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Urologist in ancient egypt tackled blood in urine – Dr Grotas brings modern approach 212 844 8941

Dr. Grotas — Tue, 25 May 2010 12:20:01 +0000

History buffs may already know that several ancient papyri detail the extensive medical knowledge known to the egyptians over 2500 bce.

the ebers and smith papyri are detail many specifics of the medical knowledge often attributed to 18th and 19th century doctors.

the website urologichistory.museum has some great fun facts about urology and history

in ancient egypt a major disease was Schistosomiasis and it is still a leading cause of bladder cancer in Egypt today.

It is contracted from waters infested with the parasite schistosoma haematobium, and would have been more common in the working class: farmers or fisherman .

Even in the United states, schistosomiasis is in the differential diagnosis for hematuria especially in those who are from the Mediterranean or other endemic areas.

With current technology blood in the urine should be investigated with microscopy, urine culture, cystoscopy and upper tract imaging with CT scan, Mri, or sonogram ( in some cases)

In Egypt they used herbs and spices now we uses antibiotics for schistosomiasis.

Dr. Grotas can help blood in urine – don’t ignore symptoms!

new treatment for prostate cancer – 1st vaccine for prostate cancer Dr. Grotas 212844-8941

Dr. Grotas — Fri, 30 Apr 2010 00:00:54 +0000

April 29, 2010 — This drug is for patients with metastatic or prostate cancer that has spread outside the prostate ( this is uncommon condition ) There are no great treatments for these patients but this therapy may help!

click on drug name to see full article from new york times today…

In a widely anticipated announcement, the US Food and Drug Administration (FDA) has approved an immunotherapy, sipuleucel-T (Provenge, Dendreon), for the treatment of asymptomatic or minimally symptomatic metastatic, castration-resistant prostate cancer (mCRPC).

Lithotripsy availabe at Beth Israel Hospital call Dr. Grotas 212-844-8941

Dr. Grotas — Thu, 22 Apr 2010 17:02:52 +0000

We are pleased to announce that lithotripsy procedures including Medicaid, Medicare, and patients with managed care plans can now be performed at Beth Israel Medical Center, at both the Petrie Campus and the Kings Highway Division.

ESWL or extra corporeal shock wave lithotripsy is a minimally invasive treatment for kidney stones.

call or make an appointment online

prostate stones – do they need treatment? Dr.,

Dr. Grotas — Tue, 13 Apr 2010 19:01:03 +0000

prostate stones are common and not usually a problem if they are found due to symptoms of urinary discomfort or prostatitis the underlying symptoms can be address below is from http://www.prostatitis.org/stones.html

and is a helpful explanation as well. Unlikely kidney or ureteral stones which if left untreated can damage the urinary tract prostate stones often are harmless and require no active treatment

a transrectal ultrasound or CT-scan are ways to detect prostate stones

come see Dr. Grotas if you are confused about urination, prostate stones, or just want to urinate better!

Stones in the prostate are very common. They appear to be calcified proteinaceous bodies called corpora amylacea. The are thought to occur because the secretions of the prostate cannot get out of the gland because of the disarray of the architecture of the ducts due to BPH or benign prostatic hypertrophy, an almost universal growth of the prostate in men as they age. It is thought that these secretions dry out or become “inspissated” and form into a round proteinaceous body, much like a pearl in an oyster. They then become calcified.
This is not the only mechanism leading to the formation of prostate calcifications. They may appear secondary to an infection with insufficiently drained pus and detritus, eventually calcifying. Other calcifications, usually more widespread, can show up in the tissue surrounding the prostatic glandular units following an inflammatory process associated with tissue destruction or changes in the local biochemical environment (acidity, electrolyte changes). Finally, calcifications detected in the prostate can be located intraluminally inside the ejaculatory ducts, resulting from calcification of detritus in the seminal tract, eventually moving down into some narrow segment of the ejaculatory duct.
Prostatic stones are very common and generally do not cause symptoms in and of themselves but may be associated with the symptoms of BPH which men can get as they age and their BPH progresses. The stones are usually located between the BPH growth or “adenoma” and the compressed, normal prostatic tissue around the adenoma which is called the “surgical capsule” of the gland because it is the limit of resection of BPH when performed transurethrally. Stones in the urinary tract are completely different. These stones are found in the kidney where they form and can cause symptoms when the stone “passes” by moving down the ureter, the muscular tubelike structure that connects the kidney to the bladder. The presence of the stone, if it is large, in the ureter causes blockage of the ureter and “urethral colic”, a spasm type pain that is severe and is often described by my patients as the worst thing they have ever felt in their lives. Kidney stones form from the urine and are often associated with some sort of metabolic problem that predisposes the patient to forming stones but this is not always the case of some patients simply form stones for no reason that can be elucidated. Kidney stones can sit in the kidney for years and not cause symptoms but can become infected and be a persistent nexus or source of infection for years. Typically infection stones are a different type of mineral and the infection cannot be cleared without removing the stone. It is possible that prostatic stones could be the same, that is, they could serve as a source of persistent and recurring infection in prostatitis. The only thing that makes me less enthusiastic about this possibility as an explanation for the relapsing and recurrent symptoms of prostatitis is that so few patients with prostatitis have a bacterial infection documented to be present in the urine or prostatic secretions. In large series of men a bacterial infectious etiology is found in only 510% of men. Unfortunately, urologists have concentrated on this subpopulation because it represents something they can treat but still does not appear to be relevant to 90% of men with the symptoms but no infection.
Many patients have had symptoms and several courses of treatment long before a culture has been attempted. The microorganisms may have been killed, but, without removal of obstruction, the inflammatory process may continue in the affected gland. This chronic inflammation may, eventually, live its own life, either due to persistence of highly resistant clones of microorganisms in low concentration and/or inflammatory reaction to products of the immunological defense mechanism and/or inflammatory reaction to glandular secretions/pus/detritus which cannot escape. Therefore, cultures
From prostatic expressed secretion may not yield a positive result. Furthermore, even in presence of microorganisms in high = culturable concentrations, the culture may be (permanently or temporarily) negative if the process is sealed off by a stone or scar tissue.

psa editoral controversy continues Dr. Grotas 212-844-8941

Dr. Grotas — Thu, 08 Apr 2010 13:31:08 +0000

PSA is helpful for some men especially after the diagnosis of prostate cancer i don’t really agree with this editorial but it’s interesting!
Op-Ed Contributor
The Great Prostate Mistake
By RICHARD J. ABLIN
Published: March 10, 2010
Americans waste an enormous amount of money on an inaccurate test for prostate cancer.
http://www.nytimes.com/2010/03/10/opinion/10Ablin.html

Male Infertility Linked With Prostate Cancer 2128448941 Dr. Grotas can help

Dr. Grotas — Thu, 25 Mar 2010 14:05:26 +0000

This well written review by times columist places the issue into perspective. When patients get screened we find more cancers male infertility and testicular cancer is also linked due to increased detection.

This is a trick situation. A urologist is the best person to evaluate male infertility, sexual health and screen for prostate cancer.

Dr. Grotas is a board certified urologist practicing in NYC and the five towns. He authored a chapter in the latest edition of Infertility in the Male

click on request an appointment to contact the doctors staff!

Health
Well: Male Infertility Linked With Prostate Cancer
By By TARA PARKER-POPE
Published: March 23, 2010
New research linking male infertility with aggressive prostate cancer joins a growing body of evidence that male infertility is an important risk factor for long-term health problems.

prostate surgery not just for young men Dr. Grotas 212-844-8941

Dr. Grotas — Tue, 23 Mar 2010 20:31:48 +0000

Older Men Have Excellent Prostate Surgery Outcomes – Renal and Urology News: http://bit.ly/9c8gQm

read this interesting article regarding age and surgical outcomes

be informed when you make a decision regarding treatment for prostate cancer.

Appropriately selected older men with prostate cancer have excellent overall and prostate-cancer specific survival after radical prostatectomy (RP), data show.

Extracorporeal Shock Wave Lithotriptor Indicated for Fragmenting Urinary Stones in the Kidney

Dr. Grotas — Sat, 13 Mar 2010 15:36:01 +0000

more info on clinical trial for shock wave for kidney stones http://bit.ly/avYbpF
if you have a stone and need treatment contact dr. grotas today he uses all modalities to treat kidney stones: shock wave, laser lithotripsy and percutaneous nephrostolithotomy

Robot prostate even resistors are joining in! Dr. Grotas 212-844-8941

Dr. Grotas — Sun, 14 Feb 2010 13:32:30 +0000

I recommend robot prostatectomy as the surgical option for most patients with prostate cancer.

At Beth Israel Dr. Caner Dinlenc leads our robot prostate program. Drs. Tareen and Grotas also perform this surgery. We are here to help!
Have you already had a robot? need follow up have erectile dysfunction? positive margin? rising PSA? incontinence?we can help click to on request an appointment if you have questions or need an opinion!

no medical advice will be given over email all urologic consultations are done in person.
NYTIMES 2-14-2010 Health
Results Unproven, Robotic Surgery Wins Converts
By GINA KOLATA
Published: February 14, 2010
Robot-assisted prostate cancer surgery makes sense on some levels but it costs more, and it is not clear whether its outcomes are better.

PSA Levels Decline After The Start of Statin Therapy Dr. Grotas 212-844-8941

Dr. Grotas — Fri, 22 Jan 2010 21:14:56 +0000

I read this interesting news report regarding cholesterol medicine and PSA blood tests ….. From the January 2010 Issue of Renal And Urology

Onset of statin use is associated with a significant reduction in serum PSA level, data suggest.

David J. Mener, MD, and colleagues at the University of Rochester/Strong Memorial Hospital in Rochester, N.Y., used computerized medical records to identify men who filled statin prescriptions between May 31, 2008 and September 30, 2008. For their study, the researchers included 962 men who had at least one PSA test performed within two years before and at least one PSA test performed within one year after starting a statin. The mean serum PSA level decreased significantly by 0.29 ng/mL (8.04%) after the start of statin treatment, the investigators reported in The Prostate (2009; published online ahead of print).