Urology News Blog by Dr. Eric K. Diner
When to Ask for a Surgical Second Opinion
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.
Steps to Treating Urinary Incontinence
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.
Medications
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.
Surgery
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.
Preparing for Surgery
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.
Educating Yourself
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.
Weighing Your Prostate Cancer Treatment Options
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:
- exams
- 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.
Prostate Surgery
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.
Questions to Ask Your Doctor if You are Considering A Vasectomy
Questions to Ask Your Doctor if You are Considering Permanent Birth Control
For some people, permanent birth control is the best option to guarantee that they will not have any more children. However as the name explains, permanent birth control is, well, permanent. In very few cases are these procedures reversible. Before you make the decision to go with a permanent option, you will want to ask your doctor all of the right questions. Be sure you know everything you need to about the procedure before you make a decision.
Below are a few questions that you should ask your doctor before you make your decision.
General Questions
- What are my options for permanent birth control?
- Is a permanent option the right one for me?
- Are there other options that I should consider before I make the decision?
- What type of birth control, permanent or nonpermanent, would you recommend?
Ask these questions in the beginning. They will give you a good starting place to determining if permanent birth control is the right choice for you.
Vasectomy
A vasectomy is a permanent method in which your partner will be rendered infertile by making it impossible for sperm to be included in ejaculate. This is a permanent procedure as well.
- What are the risks involved with choosing a vasectomy procedure?
- Is a vasectomy 100% successful?
- Can a vasectomy be reversed?
- What can my partner expect as far as pain and recovery?
- Do you recommend a vasectomy as our permanent birth control method?
The most important thing to remember is that permanent birth control methods should only be chosen if you absolutely know that you never want to have children. There are emotional factors to consider. How will you handle it if you change your mind at a later date and wish to have children? Consider all of the ramifications of the birth control that you are choosing before you go through with any procedure.
Make sure to ask all of the questions above when you talk to your doctor to help you make the right choice.
To learn more, contact Dr. Diner at (727) 824-7146
Dr. Diner Performs Robotic Prostatectomy in St. Petersburg
Robotic minimally invasive prostatectomy using the da Vinci Surgical System by Dr. Eric Diner in St. Petersburg Florida.
da Vinci Surgery Offers Minimally Invasive Option for Kidney Disease
If your doctor recommends surgery for a kidney disease such as kidney cancer, you may be a candidate for a minimally invasive, kidney-sparing surgery. A surgical technique called partial nephrectomy removes only the diseased part of your kidney while sparing the healthy, functioning kidney tissue.
The da Vinci Surgical System uses state-of-the-art technology to help your doctor provide the gold standard treatment, where indicated, and also perform a more precise operation. da Vinci offers several potential benefits to patients facing kidney surgery, including:
- Excellent clinical outcomes and cancer control
- Short hospital stay
- Low blood loss
- Precise tumor removal and kidney reconstruction
- Excellent chance of preserving the kidney, in certain operations
- Low rate of operative complications
To learn more, check out our section on [da Vinci Surgery for Kidney Cancer].
Drug for Breast Cancer May Help Men On Prostate Cancer Therapy
A new study shows that tamoxifen, a breast cancer drug, may help reduce the side effects caused by hormone therapy for prostate caner. Through four independent clinical trials, tamoxifen was used to manage side effects in prostate cancer patients undergoing androgen-suppression therapy.
The study found the drug reduced pain in three, six, nine, and 12 months of treatment compared to men who did not take tamoxifen.
The study appeared online in the journal BMC Medicine and can be found [Here].
Da Vinci Pyeloplasty Offers Minimally Invasive Option for Urinary Obstruction
If your doctor recommends surgery to treat urinary obstruction, you may be a candidate for a new, minimally invasive approach - da Vinci ® Surgery for Urinary Obstruction. The pyeloplasty surgery removes blockages in the urinary system.
da Vinci ® Surgery uses state-of-the-art technology to help your doctor perform a more precise operation than conventional surgery. It offers several potential benefits over a conventional open surgery, including:
- Significantly less pain
- Less blood loss
- Fewer transfusions
- Less risk of infection
- Less scarring
- Shorter hospital stay
- Shorter recovery time
- Better clinical outcomes, in many cases
To learn more check out our section on [Pyeloplasty].
Urinary Incontinence Affects 17 Million Women In the U.S.
Urinary Incontinence occurs in women between the ages of 18 and 60 and is usually a result of the urethra not being closed tightly to keep urine in the bladder. Symptoms vary from:
- an inability to prevent leaking urine when exercising or other involuntary actions such as coughing or sneezing
- an overwhelming urge to urinate that often causes them to urinate before getting to a bathroom.
There are a variety of treatment options for urinary incontinence depending on the specific case. Such treatments include:
- Behavior Therapy
- Pelvic Muscle Exercises
- Catheter
- Medications
- Various Surgical Procedures
For more information on female urinary incontinence [Click Here]
Connect With Us
