Urology Conditions and Procedures
The Center for Urology offers treatment options for the following urological conditions and procedures. Select one of the links to learn more about these conditions and procedures:
If you would like to schedule an appointment to discus any of these conditions and procedures, please contact us.
Bladder cancer is currently the sixth most common cancer in the United States. In recent decades there has been a steady increase in the incidence of bladder cancer. Medical advances continue to improve the previously dim survival rates.
A number of substances that cause bladder cancer have been identified include cigarette smoke and various industrial chemicals. Cigarette smoking alone has been estimated to cause 50 percent of all bladder cancer cases in the United States. The symptoms of bladder cancer include painless blood in the urine (hematuria) which eventually occurs in nearly all bladder cancer cases; however, the presence of hematuria can be symptomatic of other conditions outside of bladder cancer. Other bladder cancer symptoms may include frequent and painful urination.
A consultation with the urologist will include a medical history and physical examination, including urinalysis. Cystoscopy can be used to view the inside of the bladder. Treatment options include removing the tumors and chemotherapy. Your urologist can provide more information and treatment options.
Circumcision, the removal of the foreskin of the penis, is usually a rapid and safe procedure when performed by an experienced urologist. The American Urological Association believes that circumcision performed on a newborn has potential medical benefits and advantages as well as disadvantages and risks.
The immediate risks to circumcision include bleeding, infection and penile injury in addition to poor cosmetic appearance. Some of these complications could demand surgical correction, but when performed on healthy newborn infants as an elective procedure, the incidence of serious difficulties remains extremely low.
Properly performed newborn circumcision prevents urinary tract infections and is associated with a decreased incidence of cancer of the penis among males in the United States. In addition, there is a connection between the foreskin and urinary tract infections in the newborn. Circumcision should be considered in detail taking into consideration the medical benefits and risks, as well as any ethnic, cultural, religious and individual preferences to the procedure.
Enlarged Prostate (BPH)
As a man ages, his prostate (the tube that carries urine from the bladder out through the penis) may become larger and start to cause frequent or painful urination. Benign Prostatic Hyperplasia (BPH) is a common urological condition caused by the non-cancerous enlargement of the prostate gland in aging men. BPH is very common, affecting fifty percent of men over the age of 50 and up to 90 percent of men age 80 or older. Men should see their urologist if blood is seen in the urine (hematuria), or if there is pain or burning with urination.
Evaluation with a qualified urologist will include a physical exam, a urinalysis test, and a thorough medical history. Cystoscopy allows the urologist to look directly in the urethra and/or bladder using a small flexible scope. Treatment options include pharmaceutical options and other possibilities, and your urologist can provide an appropriate course of action.
The Center for Urology is pleased to offer various treatments, including Water Vapor Therapy (Aquablation and Rezum) and Laser Therapy systems (Greenlight or Cyber laser) to patients experiencing Enlarged Prostate (BPH) symptoms.
Dr. Rockove is able to offer two forms of Water Vapor Therapy. He is the first in the state of Oregon to be offering surgical treatment, known as Aquablation. Aquablation is done utilizing high-tech, robotic technology, which can mark out the exact location of prostate tissue to be removed, and within minutes have it removed using a heat-free waterjet.
Not ready for surgery, but don’t want to be on medication? The other form of Water Vapor Therapy we offer is Rezūm. It's an option designed to reduce BPH symptoms in men with enlarged prostates — without the side effects of BPH medications. Rezūm™ uses the natural energy stored in water vapor, or steam.
Lasers are now used in many areas of medicine, including eye and cosmetic surgery. They are also used to treat an enlarged prostate. During the Laser Therapy procedure, the tissue blocking your prostate is rapidly heated and vaporized. Natural urine flow is rapidly restored in most patients. Typically, the procedure is performed as a same-day surgery. Many patients can go home without a urinary catheter. An overnight stay may be recommended for some patients.
Hematuria (blood in urine)
Hematuria is the abnormal presence of blood in the urine. When the urine is visibly red or pink, it is referred to as gross hematuria. When no blood is visible in the urine, but blood can be seen under the microscope, it is called microscopic hematuria.
The causes of hematuria can stem from many sources. The most common causes of significant hematuria are infections, kidney stones, trauma and tumors. The blood that appears in the urine can come from anywhere along the urinary tract, including the kidneys, the ureters (the tubes that connect the kidneys to the bladder), the bladder, the prostate (in men), and the urethra (the tube that drains the urine out of the body).
Patients with hematuria should come to our clinic for an evaluation where a detailed patient history, physical exam, a blood sample and a urine sample will be obtained. Depending on the situation, an intravenous pyelogram or cystoscopy may be required.
Treatment for hematuria depends on the cause. A small quantity of blood can turn the urine bright red, and hematuria rarely requires a blood transfusion. Some types of hematuria will require immediate attention if clots are present in the urinary tract; however, most forms of hematuria can be evaluated in a non-life threatening manner. Hematuria from an infection can be treated with the appropriate antibiotic. If a kidney stone or tumor is the culprit, appropriate treatment options can be applied to remove the invader. However, in approximately twenty percent of all cases, no cause can be determined (the so-called "idiopathic hematuria"), so patients need to be followed for six to twelve months with a urinalysis regimen to see if the problem persists.
Hematuria is a warning signal that should not be ignored by the afflicted patient. A thorough evaluation should be administered by a qualified urologist, and prompt treatment lowers further complications.
Urinary Incontinence is the involuntary loss of urine. Over 12 million Americans are estimated to have some degree of urinary incontinence. Incontinence affects all ages, including 15 - 30 percent of people over the age of 60. Women are affected twice as often as men, and because of the social stigma, many do not report their problem which can be quite troublesome for the afflicted.
There are several types of incontinence. Stress incontinence is the loss of urine during coughing, laughing, or other physical activities that increases abdominal pressure. Urge incontinence is the loss of urine with a sudden and severe desire to void the urinary tract. Overflow incontinence occurs when the bladder becomes so full that it simply overflows against the wish of the afflicted person. Transient incontinence results from something that can be easily reversed using the right methodology. Sometimes incontinence can be a mixture of more than one of the above.
Patients afflicted with incontinence should come to our clinic for an evaluation. Evaluation will include taking a detailed history and a physical exam, urinalysis, a post-void residual (PVR) analysis (which measures the amount of urine left in the bladder after urination.) Occasionally a voiding diary, cystoscopy, intravenous pyelogram and urodynamic testing may be required to fully ascertain the extent of the incontinence.
Treatment options include behavioral techniques, medications and surgery. Options and applications of each can be discussed at the time of the evaluation. For more information, see this brochure on Coaptite and this brochure on Urinary Incontinence.
Incontinence affects one's emotional, psychological and social wrathfulness, but the great majority of incontinence causes can be treated successfully.
Kidney Stones form when excess unwanted material crystallizes in the kidney. Kidney stones affect about 10 percent of the population of the United States, and men are affected more often than women. Symptoms will often include back and groin pain, urination pain, and blood in the urine (hematuria). Some kidney stones can cause urinary tract infections. Rarely stones will exhibit no symptoms in the patient but will still lead to kidney damage. The best method to avoid kidney stone formation is to keep well-hydrated with water. Regrettably more than 50 percent of patients form another kidney stone within 10 years, so following up with the patient is critical.
Patients besieged by kidney stones should come to our clinic promptly for an evaluation. The evaluation will include some or all of the following: urinalysis, blood tests and X-rays.
A variety of treatment options exist which can be enacted in tandem depending on the circumstances and the patient. Often the best method is for the patient to pass the kidney stone on his/her own, but other options include Extracorporeal Shock Wave Lithotripsy (ESWL), a ureteral stent, ureteroscopy, percutaneous nephrolithotomy and even open surgery.
An Overactive Bladder is a condition characterized by a sudden, uncomfortable need to urinate with or without urine leakage. Overactive bladder symptoms can occur with both daytime and nighttime frequency. Overactive bladder symptoms occur when the smooth muscle of the bladder squeezes or contracts more often than normal and at inappropriate times. Instead of staying at rest while urine fills the bladder, the muscles contract while the bladder is filling with urine.
The cause of an overactive bladder is unknown; however, identifiable underlying causes can include drug side effects, nerve damage or neurological diseases. Diagnosis includes keeping a urination diary; medical procedures include catherization, cytology and cystoscopy. Your urologist will give you more details regarding the appropriate diagnosis and treatment. Treatment options can include drugs, behavioral medications, Kegel exercises and other therapies. Your urologist will assist you with appropriate choices for treatment.
Other Urological Conditions
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