Vasectomy Reversal – Does it REALLY work?

A vasectomy reversal is the procedure to reconnect the tubes (vas deferens) that are cut and sealed off during a vasectomy. Though still considered a permanent method of birth control, advances in microsurgery have ensured that it can be reversed even after 15 years or more. Men can choose to undergo a vasectomy reversal after a remarriage, a change of heart, loss of a child, or to treat testicular pain associated with a vasectomy. The reversal is typically an outpatient procedure performed under general or local anesthesia, taking around 3 hours and followed by a short recovery period. Nevertheless, only about 6 percent of men who undergo a vasectomy choose to have it reversed later.

Success rate of vasectomy reversal

The success rate of reconnecting the tubes severed during vasectomy is quite high, about 90 percent. After a successful reconnection of each tube, sperm is again able to pass from the testicles through the tubes and reach semen, and a man may again be able to get his partner pregnant. But the success of a vasectomy depends on a number of factors, such as the state of the tubes during the reversal and how many years have elapsed since the vasectomy was done.

If you undergo a vasectomy reversal within seven years of the vasectomy, the reversal is a simple procedure of putting the vas deferens back together. But if the tubes are too short to reconnect, if there is scarring or it’s been more than seven years since you had the vasectomy, the reversal process may be more complex. However, even with the more complex procedure, the success rate is still around 50-60 percent with no much difference in pregnancy rates — the average being 50-60 percent likelihood of pregnancy, which drops to 44 percent if time since a vasectomy is greater than 15 years.

If the time since vasectomy is less than 15 years, the reversal provides a pregnancy rate that’s higher than in vitro fertilization (IVF) and sperm aspiration with intra-cytoplasmic sperm injection (ICSI). And even after intervals greater than 15 years since a vasectomy, the reversal still gives outcomes equal or greater than IVF with ICSI.

Vasectomy reversal techniques

Vasectomy reversal is usually performed in two ways. The first technique is vasovasostomy (VV), which is basically the piecing back together of the two sides of the tubes (vas deferens) — that is vas deferens to vas deferens. The other technique is vasoepididymostomy (VE), which involves reconnecting the vas deferens to epididymis, the duct that transports sperm to the vas deferens. Generally vasovasostomy (VV) is done if sperm is present in the vas fluid. If sperm isn’t present in the fluid, vasoepididymostomy (VE) is the go-to procedure. In some cases, a combination of both techniques may be necessary, with a vasoepididymostomy done on one side and a vasovasostomy on the other.

A vasoepididymostomy is slightly more complicated and therefore chosen only when a vasovasostomy is impossible or can’t work. You won’t know the technique that the surgeon will use until the operation begins and that usually depends on whether sperm is present in the fluid found in the vas deferens at the time of surgery. Both are outpatient procedures that take less than 3 hours. A man has a successful vasectomy reversal if sperm evaluations performed several months later indicate he has the normal sperm count necessary for conception.

How should you prepare for a vasectomy reversal?

A vasectomy reversal is a complex and expensive procedure that’s often not covered by insurance. So you should find out what you’ll need and all the costs well ahead of time. The procedure is generally more successful when performed by surgeons who are trained and experienced in microsurgical techniques and who have done the procedure several times. So when choosing a doctor for the procedure, find out how many reversals the surgeon has performed, the techniques used, how often pregnancy has occurred after surgery, and the risks and complications involved.

Similarly, you’ll need to buy tight-fitting undergarments (like an athletic supporter) that you will wear after the procedure to hold bandages in place and support your scrotum. You also will need to stop taking medications that increase the risk of bleeding, including pain relievers (like ibuprofen or aspirin) and blood-thinning drugs. You should make arrangements for your travel to and from the hospital and for the length of time you will need to recover after surgery.

What should you know before a vasectomy reversal?

Vasectomy reversal is performed as an outpatient procedure that doesn’t require an overnight stay in a hospital. Before the procedure, the surgeon will take your medical history and conduct a physical examination to make sure you’re not having any health problems that may lead to complications after or during surgery. If your physical exam shows abnormal results or you’ve got sexual function issues, the doctor may consider running some blood tests. Likewise, a review of your surgical history is done to assess whether you had any previous surgeries other than the vasectomy or prior injuries that can hinder the vasectomy reversal. The doctor also will confirm whether you can produce healthy sperm. While evidence of fathering a child before is usually sufficient proof of the health of your sperm, additional testing may be necessary if there is uncertainty.

What happens during a vasectomy reversal?

Once you’re in the operating room, anesthesia is applied to minimize discomfort during the procedure. That may either be general anesthesia to keep you unconscious throughout the procedure or a local, spinal or epidural anesthesia to minimize pain but without putting you to sleep. The surgeon then makes a small incision on the underside of your scrotum to expose the tubes (vas deferens) and free them from surrounding tissues. Cutting open the vas deferens, the surgeon examines the fluid inside the tubes to establish whether sperm is present. If it’s found that sperm is present, the doctor simply reconnects the ends of the tubes to enable sperm passage. If the fluid inside the vas deferens is pasty, thick or contains partial or no sperm, that’s usually an indication that there’s a blockage of sperm flow and that vasovasostomy may not work. In that case, vasoepididymostomy is the more appropriate procedure.

What happens after the procedure?

After the procedure, the doctor applies bandages to cover the incisions. Make sure to ask your doctor when it will be OK to take the bandages off. The stitches applied should dissolve in 7-10 days. You will be required to wear tight-fitting undergarments (like athletic supporter) and apply ice to minimize swelling. The area may feel sore for many days, but the pain shouldn’t be severe and should improve within a few days to one week.

Once back at home, make sure to take it easy and avoid any activities that may move the testicles excessively or pull on the scrotum or testicles, such as heavy lifting, biking, jogging or sporting activities. For the next several weeks, wear an athletic supporter at all times, removing it only when showering. Avoid activities such as swimming and bathing for the first two days following surgery because they can make the surgery site wet. If your job requires much driving, walking or physical exertion, seek your doctor’s advice on when it’s safe to return to work. But for a desk job, you can return to work within a few days after surgery — only making sure that nothing harms the surgery site. Do not ejaculate or engage in sexual intercourse until your doctor gives you a go ahead — that is often 2-3 weeks after surgery.

What results should you expect?

To assess the success of a vasectomy reversal, the doctor will examine your semen 6-8 weeks after surgery. If the procedure is successful, sperm will be present in the semen. The appearance of sperm in semen should happen within a few months, but may take a year or more in some cases. So the doctor may have to conduct periodic semen analysis to evaluate the success of the procedure, unless your partner gets pregnant soon after the reversal. The prospect of achieving pregnancy usually depends on a number of factors, including the age of your female partner and the duration of time that has elapsed since the vasectomy.

Can the reversal fail to work?

If a blockage develops in the tubes after surgery or there is an underlying issue with your testicles that wasn’t recognized during surgery, a vasectomy reversal can fail to work and you may need a second-attempt reversal procedure. Doctors often opt to collect and freeze some sperm during a vasectomy reversal, which can then be used if the procedure doesn’t work. But if sperm isn’t frozen during the procedure or you completely lack sperm in your ejaculate, sperm can still be retrieved directly from your epididymis or testicle to help you have children via assisted reproductive techniques, like in vitro fertilization.

At St Pete Urology, we have a huge pool of urologists trained in andrology and experienced in microsurgical techniques. We conduct the procedure under very high-level magnification using incredibly small sutures. We perform several vasectomy reversals every year and boast significantly high success rates. So if you are looking for specially trained and skilled doctors to reverse a vasectomy in a way that will maximize your chances of having children, come and see one of our urologists. For more information on vasectomy and vasectomy reversal procedures, visit the “St Pete Urology” site.

GreenLight PVP Laser, a Great Treatment Option for BPH

Photo-selective Vaporization of Prostate (PVP) is increasingly becoming a popular method of treating benign prostatic enlargement (enlarged prostate or BPH). Using a combination of a high-powered laser beam and fiber optics to vaporize overgrowths of cells in the prostate, PVP helps to shrink the prostate gland quickly and accurately and swiftly relieves symptoms of Benign Prostatic Hyperplasia. The GreenLight Laser PVP is an alternative to the more common TURP (Transurethral Resection of Prostate). While the PVP procedure offers equal effectiveness in improving BPH symptoms, it’s simpler, has minimal short-term side effects, and offers quicker symptom relief, comfort and ease of urine flow.

How Is The Procedure Performed?

Conducted as an outpatient procedure by a urologist trained in the technique, the GreenLight Laser PVP requires nerve-blocking, spinal or general anesthesia along with sedation. During the procedure, the urologist inserts a cystoscope (tube supplied with light) via the urethra into the prostate, then runs a thin fiber through the cystoscope and places it in the urethra just adjacent to the obstruction. The urologist directs the laser at the prostate with intense pulses of light radiating from the ends of the fiber that are absorbed by blood.

As the blood absorbs light its temperature increases rapidly, heating up and vaporizing nearby cells. The surgeon continues to apply the laser light to destroy tissue overgrowth and reduce restriction on the urethra. The tissue that’s evaporated seals the blood vessels and reduces bleeding. The procedure takes roughly 40-60 minutes and a temporary catheter is usually inserted to help drain urine from the bladder.

So what are the benefits of Laser PVP?

  1. Minimal bleeding.
  2. Patients return home the same day.
  3. Return to normal activities in 2-3 days with caution.
  4. Only about 30 percent of patients require a post-op catheter.
  5. Return to strenuous activities in 4-6 weeks.
  6. Complications are rare, but quite mild if they occur.
  7. No post-operative impotence.
  8. PVP has not been associated with erectile dysfunction.
  9. Less likely to cause retrograde ejaculation.
  10. Lasting improvement in urine flow.
  11. Urinary obstruction is less likely with PVP.

Recovery after GreenLight Laser PVP

After laser PVP, patients remain in a recovery area where they are observed and prepared for discharge, typically within a few hours. If a temporary catheter is inserted, it’s usually removed 2-3 days after treatment, but may be left for a longer period in men who have had very severe symptoms or suffered prior bladder damage. During the first week following the procedure, a slight burning and discomfort may be experienced when urinating and small amounts of blood may occur in urine. While a dramatic improvement of symptoms and urine flow occurs within 1-2 days after the procedure, patients may still experience frequency and a sudden urge to pass urine for some time after treatment since the urethra is still adjusting to changes. And those with multiple health problems may not realize improvement that quickly.

Many men resume normal activities three days or so after laser PVP, but it’s recommended that they refrain from heavy lifting, pushing, strenuous exercise and vibrating equipment for at least 2 weeks because such activities may aggravate the urogenital area and cause bleeding. Sexual activity should be avoided for 2-3 weeks and only resumed when the patient is really comfortable doing so. It’s crucial to take things slowly and realize that it’ll take a while to get everything back to normal, including sexual desire. At times, retrograde ejaculation or reduced volume may occur, but these do not affect sexual pleasure or orgasm.

Is Laser PVP Safe?

The GreenLight Laser PVP is a significant improvement on the other minimally-invasive procedures used to treat BPH. It accurately vaporizes the overgrowth of the prostate gland without damaging any surrounding tissues and vessels. High-powered energy beams are delivered through a very thin laser fiber resulting in safe and precise vaporization of the overgrown tissue that’s blocking normal urine flow. As the high-pulsed laser removes the tissue causing blockage, it coagulates blood vessels and minimizes bleeding. Compared to other options for treating BPH, the GreenLight Laser PVP is much safer, simpler, faster, more precise and more effective. And most importantly, it allows quicker recovery than the other treatment options.

How does laser PVP compare with TURP?

Previously, effective BPH treatment required open prostatectomy — a major abdominal operation that needed a longer hospital stay and several months for recovery. But with the availability of instruments for accessing the prostate via the urethra instead of through the abdomen, TURP (transurethral resection of prostate) became the preferred treatment as it offered more safety, efficiency and effectiveness. However, there was still need for a better treatment that could offer quicker results, shorter recovery times and fewer long-term side-effects. The GreenLight Laser PVP has proven an improvement on TURP by being less invasive, delivering more immediate results and providing shorter recovery periods.

At St Pete Urology, we recommend transurethral vaporization procedures, most commonly the PVP GreenLight Laser and HoLAP (Holmium Laser Ablation), as alternatives for the previous gold standard TURP (Transurethral Resection of Prostate) because they are minimally-invasive outpatient operations with lower risks, durable results, safe use on large glands and patients on blood thinners, and high patient satisfaction. We perform the PVP GreenLight Laser on patients eligible for TURP, but discuss all the treatment options with our patients before we make a choice. For more information on treatment and care for BPH, visit the “St Pete Urology” site.

What Does A Urologist Do?

If you have never been to a urologist, you may feel uneasy about your first visit. You may be seeing the urologist about a very awkward and distressing condition. In truth, though, there is no reason really to worry or feel squeamish. Urologists make every effort to keep their patients at ease and as comfortable as possible. So you can be sure that you’ll meet warm, friendly and candid professionals in the urologist office, be handled with respect, courtesy and friendliness, and have your problem solved.

Who is a urologist?

Urologists are physicians with specialization in diseases of the genitourinary tract — urinary bladder, kidneys, urethra, male reproductive organs, adrenal glands and urethra. In men, urologists tackle disorders of the prostate, penis, epididymis, testes and seminal vesicles and help resolve male sexual dysfunction and infertility. But most routinely, they see both men and women for various reasons, including recurrent urinary tract infections, urinary incontinence, kidney disease, renal transplants, urologic cancers, bladder prolapse, enlarged prostate, urethra stricture, erectile dysfunction, Peyronie’s disease, painful bladder syndrome, ureteral and kidney stones, and prostatitis. They also may see children with urological problems that are too complex to be handled by non-specialized pediatricians.

Prostate and bladder cancer

For most men, a visit to the urologist is often associated with the prostate exam. The exam is quite a crucial part of assessing the overall prostate health and enables the urologist to plan well for treatment of any prostate problems. But the prostate exam is no longer at the heart of every urologist visit and you now can see a urologist and leave without being examined. In fact, with increased use of PSA tests to screen for prostate cancer, the exams are now just performed when very crucial. You shouldn’t avoid those necessary visits to a urologist merely because you don’t like prostate and rectal exams.

Remember also that if after testing you are diagnosed with prostate cancer, your urologist can help by offering timely, lifesaving care. Actually, because the physician can detect and help you recover from a disease that can potentially incapacitate you and reduce your joy of life and the time you spend with your family and your loved ones, it’s very important to visit a urologist whenever you are directed to do so.

Urologists use some of the best medical techniques and technologies to deliver safe, painless and effective treatment for urologic cancers. For example, if your urologist opts for robotic surgery then you will not be in the hospital for more than a week after a kidney, prostate or bladder cancer surgery. Most likely, you will take only a few days, even a single day — leaving soon after procedure. That’s fast and convenient, indeed. So you shouldn’t suffer in silence and have your prostate cancer spread to other areas of the body just because you believe the treatment will be painful, uncomfortable or inconvenient.

Prostate enlargement

If you have had to habitually wake up at night to pass urine and always find it difficult to produce a steady, quick urine stream as you once did, you probably have an enlarged prostate and a urologist can help you overcome the condition. This specialist doctor is quite similar to that neighborhood plumber you call to your home when pipes are clogged. So when you visit a urologist, are examined and found to have an enlarged prostate, the doctor will use a number of techniques such as laser therapy and steam treatment to remove the pressure on your bladder and obstruction on your urethra, relieving your urinary symptoms. And you can return home the same day you undergo treatment.

Erectile dysfunction

As men get older, they may experience erectile dysfunction. In fact, for men in their 40s or 50s, erections aren’t what they once were. So what should you do when you have issues with your erections? Well, one great option — a visit to a specialist who can identify the cause of your erectile problems and provide effective treatment. And that’s a urologist — a physician with training and experience in treating erectile dysfunction and male infertility issues. Since erectile dysfunction also may indicate that you have health problems in other areas of your body which may require more careful attention, a visit to a urologist can help detect a more serious disease and save your life.

Kidney stones

The pain and discomfort of a major kidney stone is something you may never forget. But with a visit to a urologist, kidney stones of all sizes can be broken down and removed from your system. A urologist sees such cases routinely, knows exactly what to do and will help you find quick relief from the pain and discomfort of the stones. And since kidney stones may recur, you will require the long-term care and well-coordinated follow-up provided by urologists. The urologist will recommend effective ways you can use to prevent kidney stones and manage any painful stones you may develop. That means you can rest easy before or after you have kidney stones knowing that you have an expert to help you deal with such troubles. So if you suspect that you have or are at risk of kidney stones, visit a urologist for proper examination and treatment.

What if you are a woman?

Urologists see women too and there is no discrimination in terms of sex. In fact, because kidney stones and bladder problems can occur in both men and women, the doors of all urologists are always open for both sexes. Nevertheless, about two-thirds of all patients seen by urologists are still men because of the lower awareness levels among women on how these specialist physicians can help them. Likewise, visits to urologists are generally practice-specific and vary according to a doctor’s area of specialty training.

While it doesn’t really matter whether you see a male or female urologist — as the quality of care will be the same — some women prefer to be treated by female urologists while some men prefer seeing male urologists. That’s just a matter of choice and you are encouraged to see the urologist you feel most comfortable with. But as you do so, remember that all urologists are focused on holistic care, effective treatment, superb outcomes and improved quality of life for all. So even if you are a guy who is generally bashful when around females, you shouldn’t fear seeing a female urologist, for whatever condition you have isn’t something the female urologist hasn’t seen before. Don’t suffer in silence because you are anxious about being attended to by a urologist of opposite gender.

What of pain?

Pain isn’t part of the treatment process. So every time you see a urologist for a procedure, you should expect the use of an anesthetic to prevent pain and keep you comfortable. For instance, before undergoing a bladder scope, you’ll be numbed first; while the first step during a vasectomy is the injection of a nice, healthy-sized local anesthesia. Similarly, before a prostate biopsy, a prostate block is done. Whereas you may feel things moving around or some pressure during a procedure, you should not feel pain. And the point here is that you should know urologists are there to help you deal with inconveniencing problems, such as sexual function issues, urinary problems, cancer or kidney stones. But when doing so, they endeavor to keep you as comfortable as possible, aiming to eventually improve your quality of life.

Friendly, compassionate care

Urologists are skilled and experienced in treating problems that people are often unwilling to talk about or which are found in body areas that people find difficult to discuss. So your urologist knows that you are already distressed, embarrassed and feel awkward about your condition even before you visit, and has already taken steps to make you feel as comfortable as possible. By being frank and friendly throughout the treatment process, with humor coming in handy to help lighten the mood around your discussions, the doctor will ensure that you feel at home as your problem is tackled. Hence, don’t be surprised when some “potty” humor is thrown your way during your chat with the urologist.

Well, that’s it. There is nothing to dread or feel restless about in seeing a urologist. In fact, you will find a long-term friend who will help you overcome troubling urological issues and improve your quality of life. At St Pete Urology, we have a big pool of skilled, experienced, board-certified urologists to help you find relief from embarrassing and distressing genitourinary problems, such as kidney stones, urinary incontinence, erectile dysfunction and enlarged prostate. And we have a culture of collaborative, compassionate, patient-centered care that helps us deliver the high-quality of treatment and care we promise our patients. Find out more about our services by visiting the “St Pete Urology” site.

10 FAQs to Urologists

Urologists tackle a variety of distressing and embarrassing conditions, improving the quality of life of their patients. From awkward urine leaks, agonizing kidney stones and humiliating failures to have an erection to life-threatening urologic cancers, urologists resolve issues that many people would rather not discuss. And because some of these issues are shrouded in secrecy, myths and untruths have developed around them which, if not tackled, may keep patients from getting treatment. There are also questions that people often seek answers for from the wrong people and which can only be properly answered by urologists. Here are 10 common, questions that urologists respond to quite frequently.

1. I feel something in my scrotum or testicle. Is that normal?

Well, there are lots of normal structures in the scrotum, particularly outside the testicle. But there are also a number of abnormal structures that may occur in the scrotum. For instance, a hydrocele is a collection of fluid around the testicle while a spermatocele is a cyst or excess fluid in the epididymis. A varicocele is a collection of unusually large blood vessels that feels like a bag of worms in the scrotum and often occurs on the left side. When a varicocele occurs, it can reduce the size of the testicle and lead to infertility. A man also may feel an actual lump in the testicle, which could indicate testicular cancer.

Whether you have a hydrocele, spermatocele, varicocele or lump in your scrotum, you should know that these are abnormal. To detect these abnormalities earlier and treat them before they advance, you should examine your testicles at least once a month. You will need to check when showering by supporting your testicle with one hand and using the other hand to feel them. If you feel anything hard or irregular inside your testicle, contact your doctor for diagnosis and treatment.

2. Can I break my penis?

Yes. While the penis is boneless, it’s made of a strong layer of tissue called tunica albuginea, which gives it rigidity during an erection. When blood flows at high pressure through these erectile bodies in the penis, this strong layer of tissue retains the blood inside and allows for erection. However, during intercourse, the fibrous connective tissue of the penis may “break” resulting in a penile fracture. When this occurs, usually in a loud, painful snap, you will bleed through the break and the erection will subside (detumescence). You also may experience swelling and bruising of the penis, which usually requires emergency surgery.

3. Should I be worried when there is blood in my semen?

Semen is typically white and thick, but may come in different consistencies. Should you have persistent blood in your semen (hematospermia), then you should definitely be worried as this may indicate a prostate problem. Likewise, you should visit your doctor for a check-up if you have painful ejaculations or a foul-smelling ejaculate as this could indicate an infection.

4. Can a young man fail to get an erection?

Only about 5 percent of men under the age of 50 have severe erectile dysfunction. So you need to speak with your doctor if you are young and can’t get an erection. Erectile dysfunction in young men may be due to a past trauma, vascular problem, disease affecting blood vessels or nerves, such as hypertension or diabetes, or some illegal drugs, prescription drugs and smoking. While this occurs only in a small proportion of young men, it should worry you if it occurs frequently.

5. How long is a normal penis? Can my small penis be made bigger?

A normal penis is 3.5-7.5 inches, with the average being about 5.5 inches. If you have a normal-size penis, just be contented with it as there is no safe way of increasing penis size.

6. Should I be concerned when my penis or scrotum has acne? Which spots are abnormal?

The hair follicles on your scrotum or penis can be infected or irritated. This is quite common and should not worry you. However, you should see your doctor if you have something that appears like the head of a cauliflower (probably a wart), an ulcerous wound or skin breakdown with a weeping wound, or something that begins as a red area then expands and produces pus (probably a signal of a serious infection).

7. Are urinary tract infections sexually transmitted? Can a toilet seat spread sexually transmitted diseases?

While some urinary tract infections have similar symptoms to sexually transmitted diseases, UTIs are generally not considered STDs. In fact, a standard UTI, such as E. coli (the most common type) is not transmitted sexually and is often caused by bacteria that’s abundant in the affected area. While a woman who is prone to UTIs may have an infection after sexual intercourse, this doesn’t mean the partner carried an STD. The woman also can not transmit a UTI to the male partner. Similarly, although it’s possible to get an infection from a contaminated toilet seat, it is quite rare for infections to be transmitted this way.

8. Should I be circumcised?

The health or medical benefits of circumcision are still debated and no doctor can make this decision on behalf of a patient. But you can choose to undergo circumcision for personal reasons. While the AAP (American Academy of Pediatrics) has reported that the health benefits of circumcision outweigh the risks involved, it does not endorse routine circumcision of newborn males. But the procedure may be valuable for treating infections of the penis and phimosis (foreskin that fails to retract) in older boys and men.

9. Should I be worried about my curved penis?

Curving of the penis is called Peyronie’s disease. Generally, curvatures of 30 degrees or less cause no functional problems and should not worry you. But if the curvature is greater than 30 degrees, it can affect intercourse and should be fixed. There are various ways of treating Peyronie’s disease. For instance, collagenase injection into the scar tissue can reduce the curvature. Likewise, a surgical removal of the scar tissue with a penile prosthesis or graft can help. Or your doctor can perform a surgical unbending (plication) of the penis.

10. I struggle to start urinating and take a long time to complete, should I be worried?

That’s probably an enlarged prostate. Also called BPH (benign prostatic hyperplasia), the condition puts pressure on the bladder and urethra and makes it difficult to start a urine stream or empty the bladder completely. There are medicines that can help relieve most cases of BPH, but if your urinary problems are very severe to the extent you can’t empty your bladder, then surgery may be necessary. If you’ve just started experiencing urinary symptoms, then you shouldn’t be worried about prostate cancer as such urinary problems occur only at a very late stage of the cancer.

Need answers for other urology-related questions? Visit the “St Pete Urology” site to find the answers to your questions.

Addressing 7 Vasectomy Myths

Alright guys, it’s time now to talk about the big V! When you hear about different birth control methods, whether through word-of-mouth, billboards, newspapers, TV or radio, you seldom hear anything about vasectomy. We want to talk to you about vasectomy now, explain away the myths and fears around it and shift the birth control discourse from the most common approach of what women should do to what men can do.

So what’s a vasectomy?

It is a simple, 15-minute non-drug permanent sterilization procedure for men. It’s performed under localized anesthesia and involves sealing off or cutting a portion of the sperm-conveying tubes (called vas deferens) in order to stop sperm from reaching the ovum when ejaculation occurs. If you are a man who has had all the children you wanted to have or are sure that you will never want to have any children in the future, vasectomy is a safe and cost-effective way to sterilize yourself.

Lots of questions

Yet, if you are like most men, you have probably heard the horror stories associated with vasectomy and you are worried that things may go wrong for you. Will it reduce my sexual pleasure? Will it turn me into a “eunuch” — a sad miserable man looking back constantly to his youthful years with nostalgia? And what if disaster strikes late in my life, or my life plans change, and I decide to have children? Can I reverse it? These and many more questions can make you have doubts about having a vasectomy. But it turns out these fears are baseless myths that shouldn’t stop you from a vasectomy.

What are the most frequent myths about vasectomy?

1. It will be intolerably painful

Honestly, for most men, the idea of the whole procedure can seem quite awkward. And since most of us have the habit of protecting our testicles from any type of direct assaults, a vasectomy seems like a real intrusion into a protected zone. But the truth is doctors who conduct vasectomies have gone through many years of study and training. They know what they are doing. They use the latest minimally invasive techniques to perform the procedure, ensuring that you feel no pain. The procedure is done under local anesthetic, so you will probably only have to worry about the needle going in. After that, you will remain aware of the procedure as it goes on but you will feel no pain or uncomfortable sensations.

2. Your penis won’t work

That’s wrong, mate. In reality, the procedure isn’t done anywhere near your penis — except of course if it’s causing an obstruction and the urologist has to move it out of the way. The snip is entirely about your balls and affects only those little tubes inside your balls that are called the vas deferens. Remember too that when you have sex and reach orgasm, the fluid that comes out, called ejaculate, is 97 percent semen and only 3 percent sperm. After vasectomy, you will still achieve orgasm and produce this ejaculate, except it won’t contain sperm and you won’t be able make your partner pregnant. That means your erections will remain exactly the same and your penis will stay as sensitive during sex as it was before the vasectomy. Likewise, your ability to enjoy sex and achieve orgasm will remain unchanged, though now you’ll be able to do so without having to worry about making anyone pregnant.

3. You will no longer ejaculate

That’s wrong, too. If you ejaculated before the snip, you’ll continue to do so after. Semen, the main component of ejaculatory fluid, is produced in the seminal vesicles and the prostate, which aren’t cut or blocked off during a vasectomy. And since only a small portion of fluid comes from the testicles with sperm, the overall volume of your ejaculate will reduce only slightly after a vasectomy — you won’t even notice it. Likewise, because the muscle contractions that propel fluid out during ejaculation typically come from the pelvis, your ejaculations won’t be affected by a vasectomy.

4. Your sperm production will shut down

Not true. Vasectomy doesn’t block sperm production and you’ll continue to make sperm after the snip. The only difference is that sperm will no longer reach semen and form part of the ejaculate. Because the sperm will go nowhere after a vasectomy, it will live for 3-5 days and decay naturally in the body. This is the same thing that happens naturally in men if they don’t ejaculate every 5 days or so. They produce sperm continuously but the sperm goes nowhere and is reabsorbed naturally in the body.

5. You can’t reverse it once it’s done

No, you can if you want. Vasectomy can be reversed through a surgical procedure called vasovasostomy (vasectomy reversal). During the procedure, the vas deferens (tubes) are reconnected, with each tube re-joined as it was before the snip in order to create a passageway for sperm, allowing sperm to again be present in semen. A successful reversal procedure restores your fertility and you can again make your partner pregnant. But when considering a vasectomy reversal, you need to consult an experienced urologist. That will ensure that no tissues are irreparably damaged during the reversal procedure.

6. Even if it’s reversed, you’ll remain impotent

Not really. With microsurgical advances currently used in vasectomy and vasovasostomy, the reversal has become more precise and more successful. So while vasectomy reversal is still technically expensive and demanding, doctors can now successfully restore a man to his pre-vasectomy condition. Although many men think that vasectomy can make them impotent, they should know that the procedure has no effect on blood flow to the spongy veins of the penis. These veins cause an erection. A vasectomy tends to make love-making more pleasurable and fun through the exhilarating feeling accompanying the ejaculation of spermless semen and also by erasing the fear of pregnancy.

7. It’s harder than a woman getting her tubes tied

A nice try indeed, but still wrong. Tubal ligation is performed under epidural or general anesthesia and typically takes longer than the 10-20 minutes required for a vasectomy. Tying a woman’s tubes also comes with a much more serious complication rate than a vasectomy. So why not just take the simpler route to contraception and block the source of sperm in order to remove the burden of birth control from women instead of looking for excuses to pressure women with contraception? After all, vasectomy is more effective than tubal ligation, costs much less and guarantees better results. In fact, for partners and couples considering family planning, vasectomy is a great cost-saving and effective solution to consider.

What if you are just one of those men who want to have multiple sexual partners without any additional responsibilities? Well, vasectomy works for that too. If you get a vasectomy, you can enjoy your lifestyle without having to worry about the possibility of fatherhood.

Want to know more about vasectomy? Speak with your partner and assess whether you have had all the children you want. Once you are sure of your decision, visit your doctor to discuss this birth control method. For more information on vasectomy and vasectomy reversal, visit the “St Pete Urology” site.

How To Manage The Pain Of Kidney Stones?

Marked by an agonizing, excruciating and intolerable pain, kidney stones account for over 1 million annual emergency room visits in the United States. The pain usually starts in the upper flank, as a sudden twinge on the side, escalates to the loins and migrates to the front of the body. The sharp stabbing pain of kidney stones is worse than childbirth pain and quickly makes it impossible to function. It is important for you to know how to prevent kidney stones and how to deal with the pain if you get the stones.

What are kidney stones?

Kidney stones are small, hard pebble-like lumps formed when there are high levels of various minerals in urine. The minerals and other substances crystallize and form hard masses before they can be flushed away. Classic stones are a blend of calcium and oxalate (an organic acid found in urine), but lumps of uric acid, calcium phosphate and other substances also may form. A stone may sit in the kidney or ureter with little or no pain. But often when the stone leaves the kidney or gets stuck in the ureter, it blocks the flow of urine and causes pain.

Symptoms of kidney stones

When a kidney stone moves around in the kidney or gets lodged in the ureter, it may block the passage of urine. Such a blockage causes:

  1. Sharp, stabbing pain on the side or in the back.
  2. Painful urination.
  3. Pain episodes that come and go.
  4. Blood in urine.
  5. Fever, nausea and vomiting in case of an infection.

Kidney stones are perhaps the most painful condition known. In fact, most patients with stones often find themselves in the hospital emergency department. In all cases of pain due to suspected kidney stones, urologists first rule out other possible causes of pain, such as bowel, gynecologic and musculoskeletal problems. The presence of kidney stones is confirmed by X-rays or CT scans. Blood and urine tests also may be used to assess the levels of various stone-forming substances in your system.

Managing Pain Due To Kidney Stones

Once it is confirmed that you have kidney stones, the urologist will give you intravenous painkillers to relieve pain. You then will be sent home with oral drugs (such as acetaminophen, aspirin, diuretics, and antibiotics) to use as you wait for the stone to pass out of your system. Drinking plenty of water, taking hot showers, sitting in a warm water tub and taking drugs that dilate the ureter will bring relief and allow the stone to pass. Eventually the agony will end when the stone passes out.

Smaller stones are more likely to pass on their own. In fact, 80 percent of kidney stones are usually less than 4 mm in diameter and typically pass on their own, though that takes up to 31 days. It is more difficult for larger stones to pass on their own. Stones of 4-6 mm in diameter tend to pass on their own 60 percent of the time while those larger than 6 mm only pass out 20 percent of the time. Therefore in most cases, a non-invasive or minimally-invasive medical procedure is necessary to remove stones larger than 4 mm and those stuck in the ureter.

Surgery for Kidney Stones

Non-obstructive stones rarely cause pain. So surgery is not necessary when kidney stones are not causing any obstruction. And even if they cause pain, medications are usually sufficient. But surgery is required when there is bothersome flank pain and imaging evidence of one or more obstructive stones.

Common surgical treatments include:

  1. Shockwave lithotripsy: A simple outpatient procedure in which sound waves are directed on kidney stones, breaking them into smaller pieces capable of passing on their own in urine.
  2. Ureteroscopy: An outpatient procedure for small-to-medium stones in which a small tube (ureteroscope) is inserted into the urinary tract and used to pull out stones or to direct laser to the stones to break them into smaller pieces.
  3. Percutaneous nephrolithotripsy: A procedure in which the urologist makes a small incision in the back and directly into the kidney, using the incision to access and remove stones. It is the most effective method for very large kidney stones.

Preventing Kidney Stones

Lifestyle changes can help you to avoid having kidney stones. For instance, drinking at least two-and-a-half liters of water every day will help you to achieve a daily urine production of two liters, which prevents stones. Fluids such as coffee and citrus juices also are very effective in preventing kidney stones. Citrus (especially from lemon and grapefruit) makes urine more alkaline and reduces the risk of almost all kinds of stones. But you must avoid sugary juices, as the sweetener in them may increase your risk of having stones and undo the good effects of the juice.

If you have had a bout of kidney stones before, you have a greater risk of getting stones. So depending on the chemical constituents of your first kidney stones, you may have to limit intake of certain foods, such as sugar, salt, proteins and dairy products. For calcium oxalate stones, you will have to cut down the amount of meat, eggs, shellfish, peanuts, spinach, chocolate, sweet potatoes, rhubarb and beetroot from your diet. For uric acid stones, taking allopurinol (a gout medication) will help prevent future episodes. Potassium citrate pills and thiazide family of diuretics (indapamide, chlorthalidone and hydrochlorothiazide) are also effective in preventing all calcium-based stones.

Looking for advice or help with kidney stones? At St Pete Urology, we offer timely and accurate advice, diagnosis and treatment of kidney stones. Our multidisciplinary, compassionate, patient-centered approach will ensure you get the best possible care. Don’t suffer the pain of kidney stones for a day more while we can help you get quick relief. For more information, visit the “St Pete Urology” site.

What foods to avoid with kidney stones?

When substances found in urine become so concentrated, they can combine to form solid masses called kidney stones. For instance, calcium in urine can combine with phosphorous or oxalate to form calcium phosphate and calcium oxalate crystals respectively. Likewise, the buildup of uric acid in urine following protein metabolism can lead to uric acid crystals. Since the urinary tract is not functionally adapted to expel solid matter, the stones become very painful to pass. Fortunately, the risk of formation of kidney stones can be reduced through dietary measures.

So what should you eat and drink to avoid getting these painful stones?

1. Drink copious amounts of water
Taking large quantities of fluid, particularly water, can significantly reduce the risk of kidney stones. Water dilutes urine and lowers its concentration, minimizing the possibility of the chemicals combining to form stones. Just make sure to drink 12 glasses or more of water every day.

2. Eat more calcium-rich foods
Calcium combines with oxalate and eliminates it. Therefore, low calcium intake allows your oxalate levels to rise while increased intake reduces the quantity of oxalate in urine. It is advisable that you get calcium from food and not from supplements (as supplements increase the risk of kidney stones). Recommended sources of calcium include cottage cheese, other types of cheeses, yogurt, milk (cow’s milk, goat’s milk, fortified soy milk and lactose-free milk), legumes, dark green vegetables, calcium-set tofu, seeds, blackstrap molasses and nuts. Intake of foods rich in vitamin D every day can ensure that the body absorbs more calcium. There are several foods fortified with vitamin D, but you also can get this vitamin from egg yolks, cheese and salmon.

3. Increase your citrus intake
Citrus provides naturally occurring citrate which is effective in stopping or reducing the formation of kidney stones. You can get citrate from citrus fruit, citrus juice, oranges, grapefruit and lemons.

Which types of food should you avoid?

1. Limit your salt intake
Increased sodium levels promote the buildup of calcium in urine. Hence, it is important to avoid adding too much salt to your food and to check all labels on processed foods to control the amount of sodium you take. Whenever possible, instruct that no salt be added in the foods you order in hotels or restaurants. Vegetable juices may contain high quantities of sodium, so check what you drink.

2. Reduce intake of animal protein
Most animal sources of protein increase the level of uric acid and reduce the level of citrate in urine. Citrate is important in preventing stone formation. Therefore, you should avoid eating large quantities of red meat, poultry, chicken, pork, eggs and fish which contain large quantities of citrate. Instead of animal proteins, you should turn to alternatives such as Greek yogurt, quinoa, hummus, tofu (bean curd) and chia seeds. Make sure to discuss what types of protein you should eat with your doctor.

3. Minimize the quantity of oxalate-rich foods
Oxalate-rich foods can increase the development of kidney stones. So if you are at greater risk or already have had stones before, then you should either eliminate or reduce the quantity of oxalates. But if you have to eat oxalate-rich foods, always follow or combine them with a calcium source to ensure the oxalate is bound to calcium during digestion and prevented from reaching the kidneys. Foods with high quantities of oxalate include beets, chocolate, nuts, tea, spinach, swiss chard, sweet potatoes and rhubarb. Speak with your doctor to determine the limits of oxalate-rich foods you should have in your diet.

4. Cut down sugar intake
High levels of added fructose and sucrose can increase the risk of stones. You should reduce or eliminate the amount of added sugar you take, particularly in processed foods, cakes, fruits, soft drinks, juices, agave nectar, honey, cane sugar, crystallized fructose, corn syrup and brown rice syrup.

5. Avoid cola drinks
Cola contains high quantities of phosphate, a chemical that promotes kidney stone formation. Avoiding colas will therefore reduce your risk of kidney stones.

Dietary tips for avoiding kidney stones

Once you have kidney stones for the first time, the risk of a recurrence increases drastically unless you take the necessary steps to prevent them. For instance, you can take medications prescribed by your doctor to prevent the stones. Likewise, you can begin to watch keenly what you drink and eat. It is also important that tests are run on the stones you currently have to determine what type they are in order to clearly define appropriate steps for preventing a recurrence. Strategies for preventing recurrence of kidney stones include:

  1. Drinking at least 12 glasses of water every day.
  2. Drinking citrus juices, like orange juice.
  3. Reducing the amount of animal protein you take.
  4. Reducing the amount of added sugar, salt and products rich in fructose corn syrup.
  5. Avoiding drinks and foods high in phosphates and oxalates.
  6. Eating a calcium-containing food at every meal, at least 3 times a day.
  7. Avoiding foods or drinks that dehydrate the body, such as alcohol.

Kidney stones can cause a lot of pain and discomfort. But with slight dietary changes, occurrence of the stones can be effectively prevented or managed. Keeping your body hydrated, pairing oxalate-rich foods with calcium and avoiding foods high in sugar and salt are crucial dietary steps for preventing kidney stones.

At St Pete Urology, we apply a range of treatments, such as lifestyle, dietary, medical and surgical interventions to ensure the best outcome possible for our patients. At our center, most patients with kidney stones are seen by specialists, taken through 24-hour urine studies and blood tests, and given the right treatment depending on the type and cause of their stones. Our urologists are experts in shock-wave lithotripsy (SWL), ureteroscopy and percutaneous nephrolithotomy, among other treatments for relieving pain and restoring a normal, pain-free life. We also develop preventive plans for our patients, giving them a clearer picture of why the stones develop and the necessary changes they should make to prevent them, including dietary, lifestyle and medications to take. For more information on the diagnosis, treatment, prevention and follow-up care for kidney stones, visit the “St Pete Urology” site.

How does a penile implant pump work?

Erectile dysfunction (ED) is a common problem, affecting up to 52 percent of all men at some point in their lives. Statistically, ED is found in 20 percent of men over the age of 20, 40 percent of men over 40 and 78 percent of men over 75. As a general marker of cardiovascular function, erectile dysfunction tends to occur more frequently in men with obesity, diabetes, high blood pressure, current smoking history, diabetes, heart disease or who are taking medications that impede cardiovascular function. In most men with ED, the problem can be successfully treated with prescription medications (pills) or a penis pump (a vacuum constriction device). However, in cases where pills and penile pumps prove ineffective, a penile implant surgery may be recommended as a last resort.

What is a penile implant?

A penile implant (also called penile prosthesis) is a medical or prosthetic device that is surgically placed and customized inside the penis and scrotum to help a man to achieve a natural-feeling and natural-looking erection, thereby gaining sexual function. It is an ideal treatment of erectile dysfunction in men who are not candidates for other ED treatments, have not been able to achieve an erection after other treatments, or have specific medical conditions such as peyronie’s disease ( a condition characterized by scarring inside the penis resulting in curved painful erections). Nevertheless, doctors usually prefer to start with the simpler, less invasive treatments for ED before opting for penile implant surgery.

Types of penile implants

There are three main types of penile implants: the three-piece inflatable pump, the two-piece inflatable pump and the semi-rigid, non-inflatable implant (malleable rods).

1. Three-piece inflatable pump

Also called the multi-component penile implant, the three-piece pump delivers the most natural, comfortable and rigid erection and offers the most suitable flaccidity when deflated. It is a larger and softer pump that is very easy to inflate by squeezing the pump and to deflate by pressing the release value above the pump. During the operation to implant the three-piece inflatable pump, two cylinders are placed in the penis, a fluid-filled container is implanted in the abdomen and an inflatable pump placed inside the scrotum. These three components are then connected using special tubing. To achieve an erection, the pump located in the scrotum is pressed to allow fluid to move from the abdominal container into the penile cylinders. Squeezing the release valve ensures that the fluid leaves the cylinders and moves back to the containers, making the penis flaccid.

2. Two-piece inflatable pump

For men with limited agility, such as those with trouble using their hands or with arthritis, the two-piece inflatable pump is ideal. Similar to the three-piece inflatable pump, the two-piece device works in the same way except that the fluid is kept in the pump located in the scrotum and not in a container in the abdomen (as with the three-piece pump). While the two-piece inflatable device is simpler and easier to place than the three-piece device, it is smaller, more difficult to inflate and offers a less-rigid erection than the three-piece pump.

3. Semi-rigid non-inflatable penile implant (malleable rods)

In some cases, the surgeon may insert two flexible rods into the penis to improve its rigidity. Once inserted, the rods will not change their stiffness or size and will keep the penis in a semi-rigid state. Typically, these rods are bent downward during implantation, but can be straightened upward or set in any other manner necessary for sexual intercourse. Non-inflatable implants can be inserted even by doctors with limited experience because they involve the simplest surgical procedure. They are completely concealed in the body and are a great option for men with limited dexterity, such as those with arthritis or problems using their hands. While malleable penile rods are very easy to use, their constant rigidity may make them uncomfortable.

Factors considered when selecting a penile implant

In order to achieve optimum results with penile implants, the needs and preferences of the patient must be carefully considered. So before doing an implant, the doctor will consider:

  • (a) Age of the patient and of his partner.
  • (b) Overall penile length and scrotum size.
  • (c) Patient’s body size and type.
  • (d) Ratio between the pendulous penis and crus (buried) penis.
  • (e) Size of glans penis.
  • (f) Any history of penile implant and previous pelvic or abdominal surgery.
  • (g) Whether the penis is circumcised or not.
  • (h) Presence of colostomy or previous kidney transplant.
  • (i) Overall health and well-being of the patient.
  • (j) Life expectancy of the patient.

Even though penile implants enable men to achieve an erection, they do not boost sexual sensation or desire. Most penile implants also will not make the penis larger or bigger than its natural size at the time of surgery. For some men, the penis may even be slightly smaller or shorter than it was before the procedure.

At St Pete Urology, our multi-dimensional and compassionate approach can be trusted to deliver excellent outcomes for all men with erectile dysfunction. For every man who comes to us, we identify the risk factors, assess the degree of dysfunction and recommend a safe and effective treatment. Apart from lifestyle modifications, medications and vacuum constriction devices, we also conduct safe penile implant surgery whenever necessary. We are committed to improving the sexual function and quality of life for all our patients. So do not suffer silently when we can provide effective solutions to your problem. For more information on prevention, diagnosis and treatment of ED, visit the”St Pete Urology” site.

BPH: Can Green Tea Cure It?

For men, living long enough means you are going to have problems with your prostate. While the prostate is typically a small, walnut-sized gland in young males, it undergoes two phases of growth later on in life which often result in urinary problems. The first phase of growth occurs during puberty and usually doubles the size of the gland, while the second phase of growth begins at around 25 and continues for the rest of your life leading to benign prostatic enlargement (benign prostatic hyperplasia or BPH). More than 50 percent of men have BPH by the age of 60 and experience urinary difficulties. Although prescription medications are commonly used to treat BPH, herbal supplements may provide much needed relief during the initial stages of the condition. One such herbal solution is green tea.

Green Tea Ingredients

Green tea is not only the second most popular beverage across the globe, but also a pleasant alternative to soft drinks and coffee. It contains potent polyphenols, catechins with anti-inflammatory, anti-carcinogenic and antioxidant properties. The active ingredients in green tea include gallic acid, caffeic acid, chlorogenic acid and epigallocatechin (EGC), among other polyphenols. The polyphenol known as epigallocatechin-3-gallate (EGCG) is effective in reducing the overproduction of cells common in BPH and in preventing the onset of prostatic enlargement. Other specific polyphenols found in green tea can treat the symptoms and eradicate various causes of BPH, making green tea invaluable for managing the condition alongside lifestyle changes, medications and other interventions.

Can Green Tea Cure BPH?

Green tea contains antioxidants that reduce the levels of dihydrotestosterone (DHT), the hormone that promotes the growth of the prostate. A reduction in the levels of DHT lowers the risk of developing an enlarged prostate. The catechins in green tea regulate the secretion of DHT and PSA, promoting normal prostate size and volume and reducing the risk of BPH. Likewise, the catechins in green tea have demonstrated efficacy in relieving urinary symptoms such as frequent urination, nighttime urination and problems with urinary flow. Improved urine flow, relief of annoying urinary symptoms and reduced prostatic inflammation lead to a higher quality of life. Besides, the catechins in green tea can kill certain viruses and bacteria, reducing the risk of urinary tract infections that may occur in men with enlarged prostate.

Factors Affecting the Efficacy of Green Tea

The strength and effectiveness of green tea depend on the amount of the tea consumed. Studies have shown that men who take large quantities of green tea regularly enjoy more prostate health benefits from the tea than those who take the tea occasionally or in small amounts. The amount of catechins in green tea also depends on where the plants are grown, how the tea leaves are harvested and how the leaves are processed. For instance, Japanese green teas usually have greater quantities of catechins than Chinese teas, with slight differences within specific groups. Remember that the power of green tea comes from the fact that its leaves are not oxidized and are able to retain essential substances such as the catechins that promote both general health and prostate health.

Consult with your doctor before using green tea to improve your prostatic health. Remember that taking herbal supplements without guidance from a qualified health professional may cause problems in your body. At St Pete Urology, we are committed to safe and effective treatment of BPH and other urological issues. We have assembled a team of highly trained and experienced surgeons to help us deliver leading-edge urological care for the best possible outcomes. Our comprehensive, multidisciplinary and patient-centered approach and a dedication to adopting new medical technologies as soon as they are available guarantee state-of-the-art treatment for all our patients. For more information on diagnosis and treatment of BPH, visit the “St Pete Urology” site.

How Are Kidney Stones Formed?

Kidney stones are hard mineral or salt deposits formed in the kidney when urine is concentrated. Originating as microscopic crystals or particles that develop over time into pebble-sized calculi or larger deposits as minerals crystallize and fuse together, kidney stones can affect any section of the urinary tract (the kidney, bladder, ureters and urethra). The kidneys filter and remove wastes from blood, add them in urine and concentrate the urine as it flows from the cortex into the renal pelvis. However, if the minerals and other wastes fail to dissolve completely in urine, microscopic particles may develop which may grow into larger stones.

Why Stones Form

Formation of urine crystals is a common occurrence even in those who never form stones. The natural existence of substances promoting crystal development in all urine means that everyone can have urine crystals. Substances that promote crystal development in urine include oxalate,calcium, phosphorus, uric acid, sodium and cystine (for those with cystinuria). Nevertheless, urine also has natural inhibitors of crystal formation such as magnesium, citrate, phytate, pyrophosphate, proteins, total urine volume and other byproducts of normal metabolism. These inhibitors promote elimination of crystals before they can attach to the kidney and develop into larger stones.

How are kidney stones formed?

Kidney stones typically form from soluble salts found in urine. For example, the soluble salt calcium oxalate is commonly found in urine in a dissolved or crystalline form. Soluble salts are usually formed when various chemical elements found in urine combine. When the urine concentration of these soluble salts is very high, solid crystals may be formed. While there is usually a high concentration of salts in urine, the presence of inhibitors makes it more difficult for crystals to develop.Therefore, urine must become supersaturated for the balance between stone-promoters and inhibitors to be broken and allow larger stones to form. Supersaturation of urine may be caused by low urine volume, very low quantities of inhibitors or very high concentration of stone-promoters.

Processes of stone formation

Kidney stone formation begins by the process of nucleation, an association of free ions into microscopic particles. Nucleation can occur in the kidney nephron and on the surfaces of the extracellular matrix and cells. Once tiny crystals are formed, they can undergo secondary nucleation or aggregation, the processes through which the crystals formed in solution form into bigger multi-component particles. Larger crystals then can grow into giant single crystals which can be retained in the kidney by further aggregation and attachment to specific intra-renal structures.

Passing kidney stones

Once kidney stones are formed, they move down the urinary tract from the kidneys through the ureter and to the bladder. Small stones can pass out on their own without causing problems. However, larger stones can become lodged in the ureter and cause severe, agonizing pain that starts in the lower back and spreads out to the groin. When a stone is lodged in the ureter, it can block urine flow, causing increased pressure build-up in the affected ureter or kidney and resulting in severe pain and spasms. Larger kidney stones (called starghorn stones) also may be problematic to the entire urinary tract, resulting in symptoms such as:

  1. Severe pain in the back, in the side or below the ribs.
  2. Excruciating pain radiating to the groin and lower abdomen.
  3. Red, pink or brown urine.
  4. Pain when urinating.
  5. Pain that fluctuates in intensity or comes in waves.
  6. Frequent urination, urinating small amounts or persistent urge to pass urine.
  7. Nausea and vomiting.
  8. Foul-smelling or cloudy urine.
  9. Chills and fever if an infection is present.

While kidney stones can cause severe pain and discomfort, they usually do not cause permanent damage when recognized early and treated promptly. In fact, depending on the situation, passing the stones may require nothing more than just taking pain medication and drinking plenty of water. In situations where the stones are lodged, obstructive or linked with urinary infections or complications, other removal mechanisms may be necessary, including surgery. The urologist also may recommend effective preventive measures to minimize the risk of recurrent stones.

At St Pete Urology, we have made a difference in many lives by helping patients get relief from the pain and discomfort caused by kidney stones. We have assembled a skilled and experienced team of urologists committed to the best practices in health care and delivering world-class urological care to all. We also have put together the latest diagnostic and treatment tools to ensure that our patients receive the very best care. With our patient-centered, collaborative approach to management of kidney stones and other urological problems, you can be sure that you will not leave our doors without getting the relief you seek.

For more information on prevention, diagnosis and treatment of kidney stones, visit the “St Pete Urology” site.