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.