I’m Dr. Sam Otto, I’m a Board Certified urologist, I work next to Ogden Regional Medical Center in the Ogden Specialties Clinic. One of the issues that comes up frequently are kidney stones and people typically notice this when they have severe back pain that can radiate into the abdomen. They may see blood in their urine. It’s very, very uncomfortable.
When I talk to the people about risk factors for stones, typically they don’t drink very much in the way of water. And so, our goal is to get them to drink more and more fluids to prevent the stones,and soda’s a bad thing, particularly the colas. Most of the stones in this country are calcium oxalate stones, and they occur because of too much calcium or too much oxalate. And when those two little ions get together,they form little crystals, and then the crystals get bigger,and then, finally, they get big enough that they drop out of the kidney and once they drop out of the kidney,they obstruct it and cause pain.
If the stone is too big, they maybe admitted to the hospital. We may do something to bypass the stone,such as using a stent that can go past the stone up into the kidney,and the urine flows out into bladder that way. That’s what a stent looks like,and there are multiple little holes in this stent, and the urine flows down through it, or in and around it, and then goes into the bladder at this end. These little curls are to keep that up in the kidney,or down in the bladder, so that doesn’t migrate out, or migrate up.
At a later, after the stone’s taken care of,then what we can do is, we just take this out, out of the bladder. Anybody who’s got stones and who is suffering from them, particularly if they’ve suffered several times,you really want to have a very careful metabolic evaluation,so that we can try to prevent their having additional stones in the future. So, the goal here is to get people in as quickly as possible and then get them scheduled for whatever they need to have done to get this stone resolved.
Treating Bladder Incontinence
Well there is a very large problem in our population with incontinence of urine. Where the urine actually comes out when we don’t want it to. There are several different kinds of incontinence. Women notice it particularly after they’ve had babies, and they’ve had stretching out of the tissues it doesn’t come back to normal, and they can have something called stress incontinence.
So when they cough or sneeze or laugh, pick up something heavy, they can lose some urine. Unfortunately there aren’t too many things to do for that, besides surgery if it’s bad enough. The surgery’s very effective, it works well. On the other hand, there’s another kind called urgency urinary incontinence and that’s the kind where you feel like you have to go and you just can’t get there in time.
For that, there are typically some behavioral changes that can be done that will really help,some strategies to help cut down the urge when it strikes,and there are medications that are very helpful in accomplishing that. There are some other kinds of incontinence as well,and that one is called overflow incontinence. And this typically is happening in men who have large prostates, and they simply do not empty their bladder, they have a very high residual urine and they go often and sometimes urine is just coming out because their bladder is so full.
It’s very important to come and see basically a urologist because we’re the ones that are most equipped to take care of that. The other part of that is that you have to be treated appropriately, you have to define what the problem is, and then treat it. There are a lot of people who are having difficulty with incontinence, and as folks are aging they may find that they’re having a problem. They may say, “oh this is just part of getting older”. No it’s not. There are people who have difficulties at any age,and they should be resolved.
What You Need to Know About a Vasectomy
When I do vasectomies, I’m doing a no scalpel approach, which just means that I’m making a tiny opening in the scrotum and bringing the vas up into the opening. When I say tiny, I’m talking about a little less than an eighth of an inch, and I bring that vas up, so the vas is right here, and I put two clips on one side, two clips on the other, cut out a segment, cauterizing both ends so there’s scar tissue there, and turning this end back toward the testicle then dropping it into the scrotum.
Go around to the other side and do the same thing through the same opening so that people only have to have that injection one time in the scrotum. The advantage of the no scalpel technique is that it diminishes the likelihood of significant bleeding, which is one of the potential side-effects of doing a vasectomy.
And we do it right in the office. It can take somewhere between 30 minutes and an hour. Just depends upon the patient and their anatomy. They get that done in the office. It’s done, and they go home,and I really want them to take it easy for that day and then for the next several days. If you think you’ve had enough children and you’re looking to have a permanent form of birth control, a vasectomy’s a good idea.