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.