Urology News Blog by Dr. Eric K. Diner
A vasectomy is a safe procedure and, for most men, is a good option for permanent birth control. Here are a few things to keep in mind when considering a vasectomy.
- A vasectomy is safe. Though on rare occurrences men experience persistent pain, there are no serious consequences associated with the procedure.
- Vasectomies are effective overall. It’s also important to keep in mind that, while vasectomies are effective, statistics show that 11 out of 1,000 vasectomies will fail, causing an unintended pregnancy.
- Vasectomies aren’t effective immediately. It’s important for men to know that it may take up to 12 weeks to eliminate viable sperm from the system. After 12 weeks, a semen analysis will be done to ensure that there is no live sperm.
- Make sure permanent birth control is right for you. Although a vasectomy can be reversed, the procedure should not be considered unless the man is sure he doesn’t want more children. The longer a man has a vasectomy, the less likely it is for him to conceive if he chooses to reverse the procedure. If the vasectomy is reversed within three years, the chance of getting sperm back in to semen is around 97 percent. That number decreases substantially after ten years.
- Vasectomies won’t affect sex drive. Many men worry that a vasectomy will reduce the testosterone and, therefore, reduce sex drive. The procedure only blocks sperm and has no effect on sex drive.
Consult your physician today for more information on vasectomies and vasectomy reversal.
September is Prostate Cancer Awareness month. It’s important to be aware of the symptoms and treatment options for prostate cancer so you can detect and treat it as early as possible.
What is Prostate Cancer?
Prostate cancer starts in the prostate gland, which is a small, walnut-sized structure that is part of the man’s reproductive system. Though there are some cases of prostate cancer that are more aggressive, prostate cancer usually grows slowly and remains confined to the prostate gland.
Symptoms of Prostate Cancer
Prostate cancer in its early stages might not cause noticeable symptoms. As it becomes more advanced, it may cause symptoms including:
- Discomfort in the pelvic area
- Blood in both semen and urine
- Difficulty urinating
- Pain in lower back
- Pain in hips or thighs
- Light stream of urine
Treating Prostate Cancer
Treatment options for prostate cancer depend greatly on the stage the cancer is at. The stages of prostate cancer include:
- Stage I – During this stage, the cancer isn’t considered aggressive. During this stage, your physician may decide that treatment isn’t necessary and may choose to simply monitor the cancer.
- Stage II – Cancer at this stage may still be considered aggressive. It may be larger and may involve both sides of the prostate gland.
- Stage III – The cancer has spread from the prostate gland to other nearby tissues.
- Stage IV – During stage IV, the cancer has spread to nearby organs, such as the bladder or lymph nodes.
Depending on the stage of the prostate cancer, your physician may choose radiation therapy, hormone therapy, surgery to remove the prostate, chemotherapy or immunotherapy.
A vasectomy reversal, also known as a vasovasostomy, is a surgical procedure where the tubes are reconnected. A vasovasostomy is considered an outpatient procedure, so an overnight hospital stay isn’t necessary.
Before considering a vasectomy or a vasectomy reversal, it’s important to know the risks associated with the reversal of the procedure.
How Effective is Vasectomy Reversal?
Vasectomy reversals are successful a majority of the time. However, the amount of time that has passed since the vasectomy has a major impact in how effective the reversal is.
If the reversal is done within ten years of the vasectomy, it usually results in overall pregnancy rates of greater than 50 percent. If the procedure is done within three years of the vasectomy, the chances of conception are even greater.
Are There Risks When Getting a Vasectomy?
Almost all vasectomies can be reversed without complications. However, there are some things to keep in mind when considering a vasectomy reversal. Some risks of the procedure include:
Bleeding in the scrotum – The procedure can cause a collection of blood in the scrotum. To ensure this doesn’t happen, follow the doctor’s instructions to rest after surgery.
Infection at the surgery site – Though uncommon, infection at the surgery site is a risk everyone takes when getting surgery.
Chronic pain – Not many men experience pain in the testicle area after a vasectomy reversal, but it’s possible.
Sperm granuloma – Sperm can link into the scrotum, causing an inflamed mass called a sperm granuloma. This is usually a sign that the reversal wasn’t successful.
See your physician today for more information on vasectomy reversals.
In 2013, 55,000 men and 18,000 women will be diagnosed with bladder cancer in the United States. Learning about bladder cancer will help you diagnose and treat it faster.
Bladder Cancer Symptoms
Bladder cancer most commonly causes the following symptoms:
Finding blood in urine which causes urine to look rusty or dark red.
Feeling an urgent need to empty your bladder more often than usual
Feeling pain when you use the restroom
Common Reasons for Getting Bladder Cancer
When getting diagnosed with any cancer, it’s natural to wonder what caused the disease. Though there is not one definite answer, there are risk factors that may have caused the disease such as:
Smoking. Smoking tobacco is the most common risk factor in bladder cancer.
Working around chemicals. People who work in the dye, rubber, chemical, metal, textile and leather industries have an increased risk of getting bladder cancers because the chemicals they are working with may be cancer-causing.
Family history of bladder cancer. People with family members who had bladder cancer or having a personal history with bladder cancer increases the risk of getting bladder cancer.
Arsenic. Arsenic may be found in drinking water in some areas of the world.
Bladder Cancer Stages & Treatment
In order to properly treat bladder cancer, your doctor needs to learn the extent of the disease. The stages of bladder cancer are:
Stage 0. The cancer cells are found only on the surface of the inner lining of the bladder.
Stage I. The tumor has grown deeper into the lining of the bladder
Stage II. The tumor has invaded the muscle layer of the bladder
Stage III. The tumor has grown through the muscle to tissues near the bladder.
Stage IV. The tumor has invaded the wall of the pelvis or abdomen, but has not spread to the lymph nodes.
Depending on the stage, your doctor will treat bladder cancer with surgery, chemotherapy, biological therapy or radiation therapy.
Consult your doctor today if you feel you may have bladder cancer.
Odds are that someone you know had a kidney stone. They are fairly common, affecting one in eleven people at some point in their life. There is no single cause for kidney stones, but educating yourself on kidney stones can aid in prevention of them.
What is a Kidney Stone
A kidney stone is a solid piece of material that forms in a kidney when substances in urine become highly concentrated. Though some kidney stones are so small that they pass without causing pain, they can also grow large enough to get stuck in the urinary tract, which causes severe pain and even bleeding.
Four different kinds of kidney stones can form:
- Calcium stones. These are the most common form of kidney stone and are often caused by high calcium and high oxalate excretion.
- Uric acid stones. Uric acid stones are usually present when the urine is acidic due to a large intake of certain meats, fish and shellfish.
- Struvite stones. Struvite stones are a result of kidney infections.
- Cystine stones. A genetic disorder causes cystine to leak into the urine, which forms crystals that turn into cystine stones.
Diagnosing & Treating Kidney Stones
To properly diagnose kidney stones, your doctor will perform a physical exam and ask questions about your history with kidney stones, diet, GI problems, and other diseases and disorders. In addition to a physical exam and discussing your medical history, he or she may also perform a urine sample, blood test, abdominal x-ray and CT scans.
After properly diagnosing the kidney stone, your physician will determine a treatment plan based on the size of your kidney stone what it is made of. Smaller stones usually pass through the urinary tract without treatment. Treatment options for larger stones can include:
- Shock wave lithotripsy. a machine called a lithotripter is used to crush the kidney stone.
- Ureteroscopy. A uteroscope, which is long, tube like instrument, is used to find the stone with a small basket or used to break up the stone with a laser.
- Percutaneous nephrolithotomy. A procedure that uses a thin viewing instrument to locate and remove the stone.
Preventing Kidney Stones
Preventing kidney stones depends greatly on the reason the stone is forming. However, focusing on your diet is the first step in preventing any kind of stone from forming. Reducing sodium intake, limiting animal protein, avoiding foods high in oxalate and getting enough calcium are all important in the prevention of kidney stones.
In addition to altering your diet, some health care providers may also prescribe certain medications depending on the type of stone.
For more information on diagnosing and preventing kidney stones, talk to your physician today.
Surgical procedures have come a long way. Today surgery can be done with much more precision. Through robotic surgery, surgeons are now able to reach the minutest areas and increase their visual field. Through robotic arms, the surgery itself is clean and precise. Before you undergo robotic surgery, you should always ask your doctor questions.
Is Robotic Surgery the Right Choice for My Surgery?
Not all surgical procedures can even be performed through this cutting edge method. Depending on the condition that you have and the procedure that you need to undergo, it may or may not be an option for you. You will need to talk to your doctor to determine if this is the right choice for you.
Are There Reasons Why the Procedure May Not be the Best Choice?
Even if you can undergo robotic surgery, you will need to understand that there may be reasons why it is not the best option. You could have some types of underlying medical conditions. There may be specific things that you and your doctor need to discuss. Be sure to understand what those things are to determine if you still want to undergo robotic surgery.
What Types of Risks are There with Robotic Surgery?
Of course, there are always risks to any type of surgical procedure. You need to understand those risks well before you decide to proceed. Talk to your doctor about the specific risks that may come along with robotic surgery as compared to the risks that come with other treatment options you may have.
What Type of Recovery Time Can I Expect from Robotic Procedures?
Often, the recovery time from a robotic surgery will be much shorter than other procedures, but this can depend immensely on the type of procedure you are undergoing. Be sure to discuss the recovery time you can expect from robotic surgery as opposed to other types of treatments.
How Long Will the Procedure Itself Take?
Robotic surgeries involve different time frames, when compared to other types of treatment and procedures. You will be under anesthesia during that time, and you need to know how long the surgery will take. Be sure to discuss the robotic procedure with your doctor and the time frames of it or any other surgical procedure you could consider for your condition.
Anytime you need to have a surgical procedure performed, you will need to ask all of the right questions. If you have the option of robotic procedure, then you will definitely need to understand everything about it before you undergo anything so that you can determine if it is the right choice for you.
No one wants to find out that they need surgery. There can be many scary unknowns. However, there are times when an operation is an absolute must to relieve pain, cure conditions, and restore health. If you have come to that point and your doctor has just informed you that you need surgery, you may feel a little overwhelmed or afraid.
Although your doctor may be 100% right that you need a surgical procedure, there is always room for human error or opinion-based decisions. There are times when a second opinion should not be just thought of as an option—it should be considered a must. How do you know when it’s the right idea to get a second opinion?
There is No Rule
There is no specific rule that gives you a clear-cut line when you should get a second opinion. However, there are some things you should discuss with your doctor or research on the Internet. Asking the right questions will tell you a few things.
- Why do you think I need this operation?
- Are there other alternative options to surgery to consider?
- What would happen if I chose not to have surgery?
- What are the risks and dangers of this surgery?
- Will the operation completely improve my condition or will I still have problems?
- Will there be negative changes to my body as a direct result of the surgery?
- Are you 100% confident that surgery is my only option?
If you can, get these answers from your doctor.
It is Your Decision
The bottom line is, it is your decision. Even if you cannot find any other option but surgery, there is nothing wrong with getting a second opinion to ensure that it’s the right option for you. Often if you are having trouble committing to the surgery, then hearing the same advice from another expert can confirm what you know and help you go ahead with that decision.
When should you get a second opinion? Often, you will want to consult another professional if there is any waver or if there are any other treatment options. Bottom line – it is your decision.
Urinary incontinence is not something that any woman wants to deal with. While common, incontinence can be due to a wide variety of factors, like age, having a baby, genetics, and illnesses. If you are dealing with urinary incontinence, then you know it comes along with embarrassment and frustration. The good news is that there are ways to treat your condition. With many different options, you will want to discuss those options with your doctor.
At Home Techniques
You cannot completely cure your incontinence at home, but there are definitely things you can do that will help the issue to some level. Here are some things you can do at home to deal with your condition:
- Training your bladder by teaching yourself to hold your urge to go a little longer each day.
- Scheduling your visits to the bathroom about every two to four hours.
- Avoiding beverages that make you need to go quicker, like alcohol, caffeine, and foods that are high in acid.
- Kegel exercises to build strength in the muscles of the pelvic floor.
- Wearing incontinence pads or underwear
- Using a catheter
These at home methods are often just methods of dealing with the urinary incontinence. However, if you only have the mildest of versions, they may be feasible. If you have more severe cases of urinary incontinence, then you will need to talk to your doctor about your options, such as medications or surgical procedures.
There are a few different medications that your doctor may prescribe. Of course you will still need to use other methods like some of those above, but when taken together, they can be successful for some types of urinary incontinence. Here are some of the medications that your doctor may prescribe.
- Duloxetine. This is an antidepressant that can be used for the types of urinary incontinence called stress incontinence.
- Imipramine. This is also an antidepressant that can be used to treat stress incontinence.
- Topical Estrogen. This low dose estrogen can be found in three different forms: vaginal cream, patch, and ring. The topical estrogen can be used to build the strength of tissues in the urethra and the surrounding areas.
- Anticholinergics. These medications are designed specifically for those who have an overactive bladder. They come in many names, including Detrol, Ditropan, Enablex, Toviaz, Sanctura, and Vesicare.
In many cases, surgery is the best option for urinary incontinence. If you have severe incontinence, then a surgical procedure can be a permanent solution so that you do not have to continue dealing with the embarrassing problem.
- Pelvic Sling. This sling is made from natural body tissue to create a hammock type device that will support the urethra.
- Bladder Suspension. A section of muscle will be used to create a device that will support the bladder neck. This helps to take pressure off the urethra.
You have a number of different options to treat urinary incontinence and you will definitely want to discuss each with your doctor.
In the days and weeks leading up to your surgery, you will need to start preparing yourself, both mentally and physically. Any surgery can be stressful, but with enough preparation, much of your anxiety will go away.
One of the best ways to prepare yourself for surgery is by learning about the surgical procedure and asking questions of your doctor. Well-informed patients are often more satisfied with the results of their surgery. Before you arrive at the hospital:
- Meet with your doctor and anesthesiologist. Some hospitals include this as part of the pre-operative assessment.
- Ask many questions of your doctor and anesthesiologist, such as about the risk of complications, healing time, type of anesthesia that will be used and the best ways to speed your recovery.
Attending Your Pre-Operative Assessment
Many hospitals require that you meet with a doctor or nurse before your surgery—either in person or over the phone—one or more days before your operation. During this meeting, you will be asked about:
- Your health
- Your medical history
- Results of previous tests
- Medications, vitamins and herbal supplements that you are taking.
You may also be required to have pre-surgery blood tests. Be sure to follow any directions that your doctor gives you, such as fasting before surgery, when to stop taking your usual medications and what to bring with you.
Fasting Before Surgery
You may be required to stop drinking or eating before your surgery. It’s important that you follow your doctor’s instructions because having food or liquid in your stomach can cause you to vomit during or after surgery.
Packing For Your Trip
Pack an overnight bag with the essentials, such as:
- Nightgown or pajamas
- Day clothes and clean underwear
- Toiletries, including razor and travel-sized bath products
- Books or magazines
- Small amount of money
- Your usual medications
Bring loose-fitting clothes to wear after your surgery. Button-down shirts will be easier to put on than pullovers. Pants with elastic bands may be more comfortable after surgery.
Getting To and From the Hospital
After surgery, you may not feel well enough to drive yourself home. Make arrangements with your friends or family beforehand. Some hospitals may provide assistance with transportation after surgery.
Preparing Your Home for Recovery
When you arrive home after your surgery, the last thing you want to do is worry about shopping for food or cleaning your house. Stock up on healthy foods, buy extra personal hygiene products and medical supplies, and change the linens on your bed.
Take care of these things before your surgery, or ask a friend or family member to help you during your recovery. This may include asking someone to stay at your house to keep an eye on you.
Living a Healthy Lifestyle
Having a healthy lifestyle can speed your recovery after surgery, and reduce the complications and pain associated with surgery. Make changes to your life before surgery, as soon as possible:
- Eat healthier: increase your intake of fresh fruits and vegetables, cut back on foods high in saturated fats and reduce your intake of processed meats.
- Exercise more: Most guidelines suggest at least 150 minutes of moderate physical activity each week.
- Reduce your alcohol intake (or stop completely) at least 1 month before surgery. Alcohol can interact with anesthesia and cause excessive bleeding or liver damage.
- Stop smoking at least 2 weeks before surgery. Smoking increases the risk of infection and surgery complications. Quitting before surgery can also help you heal faster.
Men diagnosed with prostate cancer now have many treatment options available to them, including radiation, surgery, and drugs that stop the growth of the prostate cancer.
With so many choices, all of which have their own benefits and risks, choosing the best prostate cancer treatment can be difficult. The most appropriate therapy will depend upon the size and aggressiveness of the cancer, as well as whether it has spread to other parts of the body. In some cases, multiple treatments are used.
Watch and Wait: Active Surveillance of Prostate Cancer
Improved screening and detection of prostate cancer means that many cancers are found long before they are likely to pose a serious threat.
When theprostate tumor is very small or slow-growing (early stage), many men opt to “watch and wait,” an approach known as active surveillance.
This doesn’t mean do nothing. Your prostate cancer will be monitored regularly for changes in its size or growthusing:
- blood tests
- imaging (such as MRI)
- follow-up biopsies.
Radiation Treatment for Prostate Cancer
Radiation can be used to kill prostate cancer cells. Improved methods have allowed doctors to use higher doses of radiation, but with fewer side effects. The two main types are:
- External beam radiation therapy (EBRT).X-rays are aimed at the prostate cancer from outside the body.
- Radioactive material implants(Brachytherapy). Thisinvolves placing radioactive material (or “seeds”) inside the prostate gland.
During prostate surgery, the prostate gland is removed (radical prostatectomy), along with any nearby lymph nodes (part of the immune system) that have become cancerous.
While any surgery has a risk of complications, minimally invasive techniques, such as robotic prostatectomy using the da Vinci® Surgical System, combines the latest robotic and surgical techniques. Prostatectomy performed using the robot has many benefits, such as:
- less pain and blood loss
- fewer complications
- shorter stay in the hospital
- faster return to your normal activities.
Success of this procedure depends on both the skill and experience of the surgeon, as well as the technique used.
Hormone Therapy for Prostate Cancer
Hormone therapy blocks or reducesthemale hormones, such as testosterone, that fuel the growth of prostate cancer. Side effects include decreased sex drive and loss of muscle mass. This treatment can involve:
- Androgen deprivation therapy (ADT), which blocks the production of testosterone using either medicines or removal of the testicles (the place where testosterone is made).
- Anti-androgens, medicines that keep the prostate cancer cells from using testosterone.
Treatment Options for Advanced Prostate Cancer
If the prostate cancer moves beyond the prostate gland (metastasis)—such as into the lymph nodes or other organs—doctors may use multiple types of therapies in order to treat this aggressive form of cancer.
In addition to hormone therapy, another treatment option is chemotherapy, which uses special drugs to slow or stop the growth of prostate cancer cells. These drugs are usually given in cycles, such as every 21 or 28 days.
The main side effects of chemotherapy are:
- nausea and vomiting
- temporary hair loss
- drop in white blood cells which increases the risk of infection.