Medical Services

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General Patient Information Financial Policy Information
Commercial Insurance
Assignments of Benefits
Medicare Assignments
of Benefits
Patient Information Form APatient Survey
Bladder Symptom Questionnaire (B)
MALE SELF-ASSESSMENT BPH SYMPTOM SCORE

Reason for coming in:

Urinary Tract Infection (UTI)Urinary Problems Rev
Urinary ProblemsUrinary Incontinence
Testicular Mass Scrotal MassSterlization
Prostatitis Groin/Testicular PainRenal Mass
Instructions After Prostate BiopsyEnlarged Prostate
Sexual DysfunctionElevated PSA
Hematuria

Patient Information

Catheter Removal

INSTRUCTIONS TO  FOLLOW AFTER CATHETER REMOVAL

  1. After the catheter is removed, you should be able to void in about two or three hours. If you are  unable void within in two or three hours. then sit in a bathtub if warm water until you void. If you do not have a bathtub, you can take a warm shower instead.
  2. If your catheter is removed before 9:00am, you are to drink only 6-8 glasses of water spaced evenly throughout the day. If your catheter is removed after 11:00am, then you are to drink only 5 to 6 glasses of water spaced evenly throughout the day. There is no need to drink excessively
  3. You will experience burning and stunning when you void the first couple of days which normal. Drinking water will help .
  4. You may observe some spotting of blood when you void, which is normal. Drinking water will help resolve this. Water prevents clots from forming
  5. You may experience some incontinence, which may last up to few weeks. If this occurs, do kegel exercises to retrain the bladder muscle. Kegel exercises are done by tightening the rectum for 5 seconds at a time, release and repeat this for five minutes. It is recommended that these excursus be done every hour on the hour, during waking days only. If the incontinence has not resolved after 3 months call the office.
  6. If you have not voided or had any leaking within 4 to 6 hours,  after hours, please go to the emergency room to have another catheter put in place. It is rare for this to occur.
Hospital/Out Patient Pre-Operative Instructions

INSTRUCTIONS TO  FOLLOW AFTER CATHETER REMOVAL

  1. After the catheter is removed, you should be able to void in about two or three hours. If you are  unable void within in two or three hours. then sit in a bathtub if warm water until you void. If you do not have a bathtub, you can take a warm shower instead.
  2. If your catheter is removed before 9:00am, you are to drink only 6-8 glasses of water spaced evenly throughout the day. If your catheter is removed after 11:00am, then you are to drink only 5 to 6 glasses of water spaced evenly throughout the day. There is no need to drink excessively
  3. You will experience burning and stunning when you void the first couple of days which normal. Drinking water will help .
  4. You may observe some spotting of blood when you void, which is normal. Drinking water will help resolve this. Water prevents clots from forming
  5. You may experience some incontinence, which may last up to few weeks. If this occurs, do kegel exercises to retrain the bladder muscle. Kegel exercises are done by tightening the rectum for 5 seconds at a time, release and repeat this for five minutes. It is recommended that these excursus be done every hour on the hour, during waking days only. If the incontinence has not resolved after 3 months call the office.
  6. If you have not voided or had any leaking within 4 to 6 hours,  after hours, please go to the emergency room to have another catheter put in place. It is rare for this to occur.
Urinary Tract Infections in Older Women


Urinary tract infections (UTis) are common, especially in older women.
Your urinary tract is made up of the bladder, ·the urethra, the ure­ters. and the kidneys. Urine is made by the kidneys. It then passes through the ureters to the bladder. It is stored in the bladder before leaving your body through the urethra.

What ls a UTI?
Having a UTI means that germs (bacteria) in your urine are causing symptoms. If you have a UTI, you will need medical treatment.
What Are the Symptoms of a UTI?
You should tell your doctor if
You feel burning when you pass urine
You need to pass urine more often than usual
You have more leakage of urine than usual
You see blood in your urine
Drinking more water or other fluids might relieve some of these symptoms. But if you have these symptoms, you should still tell your doctor .
What Will My Doctor Do If I Have These Symptoms?
These symptoms might mean that you have a UTI. But they also might be a sign of another condition. For example, you might have  1oss of bladder control. To find out the cause of your symptoms. your doctor will examine you.

Your doctor also might order tests of your urine. One such test is called a urinalysis. This test looks for germs and signs of infec­tion (white blood cells). Another such test is called a urine culture. This test can tell your doctor 2 things. First, it can tell what kind of .germs you have in your urine. Second, it can tell what medicine you should take to help get rid of the germs.

Your doctor might order tests of your blood, especially if:

You have a fever
You have pain in your lower back
You are throwing up

These symptoms can mean that your UTI is more serious.
What Else Do I Need To Know?
You probably will only need to take medicine for 3 days. But your doctor will tell you how long you should take your medicine.
You should drink lots of water or other fluids; This is especially  important if you have had 3 or more UTls in a year.
You can help prevent UTis by passing urine after you have sex. This is especially important if you often get UTls after having sex.
If you no longer have periods, you might prevent UTls by using vagi­nal estrogen preparations. But estrogen is not safe for all women. Your doctor might suggest using estrogen if it is safe for you.

Shock Wave Lithotripsy

LITHOTRIPSY

To Help Pass a Kidney Stone Passing a kidney stone can be very painful. Shock wave lithotripsy is a treatment that helps by breaking the kidney stone into smaller pieces that are easier to pass. This treatment is also called extracorporeal

shock wave lithotripsy (ESWL).

How Does Lithotripsy Work?

Shock wave lithotripsy crushes a kidney stone that’s still inside your body. It doesn’t require any incisions. Instead, sound waves are sent through your body. When these hit the stone, it crumbles into tiny, sand like pieces. The pieces can then pass through the urinary tract more easily.

     Possible Risks and·Complications

       • Infection

       • Bleeding in the kidney

       • Bruising ofthe kidney or skin

       • Obstruction of the ureter

       • Failure to break up the stone (other procedures may be

         needed)

YOUR URINARY TRACT

WHEN KIDNEY STONES FORM

The urinary tract helps your body get rid of liquid waste (urine). The two kidneys collect unneeded chemicals and water, making urine. 

The urine then travels through long tubes

called ureters to the bladder.

The bladder stores urine until you’re ready to release it.

The urethra is the canal

that carries urine from the

bladder out of the body.

 Chemicals in the urine can sometimes form crystals. These are like little bits of sand. If the crystals stick together, they become a hard mass called a stone. The stone can get stuck in a kidney or ureter. This blocks urine from getting to the bladder, causing severe pain.

Sound waves are sent through your body. When these hit the stone, it crumbles into tiny, sand like pieces. The pieces can then pass through the urinary tract more easily.

YOUR EXPERIENCE

Lithotripsy takes about an hour. It’s done in a hospital, lithotripsy center,or mobile lithotripsy van.You will likely go home the same day.

DURING THE PROCEDURE

AFTER THE PROCEDURE

• You receive medication to prevent pain and help you relax or sleep during lithotripsy. Once this takes effect, the procedure will start.

• First, a stent (flexible tube with holes on each end) may be placed into your ureter. This

helps keep urine flowing from the kidney.

• Your healthcare provider then uses x-ray

or ultrasound to find the exact location of

the kidney stone.

• Sound waves are aimed at the stone and sent at high speed. If you’re awake, you may feel a tapping as they pass through your body.

• You’ll be monitored in a recovery room for about 1 to 3 hours. Antibiotics and pain medication may be prescribed before you leave.

• You’ll have a follow-up visit in a few weeks. If you received a stent, it will be removed. Your doctor will also check for pieces of stone.

• If large pieces remain, you may need a second lithotripsy or another procedure.

PASSING THE STONE

It can take a day to several weeks for the pieces of stone to leave your body. Drink plenty of liquids to help flush your system.

During this time:

• Your urine may be cloudy or slightly bloody. You may even see small pieces of stone.

• You may have a slight fever and some pain. Take prescribed or over-the-counter pain medication as instructed by your healthcare provider.

• You may be asked to strain your urine to collect some stone particles. These will be studied in the lab.

CONTACT YOUR DOCTOR RIGHT

IF YOU HAVE THE FOLLOWING:

  • Fever over 101° F (383°C)
  • Heavy bleeding
  • Pain that doesn’t go away with medication
  • Upset stomach and vomiting
  • Problems urinating

After your lithotripsy, take these steps to prevent future stones:

  • Drink plenty of water.
  • Make any diet changes your healthcare
  • provider recommends.
  • Take any prescribed medications.
  • See your healthcare provider for checkups.

Associates in Urology of Central Florida

a division of Orlando Physician Specialists, LLCHome Page

GreenLight Laser FAQs

GreenLightTM Laser Therapy Frequently asked questions

What is GreenLight Laser Therapy?

GreenLight Laser Therapy uses a laser to remove excess prostate tissue. The laser treatment is delivered through a thin, flexible fiber, which is inserted into the urethra through an instrument called a cystoscope.

How does GreenLight Laser Therapy work?

A small fiber is inserted into the urethra through a cystoscope. The fiber carries laser energy that quickly removes prostate tissue. The tissue removal will allow urine to pass through freely. Natural urine flow is rapidly restored and urinary symptoms are quickly relieved in most patients.

Do I have to stay in the hospital after a Greenlight procedure?

GreenLight Laser Therapy is generally an outpatient procedure. Typically, no overnight stay in the hospital is required, but it will depend on your individual condition.

Will I experience discomfort during the procedure?

Your doctor will discuss anesthesia requirements, as well as pain medication to ensure your comfort during and after the procedure.

Will I experience discomfort after the procedure?

Most patients experience mild discomfort such as slight burning during urination for a week or so. This can be managed with mild pain and anti-inflammatory medication.

What are the risks of Greenlight LaserTherapy?

All surgical treatments have inherent and associated risks. The GreenLight Laser System is intended for removal of soft tissue, including vaporization of the prostate for benign prostatic hyperplasia (BPH). Potential risks include irritative symptoms, bleeding, retrograde ejaculation and urinary tract infection. You should
talk with your doctor about benefits and risks before moving forward with any treatment option.

How long will it be before I notice results?

Most patients experience very rapid relief of symptoms and a dramatic improvement in urine flow. This typically occurs within 24 hours of the procedure. However, medical history, your health condition and other factors can influence treatment and recovery.

How soon can I return to work or normal activity?

Most patients can resume normal activities within a couple of days. Typically, strenuous activity can be resumed withi. n a short time. Your doctor will discuss any restrictions and your specific condition during your consultation.

Will there be any sexual side effects?

You should be able to have normal sexual experiences, including the same sensation of an orgasm, after the procedure. Some men may experience “retrograde ejaculation,” or “dry climax.” This does not affect erection or orgasm.

How is GreenLight'” LaserTherapy different from transurethral resection of the prostate (TURP)?

Transurethral resection of the prostate (TURP) is a procedure that involves use of a heated wire to cut excess tissue from the prostate and has been used to treat an enlarged prostate for many years. Instead of cutting, GreenLight Laser Therapy uses a laser to vaporize excess prostate tissue.

Is Greenlight LaserTherapy as effective as TURP?

A recent clinical study to compare the two procedures showed similar improvement in urinary symptoms and urine flow. GreenLight Laser Therapy was shown to provide shorter recovery and less catheterization time. 1

Is Greenlight LaserTherapy covered by insurance?

Medicare and most private insurers cover the GreenLight Laser Therapy procedure. Boston Scientific does not guarantee insurance coverage for any procedure or product. It is the responsibility of the patient to contact their insurance provider for specific coverage information.

How long has GreenLight LaserTherapy been around?

GreenLight Laser Therapy has been marketed since May 2001 and over 900,000 patients have been treated worldwide with the therapy.2

How do I know if I am a candidate for GreenLight LaserTherapy?

Only your doctor can determine if you are a candidate for Greenlight Laser Therapy. The GreenLight procedure is generally appropriate for most symptomatic BPH patients. You and your doctor will assess your symptoms and desired outcomes together and determine the best course of treatment.

How do I know if I should have a Greenlight LaserTherapy procedure?

You and your doctor will assess your symptoms and desired outcomes together before choosing the best course of treatment for you.

Urological Conditions


Procedure Information

AFTER CATHETER REMOVAL

INSTRUCTIONS TO FOLLOW AFTER CATHETER REMOVAL

  1. After the catheter is removed you should be able to void in about 2 to 3 hours.
  2. If you are unable to void within 2 to 3 hours then sit in a bath tub until you do if you do not have a bathtub you can take a warm shower instead.
  3. If your catheter is removed before 9 AM you are to drink six medium sized cups of water spaced evenly throughout the day. there is no need to drink excessively.
  4. You will experience burning and stinging and when you void the first couple days which is normal drinking water will help if there is no relief please call the office.
  5. You may observe some spotting of blood when you void which is normal drinking water will help resolve this.
  6. You may experience some incontinence which may last up to a few weeks if this occurs do Kegel exercises to retain the bladder muscle. Kegel exercises are done by tightening the rectum for 5 seconds at a time, release and repeat for 5 minutes. It is recommended that these exercises be done for five minutes every hour on hour during waking hours if the incontinence is not resolved after one month call the office.
  7. If you have not had any leaking within 4 to 6 hours after office hours please go to the emergency room to have another catheter put in place it is rare for this to occur.
  8. Call the office back and left the office or yours know how many times you have voided weather is a small, moderate or large amount and how many pads you have soaked.
  9. Come back this afternoon at Orlando or Lake Mary office for a bladder scan to make sure that your bladder is empty well if you do not have this appointment called the nurse at the office in four hours.
SHOCKWAVE LITHOTRIPSY PROCEDURE

SHOCKWAVE LITHOTRIPSY FOR KIDNEY STONES

You have been diagnosed with kidney stones and a special high-tech procedure called extracorporeal shockwave lithotripsy will be carried out for disintegrating the same. In this operation usually a small strong is inserted and placed between the kidney and the bladder which is not visible however the stone is been subjected to pressure waves which disintegrate as a result the resultant fragments are mainly very small and dark cold stone dust 13 beat some large fragments remaining the patient is usually sent.

PREPARING FOR THE PROCEDURE:

Early  preparations soon as the decision is made for this treatment on general measures are useful. Blood thinners and anti-inflammatory medication must be stopped in about 10 days in advance. This includes aspirin Ecotrin, ibuprofen, meloxicam, warfarin, Coumadin, plavix, pradaxa, eliquis, and lovenox.

All herbal supplements are to be stopped 14 days in advance. This include but not limited to ephedra ginsing kava valerian root, St Johns wort, garlic fish ginkgo appetite suppressant’s vitamins and on over the counter products.

Metformin / glucopage must be discontinued 48 hours prior to your procedure.

You may require assistance of you primary care or cardiologist. Please check with our office regarding any unusual medications you may be on.

Stopping smoking reducing wait keeping on medical diseases like diabetes blood pressure and heart disease under control is important.

You may need to obtain a preoperative clearance from your primary doctor or specialist.

THE DAY BEFORE THE PROCEDURE

Satisfactory hydration avoid heavy meals and meat products the evening meal should consist of clear liquids like bouillon soup and fruit dishes. Do not dehydrate yourself if you have a tent and seek to constipate you may start stool softeners on this day.

THE DAY OF THE PROCEDURE

Continue medications for high blood pressure or any neurological condition. Diabetics should not take any medications in the morning. Simply shower with soap and water for cleanliness. If you notice anything unusual please report it to the nurse upon admission to the facility.

WHAT TO EXPECT DURING THE PROCEDURE

In this operation the patient is under full anesthesia and therefore no pain is experienced. You may have a catheter inserted from the bladder to the outside. This is generally removed in the recovery room but for other reasons may be left in when you go home.

WHAT TO EXPECT AFTER THE OPERATION

There is no specific pain and there is no incision. The main type of discomfort and pain is from the stent within. This may be at the level of the kidney or a cane the spasmodic towards the bladder. This may result in a desire to void and frequency may result due to that tube.

Usually patient will be given to either orange or blue to help relax the muscle and alleviate the pain.

The tube (stent) from the kidney to the bladder or is generally left for about a week. You will be advised to obtain renal  ultrasound in about a week at the office to determine the absence of any large fragments. If none are present the stent is generally removed in the office, for which a local anesthetic is all that is necessary.

POST OPERATIVE CARE

The patient is usually discharged the same day and advised to hydrate him or herself well. You should continue all medications. Urgency is fairly common and frequency of urination may result. In mild pain is not usual but is well controlled by medication’s severe pain is rare. If you have high fever with chills with or without pain please notify the office immediately.

STENT REMOVAL

The day of the stent removal the patient should not eat a heavy meal and should stay well hydrated. Upon a visit to the office the nurse will place the patient on the table and anesthetic jelly is used for this procedure. A special instrument called a scope is used to visualize the bladder and a special grasping forceps used to seize the stent and gently remove it from your body.

Most patients have found that sought to be worse than the actual procedure. There is some urgency running to the bathroom that follows for up to 24 hours. Rarely the Ureter (your natural passage tube from the kidney to the bladder) me have spasmodic activity and meet also give you discomfort and at times severe pain. You are encouraged to drink plenty of water to reduce or avoid the pain.