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Browse the current list of conditions we treat at Urology Centers of Alabama. If you have further questions or need a one-on-one consultation, don’t hesitate to contact us and set up an appointment.

Problems

Adrenal Cancer

The adrenal glands are small endocrine organs that produce a variety of hormones essential for regulating and maintaining fluid and electrolyte balance, blood pressure as well as other vital bodily functions. Anatomically they are located within the fat at the top of each of the kidneys and possess a delicate and rich blood supply. Due to the many functions these hormones control, many different disease states can result from decreased or increased production of these hormones. Increased production can result from hyperplasia, which is an abnormal increase in the number of cells, or from a tumor that can produce too much hormone. The diagnosis of these major adrenal disorders is actually simpler now than in the past because of precise diagnostic assays and radiological tests. Once an exact cause has been diagnosed different treatment options are available depending on the pathological process involved. Some disease states are treated medicinally while others may require surgical correction. Surgery of the adrenal gland consists of operative procedures to correct endocrine abnormalities due to over or under production of hormones or to treat malignant diseases. The preferred method now is either a laparoscopic or robotic approach which is normally associated with less blood loss and a shorter hospital stay.

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Benign Prostate Hyperplasia

Benign Prostatic Hyperplasia (BPH)
is a non-cancerous enlargement of the prostate, which affects a majority of men over age 50. The symptoms of Benign Prostatic Hyperplasia usually begins with urinary frequency, having to get up at night, and other minor inconveniences. Many men who have enlarged prostates never experience any symptoms, but the likelihood of developing symptoms increases as men age.

The prostate is an internal gland of the male reproductive system that is located in front of the rectum and below the bladder. The prostate gland wraps around the upper part of the urethra, the tube that carries urine out of the bladder. Benign Prostatic Hyperplasia affects the innermost part of the prostate first, so the enlargement frequently results in a gradual squeezing of the urethra where it runs through the prostate, sometimes causing difficulty urinating or other urinary problems.

Benign Prostate Hyperplasia Symptoms

Many men with BPH may have no significant symptoms, but the most common symptom that men first notice as prostate enlargement progresses is difficulty in urination. Characteristic symptoms of BPH include:

  • A weak urinary stream
  • A feeling that the bladder is not completely emptied after urination
  • Difficulty starting urination
  • Urgency (difficulty postponing urination)
  • Frequent urination
  • Nocturia (getting up at night to urinate)
  • Dribbling at the end of urination
  • Interruption of the stream (stopping and starting)
  • As the prostate gland enlarges, the urethra is squeezed more tightly and it becomes difficult for the bladder to empty completely. In a small percentage of men, this leads to urinary tract infections or gradual bladder and/or kidney damage.

    Diagnosing Benign Prostate Hyperplasia

    If you are experiencing any of the symptoms listed above or burning or pain on urination you should see your doctor. Your doctor may ask you questions about how you void or want you to fill out a questionnaire to help evaluate the severity of your symptoms. Depending on the symptoms, some additional tests may be ordered to see if you have an obstruction. A rectal examination and a blood test to check for prostate cancer (PSA test) will most likely be done on the initial visit to the urologist. The American Urological Association recommends that men age 50 and over have a prostate exam with PSA every year.

    We now have an online version of the BPH Symptoms Questionnaire. Click on the link below to complete the online questionnaire.

    Benign Prostatic Hyperplasia Treatments

    Benign Prostatic Hyperplasia requires treatment only if the symptoms are bothersome or urinary function is seriously affected. If your symptoms are not bothersome enough, you and your doctor may decide on a course of “watchful waiting” – involving yearly or more frequent checkups. If your symptoms are more bothersome, there are several methods of treatment available to men affected by BPH. Your doctor can discuss these treatments with you to determine which is most appropriate for your condition. Medication: Four types of medication are currently being used in the treatment of BPH.

    4 Types of Medications

    Alpha-blockers are medications that can relax the muscle tissue in the prostate and, in this way, may relieve part of the blockage. The second type of medication, 5-alpha-reductase inhibitors, partially shrinks the enlarged prostate by blocking the effect on the prostate of the major male hormone, testosterone. The third medicine is a specific phosphodiesterase inhibitor called Cialis (and actually it is the daily, low-dose form of this medication indicated for the treatment of BPH). The exact mechanism of action is not clear but it has the added benefit of also potentially improving the patient’s erectile function. The final category of “medication” is herbal products, the most commonly used being saw palmetto. Many men get significant symptom relief with these over the counter “supplements.” One drawback to herbal products is the lack of standardization of their content and labelling since they are not regulated closely by the FDA. Trans-Urethral Microwave Thermotherapy (TUMT): Microwave therapy gives an alternative to surgery or a lifetime of medication for certain patients. The procedure involves placing a special catheter in the urethra that delivers heat to the prostate via microwaves, causing shrinkage of the prostate gland. It takes approximately one hour to perform the procedure and the patient is placed under local anesthesia. Because of the simplicity of the procedure, it is usually done on an outpatient basis or in the office and it can offer a significant improvement in urine flow and symptoms for most patients. Many men are good candidates for this procedure, but your doctor will take under consideration certain criteria like overall health and the severity of the symptoms. It is generally the only procedure that is completely safe for men who must remain on blood thinners at all times. For more information: www.Prolieve.com Transurethral Resection of the Prostate (TURP or “standard” TURP): Transurethral resection of the prostate is a surgical procedure, which has been done for decades. It involves inserting a scope into the urethra (the tube inside of the penis) and surgically removing a portion of the obstructing prostate tissue. This procedure reduces pressure on the urethra, which is being “pinched” by the enlargement of the surrounding prostate. No external incisions are made, it is all done through the scope inside the urethra. TURP remains an excellent treatment for BPH although it does introduce some surgical risk. A newer technology which decreases bleeding and speeds healing is called a “bipolar TURP.” What makes this different is the electrical energy source used to cut through the tissue being removed. Both forms of the TURP have the slight advantage of providing tissue to examine under the microscope. In uncommon instances where the possibility of prostate cancer is an unanswered question, this can be desired. Visual Laser Ablation of Prostate (VLAP) also called a “laser TURP”: Like a TURP as described above, the VLAP eliminates the obstructing prostate tissue. This is achieved by vaporizing the tissue with high energy from a laser inserted and directed through the scope. It generally involves less bleeding, less pain and a shorter recovery time than a standard TURP, although it still requires an anesthetic. Its disadvantage is that a very large prostate may not be adequately treated with this procedure. The two most commonly used lasers for this procedure are the “Green Light” and the holmium lasers. TransUrethral Vaporization of Prostate (TUVP): This is basically the same as the VLAP, except that the energy source used to vaporize the obstructing prostate tissue is electrical instead of laser. Subtotal prostatectomy: If the prostate is really large, the above options are less successful than desired. For such prostates a “subtotal” is a better choice. If you think of the prostate like an orange with the urethra running through its middle, it is the pulp that blocks the flow of urine. All of the above procedures remove the “pulp” while leaving the “peel” intact. A subtotal prostatectomy utilizes a laparoscopic approach requiring several small (1/2 – 1”) lower abdominal incisions. The surgeon uses lighted instruments to open the “peeling” and remove the “pulp.” The peeling is then sewn back together. This is very effective for very large prostates.
    Could you benefit from treatment for BPH? Please pick the answer that best describes your response to each of the following questions.

    0=Not at All

    1=Less than 1 time in 5

    2=Less than half the time

    3=About half the time

    4=More than half the time

    5=Almost Always

    Incomplete emptying over the past month, how often have you had a sensation of not emptying your bladder completely after you have finished urinating?

    0 1 2 3 4 5

    Frequency over the past month, how often have you had to urinate again less than 2 hours after you have finished urinating?

    0 1 2 3 4 5

    Intermittency over the past month, how often have you found you stopped and started again several times when you urinated?

    0 1 2 3 4 5

    Urgency over the past month, how often have you had a weak urinary stream?

    0 1 2 3 4 5

    Weak Stream over the past month, how often have you had a weak urinary stream?

    0 1 2 3 4 5

    Straining over the past month, how often have you had to push or strain to begin urination?

    0 1 2 3 4 5

    Nocturia over the past month, how many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?

    0 1 2 3 4 5

    Score ___________

    Add the numbers from your answers to questions 1 through 7. The maximum possible score is 35. Remember: This information is not intended as a substitute for medical treatment.

    Note: This test is used to measure the severity of your symptoms. This is not a diagnostic test. In other words, it will not tell you whether or not you have BPH. Talk to your doctor to determine if your symptoms are due to BPH.

    Adapted from Barry MJ, et al. The American Urological Association symptom index for benign prostatic hyperplasia. J Urol. 1992; 148: 1549-1557.

    Bladder Cancer

    Bladder cancer is a cancer that starts in the bladder, the body part that holds and releases urine. The exact cause of bladder cancer in uncertain. However, several things may make you more likely to develop it, including: cigarette smoking, chemical exposure at work, chemotherapy, radiation treatment, and long-term infection.

    Symptoms:

  • Blood in the urine
  • Painful urination
  • Urinary frequency and urgency
  • Weight loss
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    Diagnosing Bladder Cancer

    Your doctor will perform a detailed history and physical examination, including a rectal and pelvic exam. Tests that may be done to look for bladder cancer include:
  • CT scan: x-ray imaging that show detailed views of the abdominal and pelvic organs
  • Urinalysis: a test performed in the doctor's office used for finding blood in the urine
  • Urine Cytology: detailed microscopic evaluation of the urine looking for cancer cells floating in the urine
  • Cystoscopy: visualization of the inside of the bladder with an endoscope
  • Bladder biopsy: usually done in the operating room, where suspicious areas are sampled to determine if cancer is present
  • Bladder Cancer Treatments

    Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health.

    Superficial bladder cancer:
    Cancer in the lining of the bladder.
  • Treatment usually involves removing the tumor through an endoscope.
  • Subsequent treatment may include chemotherapy and/or immunotherapy treatments, which is medicine instilled into the bladder over a series of weeks. This helps to reduce the chance that the cancer may return.
  • Routine follow up is needed to ensure that the cancer hasn’t returned. This usually involves repeat Cystoscopy in the office every 3-6 months for several years.
  • Muscle-Invasive bladder cancer:
    Cancer that has grown into the wall of the bladder.
  • If the bladder cancer has progressed, and has grown into the wall of the bladder, much more aggressive treatment is warranted.
  • Radical Cystectomy:
    Complete removal of the bladder.
  • This is major surgery, usually involving a hospital-stay of up to a week. The lymph nodes around the bladder are also removed to determine if the cancer has begun to spread.
  • If you are a male, the prostate is removed along with the bladder.
  • If you are a female, the uterus and ovaries are removed, if still present.
  • Once the bladder is removed, the options for removing the urine are:
  • Ileal Conduit:
    A small section of your small bowel is used to create an ostomy on your abdomen for urine to drain into a bag. This is the most common type of diversion, and offers greatest ease of use and lowest risk.

  • Neobladder: A larger section of your small bowel is used to create a reservoir in which to hold your urine inside you body. It is attached to the urethra, and the patient continues to urinate much in the same way as you do now. While a more attractive option for some patients, it is not for everyone and comes with it’s own set of drawbacks. Ask your urological surgeon if this option is right for you.
  • Robotic Surgery for Bladder Cancer: at Urology Centers of Alabama, the physicians continue to lead the forefront in robotic surgery for various urological diseases. With an expanded robotics program for the treatment of bladder cancer with robotic radical cystectomy. Specially trained robotic surgeons at Urology Centers of Alabama are among the nations’ most experienced in the field of bladder cancer.
  • Robotic surgery offers many advantages including:
  • Much less blood loss, resulting in very seldom need for blood transfusions
  • Less pain
  • Shorter hospital stay
  • Better cosmetic result
  • Ask your urologist if robotic surgery might be an option for you.
  • Radiation & Chemotherapy: If surgery is not an option for you, due to poor overall health, your doctor may recommend combination radiation and chemotherapy to kill the cancer.
  • As with all treatments, side effects are possible. Be sure to ask your doctor the pros and cons to each option, to decide which is right for you.
  • Bladder Cancer Prognosis

    How well a patient with bladder cancer does depends on the initial stage and response to treatment. The outlook for early bladder cancer is fairly good, while those with more advanced cancer at diagnosis lessens.
    Call your physician if you have blood in the urine or other symptoms of bladder cancer. Early referral to a urologist is very important, in that early detection is key.

    Patient Testimonial

    Erectile Dysfunction

    Erectile Dysfunction

    Erectile dysfunction is the inability to obtain an erection that is sufficient for satisfactory intercourse. Millions of men in the United States suffer from erectile dysfunction and many men do not seek treatment for this very common problem. At Urology Centers of Alabama we specialize in the non-surgical and surgical treatment of erectile dysfunction. Our surgeons and nurses have a strong commitment to treating patients with erectile dysfunction and their partners with compassion, respect and empathy. A man does not need to feel embarrassed when he comes to Urology Centers of Alabama seeking treatment for erectile dysfunction. Our goal is to return patients to these most intimate and private activities that can truly improve the quality of life. The non-surgical and surgical treatment options for erectile dysfunction can be highly effective. We encourage you to begin the journey toward erectile restoration by coming to see us.

    Causes of Erectile Dysfunction

    Erectile dysfunction results from inadequate blood flow into the penis that would normally allow for a rigid erection. There are a number of medical conditions that can cause erectile dysfunction, but the most common causes are diabetes and high blood pressure. Other conditions such as spinal cord injury can also lead to erectile dysfunction or the side effects of radical surgeries used to treat prostate cancer or bladder cancer. As a man increases in age it is increasingly common for the quality and stiffness of his erections to diminish. Again, the good news is that regardless of the cause of erectile dysfunction we can almost always be successful with our treatments.

    Non-surgical Options to Treat Erectile Dysfunction

    Medications can be used to treat erectile dysfunction, such as Viagra, Levitra and Cialis. Oral medications are effective in about 70% of men with erectile dysfunction. Other non-surgical treatment options would include the use of penile injection therapy. In this treatment a small needle and syringe are used to inject medication directly into the penis. These medications can increase blood flow into the penis causing a firm erection. The discomfort associated with penile injection therapy is not severe and the risk of complications is low. A side effect of non-surgical treatments is priapism, an erection that persists for several hours. Adjustment of the dosage of medications injected is critical to avoiding priapism, and the physicians and nurses in our ED Department are well schooled in helping the patient to determine the appropriate dose of injectable medications. Another non-surgical treatment is a vacuum erection device (VED). It is a plastic cylinder that goes over the penis and produces a vacuum. The vacuum draws blood into the penis and then a rubber constriction ring placed around the base of the penis holds the blood in the penis allowing for penile rigidity. We work with a patient to instruct him how to use the VED

    Surgical Options to Treat Erectile Dysfunction

    Penile Prosthesis are surgical treatments for men with erectile dysfunction. Penile prostheses are safe and have been used for several years and are continually being improved. Patients have several different types of prostheses to choose from and your prosthetic urologist will help you make the decision that is best for you.

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    Fistulas

    Fistulas

    Fistulas are an abnormal connection between 2 organs. A vesicovaginal fistula is an abnormal connection between the bladder and the vagina, that allows continuous urinary leakage (discharge) into the vagina. This problem has a profound effect on a woman’s well-being.

    The majority of vesicovaginal fistulas in developed countries are a consequence of gynecological surgery- The majority occurring after a hysterectomy

    Symptoms-
      Symptoms that a woman may experience include:
    • Uncontrolled leakage into the vagina
    • Patients that experience flank pain
    • Infections may be suspect for urethral injury
    Treatments

    Small fistulas may sometimes resolve with a foley catheter drainage. However, the majority of times, surgical treatment is needed. Depending on the location of a fistula, the physician may repair the defect either vaginally or abdominally. Trained physicians can repair this robotically, which greatly minimizes post-operative discomfort.

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    Incontinence

    Incontinence

    Urinary incontinence in women can be troublesome and embarrassing, but it is treatable. There are several types of incontinence, but the most common are urinary urge incontinence, stress incontinence, and mixed incontinence. Incontinence is a very common condition and the prevalence does increase as one ages. Urinary urge incontinence involves the involuntary loss of urine usually associated with a sudden urge that cannot be suppressed. Some of the causes may be related to infection, hormone status, childbirth, or previous pelvic surgeries. A thorough history and comprehensive pelvic floor exam are vital. Not only is it important that the physician know all of the medications that the patient is taking, but it is equally important to know the toilet habits and dietary habits. It can be exacerbated by certain types of foods/beverages. A urinalysis is needed to rule out an infection. Further testing either with urodynamics or cystoscopy or both may be needed.

    Treatments

    Treatments for Urinary Urge Incontinence

    Non-Invasive-
      Symptoms that a woman may experience include:
    • Behavioral Changes- This includes weight loss, smoking cessation, and pelvic floor muscle therapy.
    • Botox- This is an In-office treatment, that uses Botox to calm that nerves that trigger the overactive bladder muscles, that cause incontinence.
    • Dietary Changes
    • Pharmacological- This involves a trial of medications that are known as anticholinergics. It is important that the patient is aware of the side effects of medications. If the medications are not helpful or cannot be taken, then other surgical modalities are investigated
    • Physical Therapy- Pelvic floor muscle therapy
      Minimally Invasive -
  • Interstim - The therapy uses a small, implanted medical device to send mild electrical pulses to a nerve located just above the tailbone. This nerve, called the sacral nerve, controls the bladder and surrounding muscles that manage urinary function. The electrical stimulation may eliminate or reduce bladder control symptoms. Interstim therapy does not treat symptoms of stress incontinence. 
  • Stress Urinary Incontinence

    Symptoms

    Stress incontinence is the involuntary loss of urine associated with physical activity such as coughing, sneezing, and exercising. It is caused by several factors some of which may be childbirth and previous pelvic surgeries. As many as 50% of all women experience symptoms of stress urinary incontinence. As with urinary urgency incontinence, a thorough history and physical exam is crucial.

    Treatments

    Treatments for Stress Incontinence

      Non-Surgical
    • Kegal Exercises
    • Dietary Modification / Times Voiding
      Surgical-
    • Sling
    • Non-mesh Option
    • Bulking Agents
    Treatments

    Small fistulas may sometimes resolve with a foley catheter drainage. However, the majority of times, surgical treatment is needed. Depending on the location of a fistula, the physician may repair the defect either vaginally or abdominally. Trained physicians can repair this robotically, which greatly minimizes post-operative discomfort.

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    Urethral Stricture Symptoms

  • Blood in the urine
  • Difficulty urinating
  • Frequent urination
  • Painful urination
  • Spraying of the urinary stream
  • Discharge from the urethra
  • Diagnosis includes a detailed history and physical including onset of symptoms and severity. Your doctor may also choose to evaluate your urethra with a variety of office tests including:

  • Post-void residual volume: determining how well you empty your bladder
  • Urinary flow rate: strength of urinary stream retrograde urethrogram: X-ray performed while instilling dye into urethra
  • Cystoscopy: looking into the urethra and bladder with a small telescope
  • Incontinence Treatments:

    Various treatment options exist, each with their own advantages and disadvantages.

  • Urethral Dilation
    : Gently stretching the stricture with sequential dilators. Usually performed in the office with local anesthesia, however recurrence rate is high.
  • Endoscopic Incision
    : The stricture is cut using a special cystoscope while under general anesthesia in the operating room. Typically performed on outpatient basis, and no formal skin incision is needed. Success rate is typically pretty good, but depends on location of the stricture and length of the stricture. Each subsequent incision carries higher recurrence rate.
  • Open Urethroplasty
    : Removing the diseased segment and replacing with healthy tissue. The technique used depends on location and length of the stricture, as well as surgeon experience. For longer strictures, a tissue graft is usually needed to bridge the gap. The tissue used for grafting can include local penile skin or even buccal mucosa from inside the cheek. Success rates are typically very good with low recurrence rates, especially with surgeons with experience in performing these procedures.
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    Interstitial Cystitis

    Interstitial Cystitis (IC) is a condition that causes pain or discomfort in the bladder and the surrounding pelvic region. The symptoms are different for each person and can change on a case to case basis. Pain may worsen as the bladder fills or is emptied. The pain typically can be worse for women, during menstruation, but can also affect women who have had hysterectomies.

    Due to the varying nature of symptoms and severity, most researchers in the field of study, believe that interstitial cystitis is several diseases. Scientists have recently started using the term bladder pain syndrome (BPS) or painful bladder syndrome (PBS) to describe painful urinary symptoms that do not meet all of the definitions of interstitial cystitis.

    Symptoms
    • Urgent need to urinate
    • Frequent need to urinate
    • Mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area

    Some symptoms of interstitial cystitis appear to be those of a bacterial infection, but tests show no organisms in the urine of people that have interstitial cystitis or painful bladder syndrome. Patients that suffer from interstitial cystitis do not respond to antibiotic therapy.

    Some people with severe cases may urinate up to 60 times per day, including nocturia, which is frequent nighttime urination.

    Diagnosis
    • Urinalysis and Urine Culture
    • Cystoscopy under Anesthesia with Bladder Distention Biopsy
    • Biopsy
    Treatment

    While there is no cure for interstitial cystitis, there are many treatment options designed to help relieve symptoms associated with IC

    Non Surgical
    • Dietary Changes
    • Smoking Cessation
    • Bladder Instillation
    • Oral Medications
    • Exercise
    • Bladder Training
    • Physcial Therapy
    Surgical
    • Cystoscopy with hydrodistention, +/- biopsy
    • Sacral Neuromodulation
    • More aggressive surgery may be an option as a last resort
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    Kidney Cancer

    Kidney Cancer

    Kidney cancer is cancer that originates in the kidneys, two bean-shaped organs, each about the size of your fist. Each year about 190,000 people will be diagnosed with kidney cancer worldwide. Kidney cancer is slightly more common in men and is usually diagnosed between the ages of 40-80 years of age. Many kidney cancers are detected during procedures for other diseases or conditions. Imaging techniques such as computerized tomography (CT) are being used more often, which may lead to the discovery of more kidney cancers earlier. It is important to realize that with early diagnosis and treatment, kidney cancer can be cured.

    Risk factors for renal cell carcinoma include smoking, long term dialysis, family history, Von Hippel – Lindau disease, age and African American race, and high blood pressure. Symptoms are usually none and tumors are most often found incidentally with CT imaging. Symptoms may include blood in urine, flank or side pain, a mass or lump felt in the side of the abdomen, and even an array of non-specific abnormalities including weight loss, appetite changes and lab abnormities of the blood.

    Treatment is usually surgical and we at Urology Centers of Alabama offer all the cutting-edge treatments including, robotic surgery for removal or partial removal of the kidneys and the tumor, laparoscopic cryoablation of small kidney masses, and other open or laparoscopic techniques.

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    Kidney Stones

    Kidney Stones

    Many patients consider kidney stones as simply a very painful nuisance which has to be tolerated periodically. In fact, kidney stone disease is a complex problem with various types of stones and with many different causes. At Urology Centers of Alabama, we utilize state of the art equipment and techniques to successfully treat stones. However, careful evaluation and management options also allow us to successfully prevent recurrent stone episodes in many patients.

    What Causes Kidney Stones?

    Stones may develop because of one or a combination of reasons:

  • Geography – hot, humid climates, such as in our southeastern part of the country, may increase the risk of stones in susceptible persons by either excess loss of fluids or inadequate fluid intake.
  • Genetics – many stone patients have a family history of stones.
  • Diet – see section below on stone prevention.
  • Medical problems – hyperparathyroidism, gout, chronic diarrhea and several other inflammatory GI problems including some GI surgeries, and others.
  • What Symptoms Caused Kidney Stones?

    Everyone knows about the terrible flank pain associated with kidney stones. Many think that this pain is caused by a scratching of the stone as it passes through the ureter. In fact, most of the pain is caused by obstruction of the ureter, causing a backup of urine into the kidney with resultant stretching and dilation of the tissue. Nausea and vomiting are often present during acute episodes. Some patients may have an urgency to urinate or blood in the urine. Some patients may even have no symptoms at all.

    Treatment of Kidney Stones

    There are various methods and equipment used for treating kidney stones, depending on the situation.

    Kidney Stone Prevention

    Even though we have a multitude of treatment options and equipment to successfully treat kidney stones, our goal is to help patients avoid recurrent stones. To achieve this, your urologist might recommend a change in your diet or a special medication. Calcium stone formers might be advised to drink more water, avoid salt, decrease oxalate intake and avoid calcium supplements.

    Low Oxalate Diet

    The following foods and drinks should be avoided when trying to maintain a low oxalate diet:

  • Tea
  • Strawberries
  • Spinach
  • Rhubarb
  • Chocolate / Cocoa
  • Wheat bran
  • Nuts
  • Beets
  • The following foods contain oxalate , but not as much as the above products: Beans, blackberries, celery, dark leafy greens, swiss chard, draft beer, sweet potatoes, eggplant, white corn grits, instant coffee, okra, leeks, and soy tofu.

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    Low Testosterone

    Low Testosterone

    Testosterone is a male sex hormone mainly produced by the testicles. It is becoming increasingly more common for male patients to come in talking about low testosterone, also known as hypogonadism. This isn’t necessarily a new problem; men are just becoming more open to talking about erectile dysfunction. As men age, most will begin to experience a gradual decline in testosterone. Often the most noticeable side effect is a decrease in sex drive.

    Symptoms of Low Testosterone

    There are both sexual and non-sexual symptoms of low testosterone. Some sexual signs include poor erectile function, low libido and weaker erections. Non-sexual symptoms related to low testosterone include reduced muscle mass, decreased energy and fatigue and depression. Men with high blood pressure and high cholesterol levels can also have low testosterone levels. Other diseases that can contribute to lows testosterone are diabetes, obesity, HIV / AIDS and chronic opioid. Low Testosterone is diagnosed with a blood test with the presences of symptoms.

    Treatments for Low Testosterone

    There are several ways to treat low testosterone. Replacement therapy can be used in many forms including skin gel, injections, patches, oral inserts and pellets. Skin gel or cream can be applied to the skin each morning and the testosterone is absorbed into the bloodstream.

    Injections are a very reliable treatment that can be administered every week or every other week.

    Testosterone pellets are tiny pellets places under a patient’s skin that needs to be repeated every 5-6 months.

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    Pelvic Prolapse

    Pelvic Prolapse

    Pelvic prolapse or vaginal vault prolapse is a very common condition characterized by the herniation of pelvic organs, bladder (cystocele), rectum, (rectocele), small intestine (enterocele), uterus, or vagina. These organs herniated due to weakness of support structures in the pelvis. The supporting muscles can become torn or stretched due to a number of things, including childbirth or age. Other risk factors for pelvic prolapse include: genetics, connective tissue disorder, obesity, and frequent constipation.

    Patients may notice a bulge in the vagina, and may even have to reduce this bulge manually in order to urinate or defecate. Patients may also have urinary incontinence accompanying the prolapse. This may surprisingly may improve as the prolapse worsens. Furthermore, patients can also complain of constipation, and dyspareunia (painful intercourse), back pain and can have recurrent urinary infections.

    Diagnosis begins with a thorough history and physical exam. A urinalysis is useful to evaluate blood in the urine or infection. A post void residual is obtained to ensure the patient is emptying. other important test that may be done include a cystoscopy and urodynamics which provide comprehensive evaluation of the bladder function and pelvic floor.

    Nonsurgical Treatment Options

    Treatment options may include conservative options such as pelvic floor retraining, biofeedback, and a placement of a pessary. A vaginal pessary is a removable device that is designed to support the areas that may cause pelvic organ prolapse. Our staff is trained to place the pessaries in the office.

    Surgical Treatment Options

    Surgical treatment options include various procedures that address the pelvic floor defect. The da Vinci robot is used to repair pelvic floor defects. This procedure is called a da Vinci Sacrocolpopexy.

    The robotic procedure allows the surgeon to work deep in the pelvis to recreate the suspension. Often, a small piece of mesh is used to help with this.

    Several advantages are noted utilizing this technique. These include shorter hospitalization stay, less blood loss, and return to normal function sooner. Our physicians are trained to deal with all types of pelvic floor prolapse.

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    Overactive Bladder (OAB)

    Overactive bladder is a problem with the storage function of the bladder. This problem causes a sudden urge to urinate. Often times, this urge is difficult to stop, which leads to an involuntary loss of urine, also known as incontinence.

    Women may experience frequency and nocturia (needing to frequently get up at night the void).

    The prevalence of OAB varies from 16-43%, and it affects more women than men. The prevalence of OAB increases with age.

    Some women may experience urinary urgency incontinence. This is sudden leakage that cannot be stopped. This can be very distressing for women.

    Overactive bladder can usually be diagnosed after a thorough history evaluation from the physician.

    Diagnosis
    • In-office exam for physical and history evaluation, as well as a urinalysis.
    • Post-void residuals
    treatment
    First Line:
    • Behavioral therapies (bladder training, bladder control strategies, pelvic floor training)
    • Pharmacological management
    Second Line:
    • Medications- these are several medications that a physician may try, but some of the side effects of the medications may dictate which medications may be used.
    Third Line:
    • Botox- This is an In-office treatment, that uses Botox to calm that nerves that trigger the overactive bladder muscles, that cause incontinence.
    • Percutaneous Tibial Nerve Stimulation- a needle electrode is used to send an electrical pulse to the Tibial nerve, in an attempt to stimulate the nerve, to decrease the frequency of urination.
    • Sacral Nerve Stimulation- This is a non-invasive procedure that involves sending electric pulses through externally attached electrode pads, to the sacral nerve.
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    Pelvic Disorders

    Pelvic Disorders

    Pelvic Prolapse

    Pelvic prolapse or vaginal vault prolapse is a very common condition characterized by the herniation of pelvic organs, bladder (cystocele), rectum, (rectocele), small intestine (enterocele), uterus, or vagina. These organs herniated due to weakness of support structures in the pelvis.

    Patients may notice a bulge in the vagina, and may even have to reduce this bulge manually in order to urinate or defecate. Patients may also have urinary incontinence accompanying the prolapse. This may surprisingly may improve as the prolapse worsens.. Furthermore, patients can also complain of constipation, and dyspaurenia (painful intercourse), back pain and can have recurrent urinary infections.

    Diagnosis begins with a thorough history and physical exam. A urinalysis is useful to evaluate blood in the urine or infection. A post void residual is obtained to ensure the patient is emptying. other important test that may be done include a cystoscopy and urodynamics which provide comprehensive evaluation of the bladder function and pelvic floor.

    Treatment options may include conservative options such as pelvic floor retraining, biofeedback, and a placement of a Pessary. A vaginal pessary is a removable device that is designed to support the areas that may cause pelvic organ prolapse. Our staff is trained to place the pessaries in the office. Surgical treatment options include various procedures that address the pelvic floor defect. The da Vinci robot is used to repair pelvic floor defects.

    Several advantages are noted utilizing this technique. These include shorter hospitalization stay, less blood loss, and return to normal function sooner. Our physicians are trained to deal with all types of pelvic floor prolapse.

    Pelvic Pain

    One of the most challenging urological disease conditions for patient and doctor alike is chronic pelvic pain. If you are frustrated by this problem you are not alone. Chronic pelvic pain includes the syndromes chronic prostatitis and interstitial cystitis/painful bladder syndrome. It can affect both men and women. Symptoms vary but usually include urinary frequency and urgency, pain and/or pressure perceived to arise from the bladder. Frequency usually involves urinating several times throughout the day and night, sometimes even several times an hour. At times, pain is associated with bladder filling and can be severe, and it may be relieved by voiding. Sometimes, a trigger can be identified. It can be a certain type of food or it can be a stressful situation. In women, it may be associated with the onset of a menstrual cycle. Patients may see several doctors before they are diagnosed. The diagnosis of this condition is usually made after excluding other identifiable causes such as a urinary tract infection, bladder cancer , prostatitis, and endometriosis. The proposed pathophysiology suggests that there may be an initial insult—possibly trauma or infection that sets up tissue injury in the bladder/prostate. This further promotes inflammation and release of cytokines and upregulation of pain fibers. Subsequently, this causes the bladder lining to be “leaky” and very sensitive to the urinary toxins and can causes over sensitivity with the pain fibers. Also of interest, many people may suffer with other chronic pain conditions such as fibromyalgia, irritable bowel syndrome, migraines and painful intercourse and pelvic floor spasm. Treatment should be based on a multidisciplinary approach. Pharmacology, behavior and lifestyle modification, and dietary changes are implemented. Of note, it is found that if patients exhibit myofascial pain or a hypertonic pelvic floor, then physical therapy is extremely beneficial. Pelvic pain syndromes require a multidisciplinary approach with realistic goals agreed on by the patient and doctor.

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    Pelvic Prolapse

    Pelvic Prolapse

    Pelvic prolapse or vaginal vault prolapse is a very common condition characterized by the herniation of pelvic organs, bladder (cystocele), rectum, (rectocele), small intestine (enterocele), uterus, or vagina. These organs herniated due to weakness of support structures in the pelvis. The supporting muscles can become torn or stretched due to a number of things, including childbirth or age. Other risk factors for pelvic prolapse include: genetics, connective tissue disorder, obesity, and frequent constipation.

    Patients may notice a bulge in the vagina, and may even have to reduce this bulge manually in order to urinate or defecate. Patients may also have urinary incontinence accompanying the prolapse. This may surprisingly may improve as the prolapse worsens. Furthermore, patients can also complain of constipation, and dyspareunia (painful intercourse), back pain and can have recurrent urinary infections.

    Diagnosis begins with a thorough history and physical exam. A urinalysis is useful to evaluate blood in the urine or infection. A post void residual is obtained to ensure the patient is emptying. other important test that may be done include a cystoscopy and urodynamics which provide comprehensive evaluation of the bladder function and pelvic floor.

    Nonsurgical Treatment Options

    Treatment options may include conservative options such as pelvic floor retraining, biofeedback, and a placement of a pessary. A vaginal pessary is a removable device that is designed to support the areas that may cause pelvic organ prolapse. Our staff is trained to place the pessaries in the office.

    Surgical Treatment Options

    Surgical treatment options include various procedures that address the pelvic floor defect. The da Vinci robot is used to repair pelvic floor defects. This procedure is called a da Vinci Sacrocolpopexy.

    The robotic procedure allows the surgeon to work deep in the pelvis to recreate the suspension. Often, a small piece of mesh is used to help with this.

    Several advantages are noted utilizing this technique. These include shorter hospitalization stay, less blood loss, and return to normal function sooner. Our physicians are trained to deal with all types of pelvic floor prolapse.

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    Peyronie's Disease

    Peyronie's Disease

    About Peyronie's Disease

    Peyronie's disease is the development of scar tissue in the penis. We do not always know what causes Peyronie's; however, most times Peyronie's the result of an injury or decreased blood flow. Peyronie's can cause pain and/or curvature of the penis and may also result in a decrease in penile size and erections.

    Treatments for Peyronie's Disease

    There are a number of treatment options and each will have different results. These include:

  • Surgical treatment of Peyronie's Disease is effective, causes minimal discomfort, and is performed as an outpatient procedure.
  • Plaque injections with XiaFlex or Verapamil can sometimes be useful to treat Peyronie's Disease.
  • Vacuum Erection Devices can be of benefit in stretching and remodeling the scar tissue of Peyronie's Disease.
  • Dr Brian Christine, our expert in men's sexual health and prosthetic urology, is one of a limited number of urologic surgeons who has been trained to offer XiaFlex as a treatment option.

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    Prostate Cancer

    Prostate Cancer

    Introduction

    The prostate gland is part of the male reproductive system and is responsible for the production of fluid to nourish and transport sperm. The prostate lies deep in the male pelvis between the bladder and the urethra (the tube that transports the urine and semen through the penis). Prostate Cancer develops when the cells of the gland mutate and undergo malignant changes. Cancer cells grow more rapidly than normal cells and refuse to die, and they also develop the ability to invade and destroy normal tissue. Over time, the spread of the malignant cells can result in the patient having symptoms, health problems and ultimately death.

    Prostate Cancer is one of the most common male malignancies in the United States and it is expected that more than 241,740 men will be diagnosed with this condition annually. Men have a 1 in 6 lifetime chance of prostate cancer and it is the third leading cause for cancer death in men. The annual prostate cancer death rate has been declining recently which we think may be due to screening and early detection of the disease. Prostate cancer usually occurs later in life and grows slowly, but this is not always the case. While some types of prostate cancer may need minimal or no treatment, other types are aggressive and can spread quickly. If prostate cancer can be detected early while it is still confined to the prostate, the chance for successful treatment of disease is very good.

    Symptoms

    For most men, prostate cancer is first detected during a routine screening such as a Prostate Specific Antigen blood test (PSA) and/or a digital rectal exam (DRE), and since the cancer is usually detected much earlier with screening, there are often no associated symptoms. Later in its course, the cancer can cause compression on the urinary tract and this compression results in urinary symptoms such as decreased force of stream and stopping & starting of the urinary stream. Since these are the same symptoms associated with Benign Enlargement of the Prostate (BPH), it is important to be checked with the PSA and DRE to be sure that the symptoms are not due to Prostate Cancer. Later stages of Prostate Cancer can cause pelvic pain, bone pain or bone fractures, but because of routine screening, Prostate Cancer rarely presents with these advanced symptoms.

    Risk Factors

    The main risk factors include:

  • Age –
    Prostate cancer is more common as men get older
  • Race or Ethnicity –
    For reasons that aren’t well understood; African American men have a higher risk of developing and dying of prostate cancer.
  • Family History –
    If there is a family history of prostate cancer, the chances of getting it are higher. The closer the relative, the more relatives with this condition and the younger that it was found in the relative, all increase the risk of getting and dying of prostate cancer.
  • Diet –
    A high fat diet and obesity may increase the risk of prostate cancer.
  • When to seek medical advice

    If you have difficulties with urination, contact your doctor. These symptoms are not always caused by prostate cancer, but screening for prostate cancer is advisable.

    The American Cancer society and the American Urological Society recommend that the pros and cons of regular prostate cancer screening be discussed with the patient starting at age 40.

    Prostate Biopsy

    If the screening tests suggest prostate cancer (the Prostate Specific Antigen blood test and/or the Digital Rectal Exam), the pros and cons of a Prostate Biopsy will be discussed with the patient. This is an outpatient procedure using a small ultrasound probe in the rectum to visualize the prostate. Guided by images from the probe, numbing medication is injected around the prostate and using a fine, spring-propelled needle, samples of tissue are taken from the prostate to determine if cancer is present and how aggressive the cancer is. Using the current technique, most patients tolerate the procedure well and complications from the biopsy are rare.

    Treatment

    The decision for treatment of prostate cancer depends on the age and health of the patient, the aggressiveness of the cancer and the extent of the cancer at the time of diagnosis. Virtually all treatments for prostate cancer except observation may have an effect on the quality of life with urinary control, erectile function and bowel function being the primary concerns. So, it is important to have a thorough discussion with your urologist about the benefits, risks, morbidity and side effects of the treatment options.

    If the patient is older and has a slowly progressive prostate cancer, observation and treatment with palliative therapy at a later date is an option. Some younger patients with low volume non-aggressive cancer may be candidates for surveillance in which case the cancer is carefully watched by doing infrequent, repeated prostate biopsies and curative therapy is done if the cancer shows signs of progression.

    For many patients, curative therapy is the best choice and there are basically 4 options:

  • Surgical removal of the prostate
  • Radioactive Seed Implants
  • External Beam Radiation therapy (EBRT)
  • Cryosurgery (freezing of the prostate)
  • If the cancer is very aggressive or more extensive than usual, a combination with hormone therapy (shots to remove male hormone) or a combination of surgery followed by EBRT or Radioactive Seeds plus EBRT may give the best chance for cure. When surgical removal of the prostate is indicated, we are fortunate to have well qualified, experienced robotic surgeons at Urology Centers of Alabama, and we feel that the robotic technology offers less morbidity & side effects and excellent cancer control.

    Hormone Therapy

    Hormone therapy involves stopping your body from producing the male sex hormone testosterone which stimulates the growth of prostate cancer cells. Another type of this therapy can block testosterone from getting into the cancer cells. Sometimes a combination of two drugs is used to achieve both effects. Hormone therapy is occasionally used to stop the growth of the cancer when needed curative therapy cannot be given in a timely manner, sometimes it is used as adjunctive therapy to improve the cure rate of Surgery and External Beam Radiation Therapy (EBRT) and often, it is used as palliative therapy to stop the progression of widespread, incurable cancer. It is a very effective and useful treatment for prostate cancer but does have some side effects. Side effects of hormone therapy can include:

  • Breast enlargement (gynecomastia)
  • Reduced sex drive
  • Erectile dysfunction
  • Hot flashes
  • Weight gain
  • High-Intensity Focused Ultrasound (HIFU)

    High-Intensity Focused Ultrasound (HIFU) is a newly FDA cleared, minimally invasive treatment designed to provide men with a surgery-free option for prostate cancer. The treatment uses high-intensity sound waves to heat and destroy cancer cells. This allows the cancer to be targeted rather than removing the prostate entirely.

    The benefits of this treatment include:

  • Shorter hospital stay
  • Lower risk of erectile dysfunction
  • Decreased probability of incontinence
  • lthough side effects may be less likely with HIFU, there’s still a chance that you may have some. For example, you may have erection problems after the procedure. Some men have problems with urination and are more likely to have bladder infections, after the procedure.

    Drs. Andrew Strang and Bryant Poole are the certified physicians at Urology Centers of Alabama that will be performing this procedure.

    This treatment is not suitable for all cases of prostate cancer. Potential candidates for this procedure are men who have low-volume, previously untreated prostate cancer. Talk with your urologist to determine the best treatment option for you.

    Reduction in muscle and bone mass

    Recent reports have shown that men who undergo hormone therapy for prostate cancer may have a higher risk of having a heart attack in the first year or two after starting hormone therapy. So you doctor should carefully monitor your heart condition and aggressively treat any other conditions that may predispose you to a heart attack, such as high blood pressure, high cholesterol or smoking.

    Surgery to remove the testicles, which produces most of the testosterone is as effective as other forms of hormonal therapy. Many men are not comfortable with the idea of losing their testicles, so they opt for shots or medication to control the testosterone. However, removing the testicles has the advantage of not having to have an injection every 3 to 6 months and can be less expensive. The surgery to remove the testicles is done on an outpatient basis.

    Prostate Cancer Prevention

    Prostate cancer may not be preventable in some people but you can take measures to reduce your risk or possibly slow the disease’s development. This includes the following:

  • Healthy Eating.
    High-fat diets and obesity have been linked to prostate cancer as well as a number of other health problems. Limiting your intake of high-fat foods and emphasizing fruits, vegetables and whole fibers may help you reduce your risk. Foods and supplements containing lycopene (an ingredient in cooked tomatoes), selenium, soy, vitamin D and Vitamin E may also be of help.
  • Get regular exercise.
    Regular exercise can help prevent a heart attack and conditions such as high blood pressure and high cholesterol. When it comes to cancer, the data aren’t as clear cut, but studies do indicate that regular exercise may reduce your cancer risk. Exercise has been shown to strengthen your immune system, improve circulation and speed digestion – all of which may play a role in cancer prevention. Regular exercise may also minimize you risk of prostate gland enlargement or benign prostatic hypertrophy (BPH).
  • The important thing to remember is that what is prostate healthy is heart healthy, cancer healthy and healthy for your vascular system. In addition, healthy living helps to prevent obesity and diabetes and it improves your quality of life.

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    Prostatitis

    Prostatitis

    Prostatitis is swelling and inflammation of the prostate gland, a walnut-sized gland located directly below the bladder in men. The prostate gland produces fluid (semen) that nourishes and transports sperm. Prostatitis can be caused by the same bacteria that commonly cause urine infections. However, in most cases, an identifiable cause is not found and may not be an infection, but just inflammation and irritation of the prostate gland.

    Symptoms of Prostatitis
  • Painful or difficult urination
  • Frequent urination
  • Blood in the urine
  • Pain in the genitals
  • Painful orgasm
  • Sometimes flu-like symptoms
  • Tests for Prostatitis
  • Urinalysis: evaluation of the urine under the microscope
  • Urine culture: to see if bacteria is actually present in the urine
  • Semen culture: to see if bacteria is actually present in the prostate secretions
  • Ultrasound: to see detect for possible abscess (pocket of infection)
  • Cystoscopy: look inside the prostate and bladder to assess for blockage
  • Prostatitis Treatments

    Antibiotics:
    specific antibiotics are chosen to target the most-common causative bacteria. Complete eradication of prostate bacteria may take weeks, so be sure to take ALL of your prescribed antibiotics, or your infection may recur.

    Alpha blockers:
    these medications help relax the muscle fibers in the prostate, helping you to urinate more freely. These may also help to clear infection more quickly.

    Urinary analgesics:
    help to alleviate discomfort when urinating

    Prostate massage:
    not done very often anymore, however may be recommended by your doctor for prolonged infections that are not responding to antibiotics.

    Other treatments:
    other treatments are being studied, since as stated earlier, often times a chronic “infection” is likely not infectious at all. Thus repeated course of antibiotics may not be useful.

    Surgery is rarely needed.

    Having prostatitis does not increase your risk of developing prostate cancer. However, you should continue to have regular exams and blood work (PSA) to check for prostate cancer.

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    Sexually Transmitted Diseases

    Sexually Transmitted Diseases

    “Sexually transmitted diseases (STDs) are infections passed from one person to another during sexual contact. There are numerous sexually transmitted diseases, most of which cannot be diagnosed with certainty without specialized testing. The only STD that rarely needs any special testing to diagnose is HPV which causes genital warts (also called condyloma). The other common STD’s (Genital Herpes, Chlamydia, Gonorrhea, Syphilis, HIV) usually require diagnostic testing that is not readily available in physician offices. For these, the patient needs to be seen at their local county Public Health Department.”

    Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI). There are more than 40 strains of HPV that can infect the genital areas of males and females. HPV can also infect the mouth and throat. Most people who become infected with HPV do not even know they have it. Very rarely a mother with HPV infection can transmit the virus to her infant during delivery.

    Symptoms of HPV

    Most people with HPV do not develop symptoms or health problems. Approximately 20 million Americans are currently infected with HPV. In 90% of cases, the body’s immune system clears HPV naturally within two years. However, certain strains of HPV can cause genital warts in males and females. High-risk or oncogenic HPV strains can cause cancer. There are roughly a dozen high-risk strains that have been identified that affect approximately 5% of all cancer patients.

    HPV and Cancer Risks

    High-risk or oncogenic HPV strains, mostly commonly types 16 and 18, can lead to cancer. These strains can cause cervical, vaginal, vulvar and penile cancers. HPV strains cause normal cells to turn into abnormal cells and when the body can’t fight them off it can lead to cancer. Early stages of cervical cancer often don’t cause signs or symptoms, therefore is it is important for women to have regular Pap tests to detect precancerous changes in the cervix.

    HPV Vaccines

    There is a vaccine called Gardasil that protects against some strains of HPV that cause warts or lead to cancer. Another vaccine called Cervarix protects against some strains that lead to cancer, but not warts. It is recommended for boy and girls to get the vaccine between the ages 12-26. It is most effective if given before becoming sexually active.

    Treating HPV

    There is currently no cure or treatment for HPV. Most inflections are fought off by the body’s immune system and go away on their own. Abnormal cells can be removed by biopsy to help decrease the chance of abnormal cells reproducing. Removing abnormal cells can be treated through colposcopy, cryotherapy and LEEP treatments.

    Medications can be used to eliminate warts that are a side effect of some strains of HPV. Medication can be applied directly to the lesion and usually goes away after several applications. If medications don’t work, warts may be physically removed by freezing with liquid nitrogen, electrocautery or laser surgery.

    If you suspect you may have Genital Herpes, Chlamydia, Gonorrhea, or Syphilis, you need to seek care at your local county public health department
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    Genital Herpes

    Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). Most patients have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. Genital herpes is a fairly common and highly contagious STD affecting about 16.2% of people ages 12 to 49 years old in the United States.

    HSV is spread from person to person during sexual contact. There is a higher probability of spreading HSV when a person has an outbreak, but you can still spread it between outbreaks as well.

    Symptoms of Genital Herpes

    Genital Herpes typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first. The second outbreak is usually less severe and shorter. Other symptoms may include decreased appetite, fever, general sick feeling, swollen and tender lymph nodes in the groin during an outbreak, muscle aches in lower back, buttocks, thighs or knees.

    Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years. Various factors can trigger future outbreaks which include:

  • Stress
  • Fatigue
  • Illness
  • Surgery
  • Menstruation
  • Tests for Genital Herpes

    A doctor can usually diagnose genital herpes based on a physical exam and laboratory tests. Your doctor can order a DNA test, blood test or viral culture to determine if you have genital herpes.

    Genital Herpes Treatment and Prevention

    There is no cure for genital herpes but medication can help relieve discomfort. Medications may help sores heal sooner, lessen the severity and length of symptoms with breakouts, reduce the recurrence of breakouts and minimize the chance of transmitting the disease to others. Your doctor might recommend taking medication during the breakouts or every day.

    The only way to 100% prevent genital herpes is to abstain from sexual activity. The lesions are highly contagious when present, so abstain from sexual activities during the breakouts. Other ways to avoid getting an STD include using condoms correctly.

    If you suspect you may have Genital Herpes, Chlamydia, Gonorrhea, or Syphilis, you need to seek care at your local county public health department
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    Chlamydia

    Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis. Like some other STDs, a patient might not know they have chlamydia because some people never develop symptoms. Chlamydia can affect both men and woman and isn’t difficult to treat once you know you have it, however untreated it can cause more serious health problems.

    Chlamydia and Infertility

    If women go untreated the infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). This happens in about 10 to 15 percent of women with untreated chlamydia. The inflection can also cause fallopian tube infection without any symptoms. PID and “silent” infection in the upper genital tract can cause permanent damage to the fallopian tubes, uterus and surrounding tissues. This damage can lead to chronic pelvic pain, infertility and potentially fatal ectopic pregnancy (pregnancy outside the uterus).

    All pregnant women should have a screening test for chlamydia.
    Chlamydia Symptoms

    Often there are no early signs of chlamydia. Symptoms will usually occur one to three weeks after the patient has been exposed to the STD. Sometimes symptoms are mild enough that a patient might not recognize them. Symptoms of infection may include:

  • Painful urination
  • Lower abdominal pain
  • Vaginal or penis discharge
  • Painful sexual intercourse in woman
  • Testicular pain in men
  • If you show any signs or learn that a sexual partner has chlamydia you should contact your doctor. If your partner has the infection, your doctor will give you antibiotics even if you do not show signs. A swab or urine test can be used to determine if you have chlamydia.

    Chlamydia Treatment and Prevention

    Chlamydia is treated with antibiotics. In most cases the infection clears up within one to two weeks. Patients should abstain from sex during this time. Your sexual partner should also receive treatment even if he or she does not show symptoms.

    If you suspect you may have Genital Herpes, Chlamydia, Gonorrhea, or Syphilis, you need to seek care at your local county public health department
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    Gonorrhea

    Gonorrhea is a common sexually transmitted disease (STD) that is caused by Neisseria Gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas. Gonorrhea can infect both females and males and most often affects the urethra, rectum or throat. While gonorrhea is most commonly spread through sexual intercourse, babies can be infected during childbirth.

    Signs and Symptoms of Gonorrhea

    Symptoms of gonorrhea most commonly appear in the genital area, but can also affect other parts of the body. Symptoms vary slightly from males to females. Male symptoms include painful urination, pus-like discharge and pain or swelling in one testicle. Woman may experience increased vaginal discharge, painful urination, abdominal or pelvic pain or vaginal bleeding between periods and after vaginal intercourse.

    Symptoms of gonorrhea on other places on the body

    Gonorrhea can affect other parts of the body including the rectum, eyes, throat and joints. Patients may experience anal itching, push-like discharge from the rectum, bright red bleeding or strain during bowel movements. Symptoms in a patient’s eye will cause pain, sensitivity to light or pus-like discharge. If the disease reaches a patients throat will become sore and have swollen lymph nodes. Joints can become warm, red, swollen or extremely painful when affected with gonorrhea.

    You should make an appointment with your doctor if you experience a burning sensation when you urinate or a pus-like discharge. You should also make an appointment if your sexual partner has been diagnosed with gonorrhea.

    Treatments for Gonorrhea

    Your doctor will use a urine test or swab of the affected area to determine if the gonorrhea bacterium is present in your body. Once a doctor determines you have gonorrhea, an antibiotic is used to treat the disease. It is recommended your partner be tested and treated even if he or she doesn’t show symptoms. Even if you have been treated, you can be reinfected by an untreated partner.

    Untreated Gonorrhea can lead to complications

    If gonorrhea goes untreated, the following complications could occur:

  • Infertility in men and women
  • Infection can spread to joints and other areas in the body
  • Increase the risk of HIV/AIDS
  • Complications to unborn babies including blindness, sores on the scalp or infections
  • Pelvic Inflammatory Disease
  • If you suspect you may have Genital Herpes, Chlamydia, Gonorrhea, or Syphilis, you need to seek care at your local county public health department
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    Syphilis

    Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. It has often been called "the great imitator" because so many of the signs and symptoms are indistinguishable from those of other diseases. The disease often starts as a painless sore typically on the a patients genitals, rectum or mouth. Syphilis can lie dormant in your body for decades before being active again after initial infection.

    Symptoms and Signs of Syphilis

    Syphilis develops in stages and symptoms can overlap and vary with each stage. A patient might also be infected and not notice symptoms for years. The following are the stages of syphilis and the symptoms that come with each stage.

    Primary Syphilis and Secondary Syphilis

    The first symptom of syphilis is a small sore that appears at the site where the bacteria entered your body. Most people only develop one sore, but several can appear. The sore usually appears three weeks after infect and most people don’t notice it because it is painless and hidden in the vagina or rectum. The sore will heal on its own within six weeks.

    A few weeks after the sore has healed, a rash may develop on your core, but will eventually cover your entire body developing secondary syphilis. The rash usually is not itchy and may cause sores on the mouth and genitals. Other symptoms may include muscle aches, fever, swollen lymph nodes and a sore throat. These symptoms can come and go for up to one year

    Latent Syphilis and Tertiary Syphilis

    Patients who go untreated develop into the latent, or hidden, stage. This stage can last for years and symptoms may never return or may progress into the tertiary stage. Roughly 15-30% of people who aren’t treated for syphilis will develop the tertiary stage. In the late stages syphilis may damage your brain, nerves, eyes, blood vessels, liver, heart, bones and joints. These problems can occur years after the initial, untreated infection.

    Congenital Syphilis

    Mothers who are infected with syphilis can infect the baby through the placenta or during birth. Most babies with congenital syphilis display no signs or display a rash on the palms of their hands and feet. If untreated later symptoms may include deafness, teeth deformities or a saddle nose.

    Syphilis Treatments

    Syphilis can be diagnosed by testing blood, fluid from sores or cerebral spinal fluid. When diagnosed and treated in the early stages, syphilis is easy to cure. The preferred treatment is antibiotics that kill the organism that causes syphilis. If you have been infected with syphilis for more than a year, additional doses of antibiotics may be necessary to kill the disease. If you are treated for syphilis during pregnancy, your child should also receive treatment after birth.

    You may experience slight side effects the first day of treatment including fever, chills, nausea, achy pain and headaches. These side effects shouldn’t last longer than a day.

    Treatment Follow-up

    After being treated for syphilis you may be asked to have blood tests to make sure your body is responding to treatments. You should avoid sexual contact until the treatment is completed and blood tests confirm the infection is gone.

    If you suspect you may have Genital Herpes, Chlamydia, Gonorrhea, or Syphilis, you need to seek care at your local county public health department
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    Urinary Tract Infections

    Urinary Tract Infections

    Urinary Tract Infections are one of the most common infections to affect people. Urinary tract infections (UTIs) can affect men, women, and children, but women suffer more frequently from these infections. Fortunately, UTIs can usually be treated successfully if they are diagnosed and treated early.

    A urinary tract infection occurs when bacteria gets into the urinary tract and infects the system. Occasionally, the kidneys may become infected as well, causing a serious UTI, which could result in kidney damage. Many women who have one UTI will experience others in their lifetime. It is estimated that nearly 20% of women who have an episode of urinary tract infection will have another, 30% of those will have a third infection, and approximately 80% of those with recurrent infections will experience even more.

    Bacteria can also infect a man’s urinary tract, even though this is not as common. The majority of UTIs in men are caused by an obstruction, usually an enlarged prostate gland. This type of obstruction can cause incomplete voiding and the back up of urine in the bladder. The residual urine can lead to an infection in the bladder.

    Factors that contribute to Urinary Tract Infections

    There are a number of factors that may increase a person’s risk of getting urinary tract infections. These include:

  • Certain people with diseases like diabetes or an abnormal urinary system. Also kidney stones can increase the risk of UTIs.
  • An enlargement of the prostate gland
  • Certain people who have recently undergone catheterization or a procedure that involved having a medical instrument inserted into the urethra.
  • Urinary tract infections also occur in infants and children who are born with urinary tract abnormalities, some of which need to be corrected with surgery.
  • Sexual intercourse, especially for women.
  • The use of birth control methods such as the diaphragm.
  • Pregnancy can also be associated with a higher rate of urinary tract infections because of hormonal and other changes in the anatomy of the urinary tract during pregnancy.
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    Vaginal Atrophy

    Vaginal atrophy is the thinning, drying, and inflammation of the vaginal walls that occurs as estrogen levels drop. It is mostly more pronounced after menopause. Vaginal atrophy can cause painful intercourse, and an increase in UTIs, as well as other urinary symptoms.

    Treatments

    Sometimes, vaginal estrogen creams are recommended. Also, the MonaLisa Touch is an excellent treatment for vaginal atrophy, as it can actually cause an increase in the collagen layer, which results in less

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