General Urology

IncontinenceInterstitial Cystitis | Overactive Bladder |  Urinary/Kidney Stones | Urinary Tract Infections

Incontinence

Diagnosis

Incontinence is the loss of voluntary control over your urinary functions.

There are six main types of urinary incontinence:

  • Stress -  Losing urine involuntarily during certain physical activities: coughing, laughing or sneezing; lifting; walking or performing other forms of exercise; moving to get up from a chair or out of bed.
  • Urge - Inability to control the sudden urge to urinate. A large amount of urine may be released. Urge incontinence may occur after a sudden change in position or activity.
  • Mixed - A mixture of stress and urge incontinence.
  • Overflow - Failure of the bladder to empty normally. The bladder remains at least partially full, and small amounts of urine are leaked on a nearly continuous basis.
  • Neurogenic - Related to defects in the nervous system, which conducts urination signals between the bladder and the brain. Patients may have severe, total incontinence.
  • Post-prostatectomy - Occuring after prostate surgery; may take the form of stress and/or urge incontinence.

Treatment Options

Dr. Ryan currently offers several therapies for treatment of Incontinence including:

  • Medication Therapy
  • Traditional Urodynamics (bladder function testing)
  • Interstim Therapy
  • Surgical Treatments- TOT (Transobturator Taping) & TVT (Transvaginal Taping)

Interstitial Cystitis

Diagnosis

Interstitial cystitis (IC) is a long-term condition where the bladder wall can become irritated and inflamed. Women with IC typically complain of pain or pressure in the pelvic area, pain during or after sex, and frequent, sometimes painful, urination. Some or all of these symptoms may come and go at different times. In addition, women with IC are typically diagnosed with two or more urinary tract infections a year.

To diagnose IC, your doctor may perform:

  • Cystoscopy – a tiny scope inserted in the bladder that looks for abnormalities and pinpoints bleeding or ulcers.  Your doctor will use liquid during the exam to stretch the bladder and test its capacity.
  • Biopsy of the bladder wall – a tissue sample is examined under a microscope to rule out bladder cancer and check for microscopic changes suggestive of IC.

Treatment Options

There is no cure for IC; the goal of treatment is to relieve symptoms. Often, treatment effectiveness wanes and a replacement must be found through trial and error. Most patients who suffer from IC find relief, usually with multiple, complementary treatments.

Medications - There is an FDA-approved oral prescription medication for interstitial cystitis designed to form a protective coating on the bladder lining and repair defects in the lining. Dr. Ryan may prescribe this or other types or oral medications to help relieve your symptoms.

Hydrodilation - Uses liquid to expand the bladder to increase capacity and reduce irritation

Bladder Instillation - Medication goes through a catheter or syringe to your bladder to reduce inflammation and prevent muscle contractions.

Overactive Bladder

Diagnosis

Overactive bladder causes your bladder muscles to tighten or contract on their own – giving you a strong, sudden need to urinate, even when you bladder is not full. Your body may only give you a few seconds of warning before the strong urge is followed by an uncontrollable leak, or even gush, of urine.

Everyone is different, but the most common signs of overactive bladder are a sudden urgency, frequency and leakage.

Treatment Options

Guadalupe Urology currently offers several therapies for treatment of overactive bladder including:

  • Traditional Urodynamics (bladder function testing)
  • Prolapse (fallen bladder) Repair
  • Neurostimulation (InterStim) Therapy

Urinary/Kidney Stones

Diagnosis

For reasons that are not completely understood, some of the substances in urine, uric acid and calcium in particular, may crystallize within the kidney, forming rock-like particles (calculi) called stones. The medical term for this condition is nephrolithiasis or renal stone disease. Kidney stones may be as small as a grain of sand or larger than a golf ball. Depending on their composition, they may be smooth, round, jagged, spiky or asymmetrical. Most stones are yellow to brown in color, although variations in chemical composition can produce stones that are tan, gold or black.

Some stones stay within the kidney, where they often produce no symptoms. Other stones may break loose and travel down the urinary tract. The smallest, smoothest stones may pass out of the body with little resistance and minimal discomfort to the patient. Larger, irregularly shaped stones cause intense pain. They also can become lodged in the ureter, bladder or urethra, the tube that carries urine from the bladder out of the body.

In addition to causing severe pain, a lodged stone can block the flow of urine, causing wastes to back up into the kidneys. Such a condition must be corrected swiftly, either by surgically removing the blocking stone or by nonsurgical medical procedures that break it up and allow it to pass naturally out of the body. If not, serious kidney damage and related medical problems can result

Treatment Options

Drink Water

If your stone is small, Dr. Ryan may advise you to drink two to three quarts of water each day until your kidney stones pass through you urinary tract.


Catch your stones

Urinate through a strainer to collect the stones when they pass.  Then, take the stones to the lab; which may provide useful information for preventing future stones.


Medications

The medication Dr. Ryan recommends will vary depending on the type of stones you have.  In general, there are medications available to:

  • reduce the likelihood that crystals will stick together in the urine
  • prevent calcium and uric acid stones
  • decrease the amount of calcium that is not absorbed by your kidneys
  • bind oxylate (a potent stone former) in your intestines and prevent excessive absorption in your urine
  • reduce the amount of cystine in you urine
  • prevent bacterial infections that lead to stone growth

Surgeries

Extracorporeal shockwave lithotripsy (ESWL®) uses shockwaves to break down stones so they pass through your urinary tract.

Ureteroscopy uses a very small, fiber-optic scope to remove stones in the ureter and kidney or if it is a larger stone, fragment it into smaller pieces.

Once the stone has been completely treated, the procedure is done. In many cases, the urologist may choose to place a stent within the ureter, to allow any post-operative swelling or reaction to subside.

Urinary Tract Infections

Diagnosis

Urinary tract infection (UTI) is a common infection that usually occurs when bacteria enter the opening of the urethra and multiply in the urinary tract. The urinary tract includes the kidneys, the tubes that carry urine from the kidneys to the bladder (ureters), bladder, and the tube that carries urine from the bladder (urethra). The special connection of the ureters at the bladder help prevent urine from backing up into the kidneys, and the flow of urine through the urethra helps to eliminate bacteria. Men, women, and children develop UTIs.

Treatment Options

Usually doctors prescribe antibiotics, antifungal or antiviral medications to treat UTIs. Once you start taking medication, your symptoms should go away in a few days…but this doesn’t mean you can stop taking the medicine. As with any medication, it’s important to complete the treatment and to follow your doctor’s instructions.

 

 

© 2011 Guadalupe Urology ~ Robert T. Ryan, III, M.D. ~ Seguin | Gonzales | Cuero | Yoakum