great idea for men with chronic pelvic pain syndrome, prostatitis, wearing a catheter or hemmorhoids/rectal surgery

read this article and maybe even make your own stand up desk

A Desk That Allows You to Stand or Sit – NYTimes.com

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.

kidney stones can come from dehydration, excessive intake of foods such as calcium supplements, red meat, chocolate, coffee, other metabolic conditions, gastric bypass surgery etc.

they are crystals of calcium combined with other minerals or just made up of uric acid

once a stone has passed or from information derived from X-rays done by your doctor the composition of the stone can be found out.

A urologist or nephrologist can then recommend medical therapy to prevent stones in the future. 

As a urologist this is one of the most common problems I see in my clinical practice.  There are options about how to treat stones.

Do you have flank pain all the time but no stones? Did you doctor tell you your kidney is swollen.  You may have ureteropelvic junction obstruction.  Do you have pain every time you have coffee or drink alcohol?  That is called Dietels crisis.  Its when a blocked kidney feels more pressure from the diuretic (extra urine production) effect of alcohol or caffeine or just too much water.

An ultrasound and then a Ct-scan is performed to identify the anatomy and then a renal scan is performed to show the blockage and function of the kidney. 

Ureteropelvic junction obstruction in adults is fixed with surgery or endoscopic balloon dilation and cutting Acucise endopyelotomy or Percutaneous Endopyelotomy http://www.appliedmed.com/professionals/procedure_detail.aspx?proceGroupID=4&proceID=29&Title=Acucise%3Csup%3E%C2%AE%3C%2Fsup%3E+Endopyelotomy%2F+Endoureterotomy

Using standard laparoscopic technique or the Da-Vinci Robot (Intuitive surgical) The scared area of the ureter and be cut and the ureter repaired with small incisions (between a dime and a quarter in length)  a indwelling stent (plastic tube) is left inside to allow healing.  Patients usually are eating the next day and leave the hospital in 2 days. 

in small children or adults with complicated anatomy the open surgical approach with a large incision is still standard of care. 

I have published peer-reviewed articles on complications and treatments of this disorder and on radiology tests to diagnosis this disorder.

We have all heard that drinking water is good for us.  That is true but too much water may be unwise if you are running to the restroom frequently.   Drinking copious amounts of water may help you pass a kidney stone or feel full without overeating but it isn’t always sage advice.  You should drink when you are thirsty.  Caffinated beverages will dehydrate you and make you take in more liquid.  If your goal is to avoid urinating as often during the day or night don’t drink 8-10 glasses of water.  Some people must drink water with medicine or due to other medical conditions but if you are otherwise healthy avoid overconsumption of liquids and you will be ahead of the game.

drinking a lot of water is a myth! Drink when you are thirsty!

These drugs are not for everyone and they are only available by prescription.  Please consult your doctor before trying or switching medicines.

http://www.urologyhealth.org/index.cfm

This link is a great resource for patients regarding many urology conditions.  It is sponsered by the AUA the American Urologic Association.  It includes webinars, video and good informations for patients with a myriad of urologic problems.

If you have questions between appointments this is a great resource.

we all have to go sometime.  Dr. Grotas understands

Many men are troubled by an extra drop or more of urine that comes out after voiding. Urinary dribbling can lead to awkward social situations but is usually not an indication of serious medical problems. Most men shake the penis to get the last drops of urine out – this is ineffective. The best way to avoid staining underwear is to apply pressure at the base of the penis and dab the tip with a toilet tissue. Another technique is the apply pressure and milk the last drops out. Both of these techniques can work.

Young men usually do not need a formal evaluation if this there only complaint. Men over 40 should be evaluated for other urinary symptoms to assure that the dribbling isn’t related to prostatic enlargement or ineffective urination. A urologist can assess voiding dysfunction both from talking to the patient and a few simple tests in the office.

If you are concerned that dribbling might be part of a bigger problem – seek help.