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Putting Patients First


Welcome to Fifth Avenue Urology, the practice of Drs. Michael S. Brodherson, Yaniv M. Larish, and Leonard Glickman. We are located in Manhattan, in New York City’s beautiful Upper East Side. We offer the most advanced state of the art diagnosis and treatment for all problems of the male and female urological and reproductive systems.

Dr. Brodherson has been the Interim Chief of Urology at Lenox Hill Hospital and Dr. Larish served as the former chief resident in the same department. They are both focused on providing exceptional, detail oriented, unrushed, and compassionate urological care to men and women of all ages. Both physicians view the ability to practice medicine as a privilege, not a right. They treat their patients with respect, professionalism and compassion.


Schedule an appointment today

212-675-3186


Michael S. Brodherson, M.D.

dr-michael-brodherson-top-urologist-nycDr. Brodherson has been in the private practice of urology on New York’s Upper East Side since 1979 when he finished his training at Lenox Hill Hospital. He is known throughout the New York metropolitan area as a senior, highly skilled, capable and compassionate general urologist with vast expertise in his field.

Besides a full office practice, he has a special interest in the urologic care and treatment of complex surgical and gynecological operative procedures involving urology secondarily. Since Dr. Brodherson has extensive experience in open urologic procedures he is an ideal expert consultant for these complicated cases of other specialties and is well known to be available on an emergency basis for immediate consultation in such matters.


Yaniv M. Larish, M.D.

dr-yaniv-larish-fifth-avenue-urology2Dr. Larish is a urologist and surgeon treating women and men with a variety of urological conditions. His expertise is in treating complex kidney stones, enlarged prostates (BPH), incontinence, erectile dysfunction, infertility, and urological oncology (prostate, bladder, kidney, and adrenal cancers). He is an expert in general urology and is often consulted for second opinions.

Dr. Larish’s dedication to patients and their families drives his belief in prompt evaluation and care. He treats all his patients like family. As such, same day appointments are available for urgent issues and house calls can be made in select cases.


Leonard Glickman, M.D.

top-urologist-nyc-glickmanDr. Glickman is specialty-trained in robotic and minimally invasive surgery for treatment of a variety of kidney and prostate conditions including kidney and prostate cancer. He also sees patients for a variety of other urologic conditions including general urology consultations, kidney stones, urinary tract infections, anti-aging treatments, vasectomy, and male infertility.

Dr. Glickman is committed to providing his patients with the best care possible while maintaining a warm and comforting bedside manner. He is up to date on the latest treatments and technologies.

Prostate Cancer: Symptoms & Treatments

Prostate Cancer: Symptoms & Treatments

The prostate is one of the smallest organs in the body located just before the groin. Urine in your body passes through your prostate as it controls the flow of urine outside of the body. The prostate is also responsible for nourishing and protecting the sperm with the help of a fluid. However, regardless of its use and importance in the body, the prostate is very susceptible to different diseases. The most common of which, is prostate cancer. Prostate cancer is the most common cancer among men in the United States even surpassing skin cancer.

Causes for Prostate Cancer

Although prostate cancer is the most common cancer among men, researchers have yet to find a definitive cause for its occurrence. They have seen that there are certain age related factors that contribute to cancer in the prostate. So, if you have the following risk factors then it is very possible that you may have to face prostate cancer in the future:

  • Age
  • Family history
  • Race
  • Geography
  • Certain birth ailments

Although it is very possible to not have any of these risks and still get prostate cancer, these risks can prepare for the worst case scenario.

Symptoms

The symptoms are intense and can be very painful to experience, leaving not a doubt in your mind that something is wrong. And while there are not a lot of symptoms during the early stages of prostate cancer, the ones that do occur go as follows.

  • Blood in the urine
  • Having difficulty maintaining or achieving an erection
  • Painful ejaculation or urination
  • Difficulty maintaining or starting urination
  • Frequent urges to urinate especially at night.

Now there are just some of the symptoms of the early stages of prostate cancer. As the cancer slowly starts to develop and enter the later stages, symptoms can also increase greatly. Along with the increase in pain near the prostate, you may also experience these symptoms:

As the cancer further develops, symptoms become severer and more common. So, if you are experiencing these symptoms, you should contact your urologist immediately.

Treatment

As for the treatment of prostate cancer, it varies depending on the severity of the cancer. Early stage treatment is not often invasive or obtrusive, whereas late stage treatment can get very serious.

Early Stage Treatment

Early stage treatment can sometimes be as simple as just waiting and monitoring the growth of the cancer instead of rushing into treatment. These treatments include:

Late Stage Treatment

Unfortunately, there are not a lot of treatment options when it comes to late stage treatment. Late stage treatments include chemotherapy and Androgen deprivation therapy (ADT). Chemotherapy is especially a very late stage treatment option as it tends to kill cancer cells across the body.

Conclusion

Prostate cancer is a very serious disease and is very likely among men that cross the age of 50. Along with other issues that your prostate may experience as you age, cancer is possibly the worst one.

Call today for a discreet consultation:

212-675-3186

Peyronie’s Disease Causes & Symptoms

What are the causes and symptoms of peyronie’s disease? Diseases or conditions near or on the genitals can be incredibly troublesome. Not only can they take a long time to heal, but also cause a lot of pain and discomfort, making it much harder for people to move around. One of these conditions is called the Peyronie’s Disease.

This disease affects the penis, and due to scar tissues or plaque forming inside the penis, you can experience serious pain. This disease is incredibly dangerous for the simple reason that the scar tissue can result in a bent erect penis, rather than usual straight erection. And although you can still have sex with Peyronie’s Disease, it can cause a lot of pain or lead to erectile dysfunction.

Causes

Not much is known about the causes for Peyronie’s Disease and how most men get it in the first place. There are a few known reasons for why men suffer from this disease, one of them is injury to the penis. An injury to the penis can be due to a multitude of reasons, from sporting injuries to experiencing damage to the penis during sex. But there is no specific cause for Peyronie’s Disease and it can be any number of possible outcomes.

Originally, when you get an erection, small sponge like tubes inside the penis receive an increase in the blood flow that makes the penis erect. On the other hand during this disease some of the blood vessels inside the sponge tubes block blood flow giving the penis a disfigured shape or even causing pain.

Symptoms

Symptoms for Peyronie’s Disease are quite easy to notice. Even if you are suffering from this condition for the first time, you can easily spot that something is wrong as most of the symptoms are very external. One of these symptoms is obviously a bent penis. If you see that your penis has a strange bend to it then it is very likely that you may be suffering from Peyronie’s Disease.

Another symptom is that you may be experiencing problems getting an erection or you feeling a scar tissue in your penis. Finding a scar tissue in your penis is very easy, as you can effectively feel out a strange lump or hard skin in your flaccid penis. You may also possibly witness your penis becoming shorter. Also, you may feel incredible pain while getting an erection.

Risks

Even if you do not have any of the symptoms of Peyronie’s Disease, it is very possible for you to experience this condition throughout your life. There are certain factors that determine just how likely you are to get this disease. One of the factors is of age. As you grow older, it is a lot more likely for you to experience this disease, especially if you are older than the age of 55 years.

Other factors include your heritage. If your father or a family member has Peyronie’s Disease then it is very likely that you will also have it.

Conclusion

Peyronie’s Disease is a very serious condition that can not only lead to a lot of pain, but can eventually cause erectile dysfunction. So, if you are experiencing a particular bend in your erect penis, then it is probably best for you to visit a urologist.

Visit our website and learn more about our urologists who dedicate themselves to serving you in the best way possible.

Erectile Dysfunction: Causes and Treatments

What are the causes and treatments of erectile dysfunction? Erectile dysfunction is an ailment that can occur in men of all ages. While it is not very common among young boys, it becomes a lot more common among men over the age of 30. And while it is common for men to experience difficulty in getting an erection, Erectile Dysfunction is completely different. Erectile Dysfunction refers to not getting satisfactory sexual performance on a multitude of occasions over a long time, leaving you in a very awkward and embarrassing predicament.

However, Erectile Dysfunction is a much more recognized ailment, which has a cure as well. There is a wide range of treatment options from surgery to medication. Even if you can’t come to talking to your doctor about it, just know that they are well aware of this particular ailment and how common it is. You may be wondering how you got Erectile Dysfunction (ED) in the first place, well there are a number of reasons for why you have ED.

Causes of Erectile Dysfunction

Causes for Erectile Dysfunction can be very different for each person. There is no single cause for Erectile Dysfunction; rather there are multiple reasons why someone may be suffering from this predicament. So, let’s take a look at all of the different causes for ED, to know more about their treatments.

Physical Causes

The physical causes imply that you may be having Erectile Dysfunction due to another disease, or another medical condition. They also include any physical trauma that you may endure on your genitals, or any other real world problem that is affecting your ability to sustain an erection. This includes:

  • Obesity
  • High blood pressure
  • High cholesterol
  • Smoking, substance abuse, or alcoholism
  • Parkinson’s disease
  • Diabetes
  • Heart disease
  • Hormonal disorders or imbalances

It is also possible that the ED may be a result of medication that you are taking in order to relieve other diseases or problems. These include:

  • Cancer medication
  • Opioid painkillers
  • Anxiety medication
  • Hormone drugs
  • Drugs for high blood pressure
  • Sleeping medication and other drugs that affect the central nervous system
  • Prostate treatment drugs

The physical causes are about 90% more likely to cause ED than psychological causes ever could. But that is not to say that they are not responsible.

Psychological Causes

Psychological causes are not as rampant, or as worry some as physical causes. Most people that suffer from ED often do so because of a physical cause, instead of a psychological one. That said, some of the psychological reasons for ED are:

  • Guilt
  • Anxiety
  • Depression
  • Fear of Intimacy

While these may seem like very menial limitations, these can be very frightening for the person suffering from this. So if you are having ED, maybe you need more psychological help than physical.

Treatments for Erectile Dysfunction

Treatments for Erectile Dysfunction come in a variety of forms. From temporary medication and solutions to permanent surgery and other medication, there is a lot for you to choose from.

Temporary treatments

When it comes to temporary medication, medicines like Viagra nitroglycerin work wonders for you. However, if you do not want to take these medications for any reason, temporary methods include using a vacuum-like device that pulls the blood to the penis and keeps it there with a band. That said, this can cause a lot of discomfort, so be sure to discuss with a physician before using this machine.

Permanent treatments

Permanent solution also makes use of medication, but also gives you the option to opt for surgery to help with the condition. There are two types of surgery that can rid you of erectile dysfunction: penile implants and vascular surgery.

Vascular surgery tries to correct some of the blood vessels that are causing the ED. On the other hand, penile implants are a last resort for people who have not had any success with any other form of treatment.

Conclusion

This guide obviously does not cover everything about erectile dysfunction, and it can’t. But, if you are looking for a good urologist that can help you get back on track, visit our website to find out more.

FIFTH AVENUE UROLOGY
212-675-3186

What is Urinary Incontinence?

Urinary incontinence is a serious bladder problem that can put you in an embarrassing position. Incontinence, or loss of bladder control, can range in severity and types but all of them are quite troublesome. While on the lowest level, men experience small leaks of urine when coughing or sneezing, the extreme condition is when men feel a very sudden urge to use the bathroom and cannot make it in time.

Although most people believe that this is a consequence of getting older, younger men can also have this serious problem. In other words, men of any age can have urinary incontinence, making it all the more troublesome. However, you don’t have to stay this way, as there are cures for this condition that are sure to get you back on track.

Symptoms

Urinary Incontinence is a very serious disease that affects thousands of people across the United States alone. With that said, it is also one of the easiest genital diseases to diagnose because of for the clear unambiguous symptoms.  Overflow Incontinence is one of the symptoms of this condition, and it leads to your penis leaking continuously because your bladder is never properly empty. Stress incontinence is possibly the most common, as this causes urine to leak when person experiences stress on the bladder for any reason. This means laughing, sneezing, coughing, or even exercise can lead to urine leaking.

Other symptoms include urge Incontinence and functional Incontinence, which cause leaks due to a sudden urge to urinate.

Risks

Even if you are not experiencing some of these symptoms, it does not mean that you are completely safe from Urinary Incontinence. There are several factors which show that you can possibly be susceptible to this particular condition. Factors like age and gender are especially relevant in this case. Women are much more susceptible to stress Incontinence than men, and over the age of 50, it is prevalent in both genders.

Smoking is also a factor that puts you under the risk of incontinence, as well as being overweight because that puts more pressure on your bladder. But there are also certain items (consumables) that make your bladder a lot weaker and more susceptible to temporary Urinary Incontinence. The items include caffeine, chocolate, chili peppers, alcohol, and sparkling water, among other things.

Causes

While some Urinary Incontinence is temporary, most of it can last much longer than it needs to. Persistent Urinary Incontinence is often due to multiple factors, including urinary tract infections and constipation both very easily curable diseases. On the other hand, Urinary Incontinence can stay if the woman is pregnant or in menopause. It can also be because of an enlarged prostate or even prostate cancer. But there are of course more natural reasons for this including aging.

Conclusion

Urinary Incontinence can be a very embarrassing yet serious condition if left unchecked. If you are noticing some of these symptoms, then you shoud seek a urologist to get a checkup.

FIFTH AVENUE UROLOGY
4 East 76th Street
New York, NY 10021
——–
212-675-3186
https://www.fifthavenueurology.com/

Benign Prostate Hyperplasia (BPH)

What is Benign Prostate Hyperplasia (BPH)? The prostate is one of the most essential parts of the body. It is responsible for the transfer of urine out of the body as well as nourishing the sperm in semen fluid. However, regardless of the importance of the prostate, it is still incredibly susceptible to various diseases and conditions. One of these conditions is Benign Prostate Hyperplasia (BPH), which gets a lot more common as men get older.

During this condition, the prostate enlarges to a dangerous level, leading to a blockage in the flow of urine. The enlarged prostate can also be responsible for a slew of other problems like kidney, urinary tract, and even bladder complications. This is quite a simple complication to reverse, as there are many treatments available for this condition such as medication, therapy, and surgery.

Causes

There are a few different conditions that can lead to your prostate enlarging and causing a (BPH). Here are some of the conditions that can lead to your prostate enlarging.

  1. Scarring in the bladder due previous trauma or surgery
  2. Prostate cancer or kidney cancer
  3. Suffering from bladder or kidney stones
  4. Narrowing of the urethra or a urinary tract infection
  5. Inflammation of the prostate

Since the urethra passes through the prostate, the enlargement of prostate is very troublesome. To make matters worse, the prostate grows larger with age making this condition a lot more serious than it should be.

Symptoms

Benign Prostate Hyperplasia (BPH) is a very serious condition that can lead to very acute and excruciating pain in the body. But there are many more symptoms than just pain near your genitals, which can possibly show that you have BPH

  1. Difficulty urinating
  2. Frequent need to urinate, especially at night
  3. Bladder is never completely empty after urination
  4. Dripping after urination
  5. Interrupted urine streams or weak urine streams
  6. UIT (urinary tract infection) or blood in the urine

These symptoms are very common in people that have an inflamed or enlarged prostate. That said, the size of your prostate does not always mean that you will have more symptoms.  Some men who have a very enlarged prostate will show very little symptoms whereas people who only have a slightly inflamed prostate can experience all of the aforementioned symptoms.

Risk Factors

Other than the original causes for your BPH, there are other reasons why you may be suffering from this condition or may suffer from this condition in the future. Age is possibly the biggest reason why men contract BPH in the first place, as this condition become especially common among people that are over the age of 60. Other reasons why you are at a risk of BPH is your family history, your diabetes, or even your lifestyle. Although these factors do not in any way confirm that you will have these problems or symptoms, there is a possibility that these factors put you at a higher risk of BPH.

Conclusion

BPH is a very serious disease and is unfortunately very common. So if you are experiencing the same symptoms, then there is nothing that a quick trip to a urologist can’t solve. Visit our main website at https://www.fifthavenueurology.com to read more about our talented and skilled urologists who can help you with your BPH symptoms or any other issues that you may have with your genitals.

What is a Urethral Stricture?

Urethral stricture: An Overview

The narrowing down of urethra, the tube via which urine passes from the kidneys to the bladder, is known as urethral stricture. Formation of scar tissue inside a specific segment of the urethra causes the stricture.

An individual with urethral stricture will experience difficulty urinating, and the urine will fill up the urinary tract.  Consistent deposition of urine in the urinary tract could eventually cause kidney malfunction and damage. The condition predominates in males as they have a longer urethra than females, rendering the former more vulnerable to stricture compared to latter.

Urethral Stricture Symptoms

We always advise individuals with urethral stricture to opt for treatment as early as possible to prevent kidney infection and formation of kidney stones. The urinary bladder could expand and stop functioning in due course if and when urinary retention becomes chronic. We tell patients to watch out for the following symptoms of urethral stricture:-

  • Urgent urination (a strong urge to urinate frequently)
  • The feeling of bladder fullness
  • Taking a long time to urinate
  • Recurrent urinary tract infections
  • Experiencing pain during urination
  • Straining to urinate
  • Urine emerging in a thin stream
  • Distension of the adjacent organs including the penis

Causes of Urethral Stricture

More often than not, the condition tends to be idiopathic, i.e. the exact cause behind urethral stricture remains unknown. However, a few risk factors are alleged to be linked to the stricture. An individual could be at risk of developing urethral stricture if he has/had:-

  • STD (sexually transmitted disease)
  • Undergone radiotherapy for BPH (benign prostatic hyperplasia)
  • Been operated upon for a prostate or bladder problem
  • Used catheter
  • Prostatectomy
  • Prostrate brachytherapy (radiation therapy for prostate cancer)
  • Suffered a trauma due to injury in the area surrounding the scrotum

Diagnosis

To confirm whether someone has a urethral stricture, we perform a physical test, enquire about medical history, and symptoms. Furthermore, we suggest patients opt for one or more of the following tests for ascertaining the exact location, extent, and cause          of the stricture:-

  • Urinary flow assay
  • Urinalysis
  • Pelvic ultrasound
  • Urethral ultrasound

Conducting a Cystoscopy enables us to confirm a diagnosis. We insert a cystoscope inside (a tubular device carrying a small camera) into the urethra to scan its entire span. The camera lens helps us to locate the stricture as well as the level of constriction or narrowness.

After that we study X-rays (Retrograde urethrogram) to identify the length of the stricture.

Treatment

We place a urethral stent or perform urethroplasty following confirmation of the presence of urethral stricture. We conduct urethroplasty for the sake of restoring the urethra to its original shape or form. The procedure entails eliminating the stricture, and grafting tissue from the patient’s body and positioning it in the urethra for widening it.

In some cases, we place a stent within the narrowed section of the urethra to keep it wide enough for urine to pass through smoothly.

Conclusion

We always recommend individuals diagnosed with urethral stricture to seek medical intervention. We counsel patients on different surgical procedures.

Our Urologists advise patients who’ve undergone surgery for urethral stricture to remain in touch. The stricture could recur even after successful surgery, and hence, it is important to regularly consult our urologists in NYC for monitoring symptoms.

Our exceptionally qualified urologists at Fifth Avenue Urology have been and continue to deliver superlative urological services. Dr. Michael Brodherson, M.D. is a veteran, specializing in gynecological operative procedures and complicated surgeries. He has amassed many years of experience performing open urological operations.

Dr. Larish is a surgeon and urologist with wide-ranging experience in the treatment of adrenal, kidney, bladder, and prostate cancers, and infertility. Dr. Glickman is adept in carrying out minimally invasive surgeries for various urological issues. In this blog, we shed light on urethral strictures.

For a confidential consultation, contact us today:

FIFTH AVENUE UROLOGY
212-675-3186

 


References

  1. https://www.gaurology.com/urethral-stricture-males/
  2. https://www.medicalnewstoday.com/articles/324983.php 
  3. https://www.mayoclinic.org/diseases-conditions/urethral-stricture/care-at-mayo-clinic/mac-20362386

I have erectile dysfunction

Erectile Dysfunction: Treatment Options & Procedures

Many men who we see at our practice often opine, “I have erectile dysfunction.” We tell our patients that not having an erection once in a while should not bother them. We recommend the patients to consult our urologists only when they fail to have an erection consistently.

Our patients heave a sigh of relief when we make it clear to them that all types of ED can be cured. And Dr. Larish is thoroughly capable of dealing with both simple and complicated cases of ED. Treatment options for ED include topical medications, oral medicines, penile implant surgical procedure, and injectable medications.

Before we start treating, we carry out a thorough evaluation to determine and ensure the procedure that’ll be optimal for a particular patient. For a start, we try to bring the patient’s blood pressure and blood sugar under control. At the same time, we advise ED patients to completely stop smoking as the habit adversely affects one’s libido.

Medicinal Treatment

We suggest medicinal therapy as the first line of treatment, which can offer good results. Viagra, Levitra, Stendra, and Cialis are four PDE5 Inhibitors that are effective for more than 60% of men diagnosed with ED. Cialis is the most popular of all PDE5 Inhibitors as the medicine’s effects remain for nearly 36 hours and do not need to be taken on an empty stomach.

Nevertheless, we’ve seen from experience that these medicines do not work for more than 50% of men suffering from diabetes and ED. Alternatively

External Mechanisms

External mechanisms or devices like vacuum pumps medicated urethral options, and penile self-injection therapy rarely produces desired results in the long run. Very few men choose external devices for dealing with ED borne out by the extremely low replenishment and steep dropout rates.

The biggest reason why men choose to refrain from using external devices is the meticulous planning needed for such therapies.

Penile Implants

Men diagnosed with ED opt for penile implant procedure as a last resort when medications and external devices prove ineffective. For such men, we recommend IPP (internal penile pump), popularly referred to as ‘inflatable implant.’ Dr. Larish has the competency to install various kinds of penile implantation devices in men with ED.

The outpatient operative procedure takes about 45 minutes. Dr. Larish first makes a 1-inch cavity in the scrotum for inserting the penile pump. The patient needs to press the pump for pumping the semen into the genital organ (penis). Once the semen fills up the penis, the patient experiences an erection that endures.

Fifth Avenue Urology

Our team of urologists at Fifth Avenue Urology has been and continues to provide exceptional urological services to the young and old alike. Dr. Brodherson, who had a former Chief of Urology at Lenox Hill Hospital, and Dr. Yaniv M. Larish, erstwhile chief RMO in the urological department of the same hospital are committed to offering the best possible urological care.

Our urologists are capable of furnishing the best possible treatment for a wide gamut of complications affecting the urinary tract, including the kidneys, bladder, ureters, and urethra. We offer treatment and care for erectile dysfunction, prolapsed uterus, prostatitis, and a host of other urological complications. All men with erectile dysfunction who visit our clinic are referred to Dr. Larish, a surgeon, and urologist, who has extensive experience of treating erectile dysfunction.

Conclusion

We suggest men suffering from ED to contact us as early as possible for an appointment with our urologists. Dr. Larish, who has several years of experience in successfully handling ED cases, is always willing to consult with patients on this issue.

FIFTH AVENUE UROLOGY
——–

4 East 76th Street
New York, NY 10021
——–
212-675-3186

 


References

  1. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-how-it-works
  2. https://www.urologicalcare.com/erectile-dysfunction/ed-treatment-options/
  3. https://www.emedicinehealth.com/surgical_treatment_of_erectile_dysfunction/article_em.htm#what_are_the_surgical_options_for_erectile_dysfunction
  4. https://www.urologicalcare.com/erectile-dysfunction/ed-treatment-options/
  5. https://www.fifthavenueurology.com/services/#ed

What is Benign Prostate Hyperplasia (BPH)?

urologist-benign-prostate-hyperplasia-BPH-info-01What is benign prostate hyperplasia (BPH)?  We’ve outlined relevant details about BPH in this article, including common symptoms, causes, risk factors, diagnosis methods, and treatment options.

Benign prostate hyperplasia (BPH)

Benign prostate hyperplasia (BPH) implies a urological condition where the bladder becomes enlarged. BPH exclusively affects men aged 51-60 who experience a blockage in the smooth release of urine. Benign prostatic hyperplasia could also lead to renal (kidney), urinary tract, and urinary bladder issues.

A men prostrate grows to twice its original size during the early phase of puberty. The gland experiences a second growth phase when a man becomes 25, and it continues to develop consistently with age. An enlarging prostate creates pressure on the urethra, causing the latter to become narrowed or constricted.

The urinary bladder is unable to empty itself owing to urethral narrowing leading to the occurrence of BPH. The word ‘benign’ preceding prostatic hyperplasia implies that the condition is not cancerous. However, a man with BPH could always be vulnerable to cancer, not necessarily because he’s suffering from the former.

BPH Symptoms

As per our experience, the symptoms of BPH and their acuteness could vary from one individual to another. With time, the symptoms tend to deteriorate. The most common symptom is the urge to urinate frequently. Other usual symptoms of BPH comprise:

  • Nocturia or the increasing urge to urinate more often at night
  • Streamlined and intermittent urination, i.e., thin discharge that starts and stops time and again
  • Finding it difficult to urinate
  • Trickling after urination
  • Experiencing difficulty in emptying the bladder

The less common symptoms include:

  • Hematuria (blood in urine)
  • Urinary tract infection (UTI)

Causes

bph-symptonms-treatment-options-nyc-specialists-02BPH tends to be idiopathic; researchers are yet to pinpoint the exact cause or causes behind the condition. The functioning of the testes and aging are generally regarded as the chief causative factors of benign prostate hyperplasia. The fact that men whose testes were surgically excised before they attained adolescence do not develop BPH lends credence to the above postulations.

As men grow older, the production of male hormone testosterone decreases, which tilts the balance in favor of estrogen. Incidentally, men also produce a small proportion of the female sex hormone estrogen. This imbalance leads to a proliferation of substances that trigger the incidence of BPH.

A large number of medical experts also feel that increased levels of DHT (dihydrotestosterone) could also cause BPH. Other potential causes of BPH are:

  • Bladder or prostate cancer
  • Kidney or bladder stones
  • Urethral stricture (narrowing)
  • Prostatitis
  • UTI

Complications or risk factors of BPH

The likely complications of benign prostate hypertrophy are:

  • Kidney damage
  • Bladder damage
  • Bladder stones
  • UTIs
  • Urinary retention (the inability to empty the bladder)

The possible risk factors comprise

  • Obesity
  • Heart disease
  • Diabetes
  • Genetic predisposition
  • Aging

Diagnosis

Our urologists review patients’ medical history and analyze the symptoms and perform one or more of the following assays for confirming BPH:

  • PSA
  • Urinalysis
  • Urinary blood exam
  • Physical exam
  • Digital  rectal exam (DRE)
  • Prostate ultrasound
  • Urodynamic pressure test
  • Cystoscopy

We also carry out another diagnostic test for establishing whether a patient has BPH.

Treatment

We offer a range of treatment options at Fifth Avenue to BPH patients, including medicines (alpha blockers and alpha reductase inhibitors), self-catheterization, surgical procedures, and lifestyle changes.

Schedule a Confidential Consultation Today

Our urologists at Fifth Avenue Urology, Drs. Michael Brodherson, Leonard Glickman, and Yaniv Larish provide exemplary urological care. We’re fully conversant with the issues involving the human urological system, starting from the kidneys up to the reproductive system. At the same time, we’re aware of the physical and psychological aspects of urological conditions.

We treat all urological issues. The urological services we proffer comprise treatment for prostatitis, incontinence, kidney, prostate, testicular, and bladder cancers, vasectomy, circumcision, and BPH.

Talking about BPH, we regularly offer consultation and treatment to men in their fifties and sixties with an enlarged prostate.

FIFTH AVENUE UROLOGY
——–
4 East 76th Street
New York, NY 10021
——–
212-675-3186


References

  1. https://www.medicinenet.com/benign_prostatic_hyperplasia/article.htm
  2. https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/diagnosis-treatment/drc-20370093
  3. https://www.urologyhealth.org/urologic-conditions/benign-prostatic-hyperplasia-(BPH)

I have Peyronie’s Disease. What are my options?

top-nyc-urologists-peyronie’s-disease-01Peyronie’s Disease causes a male’s penis to bend or curve abnormally when he experiences an erection. The growth and proliferation of fibrous plaques (fibrous scar tissue) beneath the skin of the penis cause the curvature. The anomalous bending of the penis during erection can be quite painful for the individual.

It is quite normal for the male sex organ to somewhat arch when fully erect. However, if the curvature tends to be considerable, a man may not be able to enjoy coitus. The abnormality could lead to men experiencing difficulty in having or maintaining an erection-a medical condition known as ‘erectile dysfunction.’

Understandably enough, men suffering from Peyronie’s Disease have to undergo a lot of anxiety. More often than not, the condition resolves automatically, but sometimes the problem aggravates in due course. The condition can be corrected using first and second line treatment methods.

However, surgical intervention becomes indispensable when first and second line treatment options prove ineffective.

Treatment options for Peyronie’s Disease

peyronies-penis-info-urologist-specialists-nyc-02We get many patients on a recurrent basis who opines “I have Peyronie’s disease. What are my options”?  For a start, we try to find out the symptoms and the length of time they’ve been suffering from the same. We also carry out a physical evaluation.

Our doctors normally adopt a wait and watch policy if we observe that the patient experiences negligible pain, and the bending doesn’t aggravate. We only recommend surgery as a last resort when we notice significant changes in symptomsover a year.

Medications

We advise medicinal therapies and injectable drugs for mild cases of Peyronie’s Disease. We suggest a set of 6-12 Verapamil injections for softening the fibrous palates. Based on our past experiences, we’ve seen that the injections usually prove effective in preventing further curvature of the penis.

We prescribe Clostridium hystolyticum (Xiaflex) medicine (the sole drug approved by FDA) for individuals whose penises’ incline 30˚ or above during erection. Sometimes, we recommend nondrug therapies, including vacuum devices, penile traction, and shock wave treatments.

Surgical procedures for Peyronie’s Disease

Our urologists advise going under the scalpel only if the bending restricts the patient from enjoying effective intercourse. There are two distinct ways in which we perform a surgery-we either lengthen or shorten the penis from one side.

Elongating the penis

To allow the stretching of the sheathing, we excise the scar tissue at several sections. The normal stretching of the sheath allows the male to achieve an erection without any curvature. We remove portions of the fibrous scar tissue during the operation and regraft the same over the excised section.

This procedure tends to be more suitable for men with a very pronounced bending or a short penis.

Shortening the penis from one side

According to this process, the unaffected end (the side without scar tissues) is shortened for remedying the curvature during erection. However, the surgical process causes a shortening of the penis, and hence recommended for men with a lengthy penis (longer than normal).

Conclusion

The medical practitioners at our Fifth Avenue Urology specialize in urology and therefore excel in furnishing quality urological services. Our urologists fully empathize with patients grappling different urological problems. Men with Peyronie’s Disease may not be able to lead an active sex life. Hence, patients diagnosed with the condition should get in touch with one of the best urologists in NYC.    

We encourage men suffering from Peyronie’s Disease to visit our Fifth Avenue Urology clinic in Upper East Side in Manhattan for consultation and treatment.


References

  1. https://www.webmd.com/men/peyronies-disease#1
  2. https://www.medicalnewstoday.com/articles/242682.php
  3. https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468

Best Treatments for Kidney Stones

top-urologists-for-kidney-stones-01 at our Fifth Avenue practice have amassed extensive experience in effectively dealing with nearly the entire gamut of urological issues. We specialize in both surgical and conventional modes of treatment for BPH, kidney cancer, prostatitis, UTI, and a host of other urological conditions. We strictly maintain ethical standards of treatment and carry out day to day operations in a transparent manner.

Our urologists treat patients with respect and accord the highest level of care possible. We give due credence to our patients’ opinions and never recommend surgery if the condition can be remedied using non-invasive or minimally invasive treatment methods.

What are kidney stones?

Kidney stones, medically known as renal calculi, usually develop inside the kidney as solid crystalline lumps. However, the stones could form anywhere in the upper or lower urinary tract, including the urethra, bladder, kidney, and ureters. Different types of stones can develop within the kidney like calcium stones, Struvite stones, Cystine, and uric acid masses.

Practical treatments for nephrolithiasis or kidney stones

nyc-urologist-kidney-stone-treatment-02What are the best treatments for kidney stones? The stone type (calcium, uric acid, Cystine or Struvite), as well as the cause(s), determines the suitable treatment mode.

Removing small stones from the kidney: Treatment options

Our urologists at Fifth Avenue Urology know from experience that the majority of the kidney stones tend to be small. The stones are so small that these drain effortlessly into the bladder via the ureter. Usually, the small stones are removed from the urological system through the urine.

Medical intervention may not be necessary for removing stones, having a size of 0.5mm or less.

The removal of small stones can be expedited by:

Medication

We recommend a range of effective medications like corticosteroids, calcium channel blockers, and alpha-adrenergic blockers for speeding up removal. These medicines serve as muscle relaxants, somewhat loosening the ureter muscles to facilitate the elimination of stones. We also prescribe Advil, Aleve, and Tylenol for pain relief; phosphorus solutions and thiazide diuretics for checking calcium stone formation.

Drinking sufficient water

We advise patients with kidney stones to drink at least 7-8 glasses of water daily to boost up urination. Also, drinking 2-3 liters of water every day produces clear urine and makes it less acidic.

Treatment procedures for getting rid of large kidney stones

large-kidney-stone-removal-options-03Removing large kidney stones usually, call for more extensive or advanced treatment procedures. Urinary calculi that are too big to go out automatically could cause UTIs, kidney damage, or bleed if not removed surgically.  Some of the most popular treatment methods include:

ESWL (extracorporeal shockwave lithotripsy)

We suggest ESWL-a non-invasive procedure to patients with specific sizes of kidney stones. This technique makes use of ultrasonic shock waves to generate powerful vibrations for fragmenting the stones into microscopic pieces. Breaking the large renal calculi into very small pieces allow the latter to drain away smoothly with urine.

The procedure normally takes about an hour and causes mild discomfort and pain as the pieces go through the ureter. Therefore, we administer local anesthesia or sedatives for helping patients cope with pain and discomfort.

Ureteroscopy (ureteroscopic surgery)

We resort to ureteroscopy for getting rid of small stones trapped in the bladder or ureter. Such small stones also cause excruciating pain to the patients and could be responsible for causing UTI. Our urologists insert a ureteroscope fitted with a small camera in the ureter via the urethra and urinary bladder to trace the stone.

Sophisticated tools trap the stone and crack it up into tiny bits. After that, we position a stent in the ureter to alleviate inflammation and speed up healing.

Nephrolithotomy

Sometimes we take advantage of percutaneous nephrolithotomy (PCNL) to remove oversized renal stones. We make a small opening on the patient’s lower back for inserting special tools and tiny telescopes for locating and removing the stone.

Conclusion

Kidney stones should not be a cause of concern for patients provided they consult a specialist for their removal. We at Fifth Avenue Urology offer non-invasive and minimally invasive therapeutic procedures for removing kidney stones.

Call today for a consultation:

FIFTH AVENUE UROLOGY
212-675-3186


References

  1. https://www.healthline.com/health/kidney-stones#types
  2. http://urology.ucla.edu/kidney-stone-treatment
  3. https://www.mayoclinic.org/diseases-conditions/kidney-stones/diagnosis-treatment/drc-20355759
  4. https://www.medicinenet.com/kidney_stones/article.htm
  5. https://www.msdmanuals.com/en-in/professional/genitourinary-disorders/urinary-calculi/urinary-calculi