Urology 101
This covers a lot of ground in terms of the types of conditions urologists see, which is why these specialists sometimes further subspecialize, focusing their practice on particularly complex disorders or procedures in which they develop advanced expertise. Still others are general urologists who diagnose and manage a breadth of urological conditions in both adults and children. Fortunately, the desert is home to a wealth of urological expertise, and there are a number of skilled urologists who admit patients and perform surgery at Eisenhower Health.
Board Certified Urologists in the valley have a variety of interests, from general urology care to sub-specialized care focusing on specific health concerns, such as pelvic organ prolapse, which occurs when the muscles and tissues supporting the uterus, bladder, or rectum become weak or loose, allowing one or more of these organs to drop into or press out of the vagina.
Incontinence
It also includes various types of incontinence, including stress incontinence (the unintentional loss of urine, which occurs when physical activity such as coughing, sneezing, running or heavy lifting puts pressure — stress — on the bladder) and overactive bladder (a problem with bladder function that causes the sudden uncontrollable need to urinate), or a combination of the two. All of these conditions, under the umbrella term of pelvic floor dysfunction and incontinence, are commonly seen by urologists in the area.
Urologists note that treatment options range from lifestyle changes, such as diet modification, biofeedback and pelvic floor exercises, to medications (there are eight different medications now available), to Botox® injections to the lining of the bladder, to surgery.
Overactive bladder
In a quickly evolving area of care, more options are available than ever before for incontinence. For instance, overactive bladder can be treated with posterior tibial nerve stimulation, in which an acupuncture needle is placed just behind the ankle, on the medial side, and low-level electricity is used to stimulate the nerve and calm down the bladder. This outpatient procedure takes about 30 minutes and has been found to be effective.
Another option for treating urinary incontinence due to overactive bladder as well as fecal incontinence is called InterStim®. It is a reversible treatment, also referred to as sacral nerve stimulation or neuromodulation, in which a small implanted device sends electrical impulses to nerves located in the lower back (just above the tailbone).
BPH and prostate cancer
Other urologists specialize in conditions specific to the male anatomy, such as benign prostatic hyperplasia (BPH) and prostate cancer. BPH is a fairly common age-related condition in which a man’s prostate gland becomes enlarged, often causing urination difficulty, and can be treated with two leading-edge, minimally invasive procedures: UroLift® and holmium laser prostate surgery, also called holmium laser enucleation of the prostate (HoLEP).
UroLift is an office-based surgical system that lifts and holds the enlarged prostate tissue so it no longer blocks the urethra. It is the only BPH treatment performed by a urologist that does not require heating, cutting or removal of the prostate tissue.
HoLEP is a minimally invasive treatment for an enlarged prostate that uses a laser to remove tissue that is blocking urine flow through the prostate. It is similar to traditional open prostate surgery but requires no incisions. It can be an option for men with a severely enlarged prostate. Importantly, HoLEP can offer faster recovery and symptom relief compared with traditional prostate surgery.
Another area of focus among urologists is penile implant procedures to treat erectile dysfunction and male incontinence.
While urinary incontinence affects twice as many women as men, many people experience the condition as they age, with more than four in 10 women age 65 and older having urinary incontinence. These and other conditions are familiar to urologists who stress the need for patients to discuss their concerns with their physician, emphasizing the non-judgmental, supportive care they offer for these health issues that often cause embarrassment and even isolation when quality of life is impacted by changes in urological health.
Urologists with privileges at Eisenhower Health:
Bobby Alexander, MD
John Faulkner, MD
Jeffrey Herz, MD
Pedram Ilbeigi, MD
Farshid Mirzaee, MD
Cesar Mora-Esteves, MD
Michael Sanford, MD
Kevin Shandera, MD
Lance Walsh, MD
To find a physician, visit EisenhowerHealth.org or call 760.568.1234.