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 ....

Urological Emergencies

Overview

Some urological conditions have serious or life-threatening consequences and require immediate medical attention. These medical emergencies include

acute urinary retention,
Fournier’s gangrene,
paraphimosis,
priapism, and
testicular torsion.

While these conditions are unrelated and have different symptoms, they all require urgent care. Delaying treatment in some cases can result in orchiectomy (surgical removal of testicles), permanent impotence (inability to achieve an erection), or death.

Acute Urinary Retention

Acute urinary retention is the sudden inability to urinate and is usually symptomatic of another condition that needs treatment.

Incidence and Prevalence

Anyone can experience acute urinary retention. The causes and rate of occurrence varies greatly between genders until about age 60, when men are more often affected as a result of benign prostatic hyperplasia (BPH).

Risk Factors

Kidney stones, prostate cancer, prostatitis, and BPH are risk factors in men. Women with a history of kidney stones or urinary tract infections (UTIs), pregnant women, and those who have had recent gynecological surgery are at higher risk.

Causes

Acute urinary retention is caused by obstruction in the bladder or urethra (the tube that carries urine from the bladder outside the body), a disruption of sensory information in the nervous system (e.g., spinal cord or nerve damage), or a situation or event that causes the bladder to become distended.

Factors associated with acute urinary retention include the following:

alcohol consumption
allergy or cold medications containing decongestants or antihistamines
certain prescription drugs (e.g., ipratropium bromide, albuterol, epinephrine) that cause the urethra to become narrow
delaying urination for a long time
prolonged exposure to cold temperatures
long period of inactivity or bed rest
spinal cord injury/nerve damage
surgery (e.g., complication of anesthesia)
urinary system obstruction (e.g., benign prostatic hyperplasia (BPH), kidney stones)
urinary tract infection

Signs and Symptoms

Acute urinary retention produces severe lower abdominal pain, a distended abdomen, and/or the sudden inability to pass urine.

Complications that may develop with untreated urinary retention include bladder damage and chronic kidney failure.

Diagnosis

Diagnosis is based on a sudden lack of urinary output and bladder distention (swelling) observed during a physical examination.

Treatment

Treatment should be obtained within 5 hours of the onset of symptoms to avoid the development of complications. The underlying cause of urinary retention (e.g., kidney stones) must be diagnosed and treated as well.

A catheter (small tube) is inserted into the bladder through the urethra to drain the urine. Catheterization relieves pain and distention.

Prognosis

Depending on the underlying cause, the recurrence rate can be up to 70% within a week after initial treatment. BPH is responsible for most recurrences.