Everything You’ve Wanted to Know about Vaginal Cosmetic Treatments

When it comes to cosmetic procedures, no area of the body is off limits! As plastic surgery has become more and more socially acceptable, it is no surprise that women are curious about ways to rejuvenate and beautify their “intimate anatomy” with cosmetic gynecology procedures. Many women feel self-conscious or embarrassed about the appearance of their genitalia, particularly if the delicate skin is large or misshapen, while others want to reverse the effects that age, hormones, and motherhood have had on their bodies. Fortunately, there are a variety of safe and effective vaginal cosmetic treatments to choose from, some of which do not even require surgery, such as ThermiVa.

At Comprehensive Urology, we have extensive experience performing medical and cosmetic vaginal treatments designed to help women feel comfortable and regain their sexual confidence again. To learn more, please review the following information and then schedule a consultation at our Beverly Hills office.

Types of Feminine Rejuvenation Procedures

There are a variety of cosmetic vaginal treatments available to give women younger, sleeker, and more aesthetically pleasing genitals (externally and internally) while also providing actual medical benefits as well.

The most effective cosmetic vaginal rejuvenation treatments include:

Labiaplasty

One of the most common cosmetic vaginal treatments in LA, labiaplasty involves surgically reducing the size of the labia minora (inner lips) and/or the labia majora (outer lips) of the vulva. Some women may simply dislike the size and shape of their labia, or some may experience irritation or chafing as a result of the inner labia extending past the outer labia. Labiaplasty can address both of these issues by shortening and/or re-shaping the labia.

Vaginoplasty

Often requested by mothers who have given birth vaginally, a vaginoplasty involves tightening the vaginal canal and opening by surgically removing excess tissue in order to create a smaller diameter. The procedure can help restore a tighter tone and texture to the vagina after childbirth.

Learn more about the cosmetic vaginal treatment vaginoplasty at Wikipedia.org.

FemiLift ®

FemiLift is a non-surgical treatment designed to tighten vaginal tissue, improve nerve function, and establish younger-looking tissue using laser energy. This painless procedure is performed with a thin probe that is inserted into the vagina where pulsed laser energy transforms the tissues and structures of the internal and external genitals. The FemiLift vaginal cosmetic treatment can also relieve mild to moderate forms of urinary incontinence by tightening the pelvic muscles and can even “bleach” darkened vaginal skin.

ThermiVa®

Similar to FemiLift, ThermiVa relies on radiofrequency waves to heat the vaginal tissue and cause it to rejuvenate and tighten. The radiofrequency waves stimulate collagen and elastin fiber production in the skin, which leads to a firmer, more supple texture while also triggering increased blood flow and nerve production. As a result, ThermiVa effectively improves the appearance and function of the vaginal tissue and muscles. With just one vaginal treatment session, most patients easily see and feel the difference.

How is Recovery After a Vaginal Tightening Procedure?

The recovery process will vary depending on whether a patient has undergone vaginal plastic surgery or a non-surgical vaginal rejuvenation treatment in Los Angeles. Surgical treatments can be performed on an outpatient basis, but the patient will undergo local or general anesthesia followed by incisions to remove and shorten the delicate tissue. Following surgery, patients can experience swelling and tenderness for a few days while the incisions heal. During this time, it is suggested that the patients do not engage in any strenuous physical activities including intercourse.

Non-surgical treatments, on the other hand, such as ThermiVa do not require any downtime and patients can return to everyday activities, and even engage in sex, immediately after treatments.

Who is a Candidate for Vaginal Cosmetic Treatment?

In order to be eligible for surgical or non-surgical vaginal cosmetic treatments, it’s crucial to consult with a skilled specialist with extensive experience in performing such cosmetic treatments. The urologists at Comprehensive Urology determine a good candidate for vaginal cosmetic treatments based on whether she is in good health, has mild to moderate vaginal looseness or stretching, does not suffer from severe pelvic floor damage, and has realistic expectations. Surgical procedures (e.g. vaginoplasty), or non-surgical (e.g. ThermiVa), each come with various potential risks and benefits, which is why it is so important to only undergo treatment with an expert and to discuss each option in-depth before choosing one.

For more severe vaginal concerns, the Los Angeles team at Comprehensive Urology can conduct a thorough exam to determine the best treatment options as well. Do not hesitate to schedule a consultation to receive the care and treatment you need to regain control and comfort.

In a Nutshell: Vaginal Rejuvenation Treatments

• Popular: Increasing numbers of women are actively exploring and utilizing methods to rejuvenate and enhance their “intimate anatomy.”
• Multiple Benefits: Improved self-esteem, sexual confidence, and cosmetic appearance of the female genitalia aside, many patients also report improved urinary and sexual function.
• Methods: There are many options available based on the individual patient’s needs. Surgical options include vaginoplasty and labiaplasty. Non-surgical procedures include Femi-Lift® and ThermiVa®. Full counseling by our expert urologists will help you identify the best treatment option(s) for you.

Call Comprehensive Urology for Vaginal Rejuvenation Today!

If you are interested in vaginal cosmetic treatments or would like to address a medical issue, such as incontinence or prolapse, contact a skilled urologist in LA for an accurate diagnosis and personalized treatment options. Our team at Comprehensive Urology has decades of experience helping women of all ages. Call (310) 499-2756 today to schedule an appointment or comprehensive exam.

Next, read How This Unknown Cause of Male Infertility Could Be Affecting You

The post Everything You’ve Wanted to Know about Vaginal Cosmetic Treatments appeared first on Comprehensive Urology.

The 5 Greatest Risk Factors for Bladder Cancer

According to the American Cancer Society, bladder cancer is the fourth most common cancer among men and is the 8th most common cause of death in men due to cancer. The symptoms are wide-ranging but don’t always show themselves, so yearly checkups with your doctor are strongly advised – you’ve got family and other responsibilities to uphold.

Even if the symptoms aren’t always noticeable, there are plenty of risk factors to be aware of and avoid as much as possible. At Comprehensive Urology in Los Angeles, we specialize in diagnosing cancer of the bladder and bladder cancer treatment, and we want to make sure you understand the most common risk factors for this disease.

Common Risk Factors

These factors increase chances of a person acquiring bladder cancer:

General Personal Makeup

Simply put, if you are a white male aged 55 or older, you’re at the most risk.

Men are three times more likely than women to get bladder cancer. Nearly nine out of every 10 Americans who get this disease are 55 or older. Caucasians are twice as likely to get it as African Americans, and several times more likely than Asians, Hispanics, and Native Americans.

Like most cancers, the incidence of bladder cancer increases with age and generally speaking older patients have a higher chance of having cancer of the bladder compared to younger patients.

Genetics/Family History

If you’ve had a family member with bladder cancer, your risk rises significantly. In some cases, there may be certain aspects of your DNA that make you more prone to developing this form of cancer, while in other instances, it could be that you and your affected family members were exposed to the same carcinogen. Either way, family history plays an important part.

Environmental Exposure

We don’t want to make you paranoid, but there are many chemicals in your surroundings that are big risk factors. Aniline dyes and some of the dye in your clothes, such as benzidine, has been strongly linked with bladder cancer. This is true for many other petrochemicals. In fact, many products in your LA home or office made of leather, rubber, textiles, or ink could contain chemicals that expose you to more risk.

Arsenic in public drinking water has also been found to be associated with it, though every locality has safety measures in place that restrict the amount of level in the sources of public drinking water. Certain jobs are thought to be riskier, as well. These include painters, printers, truck drivers, dry cleaners, and hairdressers, to name a few.

Previous Personal History

If you’ve undergone chemotherapy or radiation therapy for another type of cancer, your risk of bladder cancer is heightened. A chemotherapy drug called cyclophosphamide has been linked to higher risk as has frequent radiation aimed at your pelvic region.

If you already have a history of cancer, then your risk is certainly elevated, as cancer can return in other, connected regions such as your kidneys, ureter, or urethra. If you’ve had bladder cancer treatment in the past in Beverly Hills, you should closely monitor your recovery and be alert for any signs of recurrence because it commonly happens.

Smoking

Last, but most certainly not least, is smoking. In fact, it’s probably not a surprise that smoking and tobacco use are the most common risk factors – it’s thought to be the cause of more than half of all bladder cancer cases. In fact, smokers are up to four times more likely to develop it than are nonsmokers.

If you quit, you’ll almost immediately lower your risk of getting this cancer. When you inhale cigarette smoke, cancer-causing chemicals are eventually filtered by your kidneys and deposited into the urine in your bladder, which damages cells on the organ’s walls and increases your risk.

“Second-hand” smoke or inhalation of another person’s tobacco some who is in the same location with you, also poses a risk.

Learn more about risk factors for this disease at WebMD.com.

Bladder Cancer Prognosis and Survival Rates

After it’s been found that you have this cancer, the next step is to undergo a bladder staging test, such as a CT scan or MRI, to determine which of the four levels of this cancer you have:

• Stage I – Cancer is in the bladder inner lining but not yet in the muscular bladder wall.
• Stage II – Cancerous cells are now in the bladder wall but still confined within the organ.
• Stage III – The diseased cells have spread to tissue surrounding the bladder.
• Stage IV – Cancer has spread to the lymph nodes and other organs.

Your bladder cancer prognosis depends on a variety of elements, including which stage you’re in, the treatment you choose, and your body’s reaction to bladder cancer treatment.

As such, bladder cancer survival rates vary from patient to patient. However, here are some general survival rates:

• 5-year survival rate (SR) = 77%
• 10-year SR = 70%
• 15-year SR = 65%

These general rates are based on the cancer being confined to your bladder.

On the other hand, the rates of survival plummet once the cancer is no longer confined to the bladder. If cancer has spread to nearby organs, it drastically cuts down survival rate (e.g., 5-year SR is 34%). If cancer spreads to other, distant parts, there’s an even sharper decline (e.g., 5-year SR is 5%).

In a Nutshell: Bladder Cancer

• Risk factors: Smoking, chemical exposures, age and ethnicity, family history, chemo or pelvic radiation therapy for other cancers

• Symptoms: These may vary but most importantly include no symptoms, weight loss, blood in the urine, change in urinary frequency/urgency

• Staging: If diagnosed with bladder cancer, it is important to know if the cancer is confined to the bladder or involves other organs as this can significantly affect treatment.

Bladder Cancer Questions? Contact Comprehensive Urology Beverly Hills Today

If you are exposed on a daily basis to any of the risk factors mentioned above, you should be checked by a specialist. Know the general carcinogens for developing this cancer as well as your own personal risk factors. Contact the Los Angeles bladder cancer specialists at Comprehensive Urology for a consultation. Visit us online or call 310.499.2756 to schedule an appointment and learn more. Your family will thank you.

Next, read Everything You’ve Wanted to Know About Vaginal Cosmetic Treatments

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How This Unknown Cause of Male Infertility Could Be Affecting You

When trying to become pregnant, there are so many necessary elements involved that it may seem like a miracle that couples are ever able to conceive. When the process does become difficult or unsuccessful, however, it means that there are numerous elements to evaluate in order to find the solution. Nearly 30% of infertility issues are male-based and a remarkable number of men have a condition called varicoceles. Varicoceles of the testicle have been linked to male fertility issues, and men may not even know it until they try to become a father. It is important to consult with a specialist to receive effective varicoceles treatment.

Enlarged veins occur when the veins responsible for draining blood away from the testicles become enlarged like varicose veins. As a result, varicoceles can increase pressure in the testicular vein and cause the testes to overheat, which can significantly impair sperm production.  The enlarged testicular vein more often develops on the left testicle, but can also affect both the left and the right. Nearly 10 to 15 out of every 100 men have some degree of varicocele vein enlargement. However, it is important to note that not all men experience symptoms or reduced male fertility as a result of varicoceles in Los Angeles.

What Causes Enlarged Testicular Veins?

There are several theories behind why some men develop varicoceles. Unfortunately, the exact cause is still unknown. It is suspected that varicoceles may develop when the valves inside the testicular vein, which directs blood from the testicle toward the heart, do not function correctly, causing the blood to pool within the vein. Over time, the varicoceles testicular vein can dilate or become wider, which can reduce the pressure needed to keep the blood flowing consistently.

In many cases, varicoceles develop during puberty without causing noticeable symptoms until later in life, while some men who have varicoceles may never experience symptoms or complications as a result of the testicular vein enlargement.

In a Nutshell:

• What is it? Some of the veins draining blood from the testicle(s) become dilated and enlarged, which can cause the testicle(s) to “overheat.”
• Symptoms: Varicoceles may have no symptoms or cause male infertility, testicular shrinkage (atrophy), pain and discomfort in the testicle(s), etc.
• How it is diagnosed: Detailed physical examination by your urologist and possibly a testicular ultrasound
• Treatment: If varicoceles cause problems, surgical ligation or embolization of the affected veins can resolve the issue. Varicoceles can be treated with microsurgery and through a small incision, which is done as an outpatient and you can expect fast recovery afterwards.

Do You Have Varicoceles?

The signs and symptoms of testicular vein enlargement can vary widely for each individual, and many men may not even experience any symptoms. The most common signs include:

•    Pain or discomfort, particularly after a long day of standing or activity
•    Pain or discomfort that subsides when lying down to rest
•    Swelling of the scrotum
•    Enlarged, twisting veins inside the scrotum that can be seen or felt
•    Limited or slow growth of one testicle
•    Testicular atrophy (shrinkage)
•    Low sperm count
•    Low testosterone

Varicoceles can be accurately diagnosed with a physical exam by a skilled doctor, such as the urologists at Comprehensive Urology in Beverly Hills. The exam may also involve a scrotal ultrasound in order to gain a detailed image of the veins if they cannot be seen or felt. Dr. Kia Michel and his team at Comprehensive Urology will determine whether or not to treat varicoceles based on the following factors:

•    The testicular vein enlargement reduces sperm count and cause infertility
•    The condition causes testicular atrophy
•    The testicular vein enlargement causes pain and discomfort

Men who suspect they may have varicoceles should consult with a urologist for a reliable diagnosis and access to the best varicoceles treatment options available for restoring male fertility.

What are the Best Treatments for Enlarged Testicular Veins?

In the event that testicular vein enlargement treatment is recommended, a patient may be eligible for the following treatments at Beverly Hills Comprehensive Urology. It is important to note that surgery and treatment may not always be necessary for varicoceles, so it is vital to consult with a male fertility specialist and urologist.

Varicocelectomy

A varicocelectomy is a minimally-invasive microsurgical procedure in which the abnormally large testicular vein is dissected and sutured shut in order to direct the blood flow to the normal surrounding veins and restore male fertility. The testicular vein enlargement treatment is performed on an outpatient basis, which means that patients can return home within the same day as the operation. In most cases, patients will fully recovery from a varicocelectomy within two to three days. Read more about varicocelectomy at WebMD.com.

Varicocele Embolization

This non-surgical treatment for symptomatic varicoceles is performed using a catheter that is directed through a vein in the leg or the neck. A small coil is placed in the enlarged testicular vein to block blood flow and redirect the blood to other normal veins. The procedure involves such a small incision that sutures are not necessary and the entire procedure is completed in only an hour.

To learn more about male fertility treatment options for varicoceles and whether this condition is responsible for your infertility issues, it is crucial to undergo expert care with a board-certified urologist.

Schedule a Male Fertility Consultation Today

If you suspect that varicoceles are interfering with your plan to start a family or causing pain and discomfort, do not hesitate to contact a skilled urologist in Los Angeles today for an accurate diagnosis and individualized varicoceles treatment plan for male fertility. The male fertility specialists at Comprehensive Urology have decades of combined experience and understand the importance of achieving the best possible outcome for each and every patient. Please call (310) 499-2756 today to schedule a consultation or comprehensive exam.

Next, read How to Manage Prostatic Hyperplasia

The post How This Unknown Cause of Male Infertility Could Be Affecting You appeared first on Comprehensive Urology.

What are the Advantages of a Vasectomy?

When a man chooses to undergo a vasectomy as an option for permanent birth control, it shows his willingness to take charge of his life and the life he shares with his partner. By choosing to undergo the procedure, the man shows his love for his partner by opting to save her from the sometimes unreliable and toxic birth control methods designed for women. As you explore your options on vasectomy in Beverly Hills, you may have fears of medical complications, losing your libido, and the possibility of reversal or even having children in spite of the vasectomy procedure.

Types of Contraceptives

The many forms of contraception available show the need to explore the success rate of each as well as their pros and cons. Some choose to use contraceptives to control the number of children they wish to have and their spacing. Others opt for various forms of birth control to protect themselves from sexually transmitted infections, while others pick them for their ability to control their menstrual cycles. Regardless of their effectiveness, implications, and side effects, users and health care providers concur that these contraception methods bring peace of mind and independence, which all have a positive impact on one’s general well being.

Male Birth Control

Research is ongoing for various types of male birth control. While such studies progress, not much is getting to the public during these preliminary stages. The scant details that are available, however, indicate that new forms of male birth control involve contraceptive injections with a mix of hormones (e.g. testosterone and progesterone) or injecting a gel-like substance into the vas deferens to prevent sperms from passing.

Male birth control remains elusive as the old joke among contraceptive researchers points out: “Twenty years ago, the male contraceptive pill was just 10 years away!” Consequently, even with a male pill in the pipeline, men find themselves left with two main male birth control options: vasectomy procedure and condoms.

Vasectomy

Vasectomy is a male sterilization operation performed to prevent sperm from going to the penis or mixing with seminal fluids. It is typically an outpatient procedure because it is a minor operation. However, even after recovery, which takes about a week or so, it takes almost 12 weeks before the sperm count in the ejaculate drops to zero. In the meantime, alternative birth control methods must compliment this sterilization operation until your doctor confirms the zero sperm count and gives permission to stop using other contraceptives.

How Does a Vasectomy Work?

In the male reproductive system, the testicles produce sperm. The sperm then passes through the tube of vas deferens and make semen after mixing with seminal fluids. A vasectomy involves blocking the vas deferens so that the sperms coming from the testicles do not get to mix with the seminal fluid, which the penis ejaculates. With no sperm in the man’s ejaculate, conception cannot occur. There are various vasectomy procedures include clip vasectomy and no-needle, no scalpel vasectomy. For more information about the vasectomy procedure, please visit webmd.com.

Birth Control Methods

The Centers for Disease Control and Prevention (CDC) explain that the most successful way of reducing unplanned pregnancy among sexually active women is correct and consistent use of birth control. The CDC further classifies these methods as either reversible methods or permanent methods and further breaks them down to hormonal, barrier, and fertility awareness-based methods.

Hormonal Methods: The pill, the ring, birth control shots, implants, and the patch.

Barrier methods: The male and female condoms, cervical cap, diaphragm, the sponge, and various spermicides, according to experts.

Abstinence and natural family planning comprise the fertility awareness methods.

Irreversible methods or sterilization includes vasectomy, tubal ligation, and trans-cervical sterilization.

Vasectomy Recovery

Recovery from the operation takes less than a week. Some men complain of on-going pain in the groin and bruised or swollen testicles. However, this portion of the population go on to make a full recovery soon after with proper medical care. Many resume sexual activity within a week of the operation. Medical practitioners suggest using antibiotics, anti-inflammatory, and anti-bacterial medication to alleviate any pain and discomfort. On the other hand, the CDC established that approximately 11 out of 1,000 procedures will fail.

Ejaculation after Vasectomy

Planned Parenthood reports that with vasectomy procedure, four out of every 100 men report that they cannot have an erection. They insist that this decreased sexual desire and/or inability to have an erection is an emotional problem since vasectomy does NOT cause any physical reason for the lack of libido or loss of erections.

Vasectomy Complications

Vasectomy complications rarely arise. However, you should be keen to note signs of infection, such as fever, excessive pain and swelling, and pus or blood oozing from the wound. Other complications include sperm granuloma, where sperm forms a lump under the incision after leaking from the tubes. All of the complications clear up with proper medical attention.

Vasectomy Costs in California

Vasectomy costs vary depending on the hospital and doctor. You should confirm the fee and negotiate a payment structure with the clinic. In some instances, clinics calculate fees according to sliding income factor. Consult a qualified and approved doctor for a full quotation.

Most doctors in Los Angeles offer no-scalpel vasectomy as it is an affordable, simple, safe, and quick method with a quick recovery route.

In a Nutshell

• What is it? A “permanent” method of contraception for men, vasectomy involves ligating or blocking the vas deferens (tube that carries the sperm from testicles) on both sides and thus having no sperm in the ejaculate
• How is it done? Usually as an outpatient minor surgical procedure. Patients get to go home the same day.
• What is recovery like? No sexual activity and only light physical activity for a week, then may resume protected intercourse until cleared by your urologist to discontinue other contraceptive methods (after at least two semen analyses to make sure no sperm is seen in the semen).
• Complications? Usually minimal but may include failure, pain, infections, and psychological lack of libido (rare).

Vasectomy Reversal

In instances of severe pain or other complications, a good urologist may be able to reverse the operation. While this is rare, there are equally rare cases of the cut ends of the vas deferens growing back together within four months of the operation and resulting pregnancy. A man, however, may seek a reversal in order to have children.  With the successful reversal, fatherhood is possible within a year.

Schedule a Consultation with a Male Fertility Expert in LA

Although a vasectomy is a simple procedure, you need comfort and peace of mind. Consult with a qualified urologist for all your vasectomy concerns and questions. To ensure you get a safe and quick vasectomy procedure, contact Comprehensive Urology in Los Angeles by calling (310) 596-1409 for further information and to schedule an appointment.

Next, read Kidney Stones and How to Treat Them

The post What are the Advantages of a Vasectomy? appeared first on Comprehensive Urology.

Kidney Stones and How to Treat Them

Urinary tract stones affect approximately 1 in 11 people in the United States. They can be silent and without symptoms, or manifest with severe pain, nausea, etc. Kidney stones are among the top 10 causes of Emergency Department visits, and in fact are the most expensive one by far, compared to others. They are slightly more common in men, and can affect both sexes.

Incidence of kidney stones is rising and recent studies have shown that 10.6% of men and 7.1% of women are affected by kidney stones each year. This shows a significant increase compared to prior studies. Kidney stones can be made of calcium with other substances (about 70% of all stones), uric acid, or other chemicals.

In a nutshell:

• Kidney stones are a common cause of Emergency Department visits or can be incidentally discovered on imaging.
• If symptomatic, urinary stones can cause flank pain, bloody urine, nausea, vomiting, etc.
• Spontaneous passage: mainly influenced by size and location of the stone. More than half of stones smaller than 5 mm (one fifth of an inch) may pass. Certain medications can be used to increase the passage rate.
• Treatment: Kidney stone treatment has to be carefully chosen based on stone and patient factors. Most common procedures include shockwave lithotripsy (ESWL), ureteroscopy (URS) with laser lithotripsy, and percutaneous nephrolithotomy (PCNL).
• Prevention for most common type of stone (Calcium Oxalate): increased hydration (water), low salt diet, low animal protein intake, increase citrate intake (lime and lemmon juice), and low oxalate intake (spinach, kale, nuts, chocolate, strawberries, etc). Do NOT limit your calcium intake (take the recommended daily amounts for your age and gender).

Kidney Stone Symptoms:

Patients will experience no symptoms if they have stones in the kidney that are not obstructing the passage of urine. These stones can be discovered incidentally on imaging studies obtained for other purposes. They are silent and some never manifest with other symptoms, they may grow in size or remain stable, and some may relocate to a spot where they block the urine flow (i.e. in the ureter) and then cause different symptoms.

The symptoms usually include:

• Severe intermittent pain in the flank region (depending on location of stone the pain may be lower, or radiate to the genitalia or groin)
• Presence of blood in the urine
• Nausea and/or vomiting
• Passage of sand-like particles in the urine

If the obstructing stone picture is complicated by a concurrent urinary tract infection, then the patient usually feels very sick with fever, shaking chills, lightheadedness, and sometimes low blood pressure and shock. This situation is considered a medical emergency and needs to be treated right away by a Los Angeles urologist.

Some stones can silently obstruct the urine flow from the kidney and in some cases lead to loss of function of that kidney over a long period of time.

Urinary Stone Treatment Options:

There are multiple options available for treatment of kidney stones. A common question that patients may have is: “Will I pass my stone?” Spontaneous passage of urinary stones is influenced by many factors, most importantly the size of the stone (can be measured on CT scan) and its location, as well as individual patient anatomy. Usually stones smaller than 5 mm (about one fifth of an inch) have a greater than 50% chance of passage. Stones that are 7 mm or larger are less likely to pass.

In general the following treatment options are available for urinary stones:

Observation and trial of passage, with or without Medical Expulsive Therapy (MET, medications that are thought to help with the stone passage).

Dissolution Therapy: involves medications that will help change the urine acidity and dissolve the stone. This is only used for a certain type of stone (uric acid) and with variable success.

Extracorporeal Shockwave Lithotripsy (ESWL or “shockwave”): This is a non-invasive treatment which uses shock waves that are generated outside the body and focused on the stone to pulverize and break the stone, which then is passed by the patient as sand or small fragments in the urine. It works well for carefully selected stones / patients. Factors that influence this treatment include stone size, stone density (hardness), suitable body size (no too large), and the location of the stone in the urinary tract.

Ureteroscopy (URS): This is a commonly utilized and minimally invasive option, which does not involve any cuts or incisions on the skin. Different scopes are used to enter the urinary tract through the urethra and locater the stone, with patient under general anesthesia. Laser energy may be then used to fragment or pulverize the stone, and pieces are removed with special baskets that are inserted through the scope. Usually a “ureteral stent” is then left to prevent obstruction of the ureter due to swelling after surgery, and is removed about a week later in the office. This is an ideal method for small and medium stones that have not passed, or did not respond to above treatments.

Percutaneous Nephrolithotomy (PCNL): Usually reserved for larger stones or multiple stones affecting the kidney, this procedure involves a very small incision (about half inch) on the back and establishment of a tract into the kidney. Special scopes and devises are then used to bread the stone(s) and remove them. After this procedure usually a “ureteral stent” is placed. Some patients will have a temporary drainage tube in their back. “Tubeless PCNL” does not require the latter and we close the back incision with a stitch.

Pyelolithotomy: Whether done with open surgery or robotic/laparoscopic method, this procedure is rarely performed nowadays and usually reserved for special circumstances. It involves cutting the collecting system of the kidney open and removing the stones.

Is it Possible to Prevent Stones?

Prevention of stone recurrence or progression is a very important aspect of managing Los Angeles patients with recurrent kidney stones, and has to be tailored to the patient situation and stone type. In general for most common type of stones (e.g. Calcium Oxalate stones) some simplified preventive measures include:

• Increased hydration (drinking water regularly and having sufficient urine output everyday)
• Low sodium (salt) intake
• Low animal protein intake (usually about 6-8 oz per day)
• High citric acid (citrate) intake: can be preventive for new stones and slow the growth of existing ones
• We do NOT recommend limiting calcium intake beyond the recommended daily allowance for each patient
• Low oxalate intake (oxalate can be found in spinach, kale, nuts, strawberries, chocolate, etc).

Contact the Urologists at Comprehensive Urology in Los Angeles

If you or someone you care about is suffering from kidney stones, get in touch with the kidney stone specialists at Comprehensive Urology in Los Angeles. Dr. Arash Akhavein is a recognized expert in urinary stone surgery and minimally invasive endo-urological procedures. He joins us from the Cleveland Clinic, and brings his specialized expertise to Southern California.

Dr. Akhavein and his colleagues offer thorough counseling as well as all of the available treatment options for kidney stones. Our team can provide the necessary workup and carefully chosen treatment for stone disease and related issues to you or your loved ones.

Call 310-341-2557 today to schedule an appointment or contact us online.

Next, read How This Unknown Cause of Male Infertility Could Be Affecting You

The post Kidney Stones and How to Treat Them appeared first on Comprehensive Urology.

How to Manage Benign Prostatic Hyperplasia

As men get older, the likelihood of developing a condition called benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, increases. In fact, the majority of men will experience one or more of the symptoms of prostate enlargement (BPH) at some point in their 60s and older. Benign prostatic hyperplasia refers to the gradual enlargement of the prostate gland, which can eventually compress the urethra (urine channel) and lead to a variety of uncomfortable symptoms, such as urinary hesitancy or slow urine flow. While it is possible for most men to manage the symptoms with conservative methods, such as medication, some men may require a form of surgical treatment for this condition.

If you or a loved one has been experiencing the symptoms of BPH, it is crucial to seek an accurate diagnosis as soon as possible in order to not only receive effective treatment and improve the quality of life but to also rule out the possibility of prostate cancer. The skilled urologists at Comprehensive Urology in Los Angeles are renowned leaders when it comes to benign prostatic hyperplasia treatment. Please contact us at (310) 499-2756 today to schedule an appointment today.

BPH Symptoms

Fortunately, many men with BPH do not have noticeable symptoms regardless of the extent of their prostate enlargement. Some men may experience the symptoms more often during cold weather or when stressed, and others may suffer severe symptoms from only the slightest enlargement. It is important to seek a diagnosis from a board-certified urologist if you or a loved one has one or more of the following BPH symptoms:

• Weak urine flow
• Straining to urinate
• Difficulty starting urination
• Painful urination
• Dribbling after urinating
• Feeling that the bladder does not empty completely
• Frequent need to urinate, especially at night
• Urinary urgency
• Leakage of urine
• Blood in urine
• Erectile dysfunction

If left untreated, BPH can lead to more serious urinary issues, such as recurrent urinary tract infections, obstruction of the kidneys, and kidney failure. Contact Comprehensive Urology for a thorough diagnosis. Urinary issues do not automatically indicate BPH and a board-certified BPH specialist can help determine the best course of action based on each patient’s unique health and circumstances.

To learn more about BPH and BPH treatment, please visit wikipedia.org.

Benign Prostatic Hyperplasia Treatments

In many cases, benign prostatic hyperplasia is characterized by bladder dysfunction, such as difficulty urinating or storing urine. Depending on the symptoms and the patient’s health, Dr. Kia Michel Michel and his Comprehensive Urology team in Los Angeles can create a personalized treatment plan for each patient depending on the symptoms as well as the patient’s age and overall health.

Many patients respond well to the following conservative methods:

Medication – Different groups of medications are available: Alpha Blockers, 5 Alpha Reductase Inhibitors, and recently daily PDE5 Inhibitors. These medications can mitigate, reduce or block prostate enlargement in order to relieve urinary symptoms, with relatively low side effect profiles.

Pelvic Floor Rehabilitation – Strengthening the pelvic floor muscles with physical therapy as well as electrostimulation can help alleviate urinary issues caused by BPH.

In the event that benign prostatic hyperplasia medications or other conservative BPH treatments are ineffective, the following surgical options may be recommended.

Trans-urethral Microwave Therapy (TUMT) – This non-surgical BPH treatment uses microwave energy to shrink the prostate, allowing the urethra to open to its original size within eight to 12 weeks after the procedure.

The UroLift System – This revolutionary BPH treatment is minimally invasive and provides permanent results. Small implants are placed around the prostate and stitched into place to hold open the urethra for normal urinary function. The procedure is highly effective and patients can return to their everyday activities in a matter of days.

The Rezum system ®– This cutting-edge BPH treatment is the newest weapon in our arsenal for treating BPH. This is a minimally invasive procedure which can be done in the office. You urologist will perform this through the urethra (no incisions) and use direct injection of water vapor (steam) into the enlarged, obstructing parts of the gland, allowing cell death by convective heat energy and natural absorption by your body.

Transurethral Resection of the Prostate (TURP) – This surgical procedure is recommended when medication and conservative treatments have failed. TURP involves removing all or part of the enlarged prostate gland with a resectoscope, which is inserted through the urethra (no external cuts or incisions). The middle portion of the prostate is typically removed to help widen the urethra channel and allow for normal urine function. TURP may be used to treat BPH and sometimes prostate cancer.

Photoselective Vaporization of the Prostate (PVP) – This is also known as the Green Light Laser® therapy and is recommended when medications have failed. In this procedure which is done through the urethra (similar to TURP), a powerful green laser beam is used to vaporize the excess BPH tissue. The enlarged parts of the gland are targeted and vaporized by the surgeon, thus creating an open channel for the urine to flow easily. PVP has the advantage of minimal bleeding and can be done for patients who are taking blood thinners.

Robotic Simple Prostatectomy – Often recommended for patients with very large prostates, a robotic simple prostatectomy involves removing the entire prostate. The procedure is conducted with the da Vinci surgical robotic system, which requires much smaller incisions than traditional open prostatectomy, reducing the risks of bleeding and infections, as well as greatly improving recovery times.

The best BPH treatment will depend largely on the patient, however, it is crucial to have a skilled urologist and medical team on your side to diagnose an enlarged prostate and provide the most comprehensive care and treatment available.

In a Nutshell

What you should know about BPH treatment:

• BPH: Benign enlargement of the prostate gland can cause many urination problems
• Symptoms: Weak urine stream, dribbling, need to push too much to urinate, need to urinate too often and urgency to do so, waking up multiple times at night to urinate, etc.
• Evaluation: Visit your urologist and discuss your symptoms, how they affect your life, and undergo simple office tests (e.g. Uroflow to measure your stream, Ultrasound to assess bladder emptying, Urine analysis, etc)
• Treatment: Many BPH treatment options are available based on your goals and condition. Non-invasive (lifestyle tips, medication, etc.), minimally invasive (TUMT, Urolift, Rezum, TURP, PVP, etc.), and other surgical treatments are all offered by Comprehensive Urology.

Contact the Urologists at Comprehensive Urology in Los Angeles

If you or someone you care about is suffering the symptoms of BPH, get in touch with the prostate condition specialists at Comprehensive Urology in Los Angeles.  Our team can provide screening and treatment for BPH and other prostate issues.

Call 310-341-2557 today to schedule an appointment or contact us online.

Next, read The Biggest Trends in Urology for 2016

The post How to Manage Benign Prostatic Hyperplasia appeared first on Comprehensive Urology.

For Colon Cancer with Liver Metastisis, Immunotherapy Combined with RFA May Benefit Patients

Researchers at the University of Pittsburgh found that radiofrequency ablation (RFA) combined with an immune checkpoint inhibitor resulted in a stronger antitumor immunity with extended survival in human samples of primary colon tumor with liver metastasis and mice models of the disease.

The findings, titled “PD-1 Blockade Boosts Radiofrequency Ablation–Elicited Adaptive Immune Responses against Tumor,“ were published in Clinical Cancer Research , a journal of the American Association for Cancer Research.

Colorectal cancer is a disease causing abnormal growth of cells found in the lining of the colon or rectum, largely as a result of genetic mutations. The spread of the tumor cells to other parts of the body, mostly to the liver, is called metastasis of colorectal cancer.

“Liver is the most common site of colorectal cancer metastasis, and about 20 percent of colorectal cancer patients have liver metastases at the time of diagnosis [synchronous liver metastases],” Binfeng Lu, Ph.D., an associate professor in the Department of Immunology at the University of Pittsburgh, said in a press release.

After colorectal cancer patients are diagnosed with liver metastasis, the best alternative treatment to surgery is RFA, especially for patients with smaller size liver nodules. The procedure uses imaging guidance to position a needle electrode through the skin into the liver tumor, where medium frequency alternating currents (350–500 kHz) pass through the electrode to induce heat that destroys tumor cells. However, RFA has little effect in stopping cancer from progressing, so researchers have investigated the immune-suppressive mechanisms limiting the efficiency of RFA.

Read the full article here: https://coloncancernewstoday.com/2016/03/28/adding-immunotherapy-to-rfa-may-benefit-colorectal-cancer-patients-with-liver-metastasis/