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Male & Female Urinary Problem Treatments

Male & Female Urinary Problem Treatments

Temple urologists are highly experienced in treating male and female urinary problems. Depending on the type and severity of the condition, one or more of the following treatments may be used:

Medical therapy

Medications can effectively treat most male and female urinary problems, offering relief from daily symptoms without the need for surgery. Most conditions can be treated with a variety of drugs, either alone or in combination. Temple's urologists are highly experienced in choosing the right medications by considering the unique needs of each patient.

For overactive bladder, popular medical therapies include:

  • Detrol
  • Ditropan
  • Oxytrol (a skin patch)
  • Sanctura
  • Vesicare
  • Enablex

For stress incontinence, effective medications include:

  • The drugs listed above for overactive bladder
  • Imipramine - a tricyclic antidepressant that increases the strength of the urethral sphincter
  • Estrogen therapy - can improve the frequency of urination, decrease urgency and resolve any sensations of burning in women. However, it is unclear if estrogen improves stress incontinence directly.

For bladder or urinary tract infections, oral antibiotics will resolve the infection and prevent bacteria from spreading to the kidneys. Women with infections will usually take antibiotics for three days, while men will take them for one to two weeks.

For BPH (enlarged prostates), there are currently two classes of effective drugs:

  • Alpha-andrenergic receptor blockers (Hytrin, Cardura and Flomax) relax the muscles and blood vessels within the prostate and bladder, potentially increasing urinary flow and decreasing urinary frequency.
  • 5-alpha reductase inhibitors (Proscar) prevent the chemical conversion of testosterone within the prostate, thereby shrinking the prostate and easing BPH symptoms.

For neurogenic bladder, possible medical therapies include:

  • Estrogen derivatives
  • Anticholinergic drugs for inhibiting involuntary bladder contractions
  • Antispasmodic drugs to prevent bladder spasms
  • Tryicyclic antidepressants

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

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Comprehensive urodynamic testing of the bladder

Urodynamic testing measures how well the bladder and urethra can hold and discharge urine. These tests allow Temple's urologists to diagnose the root cause of many common male and female urinary complaints, including:

  • Frequent urination
  • Sudden, intense urge to urinate
  • Incontinence
  • Slow-to-start urination
  • Painful urination
  • Recurring infections of the urinary tract
  • Inability to completely empty the bladder

Urodynamic testing is usually performed on men with enlarged prostates and women with difficult-to-treat incontinence. Most tests take about 30 minutes. They generally involve filling the patient's bladder with fluid and then measuring how the bladder and urethral sphincter muscles react. The specifics of the test depend on the nature of the patient's urinary problem.

Some common urodynamic tests include:

  • Free uroflowmetry: this test measures the speed at which patients can completely empty their bladder. Free uroflowmetry can pinpoint the underlying causes of voiding dysfunction, such as urinary obstructions or weakness of the bladder muscle.
  • Pressure uroflowmetry: this test expands on free uroflowmetry by adding a measurement of bladder and rectal pressure for increased diagnostic capability.
  • Multichannel cystometry: this test uses two separate catheters to measure bladder and rectal pressure independently. It can detect contractions of the bladder wall that often lead to urinary problems. It can also diagnose general stress incontinence by gauging the strength of the urethra.
  • Post-void residual volume: this test measures the volume of urine that patients can discharge. High volumes (about 180 ml or greater) can indicate a urinary tract infection or overflow incontinence.

Other tests may include:

  • Microscopic examination of urine to detect infections
  • Urethral pressure profilometry to measure the strength of the urethral sphincter
  • Video X-ray (fluoroscopy) of the bladder and bladder neck while urinating
  • Measurement of electrical activity in the bladder neck using electromyography
  • Assessment of urethral tightness

Urodynamic testing is the first step toward diagnosing and treating troublesome urinary problems. Temple's urologists are highly experienced in the full range of urodynamic tests.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

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Neural stimulation for bladder disorders

Neural stimulation is a treatment for urinary problems that do not respond to medications and/or lifestyle changes, using electrical currents to trigger the nerves of the bladder. This stimulation can resolve common symptoms of an overactive bladder, including urge incontinence, urinary urgency and frequent urination. Neural stimulation can also treat nonobstructive urinary retention, a condition in which patients require a catheter to urinate and can only produce a small amount of urine despite considerable effort.

To perform neural stimulation, a Temple urologist implants a neurotransmitter device under the skin of the patient's upper buttock. The device emits mild electrical impulses that activate the bladder sphincter and pelvic floor muscles.

Installing the neurotransmitter is a two-step process. First, in a simple 30-to-45 minute outpatient procedure, a Temple urologist will implant a short-term trial device. After a one-to-two week trial period, patients return to their urologist to receive a long-term device. Installing the long-term device is an outpatient procedure that lasts about 15 minutes. Since the neurotransmitters run on batteries, patients must return to their urologist every three to five years to receive a replacement device.

Neural stimulation can eliminate or significantly reduce urinary problems in patients with bladder disorders. Temple's urologists are highly experienced in selecting the right device for each patient and implanting them quickly and safely.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

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Advanced surgical treatments for overactive and neurogenic bladders

Temple's urologists offer bladder surgery as a last resort for patients with overactive or neurogenic bladders that have not responded to other treatments.

Patients with overactive bladders experience frequent urges to urinate, lose control of bladder function and/ or retain urine due to bladder contractions and spasms. Patients with neurogenic bladders experience similar symptoms due to a brain or nerve condition, such as stroke, Parkinson's, or multiple sclerosis.

There are two main types of bladder surgery, bladder augmentation and bladder reconstruction.

Bladder augmentation is a surgical procedure that increases the size of the bladder using tissue transplanted from the patient's intestines or stomach. After surgery, the enlarged bladder is able to hold a greater amount of urine, thereby decreasing the urge to urinate and possibly preventing future incontinence. The surgery also reduces the amount of undesired bladder contractions.

Bladder augmentation is considered major abdominal surgery and requires a lengthy hospital stay. The recovery process often lasts six weeks, and patients may have to use a catheter to urinate for the rest of their lives.

Urinary problems may become so severe that a Temple urologist will recommend the complete removal and reconstruction of the bladder. In these cases, the urologist will surgically construct an entirely new pathway for urination. Most methods involve recreating the bladder using a part of the patient's intestines. Like bladder augmentation, bladder reconstruction is considered major surgery and requires a lengthy hospital stay and recovery period.

Temple's urologists are highly experienced in deciding when bladder augmentation or reconstruction is necessary. They also possess the complex surgical skills needed to ensure success and minimize complications and recovery times.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

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Laser therapy for obstructing prostates

When overgrown prostate tissue interferes with urination, Temple's urologists can remove the excess tissue with a high-energy laser beam. Laser therapy generally provides immediate relief from the symptoms of an overgrown prostate. Temple offers an array of laser therapies depending on the size of the prostate and location of the overgrowth, as well as the preferences of the patient. Available laser therapies include:

  • HoLAP (Holmium laser ablation of the prostate)
  • VLAP (Visual laser ablation of the prostate)
  • PVP (Photoselective vaporization of the prostate)
  • HoLEP (Holmium laser enucleation of the prostate)

The first three therapies (HoLAP, VLAP and PVP) ease urination by burning away excess prostate tissue pressing on the urethra. However, these therapies may cause irritation. They may also need to be repeated in order to be completely successful. Because the excess prostate tissue is burned off, it cannot be biopsied for cancer.

The enucleation therapy (HoLEP) is closer to traditional open surgery, but presents fewer risks. The procedure aims to remove the excess prostate tissue and prevent it from growing back. Unlike the ablative therapies discussed above, enucleation therapy preserves enough tissue for a cancer biopsy.

Temple's urologists are highly experienced in selecting the right laser therapy for each patient, as well as delivering the treatment efficiently and safely.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

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Laparoscopic removal of nonfunctioning kidneys

When a kidney ceases to function due to an injury, cancer or other disease, Temple's urologists remove the nonfunctioning organ from the body using minimally invasive (laparoscopic) surgery. Compared to traditional open kidney removal, which requires an incision measuring between eight and 20 inches, laparoscopic removal is performed through keyhole-sized incisions. This offers the patient a quicker recovery with less pain and a decreased risk of infections.

Kidney removal is performed under general anesthesia. A Temple surgeon creates a few small incisions in the abdomen. Through these incisions, the surgeon inserts a tiny camera for visualizing the surgical site, as well as an instrument to separate the kidney from the surrounding organs. If the entire kidney is being removed, a slightly larger incision of about two inches must be created to accommodate its size.

Temple's urologists are highly experienced in removing nonfunctioning kidneys with the most advanced minimally invasive techniques available today.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

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