Urinary incontinence is defined as the involuntary loss of urine which the patient describes as being “wet”. Urinary control is maintained by an intact nervous system which directs the muscles and sphincters of the pelvis. If there is compromise of the nervous system (neurologic disease such as Parkinson’s, Alzheimer’s, Diabetes, etc.) or the muscles/sphincters (trauma, surgery, radiation, infection) then urinary control may be adversely affected.
In addition to the above, there are general causes of incontinence which often vary by gender particularly as men/women age. In men, there may be overflow incontinence in which the bladder is blocked often by an enlarged prostate. In women, there may be stress incontinence, caused by laxity of the pelvic muscles which occurs with age and is often accentuated as a result of childbirth.
Both men and women suffer from urgency incontinence (i.e., getting to the bathroom in time). This occurs as the bladder becomes fibrotic (less compliant) with age. As a result of this, older adults can’t postpone urinating and void more frequently that younger people. The same is true for older people whose bladder awakens them at night and often interferes with what had been ‘normal’ sleep habits.
There is treatment available for all forms of incontinence and urinary urgency and frequency. These run the gamut from behavioral therapy, timed voiding, medication and surgical procedures.
Kidney Stones in 2013
Thirty years later, I came down with yet another kidney stone. Having experienced one back in ‘84 was enough for me to cringe at the possibilities. However nowadays we have more advanced medications like alpha blockers which can help facilitate passage of small stones. We used Toradol for pain, which is non narcotic. In the process of diagnostics, we used a CT scan, which are easier and quicker to perform and do not require IV contrast. CT scans also provide more information to help with the treatment process. Once the stone was found treatment was decided. We had some options. One of which was ESWL (Extra-corporeal Shock Wave Lithotripsy) which was not available back in 84. This procedure is non invasive.
However for my stone, a urethral stone extraction was done. Today’s instruments are more advanced and much smaller. This helped reduce pain and trauma during the procedure. This was carried out at an out patient facility. After the extraction was performed a stent was placed in. This was a more tolerable experience due to the softness and flexibility of today’s Stents. Additionally, the stent was removed in only 3 days.
All in all, treatment for kidney stones has advanced vastly. From medications to instrumentation we have great options to help you with this problem in an efficient and effective manner.
We recently took some time to actually talk to some of our Urologists.
As a practice, we all spend a lot of time together. Its that kind of family like relationship, where sometimes you cant stand your little brother, or get annoyed at your dad not letting you go out this or that night. Oh, the memories! After spending some time with our doctors, not interviewing them but just talking to them outside of their Doctor like environment we came to realize how much like you and me they are (yes behind the MD title there is a person too). They are people with the same concerns we have and then some. Namely, taking care of you as a patient and us as their employees.
In the last few months, we have talked to them for some time. While you may think its just urology, its amazing how passionate they are about the cases they are working on and about their trade. Urology, Medicine they’re trades too, also an art in some ways. These require attention and keeping tabs on new techniques and/or medications to treat you know who? You. They sometimes get together over coffee and discuss some of their patients with the other Doctor’s in the practice. They do so with the utmost concern and passion, which sometimes is very inspiring. We as administrative staff may not know the medical lingo the way they do, but its kinda funny to hear them talk about some technique or the other for a surgical case. They are excited about it, about the challenge that those surgical procedures entail and how they’re ready to help YOU beat what ails you. On occasion we’ve asked them how did it go with this patient and his kidney stones, or the other with their bladder tumor? How did it go with that urethral repair? Its great to see them happy with each successful case. As with every thing not all cases have a single treatment solution, but the doctors come back with more information to create the next step in treatment. No, not all cases are surgery. Some are office treatment courses, or studies that help them figure out problems.
On top of having the constant pressure of dealing with their day to day life, they are concerned about you their patient. Besides this, many of our Urologists also lecture at teaching hospitals. It had been our impression that their work day was mostly 9-5 when in the office and which ever surgery cases they had at the hospital. Well, its not just that. Many times they arrive at our office after teaching at the hospital, presenting some conference at 730am. When thinking about that, consider that some of the doctors in our practice come from Long Island or New Jersey!
Medicine is not all glamor. Understanding all they do puts everything into perspective. It takes a lot of sacrifice and dedication, that not many people are willing to make. After coming to this understanding about the doctors at our practice, we have new found respect for them. We may complain sometimes about a stressful day at the office, and that’s fine, but now when we do, we also remember that these doctors we’re working for, never leave the proverbial office because they’re always available in some form to take care of their/our patients.
To ALL Urologists in our practice, and doctors everywhere we have to say thanks for letting us assist in the privilege of caring for your patients!
New York Urological Associates, PC is very pleased to announce that Ciara Marley, MD will be joining the practice effective November 1, 2013.
Welcome to the new revamped New York Urological Associates website! We are listening to your suggestions and have updated our site to clearly reflect more relevant information for our visitors. We will continue to update a number of features, but for now, please have a look around at the list of new resources!
Get to know our doctors
All of our urologists are here to help you with a wide range of urological conditions that may be ailing you. Feeling comfortable with your doctor is a key element in patient care, so now you can find out more about each doctor’s experience and perspectives. Find out more about their experience, areas of speciality, current contributions & more one-on-one detail.
Request appointments online
You can now submit an appointment request online by filing out the form on the right of all our pages. Our staff will get back to you to confirm your appointment or to provide alternative options. For same or next day appointments, it is still strongly suggested to call our office directly at 212-570-6800.
We have a news section on our site to provide updates regarding our office and as a medium to provide the latest in urology news or events. We can also be found in social media outlets such as Facebook, Twitter, LinkedIn and Google +.
As always, your privacy is paramount and we appreciate that our visitors use their best judgment when providing any personal health information online.
We look forward to continue providing the high quality care you have come to expect from New York Urological Associates.