Urology Clinic of Lake Charles, LA

Dr. Reed Fontenot, Jr.
Dr. Stacy McBroom
Dr. John Upshaw

News

July 18, 2008
Computerized Tomography Findings In Pediatric Renal Trauma - Indications For Early Intervention?
UroToday.com - The study out of Children's Hospital of Pittsburgh evaluated CT scans for blunt renal trauma to see if they correlated with the need for operative intervention when urinary extravasation was present.

A total of 17 patients with grade IV blunt renal trauma and urinary extravasation were identified between 2000 and 2007. Each CT scan was reviewed to determine location, size and number of sites of extravasation, as well as the presence of contrast material in the ipsilateral ureter. These were then compared to the findings at the time of surgery - whether surgey included stent placement, percutaneous urinoma drainage, angiographic embolization and nephrectomy. Read entire article here.

July 15, 2008
Increased Risk Of Kidney Stone Disease Due To Global Warming, Predicts UT Southwestern Researchers
Global warming is likely to increase the proportion of the population affected by kidney stones by expanding the higher-risk region known as the "kidney-stone belt" into neighboring states, researchers at UT Southwestern Medical Center and UT Dallas have found.

Dehydration is one of the risk factors linked to kidney-stone disease, and the paper suggests global warming will exacerbate this effect. The researchers predict that by 2050, higher temperatures will cause an additional 1.6 million to 2.2 million kidney-stone cases, representing up to a 30 percent growth in some areas. Read entire article here.

Information
Prostate cancer is the second leading cause of death among men. In 2002 it is estimated that 30,200 men will die from prostate cancer and 189,000 men will be diagnosed (American Cancer Society Facts & Figures 2002). The incidence of prostate cancer increases with age with 75% of all prostate cancers being diagnosed in men over the age of 65.

Prostate Cancer Management
The critical focus for the treatment of prostate cancer is to treat those cancers where it is necessary, and not to treat those that do not need it.

Decisions about the best management of prostate cancer can be complex and depend upon the:

Pathology of the cancer (unlike other cancers, prostate cancer often progresses very slowly)
Stage of the disease (non-metastatic (localized or locally advanced), metastatic or hormone refractory)
Age and general health of the patients at diagnosis
The impact that treatment can have on quality of life, including sexual activity.
Patient's preference for treatment
PSA at diagnosis

Please visit the National Prostate Cancer Coalition for more information.

August is National Immunization Awareness Month
Vaccine-preventable disease levels are at or near record lows. However, we cannot take high immunization coverage levels for granted. To continue to protect America's children and adults, we must obtain maximum immunization coverage in all populations, establish effective partnerships, conduct reliable scientific research, implement immunization systems, and ensure vaccine safety.
Read more ....

Benign Prostatic Hyperplasia

Overview

Benign prostatic hyperplasia (BPH) is not simply a case of too many prostate cells. Prostate growth involves hormones, occurs in different types of tissue (e.g., muscular, glandular), and affects men differently. As a result of these differences, treatment varies in each case. There is no cure for BPH and once prostate growth starts, it often continues, unless medical therapy is started.

The prostate grows in two different ways. In one type of growth, cells multiply around the urethra and squeeze it, much like you can squeeze a straw. The second type of growth is middle-lobe prostate growth in which cells grow into the urethra and the bladder outlet area. This type of growth typically requires surgery.

Anatomy

The prostate is a walnut-sized gland located beneath the bladder and in front of the rectum. It is surrounded by a capsule of fibrous tissue called the prostate capsule. The urethra (tube that transports urine and sperm out of the body) passes through the prostate to the bladder neck. Prostate tissue produces prostate specific antigen and prostatic acid phosphatase, an enzyme found in seminal fluid (the milky substance that combines with sperm to form semen).

Incidence and Prevalence

It is difficult to establish incidence and prevalence of BPH because research groups often use different criteria to define the condition. According to the National Institutes of Health (NIH), BPH affects more than 50% of men over age 60 and as many as 90% of men over the age of 70.

Risk Factor

BPH is a condition of aging. Nearly all men over the age of 50 have an enlarged prostate.

Causes

The cause of benign prostatic hyperplasia is unknown. It is possible that the condition is associated with hormonal changes that occur as men age. The testes produce the hormone testosterone, which is converted to dihydrotestosterone (DHT) and estradiol (estrogen) in certain tissues. High levels of dihydrotestosterone, a testosterone derivative involved in prostate growth, may accumulate and cause hyperplasia. How and why levels of DHT increase remains a subject of research.

Signs and Symptoms

Common symptoms of benign prostatic hyperplasia include the following:

Blood in the urine (i.e., hematuria), caused by straining to void
Dribbling after voiding
Feeling that the bladder has not emptied completely after urination
Frequent urination, particularly at night (i.e., nocturia)
Hesitant, interrupted, or weak urine stream caused by decreased force
Leakage of urine (i.e., overflow incontinence)
Pushing or straining to begin urination
Recurrent, sudden, urgent need to urinate

In severe cases of BPH, another symptom, acute urinary retention (the inability to urinate), can result from holding urine for a long time, alcohol consumption, long period of inactivity, cold temperatures, allergy or cold medications containing decongestants or antihistamines, and some prescription drugs (e.g., ipratropium bromide, albuterol, epinephrine). Any of these factors can prevent the urinary sphincter from relaxing and allowing urine to flow out of the bladder. Acute urinary retention causes severe pain and discomfort. Catheterization may be necessary to drain urine from the bladder and obtain relief.