Urology Partners and Your Health

KIDNEY

The kidney produces urine as a filtrate of blood. The kidney has an elaborate system of millions of drainage tracts that eventually create a single drainage tube called the ureter. A neurologist treats disease that effect the kidney’s function. The urologist treats diseases that effect drainage, malignant and non-malignant growths of the kidney, and kidney stones.

In the past, many diseases of the kidney required open surgery to remove stones, or the entire kidney was removed even for small cancers. Today, most kidney stones are treated with sound waves that penetrate the body to pulverized the stone without the need for incisions. Stones can also be removed from the inside of the urinary system using an endoscopic camera and operating scopes. Tiny lasers and “baskets” can also be used to remove stones. Small kidney cancers can be treated with freezing or high frequency probes to destroy the mass (cryoablation and radio frequency ablation) without large incisions, and also preserve the remaining kidney.

Urology Partners physicians are highly trained in the treatment of kidney stones without surgery, kidney-sparing cancer surgery and laparoscopic kidney surgery. Urology Partners also performs endoscopic treatment of the kidney by examining the kidney from inside the urinary tract without incisions. On-site CT scanning also expedites the diagnosis of kidney diseases and kidney stones. Many of these advances were pioneered in Manatee County by the physicians of Urology Partners.

BLADDER

The bladder, in the simplest terms, stores urine and expels urine in a coordinated manner and with patient control. Common problems include: cancer of the bladder, “over-active” bladders, frequency and urgency, incontinence, hematuria (blood in the urine), urinary tract infections, painful voiding (interstitial cystitis). The bladder can also be effected by neurological problems such as Parkinson’s disease and strokes, endometriosis and gynecological cancers, and diseases of the spinal cord.

Management of bladder disease and malfunction, require a comprehensive history, bladder function testing (urodynamics) and examinations. Incontinence treatments can include drugs to alleviate urgent/frequent urination, and simple outpatient surgery to cure incontinence provoked by activities (stress incontinence). Bladder cancers can often be managed with outpatient endoscopic surgeries, and our in-house pathologist provides specialized urologic pathology to both grade and stage the disease accurately.

Complete hematuria work-ups can be accomplished entirely at Urology Partners facility. Our full service laboratory allows our patients to get confirmation about urinary tract infections the same day.

PROSTATE

The prostate is a solid doughnut-shaped male organ that encircles the urethra (voiding channel) at the base of the bladder. Its main purpose is to excrete supportive fluid for sperm survival. Unfortunately, many diseases affect the prostate. Most commonly, the benign enlargement that occurs in older men can restrict the force of urination, increase frequency and urgency of urination, and can lead to nocturia (frequently getting out of bed to urinate). Another common disease is prostate cancer that effects one out of eleven men, and rarely has any symptoms to warn the patient. In younger men, prostate infections (prostatitis) and prostate pain without infection (prostadynia) can occur.

Detection of prostate diseases involves examination, prostate ultrasound, and sometimes biopsy. Prostate biopsy is commonly done if the PSA test is elevated. This laboratory test measures a protein excreted only by the prostate, and if elevated, can be a first sign of prostate cancer. Prostate biopsies can be done in the office in a 5-minute session with minimal discomfort.

Treatment of BPH (benign enlargement) has made tremendous advancements in the last 5 years. Traditionally, only surgery helped; now, the majority of men find relief in medication. Others can benefit from in-office “non surgical” prostate microwave treatments. Surgical treatment of the prostate now commonly uses the laser to remove tissue. This advanced surgical technique has dramatically reduced risks such as bleeding as compared to prior prostate surgery. It is often performed as an outpatient often without the need for a catheter.

Urology Partners provides all of the above diagnostic and therapeutic options to the patient in a single setting. Even if you are currently being treated with medication, our office can provide timely advice regarding other long-term options to eliminate the need for medication.

INCONTINENCE

Both men and women experience uncontrolled loss of urine. In men, advanced prostate disease is a common reason for incontinence, as are other neurological diseases effecting the bladder. In women, childbirth, age, and obesity contribute heavily to incontinence. Incontinence affects women at younger ages than men. In the past, little could be done about incontinence; but, today the majority of incontinence is treatable.

Treatment of incontinence often uses medication especially in those with urgency and frequency of urination. Stress incontinence (loss of urine with activity) is surgically corrected with outpatient 20-minute surgeries that use small incisions. These surgeries, known as “sling” procedures, utilize revolutionary artificial support tapes that compress and support the urethra to prevent leakage. Patients rarely require catheters beyond a few days and can resume normal activities in less than one week in most cases.

Botox can also be injected into the bladder wall to increase bladder size and alleviate incontinence associated with uncontrolled frequency. Bladder training can also improve incontinence by using biofeedback to retrain proper bladder sensation and control.

Urology partners perform more incontinence surgery in Manatee County than any other group. Our facility has state-of-the-art bladder urodynamics and a fully trained specialized nurse in urodynamics. Botox injections can be performed within the Urology Partners clinic, and our surgeons work closely with the gynecologists of Manatee County to coordinate combined vaginal and bladder surgeries.

INFECTIONS

Urinary tract infections are a common malady in women, affecting men less often. In women, the majority of infections are not accompanied with a significant anatomic abnormality; rather, multiple contributing reasons increase the risk of a urine infection such as: poor fluid intake, altered vaginal bacteria, inadequate emptying of the bladder, sexual intercourse, altered bowel function and diabetes. Management of infections in women requires a comprehensive interview and accurate urine examination and culture. All the above are available at Urology Partners.

Urine infections in men are usually accompanied with a anatomic abnormality such as: prostate enlargement, kidney stone, inadequate emptying of the bladder and scar tissue of the urethra (water channel). Both examination and diagnostic testing is critical in men with urine infections.

HEMATURIA

Blood in the urine, either microscopic (not visible to the patient) or gross (visible) requires urologic evaluation. A comprehensive physical exam, CT imaging of the kidneys, and direct visualization of the bladder (cystoscopy) need to be done. Some common reasons for blood in the urine include: infection, stone, scar tissue in the urinary system, cancer of the kidney, or cancer of the lining of the urinary system. Urology Partners can complete the evaluation of hematuria within a single facility, under the supervision of your doctor.

ERECTILE DYSFUNCTION

Erections in men are a complex interaction with emotional, neurologic and vascular systems. Malfunction of any of the above can lead to inadequate erections. Medications often can alleviate vascular obstruction as the source of impotence. Often vascular disease has progressed too far for these medications to work. Physical examinations and laboratory testing often identify other issues such as low testosterone. Options for treatment include medication, penile injections, vacuum pumps and inflatable penile implants. All the above are available at Urology Partners.