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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 >

Category Archives: Urological problems

Why Does it Burn When I Pee?

burning urinationThere are lots of things that can cause issues with urination. If you experience a burning sensation when you try to urinate, this is usually an indication of a problem with the urinary tract. Urinary tract infections are most often to blame, but there can also be things like urethral strictures that can cause the same sensation. Here we are going to look at what can cause a burning sensation when you try to pee and what you can do if you have these symptoms.

What Causes Discomfort When Urinating?

If you have noticed a burning sensation when you try to urinate or feel that you need to urinate when actually it is difficult to produce anything when you try, this is usually a sign that something is wrong in the urinary tract. In both men and women, this is most often associated with a urinary tract infection.

burning urinationThis is caused by bacteria present in the urethra, bladder, and the urinary system as a whole that would not normally be there, causing some inflammation and pain. However, this is not the only reason why you may experience these symptoms. Pain and discomfort when urinating can also be a sign of other things, such as some types of cancer, prostate issues in men, and scarring or inflammation in the urethra caused by injury, surgery, or trauma. When it is the latter, this is usually deemed to be a urethral stricture, which is something that may need to be treated with surgery.

What Should I Do About Discomfort When Urinating?

burning urinationThe first thing that you should do if you are experiencing problems when you pee is to see a doctor or a specialist urologist. If you have experienced some injury to your lower abdomen or have had some surgery that may have affected your urethral system, then it could be that you have something that will need further intervention. If you do not think that this is a likely cause, then it is most probable that you have an infection of some kind. However, since these symptoms can be related to something more serious such as certain types of cancer, it is very important to get a proper diagnosis. Urinary tract infections can be treated quite easily with antibiotics, but there could be something else at play that your doctor will need to investigate.

If you are experiencing a burning sensation when you urinate, please make an appointment with us today and speak to a urologist who will be able to identify what is going on and recommend the best course of treatment to make things more comfortable for you.
Contact an expert urologist in NYC for more information!

 

 

Call us today at 646.205.3039 to schedule an appointment to meet with the best NYC urologist.

What are Bladder Stones?

What are Bladder Stones?Did you know that your bladder could be home to hard lumps of minerals called bladder stones? Often, they are so small that they don’t cause symptoms, which means you could have them without even knowing. So what exactly are these stones, how do they form, and what can you do about them? Here’s a closer look.

What is a Bladder Stone?

Bladder stones are little stones that develop from the minerals found in your body. What happens is the minerals that are found in your urine crystallize and become hard. You can have just one or many. They can also range in size from being very small to quite large. If you just have small bladder stones, then there is a good chance you won’t even realize they are there and they will leave in your urine without any pain.

What Causes Bladder Stones to Form?

So what causes these hard little stones to form in your bladder? The most common reason is that you aren’t emptying your bladder completely, therefore, it gives the minerals a chance to crystallize. Men who have an enlarged prostate gland tend to be more at risk of developing bladder stones since they are unable to completely empty their urine. The enlarged area blocks the flow of urine.

Those who have nerve damage to their bladder also tend to be at a higher risk of developing these stones.

What are the Common Symptoms?

What are Bladder Stones?It’s important to note that not all bladder stones cause symptoms. If the stone is small, then you may not know it exists. Even large ones may not present with symptoms.

Here’s a look at the common symptoms that can be associated with bladder stones.

    • Increased amount of urination
    • Lower abdominal pain
    • A burning feeling when you urinate
    • Pain in the testicles or penis
    • Blood in the urine
    • Dark or cloudy looking urine
    • An interruption in the urine flow or difficulty urinating
What Can You Do About Bladder Stones?

What are Bladder Stones?As far as treatment goes, bladder stones should be removed. In most cases, this will happen on its own, but you can speed things along by drinking plenty of water. If the bladder stones were caused by the inability to empty the bladder, however, then drinking lots probably won’t help.

It’s not uncommon for the bladder stones to be removed by the doctor. This procedure is called a cystolitholapaxy. The doctor will insert a small tube with a camera into your urethra and then break the stone into small pieces.

If you suspect you may have bladder stones and they are causing discomfort, then you will want to contact us 646-205-3039

What is Urinary Retention?

Urinary retention is a condition where the bladder does not complete empty. This means that someone either cannot start the urination process or that they are unable to completely empty their bladder. There are several different types of urinary retention, obstructive and non-obstructive, and acute and chronic. Acute is much more serious than chronic, and requires immediate medical treatment.

Causes Of Urinary Retention

urinary retentionUrinary retention can be one of two types, obstructive and non-obstructive. Obstructive urinary retention results from blockage of some kind, like kidney stones. This can be caused by cancer, blockage, and an enlarged prostate. Non-obstructive urinary retention can be caused by things like nerve issues and weak muscles in the bladder. Sometimes, it’s just a missed signal between the bladder and the brain, which is usually due to damaged muscles, nerves, brain muscles, or the spinal cord. Other times, this can be the result of pelvic trauma, a stroke, or traditional childbirth.

Signs and Symptoms

urinary retentionIf you are suffering from chronic urinary retention, there are several symptoms. These can include pressure on the stomach, waking up for frequent urination, difficulty urinating, and trouble telling if your bladder is full or not. It can also result in some small amounts of bladder leakage during the day. This can be a long-term condition. Occasionally, someone won’t even notice that they are suffering from chronic urinary retention until another health problem becomes visible. Acute urinary retention is much more serious. These symptoms include the inability to urinate, urgent urination, or pain or bloating in the abdomen. If you experience any of these symptoms, talk to your health care provider as soon as possible.

Treatment

urinary retentionDepending on the type of urinary retention and how long you have suffered from it, there are several different treatments available. These treatments can include bladder draining, surgery, prostate medication, urethral dilation, and urethral stents. Bladder drainage is performed by using a catheter to help drain the excess fluid from the bladder, while stents and dilation both involve widening the urethra to help improve flow. Surgery can also help fix some issues that can lead to urinary retention.

 

If you are experiencing pain or discomfort in your abdomen and/or your urinary tract, or you are entirely unable to urinate, seek medical help immediately. If you have any questions or think you might be experiencing urinary retention, contact us today to schedule an appointment with the best urologist in New York City.

Call our offices today at 646-205-3039 to discuss the concern and to learn what solutions may be available to you.

Can a Urologist Help with Male Fertility?

Can a Urologist Help with Male FertilityA urologist is focused on the areas of the man’s body that deals with the reproductive organs and other matters. Because of this, he or she is perfectly placed to assist with problems that are stemming from the man’s body (rather than the woman’s).

Given the area of specialization that a urologist has, they’re able to conduct useful questioning of the patient and testing to ascertain what the difficulty is, where it is happening, why it is occurring, and what can be done about it.

Are There Any Treatments for Me?

Treatment is largely dependent on what is causing the infertility issues in the first place. There are many different courses of treatment available to a urologist, including multiple types of mediation and different surgical approaches to rectify a wide variety of issues, some of which directly affect fertility success rates.

Drug treatments to address infertility
Surgical procedures to fix problems that medicine alone cannot resolve
Different treatments for other causes of infertility in men
Non-Surgical Options

There are several options for fertility problems that don’t involve going under the knife.

Can a Urologist Help with Male FertilityBroad spectrum antibiotics can treat bacterial infections that are preventing the proper functioning of the reproductive organs. The system relies on the urethra and the bladder and this can be interrupted when bacteria build up in the urethra preventing the normal flow of sperm.

There are several other methods to assist in the reproductive effort. Several approaches are available to collect sperm and help in creating a successful pregnancy when the reproductive system isn’t currently functioning as it might be. This includes IVF and other treatments that are often effective when applied with persistence.

Surgical Options

There are many types of surgical options available to the patient, depending on the exact cause of their infertility problems.

One example is a varicocelectomy where veins are dilated along the scrotum area and need to be rectified because they are causing fertility issues. Such a procedure isn’t overly involved and is accomplished as an outpatient, usually with the patient able to return home later the same day or early the next day.

Can a Urologist Help with Male FertilityThere are also several surgical procedures that remove blockages in various parts of the reproductive systems to allow normal intercourse and pregnancy to happen naturally post-operation.

It can be a little daunting at first to consider going to a specialist, but you’re likely to get a far more accurate diagnosis and medical solution that way. Contact our office today to make an appointment for your first checkup with the best urologist doctor in New York City.

Call our offices today at 646-205-3039 to discuss the concern and to learn what solutions may be available to you.

Urinary Incontinence in Women

urinary incontinenceUrinary incontinence in women is one of the most common complications for women having to do with the urinary system as women get older. This is not a disease specifically. Rather, it is a symptom of an underlying condition that is important for women to understand. There are many reasons women may suffer from this condition including due to physical problems, medical conditions, and everyday habits. It is not something to put off getting help for if you do suffer from it. Turning to a New York urologist can help you to overcome these types of complications.

What Causes It?

urinary incontinence

Most commonly, women experience temporary urinary incontinence. This may be due to the foods they consume (some foods work as diuretics, encouraging the bladder to work and increasing the amount of urine produced). This includes foods such as alcohol, caffeine, corn syrup, carbonated drinks, tea and coffee. In addition to this, temporary urinary incontinence can occur as a result of a urinary tract infection. These infections can irritate the bladder and cause strong sensations to urinate. Constipation can also cause this type of pressure.

For other women, the problem remains long term. For some, this is brought on by pregnancy. The hormonal changes occurring here and the increase in weight can cause stress incontinence. Childbirth can also be a concern. Delivery causes a weakening of the muscles that control the bladder and may damage the nerves that sense the need to urinate. Other causes of more long term development of urinary incontinence in women include:

  • The onset of menopauseurinary incontinence
  • Hysterectomy
  • Obstruction
  • Cancers
  • Neurological disorders

What can be done if you suffer from this condition?

This depends on the cause and the underlying complications. Bladder training is one of the options for many women. Double voiding, scheduled trips to the bathroom, and fluid management can help. Improving the muscles in the pelvic floor can help many women as well. By strengthening these muscles, it becomes possible to tighten up control and to reduce the risk. Medications are available as well. And, for those experiencing more serious forms of the condition, medical devices and surgical procedures are available.

For most women, this isn’t something they want to talk about but it is something you should seek medical help for. Come in to see one of the best urologists in New York to learn more about all of your options for treatment.

To find out what your options are and to ensure you have every treatment option available to you, call our offices at 646-205-3039 and schedule a consultation with one of the best urologists in New York City. Find out what your options are.

What Is Pelvic Outlet Relaxation Disorders?

pelvic relaxationFor some people, the structure of the body changes due to a variety of circumstances, making it difficult for the bladder to work properly. When this occurs in women, it is often called a type of pelvic outlet relaxation disorder or more commonly pelvic relaxation. If you are suffering from this you may need to seek medical support from a trusted urologist. Do not overlook the treatment options that may be available to you.

What Is Pelvic Relaxation?

Over time and as we age, the body changes. The support system that helps to hold the bladder and the uterus in place, for example, can become weak. This happens for many reasons but most commonly because of:

  • Being overweight or obese
  • Smoking
  • Giving birth
  • Being older
  • Other factors

When these elements occur, it can cause changes in the structure and relaxation of the pelvic. In some cases, the uterus comes down while in other situations, the bladder can also come down. This creates a sensation of pressure and discomfort in the pelvic area. It can also cause:

  • Pain especially when the condition worsens
  • Discomfort during sexual activity
  • Bulging of the tissue located at the top of the vaginal opening

One of the most common symptoms of this condition occurs after childbirth. Childbearing, especially when a woman’s body is unable to regain strength in between pregnancies (because of the frequency of pregnancies in a short period of time), can be a big factor in the development of relaxation. In these instances, the bladder can leak, especially when a person sneezes, coughs, or laughs. This can also occur during sexual intercourse. It can be embarrassing and hard to explain. However, it can also be a problem related to your health, especially when it leads to a bladder infection, irritability, or irritation.

What You Should Do Now

pelvic relaxationIf you are struggling with pelvic relaxation or you believe you could be at risk for it, realize there are treatment options that can help you. Many women, as well as men, can struggle from these types of changes within the structure of the body. To get any health, contact your urologist and schedule a consultation to learn more about your options.

When you come in to see our urologist one of the best in New York City, you’ll get the one on one care and attention you need to overcome the limitations that pelvic relaxation can often bring.

 

To find out what your options are and to ensure you have every treatment option available to you, call our offices at 646-205-3039 and schedule a consultation with one of the best urologists in New York City. Find out what your options are.

What Can You Expect from a Prostate Biopsy?

Prostate BiopsyFor many men, the thought of having a prostate exam can be worrisome. Just being told there is a concern can be worrisome. However, the procedure is not necessarily as difficult as most people believe. When a prostate biopsy becomes necessary, which means there is likely abnormal tissue present that needs to be examined more closely, your doctor will recommend a biopsy and a type. There are several ways in which tissue can be collected.

Methods of Obtaining a Prostate Biopsy

Prostate BiopsyThe following are the most common methods used to obtain a biopsy:

  • The doctor may pass a needle through the wall of the rectum to access the prostate exam. This method is called a transrectal biopsy. This is the most common type of prostate biopsy performed.
  • The doctor collects the tissue sample through the tip of the penis. This is called a transurethral biopsy. A camera is passed through the urethra in order to access the prostate and obtain the necessary sample.
  • A third option is passing a needle through the skin located between the scrotum and anus. This method requires an incision to be made in this area and a doctor will insert the needle here to collect the necessary sample.

In many situations, these procedures are performed at the doctor’s office, but in some cases may be done in a surgical suite. The goal is to gather the necessary tissue from the area of concern. Your doctor will discuss the method to be used with you prior to the procedure and give you specific steps to take in preparation, if any. In some cases, ultrasound images are collected with the help of an inserted camera. This can also provide more information to the doctor.

Prostate BiopsyIn most cases, the process takes a short amount of time and provides a very accurate opportunity to diagnose any potential condition. In most situations, doctors will collect several tissue samples, each one taking about five to ten minutes to complete.

If you believe there is a need to have a prostate biopsy or you have been requested to obtain one by your doctor, do not put off getting it. It can provide very important and very accurate information to your doctor about your health and can help you to get any treatment that is necessary.

Schedule an appointment with the best urologist in New York City at
646-205-3039 to get started.

What Are Pearly Penile Papules?

Pearly Penile PapulesDo you have small, raised bumps on your penis? Are you wondering what is happening and, more importantly, what you need to do about them? In some situations, this may be a condition called pearly penile papules. While you may not realize it, it is not that uncommon and it does not indicate a high risk disease.

However, it is important that you visit your urologist to learn more about your condition and what treatment options may be available to you specifically.

What Are They?

Pearly penile papules are a small and benign type of growth that forms on the penis. They tend to be white in color, but can also be pink, yellow, or even a translucent color. In most cases, they are very small using only one or two millimeters in size. However, some can be larger and their shape may vary from one to the next. It is common for symptoms to vary among patients. Most often, they are found at the head of the penis or in this area and usually in a single or double row.

Pearly Penile PapulesWhy Do They Happen?

Researchers are not fully sure why some men develop this condition and others do not. They are not harmful in any way. They are also not any form of disease or any form of illness. They are not a symptom of an illness either. In some cases, they are simply considered a skin variation. Men of all races can develop them no matter where they are located or what their sexual preference is. It’s important to know they are not related to sexually transmitted disease. In addition to this, they are not contagious. You cannot infect someone with them.

What Treatment Is There?

Pearly Penile PapulesWhat should you do about them? That is a question that only you can answer. For many men, there is no treatment necessary. While there is no need to have this condition treated, many men choose to talk to their doctor about treatment options. It is best not to try to pop them, freeze them, or use a wart remover on them. This can cause damage to the penis and lead to pain, infection, and much more complex outcomes. Instead, talk to your doctor about the treatment options that may be available to you for cosmetic improvement.

 

Call our offices today at 646-205-3039 to schedule an appointment with one of the best urologists in NYC to learn more.

Tests to Evaluate and Diagnose Urethral Strictures: Part 1

Two of the most important tests to diagnose and evaluate a urethral stricture are the retrograde urethrogram (RUG) and a cystoscopy. The retrograde urethrogram can be done by a radiologist or by a urologist. In our experience the information gained when an urologist does the RUG is usually more helpful then when done by a radiologist, but many urologist may not do the RUG because they lack the x-ray facilities for the test in their office. In our office, we are able to do fluoroscopy and, consequently, retrograde urethrograms in the office to diagnose and evaluate urethral strictures. The RUG is typically done by placing the patient on his side with a bottom leg bent and the top leg straight. The penis is put on mild stretch and contrast is gently injected into the urethra using either a small catheter or a specially designed syringe. As dye is injected into the urethra, multiple x-ray images are take to look for narrowing suggestive of a stricture.
1

Urologists specializing in urethral reconstruction know what to look for and can shift the position of the patient during the study to maximize important information to plan the best surgery to correct the urethral stricture. When a radiologist does this test, however, they may not be aware of the diagnostic needs of the surgeon. It is not uncommon for us to need to repeat the retrograde urethrogram for a patient who has been diagnosed with urethral strictures because of the poor quality of the original films done by a radiologist.

The retrograde urethrogram provides critical information about the length and location of the stricture as well as the extent of spongiofibrosis (a term we’ve previously discussed) and the density of the stricture. The extent of spongiofibrosis has a great impact on counseling patients as to the best type of surgery to correct the stricture.

Occasionally, however, the patient may have multiple dense strictures or may have a stricture in the back (posterior) portion of the urethra which are not very well visualized by retrograde urethrogram. In patients with more than one stricture (termed synchronous urethral stricture) the dye may not get past the first stricture and the extent of the patient’s stricture disease can be significantly underestimated. In these cases, a voiding cystourethrogram (VCUG) in addition to the retrograde urethrogram can be a useful test to evaluate the patient’s stricture, particularly if surgery is anticipated for the patient. The voiding cystourethrogram is done by placing a suprapubic tube, or a catheter that enters the abdomen below the belly button and goes straight into the bladder. Dye is placed through the catheter directly into the bladder and the patient is asked to urinate while x-rays are obtained. The voiding cystourethrogram can help visualize the proximal portion of the urethra when the retrograde urethrogram alone is inadequate.

Rarely, we have found that an ultrasound done of the urethra may also be helpful. This was particularly helpful if we are concerned that the patient has more extensive spongiofibrosis than may be apparent on the retrograde urethrogram. We typically will do the ultrasound of the urethra prior to surgery to better anticipate the type of surgery the patient will need. In our next urethral stricture blog post we’ll discuss the usefulness of a cystoscopy for diagnosing urethral strictures.

Why you might think you have a urethral stricture

Rajveer S. Purohit, MD, MPH

urethral strictureFirst consider your medical history. If you’ve had any trauma to the pelvis, sexually transmitted infections, had anything inserted in the urethra – particularly if it was traumatic – you are at risk for having a stricture. Also, if you’ve had a stricture in the past and have developed urinary symptoms you are at much higher risk of a stricture. These are just a few of many things in your medical history that raise the possibility of a stricture.
But the past history can be misleading – about 1/3rd of the time, patients can present with dense strictures that have no known cause (called idiopathic strictures).

One additional indication of a stricture is if you currently have bothersome urinary symptoms. These include obstructive urinary symptoms including a slow urinary stream, urinary hesitancy, and a sense of incomplete emptying after you urinate – which is a sensation that after you urinate you still feel that you retain urine in the bladder.

Some patients can also present with what are termed irritative urinary symptoms which include urinary urgency, frequency, night time urination and even incontinence.

What makes reliance on symptoms difficult is that many of urethral stricture symptoms also overlap with other common urinary problems such as benign prostatic obstruction (BPO) and overactive bladder. Furthermore, on physical exam you might have an enlarged prostate but the primary source of your symptoms is actually a urethral stricture.

A little confusing, huh?

So what kinds of tests can be done to determine more definitively if you do have a stricture?

Common noninvasive tests we perform are the uroflow and post-void residual. We ask patients to urinate with a full bladder into a machine that measures, over time, changes in the speed of their urination and the amount that was urinated. After urination, we measure the amount of urine your bladder is still holding (residual urine) using a hand-held portable ultrasound. Patients who have strictures will not only often have a slow urinary flow measured by the machine but also a characteristic change (flattening) in the graph that measures speed over time. Again, however, many of these uroflow findings are mimicked by benign prostatic obstruction (BPO) as well.

In considering this problem we’ve researched if minor tweaks in the noninvasive uroflow can help distinguish urethral strictures from BPO and presented our findings at the American Urological Association’s annual meeting in New Orleans in May 2015. We found that asking patients to increase their abdominal pressure while they urinated (termed Valsalva voiding) helped distinguish strictures from BPO. In patients with strictures alone Valsalva voiding will increase the speed of their urination while those with BPO will not. We think that this test will be particularly useful for those who may have had their strictures treated but are at risk for recurrence. Results from the presentation can be seen in the slide below.

The gold standard, however, for diagnosing the urethral stricture is more invasive x-ray studies called the Retrograde urethrogram (RUG) and sometimes voiding cystourethrogam (VCUG) and a study using a fiberoptic scope inserted into the urethra (with local anesthesia, of course!), called the cystoscopy.

We’ll talk in more about these tests on an upcoming blog post. Stay tuned!

 

Urethral Stricture