Dr.Khaled
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Should I Consider Minimally Invasive Treatments?

As men get older, the prostate gland naturally enlarges, leading to urinary symptoms and discomfort.

Traditionally, treatment options for BPH have often been limited to surgery or medication, but recent advancements in medical technology have opened the door for less invasive yet highly effective treatment options.

In this article, we will explore minimally invasive surgical therapies, more commonly known as MIST, to help you answer a very common question – should you consider getting a minimally invasive treatment to alleviate your BPH symptoms?

What is MIST?

Firstly, let’s begin by breaking down exactly what MIST is. Minimally invasive surgical therapies (MIST) for benign prostatic hyperplasia (BPH) are procedures that can be done without general anesthesia or a hospital stay.

These minimally invasive procedures have minimal downtime, are outpatient procedures, and do not always require patients to wear a catheter post-procedure. Patients who undergo these treatments are able to return to their daily activities within a few days after the procedure.

They relieve patients of BPH symptoms without the use of medications or permanent implants, and allow patients to experience symptom relief within two weeks.

Benefits of Minimally Invasive Therapies

So, what are the benefits to getting a minimally invasive procedure? Well, there are quite a few, including the following:

  • The procedures have minimal downtime. The main difference between MIST treatments and other BPH treatments is that they are minimally invasive with minimal downtime. Patients do not have to spend time in the hospital, or take significant time off. Instead, they are able to return to their regular activities within a couple of days.
  • They preserve sexual function. MIST treatments can preserve sexual function. They do not generally produce sexual side effects, nor do they interfere with patients’ ability to perform during intercourse. Patients have reported that these treatments do not cause erectile or ejaculatory dysfunction that may arise with other BPH treatments.
  • They are non-invasive and drug-free. MIST treatments relieve symptoms of BPH safely and effectively, without requiring patients to take any medications or have any permanent implants. Patients generally experience symptom relief within just two weeks after the procedure.

Am I a Candidate for MIST?

After learning more about these procedures, you may be asking yourself – am I a candidate for a minimally invasive procedure?

Well, MIST therapies are typically suited for men that do not want to take any medication for their BPH symptoms on an ongoing basis, or have had a previous bad experience with medication. It is also recommended for men that do not wish to undergo the risks of a standard surgical intervention.

If satisfactory treatment results can be obtained with a MIST option, then this is usually the preferable option to avoid the risks and side effects of surgery or medication.

BPH

BPH: Myths vs. Facts

BPH: Myths vs. Facts

Navigating the misconceptions and uncertainties surrounding Benign Prostatic Hyperplasia (BPH) can be quite difficult. As a common condition affecting men, BPH often finds itself entangled in myths that can hinder an accurate understanding and timely intervention.

Here, we aim to unravel the truths surrounding BPH, distinguishing between myths and facts. We will debunk common misconceptions and gain a clearer understanding of this aspect of men’s health.

MYTH: Having BPH Automatically Means You Have Cancer

This is probably the most common myth that circulates the issue of BPH. No, having BPH does not automatically mean that you have cancer. While BPH and prostate cancer do share some similar symptoms, they are completely distinct conditions.

BPH is a non-cancerous condition that commonly occurs in aging men, and involves the enlargement of the prostate gland. Prostate cancer, on the other hand, is a malignant growth of cells in the prostate gland. It is important not to jump to conclusions, as many men with BPH do not develop prostate cancer.

MYTH: A Larger Prostate Causes Worse Symptoms

Once again, this is a myth. Having a larger prostate does not necessarily mean that you will have worse symptoms. While a larger prostate does not guarantee issues, a smaller one does not guarantee avoiding treatment.

When it comes to BPH symptoms, what matters is not the size of the prostate, but rather what is happening inside of it. If a doctor feels a large prostate during a rectal exam, it does not automatically mean there is an obstruction inside.

FACT: BPH is Extremely Common in Men

Yes, it is true that BPH is a common condition in men, particularly as they age. The prostate naturally grows larger as men get older, and this enlargement can lead to various urinary symptoms.

In fact, the prevalence of BPH increases with age, and it is estimated that about 50% of men aged 51 to 60 have some degree of prostate enlargement. By the age of 80, around 80% of men may experience symptoms of BPH. While BPH is common, not all men with an enlarged prostate will necessarily develop significant symptoms.

FACT: BPH Can Cause Other Serious Issues

While BPH itself is not considered a serious or life threatening condition, it can lead to complications and affect a person’s quality of life. BPH can lead to incomplete emptying of the bladder, increasing the risk of urinary tract infections (UTIs). Additionally, the inability to completely empty the bladder may result in the formation of bladder stones.

In some cases, BPH can cause a sudden and complete inability to urinate, leading to a medical emergency known as acute urinary retention. Severe cases of BPH, if left untreated, may lead to chronic kidney problems due to urinary retention and backflow of urine into the kidneys.

Urology

Get Rid Of Kidney Stones With Scarless Laser Treatment

Get Rid Of Kidney Stones With Scarless Laser Treatment

Retrograde Intrarenal Surgery (RIRS) is an endoscopic surgery performed to remove renal stones. The procedure is done using a flexible ureteroscope, which is placed through the urethra (the urinary opening) into the bladder and then through the ureter into the kidney (intrarenal area). Through this device, a laser fiber (Holmium laser) is used to treat the stones.

How Kidney Stones Are Treated With RIRS?

The ureteroscope has a small camera fitted at its end which is used to inspect the kidney stones. A monitor screen present in the surgery room displays the entire anatomy of the patient’s kidney captured by the ureteroscope. Through an ultrasound wave or a laser probe, the stones are crushed into fine powder or pieces. These fine pieces can pass easily through the urination process.

What Are The Advantages Of RIRS Over Older Techniques Like PCNL (Key Hole Surgery)?

RIRS is definitely less invasive than older techniques like PCNL, laparoscopic or open surgery as it is completely scarless. Because we enter the kidney passing through normal urinary tract and there is no need to make any cuts on skin or hole into the kidney (as in PCNL), there is lesser risk of severe bleeding, hospital stay is very short (daycare surgery in most cases), there is markedly shorter period of recovery and patient can very soon get back to his normal routine.

Who Can Perform RIRS?

RIRS is performed by a urologist (endourologist) with special expertise in RIRS.

What Is The Advantage Of Using A High Power Laser In RIRS?

The best outcome for patients can be given with the use of High power laser. Stone clearance in patients with kidney stones up to 4 cm (staghorn stones) can also be possible only with a high power holmium laser.

Is A Stent Required To Be Placed After RIRS? Is It A Permanent Stent?

Yes, like any other kidney stone surgery, a double J stent is placed in the ureter in most cases of RIRS. The purpose of Double J stent is to keep the ureter open while the laser fragments of stone are washed out and it also decreases the risk of ureteric stricture formation after any intervention. No, Double J stent is only kept temporarily for 2 to 4 weeks and then removed through urethra endoscopically which is a short procedure and the patient can go home the same day after getting it removed.

Can RIRS Be Used To Treat Other Diseases Apart From Kidney Stones?

Yes, RIRS can be used to treat blockages in the ureter (Strictures/PUJ obstruction), Ureteric and collecting system tumors (for diagnosis as well as treatment).

RIRS is the future of stone surgery. It does require a reasonable amount of experience to master the technique of RIRS but it is immensely beneficial to the patient. At Sarvodaya Hospital, we have a specialized Institute of Laser Urological Surgery equipped with the latest technology and highly advanced Holmium Laser machine to treat several types of complicated kidney stone cases. A patient coming to the hospital with a kidney stone today can walk out of the hospital after surgery the next day itself and soon return to work. The patient has to take a lesser number of days off from work after surgery.

Urology

Kidney Stones Treatment

Kidney Stones Treatment

Because kidney stones are a common disease, it is natural to seek effective remedies for these vexing stones.

Of course, there are numerous methods for treating kidney stones. And none of us wants to be sorry later for choosing the ‘insufficient’ solution for any condition.

When someone wants to get rid of a painful problem to avoid subsequent complications, picking a treatment option that is both painful and potentially dangerous is not a good decision.

A successful kidney stone treatment must be both safe and effective. The current kidney stone operation with laser accomplishes the intended result.

Meaning Of Laser Lithotripsy

Short and powerful infrared light pulses are used in laser lithotripsy. When employed correctly, these pulses are so powerful that they can shatter any type of stone into small bits. The same method is used in laser lithotripsy to remove kidney stones, in which the stones in the kidney are shattered into tiny pieces and expelled through urine.

It is a painless normal operation, and the patient can recover quickly as opposed to conventional and traditional forms of surgery that are not only difficult but also take time to assist people in recovering.

Advantages of ureteroscopy compared to other stone treatments

  • Flexible ureteroscopy has the advantage of allowing entrance into all sections of the kidney if the kidney stones are of acceptable size and position. As long as the ureter is large enough to allow the ureteroscope to pass through, the stone may be shattered and removed in a single surgery.
  • Unlike SWL, a kidney or ureteral stone can be viewed directly by the ureteroscope, allowing laser lithotripsy followed by basketing and removal. Patients are requested to pass stone particles themselves during shock wave lithotripsy, which may cause further pain or obstruction. Furthermore, shock wave lithotripsy may not break up extremely dense, hard stones (termed SWL-resistant stones). If the stone is visible to the ureteroscope, ureteroscopy with a contact holmium laser can break it up. Furthermore, ureteroscopy can treat stones not visible on standard x-ray (“acid” stones).
  • Unlike percutaneous procedures, the ureteroscope is passed through natural bodily orifices and does not require any skin incisions. It is an outpatient surgery, whereas PCNL necessitates at least an overnight stay in the hospital. Certain patient groups that cannot be treated with ESWL or PCNL (such as those on blood thinners, pregnant women, the extremely obese, and airline pilots/astronauts) can be safely and efficiently treated using ureteroscopy.

Things that happen on surgery day

Before treating kidney stones with laser, your surgeon will advise you on handling your medications and food. Most laser kidney stone treatments are outpatient procedures, so you can go home the same day.

You will be sedated during the procedure because you will be under general anesthesia. It ensures that you remain still while the small instruments are within your body. Newer lasers are more precise and powerful, making it easier for surgeons to control and break the stone. It shortens the duration of your procedure, allowing you to sleep less and return to your daily routine sooner.

Feeling after surgery

After laser surgery, you may still feel pain. If you have a stent between your kidney and ureter, the stent is likely to be the source of your pain because it can rub on your kidney or bladder. It can also make you feel the need to urinate, and it may cause some blood in your urine. Men may also have pain in the penis or testicles.

Following surgery, your doctor will prescribe medications. They may generally include an antibiotic to prevent infection, pain relievers, and medication to ease bladder spasms and burns during urination.

Drink plenty of water to keep the stent lubricated and any tiny stones out of the kidney. You may probably need to urinate more frequently, so have a restroom nearby.

You can return to your normal activities the next day or as soon as you feel comfortable. High-intensity exercise should be avoided until your stent is removed. Some pain relievers prohibit activities such as driving, so read the label carefully. Additional guidelines will be provided by your doctor.

Follow-up care is required

After surgery, you will see your surgeon or his assistants about a week later. If you have a stent, it will be removed using a little illuminated instrument at this point (cystoscope). It is done again through your bladder and can be done while awake in the office. If your surgeon believes it will aid in healing, the stent may be left in place for a longer period. The stent can remain in place for up to three months, so don’t be concerned if your stent removal is delayed. The stent must be removed, so don’t forget to schedule your post-surgery check-up.

The surgeon will have sent one of your kidney stones for analysis after removing them. Your doctor will advise you on how to avoid future kidney stones based on the stone’s makeup. The doctor may also offer recommendations based on urine analysis. For example, the doctor may advise you to make dietary modifications or to take supplements or drugs.

Because kidney stones are a chronic condition, they may reoccur at some point in the future. You now understand the symptoms and that effective remedies are accessible. Follow your urologist’s advice to help prevent additional kidney stones, and don’t hesitate to call if symptoms return.

Complications & Risks

Ureteroscopy with laser lithotripsy is a safe and effective therapy with a quick recovery. As a result, there are no dangers or difficulties linked with the operation. However, unusual side effects include nausea and a brief period of bleeding.

Conclusion

Kidney stones can surely be excruciatingly painful and make your life miserable. Having them operated on with standard treatments takes time to cure, and recovery is also slow. Fortunately, we can now treat kidney stones with ureteroscopy and laser lithotripsy. The risks are minor, and the patient heals rapidly with no significant side effects. The entire treatment is risk-free and takes anything from 10 minutes to an hour, depending on the severity of the operation.

If you have kidney stones for an extended period, you should consult a doctor about advanced laser treatment. It is unquestionably the best option for dealing with the stones ruining your life.

Penile Implants

What You Need to Know About Penile Implants Surgery

What Are Penile Implants?

Erectile dysfunction can affect any man at any age. There are various treatment options like medications, pills, testosterone treatment, and injections. But some of those treatments may not work for some men. Some doctors might recommend getting a penile Implant. There are two types of penile implant procedures that can help with different problems. One is inflatable, and one is non-inflatable. The purpose is to help with erectile dysfunction and with transgenders. Sometimes it’s used to help reconstruct a penis, if necessary. Here, Happy Urology will discuss penile implants surgery, from how it works to how much it costs.  

How Does a Penile Implant Work?

Penile implants work to help maintain an erection or to help with cosmetic effects. The main two types are inflatable implants and non-inflatable. An inflatable penile implant consists of two cylinders and a pump. The two cylinders are placed in the penis, and the pump is in the scrotum. To achieve an erection, the person will squeeze the pump and the cylinders by filling them with saline solution. The non-inflatable implant has a surgeon implanting two flexible rods into the penis. The rods don’t change in size or stiffness. The implants are always semi-rigid, causing the penis to feel the same way. But people can move it into any position they want.  

Life With Implants?

After the procedure, it will take about 4-6 weeks to recover from penile implant surgery. People with both implants have high satisfaction with the results after the procedure. Some people report not having any loss of sensation during intercourse. Ejaculation was not affected after surgery. The implant leaves a small surgical scar that most people cannot see. When wearing clothes, the implants are not noticeable, so you can feel confident wearing the clothes you want. In most cases, the penile implant can last between 15 and 20 years.

How Much Does the Implant Cost?

The penile implant can cost around $14,000 dollars or more. Some insurance companies will cover the cost if it’s for erectile dysfunction. The majority of health insurance companies, however, do not cover penile implant surgery, and it will come out of the patient’s pocket. Some doctors offer a payment package pricing and give some discounts to patients.

Success Rate

No surgery is entirely free of complications, though about 90% of penile implant surgeries are successful. Some of the risks are.

  • Infection
  • Scar tissue
  • Pump failure
  • Fluid not properly draining

 

The majority of the complications can be fixed with additional surgery. The implant is still a mechanical device, so it has the risk of breaking. If any complications arise, contact your doctor immediately.

Happy Urology

If you are experiencing erectile dysfunction and have tried many different treatment options, contact Happy Urology for a consultation or to learn more about penile implants surgery. We will help you with any questions or concerns about penile Implants or erectile dysfunction medication. We also offer many different urological services for your needs.

Green laser vaporization for the prostate

Green laser vaporization for the prostate

Why it's done?

Prostate laser surgery helps reduce urinary symptoms caused by BPH, including:

Frequent, urgent need to urinate
Difficulty starting urination
Slow (prolonged) urination
Increased frequency of urination at night
Stopping and starting again while urinating
The feeling you can't completely empty your bladder
Urinary tract infections

Laser surgery might also be done to treat or prevent complications due to blocked urine flow, such as:

Recurring urinary tract infections
Kidney or bladder damage
Inability to control urination or an inability to urinate at all
Bladder stones
Blood in your urine

Laser surgery can offer several advantages over other methods of treating BPH. It can take several weeks to months to see noticeable improvement with medications. 

Improvements in urinary symptoms from laser surgery are noticeable right away. The advantages over traditional surgery, such as transurethral resection of the prostate (TURP) and open prostatectomy, can include:

Lower risk of bleeding. 

Laser surgery can be a good option for men who take medication to thin their blood or who have a bleeding disorder that doesn't allow their blood to clot normally.

Shorter or no hospital stay. 

Laser surgery can be done on an outpatient basis or with just an overnight hospital stay.
Quicker recovery. 

Recovery from laser surgery generally takes less time than recovery from TURP or open surgery.

Less need for a catheter. 

Procedures to treat an enlarged prostate generally require use of a tube (catheter) to drain urine from the bladder after surgery. With laser surgery, a catheter is generally needed for less than 24 hours.