Posts

Kidney Stones – Understanding Causes and Treatments

Posted on June 24 2013 by Daniel Kaplon

Odds are that someone you know had a kidney stone. They are fairly common, affecting one in eleven people at some point in their life. There is no single cause for kidney stones, but educating yourself on kidney stones can aid in prevention of them.

What is a Kidney Stone

A kidney stone is a solid piece of material that forms in a kidney when substances in urine become highly concentrated. Though some kidney stones are so small that they pass without causing pain, they can also grow large enough to get stuck in the urinary tract, which causes severe pain and even bleeding.

Four different kinds of kidney stones can form:

  • Calcium stones. These are the most common form of kidney stone and are often caused by high calcium and high oxalate excretion.
  • Uric acid stones. Uric acid stones are usually present when the urine is acidic due to a large intake of certain meats, fish and shellfish.
  • Struvite stones. Struvite stones are a result of kidney infections.
  • Cystine stones. A genetic disorder causes cystine to leak into the urine, which forms crystals that turn into cystine stones.

 

Diagnosing & Treating Kidney Stones

To properly diagnose kidney stones, your doctor will perform a physical exam and ask questions about your history with kidney stones, diet, GI problems, and other diseases and disorders. In addition to a physical exam and discussing your medical history, he or she may also perform a urine sample, blood test, abdominal x-ray and CT scans.

After properly diagnosing the kidney stone, your physician will determine a treatment plan based on the size of your kidney stone what it is made of. Smaller stones usually pass through the urinary tract without treatment. Treatment options for larger stones can include:

  • Shock wave lithotripsy. a machine called a lithotripter is used to crush the kidney stone.
  • Ureteroscopy. A uteroscope, which is long, tube like instrument, is used to find the stone with a small basket or used to break up the stone with a laser.
  • Percutaneous nephrolithotomy. A procedure that uses a thin viewing instrument to locate and remove the stone.

Preventing Kidney Stones

Preventing kidney stones depends greatly on the reason the stone is forming. However, focusing on your diet is the first step in preventing any kind of stone from forming. Reducing sodium intake, limiting animal protein, avoiding foods high in oxalate and getting enough calcium are all important in the prevention of kidney stones.

In addition to altering your diet, some health care providers may also prescribe certain medications depending on the type of stone.

For more information on diagnosing and preventing kidney stones, talk to your physician today.

What’s It Like to Have Surgery?

Posted on May 22 2013 by Daniel Kaplon

If your doctor has scheduled you for an operation, you are probably already wondering what’s it like to have surgery?
For most people, just the thought of having surgery can be stressful. You can reduce much of your anxiety by learning what to expect both during surgery and recovery afterwards.
Your surgery experience will vary depending upon the condition being treated and the type of surgery. The two main types of surgery are:

  • Inpatient surgery: Done in a hospital, inpatient surgery requires you to stay overnight for one or more days to allow the doctors and nurses to monitor your condition.
  • Outpatient (also known as ambulatory) surgery: This is done in an outpatient clinic or hospital. You will be able to go home on the day of the surgery.

In general, when you have surgery, you can expect the following steps, although outpatient surgeries may not involve all of these.

Pre-Surgery Check-In

When you arrive at the hospital or clinic for your surgery, you will be asked to provide information about your:

  • health insurance
  • medical history
  • current pain or symptoms.

A nurse will take your vital signs, such as your blood pressure, heart rate and temperature. You may also need to have other tests, like X-rays or blood tests.
You will be given a paper or plastic bracelet to wear that allows hospital staff to identify you easily.
Often, you will not be allowed to eat or drink anything for several hours before you have surgery. Food or liquid in your stomach can increase the risk of complications, or cause vomiting during or after surgery.

Anesthesia

For most surgeries, some type of medicine (anesthesia or anesthetics) is used to make you fall asleep or to numb part of your body so you don’t feel it during surgery.
These medicines are given before your surgery, and include:

  • General anesthesia: This will make you unconscious during the surgery. If this is used, an anesthesiologist (a doctor or nurse) will monitor you during the surgery and adjust the medicines, if needed.
  • Local anesthetic: These are used to numb the area of the body where the surgery will be done. You may also be given a drug that doesn’t put you to sleep but will make you drowsy.

 

Surgery Preparation

The hospital staff will prepare (also called “prep”) you for having surgery. This includes:

  • Cleaning or shaving (if needed) the part of your body that will be operated on.
  • Asking you to remove your jewelry, hair ties and contact lenses.
  • Providing you with a hospital gown to wear (instead of your clothing).
  • Having an IV (intravenous) line inserted in your arm by a nurse. This is attached to a bag of fluid and is used to give you anesthetics, fluids or medicines needed during surgery.
  • Hooking you up to equipment that monitors your blood pressure and heart rate.

 

During Surgery

In the operating room, you may notice that the doctors and nurses are all wearing protective clothing. This includes masks, gowns, caps, booties and plastic eyeglasses. These are worn to reduce your chance of getting an infection during surgery.
In some hospitals or clinics, medical or nursing students may be present in the room during your surgery. They are there to watch and learn the procedure.

Recovery After Surgery

After surgery, you will be taken to a recovery room (also known as the postoperative room, or post-op). Your condition will be monitored by nurses for up to a few hours, depending upon the type of surgery.
When you wake up from the general anesthesia, you may feel confused, groggy, nauseated, chilly, or even sad. When you are fully awake, the surgeon will meet with you to tell you how the surgery went.
If you experience any pain after surgery, you will be given pain medications (either pills or in your IV line). You may also be given antibiotics to reduce your chance of infection.
If you are staying overnight in the hospital, you will be brought to a hospital room, where nurses will monitor your condition until it is time for you to leave.

Questions to Ask Your Doctor about Robotic Surgery

Posted on April 19 2013 by Daniel Kaplon

Surgical procedures have come a long way. Today surgery can be done with much more precision. Through robotic surgery, surgeons are now able to reach the minutest areas and increase their visual field. Through robotic arms, the surgery itself is clean and precise. Before you undergo robotic surgery, you should always ask your doctor questions.

Is Robotic Surgery the Right Choice for My Surgery?

Not all surgical procedures can even be performed through this cutting edge method. Depending on the condition that you have and the procedure that you need to undergo, it may or may not be an option for you. You will need to talk to your doctor to determine if this is the right choice for you.

Are There Reasons Why the Procedure May Not be the Best Choice?

Even if you can undergo robotic surgery, you will need to understand that there may be reasons why it is not the best option. You could have some types of underlying medical conditions. There may be specific things that you and your doctor need to discuss. Be sure to understand what those things are to determine if you still want to undergo robotic surgery.

What Types of Risks are There with Robotic Surgery?

Of course, there are always risks to any type of surgical procedure. You need to understand those risks well before you decide to proceed. Talk to your doctor about the specific risks that may come along with robotic surgery as compared to the risks that come with other treatment options you may have.

What Type of Recovery Time Can I Expect from Robotic Procedures?

Often, the recovery time from a robotic surgery will be much shorter than other procedures, but this can depend immensely on the type of procedure you are undergoing. Be sure to discuss the recovery time you can expect from robotic surgery as opposed to other types of treatments.

How Long Will the Procedure Itself Take?

Robotic surgeries involve different time frames, when compared to other types of treatment and procedures. You will be under anesthesia during that time, and you need to know how long the surgery will take. Be sure to discuss the robotic procedure with your doctor and the time frames of it or any other surgical procedure you could consider for your condition.

Anytime you need to have a surgical procedure performed, you will need to ask all of the right questions. If you have the option of robotic procedure, then you will definitely need to understand everything about it before you undergo anything so that you can determine if it is the right choice for you.

 

Looking To Get A Vasectomy? Questions To Ask Your Doctor

Posted on February 27 2013 by Daniel Kaplon

For some men, permanent birth control is the best option to guarantee that they will not have any more children. However as the name explains, permanent birth control is, well, permanent. In very few cases are these procedures reversible. Before you make the decision to go with a permanent option, you will want to ask your doctor all of the right questions. Be sure you know everything you need to about the procedure before you make a decision.

Below are a few questions that you should ask your doctor before you make your decision.

General Questions

  • What are my options for permanent birth control?
  • Is a permanent option the right one for me?
  • Are there other options that I should consider before I make the decision?
  • What type of birth control, permanent or nonpermanent, would you recommend?

Ask these questions in the beginning. They will give you a good starting place to determining if permanent birth control is the right choice for you.

Vasectomy

A vasectomy is a permanent method in which you will be rendered infertile by making it impossible for your sperm to be included in ejaculate. This is a permanent procedure as well.

  • What are the risks involved with choosing a vasectomy procedure?
  • Is a vasectomy 100% successful?
  • Can a vasectomy be reversed?
  • What can I expect as far as pain and recovery?
  • Do you recommend a vasectomy as our permanent birth control method?

Emotional Factors

The most important thing to remember is that permanent birth control methods should only be chosen if you absolutely know that you never want to have children. There are emotional factors to consider. How will you handle it if you change your mind at a later date and wish to have children? Consider all of the ramifications of the birth control that you are choosing before you go through with any procedure.

Make sure to ask all of the questions above when you talk to your doctor to help you make the right choice.

 

Looking for a Surgical Second Opinion

Posted on January 24 2013 by Daniel Kaplon

No one wants to find out that they need surgery. There can be many scary unknowns. However, there are times when an operation is an absolute must to relieve pain, cure conditions, and restore health. If you have come to that point and your doctor has just informed you that you need surgery, you may feel a little overwhelmed or afraid.

Although your doctor may be 100% right that you need a surgical procedure, there is always room for human error or opinion-based decisions. There are times when a second opinion should not be just thought of as an option—it should be considered a must. How do you know when it’s the right idea to get a second opinion?

There is No Rule

There is no specific rule that gives you a clear-cut line when you should get a second opinion. However, there are some things you should discuss with your doctor or research on the Internet. Asking the right questions will tell you a few things.

  • Why do you think I need this operation?
  • Are there other alternative options to surgery to consider?
  • What would happen if I chose not to have surgery?
  • What are the risks and dangers of this surgery?
  • Will the operation completely improve my condition or will I still have problems?
  • Will there be negative changes to my body as a direct result of the surgery?
  • Are you 100% confident that surgery is my only option?

If you can, get these answers from your doctor.

It is Your Decision

The bottom line is, it is your decision. Even if you cannot find any other option but surgery, there is nothing wrong with getting a second opinion to ensure that it’s the right option for you. Often if you are having trouble committing to the surgery, then hearing the same advice from another expert can confirm what you know and help you go ahead with that decision.

When should you get a second opinion? Often, you will want to consult another professional if there is any waver or if there are any other treatment options. Bottom line – it is your decision.

 

Evaluating My Treatment Options for Kidney Cancer

Posted on December 21 2012 by Daniel Kaplon

The most common type of kidney cancer is called renal cell carcinoma. Several treatment options are available, including surgery or medical treatment.

The choice of treatment depends upon the stage of the cancer. The “stage” describes the size and aggressiveness of the cancer, including whether it has spread to other parts of the body (such as the lungs, liver, or bones). Lower stage cancers are generally not as advanced and are less likely to come back after treatment.

Treatment Options for Localized Renal Cell Carcinoma

Localized kidney cancer includes stages I through III. It is called localized because the cancer has not yet spread beyond the kidney (except for nearby lymph nodes, which are part of the body’s immune system).

Kidney Surgery

Surgery to remove part or all of the affected kidney is the preferred treatment for most people with localized kidney cancer. How much tissue is removed depends upon:

  • size and location of the cancer in the kidney
  • number of tumors present
  • how well the kidneys work.

If the tumor is large or in the center of the kidney, your doctor may remove the entire kidney, as well as nearby areas that are affected (radical nephrectomy). This is more likely to be done if the other kidney works well. Fortunately, most people are able to live well with just one kidney.

If the other kidney is not functioning properly, the surgeon may remove only part of the kidney in order to allow the kidney to keep working, at least somewhat. This can be done either surgically, or by freezing or burning the kidney tumors.

Advanced Renal Cell Carcinoma

Advanced (or metastatic) renal cell carcinoma consists of stage IV kidney cancer. This type of advanced cancer is difficult to cure.

Medical Treatments

Medicine (also known as medical treatment) is used instead of, or in addition to, kidney surgery. Three of the main types of medical treatment are:

  • Interleukin-2 (IL-2). This therapy turns on the immune system so that it attacks the cancer cells. It is usually only used when you are healthy enough to withstand the severe side effects, such as fever, kidney failure, low blood pressure, and irregular heart beat.
  • Anti-angiogenic therapies. This medical treatment keeps new blood vessels from forming and supplying the tumor with the blood that it needs to grow and survive. This will not cure the kidney cancer, but can stop the tumor from growing for a long time. Side effects include tiredness, high blood pressure, and rashes.
  • Targeted therapies. These medicines slow the growth of the cancer by interfering with the cancer cells directly. This treatment also won’t cure the kidney cancer, but can help you live longer with fewer symptoms. Side effects include tiredness, high blood pressure, and rashes.

Surgery

Surgery for advanced renal cell carcinoma is sometimes used before medical treatment, although medical treatment may be done on its own.

As with localized kidney cancer, all or part of the kidney is removed. Treatment for advanced kidney cancer, though, also involves removing areas outside of the kidney where the cancer has spread (metastases).

Surgery does not usually cure the cancer in cases of advanced renal cell carcinoma, but may reduce the symptoms and allow you to delay medical treatment.

Radiation or Chemotherapy

Radiation or chemotherapy may be used after surgery in both localized and advanced kidney cancer. These are used to kill left-over cancer cells, even if all of the visible cancer was removed. This lowers the risk that the kidney cancer will return.

With radiation therapy, X-rays or another type of radiation is used to kill the cancer cells. The radiation source is either outside the body (as with the X-rays) or placed inside the body (using a radioactive substance).

Chemotherapy drugs—taken by mouth or injected—kill the cancer cells or stop them from growing.

Follow-Up Tests

Regular check-ups after treatment are advised in order to make sure that the cancer does not return. This may include an exam, lab tests, and X-ray tests, and are done every 6 to 12 months for at least five years.

 

Dr. Kaplon brings Minimally Invasive Urologic Surgery to Sarasota

Posted on November 28 2012 by Daniel Kaplon

A new category of surgery, enabled by the da Vinci ® Surgical System, is being used by an increasing number of surgeons worldwide for prostatectomy and other urologic procedures. Dr. Daniel Kaplon in Sarasota, FL is specially trained for da Vinci ® Urology procedures including:

Prostatectomy

This minimally invasive approach, in which your surgeon utilizes the latest in computer and robotic technologies, is ideal for delicate urologic surgery. This includes prostatectomy — removal of the prostate gland to treat cancer — in which the target site is not only tightly confined but also surrounded by nerves affecting urinary control and sexual function. Using da Vinci , your surgeon has a better tool to spare surrounding nerves, which may enhance both your recovery experience and clinical outcomes.

To learn more, check out our section on the [da Vinci ® Surgical System].

Treatment for Enlarged Prostate in Sarasota, FL

Posted on October 23 2012 by Daniel Kaplon

Enlarged Prostatic Hyperplasia, or BPH, is a non-cancerous enlargement of the prostate gland that affects more than 50 percent of men over the age of 60. Dr. Kaplon in Sarasota, FL offers a variety of urology treatment options for BPH.

Medication

Drug therapy is often used to provide relief from symptoms and to help reduce the enlargement of the prostate gland. These are especially helpful where the symptoms are mild.

Surgery

The use of surgical intervention is recommended to relieve or eliminate symptoms and when symptoms are severe or other options haven’t worked. Procedures include:

Prostatectomy – performed to remove large amounts of prostate tissue. This procedure is performed in a hospital and under general anesthesia.

Minimally Invasive Treatments – by their nature, these treatments are not as invasive as surgery and can be performed in an outpatient environment. These can include:

  • Thermography – for treating patients with moderate symptoms. This treatment uses heat to destroy prostate tissue.
  • Laser Therapy – to treat mild to severe symptoms. This approach most commonly uses GreenLight & trade Laser Therapy together with TURP to provide effectiveness with fewer side effects.
  • Urethral Stent – for use with patients who are not candidates for surgery. It involves placing a mesh tube to hold the urethra open at the point where it is obstructed by the prostate gland.

To learn more, check out our section on [Treatment for BPH].

Minimally Invasive Solution for Urinary Obstruction

Posted on September 18 2012 by Daniel Kaplon

When facing a urinary obstruction, you may be a candidate for the minimally invasive approach – da Vinci ® Surgery for Urinary Obstruction. This surgery, known as pyeloplasty, removes the blockage in the urinary system.

Kidney Anatomy

da Vinci ® Surgery uses state-of-the-art technology to help your doctor perform a more precise operation than conventional surgery. It offers several potential benefits over a conventional open surgery, including:

  • Significantly less pain
  • Less blood loss
  • Fewer transfusions
  • Less risk of infection
  • Less scarring
  • Shorter recovery time

To learn more check out our section on [da Vinci Pyeloplasty].

 

da Vinci Offers Minimally Invasive Procedure For Kidney Disease

Posted on August 21 2012 by Daniel Kaplon

When suffering from kidney disease, you may be a candidate for a minimally invasive, kidney-sparing surgery. A surgical technique called partial nephrectomy removes only the diseased part of your kidney while sparing the healthy, functioning kidney tissue.

The da Vinci Surgical System uses state-of-the-art technology to provide  gold standard treatment, where indicated, and also perform a more precise operation. da Vinci offers several potential benefits to patients facing kidney surgery, including:

  • Excellent clinical outcomes and cancer control
  • Short hospital stay
  • Low blood loss
  • Precise tumor removal and kidney reconstruction
  • Excellent chance of preserving the kidney, in certain operations
  • Low rate of operative complications

To learn more check out our section on [da Vinci Partial Nephrectomy].