Hematuria

Hematuria, the medical term for blood in the urine, is both common and frightening to patients.  A symptom of numerous conditions, even a small amount of blood can cause panic.

Hematuria may either be detected by your doctor through a urine test (urinalysis) or seen by the naked eye.  That which is found only through testing is referred to microscopic hematuria, while that which is visible is termed gross hematuria.

Both of these conditions need to be evaluated with at least a repeat urinalysis and blood pressure check, 

as elevated blood pressure can cause blood cells to be forced into your urinary tract.  Further evaluation, including CT imaging for kidney stones or lesions and cystoscopy, a camera passed easily into your bladder, may also be warranted.

If you are a current or former smoker, your risk of malignancy being the source of the hematuria elevates.  Therefore, ignoring the situation is highly discouraged. 

If you or someone you know has experienced this condition, please discuss this with your physician.  It is never too late to be safe.

New Drug for Erectile Dysfunction

The FDA has now added another medication to help men suffering from erectile dysfunction.  The medication, Avanafil, now becomes the fifth FDA-approved branded oral drug for ED. The others are tadalafil (Cialis, Eli Lily), vardenafil (Levitra, Staxyn, Bayer Healthcare Pharmaceuticals), and sildenafil (Viagra, Pfizer).

Per their report, the medication is quite similar in its effect to Viagra and Levitra in length of action and dosing. 

Here is to hope that the medication will help lower the cost for these medications. 

New Medication for Overactive Bladder

In exciting news for patients suffering with overactive bladder, the FDA has now recommended approval of a novel medication, mirabegron.  Unlike the current overactive bladder medications, this medicine works on a different receptor and mechanism. 

While the effects were novel, the panel approved this medication due to its alternative treatment pathway.  Not currently on the market, look for arrival in the next year.

To read the study, follow the link  http://bit.ly/IJdiES

Circumcision and Prostate Cancer Prevention

Circumcision is a controversial subject.  In the past, doctors felt the need to recommend this procedure for “health” reasons.  However, this recommendation has come under fire in recent years as the data to medically support circumcision was thin.  Furthermore, while quick, it is not a procedure without potential complication.

Recently, in Cancer, an article was published describing a 15% reduction in the relative risk of prostate cancer.  The science behind the idea is that data is developing that shows many cancers, prostate cancer being one, are affected by chronic infection and inflammation.  Prostates from autopsy studies have shown infection (HPV, gonorrhea, trichomonas) and cancer.  

However, this article is fraught with confounding variables and is far from conclusive.  Further, any recommendation involving prostate cancer with prevention as the goal will take decades to become conclusive, if not lifetimes.  Therefore, at this juncture, circumcision for prevention is not recommended.   

Partial Nephrectomy

Port placement during a left partial nephrectomy.  Rather than a large incision, multiple small incisions are used to allow access to the kidney tumor.  This allows access for the robot to perform the cancer removal.  With such small incisions, most patients are home the next day for dinner.