What is Interstitial Cystitis, AKA Bladder Pain Syndrome?

When it comes to urological health in Saint Louis, MO, there are a number of conditions which require the expertise of a urological health specialist. One such condition is interstitial cystitis, which is likewise known as bladder pain syndrome. Those who reside in the Saint Louis area, including Creve Coeur, Florissant, Kirkwood, Crestwood, Chesterfield, and Washington, MO, can count on the specialists at Metropolitan Urological Specialists to be there for them as they cope with this serious condition. However, just prior to scheduling an appointment, why not read through the following information so you can have a basis of info about interstitial cystitis.

Female Urinary Tract

Interstitial cystitis (IC)/ bladder pain syndrome (BPS) is a continual bladder health problem. It is a sense of pain and pressure in the bladder area. Along with this discomfort are lower urinary tract signs and symptoms that have lasted for more than 6 weeks, without having an infection or other clear causes.

Symptoms range from mild to severe. For some patients the symptoms might come and go, and for other folks they do not go away. IC/BPS is not an infection, but it might seem like a bladder infection. Women with IC/BPS might experience pain when having sex. The more severe instances of IC/BPS can affect your life and your loved ones. Some people with IC/BPS have other health and wellness issues such as irritable bowel syndrome, fibromyalgia, and other pain syndromes.

Male Urinary Tract

The bladder and kidneys are part of the urinary system, the organs in our bodies which make, store, and pass urine. You have 2 kidneys that make urine. Then urine is stored in the bladder. The muscles within the lower portion of your abdomen secure your bladder in place.

How the Urinary System Works

When it is not full of urine, the bladder is relaxed. Whenever nerve signals within your brain let you know that your bladder is getting full, you feel the need to pass urine. If your bladder is functioning normally, you may put off urination for some time. Once you are prepared to successfully pass urine, the brain sends a signal to the bladder. Then the bladder muscles squeeze (or "contract"). This forces the urine out through the urethra, the tube that carries urine from your body. The urethra has muscles called sphincters. They help keep the urethra sealed so urine doesn't leak before you're set to go to the restroom. These sphincters loosen up when the bladder contracts.

Now is your chance to make the call to contact the urological health experts at Metropolitan Urological Specialists. They can walk you through what treatments are most ideal for handling your interstitial cystitis in Saint Louis, Missouri.

Types of Urinary Incontinence and What That Means For You

Urinary incontinence is leaking of urine that you aren't able to control. Many American males and females have to deal with urinary incontinence. We don't know for certain precisely how many. That's due to the fact that many people do not tell anybody about their symptoms. They might be embarrassed, or they may think nothing can be done. So they suffer in silence.

Urinary incontinence is not only a health issue. It can affect emotional, psychological and social life. Lots of folks who have urinary incontinence hesitate to undertake normal day-to-day activities. They don't want to be too far from a toilet. Urinary incontinence can keep men and women from enjoying life.

Lots of folks think urinary incontinence is just an aspect of growing older. But it's not. And it may be managed or treated by a urology expert like those at Metropolitan Urological Specialists in Saint Louis, MO. Learn more here. Talk to a physician. Discover what treatment is best for you.

Key Statistics

A quarter to a third of people in the United States suffer from urinary incontinence. That means millions of Americans. About 33 million have overactive bladder (also referred to as OAB) representing symptoms of urgency, frequency and with or without urge incontinence.

Studies suggest that many things increase risk. For instance, aging is linked to urinary incontinence. Pregnancy, delivery, and number of children raise the risk in women. Women who have had a little one have higher rates of urinary incontinence. The risk boosts with the number of kids. This is true for cesarean section (c-section) and vaginal delivery.

Ladies who get urinary incontinence whilst expecting are more probable to have it later. Women following menopause (whose periods have ceased) may cultivate urinary incontinence. This may result from the drop in estrogen (the female sex hormone). Taking estrogen, however, has not been demonstrated to help urinary incontinence.

Men who have prostate cancer are also at increased risk. Some medicines are connected to urinary incontinence and some medications make it much worse. Statistics reveal that poor overall health also increases hazard. Diabetes, stroke, hypertension and smoking cigarettes are also connected.

Obesity raises the danger of urinary incontinence. Losing weight can enhance bladder function and lessen urinary incontinence symptoms.

What happens usually?

The brain and the bladder control urinary functionality. The bladder stores urine up until you are ready to empty it. The muscles inside the lower part of the pelvis keep the bladder in position. Typically, the smooth muscle of the bladder is relaxed. This holds the urine inside the bladder. The neck (end) of the bladder is shut. The sphincter muscles are closed around the urethra. The urethra is the pipe which carries urine out of the body. When the sphincter muscles keep the urethra closed, urine doesn't leak.

Whenever you are ready to urinate, the mind transmits a signal to the bladder. After that the bladder muscles contract. This compels the urine out through the urethra, the tube that carries urine from the body. The sphincters open up whenever the bladder contracts.

What are the kinds of urinary incontinence?

Urinary incontinence is not a disease. It is a manifestation of numerous conditions. Causes may vary for males and females, but it is not hereditary or a normal aspect of getting old. These are the four types of urinary incontinence that are identified in Saint Louis, Creve Coeur, Florissant, and Kirkwood, MO:

Stress Urinary Incontinence (SUI)

With SUI, weak pelvic muscles let urine escape. It is among the most frequent types of urinary incontinence. It is common in older women. It is less prevalent in men.

SUI happens when the pelvic floor muscles have stretched. Exercise puts pressure on the bladder. Then the bladder leaks. Leaking may occur with exercise, walking, bending, lifting, or perhaps sneezing and coughing. It might be a couple of drops of urine to a tablespoon or even more. SUI can be mild, moderate or severe.

There are absolutely no FDA authorized medicines to treat SUI yet, but there are things you may do. Ways to manage SUI include "Kegel" exercises to strengthen the pelvic floor. Lifestyle changes, vaginal and urethral devices, pads, and even surgery are other methods to manage SUI.

Overactive Bladder (OAB)

OAB is one more common form of urinary incontinence. It is also called "urgency" incontinence. OAB impacts more than 30% of men and 40% of women within the U.S. It impacts people's lives. They may limit activities. They might fear they will suddenly need to urinate when they aren't near a restroom. They might not even have the opportunity to get a good night's sleep. Certain people have both SUI and OAB and this is called mixed incontinence.

With OAB, your brain tells your bladder to empty - even when it isn't really full. Or the bladder muscles are too active. They tighten (squeeze) to pass urine before your bladder is full. This results in the impulse (need) to urinate.

The main sign of OAB is the sudden urge to urinate. You cannot control or brush off this "got ta go" sensation. Another sign is needing to urinate many times throughout the day and night.

OAB is more likely in men with prostate issues and in ladies after menopause. It is caused by many things. Even diet can influence OAB. There are a number of treatments. They consist of lifestyle changes, drugs that unwind the bladder muscle, or surgery. Some people have both SUI and OAB.

Mixed Incontinence (SUI and OAB)

Some people leak urine with activity (SUI) and frequently feel the urge to urinate (OAB). This is mixed incontinence. The individual has both SUI and OAB.

Overflow Incontinence

With overflow incontinence, the body makes more urine than the bladder can hold or the bladder is full and can not empty thus causing it to leak urine. Additionally, there may be something preventing the flow or the bladder muscle may not contract (squeeze) as it should.

One sign is frequent urinating of a tiny amount. Another symptom is a constant drip, called "dribbling."

This type of urinary incontinence is rare in women. It is a lot more common in men who have prostate problems or have had prostate surgery.

Regardless of what kind of urinary incontinence you suffer from, you do not need to suffer forever. The experts at Metropolitan Urological Specialists have years of experience serving patients with urinary incontinence in Crestwood, MO, Chesterfield, and Washington, along with the surrounding areas. Please consider reaching out to them if you have questions about how to treat this or any other urological health problem.

Info Credit: Urologyhealth.org

How Do I Know If I Have Prostate Cancer?

Prostate cancer is whenever cancer forms in the prostate gland. It is the second-leading cause of cancer fatalities for men in the United States. About 1 in 7 males will be diagnosed with prostate cancer within their lifespan. This year, more than 160,000 males will be diagnosed with prostate cancer. A lot of those are going to be Saint Louis prostate cancer patients.

Growths in the prostate may be benign (not cancerous) or malignant (cancerous).

Benign growths (such as benign prostatic hypertrophy (BPH):

• Are rarely a risk to life.
• Do not invade the tissues around them.
• Do not spread to other portions of the body.
• Can be removed and may grow back very slowly (but usually don't grow back).

Malignant growths (prostate cancer):

• May sometimes be a danger to life
• Can infect nearby organs and tissues (like the bladder or rectum)
• Can spread (metastasize) to other parts of the body (such as lymph nodes or bone)
• Commonly may be removed but sometimes grow back

Prostate cancer cells can spread by breaking away from a prostate tumor. They can travel throughout blood vessels or lymph nodes to reach other parts of the body. After spreading, cancer cells might connect to other tissues and flourish to form new tumors, creating damage where they land. That is why it is very important to talk to a Saint Louis prostate cancer treatment specialist such as those at Metropolitan Urological Specialists if you have or think you might have prostate cancer.

When prostate cancer spreads from its original place to another portion of the body, the new tumor has the same kind of abnormal cells and the exact same name as the primary (original) tumor. For example, if prostate cancer spreads to the bones, the cancerous cells within the bones are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. Because of that, it's treated as prostate cancer in bone.

The Prostate

The prostate and seminal vesicles are part of the male reproductive system. The prostate is approximately the size of a walnut and weighs approximately one ounce. The seminal vesicles are two much smaller paired glands. These glands are attached to each side of the prostate. The prostate is below the bladder and in front of the rectum. It goes all the way around the urethra. The urethra is a tube which carries urine from the bladder out through the penis.

The principal job of the prostate and seminal vesicles is to make fluid for semen. During ejaculation, sperm is produced within the testicles, and then relocates to the urethra. At the same time, fluid from the prostate and the seminal vesicles also moves into the urethra. This mix -semen - goes through the urethra and out of the penis as ejaculate.

When cancer appears, it is discovered in the prostate gland and virtually never within the seminal vesicles.

Throughout its early stages, prostate cancer normally has no symptoms. Whenever symptoms do occur, they may be like those of an enlarged prostate or BPH. Prostate cancer may also trigger symptoms unrelated to BPH. If you have urinary problems, talk with your healthcare provider about them.

Symptoms of prostate cancer could be:

• Dull pain in the lower pelvic area
• Frequent urinating
• Trouble urinating, pain, burning, or weakened urine flow.
• Blood in the urine (Hematuria)
• Uncomfortable ejaculation
• Pain in the lower back, hips or upper thighs
• Loss of appetite
• Loss of weight
• Bone pain

If you see these symptoms, perhaps it is time for you to seek the advice of a prostate cancer professional. Metropolitan Urological Specialists has a team of prostate cancer experts who know how to identify the signs and symptoms of prostate cancer and develop the most ideal course of treatment. They specialize in meeting the urological health needs of St Louis, Creve Coeur, Florissant, Kirkwood, Crestwood, Chesterfield, and Washington, MO.

Info Credit: UrologyHealth.org

Solutions for Female Stress Urinary Incontinence

Metropolitan Urological Specialists of Saint Louis, Missouri, with offices in Creve Coeur, Kirkwood, Florissant, and Washington, MO is all about offering advanced answers for widespread women's health conditions. Their objective is to offer useful, easy-to-understand facts so women, with their physicians, can examine their options and work out informed decisions.

What's Stress Urinary Incontinence?

Stress Urinary Incontinence, or SUI, is the abrupt, accidental release of urine during normal, daily activities. SUI is a different condition than Overactive Bladder (OAB), a condition characterized by urgency, frequency, waking up at night with or without bladder leaks. Many women have both of the varieties of incontinence. You may have SUI if you lose urine whenever you:

• Cough, sneeze, or laugh
• Walk, exercise, or lift something
• Rise from a sitting or lying position

It's also possible to visit bathroom frequently each day to avoid accidents. If you suffer from stress urinary incontinence, this means your urethra (the tubing from the bladder by which urine leaves your body) does not stay closed until it is time to urinate. This problem may occur as a result of:

• Pregnancy and childbearing
• Sustained heavy-lifting or straining
• Menopause
• Obesity
• Cigarette smoking

Most Common Symptoms Of Stress Urinary Incontinence

If you are experiencing urine leakage, take a moment to ask yourself:

• Do you suffer from urine leakage when laughing, sneezing, coughing, or working out?
• Do you wear panti-liners or pads to absorb urine leakage?
• Do you reduce or eliminate activities to avoid leakage?
• When arranging trip, outing, or event, does the availableness of restroom facilities impact your decision?

If you responded "yes" to even one of these straightforward questions, take the next step and talk with a physician or some other healthcare professional such as those at Metropolitan Urological Specialists in St. Louis, MO. Talking about the problem is the most important thing you could do to start taking charge of your bladder symptoms. Sadly, for many women, it's the toughest step. It should not be shameful-- urinary incontinence is a medical issue which is treatable. Consider asking your physician the subsequent questions to make that discussion a little bit easier:

• Which type of urinary incontinence do I have? 
• What medications are there to help me reclaim urinary control?
• What type is right for me?
• Can you manage this issue , or can you refer me to a doctor specializing in female urinary incontinence?

Treatments

Stress urinary incontinence is treatable at every age. Yet not all of the techniques work for everyone or even for all types of incontinence. For SUI, your physician may encourage one or more of the following:

1. Behavioral/Muscle Therapy: Therapy often starts off with Kegel exercises to help you build the pelvic floor muscles. Based on the extent of your condition, nevertheless, Kegels may not bring sufficient relief.
2. Biofeedback: With this method, the patient exercises the pelvic floor muscles while connected to an electrical sensing device. The device produces "feedback" to allow you to learn to better control these muscle groups. As time passes, biofeedback will allow you to use your pelvic muscles to diminish unpredicted urges to urinate and minimize some types of pelvic pain.
3. Electrical stimulation: This technique aids pelvic floor exercises by isolating the muscles involved. 
4. Medication: Some patients have both SUI and OAB. OAB symptoms are treatable with medications; but at this time there aren't any drugs approved to relieve SUI in the United States.
5. Surgery: An outpatient treatment, called Transvaginal Tape, can be performed to place small piece of mesh underneath the tube you urinate through (urethra) through the vagina.

This information is presented by Metropolitan Urological Specialists. If you have any further queries about stress urinary incontinence for women or any other urological issues, get an appointment at one of our practices' locations in Creve Coeur, Kirkwood, Florissant or Washington, Missouri.

Information About Your Bladder Control Problems

Bladder control problems can encompass a lot of symptoms, like urinary leakage (incontinence), inability to empty your bladder entirely (retention), or simply the irritating urgency and frequency to use the restroom. If you have incontinence or any of these other irritating symptoms, you're not alone. Urinary control problems impact countless Americans, which makes it as prevalent as a lot of different prominent diseases including asthma, diabetes, and osteoporosis. It is not solely a female issue, nor is it a normal part of the aging process.

Urinary control issues may be disastrous or at least decrease one's quality of life in Creve Coeur, Kirkwood, Florissant, or Washington, Missouri. You might leak small or large volumes of urine, use the washroom really often, or be unable to fully empty your bladder. These conditions may affect your life each day and can make easy day to day activities stressful. You might feel restricted by a fear of leaking accidents, the desire to be near the bathroom at all times, and a general preoccupation with your bladder. These symptoms may affect one's social life-- you may need to scale back on your hobbies, stop working, avoid going to the movies, dining out, or meeting with friends and family.

How Come I've Got Urinary Control Issues?

Nerves carry information back-and-forth from the brain. Particular nerves manage the bladder and muscles that relate to urination. When the communication system in between these nerves and your brain isn't functioning properly, a person may have bladder issues like urinary retention and over active bladder symptoms, including urgency, frequency, nocturia (waking up during the night) with or without urinary incontinence.

Different Kinds Of Urinary Control Difficulties

With urge urinary incontinence, you may:

• Lose urine whenever you feel a powerful need to visit the washroom
• Leak urine when you can't reach the restroom quickly enough
• Leak urine whenever you consume even a modest amount of liquid, or when you hear or touch running liquid

With urgency-frequency, you may:

• Have frequent, annoying, uncontrollable urges to urinate
• Go to the bathroom more frequently than normal (more than seven times per day).
• Frequently feel your bladder isn't completely empty even after utilizing the bathroom.

With urgency-retention, you may:

• Spend a very long time at the toilet but produce just weak, dribbling stream of urine.
• Leak urine (also called overflow incontinence).
• Not have a sensation when your bladder is full.
• Have to use a catheter to drain your bladder.

If you or someone you know is going through any of these bothersome urinary symptoms, contact Metropolitan Urological Specialists and make an appointment with one of their Saint Louis physicians to start taking control of your life again.

Male Urinary Incontinence

Male urinary incontinence is typically the consequence of a damaged sphincter; the circular muscle that controls the flow of urine out of the bladder. When damaged, usually the unavoidable consequence of prostate cancer surgery, the muscle can't squeeze and close off the urethra. This will cause urine to leak.

Managing Incontinence And Recovering Your Quality Of Life

Persistent incontinence can limit your activities, keep you homebound in costly, messy pads, handling the frustration and humiliation, and the constant concern about leaking and odor. But the fact is, you do not have to deal with bladder control issues anymore. Today you'll find real solutions in the St. Louis, Missouri area that can resolve incontinence once and for all, so you can go back to the things that you love, with confidence and control.

In men, the urinary sphincter muscle is located below the prostate. The sphincter muscle encircles the urethra. When the sphincter muscle tightens up, it keeps urine in the bladder. Whenever it relaxes, the bladder contracts and the urethra opens, allowing urine to flow away from the body. When the sphincter muscle is damaged, it cannot close up the urethra.

Forms Of Incontinence

• Stress Urinary Incontinence (SUI)-The most usual kind of incontinence following prostate cancer surgery, SUI takes place when you leak urine through a strenuous activity including lifting, exercising, sneezing, and coughing.
• Urge Incontinence-Occurs when you have an overwhelming need to urinate and are not able to hold urine long enough to reach a bathroom.
• Overflow Incontinence-When your bladder never entirely empties, which causes urine to leak.
• Total Incontinence-When the urinary sphincter muscle is totally deficient, the outcome is continual leakage of urine without control.

Stress Urinary Incontinence Responses To Get Ready For Your Doctor Appointment

• Do you ever experience unforeseen, sudden urine loss either while sleeping or during the day?
• Do you experience leakage while laughing, sneezing, jumping, or doing other movements that put pressure on the bladder?
• Have you got difficulty holding urine as you rush to the restroom?
• Do you often experience a sudden and immediate urge to urinate?
• Have you observed a change in your frequency of urination?
• Do you go to the restroom to urinate more than eight times each day?
• Do you presently wear pads or liners to protect against unexpected leaks?
• When organizing a trip, outing, or event, does the availability or location of the restroom facilities impact your decision?

Treatment Options

There are a selection of ways to deal with incontinence, starting from ongoing management to permanent surgical solutions.

• Absorbent Products-Pads, diapers, and absorbable garments are frequently used to handle incontinence.
• Internal Collection Devices-Catheterization on a regular basis may be used for some men to make certain that the bladder is emptied on a frequent schedule.
• External Devices-Condom catheters may be used to collect urine, and clamps may be used to block the flow of urine.
• Biofeedback/Electrical Stimulation-Can help patients get awareness and control of their urinary tract muscles.
• Collagen Injections-Injections of bulk-producing agents, like collagen, into the urinary sphincter.
• Surgical Options-These range from implantable "male sling" treatments designed to support the muscles surrounding the urethra, to implanting an artificial urinary sphincter which mimics the function of a normal, healthy sphincter.

A lot of men search for a long-term solution instead of deal with continuously having to wear pads, limit their activities, and be concerned about leakage. You and your physician may find out that the ideal way to address your incontinence is using these effective urological surgical options. Metropolitan Urological Specialists in St. Louis, Florissant, and Washington, MO are dedicated to that very question. If you'd like to learn more on how to treat your male urinary incontinency, call them today.

Frequently Asked Urology Questions

The men and women of Saint Louis often turn to the internet to find the answers to their concerns pertaining to urological diagnosis and urological treatment. While no internet article could replace the experience and know-how of years of medical training and practice, with any luck this article can help you prepare yourself with the correct foundation of awareness to be able to talk intelligibly with a Saint Louis urologist regarding your urological health.

What is Urology?

Urology is a surgical specialization which addresses ailments of the urinary tract in males and females in addition to conditions of the male reproductive system.

What are a few of the more typical conditions urologists treat?

These are a few of the most common ailments which we treat:

• Prostate diseases (both benign and also malignant)
• Adrenal Cancer
• Bladder Cancer
• Kidney cancer-including kidney stones
• Erectile dysfunction (impotence)
• Incontinence- lack of bladder control
• Prostate Cancer
• Benign prostatic hyperplasia
• Testicular Cancer
• Testosterone Deficiency
• Urinary Incontinence
• UTI
• Vasectomy
• Vasectomy Reversal
• Peyronie's Disease
• Hematuria
• Interstitial Cystis
• Prostatis
• Urethral/ Penile Cancer
• Varicocele

What are the current screening guidelines for prostate cancer?

The American Cancer Society encourages annual screening consisting of a digital rectal examination and a PSA (Prostate Specific Antigen) blood test for all males over the age of 50. Men with family background of prostate cancer ought to go through yearly screening starting at the age of 40-45.

Is there something new for the treatment of kidney stones?

Most stones in either the kidney or the urethra (the tube which brings urine from the kidney to the bladder) are now treated with a noninvasive shockwave technique named lithotripsy. Our group has access to the most modern equipment for treating stones on an outpatient basis.

How helpful is a PSA test once a patient is diagnosed with cancer?

PSA is an exceptional marker for use during and after cancer therapy. PSA permits the patient know how the cancer is responding to the treatment.

Just what is a no-scalpel vasectomy?

The no-scalpel vasectomy is well-known in this nation due to the decreased pain that men encounter with this technique. Our group will provide you with the information needed for this treatment.

What are the signs and symptoms of Prostate Cancer?

There are usually no indicators or symptoms of early prostate cancer, which is the reason that prostate screening is so important. The following are the most typical symptoms of prostate cancer. Nevertheless, each and every individual might experience symptoms differently. Symptoms might include:

• Inadequate or interrupted flow of urine
• Urinating often (specifically at night)
• Difficulty urinating or holding back urine
• Lack of ability to urinate
• Pain or burning when urinating
• Blood within the urine or semen
• Irritating pain in the back, hips, or pelvis
• Difficulty getting an erection

The indicators of prostate cancer may appear like other ailments or medical problems. Always consult your doctor for a diagnosis.

What are some of the symptoms for overactive bladder?

Three main symptoms are associated with an overactive bladder:

• Frequency (frequent urination)
• Urgency (urgent need to urinate)
• Urge Incontinence (strong need to urine followed by leaking or involuntary and complete voiding)

What is Hematuria?

Hematuria is the existence of blood, more precisely red blood cells, inside the urine. Whether the blood is just visible under a microscope, or visible to the naked eye, Hematuria is a sign that something is creating bleeding in the genitourinary tract: the kidneys, the tubes which carry urine from the kidneys to the bladder, the prostate gland, the bladder, or the tube that carries urine from the bladder out of the body. There are two kinds of Hematuria, microscopic and gross (or macroscopic).

What is a kidney stone?

A kidney stone is a solid piece of material which develops from crystallization of excreted substances within the urine. The stone might stay in the kidney or break loose and travel down the urinary tract. A little stone might pass all the way out of the body, but a larger stone could get stuck in the bladder or the urethra. This may block the flow of urine and cause great pain. A kidney stone may be as small as a grain of sand or as large as a pearl, and a few are as large as golf balls. Around 80 percent of all kidney stones are less than two centimeters in width. They may be smooth or jagged, and are typically yellowish or brownish in color.

As was previously pointed out, this article just scratched the surface of the complicated field of urological medicine. If you live in or around Crestwood, Chesterfield, Washington, or Saint Louis, Missouri, urological specialists are no farther away from you than Metropolitan Urological Specialists.

What Is a Urologist?

Urologist Education, Training, and Certification Overview

A urologist is a physician who has specialized expertise and skill regarding problems of the male and female urinary tract and the male reproductive organs. Due to the variety of clinical problems encountered, awareness of internal medicine, pediatrics, gynecology, and other specialties is necessitated of a Saint Louis, MO urologist.

Urology is classified as a surgical subspecialty. A urologist with advanced qualifications in surgical treatment may be a fellow of the American College of Surgeons (FACS).

Specialties Within Urology

The American Urological Association has pinpointed eight subspecialty areas:

• Pediatric urology
• Urologic oncology
• Renal transplantation
• Male infertility
• Urinary tract stones
• Female urology
• Neurourology
• Erectile dysfunction (ED, impotence)

Board Certification for Urologists

To be certified by the American Board of Urology, the urologist must satisfy specified educational and examination requirements.

Education Information for Urologists

Urologists will need to graduate from an approved medical school and carry out an ACGME accredited urology residency program that is a minimum of 5 years in length. One year must be spent in general surgery, 3 years in clinical urology, and a minimum of 6 months in general surgery, urology, or a clinical discipline pertinent to urology. The final year of training will need to be spent as a senior/chief resident in urology with appropriate clinical responsibility under supervision.

Examinations for Urologists

After completing graduate education, Saint Louis, MO urology surgeons may make an application for certification by the American Board of Urology( ABU). Applicants approved by the Board to enter the certification process need to finish both a Qualifying Examination (Part I) and, following passing this examination, a subsequent Certifying Examination (Part II).

Common Conditions Treated by Urologists

• benign prostatic hyperplasia (BPH) or enlarged prostate
• cancers of the urinary tract (such as kidney cancer, bladder cancer, prostate cancer, and testicular cancers)
• infertility in women or men
• interstitial cystitis
• kidney stones
• urinary incontinence; overactive bladder
• prostatitis
• sexual dysfunction (like erectile dysfunction)
• urinary tract infections

Our Doctors

Metropolitan Urological Specialists' team of staff and physicians in Saint Louis, MO are committed to offering you the very best medical care. Our physicians are experienced, board-certified Urologists who are involved in ongoing medical education in order to provide you with the latest and most advance healthcare. Our trained staff is also dedicated to continuing education and committed to being responsive to you. Metropolitan Urological Specialists: high quality health care from dedicated professionals.

• Dr. Steven Bigg
• Dr. Michael de la Paz
• Dr. Robert Feit
• Dr. Laurence Gelstein
• Dr. J. Perry Lovinggood
• Dr. Michael Marcus
• Dr. Cathy Naughton
• Dr. Jay V. Patel
• Dr. Thomas Scully

Using Interstim Therapy To Treat Bladder and Bowel Incontinence

Interstim Therapy was FDA approved in the late nineties to treat urinary urge, retention, and urgency/frequency.  It was authorized in 2011 for bowel accidents (fecal incontinence).

What exactly are annoying bladder symptoms?

• Leakage of small or large quantities of urine
• Urinating frequently
• Urinating urgently
• Waking up at night to urinate
• Incapacity to totally empty the bladder, or may be unable to urinate at all (retention)

Exactly what are bothersome bowel symptoms?

• Fecal leakage
• Fecal smearing
• Diarrhea
• Constipation

Just how prevalent are urinary control issues?

• Over 33 million people (1 in 6 adults) suffer from urinary control issues within the United States alone.
• These problems may impact men and women.
• It might affect people of all ages; it is not simply a normal aspect of aging.

Just how prevalent are bowel control problems?

Over 18 million people or 8.3% of adults endure signs and symptoms of bowel control.
In fact, this affliction is very likely more widespread than reported as a result of the uncomfortable nature of the condition.

Exactly what are the factors behind bothersome bladder and bowel symptoms?

There might be multiple causes; like injury, adverse side effects from particular medications, neurologic diseases, infection, bearing offspring, pelvic pain, and others.

How would I know if Interstim Therapy is right in my situation?

You need to visit a doctor with a special interest, training, and knowledge about Interstim Therapy.  Dr. Naughton, one of Metropolitan Urological Specialists' physicians and voted Best Doctor in St. Louis for ten straight years since the year 2007, concentrates on the management of bothersome bladder and bowel symptoms and has one of the greatest experiences with Interstim Therapy in Missouri.

Interstim Therapy has 2 phases:

• Test trial period to determine if the treatments are right for you—Percutaneous Nerve Evaluation (PNE)
• Permanent Interstim Implant

Before placement of the permanent implant, your doctor may suggest a Percutaneous Nerve Evaluation (PNE). PNE is an easy office test which gives you an opportunity to test two temporary leads (or wires) within the pelvic nerves.  Using local anesthesia in an office setting, two temporary leads are put on each side of the pelvic nerves.  The leads are taped to the rear and connected to an external battery the size of a beeper.  The patient will have the opportunity to test both leads within the next three to five days to determine if there are any alterations to the bladder or bowel symptoms.  We consider a 50% improvement in symptoms a positive test, making the individual a candidate for implantation of the permanent device.

What to know about the Percutaneous Nerve Evaluation (PNE) Procedure

• Please get there half an hour prior to your slated meeting time.
• You might drive yourself to the procedure; nevertheless, it is much better to have somebody drive you to and from the procedure.
• This procedure is completed in the office under local anesthesia within 10-15 minutes.
• A light snack or meal is okay two hours before the procedure.
• Get rid of aspirin and ibupfren products (Motrin, Alleve, etc) for no less than five days prior to your procedure.
• Let our scheduler know whether you are taking blood thinners, such as Coumadin (warfarin), Xaralto, etc.
• No baths or showers are allowed during the test period.  You can take sponge baths and clean your hair in the sink.
• Refrain from heavy lifting or excessive bending throughout the trial.
• If you aren't able to tolerate the PNE, there's also an option to carry out the trial phase in the operating room with anesthesia.  This is known as a "Stage 1" procedure. You and the physician will decide if a Stage 1 procedure is appropriate for you.

What you need to expect on the day of the PNE procedure

• You will meet a medical assistant and representative(s) from Medtronic; the device company.
• You will be directed to lay on your stomach.  The medical assistant will wash your back and buttocks.
• Your doctor will perform the procedure with the aid of the Medtronic agent.
• The Medtronic agent and the medical assistant will fasten the leads to your back and wipe off the cleaning solution on your back and buttocks before you get dressed.
• Following the procedure, you are going to consult with the Medtronic representative to review voiding and bowel diary guidelines and set up contact plans with the representative to talk about changes in your urinary system and bowel function during the trial period.
• You'll make an appointment to see the doctor in 3-5 days in the office prior to leaving to take away the leads and talk about the outcomes of your trial.

What you should know regarding the permanent Interstim implant procedure

If you experience a greater than 50% improvement in urinary or bowel symptoms with your PNE, then you're a candidate for the full Interstim implant device.  This is an outpatient process under sedation lasting 15-20 minutes.  The battery and permanent lead is inserted all underneath the skin.  You will not be able to get a body MRI following the implant.  A brain MRI however is safe with the Interstim implant.  The battery will last 5-12 years following placement.

If you've got any queries about the Interstim therapy or anything more related to bladder problems, arrange an appointment with one of our offices in the St. Louis area, such as Washington, Florissant, and Creve Coeur, MO.

A Saint Louis Beginner's Guide to Varicoceles

A varicocele is a swelling in the blood vessels over the testicles. It's just like having varicose veins within the legs. The inflammation takes place when an excessive amount of blood collects inside the veins. A varicocele oftentimes takes place around the left testicle.

Precisely what are the symptoms?

A varicocele frequently produces no symptoms at all. Or it might cause an aching or heavy feel within the scrotum. The pain could be more intense later during the day or right after standing for a substantial period. You may even see inflamed blood vessels beneath the skin in the scrotum.

How's it identified?

Typically a varicocele is identified in the course of a physical exam. A testicle with enlarged blood vessels may be more tender. A varicocele is occasionally clinically diagnosed during examination for fertility issues. If you've got discomfort but your doctor can't feel any enlarged veins, an ultrasound exam might be done.

A varicocele can reduce sperm count. Whenever blood collects in the veins over the testicles, changes occur that decrease the number and the quality of the sperm.For men who're infertile, about 40 % to 50 percent willhave a varicocele. Typically, sperm count increases after treatment.

Treatment Solutions

About one in 6 men have a varicocele. Generally, a varicocele isn't serious. Your doctor might wait and watch the issue. If you have pain, should the veins come to be unattractive, or should you and your sex partner are having difficulty conceiving a baby, the doctor may advise surgery or another procedure to shut off the enlarged blood vessels.

Watchful waiting

If you don't have pain and you and your partner aren't attempting to become pregnant, your physician might suggest just watching the issue for a time. Make sure you keep all your appointments. If the veins do not become bigger and they don't trouble you, you possibly will not need additional treatment.

Surgery (Varicocelectomy)

Your doctor may advise that you get varicocelectomy surgery in the St. Louis, Missouri area to treat enlarged veins around the testicles. Oftentimes, surgery is performed with a laparoscope (a lengthy, thin, telescope-like device).

• First you are given anesthesia so you can stay relaxed. You might be asleep.
• One or more small cuts are made in the groin or stomach.
• The blood vessels are then tied up or sealed off.
• The incision is closed with sutures, staples, or surgical tape.

Varicocele Embolization

Instead of surgery, your physician may suggest varicocele embolization.

• First you are given anesthesia so you remain comfortable.
• Then a tiny incision is made in the groin or side of the neck.
• A tiny tube is moved through the cut.
• Led by x-rays, your doctor passes the tube into the varicocele.
• A little coil is sent through the tube. This is to block blood flow to the varicocele.
• The tube is completely removed. In most cases, stitches are not necessary.

Metropolitan Urological Specialists is proud to offer this and other informational materials about urological health. If you have any more questions for them, stop by one of their offices in St. Louis, Washington, or Florissant, Missouri.

What Is A Percutaneous Nephrolithotomy?

A percutaneous nephrolithotomy, or PCNL, is a kidney stone operation for large or multiple stones. The health care professional does the operation in a medical center operating room. It normally necessitates hospital stay of 1 to 2 nights.

What happens throughout the procedure?

A PCNL commonly will last 1 to 3 hours. Once you are under anesthesia, your doctor will make little incision within your back. Your doctor positions a protective sleeve called sheath through your back and within your kidney. The doctor then passes a video scope referred to as nephroscope through the sheath to find and remove the kidney stones.

To help your kidney heal and drain urine throughout the recovery process, your physician might place a nephrostomy tube or a ureteral stent at the conclusion of the procedure.

Some patients require second procedure to take out all of the stone. If that's the case, the nephrostomy tube and stent could be left in place until the following operation.

What do I have to do prior to the treatment?

There are 3 significant things to do prior to your procedure:

Speak with your Saint Louis urology doctor. Let your physician know:

• All of your prescribed medication, vitamins, and supplemental herbs and natural remedies, and non-prescription medications.
• Any known allergies you have to medicines and the contra agent found in some x-rays.
• If you could be pregnant.

Study the pre-operative information. Make time to review these instructions provided by your physician. For example, you may need to:

• Go to appointments for medical tests prior to the surgery like an electrocardiogram (EKG), x-rays, and blood and urine checks.
• Go over with your doctor medicines that may raise your chance of bleeding, for instance: aspirin, ibuprofen, warfarin, clopidrogel, and non-steroidal anti-inflammatory drugs. You may need to give up taking many of these medicines prior to the procedure.
• Take antibiotics, if prescribed, to help you prevent infection.
• Discuss with your doctor on which of your regular medicines to take the morning of operation. On that day, take these drugs with only sip of water.
• Don't have anything to eat or drink after midnight the night before operation (apart from the drink of water with your morning medicine).

Plan for a ride home

Following the operation, you simply can't drive yourself home. Prior to the procedure, ask a close relative or a trusted friend to pick you up and bring you home. The majority of hospitals and surgery centers in the St. Louis, MO area won't permit you to take a taxi home following the surgery.

If you've got more questions on a Percutaneous Nephrolithotomy, Metropolitan Urological Services would be glad to help you out. Their offices have locations at St. Louis, Washington, and Florissant, Missouri.

An Introduction To Bladder Cancer

Bladder cancer is the fourth most typical cancer in men in the United States. You'll find it occurs in women, although it is less common than in males. Though a number of factors are believed to elevate the chance of developing bladder cancer, smoking is hands down the greatest single risk factor. Symptoms of bladder cancer can include blood in the urine, painful urination, and increased regularity of urination.

Diagnosis and Preliminary Treatment

Most bladder cancers are diagnosed with the use of cystoscopy, a procedure wherein the urologist looks at the interior of the bladder using fiberoptic scope. When tumor has been found, it will generally be eliminated with a procedure called Transurethral Resection of Bladder Tumor or TURBT.

Superficial or Invasive?

Whenever bladder cancer is completely removed, the urologist and pathologist decide whether the cancer is superficial (limited to the lining of the bladder) or invasive (the cancer extends underneath the lining into the wall of the bladder). It's essential distinction, because a superficial cancer can not spread past the bladder, while invasive bladder cancers can rapidly spread to other parts of the body. The good news is, four out of five bladder cancers are superficial when initially diagnosed.

The Chance of Recurrence

Though a superficial bladder tumor presents no direct risk of spread, it may, if left untreated, become invasive. Total disposal of a superficial bladder cancer effectively cures that particular tumor, but the bladder stays at risk for reoccurring tumors in other areas. Once the bladder lining has cultivated one superficial cancer, there is 60 % to 80 percent risk that additional cancers will emerge down the road. Your individual risk of recurrence is dependant on a number of variables, like the tumor grade (speed of growth), number (single vs. multiple tumors) and size of the initial cancer.

Monitoring for Recurrence

When a superficial (non-invasive) cancer has been gotten rid of, the urologist will from time to time perform cystoscopy to check out the bladder for recurrences. Throughout the first couple of years after the removal of a tumor, the cystoscopies are normally done every 3 months. If no recurrences are located during those two years, the interval is increased to six months for the following two years. If 4 years pass with no recurrences, many urologists suggest that the procedure be done yearly after that.

Reducing the Risk of Recurrence

There are steps which can be taken to decrease your likelihood of superficial bladder cancer recurrence. These include medical treatments offered by your urologist, and nutritional supplements and lifestyle changes you'll be able to pursue yourself.

For more information about bladder cancer in Saint Louis, MO, consider going to Metropolitan Urological Specialists.

Vasectomy Reversal (Vasovasostomy)

A vasectomy is recognized as a permanent approach to birth control. Vasectomy reversal (vasovasostomy) reconnects the tubes (vas deferens) that were cut during vasectomy. If you are considering a vasovasostomy, you'll want to read the following important information provided by Metropolitan Urological Specialists in St. Louis, MO. Vasectomy reversal is usually an outpatient procedure (without overnight stay in the hospital). Spinal or general anesthesia is normally used to ensure that you stay totally still during the surgery.

The odds of vasectomy reversal success depend on how much time has passed between the vasectomy and the reversal. With time, further blockages can develop, and some men develop antibodies to their own sperm.

The surgery is more complicated and takes additional time whenever blockage between the vas deferens and the epididymis requires correction (vasoepididymostomy).

What To Expect After Surgery

Vasectomy reversal usually requires from 2 to 4 hours, accompanied by a few more hours for recovery from the anesthetic. You can expect to go home the same day. Pain may be mild to moderate. You ought to be able to resume normal activities, including sex, within 3 weeks.

Why It Is Done

Vasectomy reversal is done when you have had a vasectomy and now want to be fertile.

How Well It Works

Likelihood of a successful vasectomy reversal decline over time. Reversals are more successful during the first decade after vasectomy. Generally, vasectomy reversal:

• Brings about overall pregnancy rates of greater than fifty percent.
• Has the greatest chance of success within 3 years of the vasectomy.
• Causes pregnancy only about 30% of the time if the reversal is done ten years following vasectomy.

Risks

Risks of vasectomy reversal include:

• Infection at the site of surgery.
• Fluid buildup in the scrotum (hydrocele) that might require draining.
• Injury to the arteries or nerves within the scrotum.

What To Think About

Before a vasectomy reversal is done, your doctor will want to make sure you were fertile prior to your vasectomy.

You can have tests to find whether you've got sperm antibodies in your semen before and after vasectomy reversal. If there are sperm antibodies within your semen after surgery, your partner is unlikely to become pregnant. In this case, you may wish to try in vitro fertilization with intracytoplasmic sperm injection.

If you've got any questions about the reverse vasectomy or any of the other services offered by Metropolitan Urological Specialists, set up a urological health consultation with them and they'll give you the answers you need. Metropolitan Urological Specialists is a wonderful place to go for urological knowledge in St Louis, Creve Coeur, Florissant, and Kirkwood, Missouri.

The Basics of Kidney Stones

In the United States, about one person in 10 will develop a kidney stone within their life. In 2010, kidney stones were the cause of more than 600,000 emergency room visitors. The doctors with Metropolitan Urological Specialists in Washington, Florissant, and St. Louis, Missouri have some important information to keep you in the loop on your potential risks.

A kidney stone is simply mineral deposit that forms in the urinary system tract. Kidney stones build whenever crystals, that are present in the urine, start to stick together and progressively accumulate into a rock-like mass. At first, kidney stones are small in size, but over time, as more crystals attach, they're able to grow really large.

How come kidney stones form?

The deposits that develop kidney stones are made of elements typically found in the urine. These compounds include calcium, oxalate, phosphate, uric acid, and other chemical compounds. Your kidneys regularly excrete these compounds into the urine. Nevertheless, when their concentration in the urine is particularly high, these chemicals do not stay dissolved and rather begin to crystallize and precipitate away from the urine. There are other components in the urine referred to as inhibitors which help to keep the crystals from clinging together. Whenever the concentration of crystals is too high or the relative quantity of inhibitors is too low, a kidney stone will develop. Many factors can contribute to your chance of getting kidney stone, like your familial genetic predisposition, eating habits, and fluid intake, where you reside, or even your work environment.

What are the various types of kidney stones?

There are a few types of kidney stones, each having different chemical composition.

Nearly all kidney stones have calcium. Calcium stones are made up of calcium that's chemically bound to either oxalate (calcium oxalate stones) or phosphate (calcium phosphate stones). Among these, calcium oxalate is way more common. Pure calcium phosphate stones are the rarest and generally show an underlying illness or metabolic condition. The most common stone composition is in fact blend of mostly calcium oxalate with a bit of calcium phosphate.

Around 15 percent of kidney stones don't have calcium. These include uric acid stones, struvite stones, and cystine stones.

How widespread are kidney stones?

In the United States, about one individual in ten will build up a kidney stone within their lifetime. In 2010, kidney stones were the reason for over 600,000 emergency room trips. We understand that men are more likely to have kidney stones than women. Those with caucasian origin are five times more likely to have kidney stones than African-Americans. Stone incidence peaks between forty and fifty years of age and appears to decline.

Exactly what are my chances of recurrence?

Kidney stones are likely to recur. If a man has produced one kidney stone, and does absolutely nothing to reduce his chance of recurrence, research has revealed he has about a 60% to 70 % probability of having another. If a man has had 2 kidney stones, the prospects of recurrence reach more than ninety %. The odds of recurrence are slightly lower for ladies.

There are steps you can take to significantly decrease your chance of recurrence. If you have any questions, feel free to contact the experts at Metropolitan Urological Specialists. They have offices in St. Louis, Washington, and Florissant, MO.

Dr. Cathy Naughton Chosen For "St. Louis' Best Doctors 2016"

We're excited to announce that Metropolitan Urological Specialists’ own Doctor Cathy Naughton was selected to be featured in St. Louis Magazine in a feature on St. Louis’ Best Doctors 2016. The following paragraphs are taken from that article.

Dr. Cathy K. Naughton, featured on the Best Doctors in America List each year for the past decade, is director of the Center for Sexual Health, a specialized medical facility of Metropolitan Urological Specialists. Her practice is focused on general urology and the handling of male infertility, urinary incontinence, and sexual dysfunction. Dr. Naughton provides all the treatments of erectile dysfunction and received specialized training in minimally invasive penile implant techniques. She is a professional in InterStim© Therapy, a nerve treatment for overactive bladder. Also, she initiated the FOOD AS MEDICINE program to promote lifestyle and diet changes for general health and weight loss.

Dr. Naughton got her Doctorate of Medicine from the State University of New York in Buffalo. She finished her urological surgery residency at Washington University School of Medicine and a clinical fellowship in male infertility and microsurgery at the Glickman Urological Institute at The Cleveland Clinic Foundation. Dr. Naughton is accredited by the American Board of Urology.

Information from St. Louis Magazine

The Many Causes Of Male Infertility

Like anything else in the field of medicine, there's always more than one potential cause to urological problems. Male infertility isn't an exception. When patients come to a urological specialist in St. Louis, MO, they usually don't realize how many factors may be adding to their condition. When you explore your various choices, Metropolitan Urological Specialists in St. Louis, Missouri would like for you to understand the many testing options which may be available to get down to the bottom of your male infertility.

The first and foremost test of male infertility is the sperm and semen study. In essence, it happens exactly as you may expect that it would. You go to a private room and you bring out a sample of semen. The professionals will use the sample to have a look at a number of things which could affect your virility, like your sperm count, their shape, their movement, and a number of other factors. Your doctor will request that you steer clear of all sexual activity for 2 or more days before the test so your semen has an accurate representation of what your sperm usually looks like. Needless to say, a higher sperm count is preferred, but the total absence of sperm is also a comparatively advantageous thing. The complete absence of sperm in your semen is called azoospermia, and it generally implies that there's a correctable obstruction in the piping that puts the sperm into the semen.

Another test which may be performed is a comprehensive physical examination of the pubic region. A urologist like the experienced experts at Metropolitan Urological Specialists will be the proper physician to seek out problems like varicocele or hormone problems. A hormone analysis could also be conducted, but that is quite the long shot because hormones are not the issue in more than ninety five percent of infertile men.

A testicular biopsy is yet another test which may be performed under certain circumstances. A needle biopsy can reveal in a more direct way the capacity of the testes to generate an ample amount of sperm. If the testes aren't found to be the problem, it normally means that there's a blockage present in the piping which prevents sperm from reaching the semen.

Male infertility is a problem which can be solved in many cases for men in St. Louis, MO with male infertility problems. If you feel that you may suffer from this medical condition, go to a local St. Louis urological doctor like those at Metropolitan Urological Specialists. They've got plenty of experience assisting men like you beat this problem by carefully and knowledgeably diagnosing the problem and creating an individualized treatment plan for you. Don't give up yet. Allow Metropolitan Urological Specialists to help you find the right answer to your male infertility.