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Putting Patients First


Welcome to Fifth Avenue Urology, the practice of Dr. Yaniv M. Larish. 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. Larish served as the former chief resident of Urology at Lenox Hill Hospital. Drs. Larish is focused on providing exceptional, detail oriented, unrushed, and compassionate urological care to men and women of all ages. At Fifth Avenue Urology, we 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


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.


Male Factor Infertility

What is male factor infertility and what can be done to reverse this condition? Infertility is a condition that affects both men and women in the United States and other parts of the world. It’s a reproductive organ disease that reduces a patient’s ability to have children with their partner. Male infertility refers to the testicles inability to produce enough sperm cells or fertile sperm. On the other hand, female infertility is the insufficient production of eggs or fertile eggs in the ovaries causing difficulties to conceive. A list of treatment and surgical options has been introduced in the healthcare industry to help patients with infertility.

Male Factor Infertility
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In male infertility, the patient’s body might not produce enough sperms or may experience medical difficulties in releasing those sperms that help in conceiving. There can be various causes for male infertility. For most male patients, male infertility is a result of genetic conditions or health disorders.

How Do Experts Diagnose Male Infertility?

The doctors, especially urologists, can help diagnose medical conditions and diseases such as male infertility. They may propose a series of tests or a single test to check whether a male is fertile or not to conceive with a partner. Here’s what the diagnoses methods look like:

Blood Test

The doctor will check for genetic conditions and hormone problems using the patient’s blood sample. This helps them determine if the patient can conceive.

Scrotum Ultrasound

An expert urologist will look for abnormalities in veins near the testicles, mainly the ones responsible for the blood flow between testicles and the rest of the body.

Semen Analysis

The doctor will require the patient to ejaculate in a sterilized container for further testing. The semen/sperm fluid will be sent for diagnosis, where the expert will calculate the total sperm count and reproductive efficacy.

To help solve male infertility issues, expert urologists can carry out various surgeries and advise other treatment options. Surgeries are the most effective methods to treat male infertility, but they can lead to temporary pain, bruises, and, rarely, infections or bleeding.

If you’ve undergone surgery for male infertility, consider discussing the after-effects with an expert urologist. Try to talk to the person who conducted the surgery to get a better insight.

Male Factor Infertility: Micro TESE (Microscopic Testicular Sperm Extraction)?

Microscopic Testicular Sperm Extraction or Micro TESE is a medical procedure that involves the direct extraction of sperm from the male reproductive organs. The male’s reproductive organs’ tissues are targeted to extract healthy sperm out of the body and help with conceiving. If a male patient doesn’t produce or release healthy sperm, then this medical procedure is recommended to help the respective patients and their partners get pregnant.

The testicular tissue targeted for extracting healthy sperm is present on the two testicles inside the scrotum, i.e., the body part where sperm cells are produced.

The Procedure

A doctor or urologist who specializes in urinary tract issues and conditions is the best professional to see for this procedure. However, you must make sure that your chosen urology expert has extensive surgical experience to carry out the procedure effectively with minimal complications.

The surgeon will make minor incisions in the testicles to remove a part of the tissue on the male reproductive organs. Following the tissue removal, the surgeon will examine the extracted tissue to detect healthy sperms. If healthy sperms are present, the surgeon might advise carrying out fertilization with the eggs right away. In other cases, the surgeon can also freeze the sperm cells as per the patients’ discretion to thaw them later for infertility treatment.

The procedure usually takes place on an outpatient basis and doesn’t involve a long-term hospital stay. The Micro TESE procedure begins with an incision in the middle of the scrotum, and after extraction, the surgeon applies dissolvable stitches to the area.

Best Male Factor Infertility Urologist NYC
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What’s Micro Varicocelectomy?

Micro Varicocelectomy is another popular male infertility treatment method that helps in repairing “varicoceles.” It’s a condition where the scrotal veins enlarge to a state of immense pain. Some patients might even experience testosterone production impairment and strong infertility. In the case of varicocele, where your scrotal nerves are painful and impair testosterone production, resulting in poor sexual performance, your urologist can suggest the following microsurgeries.

Varicocele Microsurgery

In this treatment procedure, an experienced surgeon will use microscopic equipment to first identify the enlarged testicular arteries and scrotal nerves. Then, the surgeon will carefully tie off the enlarged nerves permanently to prevent poor blood flow in the groin area. The initial incision to access the enlarged veins will be in the middle of the groin area or where the surgeon recommends.

Varicocele Embolization

This process is less invasive than the microsurgery discussed earlier. It involves the placement of a tiny coil to stop poor blood flow to the abnormal veins.

Male Factor Infertility: Conclusion

You can visit Fifth Avenue Urology to get a diagnosis for urological conditions. The expert doctors, namely Dr. Yaniv Larish and Dr. Leonard Glickman, operate as the top urologists in NYC. They have received advanced education, training, and experience in the field of urology. Offering the best treatment solution for male patients with infertility issues, they possess a compassionate and humble attitude.

Schecule an appointment by calling Fifth Avenue Urology at 212-675-3186 today. Meet the expert urologists to consult about urological diseases and disorders and to discuss treatments.

Urge Incontinence

What is urge incontinence? If you’re aware of what it means to have an overactive bladder and a frequent urge to urinate, then you probably know about urge incontinence. There are many types of incontinence that affect both men and women. Incontinence affects women the most due to weak pelvic and vaginal muscles. This can occur as a result of complicated childbirth and aging. In this post, you’ll learn about the types of incontinence, symptoms, and complication.

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It’s quite difficult to go by your daily routine when you have to keep walking discreetly to the restroom several times within a short period. Therefore, knowing the symptoms of this health condition early on can help with prevention and timely treatment.

Types of Urge Incontinence

You may already know that frequent urges to urinate don’t always go as planned. You cannot always control the sudden urge to urinate and may have to stop whatever work you’re doing to take a trip to the restroom. But, it gets frustrating when it’s only been half hour before you get the urge to urinate again. Hence, frustration, stress, anxiety, and depression are among the most common symptoms resulting from urge incontinence.

However, the major symptom involves leakage of urine during sleep, straining exercise, laughing, sneezing, or coughing. If you tend to lose control over your bladder tissues and pelvic muscles during a straining physical activity, you might have urge incontinence. In that case, a visit to the right urologist for treatment is necessary.

Here’s a list of several types of incontinences that affect both men and women:

·       Urge Incontinence

It’s when you keep getting frequent strong urges to urinate, and most of the time, you end up losing urine involuntarily. Urge incontinence can persist throughout a 24-hour period meaning that affected patients may have to get up more than once a night to urinate.

·       Functional Incontinence

This type of incontinence is somewhat correlated with other medical health issues. For instance, if you’re experiencing a sudden urge to urinate and you fail to reach the restroom in time, it may lead to unintentional urine loss.

·       Overflow Incontinence

This happens when you urinate and feel that the bladder isn’t completely empty. Commonly, it’s followed up by constant dripping of urine due to bladder health conditions.

·       Stress Incontinence

It’s related to the unintentional loss of urine when you sneeze, cough, or laugh too hard. In other words, when you put a strain on your pelvic muscles and bladder tissues, involuntary urine loss occurs.

·       Mixed Incontinence

It refers to a combination of incontinences manifesting multiple symptoms at once. For instance, an individual with mixed incontinence might have urge incontinence and stress incontinence.

Causes of Urge Incontinence

When abnormal bladder contractions occur, the body loses control over the bladder tissues and, subsequently, pelvic muscles. That causes the sphincters, i.e., strong muscles, to relax temporarily, making it difficult for you to control urine loss. During urge incontinence, the bladder muscles contract with so much force that they override the strength of the sphincter muscles located in the urethra. Note that the urethra is the tube that offers the passage for urine secretion out of the body.

When the bladder’s irritated, urge incontinence can be a temporary symptom. On the other hand, if you have multiple sclerosis, Parkinson’s disease, or diabetes, your bladder may start malfunctioning and lead to incontinence. Here are several causes of behind this issue due to bladder malfunction:

  • Bladder inflammation
  • Bladder cancer
  • Bladder stones
  • Nerve problems
  • Spinal cord injuries

Symptoms of Urge Incontinence

Here are the most prominent signs of urge incontinence that are common in both men and women affected by the bladder condition:

  • Involuntary urine loss during a strenuous physical activity like bending, lifting, exercising, and other normal daily activities.
  • Strong and frequent urges to urinate that are extremely difficult to control.
  • Bed wetting.
  • Urine loss without any sign or urges.

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Risk Factors of Urge Incontinence

Some people are at a higher risk of contracting bladder issues. Several risk factors increase the chances of developing the said conditions. Those factors include:

  • Gender: Women who go through childbirth and menopause experience difficult pelvic and vaginal muscles movement.
  • Smoking: Tobacco and other harmful chemical substances in cigarettes increase the chances of developing several health conditions, including urge incontinence.
  • Age: With age, bladder and pelvic muscles weaken, leading to less control over the involuntary urine loss through the bladder.
  • Obesity: Additional fat and muscle weight strains the bladder tissues and pelvic muscles, leading to difficulty urinating or control once in the process.

Urge Incontinence: Conclusion

Just like any health condition that interferes with your daily routine and regular lifestyle requires immediate medical care, finding the perfect urologist for that job is important. At Fifth Avenue Urology, Dr. Yaniv Larish, and Dr. Leonard Glickman, operate as the top urologists in NYC. Both doctors have extensive experience in dealing with urological and bladder issues. They also have surgical skills and have successfully helped many patients suffering from incontinence get relief.

Contacting the right urologist once you detect symptoms of urge incontinence can help in choosing the right treatment options for prevention and recovery. Call Fifth Avenue Urology at 212-675-3186 and set an appointment with an expert today.

The Prostate Gland & Urinary Problems

What is the relationship between the prostate gland & urinary problems? The prostate gland is a walnut sized male organ. It is found at the base of the bladder and produces fluid to protect sperm. The gland sends fluid into the urethra, through seminal vesicles and the ejaculatory duct. The urethra is a thin tube that passes urine and semen from the bladder to the penis. This tube passes through the prostate gland. The prostate stores sex hormones, produced by the testicles.

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Causes of Prostate Gland & Urinary Problems

With growing age men, develops urinary problems. Inflammation of the prostate gland triggers the conditions. Men over 40 years of age experience urinary problems because of vas deferens tube blockage, resulting in male infertility.

Prostate gland enlargement is also a common cause. Another common symptom of urinary problems is difficulty in urinating. Many other urinary symptoms lead to urinary problems.

If you experience these symptoms, you should visit a urologist for rapid diagnosis and treatment. If you didn’t identify the symptoms in time, you might face severe consequences.

Symptoms of Urinary Problems

Here are some symptoms of prostate and urinary problems:

  • Frequent urination during the night
  • Urinary urgency or strong or sudden urge to urinate. Sometimes, you might even fail to reach the toilet in time.
  • Urine dribbling throughout the day
  • Lack of urine flow, making it difficult to urinate
  • Sensation in the bladder, even after you completely urinate.
  • Sensation to urinate again and again
  • A slow stream of urine

These symptoms are often frequent and cause difficulty in urinating. If you experience these symptoms, you should consult a urologist for successful treatment.

Other Urinary Symptoms

You should visit a urologist if you experience these symptoms:

  • Painful urination
  • Inability to urinate
  • Severe urinary incontinence
  • Blood while urinating
  • Unusual penile discharge

Common Urinary Problems

Here are some common urinary problems:

1.     Prostate Gland Inflammation

Bacteria can cause prostatitis or inflammation of the prostate. The underlying condition for prostate gland inflammation is still unknown. You should consult your doctor if you experience:

  • Groin pain
  • Lower back pain
  • Light fever
  • Frequent urination

When you visit a urologist for the treatment of urinary problems, they will prescribe antibiotics to eliminate the infection. If you develop chronic bacterial prostatitis, the doctor might ask you to stay in the hospital. Thus, you should immediately visit a urologist to treat prostate gland inflammation to prevent complications.

2.     Enlarged Prostate

Enlarged prostate or benign enlargement of the prostate gland is common among older men. The symptoms of this condition may be painful. But that is not always the case. Sometimes, you won’t experience symptoms.

In this condition, the prostate gland increases in size, causing urination problems. The enlarged prostate restricts urine flow and in worse cases completely blocks. To treat this condition, the urologist inserts a catheter in the bladder to release liquid waste. In rare cases, enlarged prostate causes kidney damage.

Sometimes, you might not experience urinary problems with an enlarged prostate. Various studies suggest that prostate size doesn’t cause urination problems. That said, BPH is one cause of urinary problems. There are other urinary symptoms as well such as weak bladder or bladder spasms.

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Treatment for Urinary Problems

If you develop prostate gland and urinary problems, the urologist will suggest the following treatments:

  • Antibacterial medication to eliminate bacterial prostatitis. Since urinary infection is a severe condition and difficult to remove, you have to take this medication for weeks.
  • The surgical procedure to clear blockage due to enlarged prostate. The urologist will diagnose your condition and recommend surgery according to the prostate size and urethra’s condition. Some of these procedures are:
    1. Open surgery prostatectomy
    2. Transurethral incision of the prostate
    3. Transurethral resection of the prostate
    4. Open surgery prostatectomy
    5. Laser Resection of the prostate
    6. Removal of prostate tissues
  • Medication to remove obstruction due to enlarged prostate and maintain enlarged prostate.
  • UroLift, which includes transurethral insertions of staples.
  • Many other surgical procedures reduce urinary symptoms.

Prostate Gland & Urinary Problems: Conclusion

If you experience the above symptoms, you might have urinary problems. Since the condition gets severe over time, you should immediately visit a professional urologist. A urologist will diagnose your condition and recommend an effective treatment method.

Do you want to consult a professional urologist in New York? If yes, then you should visit Fifth Avenue Urology. Our experienced and skilled urologist, Dr. Yaniv Larish, has a high level of expertise to diagnose and treat urological conditions in both men and women.

To consult with Dr. Larish, contact us today.

FIFTH AVENUE UROLOGY
Dr. Yaniv Larish

4 East 76th Street
New York, NY 10021

212-675-3186

The Current State of Erectile Dysfunction & Treatment

What is the current state of erectile dysfunction and treatment? More than 30 million men complain about the inability to keep and even get an erection. People who encounter such issues often have erectile dysfunction. ED is a common condition that men develop for many reasons.

Erectile Dysfunction & Treatment Urologist NYC

You don’t necessarily have erectile dysfunction if you develop an erection problem less than 20% of the time. But, when it progressively and routinely happens or occurs 50% of the time, you should visit a urologist for treatment. You may develop ED for these common reasons:

  • The limited blood supply in the penis
  • Damaged nerves
  • Emotional and stress work and life routine

Also, ED is an early symptom for serious health conditions such as:

  • Heart disease
  • High blood sugar
  • High blood pressure
  • Atherosclerosis

When you visit the doctor for erectile dysfunction, they will evaluate your overall well-being to find an underlying condition. As a rule, if your heart is healthy and you’re in good physical condition, then your sexual health is good.

Prevalence of Erectile Dysfunction

Experts suggest that erectile dysfunction is more common in elder men than younger men. It’s because with growing age, the risks of ED increase. Some studies claim that ED is a common type of sexual dysfunction in men.

In a 2018 review, experts suggest that about a third of men develop erectile dysfunction. Another study about ED, conducted in 2019 found that the current state of ED starts from 3% to 76.5%.

A study, performed by Massachusetts Male Aging experts concluded that about 52% of men undergo erectile dysfunction. Furthermore, about 5% to 15% of men suffer from ED ages between 40 and 70. This indicates that the risk of ED increases with the growing age. That said young men can develop erectile dysfunction as well. Another study, conducted by the Journal of Sexual Medicine suggested that about 26% of men develop ED below 40 years of age.

Considering the above-mentioned studies and others, doctors suggest that ED is a common condition and occurs in a large population of men. But, the statistics may differ because different institutions measure erection issues differently.

However, if you are unable to get or keep your penis erectile 50% of the time, you should visit an experienced urologist. The doctor will evaluate ED and suggest an effective treatment plan.

Treatment for Erectile Dysfunction

You can treat erectile dysfunction by improving your vascular and heart condition. Visit a doctor and share the problems you encounter. They will diagnose the condition and share risk factors, so you can receive proper treatment.

The doctor might ask to increase workouts, stop smoking, and eat healthily. Also, they might ask you to quit the use of alcohol or drugs. They will prescribe alternative and less harmful drugs instead.

Sometimes, emotional problems can cause erectile dysfunction. This happens due to depression, life’s stressors, relationship conflicts, or anxiety. In such conditions, the doctor will ask you to seek emotional support. Once you treat your anxiety or depression, you will cure ED.

ED Erectile Dysfunction & Treatment Doctor New York

The doctor will suggest the treatment depending upon the underlying condition. They will start the treatment process with non-invasive treatments. Most ED treatments are effective and safe. Still, you should ask the urologist about side effects. The common treatments for erectile dysfunction are:

  • Oral Drugs such as Levitra, Cialis, Viagra, and Stendra. These prescribed drugs are called phosphodiesterase type-5 inhibitors. These erectile dysfunction treatments are common in the US. These medications improve blood flow to the penis.
  • Penile Implants
  • Penile Injections such as Intracavernosal Alprostadil or ICI
  • Testosterone Therapy, especially when you have low testosterone in the body. The doctor will suggest blood testing to check testosterone levels.
  • Vacuum Erection Devices
  • Intraurethral medication such as Alprostadil or IU
  • Surgery, if you had severe pelvic trauma in your life. This condition helps bypass penile artery damage. Urologists commonly recommend this treatment to young men. Since older men have hardened arteries, this treatment is not suitable for them.

Erectile Dysfunction ED & Treatment: Conclusion

Erectile Dysfunction is not a life-threatening condition, but it can be a symptom of a serious disorder. If you experience erectile dysfunction, you should visit a urologist for diagnosis and treatment. An experienced urologist evaluates the patient for ED to find the actual cause behind the problem. Once a urologist diagnoses the condition, they suggest the best treatment for that underlying problem.

If you need to consult a professional urologist in the New York City area, then call Dr. Yaniv Larish. Dr. Larish is a highly experienced urologist in New York City and provides detail oriented, exceptional, and compassionate urological care to both men and women.

For a consultation or to schedule an appointment, contact us today:

FIFTH AVENUE UROLOGY
Dr. Yaniv Larish
4 East 76th Street
New York, NY 10021

212-675-3186

Male Infertility Causes & Treatments

Male infertility is any condition when a person loses their ability to produce or ejaculate sperm. Infertility occurs in both males and females. About 13 out of 100 couples can’t have a baby. In most of these cases, infertility is the reason behind the issue. The common cause for male infertility is lack of sperm production or sperm delivery.

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Causes for Male Infertility

Male infertility occurs for many health issues. Here are some common conditions of male infertility:

1.     Varicocele

The vein that drains sperms from testicles is called the vas deferens. When this vein swells, the sperm can’t leave the body. This is a reversible male infertility condition. Many urologists suggest that the abnormal blood flow causes vas deferens to swell. But, the actual cause is still unknown. This condition affects the quality and quantity of sperm.

2.     Infection

Various infections can negatively affect sperms health and production. These infections cause scarring in the sperm’s passage causing a blockage. As a result, you will experience inflammation in the testicles and epididymis. You may also develop an infection because of sexually transmitted infections such as HIV or gonorrhea. Also, some dangerous infections cause permanent testicular damage. But, treatments can retrieve sperms.

3.     Ejaculation Issues

Conditions such as retrograde ejaculation cause male infertility. In this condition, the sperm enters the bladder instead of ejaculating from the penis. You may develop retrograde ejaculation for various reasons such as:

  • Medications
  • Spinal injuries
  • Diabetes
  • Surgery of the prostate or bladder

4.     Some Antibodies

Antibodies are part of the immune system that fights allergens and other harmful substances that enters the body. Due to malfunction in the immune system, the antibodies detect sperms as harmful invaders. Therefore, they eliminate them causing infertility.

5.     Tumors

Nonmalignant cancers directly affect the male reproductive organs. When hormone-releasing glands that are responsible for reproductions such as the pituitary gland develops a tumor, you’ll experience infertility. A urologist can treat the condition by eliminating tumors through radiation, surgery, and chemotherapy.

6.     Hormone Imbalances

Testicle disorder can cause infertility or affect the production of hormones. Problems in hormonal systems such as the pituitary, hypothalamus, and adrenal glands can result in infertility as well. Also, many men lose their fertility because of low testosterone. Hormonal imbalances may occur due to numerous underlying conditions.

7.     Certain Medications

Many medications and drugs can decrease male fertility and impair sperm production. These medications include:

  • Anabolic steroid
  • Testosterone therapy
  • Cancer medications
  • Arthritis drugs
  • Ulcer drugs

Therefore, it is important to ask about the side effects of the medication from your doctors.

Treatment for Male Infertility

Often, urologists are unable to find the actual problem that causes male infertility. When the doctor diagnoses you for male infertility, they might diagnose your partner as well. The doctor might also suggest treatments for your partner. Also, they will teach the partner how they can help to treat the condition. Here are some treatments often used to treat or cure male infertility:

1.     Surgery

A professional urologist can suggest surgery for a wide range of male infertility causes. For instance, if you develop varicocele, they will repair the vas deferens. The doctor will surgically construct or obstruct the vein enabling the sperms to flow outside the body. Also, when your ejaculation doesn’t contain sperm, the doctor will perform sperm retrieval techniques. In this technique, the doctor directly retrieves sperms for the testicles.

2.     Treating Infections

Like other infectious conditions, antibiotic treatment can treat male infertility due to infection. When you cure with infection, the reproductive tract starts ejaculating sperms. But, this restoration doesn’t work always. Sometimes, the infection causes permanent infertility. In this condition, the doctor retrieves sperms directly from testicles.

Male Infertility Causes & Treatments Urologist

3.     Sexual Intercourse Problems

Counseling or medication often improves male infertility such as premature ejaculation or erectile dysfunction.

4.     Hormone Treatments

A urologist may recommend hormone medications or replacement surgeries to treat infertility. In most cases, hormones are the major cause. Whether the hormone production is higher or lower, you can develop infertility. The doctor recommends medication to balance hormone production.

5.     Assisted Reproductive Technology (ART)

Many patients find ART treatment to generate sperms and cure their infertility. They obtain sperm through surgical extraction or normal ejaculation. After receiving sperms from the male, the doctor inserts them inside the female genital tract. Intracytoplasmic sperm injection or vito fertilization are helpful to treat infertility.

Male Infertility Causes & Treatments: Conclusion

Can you relate to any of these male infertility conditions? If yes, then you should consult with a urologist. Dr. Yaniv Larish is an experienced urologist in New York with a high success rate treating male as well as female infertility.

Visit or call us today at Fifth Avenue Urology to schedule an appointment or consultation.

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

Overactive Bladder Urology

In simple words, OAB, short for “overactive bladder” in urology refers to experiencing the frequent urge to urinate. It can trigger urine loss (involuntary) and cause urinary incontinence in an individual. The condition affects millions of people around the world and in the US as well. However, most experts believe that women are more prone to overactive bladder conditions and health risks compared to men. Overactive bladder conditions aren’t easy to deal with, so doctors suggest being proactive in identifying any symptoms or causes for them.

Top overactive bladder urologist NYC

People with overactive bladder conditions keep going to the restroom over and over again due to frequent urination urges. This causes most affected people to limit their social interactions as it can be difficult to control these urges and simply urinate at a later time. This can affect the quality of life, and some patients have also remained isolated and depressed before finding the right medical solution.

Symptoms

If you don’t have in-depth knowledge of what an overactive bladder condition is, then you can learn about the most common symptoms here. Learning symptoms and causes of OAB will keep you informed and proactive in identifying the health disorder at an early stage leading to better recovery and treatment chances. As per most experts, overactive bladder severity is measured in terms of urination frequency and the intensity of the urge. Here’s a list of common overactive bladder symptoms:

  • Involuntary urine loss frequently
  • Frequent urination urges (some people go over eight times within 24 hours)
  • Uncontrollable urge to urinate
  • Urine loss when laughing too hard
  • Waking up multiple times at night to urinate

The symptoms can vary from patient to patient and worsen quite rapidly if not attended to on time. After early detection of symptoms, you can secure better chances of improving your overactive bladder condition.

Complications

Any type of incontinence, especially an overactive bladder, adversely affects your quality of life. Overactive bladder symptoms are clearly a sign that leaving the condition unchecked can have a negative effect on your lifestyle:

  • Anxiety
  • Depression
  • Sexual issues
  • Emotional distress or depression

Normally, women with incontinence have two different types simultaneously, i.e., stress and mixed incontinence. Stress incontinence refers to physical movement/ activity that results in involuntary urine loss. Such movements could be anything from coughing and sneezing to exercising and laughing. In any case, there’s no guarantee that solving the overactive bladder health condition will be an automatic recovery for stress incontinence conditions. You may have to take advice from a reputable urologist to get the right treatment methods.

Treatment Options

There are multiple treatment strategies comprising a combination of medical solutions to improve overactive bladder symptoms. Let’s take a look at some of the main treatment options that reputable urologists offer patients.

Percutaneous Tibial Nerve Stimulation (PTNS)

PTNS is similar to bio-shock therapy but doesn’t involve any harsh electric shocks that pass through your body. Your expert urologist will use a thin needle to pass through the skin right beside your ankle. The thin needle will be used to deliver electrical stimulation to the tibial nerve and then to the spine. The said electrical stimulation will directly affect the nerves that enable bladder control (as they will be connected to the spine).

Normally, expert urologists suggest going for PTNS treatments once every week for a 12-week period to treat overactive bladder symptoms.

Overactive bladder urology NY

Bladder Injections

This requires the urologist to inject Botox (scientific name: OnabotulinumtoxinA) into the bladder. The protein in the solution relaxes the bladder tissues leading to a reduction in frequent urination urges and even intensity.

It’s helpful with severe urination urge and incontinence. While the treatment is highly effective as per the most reputable urologists, they’re a recurring form of medical solution. You may have to get your bladder injections every 6 months to keep the bladder tissues in a healthy condition.

Medication

Firstly, vaginal estrogen therapy is aimed at strengthening the tissues and muscles inside the urethra. The therapy is most useful for women who have gone past the menopause age threshold and require immediate care for their incontinence issues. Vaginal estrogen comes in different varieties, including a ring, tablet, cream, or suppository. Experts believe that overactive bladder symptoms typically improve after vaginal estrogen therapy.

Most medications are aimed to relax the bladder and pelvic muscles resulting in occasional discomfort relief. Since an overactive bladder can cause involuntary urine loss, the medications ensure control over pelvic muscles to resist the frequent urge to urinate.

Overactive Bladder Urology: Conclusion

Fifth Avenue Urology is the office practice for one of the top urologists in NYC, Yaniv Larish, M.D. As one of the top practitioners in the field of urology in NYC, he offers compassionate urological care for both men and women. He has cared for countless patients and dealt with dozens of urological health conditions and effects.

Dr. Larish specializes in expert treatment of all urological conditions. Call Fifth Avenue Urology today to book an appointment or consultation:

FIFTH AVENUE UROLOGY

Dr. Yaniv Larish
4 East 76th Street
New York, NY 10021

212-675-3186

Kidney Stones & Removal

What are kidney stones and what is the process of removal? Doctors and scientists refer to kidney stones by multiple names. Some of the most commonly used phrases include renal calculi, urolithiasis, and nephrolithiasis. Kidney stones refer to mineral and salt deposits that solidify inside the kidneys and obstruct the urine flow leading to kidney damage. Since proper excretion doesn’t occur, kidneys experience massive damage due to urine pooling inside the canals.

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A range of factors such as obesity, supplements, high-profile medications, and diet deficiencies can cause kidney stones. Once kidney stones form, they can damage nearly any part of your urinary tract. That means your urinary tract extending from the kidneys to the bladder can suffer various issues and problems leading to massive discomfort. Once the minerals start to stick together, they crystallize and solidify to become stones.

It’s not possible to easily pass kidney stones with urine, and holding them inside the kidney canals is quite painful, as most patients claim. Therefore, you must acquire the best treatment methods at the right urological health institute near you to remove kidney stones as quickly as possible.

Kidney Stones: Staghorn Calculus

The term “staghorn kidney stone” and “staghorn calculus or calculi” emerged from the shape that very large kidney stones take when they haven’t been dealt with on time through effective treatments. A staghorn calculus refers to a large kidney stone that takes more than a single branch of the collecting system inside the kidney’s renal pelvis. This also affects the urinary tract on a massive scale since the said tract begins from the kidneys.

Urine forms in the kidneys when the kidneys remove waste matter and excess water from the blood. Once enough urine is collected inside the renal pelvis, it starts to travel through each ureter (a tube) in each kidney towards the bladder. Consequently, the bladder keeps collecting the urine until it’s full, after which the nerves signal the brain, and the urge to urinate is produced.

But, when stones form in the kidneys, urine collection becomes difficult and painful. Note that the urinary system is the same in both men and women, but the urethra is longer in men due to the encirclement of the prostate-staghorn calculus forms in the renal pelvis leading to difficult urine flow towards the bladder.

Percutaneous Nephrolithotomy

It’s a procedure aimed at kidney stone removal from the body. Keep in mind that very small kidney stones can, quite painfully, pass through the body via urine flow. However, some kidney stones are extremely difficult to pass from the body through urine, so surgery becomes essential. If the kidney stones aren’t removed, they can cause a range of kidney issues and problems. For your information, large kidney stones damage the kidney walls canals and may even result in kidney failure.

Also, the percutaneous nephrolithotomy procedure is recommended once the alternative treatment methods fail.

The Procedure

The procedure can take place on both an inpatient and outpatient basis. It’s best to see a professional urologist with surgical skills and years of experience in handling various kidney health issues and diseases. When the kidney stones become so large that they become resistant to other treatment methods, urologists recommend the patient to go under the complicated percutaneous nephrolithotomy procedure.

The procedure can last as long as 3-4 hours. The surgeon begins by giving the preferred type of anesthetic to the patient. Following that, the urologist uses X-ray guidance to insert a fine tube inside the small incision made around the flank area of the patient. Once the tube is entered and it reaches the desired location on the kidney (the one with stones), the surgeon will insert a small telescope through the tube.

Kidney Stone Removal Urologist NYC

The telescope helps in visualizing the internal kidney condition and highlights the kidney stones on video feed through advanced equipment. Using extremely fine surgical tools, your urologist will break down the kidney stones and remove them from the body.

In some cases, surgeons also opt for laser therapy, also known as lithotripter, to help in breaking down kidney stones into smaller pieces for easier removal. Post-procedure pain occurs very rarely, and most surgeons only advise a short-hospital stay so that they can monitor the patients’ immediate recovery.

After-Procedure Results

Once the kidney stone surgery is complete, the doctor will schedule several appointments, which will generally be within 4-6 weeks post-procedure. The doctor will use ultrasound and/or X-rays to monitor kidney health and provide insight on the urine flow that’s taking place after kidney stones’ removal. If any issue is detected, the doctor will recommend further solutions as well.

Kidney Stones & Removal: Conclusion

Are you struggling with kidney stones? Is your lifestyle getting hectic and difficult due to kidney stone-associated complications? At Fifth Avenue Urology, we help solve all health complications related to urological disorders and diseases. Dr. Yaniv Larish MD and Dr. Leonard Glickman MD are the top two choices among the best urologists in NYC. We provide healthcare where both doctors work in harmony to serve  patients with kidney stones and other urological health problems.

Make an appointment today and get specialized consultation from Dr. Larish or Dr. Glickman. Give us a call at 212-675-3186 to learn more about our services and consultation.

Common Female Urological Problems

What are the most common female urological problems? The urinary system consists of the urethra, kidneys, bladders, and ureters. The system stores, produces, and eliminates urine from the body. Kidneys create urine and transfer it to bladders. Ureters are the tubes that carry urine to the bladders from the kidney. When the bladder fills with the liquid waste, the brain receives signals and relaxes bladder muscles, releasing urine through the urethra and out of the body.

Common female urological problems

However, various diseases disrupt the urinary system. Urologists diagnose and treat these urological problems and eliminate infections and blockage. The post contains some common urological problems in women, so you can identify the signs.

Common Female Urological Conditions

A professional urologist has a specialization in areas such as the urinary tract, kidney, and bladders. Furthermore, they can perform minimally invasive surgeries, treat vaginal and pelvic prolapsed and help the patient prevent urological conditions. They treat a wide range of conditions in women’s pelvic region such as:

  • Sexual dysfunction
  • Pelvic organ prolapse
  • Incontinence
  • Pelvic pain
  • Interstitial cystitis
  • Urinary tract infection
  • Sexually transmitted diseases
  • Overactive bladder

Here are some common conditions that a professional urologist treats:

1.     Postpartum Urinary Incontinence

This condition is common in new mothers. They lose control over their bladder and involuntarily leak urine. Especially when they cough, laugh, sneeze, or perform other strenuous activities. If you find it hard to control your urine, you should visit a urologist for diagnosis. Many women feel anxious when they experience this condition. But, incontinence is normal after pregnancy.

But, you should consult with a urologist so they can diagnose for other underlying conditions that might cause involuntary urination. The doctor will suggest less invasive treatments such as behavioral and physical therapies to treat this condition. Surgical options are also available if the problem worsens or persists.

Most common female urological problems

2.     Overactive Bladder (OAB)

Overactive bladder is a combination of symptoms caused by an underlying urinary problem. In this condition, you might have the frequent urge to urinate. Usually, older women suffer from this condition as aging side effects. Also, lifestyle choices such as drinking habits and excessive caffeine intake can lead to an overactive bladder.

A urologist will recommend ways to modify your behavior. Furthermore, they will suggest treatment methods such as medications and physical therapies to treat the condition. Implantable bladder pacemaker and botox injections are some non-invasive options.

3.     Urinary Tract Infection (UTI)

UTI infects a complete urinary system, but the urethra, the bladder, and other lower urinary tract are common targets. This infection is common in women, but men can also develop this condition. If you experience pain while urinating, bloody urine, or pressure in the lower abdomen, you should immediately consult a urologist. If you delay, the complications can be worse, especially when the infection reaches the kidneys.

The common contributing factor to UTI is lifestyle choices. That’s why the doctor will ask you various questions related to your lifestyle. They will ask you to increase your water consumption. If you develop the infection because of anatomic problems, the doctor will recommend vaginal estrogen creams. The cream will balance the pH level of the body. With the change in pH levels, the bacteria won’t survive.

4.     Pelvic Organ Prolapse

Pelvic organ prolapse occurs when the pelvic organ such as the bladder moves or drops from its actual place. You might experience organ prolapse in the pelvic region because of weak muscles. These muscles hold the organ, but after the surgery or childbirth, they become weak.

When the body organ prolapsed it moves near the vaginal wall. This results in discomfort in the vagina. Furthermore, you might also notice a bulge in the vagina due to pelvic organ prolapse. The pressure increases when you cough or stand.

If you experience pain and sensation in the vagina, you should consult a urologist. They will diagnose your condition and recommend a surgical procedure. However, the surgery doesn’t need to bring back the organ to the right location. But, instead, it supports muscles and reduces symptoms until the organ naturally returns to its position.

5.     Pelvic Floor Dysfunction

The pelvic floor is a layer of muscles that support the vagina, bladder, and rectum. Particularly after childbirth, it moves from the actual position and causes inflammation and irritation. If you develop this condition, you might find discomfort to pass a bowel movement and urinate. The condition can lead to frequent urination, pain during intercourse, and lower back pain. Muscle injections and vaginal medications may help to relax pelvic floor muscles.

Common Female Urological Problems: Conclusion

Are you in need of an experienced urologist in New York for the treatment of the above-mentioned urological conditions? If yes, then you should visit Fifth Avenue Urology. At Fifth Avenue Urology, we have experienced and specialized urologists with many years of experience treating common female urological problems.

Call us today for a free consultation and to schedule an appointment.

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

How Does the Vasectomy Procedure Work?

A doctor may recommend the vasectomy procedure when you decide that you’re not looking to have children anymore. In this procedure, the urologist will block sperm cells from mixing with semen. Consequently, a vasectomy results in an ejaculation that is free of sperms to avoid pregnancy. You may also undergo treatment for various health diseases, such as scrotal skin infection, swelling in the penis, testicles, or sperm duct. A common misconception is that once you get a vasectomy, you can’t have orgasms, but this is not true. This procedure does not affect your ability to ejaculate and have sex either.

vasectomy procedure nyc
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A vasectomy is a routine procedure for a professional doctor. It will only take about 30 minutes to complete the procedure. The doctor will perform the surgery in their office and you can go home once you are done. You can also refer to this treatment as male sterilization, getting snipped, or the snip. You can consult with Dr. Yaniv Larish, a renowned urologist in NYC, by contacting Fifth Avenue Urology.

Effectiveness of Vasectomies

Vasectomy is almost 100% effective but, only in rare conditions, the vas deferens tubes can rejoin, which reinstates your ability to cause a pregnancy. After the reattachment of the tube, you will ejaculate the sperm along with semen.

Once you undergo treatment, you have to visit the doctor for follow-up tests. The urologist will analyze your semen to check if you are still ejaculating sperms or not. It is okay to ejaculate sperm soon after the treatment, but if it persists, you have to go through the procedure again.

How Does the Vasectomy Procedure Works?

Men ejaculate millions of sperm in each ejaculation. These sperms fuse with the egg cell, causing pregnancy. Testicles produce these sperm cells and mix with the semen through vas deferens. Vas deferens are a pair of tubes stretching from testicles to the penis.

Semen without sperms cannot cause pregnancy. Therefore, urologists cut the vas deferens tube, so the sperm does not mix with the semen and leave the body. After vasectomy, the sperms stay in the testicles. It may take up to three months for your body to completely prevent ejaculating the sperms. Nevertheless, the production and ejaculation would be the same. The only difference is that it won’t include any sperm. You won’t feel any difference between ejaculating and having an orgasm after the procedure.

Before the Procedure

When you visit the doctor for the first time, they will perform a physical examination and review your medical history. If you take any medication that might disrupt the procedure, they will ask you to avoid taking it for a while. You need to be honest with your doctor while talking about the medication you take as this may affect the results of your treatment. The urologist will ask you to avoid some medication one week before the vasectomy. Here are some medications you should avoid before the procedure:

  • Warfarin, clopidogrel, or other blood thinners
  • Anti-inflammatory drugs including aspirin

Follow these tips for the day of the vasectomy:

  • Wear comfortable clothes
  • Arrange your ride for reaching home after the surgery.
  • Shower before you leave the home for vasectomy
  • Follow medications as recommended by the doctor. You may also need mild sedatives before the process.

Urologist for vasectomy procedure
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You may only require local anesthesia for the procedure because the treatment is less invasive and only requires a tiny incision. The urologist will numb only the area. Also, they might give you medication for relaxation.

Three Different Vasectomy Methods

The urologist will use one of these three procedures for the treatment:

1.     Conventional Approach

The conventional method of vasectomy includes a tiny incision on each scrotum. This will disclose the vas deferens from the opening. The urologist will then cut the tube and stitch the ends of the tube. They might also cut a tiny piece of the tube. Then, your doctor will place the vas deferens back in the scrotum and close the incision with stitches.

2.     No-scalpel Vasectomy

The doctor will locate and clamp the vas deferens on the scrotal skin. They will punch a hole in the skin using a special device. Then, they will pull out the tube from the hole. That way, they can easily cut and seal the vas deferens from both ends. After this, the doctor will place back the tube. In this method, the holes on the scrotum will heal naturally. The urologist will not stitch the holes themselves.

3.     Vas Clip Vasectomy

In this procedure, the urologists can use any of the above methods to expose the vas deferens. However, they will use special clips on the tube, blocking the sperm flow.

Vasectomy Procedure: Conclusion

Contact Fifth Avenue Urology and make an appointment with Dr. Yaniv Larish. Schedule a convenient and confidential consultation and to learn about the vasectomy procedure.

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

Causes and Treatment of Urinary Tract Infection

A urinary tract infection is an infection of the bladder, kidney, and urethra. You may develop this condition because of the bacteria in your urine. Usually, urine does not contain germs and bacteria, but they can enter the body from an external source. Your urinary system filters the waste products and excessive water from the blood and stores by-products in the bladder. During this filtration process, your body does not include any contamination in the urine. However, bacteria can enter the body through the urethra during sexual intercourse. When the bacteria reach your urinary system, it causes inflammation and infection. You can refer to this condition as a urinary tract infection.

Are you suffering from urinary tract infection? Give us a call or visit the expert urologists at Fifth Avenue Urology.

What is the Urinary Tract?

Your urinary tract is responsible to produce and store urine. The urinary system consists of these four major parts:

·       Kidneys

Your body contains two kidneys on each side above your hips. These are the small organs responsible to filter the blood. After the filtration it removes the excessive water and waste from the body through ureters.

Urinary Tract Infection & Treatment
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·       Ureters

The ureters carry urine, which contains waste, from the kidneys to your bladder.

·       Bladder

The bladder works as urine storage and it is a sac-like organ. Your body stores urine in this organ before extracting it from the body.

·       Urethra

This is a tube that carries urine out of the body.

Causes of Urinary Tract Infections

You will develop a urinary tract infection because of bacteria. The bacteria enter your body through the urethra and increase in number once they enter the bladder. The urinary system prevents bacteria from entering the body but when its defense system fails, bacteria infect your urinary tract. Urinary tract infection is more common in women than in men.

1.     Cystitis or Infection of the Bladder

You will develop this condition when bacteria cause infection in the gastrointestinal tract. Different type of bacteria can cause this disorder. However, Escherichia coli are common bacteria for cystitis development. The bacteria enter the body during sexual intercourse. You may also develop this infection after sexual intercourse. Due to the anatomy of the female reproductive system, women are at a risk of developing this condition. The chances for the development of the infection are higher when you have shorter space between the anus and the urethra.

2.     Urethritis or Infection of the Urethra

You will develop this condition when GI bacteria enter the urethra. As females have less distance in between the vagina and the urethra, they have higher risk of developing this infection. Sexually transmitted diseases, including chlamydia, gonorrhea, herpes, and mycoplasma, may result in urethritis.

Symptoms of Urinary Tract Infections

Urinary tract infection infects the lining of the urinary tract. It causes irritation and inflammation. Here are some symptoms of this condition:

  • Lower pelvis pressure
  • Blood in the urine and painful urination
  • Pain in the pelvic area or abdomen
  • The need to urinate at night
  • Smell and abnormal urine color
  • Increased frequency to urinate
  • Painful urination

Here are some other but rare symptoms of urinary tract infection:

  • Lower back pain or flank pain
  • Penis pain
  • Pain while having sex
  • Vomiting
  • Mental confusion or changes
  • Fever
  • Fatigue

Treatment for Urinary Tract Infections

Your urologist will recommend treatment options based on the type of urinary tract infection. There are two types of infections. You may develop simple UTIs even you are healthy and have a normal urinary tract. On the other hand, complicated UTIs occur when you have an abnormal urinary tract. Simple UTIs are common in women, whereas, children and men develop complicated UTIs.

1.     Simple UTI

You can treat simple UTI by taking antibiotic meds. Sometimes, a doctor will only prescribe a three days course for the treatment. The dosage also depends on the infection type. You will notice the difference after a few doses of the medication. However, you need to complete the round of medication. Keep in mind that UTIs may return if you did not completely treat the condition. During the infection, you need to consume plenty of water as this will eliminate the infection through urinary system.

Causes of Urinary Tract Infection
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If you develop UTIs during postmenopausal the doctor will likely replace topical hormone with estrogen. Taking estrogen has side effects if you are also suffering from other medical issues. Therefore, you need to share medical problems with your urologist before treatment. They will decide the better treatment for your condition.

2.     Complicated UTI

The doctor will prescribe a longer course of antibiotics for complicated UTIs. Sometimes, you need to stay in the hospital for complete therapy. The doctor may keep you on IV antibiotics for short time. After that, you need to consume antibiotics from the mouth for up to two weeks. You need to undergo the same treatment method for kidney infections.

Urinary Tract Infection: Conclusion

Do you live in NYC? Then you should contact Fifth Avenue Urology and make an appointment with our doctors. We have highly qualified urologists to diagnose and treat urinary tract infections. They will carefully examine your condition and suggest the best treatment plan. Other than UTIs, our Urologists can also treat other urinary disorders.

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

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