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

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

Symptoms

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

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

Causes

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

Diagnosis

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

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

Treatments

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

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

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

Facts About Stress Urinary Incontinence in Women

What Is Urinary Incontinence?

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

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

Bladder Retraining

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

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

  • Schedule Your Bathroom Breaks

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

  • Perform Kegel Exercises

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

Other Tips to Prevent Overactive Bladder:

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

Treating Overactive Bladder With Behavioral Modifications

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

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

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

Treating Voiding Dysfunction in Women

Voiding dysfunction is a problem that affects women in increasing numbers, and it can be an embarrassing condition that curtails daily activities. Voiding dysfunction can take several forms, including urinary incontinence, painful urination and interstitial cystitis. Women over 40 are especially susceptible and it can be uncomfortable subject to bring up in conversations with doctors.

Preliminary Diagnosis

Although your primary care doctor can perform simple testing for a urinary tract infection, you may save time and discomfort by seeing a qualified urologist first. Some urological procedures for diagnosis include:

  1. Urinalysis
  2. Uroflow electromyogram (EMG)
  3. Abdominal X rays (KUB)
  4. Cystoscopy
  5. Uroflowmetry

Initial Care for Voiding Dysfunction

Your primary care doctor may recommend dietary changes such as reducing the amount of alcohol and caffeine you consume. Your doctor may even warn you about the use of tobacco if you are a smoker.

Kegel Exercises

Kegel exercises are often effective at improving voiding dysfunction in the form of bladder leakage in women. Kegel exercises (or Kegels) simply increase the strength of the pelvic floor, and can be done in bed or while emptying the bladder. However, there are instances when the woman’s pelvic floor is too tight and Kegels are not recommended. A urologist can diagnose and recommend the appropriate treatment for the various types of voiding dysfunction.

Additional treatments for voiding dysfunction include muscle relaxants, pelvic floor therapy, self-catheterization and insertion of a neuromodulation device.

Painful Urination and Treatment

Besides being unable to control bladder flow, painful urination is another dysfunction associated with voiding. You may be diagnosed with interstitial cystitis. Some refer to the condition as BPS (bladder pain syndrome). Interstitial cystitis is associated with bladder pain, overactive bladder, bladder distention and, at times, bladder stones.

Once your physician has isolated the source of the problem, he or she may recommend a medication that allows the bladder to relax.

Why Get Diagnosed and Treated for Voiding Dysfunction

Successful treatment of voiding dysfunction will allow you to enjoy life better, with:

  1. Fewer accidents
  2. More control over where and when you void your bladder
  3. Longer intervals between needing to urinate

For those who live in the St Petersburg, Tampa or Clearwater areas, St Pete Urology offers treatment and relief of this condition. Schedule a consultation today to learn how our experienced team offers the most advanced technology, minimally invasive surgery options and compassionate care.

How to tell if your prostate is enlarged?

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

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

Signs and Symptoms of an Enlarged Prostate

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

1. Frequent and sudden urges to discharge urine;

2. Difficulty starting a urine stream;

3. Weak urine stream; and

4. Dribbling urine.

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

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

2. Urinary tract infections;

3. Blood in the urine;

4. Pain when passing urine; and

5. Pain in the lower abdomen.

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

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

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

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

Ways of preventing Kidney Stones

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

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

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

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

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

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

What are the Symptoms of Pelvic Organ Prolapse?

In general terms, the pelvic region of a human body is the area between the abdomen and the thighs. The pelvic region primarily comprises the bowels and the organs of the reproductive and urinary systems. In both men and women, pelvic organs are held in place and supported by strong muscles which collectively form the pelvic floor. Pelvic organ prolapse is a condition that results from a weakening of the pelvic floor muscles in women, causing the pelvic organs, chiefly the uterus, the bladder and the small intestines, to droop or descend and press on or even through the vagina. Common causes of pelvic organ prolapse include pregnancy, vaginal childbirth, sustained and prolonged pressure on the abdomen, aging, heavy lifting, hysterectomy, obesity and prolonged chronic coughing. Some women are also genetically predisposed to pelvic organ prolapse.

Symptoms of a Pelvic Organ Prolapse

The symptoms are usually determined by the organ that is affected. The symptoms listed here do not all occur together, although they may manifest in a combination of two or three.

1. A feeling of heaviness, pressure or fullness in the pelvic area. The descending organs put pressure on the lower parts of the pelvis, causing the sensation of heaviness and fullness.

2. Seeing or feeling something coming through the vagina. With time, small parts of the descending organs or the surrounding tissue may be seen through the vagina. Even if not seen, a patient might feel a bulging at the vaginal opening.

3. Urinary incontinence. Pressure on the bladder may cause leaking of urine or a frequent urge to urinate.

4. Painful intercourse and trouble inserting tampons. The displaced organs occupy spaces and put pressure on channels that are usually open to facilitate intercourse and to allow the insertion of tampons, thus making these activities uncomfortable and even painful.

5. Trouble having a bowel movement or constipation. This is common in patients with a rectal prolapse.

6. Lower back ache. This is common with patients who have a prolapse of the bowel.

Most patients report that symptoms worsen late in the day and after standing for a long period of time or taking part in an intense physical activity.

Any of these symptoms should be reported to a urologist so tests can be conducted and treatment administered as early as possible. In addition to finding a competent urologist, a patient also should seek a treatment platform that she is comfortable with. One way to find such a platform is to study the online profiles of urology professionals, such as the one created by St Pete Urology, so as to make an informed choice. For more information, visit the St Pete Urology website.

What treatments are available for erectile dysfunction?

Are you struggling to achieve or maintain an erection? Whether you are under 35 or over 65, you are certainly not alone. Erectile dysfunction (ED) is quite common in American men, affecting more than 20 million men. Statistically, 52 percent of men between 40 and 70 years old have some form of erectile dysfunction while 25 percent of men younger than 40 suffer from the problem on a regular basis. At St Pete Urology, we see a lot of cases of erectile dysfunction every month, administer treatments and achieve excellent results for our patients.

Types of ED treatments

There are a number of safe and effective treatments for erectile dysfunction which, when properly applied, help in achieving and maintaining an erection for satisfactory sexual intercourse. The main treatments include oral medications, penile injections, vacuum erection devices and surgery. The choice of treatment depends on factors such as underlying causes and severity of the dysfunction, and overall health and preferences of the patient.

Oral medications

Dr. Adam Oppenheim of Advanced Urology InstituteAt St Pete Urology, oral medications are typically our first line of treatment. The medications commonly given are vardenafil (Levitra, Staxyn), sildenafil (Viagra), avanafil (Stendra) and tadalafil (Cialis). All these medications work by improving the action and efficacy of nitric oxide, which is a natural chemical produced by the body and used to relax penile muscles. With increased activity of nitric oxide due to these drugs, there is increased relaxation of the smooth muscles, improved blood flow to and in the penis and greater likelihood of developing an erection when there is sexual stimulation.

Though the oral ED drugs are similar in their mechanism of action, they vary slightly in chemical makeup, timing of dosage and expected period of effectiveness, and potential side effects. For instance, sildenafil (Viagra) produces the best effect when taken without food about one hour before sex and its effect lasts six hours. Vardenafil (Levitra, Staxyn) can be taken with or without food one hour before sex and its effect lasts seven hours. Like vardenafil, avanafil (Stendra) can be taken with or without food, but 15-30 minutes before sex (depending on the dose) and its effects lasts six hours. Tadalafil (Cialis) should be taken in small daily doses or in a large dose (as needed) with or without food about 1-2 hours before sex and its effect lasts 36 hours. Doctors usually consider these differences before prescribing oral ED medications.

Penile injections

An effective alternative to oral medications is injectable ED medicine. The specific injectable medication may vary, but some of the most commonly used ones are papaverine hydrochloride, alprostadil, prostaglandin E-1 and phentolamine. An injection of one or a blend of these ingredients will relax arterial wall muscles, cause increased blood flow into the penis and result in an erection. A small, sharp needle is used for the injection and there is only minimal discomfort. At St Pete Urology, we teach patients how to do the injections and once they have mastered it, then drugs are ordered and sent to them to do the injections at home.

Vacuum constriction devices

A vacuum device is an external pump supplied with a band to help trigger an erection by driving blood into the penis. Vacuum constriction devices (VCDs) have three components: the plastic tube placed around the penis, the pump that draws out air from the tube and creates a vacuum, and the elastic ring that helps to maintain an erection during intercourse by preventing the flow of blood back into the body. The elastic ring should only remain in place for a maximum of 30 minutes and then should be removed to restore normal blood circulation and prevent potential skin irritation. Using a vacuum pump requires adjustment and practice — it may make the penis feel numb or cold, purple in color and bruised, although such effects are often painless and go away in a few days. The devices also may weaken ejaculation, but they do not affect orgasm (pleasure of climax).

Implant surgery

Surgery is often a last resort treatment for ED. At St Pete Urology, we speak with our patients about whether or not surgery is right for them. Surgery can be done either to implant a device into the penis that makes it erect or rebuild the arteries and veins around the penis to improve blood flow. Implanted devices (prostheses) are an effective treatment for ED with implant surgeries typically taking about one hour to complete and usually done in outpatient setting.

There are two types of penile implants: inflatable implants that make the penis wider and longer via a pump in the scrotum and malleable implants that are basically rods allowing for manual adjustment of the position of the penis. Patients leave the hospital the day after their implant surgery and are able to use the implant to achieve an erection 4-6 weeks after surgery. Possible challenges with the implants include infection and breakage, but they are generally effective in getting and maintaining an erection.

Vascular reconstructive surgery

Another option is the urologist can perform a vascular or arterial reconstruction surgery to improve blood flow to and in the penis. Vascular reconstructive surgery is a highly delicate procedure involving either the re-routing of arterial pathways leading to the penis to bypass blocked arteries that are restricting blood flow, or to unblock blood vessels causing an obstruction. An artery can be bypassed by moving an abdominal muscle artery to a penile artery. Alternatively, a penile vein can be modified to work like an artery.

Men who are younger than 45 are the ideal candidates for reconstructive surgery, especially those who have experienced trauma or injury that resulted in the damage to blood vessels at the base of the penis. The goal of the procedure is to remove or bypass any blockages that may impede blood flow to the penis. And with the obstruction removed, there is increased blood flow to the penis and greater likelihood of an erection.

If you have erectile dysfunction, the first step is to speak with a doctor. The right treatment for you will depend on your overall health and the underlying cause of your ED. At St Pete Urology, we see a lot of cases of erectile dysfunction and endeavor to achieve the best possible outcomes for our patients. For more information on treatment of erectile dysfunction, visit the “St Pete Urology” site.

How To Treat Kidney Stones?

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

Stones come in different sizes

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

Pain due to kidney stones

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

Treatment of kidney stones

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

Types of treatments

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

1. Extracorporeal Shockwave Lithotripsy (ESWL)

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

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

2. Ureteroscopy (URS)

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

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

3. Percutaneous nephrolithotomy (PCNL)

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

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

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

Meet Dr. Adam Oppenheim

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

Becoming a urologist

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

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

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

What do we do as urologists?

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

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

Job Satisfaction

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

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

Why St Pete Urology

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

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

What causes the prostate to enlarge?

Although the exact trigger of BPH (Benign Prostatic Hyperplasia) is not fully known and may vary from one man to another, there are risk factors that contribute to the condition. Benign prostate enlargement means your prostate grows in size without being cancerous. As the prostate swells and becomes bigger, it presses on your urethra and bladder and may cause a number of urinary and bladder function problems. The known contributing factors to prostate enlargement are age, hormones, stress levels and diet.

1. Age

Your age is a risk factor and not a cause of BPH. Prostate growth is considered a normal part of aging. In fact, the prostate usually goes through two major periods of growth as a man ages. During early puberty, the prostate doubles in size. Then from the age of 25 the gland enters a second phase of growth and continues to increase in size for the rest of his life. It’s typically during this second growth phase that benign prostatic hyperplasia occurs. About 50 percent of men over the age of 50 have BPH, while up to 90 percent of men over 80 years old have the condition.

2. Hormones

Hormones have a major role in triggering BPH. For instance, testosterone — the male sex hormone responsible for sexual development, muscle mass, deep male voice and libido — is converted to DHT (dihydrotestosterone) when it is in excess in the body. DHT is a useful hormone in adolescents because it ensures normal growth and development of sexual organs, including the prostate. But the production of excess quantities of DHT results in problems such as aggression and acne in adolescents. In older men, excess production of DHT causes the prostate to continue to grow and enlarge. If left unchecked, this could lead to an enlarged prostate and other problems associated with the gland.

3. Diet

Prostate enlargement is a more common problem in Western countries such as the U.S. and UK, but occurs in lower rates in Asian countries like Singapore and Japan because of dietary reasons. A typical Western diet contains simple carbohydrates, refined sugar, meat, dairy and unhealthy fats, while traditional Asian and Eastern diets are often richer in complex carbohydrates, vegetables and healthy soya-based proteins. The dietary differences are therefore critical for the varied incidences of BPH in the Western and Eastern countries.

The regular consumption of red meat escalates the risk of developing BPH by 38 percent, and regular dairy intake not only contributes to joint pain and hay fever through inflammation, but also inflames the prostate and accelerates the enlargement process. On the other hand, consuming 4 or more vegetable servings a day decreases the risk of BPH by 32 percent, and regular intake of soya reduces the chances of having an enlarged prostate. Likewise, zinc, commonly found in seeds and nuts and often missing in typical Western diets, is critical for a healthy prostate.

Poor diets lacking in fiber can cause constipation, which badly affects the prostate. The prostate is located very close to the bowels. If toxins remain in the bowels for a long time they start to leak into the surrounding tissues and into the prostate. When that happens, inflammation and pain may occur in the prostate. Similarly, the pressure caused by constipated bowels on both the bladder and prostate can worsen BPH symptoms.

4. Stress levels

Prolonged repeated exposure to stress, such as men who have high-pressure jobs, who commute frequently or who are rarely relaxed, can lead to or worsen BPH. For men already suffering the symptoms of an enlarged prostate, stress leads to inflammation of the prostate and worsens the symptoms. It also causes muscular tension, which results in further restriction of bladder function. Increased exposure to stress quickly depletes the body of nutrients and one of the most frequently stress exhausted nutrients is zinc, which is vital for prostate health. Repeated high stress levels also lead to increased secretion of testosterone and DHT hormones, which contribute to the growth of the prostate.

So what’s your role in preventing BPH?

You can’t do anything about your age, but you can do something about your lifestyle and diet to boost the health of your prostate. Start by avoiding or cutting down on dairy and meat, add lots of vegetables, fruits, nuts, seeds and whole grains to your nutrition regimen, and try including soya products like miso, tofu and tempeh in your diet. Initially that may be difficult if you are used to consuming meat and dairy-heavy meals. But by incorporating tasty, plant-based substitutes such as tofu, three-bean curry, mushroom risotto and vegetable satay, you can quickly get used to meals without meat and dairy. Take steps to reduce your stress levels by dealing with the underlying causes of your stress. Take a stress remedy, practice mindfulness or see a counselor — whatever works best for you.

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