Surgeries & Procedures
Cystometry is a test that evaluates the pressure within the bladder. It is performed on individuals experiencing difficulties with holding or releasing urine, which may have occurred as a result of muscle or nerve problems. Before undergoing cystometry, notify your doctor all of medications you are currently taking, if you are or may be pregnant, or if you have any symptoms of a urinary tract infection. No preparation is necessary for this test, which usually takes about 30 to 60 minutes.
At the beginning of your cystometry, you will be asked to urinate into a uroflowmeter, which will create a detailed report on how long it takes for your bladder to empty, how much urine is released, and other related information. For the next stage of the test, you will be lying down on your back on an examination table, and your technician will clean your urethra and insert a catheter to measure and drain any urine remaining in your bladder. Then, your bladder will be filled with room-temperature water; this time, the catheter will contain a cystometer, which measures bladder pressure and capacity. Each time a catheter is inserted, you will be asked to mention when you first feel the urge to urinate, and then when you absolutely must urinate; at this point, you will either be asked to urinate, or your bladder will be drained through the catheter. After your bladder has been emptied, the catheter is removed and you may resume day-to-day activities.
If conservative treatments for benign prostatic hyperplasia (BPH) and troubling urinary symptoms have been unsuccessful, a minimally invasive procedure using a GreenLight™ laser may be an option to improve urine flow. GreenLight laser therapy is an effective and low-risk procedure that uses high power laser energy to remove the enlarged prostate tissue that is obstructing urine flow.
During the GreenLight laser procedure, the patient is sedated under anesthesia. The surgeon inserts a scope with a special camera through the penis into the urethra, prostate and bladder. The GreenLight laser fiber is then passed through the scope. The GreenLight laser vaporizes the targeted prostate tissue, clearing the passage to improve the flow of urine. In addition, the GreenLight laser seals the surrounding blood vessels within the area, which results in significantly less bleeding than traditional surgical methods that treat prostate problems. When the procedure has been completed, a catheter is temporarily placed in the bladder to drain urine for about 24 hours. After the procedure, patients may experience mild discomfort which can be managed with anti-inflammatory medication. Most patients can resume normal activities within a few days and experience significant urinary symptom relief within 1 to 2 days after the surgery.
Renal fusion, commonly known as horseshoe kidney, involves a fusion of the kidneys that occurs during fetal development, forming a "U" shape similar to a horseshoe. This condition may occur on its own or in combination with other disorders such as Turner syndrome and Trisomy 18, which are both genetic disorders.
Patients with a horseshoe kidney may experience pain, nausea, kidney stones and urinary tract infections. There is a low risk of developing cancerous kidney tumors associated with this condition as well. Patients with a kidney tumor may experience blood in the urine and flank pain, and should seek immediate medical attention. Some patients with horseshoe kidney may not experience any symptoms at all and may not even be aware that they have this condition.
For horseshoe kidneys that do not cause any symptoms, treatment may not be needed. Others may require treatment to relieve symptoms, but this condition can never be fully cured. Treatment for symptoms caused by horseshoe kidney may include antibiotics to treat an infection or surgery to remove kidney stones.
Benign prostatic hyperplasia (BPH) is a form of prostate disease that causes the prostate gland to enlarge and press against the urethra, causing problems with urination. If conservative treatment for BPH is unsuccessful, a surgical procedure known as the Holmium laser enucleation of the prostate (HoLEP), may be an option to improve urine flow. HoLEP is an effective and minimally invasive procedure that uses a high energy laser to remove the portion of the prostate gland that is obstructing urine flow.
During the HoLEP procedure, the patient is sedated under anesthesia and the surgeon inserts an instrument called a resectoscope through the penis into the urethra. A laser is then inserted through the resectoscope and directed at the prostate. The laser emits high energy pulses that cut the excess tissue that is obstructing the urethra. The tissue is then removed from the prostate and may be sent to a lab for examination. A catheter is temporarily placed in the bladder to drain urine. Patients may experience minimal bleeding after the procedure and may stay in the hospital for 1 to 2 days. Full recovery may take up to 2 weeks and most patients find significant relief from troubling urinary symptoms within a few weeks after the HoLEP procedure.
New Strategies for Your Overactive Bladder
The field of neuromodulation is based on an advanced understanding of the complicated neural pathways that affect bladder function. Two new and exciting treatments are available for patients who have had unsuccessful results with medications, patients who want to avoid medications, and those who like to avoid complicated surgeries.
This technology is a minimally invasive, office-based procedure with impressive published results for well-selected patients. In the comfort of the office and with no drugs or incisions, your peripheral nerves are stimulated to trigger a feedback mechanism that slowly retrains the bladder to a better function and pattern. Most insurance plans will cover this painless, very well-tolerated procedure. If you have undergone failed therapies for frequency, urgency and urge incontinence, you are an ideal candidate for this treatment.
Come in for a comprehensive consultation on this unique treatment option.
Sacral Root (Neurostim)
Just like we can pace the heart with a pacemaker, it is possible to influence and “pace” your bladder with a small yet effective device implanted under your skin.
The pacemaker is easy to implant and easy to adjust to your electrophysiological demands. This is an ideal choice for motivated patients that have failed with physical and pharmacological therapies.
Most patients with resistant and severe overactive bladders have wandered from physician to physician, therapy to therapy and drug after drug in a frustrating attempt to find improvement for their condition.
While we cannot promise 100% success for everyone, we can guarantee you these treatments are unlike any others you have tried before and may be the answer you have been searching for!