InterStim treatment for overactive bladder has low rate of serious complications, according to new study

Posted by David J. Cahn, MD on September 28, 2016 at 12:00 PM

Have you been considering InterStim therapy to treat your overactive bladder but you are worried about complications from the device or the surgery? In a new study looking at 272 patients who received InterStim therapy for overactive bladder, the rate of adverse effects (AE) was much lower than in past studies.

The study found that 30 percent of patients had some level of adverse effects, but just one had a complication considered serious. The most common side effects were an undesirable change in stimulation and device site pain, most of which occurred in the first three months after surgery.

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Tags: InterStim therapy, Overactive Bladder, Sacral nerve stimulation, Neuromodulation

Will my prostate cancer treatment cause incontinence?

Posted by David J. Cahn, MD on August 24, 2016 at 5:50 PM

Losing urinary control is a common fear when facing prostate cancer treatment. For some men, incontinence can seem worse than impotence (erectile dysfunction). And it’s no wonder. After all, it affects your life every day. If you’re worried about urinary incontinence or are dealing with it already, here’s what you need to know.

What: Urinary incontinence after a prostatectomy can present as anything from a dribble to loss of urine when you sneeze or cough (stress incontinence) to total leakage. After radiation therapy, men may have a combination of leakage and a need to urinate frequently. While incontinence is more of an annoyance than anything else, loss of control over the release of your urine can be stressful and embarrassing.

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Tags: prostate cancer, prostatectomy, incontinence

Elevated PSA but negative prostate cancer biopsy

Posted by Foothills Urology on August 16, 2016 at 12:49 PM

Each year, about half of men over age 50 receive a PSA (prostate specific antigen) screening, according to the Centers for Disease Control. PSA is a protein produced in the prostate, and high levels of PSA may indicate cancer. About 10 percent of men tested receive results that indicate elevated levels of PSA. Often, when elevated PSA levels are detected, your physician will recommend a biopsy. The good news is, nearly three quarters of those biopsies will show no cancer.

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Tags: prostate cancer, positive PSA test, elevated PSA, prostate cancer biopsy

Erectile Dysfunction: Can prostate cancer’s dreaded side effect be avoided?

Posted by Foothills Urology on August 9, 2016 at 4:41 PM

The National Institutes of Health estimates that as many as 30 million men in the U.S. experience erectile dysfunction, and prostate cancer is a contributor. Before you choose a treatment course, it’s important to understand this serious side effect and learn more about how it might be avoided or minimized.

Getting your questions and concerns out in the open will help ensure that you have the real story. Let’s start with the basics.

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Tags: erectile dysfunction, ED, impotence, side effects of prostate cancer treatment

How will an InterStim device change my life?

Posted by David J. Cahn, MD on August 2, 2016 at 6:24 PM

Having an InterStim device implanted often changes a patient’s life – for the better. In many patients, the response is truly dramatic. They can stop taking all bladder control medications – and start enjoying activities like long walks, and travel, again.

The device provides targeted, continual therapy for overactive bladder symptoms, including urinary incontinence, stress incontinence and sudden, uncontrollable urges to urinate. It is a solution for patients for whom medications haven’t worked, or who can’t tolerate the side effects of medications.

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Tags: Stress Incontinence, Urinary Incontinence, InterStim therapy, Overactive Bladder, percutaneous nerve stimulation

Choosing the right treatment for your prostate cancer

Posted by Foothills Urology on July 27, 2016 at 9:57 AM

A high PSA level. A positive biopsy. A treatment recommendation that includes the word “radical.” Once a prostate cancer diagnosis sinks in, many men just want to remove it. Now. And that’s a completely valid response. But surgery may not be the only answer. It may not even be the best option for you.

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Tags: prostate cancer, psa testing, prostate cancer surgery

How Does Interstim® Therapy for Overactive Bladder Work?

Posted by David J. Cahn, MD on July 20, 2016 at 4:19 PM

If conventional therapies for overactive bladder have not worked for you, and your bladder is still ruling your life, it might be time to consider InterStim therapy.

Overactive bladder symptoms—which include urinary incontinence, stress incontinence, frequent and urgent need to urinate, as well as problems emptying the bladder ---are treatable. Medications for overactive bladder generally work, but they are not targeted, and they have side effects, such as dry mouth, blurry vision, foggy thinking, and constipation.

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Tags: Overactive Bladder, InterStim therapy

New study endorses routine PSA screening

Posted by Foothills Urology on July 15, 2016 at 10:42 AM

Contradicting government recommendations four years ago that men should not get routine PSA testing, a new study says this simple blood test used to detect prostate cancer can reduce the number of deadly cases.

For Foothills Urology prostate surgeon Derek Zukosky, DO, the new findings reinforce his longtime position. “I strongly believe every man with a life expectancy greater than 10 years should be offered the option of prostate screening including a rectal exam and PSA test.  The issue isn’t the screening—it’s what’s we do with the information that it produces and the interventions we do or do not employ,” Zukosky says.

Prostate specific antigen, or PSA, testing measures antigens in the blood that are linked to the presence of prostate cancer. Since PSA testing was introduced in the early 1990s, the United States has seen about a 50 percent reduction in the death rate from prostate cancer, but questions remain about the role testing played. Prostate cancer remains the second leading cause of cancer death among American men and the second most common cancer in men after skin cancer.

In 2012, the U.S. Preventive Services Task Force recommended against routine PSA testing, saying the benefit was offset by the risk of exposing men to potentially unnecessary treatment.  The 2012 recommendation cited the possibility that PSA screenings could identify cancers that would never spread and never pose a risk. Detecting such non-threatening cancers would, overall, provide little benefit, but could needlessly expose men to treatment that carries potential side effects, including erectile dysfunction, urinary incontinence, and bowel dysfunction, according to the recommendation.

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Tags: prostate cancer, psa testing, advanced prostate cancer treatment

Who is a candidate for InterStim therapy for overactive bladder?

Posted by David J. Cahn, MD on July 7, 2016 at 11:39 AM

About 37 million adults in the United States have one or more symptoms of overactive bladder – a sudden uncontrollable urge to urinate, urinary incontinence, frequent need to urinate, leakage, or even getting up in the middle of the night to go to the bathroom.

For many of those patients, medications work. But mediations are not targeted, and they do have side effects, which can include dry mouth, blurry vision, foggy thinking, and constipation.

And there are people for whom the medications don’t work or don’t work sufficiently.

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Tags: Overactive Bladder, InterStim therapy, Urinary Incontinence, Stress Incontinence

Deciding if you are a candidate for sacrocolpopexy to treat pelvic organ prolapse

Posted by Dr. Diane Hartman on June 29, 2016 at 6:22 PM

Pelvic organ prolapse is not uncommon—some estimates say that 3.3 million women in the U.S. have it in some form.

For many of those women, physical therapy will ease minor symptoms. For others, particularly those who come in and say, ‘my doctor told me I have this . . .’ and they have no symptoms, I suggest taking a wait-and-see approach because the condition is not dangerous to a woman’s health. But symptoms can worsen, and when that happens, we can discuss treatment.

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Tags: sacrocolpopexy, robotic sacrocolpopexy