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Academic and clinical excellence in a private practice setting

Jerry G. Blaivas, MD, FACS

Dr. Blaivas is a world-renowned urological expert, surgeon, distinguished author, educator, and medical pioneer. He was one of the founders of urodynamics and established many of the current surgical procedures used to correct stress incontinence, urinary fistulas, urethral diverticulum, overactive bladder and neurogenic bladder.

He is also one of the few surgeons who routinely performs reconstructive surgery for prolapse and incontinence without the use of mesh. His success in this area has led him to publishing one of the largest series in the world on treatment of mesh complications.

Dr. Blaivas possesses decades of experience providing urology care to some of the most complex cases ever encountered, bringing academic and research-based modernization to the clinical forefront. His research in developing new medical techniques has become the standard in patient care, including breakthrough treatments and research in:

  • Mesh complications
  • Radiation complications
  • Autologous Slings
  • Natural Tissue Repairs

Schedule an appointment online or call Dr. Blaivas today at (646) 205-3039 to schedule a confidential consultation.

Insurance information

Dr. Blaivas does not participate with private insurance plans. He is considered an “Out of Network” physician, which means that payment in full is expected at the time of the visit and you will be reimbursed directly according to your insurance plan. As a courtesy, we offer to complete and mail claims on your behalf and assist you in obtaining timely reimbursement.

About the Uro Center of New York

At the Uro Center of New York, we combine clinical and academic excellence in a private practice setting. For over twenty years, our staff has been committed to diagnosing and treating people with bladder and prostate conditions. Our services include the use of state-of-the-art video urodynamic equipment and a custom-designed computer system that assists our physicians in ensuring an accurate and prompt diagnosis.

Learn more >

5 Things Your Doctor Might Not Reveal Before Your Pelvic Mesh Surgery

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1) Serious, often painful complications are not uncommon

Complications can range from severe unremitting pain to a “hole”, fistula, in the bladder or vagina. Many complications are never reported and patients are told to wait but never improve. Some women are even told that the pain “is in their head”. Mesh can cause serious problems and you should ask your doctor about them BEFORE surgery!

2) Surgery using your own, natural tissue is just as effective as mesh, but without the serious complications of mesh

USE YOUR OWN TISSUE! For incontinence, a small strip of tissue above your abdominal muscles (called rectus fascia) can be used effectively instead of mesh without risking mesh’s devastating side effects. This is an option that you might not hear about because only a few doctors at specialized centers, such as Urocenter of New York, are trained to do the “meshless” surgery first pioneered and championed by Dr. Jerry Blaivas.

3) It is very difficult to remove all the mesh from your body and there are many serious complications from the removal surgery.

Mesh – so easy to put in, so hard to remove. Mesh often is placed around very sensitive structures or through delicate spaces in bones using large impaling needles. These organs are often deep in the pelvis and difficult to access. Surgical removal is difficult and should be done only by experts such as Dr. Blaivas. If your doctor put the mesh in, she’s (or he’s) probably not the person to remove it!

4) Sex may never be the same again (or even possible)

Vaginal mesh can push up against the bladder, urethra or uterus during sex making it very painful. Nerves for sensation may even grow into the mesh triggering pain with intercourse. Sometimes the male partner can even feel your mesh in you and suffer pain too!

5) The mesh that is put in your body is made up entirely of petroleum byproducts that were never intended for human use

Oil? Yuck – Not a big surprise, you weren’t told that huh?


Dr. Jerry Blaivas at UroCenter of New York is among the most experienced surgeons in the world at treating mesh complications.

Dr. Blaivas has performed hundreds of these procedures and has the largest published series in the world on urethral reconstruction, a procedure that is often necessary in treating mesh complications (Outcome of Urethral Reconstructive Surgery in a Series of 74 Women).

Call Dr. Blaivas today to schedule a consultation:

212-772-3900

For More information, visit our main website: www.urocenterofnewyork.com

Is Permanent Urinary Catheterization Really Permanent?

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Urinary catheterization is used in three instances: (1) temporarily, following a surgery for people who cannot urinate or for monitoring how much urine they are making (2) long term, for people who cannot urinate well; and (3) for people with terrible incontinence for whom there appears to be no other solution. This article is concerned with the management of patients on “permanent” urinary catheterization – either an indwelling catheter or intermittent catheterization.

An indwelling catheter refers to one that is left in all the time and changed about once a month. Indwelling catheters are placed either through the urethra or the lower abdomen (suprapubic catheter). Intermittent catheterization refers to a technique whereby the patient (or a caregiver) passes the catheter periodically throughout the day to empty the bladder instead of urinating.

There are two major reasons why a patient might not be able to urinate : either the bladder does not contract well, or there is a blockage (bladder outlet obstruction). The muscle around the bladder that causes it to contract is called the “detrusor.” Impaired detrusor contractility (detrusor underactivity or DU) is how we refer to a bladder that does not contract well, and an acontractile detrusor is a bladder muscle that will not contract at all.

Urinary Catheterization: What comes first?

male-female-catheter-options-best-urologist-nyc-03Patients are often treated with an indwelling catheter when they are not able to urinate well enough to empty the bladder. Because of the risk of infection, catheters should stay in for the least amount of time possible. If an indwelling catheter is necessary, it should be changed every three to four weeks, but for the vast majority of patients intermittent catheterization is preferable and much safer – see our last blog post for more information.

When a patient is being treated with an indwelling catheter, from time to time is a good idea to check to see if the bladder is getting better. The best way to do this is with an “active voiding trial.” – the bladder is filled up with sterile water using the catheter that is already in place. When the patient feels that s/he is full, the catheter is removed and the patient is instructed to try to urinate into a urine flow meter, the an ultrasound is used to see if the bladder is indeed well enough . The active voiding trial differs from a regular voiding trial in the amount of time it takes. The voiding trial involves removing the catheter and waiting until the patient has to urinate. Sometimes when the patient has voided a little, he is sent home and develops urinary retention (is unable to urinate at all) later that night. The active voiding trial provides more information about bladder function in a shorter amount of time.

If a patient cannot void during the active voiding trial, in our judgment, the patient should be taught intermittent catheterization and should catheterize him/herself every three to six hours. Each time, just before catheterization, s/he can try to urinate first. As soon as the patient improves, both he and his doctor will know.

Will I have a urinary catheter for the rest of my life?

We believe that a large percentage of men who have been condemned to permanent catheterization could be better treated by an operation to relieve the blockage (bladder outlet obstruction) that often coexists with DU . In a study we recently published 87% of men condemned to a lifetime of catheter dependency were rendered cather free after prostate surgery. In addition, base on our sophisticated video-urodynamic studies, we were able to predict the likelihood of success or failure prior to the surgery! [1] In a separate study, we demonstrated that, in selected patients, and operation to make the bladder is smaller (reduction cystoplasty) will and will and’s can also be an effective operation for patients being treated with catheterization.[2]

Why hasn’t my doctor treated me with Surgery before?

nyc-urologist-for-urinary-catheter-options-02In our opinion, many doctors do not diagnose obstruction accurately in patients presenting with impaired DU. At least thirty percent of men with lower urinary tract symptoms have a weak bladder, which many doctors will treat with a catheter. But with a proper urodynamic study – a sophisticated diagnostic test for urinary symptoms – it is possible to diagnose obstruction even when the bladder only contracts weakly. Most men treated with a permanent catheter can turn in their catheters for surgery instead.

In fact, even if you’ve already had surgery and have been told that there is no other treatment except a catheter, there is still a good chance that you will have a successful outcome after another prostate operation [3].

Contact Dr. Blaivas Today for the Best Urinary Catheterization Options

If you need to consult with an expert to determine your best catheter options, contact Dr. Blaivas today to schedule an appointment. Dr. Blaivas is a world renowned surgeon specializing in common and complex urological conditions.

Jerry G. Blaivas, MD, FACS
445 East 77th Street
New York, NY 10075

646-205-3039


References:

[1] Blaivas, JG, Forde, JC, Davila, JL, Policastro, L, Tyler, M, Aizen, J, Badri, A, Purohit, RS, Weiss, JP. Surgical Treatment of Detrusor Underactivity: A Short Term Proof of Concept Study. Int Braz J Urol. 2017 May-June; 43(3):540-548.

[2] Blaivas, Jerry, Jeffrey Weiss, Johnson Tsui, Mahyar Kashan, James Weinberger, and Daniel Thorner. “Outcomes of Reduction Cystoplasty in Men With Impaired Detrusor Contractility.” Urology 83.4 (2014): 882-87. Apr. 2014. Web.

[3.] Blaivas, JG, Liaw, C, Policastro, L, Dayan, L Diagnosis and Treatment of Catheter-Dependent Men after Tansurethral Resection of the Prostate and Laser Failures, J Urol, 199(4S), p. e999, 2018

Intermittent Catheterization; Can it Work for You?

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What is self intermittent catheterization? If you suffer from incontinence or bladder problems that require the use of a catheter, read on to learn about this more convenient catheterization method.

If you’ve ever been to a urologist because you can’t urinate, you might have been given an indwelling catheter – a catheter that stays in the bladder and drains into a bag, usually attached to your leg – and been told to wait until the bladder recovers and return in a few days,  a week or a month. Then, when you come back, the catheter is removed and you wait around in the office until you can urinate okay. If you can’t urinate, the catheter is put back in, you go home and come back another time and try again. This saga can be repeated again and again and finally, you end up with an operation or the catheter is considered a permanent solution, maybe for the rest of your life. But, the catheter still needs to be changed about once a month!

What is Self Intermittent Catheterization (SIC)?

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“Self Intermittent Catheterization” (SIC) or “Clean Intermittent Catheterization” (CIC) is, in our judgment, a much better alternative to an indwelling catheter. If you’re new to the world of urology (and even if you’re not) this might sound like something you couldn’t or wouldn’t want to do. However, when given a choice, almost every patient says something like, “I could never do that!” But in fact, the opposite is true – almost every patient, when intermittent catheterization is recommended, is able to do it and finds it a much better than the indwelling catheter.

As you might have guessed from the name, SIC is when a patient inserts a catheter into the bladder  him/herself and allows the bladder to drain to completion before removing it. If this sounds simple, that’s because it is. Until the bladder recovers or is treated, you will catheterize yourself at intervals throughout the day to empty your bladder. Before each catheterization, you can try to urinate so you will be able to mark your own progress. If you get better, with the advice of your doctor, you will be able to stop catheterizing.

What Are The Benefits of SIC?

SIC is useful as a temporary solution while waiting for your bladder to recover after surgery, while you wait for other treatments , or, it can be a permanent solution over the course of a lifetime if you have been diagnosed with permanent incontinence or urinary retention (though, as you’ll see in a future blog post, we’ve found that many patients diagnosed with untreatable urinary retention are actually able to urinate okay with proper treatment).

In the rare case that you have a permanent problem, being able to catheterize yourself means you do not have to struggle with an indwelling catheter for the rest of your life, which can be uncomfortable, limits your day to day activities and has a higher risk of serious infection. There is even a small risk of developing bladder cancer. The best thing about SIC is it puts you back in control of your bladder and decreases the frequency of office visits. Instead, you can control when you go to the bathroom, and you can take the catheter back out and continue to live your life as normal. For many, intermittent catheterization successfully replaces normal urination.

Questions & Concerns About SIC

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“Is it going to hurt?” “How will I know when it’s in far enough?” “Don’t I need to use sterile gloves?” Sterile technique has been proven to be unnecessary for the vast majority of patients, although some doctors and patients prefer it. Though SIC is not a guarantee against infection, the risk is far lower than an indwelling catheter or living with a residual urine. All that is required is that you wash your hands before and after the procedure and clean the penis or the labia around the entrance to the urethra.

The process itself is pretty simple. Once everything is clean, you apply lubricant to the tip of the catheter and gently slide it into the urethra. For women, a well-placed mirror can be helpful to locate the urethral opening (meatus) while you are learning, but will not be necessary afterwards. For men, the penis should be held at a forty-five degree angle from the body until the urine begins to come through the catheter; at which point he should aim the penis down and let gravity do the rest. Most men prefer to catheterize standing over the toilet. Like most things, the more you do it, the easier it gets. At first, the patient will know that he or she has successfully reached the bladder when the urine begins to flow through the catheter, but eventually most  patients can do it entirely by feel.

Does Self Intermittent Catheterization Hurt?

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Though it may seem scary at first, for most people it actually doesn’t hurt at all. The very first catheterization can be uncomfortable, especially as you learn the technique, but once you’ve mastered SIC and performed it a few times the whole process becomes as easy and painless as a regular urination. In fact, in our office, we’ve often heard patients say, “That’s it?” following their first lesson. Catheterizing yourself is easier than having someone else do it.

One more thing. Most doctors and most patients think that it’s necessary to use a new sterile catheter each time you catheterize yourself. For the overwhelming majority of patients, this is simply untrue. In the vast majority of patients, all that is necessary is a single catheter and perhaps a spare that you carry around with you all the time and simply wash it out in the sink after each use. There is no need for sterile gloves only some lubricant which can be carried in individual packets the catheter and the packets of lubricant can be carried in a little plastic baggie.

Contact Dr. Balivas at Urocenter of New York

If you’re having trouble urinating or are suffering from incontinence, you should see a urologist to figure out the correct diagnosis and treatment. Dr. Blaivas treats each patient and work with you to find the best possible treatment option that works based on your preferences and lifestyle.

Call today to schedule your confidential consultation:

646-205-3039

For more information, visit our main website: http://www.urocenterofnewyork.com

Is a Vasectomy Right for Me?

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I’ve heard of a vasectomy. What is it?

A vasectomy is a simple surgical procedure that permanently protects against pregnancy. It is an operation for men otherwise known as “male sterilization,” that prevents sperm from leaving the man’s body and prevents the partner from getting pregnant.

How is a vasectomy done?

A vasectomy is a simple, quick operation that is done in a doctor’s office, hospital, or clinic. It is an outpatient surgery in which you do not have to be put “to sleep” during the procedure, and you can go home the same day.

vasectomy-medical-illustration-cut-vas-deferens-02The vas deferens are 2 small tubes in the scrotum that leave the testicles, carrying sperm and allowing them to mix with other fluids to form semen. Normally, the semen ejaculated from a man during sex contains sperm, and the man’s sperm to find and join up with the woman’s egg and cause pregnancy. “Vasectomy” is named for the “vas” in “vas deferens.” In a vasectomy, a doctor cuts or blocks each of the 2 vas deferens tubes, sealing off the road for sperm to get into the semen fluid.

Starting about 3 months after a vasectomy, sperm will no longer be part of the semen because they cannot be transported past the cut or block where the vasectomy was done. The sperm stay in the testicles and get absorbed by the body. Since there are no sperm in the semen, the semen cannot make a woman pregnant even if it gets into a vagina.

Vasectomies are very safe procedures. Complications are rare, but they can include swelling, bruising, and infection. These complications are not serious, but they should be seen by a doctor.

What happens right after a vasectomy?

Right after the surgery, it is common to feel a bit sore. Resting for about a day can be helpful. Full recovery occurs in less than one week after the procedure.

After a few days, men can have sex again normally. It can take a few months for the sperm to stop getting into the semen after a vasectomy, so it is still important to use another form of birth control during sex during that time to prevent pregnancy. After about 10-20 orgasms or ejaculations after the procedure, men can have a test done to see if there are any sperm in his semen. Once the test shows that there are no sperm in the semen, which is usually about 3 months after the procedure, a man who has had a vasectomy will no longer need to take any additional birth control steps before sex, like putting on a condom.

Note that a vasectomy is a highly effective form of birth control, but it will not prevent sexually transmitted infections. If you are a male with a sexually transmitted infection, condoms are still needed to prevent their transmission to your partner.

Is a vasectomy right for me?

Vurologist-for-vasectomy-best-nyc-urologist-specialist-03asectomies are a great birth control option for men who are positive that they do not want to get someone pregnant for the rest of their life. They are almost 100% effective at preventing pregnancies. Vasectomies are usually not able to be reversed. They should be considered permanent male birth control.

Men who have had vasectomies can still orgasm or ejaculate after the procedure. Men will still produce the same amount of semen and ejaculate the same way and amount during sex. A vasectomy does not change the way ejaculating or orgasming occurs or feels, and it doesn’t change the look, feel, taste, or smell of the semen that was ejaculated. It does not affect a man’s testosterone level, sex drive, or any other part of your sex life. After a vasectomy, the only change is that there are no sperm in the fluid that gets released, so it can’t get anyone pregnant.

If you are sure that you do not want to get anyone else pregnant and you are interested in a vasectomy, contact us today to schedule an appointment with the best urologist in NYC to see if a vasectomy is right for you.

Visit our main website at www.UrocenterofNewYork.com for more information.

I have a lump in my testicle. Could it be cancer? Understanding Testicular Cancer

testicular-cancer-medical-information-nyc-top-urologist-01Testicular cancer is a cancer that occurs in the male reproductive system. Underneath the penis, the testicles (or testes) are found inside a sac called the scrotum, which is a loose bag of skin. The testicles are two glands, each about the size of a golf ball, that normally feel firm but slightly spongy.

The testicles have an essential role in male reproduction: they produce sperm for reproduction and male sex hormones for the development of male traits.

The exact cause of testicular cancer is not clear in most cases, but research shows that it occurs when a healthy cell in the testicle becomes changed. The altered cell grows and divides abnormally, often uncontrollably, leading to the development of a tumor or mass in the testicle.

Although it is rare compared with other types of cancer, testicular cancer the most common cancer in American males between the ages of 15 and 35 years old. It usually affects one testicle at a time.

Who is most likely to get testicular cancer?

urologist-surgeon-cancer-testes-men-02There are certain risk factors that make a man more likely to get testicular cancer.

Testicular can occur at any age, but it most commonly affects teens and younger men between the ages of 15 and 35.

Those born with undescended testicles, or “cryptorchidism,” are at higher risk of testicular cancer. In male development, the testes form in the lower belly. Just before the male baby is born, the testicles usually drop down into the scrotum. In less than 5% of newborns, the testicles do not drop, and are left inside the abdomen. Although this is often fixed surgically, the males born with undescended testicles tend to be at higher risk of getting testicular cancer later in life. Although the majority of men with testicular cancer do not have a history of undescended testicles, many men with undescended testicles are at higher risk of testicular cancer.

Also, men that have had a history of abnormal testicle development, such as Klinefelter syndrome, are at higher risk.

Other risk factors for testicular cancer include having a family history of testicular cancer, having fertility problems (being unable to make a woman pregnant), having HIV infection, or having Down Syndrome.

What symptoms may indicate testicular cancer?

Most men with testicular cancer feel a lump or growth in one testicle. Many also experience swelling in the testicles. Some men with testicular cancer may also experience pain: 3 out of 4 men with testicular cancer say that the lump and swelling are painless, but 1 out of 4 say that they experienced pain in the area.

Other signs of testicular cancer are a feeling of heaviness in the scrotum or having pain or a dull ache in the testicle, scrotum, abdomen, or groin region. Some men also experience a sudden collection of fluid in the scrotum, enlargement or tenderness of the tissues surrounding the breasts/nipples, or back pain.

I think I might have testicular cancer. What should I do?

testicular-cancer-awareness-nyc-specialist-urologists-03If you suspect you might have testicular cancer, make an appointment with your doctor right away, especially if any lumps, swelling, or pain in your groin area lasts for more than 2 weeks. Many men with signs of testicular cancer wait to go to a doctor for several months. During that time, untreated testicular cancer may spread to other parts of the body, like the lymph nodes, blood, lungs, and bones. In very rare cases, it can spread to the brain. Visiting a doctor early can help avoid the spread of the cancer.

When diagnosed early, testicular cancer is treatable in most people, is curable in many, and is rarely life-threatening. It is important to get seen by your doctor and treated early. Doctors can use physical examinations, lab tests, imaging, and biopsies to check for and diagnose testicular cancer.

If you suspect you might have testicular cancer, contact us today to schedule an appointment with the best urologist in NYC.

for more information, please visit our website at: www.UrocenterofNewYork.com

What is Prostatitis?

prostatitis-prostate-issues-problems-nyc-urology-expert-doctors-01Have you recently asked yourself what is Prostatitis? It is the swelling, tenderness, or inflammation of the prostate gland in men.

In all men, the prostate is the walnut-sized gland located directly below the bladder. The prostate gland produces seminal fluid, which is fluid that nourishes, protects, and transports sperm as they travel to a female’s egg for reproduction. Usually, prostatitis is caused by common bacterial strains. Bacteria from urine can leak into your prostate gland, causing an infection.

Prostatitis is not prostate cancer, and it is not the same as having an enlarged prostate. It is most common in young or middle-aged men who have previously had another instance of prostatitis, have an infection in the bladder or urethra (tube that transports semen and urine through penis), have a pelvis injury, or have HIV.

Types and symptoms of prostatitis:

There are four types:

  • prostatitis-medical-information-different-types-consult-top-nyc-urologists-02Acute bacterial prostatitis: a sudden bacterial infection in your prostate that can result in flu-like symptoms: fever, chills, muscle aches, and joint pain. Men with acute bacterial prostatitis often experience pain around the base of the penis or behind the scrotum, trouble peeing, and a feeling of needing to have a bowel movement.
  • Chronic bacterial prostatitis: a milder bacterial infection common in older men that can remain for several months at a time. This often occurs after having a urinary tract infection (UTI) or acute bacterial prostatitis. Symptoms of chronic bacterial prostatitis can come and go, so it may be harder to detect this type. Men with chronic bacterial prostatitis often experience an urgent need to pee, peeing more often in the night, pain while urinating or after ejaculating, a feeling of heaviness behind the scrotum, blood in the semen, or a urinary blockage.
  • Chronic prostatitis/ chronic pelvic pain syndrome: This is the most common form of prostatitis. The symptoms are similar to the two forms of bacterial prostatitis described above, but if a test is run, this type of prostatitis will not show any bacteria present. It is unknown what exactly causes this type of prostatitis, but it can be triggered by stress, nearby physical injury, or nerve damage. Symptoms of this type of prostatitis including pain in the penis, scrotum, lower abdomen, lower back, and between the scrotum and rectum may last more than 3 months. Peeing or ejaculating may also be painful. Urinary problems like a frequent need to urinate, a weak urine stream, and an inability to hold in your urine may also be associated with this form of prostatitis.
  • Asymptomatic prostatitis: This occurs when a man has a swollen or inflamed prostate but does not experience any symptoms. This type of prostatitis does not require treatment, it can lead to infertility. It can be detected through a blood test from your doctor

Depending on the type, symptoms can come on suddenly or more slowly over time.

What happens if I have prostatitis?

illustration-enlarged-prostate-bladder-prostatitis-03Some cases can get better on their own, but other cases may need treatment by antibiotics. If not fully treated, a man can end up with chronic bacterial prostatitis, meaning that prostatitis can recur. Treatment needs and recommendations can depend on the type and severity of the individual case.

If you are experiencing pain while urinating or ejaculating, pelvic pain, or other symptoms, your doctor can help diagnose and treat prostatitis. Contact us today to schedule an appointment with the best urologist in NYC.

For more information, please visit our website at: www.UrocenterofNewYork.com

What is Slow Urine Flow?

urologist-for-slow-urine-flow-urination-info-01Have you ever needed to go to the bathroom, but had only a weak stream of urine comes out? Have you ever been unable to pee when you tried? If so, you may have experienced a slow urine flow.

Slow urine flow, or a weak urine stream, can occur in people of both sexes. It most commonly occurs in men, especially those over 50 years old. Otherwise known as urinary hesitancy, this condition usually develops slowly over time, and may be unnoticeable until it ultimately leads to urinary retention, or an inability to pee. This may lead to discomfort.

What can cause slow urine flow?

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A variety of medical conditions may affect normal urine flow. The most common cause of slow urine flow in men is having an enlarged prostate, or Benign Prostatic Hyperplasia (BPH). An enlarged prostate can press on the urethra, which is the tube through which urine travels from the bladder out of the body. If the urethra is compressed from the enlarged prostate, less urine can pass through, so the urine flow is slowed down. This is further exacerbated in people with diabetes that have diabetic neuropathy.

Other possible causes of slow urine flow are prostate or bladder cancer, blockage along any part of the urinary tract (from kidneys to bladder to urethra), neurogenic bladder dysfunction, frequent urinary tract infections (UTIs), and any other conditions that cause scarring or damage to the urinary tract.

Symptoms of slow urine flow

You may have slow urine flow if you have a slow urine stream. If you have slow urine flow or another lower urinary tract problem, you may dribble of urine after you finish urinating, wake up multiple times a night to pee, or feel lower abdominal discomfort. You also may feel like you have not completely emptied your bladder when you have finished urinating. Slow urine flow and associated urine problems can cause distress for many.

What should you do if you have slow urine flow?

slow-urination-graphic-what-healthy-consult-nyc-expert-03If you experience urinary hesitancy or a slow flow of urine, it is important to see a urologist. Your doctor can help you figure out why you have slow urine stream and can work with you to resolve your urinary problems.

To better understand and help you with your condition, your urologist may do a physical exam, urine tests (like urinalysis or a urine culture), and a urine flow test.

A urine flow test calculates the speed of your urine flow over time. This will help you and your urologist understand how well your lower urinary tract is working, and to determine if there is a urine blockage. This test entails peeing into a funnel that has a measuring instrument, which calculates the amount of urine, the rate of urine flow, and the amount of time until you have finished urinating.

After examination and any tests needed, your urologist may help you identify medications or lifestyle changes that can help with your urinary flow.

If you think you might be experiencing slow urine flow, contact us today to schedule an appointment with the best NYC urologist.

For more information, please visit our website: www.UrocenterofNewYork.com

Understanding Overactive Bladder

overactive-bladder-graphic-nyc-expert-01Overactive bladder (OAB) is a common condition in bladder function that causes the sudden and frequent need to urinate. It is a common problem affecting millions of Americans, especially older adults.

Urine is stored in an organ called the bladder. Normally, when it is not full of urine, the bladder is relaxed. When the stored urine level increases and bladder gets full, it sends signals to your brain telling you that you should go to the bathroom. When you urinate, the bladder muscles contract or squeeze to expel the urine out of your body.

With overactive bladder, the nerve signals between the bladder and the brain tell your brain to urinate even when your bladder isn’t full. The muscles in the bladder contract involuntarily, leading to urination even when the amount of urine in the bladder is low. This leads to urinary incontinence, or a loss of bladder control.

Signs and symptoms of overactive bladder

frequent-urination-urge-overactive-bladder-information-nyc-doctor-specialist-02The most common sign of overactive bladder is the sudden urge to urinate, and difficulty controlling that urge. This leads to “urge incontinence,” or an immediate involuntary loss of urine. Leaking urine throughout the day is also common. Overactive bladder is associated with frequent urination (8 or more times a day) and being woken up at night to pee (“nocturia”), often more than 2 times a night. Many people with overactive bladders say that it is hard to get through the day without many trips to the bathroom and they fear not being able to get to a bathroom when they need one.

Having an overactive bladder is a source of distress and embarrassment for many. The need to urinate frequently and a limited ability to control one’s bladder can lead to social isolation, limiting one’s work or social life, and other disruptions in normal daily life. It also can lead to disrupted sleep, anxiety, sexuality issues, and emotional stress.

What causes an overactive bladder?

There are many causes for overactive bladder, and doctors are still learning more about these causes through research.

Overactive bladder can occur without any underlying health issues, but there are some known health problems that are associated with it. For example, nerve damage and neurological disorders like stroke or multiple sclerosis are associated with low bladder control. Overactive bladder is also common in people with diabetes and with enlarged prostates. Parkinson’s disease, herniated discs, and having had back or pelvis surgery also can lead to overactive bladders. People with weak pelvic muscles, such as women after pregnancy, can experience urine leakage.

Aging also can lead to overactive bladder for both men and women. For women, menopause is sometimes associated with an overactive bladder.

Some medications and foods can make it harder to control overactive bladders. Medications called diuretics can cause increased urine production, and other medications require you to take them with a lot of fluids. Foods that are acidic like citrus and tomatoes, and drinks with caffeine, alcohol, and soda may make bladder problems worse.

What can help an overactive bladder?

illustration-medical-info-overactive-bladder-nyc-urologist-03For many with overactive bladders, behavioral strategies and lifestyle changes can be extremely helpful. Setting bathroom or “voiding” schedules, doing pelvic floor strengthening exercises (“Kegel” exercises), and avoiding foods and drinks that make bladder problems worse all have been shown to help overactive bladders.

If these behavioral strategies and exercises do not work, doctors also can prescribe medications to help calm the bladder.

In addition to these changes and treatments, wearing absorbent pads or underwear can help to hide any unwanted bladder leakage.

If you have any of the signs or symptoms of an overactive bladder, a doctor can help you. Contact us today to schedule an appointment with the best urologist in NYC.

What is a Urethral Stricture and what happens if I have one?

Do you have or want to know what is a urethral stricture? A Urethral stricture is a narrowing of the urethra, often caused by scarring. The urethra is the tube that carries urine from the bladder out of your body. A urethral structure restricts the flow of urine out of the body and can cause inflammation or infection in the urinary tract.

Men are more likely to experience urethral stricture than women are, as men have longer urethras. Urethral strictures are not common in women and infants.

What causes urethral stricture?

urethral-stricture-medical-infographic-information-02Urethral stricture is caused by the development of scar tissue or tissue inflammation that narrows the urethra. It can happen at any point in the urethra, from the bladder to the tip of the penis. Medical procedures that involve inserting an instrument like an endoscope into the urethra or use of a catheter or tube to drain urine from the bladder can create scar tissue. Injury to the urethra or pelvis, such as from bike riding or getting hit near the scrotum, can also create scar tissue. Scar tissue also may form from other medical conditions like an enlarged prostate, prostate gland removal surgery, urethral cancer, prostate cancer, or sexually transmitted infections.

To prevent urethral stricture, it is important to avoid injury to the urethra and pelvis and to be careful with self-catheterization and avoid sexually transmitted infections. If a sexually transmitted infection like Gonorrhea or Chlamydia is contracted, take antibiotics early to treat the infection and prevent urethral stricture. Although urethral strictures are not contagious, sexually transmitted infections are. Treating a sexually transmitted infection can help you prevent urethral stricture, and also can help prevent them in future sexual partners.

Urethral stricture signs and symptoms

Several urinary problems may indicate urethral stricture. A low or spraying urine stream, incomplete bladder emptying, and difficulty or pain when urinating are common signs. Bloody or dark urine or blood in semen may also indicate urinary stricture. Many with urinary stricture experience more frequent urination or a more frequent urge to urinate. Men with urethral strictures also may experience urinary tract infections.

What happens if I have a urethral stricture

treatment-diagnosis-urethral-stricture-blaivas-expert-03It is important to seek treatment for a urethral stricture. Without appropriate treatment, urinary problems may continue. If a urethral blockage lasts a long time, it can damage the kidneys and lead to an enlarged bladder.

Appropriate treatments for urethral strictures depend on the size of the urethral blockage and the amount of scar tissue present. A urologist can help you determine the best treatment route for you. Treatment options include dilation of the structure with gradual stretching with an instrument called a dilator, urethrotomy (cutting the stricture through a scope), or open surgery to remove the stricture.

Contact us today to schedule an appointment with the best urethral stricture urologist in NYC.

For more information, visit our website: www.UrocenterofNewYork.com

Peyronie’s Disease

Why is my penis curved? An overview of Peyronie’s Disease

Peyronie’s Disease or penile curvature: an overview

op-nyc-urologist-peyronies-disease-01Peyronie’s Disease (pronounced pay-roe-NEEZ disease)—or penile curvature— occurs when scar tissue develops inside the penis, causing curved, painful erections.

In Peyronie’s Disease, scar tissue, also known as a plaque, builds up on the inside the tissues within the penis, most commonly at the top or the bottom of the penis. As the plaque builds up, the penis can bend or curve during an erection. This can be very painful, and can make sexual intercourse very painful, difficult, or even impossible. The curvature of the penis can worsen as more plaque builds up over time.

The exact cause of Peyronie’s disease is not yet known, but it is thought to be the result of acute injury to the penis, chronic/repeated injury to the penis, or an autoimmune disease. Acute or repeated penile injury can result in bleeding or swelling within the penis tissues. If blood can’t flow normally in and out of the penis after the injury, blood clots may form and trap immune system cells inside. As the injury heals, the immune system cells may release substances that can cause too much scar tissue to form. Similarly, in autoimmune diseases, immune cells may attack the penis, and this can lead to inflammation and scarring. In both of these cases, the scar tissue then can build up and harden, reducing the flexibility and elasticity of the penis during an erection and leading to pain and a curved appearance.

The plaque that develops in Peyronie’s Disease is not harmful to other parts of the body. It is benign (non-cancerous), it is not a tumor, and it is not the same type of plaque that builds up in a person’s arteries. It is not caused by any known disease, and it is not contagious.

Aside from being painful and causing penile curvature, Peyronie’s Disease also causes stress and anxiety for many men.

Risk factors for Peyronie’s Disease

curved-penis-painful-erection-info-nyc-top-urologist-02If you participate in any vigorous activities (sexual or nonsexual) that can cause tiny injuries to the penis, you may be at higher risk of Peyronie’s Disease. Some autoimmune or connective tissue disorders also increase the chance of having Peyronie’s Disease. You are also more likely to have Peyronie’s Disease if you have a family history of Peyronie’s Disease. Your risk increases as you get older.

Peyronie’s Disease is common: researchers estimate that Peyronie’s Disease may affect up to a quarter of men between ages 40 and 70.

Symptoms of Peyronie’s Disease

Peyronie’s Disease can be recognized by any of the following:

  • Scar tissue under the skin of the penis that feel like flat lumps or a hard band of tissue;
  • A noticeable, significant bend to the penis (upward, downward, or to one side);
  • Abnormal shaping of the penis (such as narrowing, indentations, or an hourglass shape);
  • Pain in the penis, with or without an erection;
  • Erection problems; or
  • Penile shortening.

peyronies-treatment-urologist-expert-03Peyronie’s Disease can sometimes go away on its own, but more commonly, it stays the same or gets worse over time. The pain during erections can improve after one or two years, but the scar tissue and curvature often remain.

What should I do if I have penile curvature or painful erections?

See a urologist if the curve or pain in your penis makes sex difficult or impossible, or if it causes you anxiety. An individualized treatment plan may be needed.

Contact us today to schedule an appointment with the best urologist doctor in NYC for the treatment of Peyronie’s Disease.