• drs-blaivas-purohit-nyc-best-urologist
  • jerry-g-blavais-md-facs-best-urologist-nyc
  • jerry-g-blaivas-md-facs-urologist-specialist-author-mesh-complications-strictures

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

top-pelvic-mesh-expert-surgeon-surgery-specialist-nyc-faq

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

Urodynamics: What, When and Why?

What Is Urodynamics?

The videourodynamics (VUDS) lab at Urocenter of New York is widely considered one of the most advanced and innovative in the world.  Dr. Jerry Blaivas, one of the originators of urodynamics, has authored two definitive textbooks and has written over 200 book chapters and peer review articles on the subject. Dr. Purohit completed a fellowship with Dr. Blaivas in 2006 and between the two of them, they have performed over 25,000 video urodynamic studies. The videourodynamic study is an outpatient procedure performed at Urocenter of New York.  No preparation is necessary except for a urinalysis and culture.  No anesthesia is needed, and the results are immediately available to both physician and patient.

When Is Urodynamics Needed?

The most common reason that urodynamics (VUDs) is done is to evaluate lower urinary tract symptoms, or LUTS, but most patients with LUTS do not require VUDs because they can be treated okay without it. VUDs is needed when treatments are not working and/or in patients who are considering surgery to correct their LUTS.  Patients with neurologic conditions like multiple sclerosis, Parkinson’s disease and spinal cord injury (neurogenic bladder) may also require VUDs because of conditions like low bladder compliance (kind of like high blood pressure of the bladder) or destrusor sphincter dyssynergia (a blockage)  which may put patients at risk of kidney damage.

The lower urinary tract is made up of the bladder, the prostate (in men), the urethra and the sphincter. In men, the urethra runs through the prostate.  The bladder is analogous to a balloon that gradually expands as it fills, and the sphincter pinches the urethra closed and holds back the urine until it is time to go. Urination occurs when the bladder contracts and the sphincter relaxes open. Lower urinary tract symptoms (LUTS) are comprised of what are called “storage” and “voiding” symptoms. Storage symptoms include urinary frequency and urgency (having to rush to the bathroom), urinary incontinence (urine leakage) and night time urination (nocturia). Voiding symptoms are problems getting urine out – symptoms include urinary hesitancy (delay in getting urine flow started), weak stream, straining to urinate and urinary retention (inability to urinate at all).

Why Urodynamics?

The purpose of urodynamics is to determine the cause of LUTS. Small catheters are passed into the bladder and rectum, sphincter EMG is recorded with patch electrodes and the entire process is monitored fluoroscopically while filling the bladder with radiographic contrast.

The VUDs study is comprised of the following tests: 

  1. Uroflowmetry: Measures urine flow.
  2. Cystometry: Measures bladder pressure during filling and voiding, and bladder sensations and control are assessed.
  3. Pressure Flow Study: Measures detrusor pressure and uroflow synchronously; it is the only method by which urethral obstruction can be diagnosed with certainty.
  4. Electromyogram: This monitors the activity of the sphincter muscle. 
  5. Fluoroscopy: Depicts lower urinary tract anatomy using x-rays and dye during filling and voiding and is the only method by which the site of urethral obstruction can be diagnosed with certainty.

Possible Complications From The Test:

  1. Urinary tract infection (UTI).
  2. Painful or frequent urination that may last up to about twenty-four hours.
  3. Difficulty urinating or inability to urinate at all, and blood in the urine (hematuria).

These complications are rare, occurring in less than 5% of patients; Most of the patients who experience these complications have preexisting conditions which makes a complication much more likely to occur.

We generally treat with a prophylactic antibiotic just prior to the procedure to prevent infection. For patients with preexisting conditions that make a UTI more likely, we will let the patient know and take the necessary precautions.

For more informations on Urodynamics, call Urocenter of New York today:

Uro Center of New York
Jerry G. Blaivas, MD, FACS
445 East 77th Street
New York, NY 10075
646-205-3039

Urethrovaginal Fistulas

For women who suffer from urethrovaginal fistulas, the situation is even more complicated because, in addition to fixing the fistula, it is usually necessary to do an anti-incontinence operation at the same time.

However, not all urethrovaginal fistulas create a problem and not all have to be surgically mended. If a urethrovaginal fistula is discovered during an examination by your urologist, but you have no symptoms or incontinence, there is no need to fix it. However, if incontinence is present, it usually means that the fistula affects not only the urethra, but the sphincter and bladder neck as well.

Surgeries to repair these types of injuries are much more complicated than the repair of a vesicovaginal fistula and require a very experienced surgeon. First, the surgeon has to fix the urethra, and then he has to repair the incontinence.

Because he or she is performing so much surgery in such a small space, it is typically wise to bring in a new blood supply to insure the best chance for healing. This can be done with a Martius labial fat pad graft. Despite the complexity of this surgery, in experienced hands, the overall success rate is over 90% with respect to continence and a successful fistula repair.

How Do You Repair Urethrovaginal Fistulas?

Typically, there are three different approaches to repairing these injuries:

  1. Anterior bladder flaps (Tanagho procedure)
  2. Posterior bladder flaps (Young-Dees-Leadbetter procedure)
  3. Vaginal wall flaps.

Although these techniques seem similar with respect to repairing the fistula, incontinence persists in about half of the women unless it is repaired at the same time. Dr. Jerry Blaivas, world renowned surgeon at Urocenter of New York advises that there is almost never a need to do anything but a vaginal repair combined with pubovaginal sling and Martius flap. Urologists Dr. Blaivas believes that vaginal reconstruction is considerably easier and faster, is much more amenable to concomitant anti-incontinence surgery and has a much easier recovery with much fewer complications and less blood loss.

Vesico-vaginal and urethro-vaginal fistulas (holes in the vagina connected to the bladder and urethra) are rare in industrialized countries, but are common in the third world because of inadequate obstetric care. The only treatment is surgical and in the hands of experienced surgeons the success rate is very high.

Even if the surgery should fail, a second operation or even a third will almost always be successful in expert hands. Whenever a fistula is diagnosed, a careful search for associated injuries to the ureter should be undertaken and, if found, these injuries should be repaired at the same time.

If you are interested in more information regarding vesico-vaginal and urethro-vaginal fistulas, contact reconstructive urologist Dr. Jerry G. Blaivas at the URO Center of New York.

Call today to schedule a consultation:

Urocenter of New York
646-205-3039

Urethral Strictures in Women

Urethral strictures in women are rare, and they account for only about 15% of women with BOO. Urethral obstruction in women is functional or anatomical.

When the obstruction is anatomical, it can be secondary to compression or scar. Compressive obstruction can result from prolapse, urethral diverticulum or tumor. Strictures may be iatrogenic, idiopathic or traumatic, or as a result of deterioration.

Because urethral strictures are so uncommon and high quality studies are few and far between, the management of urethral strictures in women is largely experimental. Treatment options typically include urethral dilation, self-catheterization, urethrotomy and urethroplasty.

Although data is limited, it appears that urethral dilation is of benefit only in the short term, which is measured in months, not years. In our study, only 1 of 17 patients had a continual response to urethral dilation alone. This suggests that definitive surgical treatment should be considered when conservative measures fail or when stricture is associated with partial or complete loss of the urethral wall. 

Urethral Strictures in Women: Techniques

A variety of surgical techniques have been described for urethral strictures in women, including VFU, dorsal urethroplasty with labia minora, lingual graft, skin graft or pedicle flap, vestibular flap urethroplasty and buccal mucosal graft urethroplasty. Each procedure utilizes a variation on two basic urethroplasty approaches – the vaginal flap and vaginal wall grafts.

Vaginal flap neourethral restoration for urethrovaginal fistula was first described in 1935. After urethral catheterization has been completed, a U-shaped flap is created on the anterior vaginal wall. The stricture is incised and the flap is advanced, which avoids grafting or tunneling the tissue and has few problems.

Buccal mucosal graft urethroplasty has been successfully applied to both male and female urethral stricture disease. Advantages include hairless tissue that is accustomed to a damp environment and has elasticity. It is an option when there is inadequate vaginal tissue for grafting.

What is Urocenter of New York’s Experience Treating Urethral Strictures in Women?

For treatments of urethral strictures at URO Center of New York, the urethra is incised dorsally until healthy proximal urethra is identified. We use the resistance experienced during the withdrawal to assess the residual stricture. Subsequently, the graft is sutured into the urethra and covered with periurethral tissue.

Bottom Line: Urethral stricture is uncommon in women and literature on the topic is sparse. In our experience with 17 consecutive women with urethral stricture seen in a 12-year period, urethral dilation was rarely effective.

Urethroplasty had a 100% success rate at 1 year in 9 women but strictures recurred at 6 years in 2 who underwent ventral vaginal flap urethroplasty, requiring repeat urethroplasty with a buccal mucosal graft. Women with urethral strictures should be monitored for a longer term due to the small risk of recurrence.

Dr. Jerry Blaivas is the World Leading Expert on Complicated Urological Problems

For more information regarding urethral strictures in women, visit our website or call us at 646-205-3039 for an appointment.

Uro Center of New York
Jerry G. Blaivas, MD, FACS
445 East 77th Street
New York, NY 10075
646-205-3039

Questions About Sling And Prolapse Repairs Without Mesh?

The FDA has warned about serious complications resulting from synthetic sling surgery for the treatment of incontinence in women. This has prompted researchers to investigate new ways to continue to achieve the high success rate associated with this surgery without the devastating complications that can result. At URO Center, urologist Jerry G. Blaivas, MD, FACS perform an operation with a success rate that is just as high, but without the potentially serious complications.

Some may think it’s a new operation, but it’s not. And it works very effectively with practically no serious complications. In addition, both urologists New York are experts at performing the procedure. In fact, Dr. Blaivas was the first ever to recommend non-mesh slings as the standard treatment for stress incontinence in women. Dr. Blaivas has written chapters in many major textbooks focusing on fascial slings, and his work is typically referenced when others write about non-mesh slings.

Frequently Asked Questions About Sling And Prolapse Repairs Without Mesh

What is a sling?

A sling is ribbon-like substance made up of natural tissue, called fascia, or synthetic mesh that is positioned like a hammock under the urethra in surgical procedures performed to relieve urinary incontinence.

How does it work?

When you cough, sneeze, exercise, or do anything that causes your abdomen to push down, it forces down the bladder and urethra (where the urine comes out) and squeezes it against the sling just like you would compress a water hose by stepping on it to stop the flow of water.

If it works so effectively, why does anyone use synthetic slings and run the risk of serious complications?

Fascial slings require more expertise and many urologists New York are not trained to perform the surgery.

Secondly, the operation is performed through a small incision made in the lower abdomen that can leave a scar that can result in a hernia. The scars resulting from the mesh sling procedures are tiny and there is little risk for a hernia to occur.

Third, fascial sling surgery requires general or regional anesthesia and takes up to two hours, while mesh operations typically take just 30 minutes or less, and can be performed as an outpatient under local anesthesia.

If you’re suffering from mesh complications and are in need of an expert urologist, patients form all over the world trust best NYC urologist Jerry G. Blaivas, MD, FACS to help. Call us today to schedule a confidential consultation.

Dr. Jerry G. Blaivas
646-205-3039

Bladder Problems: Do You Have Neurogenic Bladder?

Bladder Problems | Best Urologist NYC

According to urologist New York at the URO Center, if you’re experiencing bladder problems, you may have neurogenic bladder. This is the name given to a variety of urinary conditions and is the result of difficulties with nerves that control how the bladder stores or voids urine.

These conditions include overactive bladder, incontinence, and obstructive bladder. Many women and men experience these bladder problems, including people who suffer with illness and injury that affect the brain and/or the spinal cord.

What are the causes associated with neurogenic bladder?

According to your urologist New York, in patients with neurogenic bladder, the nerves and muscles don’t operate together in the correct way. For example, the bladder may not fill or void correctly due to nerve damage. Bladder muscles may be overactive and contract involuntarily more often than usual and before the bladder is filled with urine.

Sometimes muscles are too loose and they allow urine to pass before you’re ready. In some other cases, the bladder muscle may be underactive, which occurs when it will not contract when filled with urine and won’t empty entirely. The sphincter muscles surrounding the urethra may also not function properly, remaining tight when you try to release urine.

What are the symptoms associated with neurogenic bladder?

The symptoms differ from person to person and depend on the type of damage they have experienced. Some symptoms include:

  • Incontinence;
  • Urgent urination;
  • Frequent urination;
  • Urinary retention;
  • Recurrent urinary tract infections.

How is this condition diagnosed?

Your urologist New York may diagnose your neurogenic bladder using methods such as:

  • Reviewing your past and present health;
  • Performing a physical exam;
  • Asking you to keep a bladder diary;
  • Performing a Pad Test;
  • Collecting urine to test for infection or blood;
  • Conducting a series of tests such as a bladder scan or urodynamic test.

Your urologist New York may need to perform additional imaging tests such as x-rays and CT scans to diagnose your condition.

The treatment is designed to control your symptoms while preventing damage to your kidneys. Treatment will be dependent on the symptoms you are experiencing, and the cause of your neurogenic bladder.  However, regardless of the cause, treatments are concentrated on improving the patient’s quality of life.

It’s vital that you determine what is causing your symptoms before they lead to more serious bladder problems.

If you are having bladder problems or need urinary treatment, you can rely on the expert care provided by the best urologist Dr. Jerry G. Blaivas, MD, FACS at the New York URO Center:

Uro Center of New York
Jerry G. Blaivas, MD, FACS
445 East 77th Street
New York, NY 10075
646-205-3039

Is Permanent Urinary Catheterization Really Permanent?

Urinary catheterization is used in three instances: (1) temporarily, for people who cannot urinate following a surgery or for monitoring urinary output; (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 instead of urinating.

There are two major reasons why a patient cannot 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 AKA detrusor underactivity (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.

What comes first?

Patients are often treated with an indwelling catheter when they are not able to urinate well. 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 presented with a patient who has an indwelling catheter, in most instances, an “active voiding trial” is recommended; the bladder is filled up with fluid using the catheter that is already in place. When the patient feels that he is full, the catheter is removed and the patient is instructed to try to urinate into a urine flow meter, and the bladder is checked to see how completely it empties with an ultrasound. 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 urinary catheterization and should catheterize every three to six hours. Each time, he can attempt to void 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 treated who had been condemned to permanent urinary catheterization could be better treated by an operation to relieve the bladder outlet obstruction that often coexists with DU . In a study we conducted (and recently updated) with fifty-four men being treated with intermittent catheterization for impaired detrusor contractility – only seventeen still needed to catheterize following a TURP (trans-urethral resection of the prostate) or KTPLAP (KTP laser ablation of the prostate).[1] So, almost 70% of patients who had been condemned to a life with a catheter were catheter free after a simple operation. In a separate study, we demonstrated that reduction cystoplasty can also be an effective operation for patients being treated with catheterization.[2]

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

In 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 urinary 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, J., M. Tyler, J. Aizen, A. Badri, M. Benedon, and J. Weiss. “TURP/KTPLAP Is an Effective Treatment for Men with Detrusor Underactivity.” Neurourology and Urodynamics 33.6 (2014): 988-89.

[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

Self Intermittent Catheterization; Can it Work for You?

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 or a week. Sometimes this is from obstruction from an enlarged prostate (BPH) or from a bladder that doesn’t work properly (acontractile bladder) or a neurologic problem (Neurogenic bladder).

What is Self Intermittent Catheterization (SIC)?

top-nyc-urologist-for-self-intermittent-catheterization-sic-01

“Self Intermittent Catheterization” (SIC) or “Clean Intermittent Catheterization” (CIC) is an alternative to leaving in 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. This is not uncommon, but the feeling comes from a lack of knowledge or experience.

As you might have guessed from the name, SIC is when a patient inserts a catheter 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 might be useful to you as a temporary solution while waiting for your bladder to recover after surgery, or while you wait for other therapies; 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 eventually 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 and limiting and has a higher risk of infection, and even a small risk of developing cancer. 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.

Will There Be Urination Complications?

Many people also find that they cannot urinate following various kinds of surgeries. Traditionally, the treatment for this would be an indwelling catheter until such a point when the physician felt the patient should be able to urinate then perform a “voiding trial.” This is the practice of removing the catheter and waiting for the patient to urinate. If the patient is unable to pee when the bladder is full, many physicians will reinsert the indwelling catheter until they feel the patient is ready to try again. This can put a lot of pressure on that patient’s first urination, and many will not be able to urinate to completion on their first try.

If the patient learns SIC instead of having a catheter reinserted, he can attempt to urinate every time he feels the urge and catheterize afterward for any residual urine. Once the residual shrinks to almost nothing, SIC can be discontinued.

Questions & Concerns About SIC

questions-concerns-catheter-uncontinence-trouble-urinating-nyc-expertAt the UroCenter of New York, it’s not uncommon to hear from our patients that they’re afraid to try SIC, or that it’s absolutely not for them. Some of the questions we hear are: “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. 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 some patients can do it entirely by feel.

Does Self Intermittent Catheterization Hurt?

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. Jerry Blaivas treats each case individually and works with the patient to find the best treatment option that works for them and their lifestyle. Together we will determine if self intermittent catheterization is the right option for you.

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?

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.

The 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?

Vasectomies 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 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?

There 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?

If 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

Go To Top

Copyright © 2017 - Best Urologist NYC
Jerry Blaivas MD, FACS | Urocenter of New York | 445 East 77th Street New York, NY 10075 | 646-205-3039
World Renowned Urological Expert Specializing in the Treatment and Surgery of Complicated Urological Conditions such as:
Mesh Complications Removal Surgery | Radiation Complications | Autologous Slings | Natural Tissue Repairs | Bladder & Prostate Problems | Urodynamics | Urinary Catheterization | Renal & Bladder Ultrasound |
Marketing by BestMarketingNYC.com
Terms of Use | Sitemap

View Full Site