What is Cystoscopy? Georgia Urology Explains

A urologist discussing Cystoscopy with her patient

Cystoscopy means literally to look at the bladder with a scope. The expert urologists at Georgia Urology have performed many cystoscopes, so they’re extremely qualified to explain all about this medical procedure.

Why Should You Get a Cystoscopy?

Reasons for doing a cystoscopy include evaluation of lower urinary tract when there is blood in the urine. Similarly, a cystoscopy might be part of the evaluation for recurrent infections or issues of incontinence. Patients with a history of bladder tumors are followed in this way. Ultimately, cystoscopy is a diagnostic test to find the source of the problem and develop a treatment plan.

How Does Cystoscopy Work?

This procedure can be performed awake or asleep, in the office, the surgery center, or in the hospital. To reach the bladder, the scope normally goes through the urethra which, in men, includes the prostate. When this procedure is done in the office or surgery center, the urologist will most likely use a flexible scope. This means the scope can go around bends and curves. Overall, the procedure is mildly more uncomfortable than having a catheter placed.

In the office setting, a cystoscopy normally takes about five minutes to perform. The patient will be prepped and often given lidocaine jelly to numb the tissues. The most discomfort comes with passing the scope into the bladder. After that, there is a sensation of bladder fullness as the urologist instills water into the bladder. It is not unusual to experience some discomfort urinating after the procedure and blood can occasionally be seen. This will most likely clear. Drinking more fluids helps “flush” the bladder. Expect to recover within the next few days.

What Happens After a Cystoscopy?

Your urologist should be able to share the findings with you after the procedure is completed. In some cases, you will need to go to the hospital for a more involved procedure. Other times, you can be followed in a routine manner in the office. In either case, the cystoscopy is an important test to evaluate your lower urinary tract and can be well tolerated with little downtime.

If you have any more questions about this medical testing, click here to contact the urologists at Georgia Urology!

Efficient Procedure Allows Couple to Conceive, Changes Family’s Life Forever

Georgia Urology patient

Amy Chang of Alpharetta, Ga. longed for motherhood. Not just one child, but “an entire basketball team,” she said with a laugh.

When she and husband Peter agreed to marry more than a decade ago, Amy explained her desire for a brood. Her groom-to-be agreed. However, a serious obstacle blocked their road to biological parenting. Years earlier, Peter had undergone a vasectomy.

This would call for in vitro fertilization (IVF), but first Peter needed a sperm extraction procedure. So the couple called upon Dr. Jerry Yuan of Georgia Urology.

“For men with normal sperm production who have had a vasectomy, the extraction procedure has only minimal challenges,” said Dr. Yuan. “Fortunately, Mr. Chang fell into that category. It required a general anesthesia, making it virtually painless. …We used an operating microscope to aid in finding sperm.”

The extraction, which Amy said took less than 10 minutes from start to finish, proved successful. She recalled both her and Peter were surprised at the quickness and efficiency of the process. The sperm was then shipped to the specialists who handled the IVF procedure. In less than three weeks, the couple had conceived.

Dr. Yuan may have performed hundreds of these extractions throughout his career, but Amy doesn’t downplay the impact it had on her family. What the physician did in mere minutes, she said, was priceless.

“Dr. Yuan forever changed our lives for the better,” she said. “And today we have our 11-year-old son, Harrison.”

If you have any further questions about vitro fertilization or are considering the procedure yourself, click here to schedule an appointment with our expert urologists!

Dietary Recommendations for Kidney Stones

urologist helping patients with Dietary Recommendations for Kidney Stones

By Dr. Jerry Yuan, M.D.

Since diet contributes to a varying degree in the formation of kidney stone, dietary recommendations for kidney stones are extremely important. In some, modifying one’s diet with multiple risk factors may be all that is needed for stone prevention while others will require specific medical treatment with dietary measures serving as an important adjunct in the overall effort in preventing future stones.

For years, the focus in dietary prevention has been calcium restriction; this is not needed in most patients with calcium stones. Unless specifically indicated, as evidenced by detailed medical evaluation, calcium restriction may actually promote stone formation and should not be undertaken unless directed by your physician.

The following recommendation serves as general guidelines for those with calcium stones; however, since individual needs may vary, we recommend you consult with your physician prior to initiating any dietary restriction.

Fluids Dietary Recommendations for Kidney Stones

  • Enough fluid to produce 2000 to 3000 cc of urine daily, this is the equivalent of 2 to 3 quarts or 60 to 100. Please be aware that the volume that matters is the urine output, not the amount of fluid intake; in other words, if you sweat a lot, you need to drink that much more. This is especially true in the summer.
  • Most kidney stones form at night! Remember how strong the urine smells when you first get up? Stone forms and grows best when urine is dark and concentrated, drink before going to bed so you have to get up at least once to urinate and drink again before going back to bed.
  • During the day, drink 12 to 16 oz of water when you get up, with each meal, in between meals, and at bedtime. If the urine has any color or smell, you need to drink more.
  • Drink water and avoid large amounts of tea or coffee.

Salt Dietary Recommendations for Kidney Stones

  • Salt, sodium chloride is excreted by the kidney in such a way that calcium follows salt into the urine at a 2:1 ratio. Excessive salt intake is among the most common factors we see in recurrent stone formers.
  • Salt is everywhere! Read the label, you will be shocked at the amount of salt in our daily pre-packaged food and beverages; take Gatorade and V-8 vegetable juice for example. If your diet involves dining out or lots if pre-made food, your salt intake will already be excessive even if you do not add any additional salt.
  • Hydrochlorothiazide/HCTZ: a mainstay in treating patients with excess urinary calcium DOES NOT work unless salt intake is restricted.
  • Remember, low salt diet!

Calcium Dietary Recommendations for Kidney Stones

  • As previously noted, calcium restriction is not needed in most patients with kidney stones. As a matter of fact, calcium restriction may be counterproductive. We recommend you continue with your regular calcium intake unless directed otherwise, assuming that you do not drink a gallon of milk every day or ingest a large number of Tums or Rolaids.
  • The main sources of dietary calcium include dairy products, meat, and dark green leafy vegetables.
  • Most female patients do not need to interrupt calcium supplement for osteoporosis prevention, check with your physician prior to making any changes.
  • One should also avoid excessive tanning or sunbathing; tanning promotes dehydration and calcium metabolism by converting excessive vitamin D to the active form.

Protein Dietary Recommendations for Kidney Stones

  • Protein, especially animal protein, is very problematic; it promotes stone formation via a variety of mechanisms. Unfortunately, high protein diets of many permutations have ruled the current dietary landscape with no end in sight. A recent study comparing various weight loss diet regimens showed that while the “Low Carb” diet may lead to quicker weight loss than others, over time, the net weight loss effects are equivalent regardless of the initial approach.
  • My recommendation is to avoid the Atkin’s or the South Beach diets and consider a more physiological approach by incorporating a balanced diet with exercise to avoid the pitfalls of high protein intake and kidney stones.
  • Limit your animal protein intake and if you love to indulge on a good steak, please double up on your water drinking.

Oxalate Dietary Recommendations for Kidney Stones

  • High level of urinary oxalate is perhaps the worst and the most difficult problem to have. We have only limited means of lowering the oxalate excretion since the bulk of the oxalate in the urine comes from body’s own amino acid metabolism.
  • Dietary sources of oxalate include mega-doses of vitamin C, rhubarb, spinach, beet, peanuts, nuts, chocolate, celery, parsley, tea, and coffee. You may consume these items in moderation and please avoid binges of excess, stay well hydrated with water to “flush out” the oxalate that may get into the system the next time you indulge in chocolate, sweet tea or salted peanuts or nuts which contains both oxalate and salt, by the way.
  • Vit B6 at 50-100 mg daily will reduce liver production of oxalate.

Citric acid or Citrate Dietary Recommendations for Kidney Stones

  • Citrate is extremely beneficial in stone prevention and is safe. The best source of citrate is prescription citrate supplement such as Urocit-K or Natural citrate can be found in lemonade, orange, or grapefruit juice. The drawback with the natural source of citrate is the need to consume a large quantity of these food products in order to obtain enough citrate for stone prevention. Lemonade is the best given the fact it contains the least amount of oxalate.
  • For those with normal urinary citrate levels not requiring pharmacological replacement, you may supplement with a large glass of orange or grapefruit juice 2 to 3 times per day including once before bedtime. 

Fiber Dietary Recommendations for Kidney Stones

  • Bran, especially corn bran, may be added to your Daily intake of 10 to 15 gram has been shown to reduce stone formation. Avoid wheat or rice bran, both contain a fair amount of oxalate.

Magnesium Dietary Recommendations for Kidney Stones

  • Magnesium is a stone inhibitor similar to citrate; dietary sources of magnesium overlap those of calcium that makes natural sources impractical. You may obtain over the counter magnesium supplement and follow the direction on the bottle. Do not over consume to avoid potential magnesium toxicity.

Obesity Dietary Recommendations for Kidney Stones

  • Obesity is now a major contributor to stone formation. Various factors associated with obesity leads to high urinary calcium, oxalate, and uric acid; insulin resistance causes metabolic acidosis which lowers urine citrate.
  • Shockwave lithotripsy is more difficult in obese patients from positioning the patients and localizing the stone and from shock wave losing its energy and effectiveness simply due to the distance it must travel to reach the stone.
  • Please consult with your primary care physicians or internist re. weight reduction; as you undoubtedly know, overweight is a major health risk and kidney stones are of minor significance when compared with all the other health risks associated with obesity.

The three most important steps in stone prevention, which are applicable in all stone formers, are

1. Fluid

2. Low salt intake

3. Decrease protein intake

Additional steps may be individually based after consulting with your physician.

We hope you find these dietary recommendations for kidney stones useful! However, if you have any more questions or concerns, contact us here.

What to Expect if You Receive a Ureteral Stent

Doctor holding a ureteral stent to show patient.

By Dr. Anand Shantha, M.D.

A ureteral stent is most often used during the treatment of stone and occasionally with other surgery involving the urinary tract.

The experts at Georgia Urology have lots of experience in placing and removing stents, so check out our guide on this common medical procedure below.

What is the Ureter?

The ureter is a tube that connects the kidney to the bladder and allows urine to flow from the kidney to the bladder.  You have two ureters, one connecting the right kidney to the bladder and one connecting the left kidney to the bladder.

What is a Stent?

A stent is a flexible plastic tube measuring about 10 to 12 inches with a curl on each end which can be temporarily placed inside the ureter from the kidney to the bladder.

Why is a Stent Used?

A stent is most commonly used to bypass an obstruction of the ureter,  to allow the ureter to heal after surgery, and to treat kidney stones. A stent is sometimes placed emergently and can be lifesaving when there is an obstruction of the ureter and an associated infection.  If this is due to a stone, the stone is left in place and will be treated later due to the infection.

As an added benefit the stent allows the ureter to passively become larger, which can make the future procedure to remove the stone less traumatic and allow any stone fragments to pass more easily once the stent is removed. A stent is also placed at times during stone surgery to allow the ureter to heal or prevent fragments from obstructing the kidney.

It is most commonly inserted by passing a scope with a camera into the urethra and bladder. The stent is then inserted into the opening of the ureter to the kidney using x-rays to visualize its placement.

What Can I Expect After I Have My Ureteral Stent?

After a stent is placed, you may have a string coming out of the urethra. This will be used to remove the stent in the future and should not be pulled on. In most cases, it will be okay if it accidentally is pulled out.

The side effects after a stent are placed can vary. If it was placed because of severe pain from a stone, stent discomfort is usually significantly less. Most patients will experience some discomfort which may include pain in the back, flank and pelvis, urinary urgency and frequency, and intermittent blood in the urine. You can continue your regular activities if you are not having significant pain or taking narcotic pain medications. You should notify your physician if there are any fevers or significant clots in the urine.

The stent is temporary and will need to be removed. Your physician should be able to tell you an approximate length of time the stent will be left in place, but this can vary significantly. Most stents after treatment for medium to small stones are kept in place for less than two weeks. Stents that have a string attached to them will be removed with the string on a follow-up appointment in the office. Stents without a string will require a minor procedure in the office. A flexible scope will be passed into the bladder and a grasper will be used to pull the stent out. After this most will have minimal urinary discomfort for 1-2 days.

If you have any more questions or concerns regarding ureteral stent, contact our urological experts like at 678-284-4053.

Peyronie’s Disease Front and Center

Urologist discussing Peyronie’s disease with patient.

By Dr. Emerson Harrison, M.D., F.A.C.S.

Peyronie’s disease was named after the famous French surgeon Francois Gigot de la Peyronie, surgeon to King Louis XV. In 1743, Dr. Peyronie described a condition characterized by scar tissue, or plaque, that forms inside the penis. This plaque caused curvature or bending of the erect penis. This disorder is now referred to as Peyronie’s Disease.

Keep reading below to learn more about this condition and how the experts at Georgia Urology can help.

Signs and Symptoms of Peyronie’s Disease 

A slight curvature of the penis is considered normal in most men. However, Peyronie’s disease is characterized by pain, hard lumps, or nodules (plaques) found within the penile shaft. This scar tissue may cause curvature as well as divots and/or indentations during erections. The condition may make sexual intercourse painful and/or difficult for the patient and his partner.

Causes

The underlying cause of Peyronie’s disease is uncertain and not well understood. The cause may be related to penile trauma, injury during sexual intercourse, or physical activity, although most patients don’t remember any traumatic event or injury.

Diagnosis

Most urologists can diagnose and institute and/or suggest treatment options for the disease. In most cases, the location, size, and hardness of the plaque in the penis are identified. A penile ultrasound can provide conclusive evidence of the Peyronie’s plaque. Patients are sometimes asked to bring in a photo of the erect penis so that the urologist can assess the degree of curvature of the penis.

Treatment

Goals of treatment include relieving pain and straightening the penis to allow for a return to satisfactory intercourse. The drug Xiaflex (or collagenase clostridium hisolyticum) was originally approved to treat a hand and forearm condition called Dupuytren’s Contracture. It is now the most common and first-line treatment for Peyronie’s disease. It is injected directly into the plaque scar tissue during several courses of treatment. This therapy dissolves the plaque tissue which causes straightening of the curvature.

Surgery

Surgery is usually considered as a last resort to correct the curvature. A penile prosthesis may be appropriate in severe cases of Peyronie’s in order to straighten the penis. Sometimes physical therapy and devices such as vacuum erection pumps are used as penile traction therapy in attempts to also straighten the curvature in the penis.

Counseling

Peyronie’s disease can often times be a physically and psychologically debilitating disease for men and their partners. Because Peyronie’s disease is difficult to cure, counseling can help men and their partners cope with the devastating effects of the disease. It is not uncommon for men afflicted with Peyronie’s disease to develop depression or withdrawal from their sexual partners.

The expert urologists at Georgia Urology can help restore confidence back to any man suffering from Peyronie’s disease. Contact us at 678-284-4053 to schedule an appointment today.

Hydroceles in Kids: What Parents Should Know

child getting checked for hydroceles

By Dr. Michael Garcia-Roig, M.D

The scrotum is the sack behind the penis where the two testicles live in males. Occasionally, some babies and older children can develop painless swelling in this area. It can come on quickly or slowly and can be constant or can come and go.

There are several reasons why the area can become swollen including a hydrocele or an inguinal hernia, varicocele, spermatocele, swelling from an insect bite, and rarely, testicular cancer.

We’re going to talk about hydroceles in kids.

What are Hydroceles?

The most common cause of painless scrotal swelling in kids is a hydrocele or collection of fluid around the testicle. Hydroceles can be communicating or noncommunicating, meaning the fluid in the scrotum freely flows in and out of the scrotum (communicating) vs only staying in the scrotum (noncommunicating).

The hydrocele fluid gets to the scrotum through an opening in the groin, called a patent processus vaginalis or a hernia. The processus vaginalis is part of normal development in babies. It’s supposed to go away at or soon after birth but stays around in some kids.

Can Hydroceles Be a Serious Condition?

The opening of the processus vaginalis is usually small, just letting fluid in and out, but sometimes it can be large or become large later in life. Larger openings are worrisome because they can let things from the abdomen, like intestines, fall into the scrotum and become strangulated, cutting off blood flow to that section of intestine. This is an emergency.

Our goal is to fix a patent processus vaginalis before this complication occurs if the opening doesn’t go away on its own in babies, or if it contains more than just fluid.

How are Hydroceles Diagnosed and Treated?

There are some tests to diagnose a hydrocele or a hernia. Often, a doctor can make the diagnosis by just examining a child. Sometimes an ultrasound helps get more information when a physical exam isn’t clear or the other conditions listed above are suspected.

Hydroceles and hernias are fixed with surgery, which is done in the hospital operating room under general anesthesia. In children, unlike adults, hernia repair does not require the use of any mesh products. Complications like bleeding, infection, or a recurrent fluid collection around the testicle are rare. Kids typically go home the same day.

If you have any more questions regarding hydroceles, contact the pediatric urology experts with Georgia Urology at 678-284-4053.

MRI Guided Fusion Prostate Biopsy: A New Tool Against Prostate Cancer

By Dr. Jerry Yuan, M.D.

Many advances have been made in the last decade in the diagnosis and treatment of prostate cancer. A great example is a prostate MRI guided biopsy or the fusion Bx. It represents a quantum leap forward when indicated. This allows for more accurate identification of those with elevated PSAs necessitating prostate biopsies, as well as more precise biopsies to better assess the extent of disease to guide further therapy.

While standard ultrasound (TRUS) based biopsy continues to be appropriate in many men, some require a different approach. This includes men in whom cancer is suspected despite a prior normal biopsy, as well as men with rather enlarged prostates which render detection quite difficult.

At Georgia Urology, with assistance from Northside Hospital and its outstanding Radiology Dept, we utilize the Eigen Artemis ProFuse Bx.

Who Would Receive an MRI Guided Fusion Prostate Biopsy?

We’ve provided an example of such a case! Here are the qualities of our index patient:

  • A man with a PSA of 5.6 who underwent a negative TRUS/12 core Bx in 2016.
  • His PSA is now 6.5 & a secondary biomarker test (SelectMDx in this case) returned at moderate risk for cancer detection.

In this instance, the MRI confirmed the presence of a 1 cm suspicious lesion on the left side of the gland. Here are the photos:

MRI Guided Fusion Prostate Biopsy live US image
Live US image matching the MRI derived prostate boundary (green outline) with target lesion in red and the predicted path & sample length of the biopsy needle to ensure proper sampling.
US image captured, outlined & refine of MRI Guided Fusion Prostate Biopsy
US image captured, outlined and refined to create a US derived facsimile of the MRI.
Two MRI Guided Fusion Prostate Biopsy images
MRI (right) and US (left) are now matched in multiple planes to superimpose live US images onto the MRI.
MRI Guided Fusion Prostate Biopsy computer rendering
Fusion complete with a computer rendering of the prostate highlighting the target lesion(s).
MRI Guided Fusion Prostate Biopsy MRI mapped preop with lesion highlighted in red
MRI mapped preop with lesion highlighted in red.

How Does an MRI Guided Fusion Prostate Biopsy Work?

The procedure is well tolerated. It’s performed under a light general anesthesia since movement will degrade the accuracy of targeting.

As in the majority of cases performed, the cancer detection rate is quite high, ranging from 50% to near 100% depending on the grade of the lesion based on the MRI criteria. Our index patient was found to have Gleason 4 prostate cancer in the index lesion and 2 adjacent locations thanks to the MRI Guided Fusion Prostate Biopsy.

Contact the expert urologists at Georgia Urology to learn more about this form of diagnosis and treatment for prostate cancer, plus more.

Georgia Urology Patient Faces Prostate Cancer With Positivity

patient success story Jack standing by his wife before prostate cancer

“You probably have prostate cancer.”

When Jack Francisco heard those words from his primary care physician, they rattled his already challenging world. It was late summer 2010, and Jack’s wife, Lee, was in the midst of recuperating from her second breast cancer surgery. A financial planner by trade, Jack recognized he and his wife’s own future plans lay in the balance.

Jack’s prostate-specific antigen (PSA) test had resulted in a remarkably high number, 59. All signs were pointing toward prostate cancer. Reading online articles about the disease, Jack fell down a rabbit hole of negative information, and he feared the worst.  

He soon found solace in Dr. Lewis Kriteman of Georgia Urology. After an initial examination, additional testing, and a biopsy, Dr. Kriteman found evidence of prostate cancer. The physician offered treatment options, and recommended a combination of hormone and radiation therapy.

“Dr. Kriteman also gave me some excellent guidance on what the side effects of the treatment would be and the length of time it would take,” Jack said. “And he gave me dietary and exercise recommendations to make sure and maximize the treatment efficacy and minimize the side effects.”

A definitive plan of action helped stabilize Jack’s anxiety, and he and Dr. Kriteman began moving forward.

In the meantime, Lee was receiving chemotherapy and radiation. Inspired by his wife’s strength and positivity, Jack trudged forward with newfound optimism. The extensive nature of her treatment required Jack to tend to his wife’s needs.

“She needed a lot more support than I did,” he said. “I think that helped me a great deal. I wasn’t dwelling on what I was going through.”

The couple went through radiation together. Lee had her treatment in the mornings, and Jack’s took place in the evenings. Throughout this experience, they sought perspective and the healing power of humor.

“We used to joke that we didn’t need to turn the lights on at night, because we were both glowing from the radiation,” Jack said.

In addition to the strength found within his marriage, Jack relished the “tremendous level of care” and tactical approach he received from Dr. Kriteman.

After approximately 90 days of treatment, Jack’s PSA plummeted to an undetectable level. Remaining diligent, Dr. Kriteman kept his patient on hormone therapy for the next three years.

Throughout this journey, Jack used his own experience and perspective to support others facing a prostate cancer diagnosis. From comforting colleagues to forging friendships on an online prostate cancer support forum, Jack chose to pay it forward.

Now age 68, Jack continues seeing Dr. Kriteman for quarterly tests and exams, and the disease is undetectable.

Jack and Lee are currently enjoying retirement. This includes golfing, traveling, cooking, woodworking, and spending time with their grandchildren. Relying on mantras such as “look for the good,” “get living” and “everyday is a gift,” help pave a road of positivity.

“My wife told me we have to look at it as diseases we’re going to manage,” Jack explained. “We have no guarantee we’re ever going to be cured. If we’re cured, that’s great. If we’re not, it’s not the end of the world. Much of this can be well managed, but we have to stay on top of it. And that’s the approach we’re taking.”

Dr. Vahan Kassabian and HIFU Help Patient Defeat Prostate Cancer

At Georgia Urology, we’re proud to showcase patient testimonials featuring our incredible staff and the technology we offer. Keep reading below to see how Dr. Vahan Kassabian and HIFU aided a patient in his battle against prostate cancer.

Biff Kinney treated with HIFU for prostate cancer riding bike.

My name is Biff Kinney. I’m 57 years young and live in Atlanta, Georgia. My life was jam-packed with all of the things I loved to do. For 32 years I have been employed by a major Japan-based company and am responsible for business development globally. I ride Harley Davidson Motorcycles, am an avid roller skater, and am married to Tracy, the love of my life since we met in 1977. I had no plans to slow down or stop anytime soon.

Receiving Prostate Cancer News

During a routine physical in August 2017, the General Practitioner I regularly visited found that my PSA had spiked to a level that needed further investigation. In November of 2017, my Urology practice at the time performed a Prostate Biopsy. On November 22nd, the biopsy lab result came back positive for cancer.

Fortunately, out of the 12 samples, only one contained 10% cancer. That meant I caught it very early and the cancer-affected region of my prostate was tiny in size.

Biff Kinney treated with HIFU for prostate cancer with wifeDiscussing the Options for Prostate Cancer Treatment

On November 29th, I visited my Urologist at the time to discuss treatment options. Active surveillance was not on the table, because I would eventually be forced to take action. We discussed prostatectomy and radiation. But the process and long-term side effects of both were unthinkable. I didn’t want to have to ruin my entire prostate, and there was no place in my life for chronic fatigue, incontinence, or impotence.

I asked about an option which could treat the cancer and leave the healthy portion of the prostate intact. However, my Urologist then said there was no such option. I decided to take some time to mull over which treatment option would be best for me, though I really didn’t want to pick any of them.

Meeting Dr. Kassabian of Georgia Urology

In January 2018, I heard a radio advertisement for Dr. Vahan Kassabian of Georgia Urology and a treatment technique named HIFU. The ad claimed HIFU is a non-invasive treatment for prostate cancer in some patients that results in low risk for long term side effects and swift recovery.

The following week I found myself in an exam room for my first meeting with Dr. Kassabian. I noticed right away that he was all business. I admired his analytical and direct approach to patient communication. After his review of my case and an MRI, it was quickly determined that I was a candidate for HIFU.

Dr. Kassabian set in motion that I would receive my treatment on April 12, 2018. At the end of the meeting, Dr. Kassabian looked at me dead in the eyes and assured me that the entire procedure would be a “piece of cake”.

Receiving HIFU

Biff Kinney treated with HIFU for prostate cancer roller skating.

I reported to the Northside Decatur Urology Surgery Center promptly at 7:00 AM on April 12th. I actually had a feeling of complete comfort and confidence. I knew instinctively that I was in good hands.

And I was right! After confirmation of recovery by Dr. Kassabian, I was released and on my way home all by 11:30. Only 4.5 hours later.

It could have been a prostatectomy, it could have been radiation, and it would have been lifelong side effects. But, thankfully, it was HIFU.

And, thankfully, it was Dr. Kassabian. I wouldn’t have picked any other Urologist to help me during this difficult journey. Dr. Kassabian was incredibly kind, resourceful, intelligent, and gracious in helping me through every step of the way. I am convinced he is one of the best urologists in the state, and I know he was my guardian angel looking out for me.

If you or a loved one are facing prostate cancer, visit Atlanta’s leaders in Urology since 1975. Give us a call at 678-284-4053 to schedule an appointment now.

Prostate Cancer Rehabilitation

happy patient and doctor discuss prostate cancer rehabilitation treatments.

By Dr. Brent A. Sharpe, M.D.

1:9 men in the US will have prostate cancer. While that in itself can be frightening enough, many men also fear prostate cancer treatments. This fear mainly stems from the potential complications of erectile dysfunction, or ED, and urinary incontinence that may occur with curative therapy. The two most common types of these therapies for localized prostate cancer are surgery and radiation.

However, with advancements in technology and the utilization of experienced radiation oncologists and high volume surgeons, these complications can be minimized through prostate cancer rehabilitation procedures.

Here is how the experts at Georgia Urology look to do just that.

Use a Combination of Treatments for Prostate Cancer Rehabilitation

First, there are several measures that prostate cancer specialists normally take to reduce the recovery time for ED and incontinence. Most high volume surgeons will use a combination of oral and penile medications, as well as vacuum erection devices to help recover the erectile function sooner. For the urinary incontinence, they usually enlist a specialized physical therapist who concentrates on pelvic floor training in order to help patients recover quickly.

Persistent incontinence and ED rates are approximately 5% and 30-40% after these treatments, respectively. However, there is still hope for these men!

Urological Prostheses

Medical prosthesis are devices which can be surgically implanted into patients and are great options for prostate cancer rehabilitation. Common examples are joint replacements and pacemakers. With the advent of urological prosthesis, essentially all permanent ED and incontinent patients have excellent curative options available to restore normal function. These options have been shown to have patient and partner satisfaction rates of 96% and 90%, respectively.  

A prosthetic urologist is a urologist with specialized training and interest in urological prostheses. They can help patients select the best device for their specific set of circumstances. Here are just a few of the options.

  • Penile implants are devices that can be implanted into patients with significant ED and they are able to restore normal sexual function. To date, more than 500,000 penile implants have been placed. This surgery is an outpatient procedure that is normally done in less than one hour and most patients return to normal activity in 1-2 weeks. There are three types of devices and most result in a normal flaccid and erect penile state.
  • Male urinary slings are a piece of material which is surgically placed underneath the urethra to allow repositioning and mild compression to restore urinary continence. The success rates for male sling exceeds 90%.
  • If patients are experiencing more severe incontinence, then an artificial urinary sphincter, AUS, maybe a better choice. An AUS is a device that takes the place of the native sphincter which was damaged by prostate cancer treatment. This is a balloon that wraps around the urethra to maintain continence and is deactivated by the patient in order to empty their bladder. The placement of an AUS, with its 98% patient satisfaction rate, is one of the most patient satisfying procedures in all of medicine.

As a prosthetic urologist, one of my personal stories is of a patient who was wearing 12 diapers per day. After having an AUS placed, he was able to resume his normal life. Both male slings and artificial urinary sphincters can be used to restore complete continence in men who have undergone prostate cancer treatment and can be done as an outpatient surgery.

As one can see, men should not have to fear treatment for prostate cancer. Prostate cancer cure rates are excellent, >90%, and side effects are minimal and treatable with complete restoration of normal function.

It is the role of the prosthetic urologist to restore every man who underwent prostate cancer treatment with full sexual function and continence. One could say their motto is, “Live long, happy and dry!”

Here at Georgia Urology, we have countless expert urologists here to help you remain confident after your treatments for with prostate cancer rehabilitation. Give us a call at 678-284-4053 if you want to learn more or schedule an appointment with any of our team members.