavioral interventions with oral medications.

Other measures for alleviating overactive bladder symptoms include:

  1. Limiting the intake of bladder irritants such as caffeine and alcohol.
  2. Cutting down excess weight.
  3. Avoiding spicy foods, citrus fruits, chocolate and tomatoes.
  4. Avoiding artificial sweeteners, which tend to aggravate symptoms.

At St Pete Urology, we have successfully treated overactive bladder for decades. Through open and candid conversations with patients, carefully selected treatments that depend on the underlying cause of symptoms and patient-oriented goals, we can help you to get back to your old routine quickly. Visit us today for evaluation and help with your overactive bladder symptoms. For more information, visit the “St Pete Urology” site.

What do you do for a kidney stone?

Kidney stones can be treated in a number of ways, depending on the cause, size and location of the stones. The treatment and management of kidney stones also depend on your overall comfort level, any complications related to the stones and on your other medical problems. Most kidney stones are small (4mm or less in diameter) and can be passed in urine with the help of medications. The medications are used to keep you comfortable as the stones pass naturally through your urinary tract, with the passage of a stone taking a few days to a few weeks. Larger kidney stones are associated with severe symptoms and may not pass without a medical expulsive procedure.

What should you do with small kidney stones?

Most small kidney stones (4mm or less in diameter) can pass through the urinary tract and out of the body without invasive treatment. To pass such a small stone, you should:

  1. Drink plenty of water: Drinking 2-3 liters of water every day will help to flush out a kidney stone. Unless your doctor says otherwise, make sure to increase your daily fluid intake (mostly water) to increase the rate of passage of any stones you may have.
  2. Use pain relievers: As a kidney stone passes through your urinary tract, it will cause some discomfort. For mild pain, your doctor may recommend over-the-counter medications such as ibuprofen, acetaminophen or naproxen sodium. For severe pain, Ketorolac or narcotics may be recommended.
  3. Medications to increase passage rate: To reduce the time required to pass a kidney stone naturally, your urologist may prescribe medications called alpha blockers (such as tamsulosin) or calcium channel blockers (such as nifedipine) to relax ureter muscles and help you to pass the kidney stone quickly and with minimal pain.

What should you do with larger kidney stones?

Larger kidney stones cannot be treated effectively with conservative measures. Likewise, a kidney stone that is lodged in an area of the urinary tract or that has moved into the ureter and is causing severe pain, bleeding or urinary tract infections may require more extensive treatment. When diagnosed with such a kidney stone, the doctor will recommend that you be admitted to hospital for treatment.

Extensive medical treatment is generally necessary if:

  1. You have a higher risk of kidney failure, especially if you have only one kidney.
  2. Your symptoms are not improving within an hour after taking painkillers or anti-nausea medication.
  3. You are pregnant.
  4. You are dehydrated and vomiting too much fluid.
  5. You are over 60 years of age.

Larger kidney stones (6mm in diameter or more) usually require treatment to remove them. The methods used to remove such stones include extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, percutaneous nephrolithotomy and open surgery. The type of treatment given will depend on the size and location of the stone.

Types of Treatment

1. Extracorporeal shock wave lithotripsy (ESWL)

This is the most commonly used method of removing kidney stones that cannot be passed in urine. The procedure involves application of ultrasound (high frequency sound waves) to identify the location of a stone with more precision. Ultrasound shock waves are then directed at the stone from a machine, breaking down the stone into smaller pieces that can easily pass in urine. ESWL is an uncomfortable procedure and is therefore performed under painkilling medication. More than one session may be necessary for the procedure to successfully treat kidney stones, but ESWL is known to have up to 99 percent efficacy for stones of 20mm or less in diameter.

2. Ureteroscopy

For kidney stones that are stuck in the ureter, the urologist may have to use a ureteroscope (a long, thin telescope) to reach and remove the stones. The thin lighted tube is fitted with a camera to help pinpoint the location of a stone with utmost precision. During the procedure, the ureteroscope is passed through the urethra and bladder into the ureter and to the place where the stone is stuck.
Once the stone is reached, it can be snared or broken down into smaller pieces using laser energy so that the pieces can then pass naturally in urine. Or the doctor may use another instrument to remove the stone without breaking it. Since ureteroscopy is performed under general anesthesia, you will not be able to drive or operate machinery for up to 48 hours after the procedure. Ureteroscopy is highly effective for stones 15mm or less in diameter, but a plastic tube known as stent may be inserted temporarily into your bladder to help drain stone fragments.

3. Percutaneous nephrolithotomy (PCNL)

PCNL is an alternative procedure that is effective for larger kidney stones. It can be used when ESWL is not suitable, such as when the person being treated is obese. Percutaneous nephrolithotomy involves using a thin telescopic device called a nephroscope. The doctor performs the procedure by making a small incision at the back and then passes the nephroscope through the hole into the kidney. Using the nephroscope, the stone is either pulled out or broken down into smaller pieces using pneumatic or laser energy. The procedure is performed under general anesthesia and is 86 percent effective for kidney stones that are 21-30mm in diameter.

4. Open surgery

Nowadays, the use of open surgery for kidney stones is very rare and only performed in less than 1 percent of cases. In fact, open surgery is only recommended when a kidney stone is extremely large or when there is abnormal anatomy in the affected section of the urinary tract. For instance, open surgery may be necessary if the kidney stones (such as calcium phosphate stones) are caused by an overactive parathyroid gland (hyperthyroidism). Removing a tumor that is causing the parathyroid glands to produce excess parathyroid hormone and hence increased calcium levels in the body also may be necessary to treat some kidney stones. During open surgery, the urologist makes an incision in your back and uses the incision to reach the ureter, bladder and kidney. The stone is then removed from its location.

Preventing future kidney stones

After your kidney stones are treated, the doctor will assess your risk of kidney stones and recommend preventive measures. Generally, the formation of kidney stones is prevented using a combination of lifestyle changes and medications.

1. Lifestyle changes

Lifestyle changes that reduce the risk of kidney stones include:
(a) Drinking plenty of water throughout the day: If you have a history of kidney stones, drinking plenty of water (2-3 liters per day) will significantly reduce your risk of having stones in future. You may have to drink even more water if you live in a hot and dry climate. To know that you are drinking enough water, check if your urine is light and clear.
(b) Reduce the quantity of oxalate-rich foods: If you have previously suffered from calcium oxalate stones, then you can reduce your risk of stones in future by scaling down your consumption of foods rich in oxalates. You may have to cut down on your intake of spinach, sweet potatoes, tea, nuts, okra, beets, rhubarb, Swiss chard, soy products and black pepper.
(c) Reduce amount of salt and animal protein in your diet: To avoid kidney stones in future, reduce your salt intake and minimize animal protein in our diet. It is advisable that you use a salt substitute (such as Mrs. Dash) and take non-animal proteins (such as legumes).
(d) Use calcium supplements with caution: Calcium-rich foods will not increase your risk of kidney stones so you can continue eating them unless your doctor says otherwise. However, calcium supplements can increase the risk of kidney stones and should be taken with caution and only after speaking with a doctor or a dietitian.

2. Medications

Certain medications are effective in controlling the quantity of salts and minerals in urine and hence helpful in preventing the formation of stones. However, the type and effectiveness of such medications depend on the type of stone you are have. For calcium stones, thiazide diuretics and phosphate-containing preparations are effective. Allopunirol and alkalizing agents are effective for uric acid stones, small doses of antibiotics can eliminate bacteria and prevent struvite stones, while cystine-reducing medications can prevent cystine stones.
At St Pete Urology, we have established an integrated and multidisciplinary diagnosis, treatment and management program for kidney stones. By bringing together a diverse team of professionals including urologists, nephrologists, clinical nurse specialists, radiologists, nutritionists and other healthcare specialists, we ensure that our patients receive the most compassionate, comprehensive and effective treatment. We offer both surgical and non-surgical treatments with very high success rates. For more help and information on the treatment of kidney stones, visit St Pete Urology’s website.

Diet Suggestions for Kidney Disease Patients on Thanksgiving Day

As Americans across the country get together with family and friends every fourth Thursday in November to give thanks for all that is good in their lives, most kidney disease patients do so while mindful of their health. And since Thanksgiving Day is also full of food, from turkey to potatoes and to various juices, kidney disease patients are all too aware of the potential damage that holiday foods can have on their lives, including worsening their symptoms. For instance, the holiday fare may be full of salted foods, increasing the level of sodium in the body beyond the limits for kidney patients.

To enjoy Turkey Day to the fullest, kidney disease patients such as those with kidney stones have to look for kidney-friendly foods. Observing certain diet restrictions can ensure that they enjoy themselves without harm to their kidney functions or making their illness worse. So what should you eat or not eat on Thanksgiving Day if you have renal problem?

Generally, the diet principles for kidney patients are high-fiber, high-vitamin, low-salt, low-potassium, low-protein, low-fat and low-phosphorous. Here are some suggestions that can help kidney patients enjoy themselves on Thanksgiving Day without worsening their symptoms or harming their kidney functions.

1. Popular dishes

Turkey is the most common food on Thanksgiving Day but renal patients should opt for natural fresh or frozen turkey. The turkey should be prepared with low-salt broth and salt-free rub. Basted turkey which typically contains too much salt must be avoided. Other popular dishes include green beans, sweet potatoes, celery, parsley, cauliflower and cranberry, which are all good foods for renal patients. However, sweet potato contains a lot of potassium, so its intake should be limited. Pecan pie, apple pie and pumpkin pie are popular and delicious Thanksgiving desserts, but renal patients should minimize their intake.

2. Best drinks

Pure water is the ideal drink for renal patients on Thanksgiving Day. However, those who do not want to drink water can have apple juice and cranberry juice. If you are experiencing fluid retention, often characterized by swelling and edema, then reduce the amount of fluid you take. Avoid alcoholic beverages because too much alcohol can damage your liver and elevate your blood pressure. Likewise, drinks containing caffeine such as strong tea and coffee should be avoided.

3. Increase your calcium, fiber and vitamin intake

If possible, increase the amount of fiber, vitamin and calcium in your Thanksgiving diet because they are good for your health. However, you should limit the intake of excitant and spicy foods and avoid high-fat foods such as spicy chicken wings. Also reduce the quantity of meat in your diet as it may increase your kidney’s burden and elevate your BUN and creatinine levels.

4. Avoid salted foods

Salt contains high quantity of sodium, which is harmful for the kidney. For instance, high quantities of sodium in the diet elevate blood pressure and trigger fluid retention, which is a very common problem in people with kidney disease. Therefore, if you have kidney disease you should avoid salted foods on Thanksgiving Day.

5. Pay attention to your protein intake

For those with early-stage kidney disease, protein intake should be limited to 0.6-0.8 gram per kilogram body weight per day. But if the disease has advanced, the protein intake must be reduced significantly to just 0.2-0.4 g/kg/d. For patients on dialysis, protein intake should be increased to 1.2 g/kg/d because some protein may be lost during dialysis. On Thanksgiving Day, high quality protein such as fish, lean meat and egg whites are recommended.

6. Monitor your potassium level

If the disease has damaged the kidney, potassium level in your blood will easily increase, so you should closely monitor your potassium level and be very careful with your potassium intake. You should avoid foods with high potassium content such as white beans, banana, salmon, white mushroom, nuts and avocados.

While it is not easy to live with kidney disease, prompt treatment and lifestyle changes can significantly improve your quality of life. As you join the rest of your family at the dining table to celebrate Turkey Day, make sure to use the above diet suggestions to avoid any detrimental effects the foods you consume may have on your health. If you have questions or something is unclear, be sure to speak with your urologist about it. At St Pete Urology, we have a team of highly-qualified and experienced urologists to help you overcome your kidney problem. For more information, visit the “St Pete Urology” site.

What does it feel like when you have a kidney stone?

Formed by crystallization of certain substances in urine, kidney stones are hard, pebble-like pieces of materials occurring in one or both kidneys when there are high levels of various minerals such as calcium or uric acid in urine. A kidney stone may be as small as a grain of sand, as big as a pebble or even as large as a golf ball. Generally, the larger the stone the more severe the symptoms. If the stone is very small in size, it can pass through your urinary tract without notice. But a large stone may cause a sharp pain in your side, groin, back or lower abdomen as it passes through the urinary tract.

So what does it feel like when you have a kidney stone?

Typically, kidney stones are formed in the kidney and a stone that remains in the kidney rarely causes pain. But when a kidney stone travels through the tubes of the urinary tract such as the ureter (tube connecting the kidney to the bladder) or the urethra (tube that leads outside the body), it may produce irritation and blockage that result in pain and other symptoms. You may feel the following symptoms depending on the size and location of the stones:

  1. No symptoms, if the stone is very small.
  2. Sudden and severe pain on the side, lower back, groin, abdomen or genitals. The pain gets worse in waves and is often described by people with kidney stones as “the worst pain I have ever experienced.”
  3. Nausea and vomiting, or a persistent stomach ache.
  4. Foul-smelling or cloudy urine
  5. Blood in urine, which occurs whether the stones remain in the kidney or travel through the ureters.
  6. Frequent and painful urination, often occurring when the kidney stone is in the ureter or after the stone has passed the bladder and is located in the urethra. In some cases, painful urination indicates a urinary tract infection occurring concurrently with the stones.

Remember there are other conditions, such as hernias, appendicitis, prostatitis and ectopic pregnancy, which may have the same symptoms. Therefore it is important to see a urologist so your condition is accurately diagnosed.

Abdominal and back pain

Kidney stones may occur in the urinary tract without causing any symptoms. In fact, if you have small stones, they are likely to pass through the urinary tract without causing pain or being noticed. However, this is often only possible before the stones move from your bladder into the ureter. Once inside the ureter or other tube of the urinary tract, kidney stones cause irritation and blockage which may lead to considerable pain and discomfort. The pain may begin while a stone is still in the kidney or after the stone moves into the ureter, urethra or bladder.

If the pain occurs while the stone is still in the kidney, it is felt in the side and on the back, typically on the same side of the body as that of the affected kidney. You also may feel a cramping sensation or a sharp pain in the pelvic area, lower abdomen or in the genitals.When pain is related to the movement of a stone through the urinary tract, it comes in waves and builds in intensity before fading in cycles of every 20-60 minutes.

Physical signs

As kidney stones move through the urinary system, you may feel a strong and frequent urge to urinate. Likewise, the movement of the stone can cause irritation and damage to the lining of the bladder or ureter, causing blood to mix with urine. As a result, you will find yourself passing bloody urine, which appears reddened, pink or rusty in color. The urine also can be cloudy or foul-smelling. Kidney stones may cause gastric distress, nausea and vomiting. If the movement of the stones through the urinary tract triggers an infection, you may experience fever and chills.

Seek prompt treatment

When you feel lasting symptoms or complications due to kidney stones, it is important to seek prompt treatment. At the doctor’s office, you will undergo thorough examination and diagnostic testing to confirm your condition. If you are diagnosed with kidney stones, your treatment will depend on the size and location of the stones. For example, if you have small kidney stones, the urologist may recommend increased fluid intake to enable the stones to pass on their own. But if the stones are large, the doctor may use a scope to remove them. In some cases, surgery may be necessary.

If you suspect that you have kidney stones, visit St Pete Urology for accurate diagnosis, effective treatment and comprehensive care. At St Pete Urology, we have successfully treated kidney stones and other urinary tract problems for several years. For more information, visit the “St Pete Urology” site.

Can You Get a Vasectomy Undone?

If for some reason, such as a remarriage or loss of a child after a vasectomy, you choose to have children, can you get a vasectomy undone? Certainly yes! In fact, you can have a vasectomy undone even after a period of time as long as 25 years. However, at St Pete Urology, we are aware that some people may misuse this procedure. For this reason, we are committed to open and informative discussions with our patients before they have a vasectomy, ensuring they know that vasectomy is a permanent birth control method which they should undergo only when certain that they no longer want to have children. We also inform them of the option of vasectomy reversal but only as an ideal option when there is a drastic change of circumstances and a pressing need to have children after a vasectomy.

Outpatient procedure

Vasectomy reversal is often done as an outpatient surgery performed under localized, regional or general anesthesia. Executed with the help of an operating microscope and taking 3-4 hours, vasectomy reversal involves reconnecting the two severed ends of the vas deferens to allow sperm to be transported out of the body. Most men are eligible for a vasectomy reversal, but we usually go through the procedure in detail with our patients to ensure it is right for them.

Techniques for reversing a vasectomy

Before embarking on a reverse vasectomy, the urologist checks for sperm within the vas deferens. The presence or absence of sperm determines the type of surgery performed by the doctor. For instance, if sperm is found within the vas, the urologist will simply need to put the two ends of the vas deferens back together in order to restore male fertility. This procedure is called vasovasostomy, a sewing back together of the severed ends of each tube that carries sperm. In other cases, a blockage closer to the testicle may prevent sperm from reaching the vas. This calls for a more complicated surgery called vasoepididymostomy, which bypasses the blockage. Vasoepididymostomy involves connecting the vas deferens directly to the epididymis (a small organ located at the back of every testicle and which holds sperm).

High success rate

A vasectomy reversal is a more complex procedure that requires more expertise and experience than the original vasectomy. Therefore, it is important that you work with a surgeon who performs vasectomy reversals on a regular basis and who has a track record of success with both types of reversals. When properly performed, vasectomy reversal has a high success rate of 80-95 percent. In fact, the return of sperm (potency rate) is as high as 95 percent, while pregnancy rates vary from 50-70 percent. However, the likelihood to achieve pregnancy after a reversal depends on various factors, including experience of the surgeon, length of time since the vasectomy was done, tissue or tube damage that occurred during original vasectomy, and fertility status and age of your female partner.

Recovery after a reversal

After reversal surgery, it takes 5-14 days to recover. Vasectomy reversal is a minimally-invasive procedure that will not have a heavy toll on your body so you may only expect some soreness in the scrotal area, but this can be relieved with pain medication. However, sexual intercourse and heavy lifting should be avoided during the first 4 weeks after surgery. Your doctor will assess the success of reverse vasectomy by examining your semen 6-8 weeks after the operation. Sperm quality will return to normal 3-6 months after reversal surgery.
At St Pete Urology, we have state-of-the-art facilities, experienced urologists and a patient-centered multidisciplinary approach to ensure your vasectomy reversal is an absolute success. For more information, visit the “St Pete Urology” site.

How do you know if you have a kidney stone?

A kidney stone is a solid piece of mineral substance formed in the kidney or urinary tract when normal substances found in urine become too concentrated. Once formed, a stone may remain in the kidney or pass through the urinary tract and eventually move out of the body. Kidney stones are a very common urinary tract disorder that can affect almost anyone. In America, one in every ten people has a kidney stone.

How do you know if you have a kidney stone?

It is almost impossible to know that you have kidney stones until symptoms appear. In fact, most kidney stones are difficult to detect until they begin to move from the kidney through the ureter (the tube that connects the kidney to the bladder) and down the urinary tract. It is this movement that tends to cause irritation and blockage in the urinary tract and result in the severe pain and discomfort that is associated with kidney stones. Nevertheless, some kidney stones may lodge in an area of the kidney or urinary tract and cause noticeable symptoms.

To know if you have a kidney stone, you should first acquaint yourself with the symptoms. Knowing the symptoms of kidney stones will then allow you to suspect the condition as soon as you experience any symptoms and to seek immediate medical attention. A prompt visit to a urologist will ensure that your condition is accurately diagnosed and treated effectively.

Here are various ways of knowing if you have a kidney stone.

1.Sharp, excruciating pain

The presence of a kidney stone is often marked by a sharp, excruciating pain on one side of the lower abdomen or upper back. The pain typically starts suddenly and then lingers for a long period, becoming more intense with time. The pain also may spread and affect a larger area, including the groin area, area below the ribs and genitals. The pain can be constant or it can come and go in waves, lasting for a few minutes and then disappearing before starting again in about 10 minutes. The pain also may last for a longer period, but with fluctuating intensity as the stone moves and changes its position in the urinary tract. The nature and intensity of pain caused by kidney stones depends on the size of the stone, its location in the urinary tract and whether or not it has caused damage, blockage or irritation in the delicate structures of the urinary tract.

2. Urination problems

Apart from causing severe pain, kidney stones also result in a variety of urinary problems. The following urinary issues will help you to know that you have a kidney stone:

  • (a) Pain during urination.
  • (b) Red, brown or pink colored urine.
  • (c) Cloudy or foul-smelling urine.
  • (d) Urge to urinate, which is stronger and more frequent than usual.
  • (e) Dribbling urine in small quantities.

3. Gastric distress

You can know that you have a kidney stone if you have pain and any of the following symptoms:

  • (a) Nausea
  • (b) Vomiting
  • (c) Chills
  • (d) Fever

One or more of these symptoms may indicate that you have a urinary tract infection and therefore need antibiotics. Make sure to visit a doctor as soon as possible if you have these symptoms.

4. Clock clues

Linking your symptoms to the time of the day also may help you to know that you have a kidney stone. Typically, the pain caused by kidney stones usually begins either early in the morning or late at night. This is due to the fact that people urinate less frequently in the early morning or late at night and the ureter remains highly constricted, allowing the stones to irritate the delicate structures of the ureter and cause pain. Therefore, monitoring the time pain occurs will enable you to tell whether or not it is caused by kidney stones.

Diagnosis of kidney stones

While the clues you get from the symptoms may be sufficient to help you suspect that you have a kidney stone, the only definitive way of knowing you have a stone is to visit a doctor for diagnosis and treatment. Generally, it is recommended that you see a doctor if you:

  1. Experience pain so severe that you are unable to stand, sit or lie down comfortably.
  2. Have serious pain in your belly.
  3. Have nausea or vomiting.
  4. See blood in your urine.
  5. Find it difficult to urinate.

When you visit a urologist, be ready to describe your symptoms clearly, including when and how they started. If possible, write them down, together with a list of the medication, vitamins and supplements you are taking. For instance, some medications such as diuretics, calcium-based antacids, topiramate (Topamax) and Indinavir (Crixivan) may cause kidney stones. You also should keep track of the amount of fluid you drink and the quantity of urine you pass in a 24-hour period.

The doctor will confirm that you have kidney stones by requesting various tests. These may include blood tests for the presence of calcium or uric acid in blood, since a buildup of these minerals may precipitate kidney stones. The doctor also may request urine tests, often on a urine sample collected in a 24-48 hour period. Apart from lab tests, the doctor may request imaging studies. For example, X-rays may be used to accurately show that you have kidney stones, particularly larger stones; computed tomography (CT) scans can be used to take in-depth images of the urinary tract from several angles, helping to identify smaller stones that X-rays can’t recognize; while ultrasound can be used to create clear images of the urinary tract in order to spot various sizes of kidney stones.

Treating kidney stones

Once the doctor confirms that you have kidney stones, you may be given a special strainer which you use every time you pass urine. The strainer will help you to collect any stones or pieces of stones you may pass. If you succeed in collecting a kidney stone, the doctor will send it to the laboratory for analysis. Knowing the type of kidney stone you have will help your doctor to recommend effective ways of minimizing the risk of such a stone in the future.

Most stones, though quite uncomfortable, will not cause serious damage to your body. So your doctor most likely will recommend that you wait for the stones to pass on their own. It may take a few days to several weeks for a stone to move from the kidney to the ureter and through the bladder to the outside of the body. Your doctor will prescribe pain medications and anti-nausea drugs and then recommend that you go home and wait for the stones to pass. Drinking 2-3 quarts of water every day also is recommended as a way of flushing out your urinary system.
But if through imaging studies the doctor finds that your kidneys stones are too big to be passed at home or notices that you have serious signs of infection, the doctor will use a medical procedure to remove the stones while you are at the clinic or hospital. For instance, lithotripsy is an effective procedure that relies on shock waves to break down larger stones into smaller pieces for easy removal. In cases where lithotripsy is either ineffective or inappropriate, the urologist will use a more invasive method such as inserting a ureteroscope (a special scope) into your urethra or reaching the stone via an incision, a technique called percutaneous nephrolithotomy.

Make sure to seek emergency treatment of kidney stones if you:

  1. Have fever and chills, which are indicators of an infection.
  2. Experience a total failure to pass urine.
  3. Have a history of kidney removal and only have one kidney.
  4. Develop severe fatigue or confusion.
  5. Have severe nausea or vomiting.

Emergency treatment should be sought even if the symptoms are mild. For more information and help with kidney stones, visit the “St Pete Urology” site.

5 Essential Reasons Why Women Should See A Urologist

Urologists are not only specialists for men but also providers of essential medical services for women. Trained to treat urinary tract problems both medically and surgically, urologists offer the best treatment for bladder control issues and other disorders of the female urinary tract and reproductive system. So when faced with urological issues at any stage of life, women may need to see these doctors for quick resolution of the problems. In fact, women should consider seeing urologists when having frequent urges to urinate, leaking urine, pain in the sides or back, bloody urine, and burning or pain during urination. The 5 essential reasons why women should see a urologist are:

1. Overactive bladder

Characterized by a sudden, uncontrollable urge to urinate, waking more than once at night to urinate and urinating 8 or more times in 24 hours, overactive bladder affects many women of all ages and has several potential causes. Since treatment for the condition is dependent on the identified cause, it is important to see a urologist to carry out tests in order to determine the cause and recommend the best treatment. At St. Pete Urology in St. Petersburg, doctors use specialized testing and recommend personalized treatment for women with overactive bladder.

2. Urinary incontinence

Bladder control problems can affect women of all ages and are a very common issue. By definition, urinary incontinence is the loss of bladder control which can lead to accidental leakage of urine. For example, women with urinary incontinence (UI) have trouble holding urine, particularly when they cough, sneeze or exercise. Caused by obesity, pregnancy later in life, childbirth and even menopause, UI affects roughly 57 percent of women between the age of 40 and 60. Treatments for the condition include exercises for strengthening pelvic muscles, medication, implanted devices, injections and surgery.

3. Recurrent urinary tract infections (UTIs)

Even though urinary tract infections commonly occur in women and can be quickly treated with antibiotics and other measures, recurrent infections may be a sign of a larger issue requiring the attention of a urologist. Women experiencing two or more urinary tract infections in 6 months, or even three or more UTIs in one year should see a urologist to explore the possibility of having a recurrent problem. The urologist will diagnose the issue using kidney scans, culture test and other tests, identify the actual cause of the recurrent infection, and recommend effective treatment for breaking the series of recurrent infections.

4. Kidney stones

While kidney stones are a more common problem in men than women, about 7 percent of women will have kidney stones at some stage of their life. There is a higher risk for a woman to develop kidney stones if she does not drink enough water, frequently eats meals high in protein, takes medicines that can cause kidney stones as a side effect, has had a stone before, has certain diseases, or is over 50. The stones can form in the bladder, ureters or kidneys and may be passed out on their own with high fluid intake or removed through different treatment options. If you are a woman experiencing extreme pain on your back, side, lower abdomen, groin, or pain during urination, vomiting, nausea or blood in urine, please visit St. Pete Urology in St Petersburg for immediate help.

5. Fallen bladder and bladder cancer

The bladder is usually held in position by the pelvic floor. But when the pelvic floor is stretched or weakened, particularly due to aging, menopause, obesity or prior pelvic surgery, the bladder may drop into the vagina, resulting in complications such as overactive bladder, urinary tract infections and urinary incontinence. Pelvic floor prolapse (also called fallen bladder or cystocele) can be corrected either surgically or nonsurgically by placing a pessary in the vagina to hold up the organs. Apart from fallen bladder, urologists are also recommended to treat bladder and kidney cancer.

Conclusion

If you are experiencing symptoms such as blood in urine, frequent urination, burning or pain when urinating, or pelvic pain, call or visit St. Peter Urology for help. Our urologists offer top-of-the-line comprehensive urological services to women and are committed to patient satisfaction. Evaluation of urological conditions includes a complete patient history, medical exam, urodynamics (bladder EKG), imaging, cytoscopy and all necessary lab tests. For more information on the treatment of urological conditions in women, visit the site, St Pete Urology.

Why Interstim Therapy is For Both Men and Women

For men who suffer from embarrassing and frustrating bladder control problems like retention and overactive bladder, it is typically difficult to control when and how much you urinate. As a result, you may be compelled to cut back on your everyday activities, feeling trapped by the fear of accidental leaks and being unduly preoccupied with your bladder. Unfortunately, you also may find out that common treatments such as behavior modification, drugs, dietary changes, use of catheters to empty your bladder or pelvic floor exercises do not effectively treat your symptoms. What can you do when traditional treatments for bladder problems fail or are intolerable? Never despair. Instead, just visit a competent urologist to administer InterStim therapy.

What is InterStim Therapy?

Also called Sacral Nerve Stimulation (SNS), InterStim is a reversible therapy for treatment of urinary incontinence, urgency (frequency), urinary retention and overactive bladder. It involves implanting an InterStim device (neurostimulator) into the skin in order to send mild electrical pulses to the sacral nerves (nerves located above the tailbone) which control the bladder and muscles associated with urinary function. As a result, the electrical stimulation of the sacral nerves promotes communication between the brain and bladder, improves bladder control functions and eliminates symptoms of overactive bladder and urinary incontinence.

Effective for Both Men and Women

Many people tend to consider InterStim therapy as an exclusive treatment for women with bladder control problems. In truth, however, the therapy is also ideal for men who have failed medications, experience serious adverse effects with bladder medications or do not like using catheters to empty their bladder. Incontinence is a common problem affecting both men and women and any person experiencing the problem can explore InterStim therapy as an effective and convenient option regardless of their sex.

How is the Procedure Performed?

InterStim therapy is a two-stage process involving minimally invasive testing (test stimulation) and the eventual placement of the InterStim device. The urologist conducts the non-invasive test to determine the possible response to the actual device while allowing patients to see if InterStim would be appropriate for them. After successful testing, the InterStim device is placed using a minimally invasive technique in which small and inconspicuous incisions are made on the skin.

InterStim improves the quality of life and will help you to return to your normal life quickly with no more worries of accidental urine leaks. Doctors at St Pete Urology have conducted hundreds of InterStim therapy since the device was approved by the FDA. We help both men and women regain their confidence and dignity. For more information on treatment of bladder control problems, visit the site, St Pete Urology.