Patient’s Guide to a Robotic-Assisted Laparoscopic Prostatectomy (RALP) for Prostate Cancer

Robotic-assisted laparoscopic prostatectomy (RALP) is used to treat prostate cancer. It is minimally invasive and involves the removal of a man’s prostate gland. Additionally, a surgeon uses a robot to control instruments during a RALP procedure.

Comprehensive Urology offers RALP and other prostate cancer treatments. Our team of expert urologists meets with prostate cancer patients, learns about their symptoms, and helps patients determine whether RALP is a viable treatment option.

In this guide, we’ll take a closer look at RALP, how it works, and its benefits. We’ll also provide an FAQ to teach patients about RALP and help them weigh the pros and cons of robotic-assisted prostate surgery.

What Is RALP?

RALP involves the use of the da Vinci Surgical System, a sophisticated robotic platform. The da Vinci System includes an ergonomic surgeon’s console, patient side cart with four interactive robotic arms, 3D high-definition vision system, and proprietary EndoWrist instruments. It scales, filters, and translates all of a surgeon’s hand movements via EndoWrist instruments. As a result, the da Vinci System enables a surgeon to perform advanced prostate cancer surgery faster and more efficiently than ever before.

In some instances, a RALP procedure feels like an “open” surgery similar to a traditional prostate cancer removal. Yet RALP surgeries are more advanced that most traditional prostate cancer procedures.

The da Vinci System allows a surgeon to magnify a patient’s anatomy like never before. A surgeon can use the da Vinci System to review a patient’s anatomy at a high magnification, in brilliant color, and with natural depth of field. That way, a surgeon can quickly identify and treat prostate cancer tissue.

During a RALP procedure, a surgeon uses the da Vinci System’s master controls to maneuver the four robotic arms on the patient s/yjAGc5lExgside cart; these arms hold EndoWrist instruments and a high-resolution endoscopic camera in place. The EndoWrist instruments feature a distinct jointed-wrist design that surpasses the natural range of motion of the human hand. Therefore, a surgeon can refine the instruments’ movements for unparalleled control and stability.

Furthermore, the da Vinci System boasts a fail-safe design. It includes many safety features to reduce the risk of human error in comparison to other prostate cancer surgery treatments.

Benefits of Robotic Prostate Surgery over Traditional Open Prostate Surgery

Robotic prostate surgery is an FDA-approved and minimally invasive surgery, and it requires only small incisions to treat prostate cancer. Also, the surgery involves the use of a 3D endoscope and high-intensity illuminators that provide a surgeon with high-definition images of a patient’s anatomy; this ensures a surgeon can identify malignant tissue and leave surrounding muscle, tissue, and organs intact.

Other benefits of robotic prostate surgery include:

• Exceptional Accuracy: The da Vinci System has flexible wrists to help a surgeon make slight, careful movements for improved accuracy during prostate cancer surgery.
• Fast Recovery Time: Because robotic prostate surgery requires small incisions, the healing time tends to be quicker in contrast to traditional open prostate surgery.
• Short Hospital Stay: Most robotic prostate surgery patients can leave the hospital and return to their everyday activities more quickly than those who undergo traditional open prostate cancer procedures.
• Reduced Risk of Infection: Robotic prostate surgery often results in less pain and bleeding for patients, as well as reduces a patient’s risk of infection.
• Improved Urine Control and Sexual Function: Studies show prostate cancer patients who undergo a RALP procedure recover from urinary continence and erections at superior rates relative to patients who receive traditional laparoscopic or open surgeries.

There is no guarantee that a prostate cancer patient is eligible to receive robotic prostate cancer surgery. And in some instances, traditional open prostate surgery may prove to be ideal.

To determine whether a patient should undergo robotic prostate cancer surgery or a traditional open retropubic radical prostatectomy treatment, it is important to consult with an expert urologist. During a urological consultation, a patient will receive a full medical assessment, and a urologist will learn about this individual’s prostate cancer symptoms. Then, a urologist can offer a proper diagnosis and determine whether a patient is a viable candidate for robotic prostate surgery.

Robotic Assisted Laparoscopic Prostatectomy vs Conventional Laparoscopic Prostatectomy

The da Vinci System generally proves to be a top alternative to conventional laparoscopy too. A conventional laparoscopy requires a surgeon to stand while operating and use handheld, long-shafted instruments on his or her own. Meanwhile, a conventional laparoscopy involves the use of a 2D monitor to view a patient’s anatomy; this monitor is typically placed a few feet away from a surgeon, and he or she must look up and away from instruments to view it. A conventional laparoscopy usually requires a surgeon and a patient-side assistant to work closely to position the camera correctly as well. Because if the camera is out of position, the surgery may fail to provide a patient with his or her desired results.

RALP Surgery Process

RALP surgery involves the following steps:
Step 1: Robotic Port and Instrument Setup
The da Vinci System is docked, and the robotic instrument ports and camera port are attached to the system’s arms. This step requires about 10 to 15 minutes to complete.

Step 2: Bladder Release
The surgeon controls the da Vinci System instruments and uses robotic “scissors” in one hand and a grasper in the other to cauterize tissues and cut them with the scissors. He or she slowly “mobilizes” the bladder and separates it from the abdominal wall. This allows the surgeon to visualize and reach the prostate gland.

Step 3: Prostate Dissection
The surgeon carefully frees the prostate gland from tissues, and he or she uses a medical “stapler” device to divide and seal prostate gland tissues and blood vessels.

Step 4: Separation of Prostate and Bladder
The surgeon cuts and cauterizes the prostate away from the bladder until he or she reaches the urethra, which is separated to free the prostate from the bladder.

Step 5: Separation of Prostate from Remainder of Urethra
The surgeon releases the prostate from the remainder of the urethra, and the urethra will later be reattached to the bladder. It is critical for the surgeon to preserve the urethra tissue to ensure a complete “repair” when he or she sews the urethra back to the bladder.

Step 6: “Bagging” of Prostate
The surgeon places the prostate gland in a specimen bag that is inserted through a da Vinci System assistant port. The bag is deployed, and once the prostate is inside the bag, this bag can be closed by pulling its strings. The bag stays inside the abdomen until the surgery is complete and the da Vinci System is moved away from the patient.

Step 7: Attachment of Cut-End of Urethra to Bladder
The surgeon uses sutures to perform anastomosis, an attachment process that involves sewing the bladder neck and suturing it to the urethra in one spot. The surgeon ensures tissues are connected correctly to minimize the risk of urine leakage and scar tissue.

Following RALP, a surgeon will insert a special catheter that will remain in place for about a week. A patient should also expect surgical sutures to dissolve on their own shortly after treatment.

Am I a Good Candidate for Robotic Prostate Surgery?

Each prostate cancer patient is different, and even though robotic prostate surgery is the right choice for some patients, it may not be the best treatment option for others.

A urologist evaluates potential RALP surgery candidates based on a variety of criteria, including:

• Patient’s age and life expectancy
• Patient’s size
• Physical condition
• Surgical history
• Weight

A urologist always allocates time and resources to teach each patient about RALP surgery and determine whether an individual can reap the benefits of this procedure. If the risks associated with a RALP procedure outweigh its benefits, a urologist will recommend alternative prostate cancer treatment options.

What Types of Robotic-Assisted Prostate Surgery Options Are Available?

The da Vinci System is used to perform two prostate cancer procedures:

1. Robotic-Assisted Laparoscopic Radical Prostatectomy

Robotic-assisted laparoscopic radical prostatectomy requires only five stitches, and each stitch is no larger than 1.5 cm in size. It allows a surgeon to dissect and remove the prostate and sew the bladder to the urethra – all without requiring the surgeon to place his or her hands inside of a patient’s body. Depending on a patient’s condition, robotic-assisted laparoscopic radical prostatectomy may be used to remove a patient’s lymph nodes as well.

2. Robotic-Assisted Surgery for Benign Prostatic Hypertrophy (BPH)

BPH refers to an enlarged prostate. When the prostate grows, it begins to squeeze down on the urethra, and the bladder wall becomes thicker. This causes the bladder to weaken and lose the ability to empty completely.

Robotic-assisted surgery has been shown to help prostate cancer patients address BPH. A surgeon uses the procedure to remove portions of an enlarged prostate via the da Vinci System. First, a surgeon determines incision placement based on the size of the prostate and evaluates a patient’s symptoms and overall health. He or she next uses the da Vinci System to make precise incisions to remove enlarged portions of the prostate and sew the prostate gland back together. Best of all, surgeons often use the da Vinci System to ensure the urethra is untouched throughout the procedure.

A urologist is happy to teach patients about both types of robotic-assisted prostate surgeries. He or she will explain how each surgery is performed, along with what patients should do to prepare for surgery and what patients should expect during each treatment recovery period.

How Should Patients Prepare for RALP Surgery?

Sometimes, patients will need to stop taking daily medications prior to surgery, but patients can resume taking these medications immediately after surgery. A urologist will let a patient know whether it is safe to continue with daily medications leading up to surgery, and patients should always disclose all medications to a urologist prior to treatment.

A urologist performs a preoperative bowel preparation on a patient prior to RALP surgery. This includes both antibiotic and mechanical bowel cleansing and reduces the potential for infection.

On the day of surgery, a preoperative enema is administered to a patient. This individual also receives sequential compression stockings, and a large-bore intravenous line is inserted that provides preoperative antibiotics.

What Should Patients Expect During Recovery from Robotic-Assisted Prostatectomy?

Recovery from robotic-assisted prostate surgery is short in comparison to conventional prostate cancer treatments. Robotic-assisted prostate surgery patients often spend one to two days in the hospital before they return home after surgery; comparatively, a traditional prostate cancer surgery patient may require a week or more in the hospital following treatment.

After robotic-assisted prostate surgery, a patient should expect some pain and swelling. These symptoms generally disappear on their own. The symptoms can also be managed with rest, or a patient may be prescribed pain medication.

Once a robotic-assisted prostate surgery patient can retain liquids and obtains acceptable laboratory tests, this individual will receive authorization to return home from the hospital. Patients are discharged with a special catheter that is held in place by a balloon inside the bladder. The catheter provides continuous drainage of the bladder into a small external collection bag, and this bag will need to be emptied periodically. A patient should not remove the catheter bag; instead, a patient requires an outpatient visit approximately five to seven days after surgery to ensure proper removal by a urologist. If a catheter comes out before a follow-up appointment, a patient should contact a urologist immediately.

Physical Activity After RALP
Patients should avoid vigorous activity like golfing, running, or exercising for at least one week after RALP surgery, and they should refrain from driving and sitting in one position for too long (45 minutes or longer). Patients should also avoid bathtubs, swimming pools, and hot tubs for as long as the catheter is in place; conversely, patients can shower as soon as they return home.

Returning to Work Post-RALP
Most patients can return to work within a few days of surgery. If a patient’s day-to-day job requires strenuous activity, this individual may need additional time to recover before returning to work.

Medication After RALP
Ibuprofen or acetaminophen initially may be used to help a patient address pain following surgery. If pain persists, stronger pain medication may be prescribed. Patients are prescribed an oral antibiotic after a catheter is removed, and a urologist will provide instructions about how often to take this antibiotic. A stool softener may be used to help a patient limit constipation as well.

Diet After RALP
A bland diet often is recommended after surgery. Patients should avoid carbonated beverages, and in some instances, may prefer a temporary liquid diet. After a patient experiences a bowel movement, this individual can start consuming soft foods like oatmeal and soup. Patients should spread out eating throughout the day with small meals and snacks and avoid large meals for the initial days following treatment.

The recovery process following robotic-assisted prostate surgery usually lasts about two to three weeks, depending on a patient’s age and overall health. A urologist is available to provide support throughout the recovery period to ensure a patient can achieve the optimal treatment results.

FAQ

How long does a RALP procedure take to complete?
On average, a RALP surgery requires two to three hours to perform. Also, the procedure is often completed under general anesthesia.

Does the da Vinci System perform the actual RALP procedure?
The da Vinci System is always controlled by a surgeon – without exception. A surgeon uses the da Vinci System’s robotic arms to operate within small spaces in the abdomen.

Does blood loss occur during RALP surgery?
The da Vinci System helps a patient minimize the risk of bleeding, but it does not stop blood loss altogether. A surgeon uses the da Vinci System for precise and minimally invasive dissection to control possible sources of bleeding. Moreover, pressure generated by the gas used to inflate the abdomen during surgery simultaneously provides a surgeon with an expansive view around the prostate and reduces a patient’s risk of blood loss.

Are there risks associated with RALP surgery?

Like any surgery, there are risks associated with a RALP procedure. Common RALP surgery risks include heart attack, stroke, and death. Prior to performing a RALP surgery, a urologist conducts a comprehensive patient evaluation to identify any potential risks. If there is any chance of health complications, a urologist will forego a RALP surgery recommendation and offer alternative prostate cancer treatment options.

Should I undergo RALP surgery?

There is no right or wrong answer to this question, and the answer depends on the patient. Before a patient decides to undergo RALP surgery, it is essential to meet with a urologist. An initial consultation is the first step of the RALP surgery process. It enables prostate cancer patients to obtain RALP treatment insights and determine whether the procedure is the right choice based on their personal needs.

Conclusion

RALP is an advanced surgical procedure that has been shown to help patients address prostate cancer symptoms. It is not right for everyone, however, and it is important for a prostate cancer patient to understand the pros and cons of the surgery.

Comprehensive Urology teaches patients everything they need to know about RALP and other prostate cancer treatments. To find out more about our prostate cancer treatment options, please contact us today at (310) 499-2756 to schedule a consultation with one of our friendly, knowledgeable prostate cancer experts.

The post Patient’s Guide to a Robotic-Assisted Laparoscopic Prostatectomy (RALP) for Prostate Cancer appeared first on Comprehensive Urology.

What Are the Best Prostate Cancer Treatments?

 

The best prostate cancer treatment varies depending on a patient’s age, their overall health status, the cancer’s grade and stage, and other factors. Both surgical and non-surgical treatments are available to address prostate cancer, and a urologist provides each patient with a personalized prostate cancer treatment plan.

There are several common prostate cancer treatments used to address stage 1 prostate cancer (i.e. disease still confined to the gland). These include:

• Active Surveillance: Involves regular monitoring of a patient’s prostate cancer measures including PSA over a set amount of time. Active surveillance usually requires a patient to receive rectal examinations and blood tests every six months, as well as an annual prostate biopsy to closely monitor for cancer progression.
• Radiation Therapy: Uses high-energy rays or particles to kill prostate cancer cells. Radiation therapy is commonly used to treat cancer that is still in the prostate gland and is low grade. Or, it may be used as part of an initial treatment for cancer that has spread beyond the prostate gland.
• Radical Prostatectomy: Involves the removal of the entire prostate gland and sometimes surrounding tissues.

The aforementioned treatments may be used to address stage 2 prostate cancer too. Other stage 2 prostate cancer treatments include external beam radiation therapy and brachytherapy. External beam radiation therapy involves the use of X-rays, protons, or other high-energy beams to destroy cancer cells. Meanwhile, brachytherapy involves the placement of radioactive seed implants into the prostate gland. Brachytherapy localizes radiation treatment to the prostate and limits its effects on the bladder, rectum, and surrounding organs. Additionally, in some instances, external beam radiation therapy and brachytherapy may be used together to treat stage 2 prostate cancer.

External beam radiation therapy, radical prostatectomy, and brachytherapy are among the treatments used to treat stage 3 prostate cancer. Hormone therapy may be used in combination with external beam radiation treatments as well.

Hormone therapy reduces a man’s level of testosterone, a hormone that accelerates the growth of prostate cancer cells. It is generally used to target prostate cancer that spreads beyond the prostate gland.

For older men or men who are dealing with severe medical problems, hormone therapy or active surveillance may be used to treat stage 3 prostate cancer. Hormone therapy and active surveillance are less aggressive than other prostate cancer treatments, and as such, may prove to be viable treatment options for these individuals.

With stage 4 prostate cancer, men may require one or more treatments. Common stage 4 prostate cancer treatments include hormone therapy, external beam radiation therapy, brachytherapy, and radical prostatectomy.

Sometimes, hormone therapy is used in conjunction with chemotherapy to treat stage 4 prostate cancer. Chemotherapy involves the use of anti-cancer drugs that are injected into a vein or give to a patient to take orally. Next, chemotherapy drugs enter the bloodstream and travel throughout the body.

Stage 4 prostate cancer treatment may also include options designed to alleviate pain and other symptoms such as urinary obstruction. For example, transurethral resection of the prostate (TURP) helps men address benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate. TURP involves the “shaving” and removal of the inner part of the prostate gland that surrounds the urethra, and it enables men to alleviate bleeding, urinary obstruction, and other prostate cancer symptoms.

There is no guarantee that the initial treatment a man uses to address prostate cancer will work. However, a revolutionary prostate cancer treatment is now available that has been shown to help patients address newly diagnosed prostate cancer or cancer that has returned to the prostate – high intensity focused ultrasound (HIFU).

HIFU: Here’s What You Need to Know

HIFU involves the use of high-frequency ultrasound waves that are used to heat and destroy cancer cells in the prostate. With HIFU, a surgeon targets cancerous tissues in the prostate and ensures nearby tissues remain intact.

During a HIFU procedure, a surgeon inserts a small probe into the rectum that provides easy access to the prostate gland. Then, the surgeon uses computer imaging to place the probe near the prostate gland. The HIFU probe delivers ultrasound waves to an area that is no bigger than a grain of rice, and the probe heats up to almost 100°C (212°F) in about 3 seconds.

HIFU enables a surgeon to adjust the number of ultrasound waves and their intensity and carefully select the areas that the energy will be applied to (i.e cancer regions). This ensures a surgeon can heat prostate cancer cells until they can no longer survive. It also guarantees ultrasound waves have no effect on tissues outside the treatment zone.

What Types of HIFU Are Available?

Not all HIFU procedures are identical, and a HIFU treatment can be used to target the whole prostate or certain areas of the prostate. There are four common HIFU treatment options:

• Whole Prostate Gland HIFU Therapy: Involves treatment of the entire prostate gland. Whole prostate gland HIFU therapy is performed as an outpatient procedure and takes about 3 hours to complete.
• Partial Prostate Gland HIFU Focal Therapy: Combines HIFU with magnetic resonance imaging (MRI) perfusion of the prostate. Partial prostate gland HIFU focal therapy enables patients to address localized cancer that is less than half the volume of the prostate.
• Post Radiation HIFU: Involves treatment of prostate cancer that recurs. Post radiation HIFU has been shown to help patients who have struggled to effectively treat prostate cancer with radiation therapy.
• Post Cryotherapy HIFU: Involves treatment of prostate cancer after cryotherapy, which is used to freeze the prostate with liquid nitrogen. Post cryotherapy HIFU is a minimally invasive outpatient procedure that has fewer side effects than those associated with prostate cancer surgeries.

Prior to undergoing HIFU prostate cancer treatment, a patient receives a prostate-specific antigen (PSA) blood test, digital rectal examination (DRE), and other tests. Proper prostate cancer screening enables a urologist to provide an accurate patient diagnosis and determine if a patient is eligible for HIFU.

Benefits of HIFU Prostate Cancer Treatment

HIFU is FDA approved, and to date, many men have reaped the benefits of this state-of-the-art prostate cancer treatment. Some of the benefits of using HIFU to treat prostate cancer include:

• Minimally Invasive: HIFU is a targeted ultrasound treatment that does not require a patient to undergo prostate cancer surgery.
• No Hospital Stay Required: HIFU is an outpatient procedure, and patients usually can go home immediately following treatment.
• Fast Procedure: A typical HIFU treatment requires between 1 and 4 hours to complete.
• Quick Recovery: Most patients can return to their normal activities just a few days after a HIFU procedure.
• Limited Side Effects: There is no blood loss due to HIFU, and patients who receive HIFU procedures face reduced risk of erectile, sexual, and urinary side effects in comparison to other prostate cancer treatments.

HIFU is an advanced prostate cancer treatment, and a patient should meet with a urologist prior to a HIFU procedure. During a urological consultation, a prostate cancer patient can learn about the different types of HIFU, the benefits of HIFU procedures, and much more. As a result, a urological consultation enables a prostate cancer patient to learn about all aspects of HIFU and make an informed treatment decision.

Schedule a Prostate Cancer Screening at Comprehensive Urology Today

Comprehensive Urology Medical Group in Los Angeles employs a team of friendly, highly trained urologists, and we are happy to teach prostate cancer patients about HIFU and other treatment options. Our team responds to patients’ prostate cancer concerns and questions and helps them determine the best course of action to address prostate cancer symptoms. This way, we enable patients to address prostate cancer for years to come. To find out more about our prostate cancer treatment options, please contact us today or call us at (310) 499-2756 to schedule a consultation with one of our urologists.

 

The post What Are the Best Prostate Cancer Treatments? appeared first on Comprehensive Urology.

Why Your Mommy Makeover Should Include a ThermiVa Treatment

What is a mommy makeover, and why is it becoming a must-have treatment for women following pregnancy? A mommy makeover generally involves one or more procedures designed to address a woman’s post-pregnancy body concerns. Some of the most common mommy makeover procedures include:

• Tummy Tuck: Improves stomach firmness and eliminates loose skin in and around the stomach.
• Breast Enhancement: Addresses sagging breasts or loss of breast volume.
• Fat Removal with Liposuction: Involves the removal of fat from the body via a cannula (thin, hollow tube that is inserted underneath the skin).
• Skin Tightening Treatments: Involves the use of different skin tightening techniques to produce collagen (protein that improves skin strength and elasticity) and boost collagen production.
• Cellulite Treatments: Enable women to eliminate dimpled skin on the buttocks, thighs, belly, and hips.
• Stretch Mark Removal: Involves the use of a tummy tuck or laser skin treatments to remove stretch marks on the stomach, breasts, thighs, hips, and buttocks.

 As women consider the aforementioned mommy makeover treatments, they may want to look at ThermiVa too. ThermiVa is a female rejuvenation procedure unlike any other, and it may help a woman achieve her desired mommy makeover results faster than ever before.

What Is ThermiVa?

ThermiVa is a non-invasive, non-hormonal vaginal rejuvenation treatment that helps women address excess stretching of the vaginal muscles that often occurs after vaginal birth or due to aging. Unlike a traditional female rejuvenation surgery, ThermiVa does not require a woman to go under the knife. Instead, a ThermiVa procedure involves the use of controlled radiofrequency (RF) energy to gently heat vaginal tissue and improve its tightness.

A typical ThermiVa procedure requires only 15 to 30 minutes to complete. During a ThermiVa procedure, a thin, slightly curved hand piece is used on both internal and external vaginal tissue. The hand piece is only about 0.5″ wide and designed with comfort in mind. It also features an active tip, a small metal square on the bottom of an electrode. This active tip gently heats the vaginal tissue via emission of RF energy. Furthermore, the active tip ensures heat is administered at a patient’s comfort level.

No anesthesia is required during a ThermiVa treatment, and the procedure causes little to no downtime or discomfort. In fact, following a ThermiVa procedure, a patient can exercise, engage in sexual activity, and perform regular tasks the same day.

Studies have shown ThermiVa delivers proven results in several areas, such as:

• Vaginal Tightness: ThermiVa improves tightness at the vaginal opening and the full course of the vagina.
• Stress Incontinence: In some instances, ThermiVa is used in combination with pelvic floor exercises to help women avoid bladder surgeries and reduce urinary leakage.
• Sexual Dysfunction: ThermiVa treatments help improve nerve sensitivity and pelvic floor muscular contractions, and as such, may enable women to achieve orgasms faster.
• Labial Cosmetic Appearance: ThermiVa tightens the labial tissues and reduces sagging, and the procedure helps women wear bikinis and other tight-fitting clothing comfortably.
• Vaginal Dryness: A ThermiVa procedure helps improve moisture both inside and outside the vagina and softens and thickens the vulva-vaginal skin, resulting in less pain and increased satisfaction during sex.
• Pelvic Prolapse: ThermiVa improves vulva-vaginal tightness, and some research indicates it can help reduce pelvic prolapse by as much as one grade.

In the past, women often required surgery to improve vaginal tightness, correct pelvic prolapse, or treat other vaginal issues. ThermiVa now provides an unprecedented female rejuvenation surgery alternative because it helps women address multiple vaginal problems at the same time. As a result, ThermiVa is becoming exceedingly popular for women who are considering mommy makeovers, and this trend may continue in the years to come.

 Benefits of ThermiVa for Mommy Makeovers

There are many reasons why women should consider a ThermiVa rejuvenation procedure as part of a mommy makeover. These reasons include:

• Fast, Effective Vaginal Rejuvenation: ThermiVa can be administered six weeks after a woman gives birth and between pregnancies.
• Long-Lasting Results: A ThermiVa procedure’s results will last up to two years.
• Pain-Free: The specially designed ThermiVa hand piece ensures each procedure is pain-free.
• Streamlined Treatment: ThermiVa enables both the vagina and labia to be treated in a single session; conversely, other vaginal rejuvenation procedures allow a patient to treat only one body part at a time.
• Minimal Maintenance: Many ThermiVa patients require a follow-up maintenance treatment only once a year.

When it comes to ThermiVa for a mommy makeover, it is important to learn about all aspects of the procedure. For those who work with an expert urologist, they can receive in-depth ThermiVa insights and determine whether a ThermiVa procedure can deliver the optimal vaginal rejuvenation results.

Consult with the Best Mommy Makeover Surgeon Before a ThermiVa Treatment

Although many women qualify for ThermiVa, the treatment is not right for every mommy makeover. Fortunately, a urologist is happy to teach a patient about ThermiVa, address a patient’s concerns and questions, and ensure this individual can make an informed treatment decision.

A urologist performs an extensive patient evaluation before administering a ThermiVa treatment. This evaluation enables a urologist to learn about a patient’s medical history and perform assorted tests as needed.

After a patient assessment, a urologist will offer his or her vaginal rejuvenation treatment recommendation. A urologist usually recommends ThermiVa if a patient is dealing with one or more of the following issues:

• Vaginal dryness
• Pain during sex
• Lack of sensation or friction during sex
• Vaginal flatulence

If a urologist determines a patient is a viable candidate for ThermiVa, he or she will explain how a ThermiVa procedure works. It is important to note, however, that ThermiVa is not intended for patients who are currently pregnant or have an infection around the area of application. If a patient does not qualify for ThermiVa, a urologist is ready to offer alternative treatment options.

ThermiVa is performed as an outpatient procedure. For those who want to achieve the best-possible ThermiVa procedure results, a urologist may recommend three sessions over a period of three months.

In most cases, patients see noticeable vaginal tissue improvements within about two weeks of a ThermiVa procedure. The vaginal tissue often begins to tighten immediately following a ThermiVa treatment, with more significant results occurring over the next three to four months. As the body starts to produce more collagen, the results of a ThermiVa treatment will become more transparent over time.

Schedule a ThermiVa Consultation with Comprehensive Urology Today

ThermiVa is a carefully controlled and non-invasive vaginal rejuvenation procedure that delivers proven results. It may be a viable option for a mommy makeover, especially for women who choose a ThermiVa treatment administered by the friendly, knowledgeable team of urologists at Comprehensive Urology Medical Group in Los Angeles.

Comprehensive Urology is a leading provider of ThermiVa and other vaginal rejuvenation treatments. Our team is happy to learn about a patient and help this individual determine whether ThermiVa is the right choice for vaginal rejuvenation following pregnancy. To schedule a ThermiVa consultation, please contact us or call us at (310) 499-2756.

The post Why Your Mommy Makeover Should Include a ThermiVa Treatment appeared first on Comprehensive Urology.

5 Warning Signs of Testicular Cancer

About 9,300 new cases of testicular cancer will be diagnosed in 2018, according to the American Cancer Society (ACS). Testicular cancer will also be responsible for about 400 deaths this year, ACS estimates. Fortunately, men who identify the initial signs of testicular cancer can properly diagnose and treat this problem.

April is National Testicular Cancer Awareness Month. At Comprehensive Urology Medical Group in Los Angeles, we strive to educate individuals about testicular cancer and other urological conditions. As part of our efforts, we’re writing blog posts to promote testicular cancer detection and treatment. Now, let’s take a look at some of the warning signs associated with testicular cancer.

5 Testicular Cancer Warning Signs: Here’s What You Need to Know

There are many early signs of testicular cancer. These include:

1. A lump or growth in one or both of the testicles
2. Dull ache in the abdomen or groin
3. Fluid collection in the scrotum
4. Discomfort or pain in a testicle or the scrotum
5. Tenderness or enlargement of the breasts

If an individual experiences one, some, or all of the aforementioned testicular cancer symptoms, it is important to meet with a doctor immediately. A doctor can provide a testicular cancer diagnosis.

Additionally, after a patient receives a testicular cancer diagnosis, meeting with a urologist is essential. A patient and urologist can work together to determine the best way to treat testicular cancer symptoms.

Why You Need to Identify the Early Signs of Testicular Cancer

If testicular cancer is not found early, it will spread throughout the body. This may happen without an individual experiencing any symptoms. However, in some instances, men may experience one or more of the following symptoms, if testicular cancer begins to spread:

• Lower Back Pain: Occurs when cancer spreads to the lymph nodes in the back of the belly.
• Chest Pain, Cough, or Shortness of Breath: Occurs when cancer spreads to the lungs.
• Belly Pain: Occurs due to enlarged lymph nodes or the spread of cancer to the liver.
• Headaches: Occur due to cancer that spreads to the brain.

Testicular cancer symptoms won’t disappear on their own. Therefore, when it comes to testicular cancer detection and treatment, it is better to err on the side of caution. By meeting with a urologist, an individual can receive proper testing to determine if testicular cancer is present and if it has spread to different areas of the body.

How Is Testicular Cancer Diagnosed? 

A urologist requests a patient evaluation to identify and treat testicular cancer in different areas of the body. At this time, a urologist feels a patient’s testicles for swelling or tenderness and evaluates the size and location of any lumps on the testicles. A urologist also examines a patient’s abdomen, lymph nodes, and other parts of the body to identify any potential signs that testicular cancer has spread throughout the body.

If a urologist believes a patient is dealing with testicular cancer, several tests may be used to confirm the diagnosis and determine the best course of action. These include:

• Ultrasound: Uses sound waves to produce images of internal organs. An ultrasound is commonly one of the first tests performed by a urologist to identify testicular cancer in the body.
• Blood Tests: Help a urologist identify increased levels of tumor markers in the blood that indicate testicular cancer is present. Blood tests are often used to follow a patient’s response to testicular cancer treatments and help guide treatments.
• Computed Tomography (CT) Scan: Involves X-rays that provide cross-sectional images of the body. A CT scan enables a urologist to determine the stage of testicular cancer and shows if cancer has spread to the lymph nodes, lungs, liver, or other organs.
• Magnetic Resonance Imaging (MRI) Scan: Provides images of the brain and spinal cord. An MRI scan is only used if a urologist believes cancer has spread to the brain and spinal cord.

After testicular cancer tests are completed, a urologist provides a patient with the complete results. Then, a urologist recommends testicular cancer treatment options and helps a patient develop an effective treatment program.

Is It Possible to Prevent Testicular Cancer?

Testicular cancer cannot be prevented, and it can affect any man, at any time. Yet scientists have found several risk factors associated with testicular cancer. These risk factors include:

• Undescended Testicle: Men with an undescended testicle are more likely to get testicular cancer than men with normally descended testicles.
• Family History: A man whose father, brother, or another close blood relative experienced testicular cancer may be more prone than others to this type of cancer.
• HIV Infection: Research indicates men infected with human immunodeficiency virus (HIV) face an increased risk of testicular cancer.
• Ethnicity: The risk of testicular cancer among white men is four to five times higher than that of black men and Asian-American men, according to ACS.

Testicular cancer awareness is key. If men understand the risk factors associated with testicular cancer, they could identify this problem before it escalates.

Is It Possible to Identify Testicular Cancer Early?

Checking a man’s testicles is a routine part of a physical examination. Some doctors also recommend a monthly self-exam for early identification of testicular cancer.

A testicular cancer self-exam requires a man to look and feel for any lumps or irregularities on the testicles. If a man notices any abnormalities following a testicular cancer self-check, he should contact a doctor right away. Because the sooner a man identifies testicular cancer, the sooner he can treat this issue.

Select Comprehensive Urology for Testicular Cancer Treatment

Recent ACS data indicates the five-year relative survival rate of patients with localized testicular cancer (occurs when cancer is only in the testicles) is 99%. Meanwhile, this figure falls to 96% for patients with regional testicular cancer (occurs when cancer has spread to nearby lymph nodes or tissues) and 73% for patients with distant testicular cancer (occurs when cancer has spread to lymph nodes or organs throughout the body). These statistics highlight the importance of early testicular cancer identification and treatment, as well as the value of taking a proactive approach to detect early warning signs of testicular cancer.

At Comprehensive Urology, our team of highly trained urologists helps patients find the optimal treatments for testicular cancer. First, our urologists perform in-depth testing to provide a proper testicular cancer diagnosis. They then discuss all treatment options with a patient and respond to any concerns or questions. Finally, our urologists work with patients to develop personalized testicular cancer treatment programs designed to deliver long-lasting results. To find out more about how we treat testicular cancer, please contact or call us today at (310) 499-2756 to schedule a consultation with one of our courteous, knowledgeable urologists.

The post 5 Warning Signs of Testicular Cancer appeared first on Comprehensive Urology.

How to Do a Testicular Cancer Self-Exam

Testicular cancer is the most common form of cancer in men between the ages of 15 and 34. But testicular cancer itself is not common; in fact, the American Cancer Society (ACS) estimates only one in 250 men will be diagnosed with testicular cancer during his lifetime. Meanwhile, testicular cancer can be treated successfully, particularly in men who identify this form of cancer in its early stages.

April marks Testicular Cancer Awareness Month, and Comprehensive Urology Medical Group is providing blog posts designed to teach individuals about testicular cancer and how to identify and treat it. Now, let’s take a look at how a testicular cancer self-exam works and its importance for men around the world.

Testicular Cancer Self-Exam: Here’s What You Need to Know

The Testicular Cancer Society (TCS) recommends men conduct a monthly testicular cancer check after a warm bath or shower. To perform this self-exam, men should first check for any swelling on the scrotal skin. Next, use both hands to examine the testicles. Place the index and middle fingers under the testicle and feel for any lumps or irregularities on the testicle’s skin or surface. Lastly, locate the epididymis (a soft, rope-like structure on the back of the testicle), and check it for any lumps or irregularities.

TCS points out most testicular cancer cases are discovered by men themselves or their partners, while few are found by a physician. The average age of a patient at the time of a testicular cancer diagnosis is 33, according to ACS. Approximately 6% of testicular cancer cases affect children and teens, and about 8% occur in men over the age of 55.

Is a Monthly Testicular Cancer Self-Exam Necessary?

If you perform a monthly testicular cancer self-exam, you may be better equipped than ever before to identify testicular cancer before it spreads throughout the body. At this point, testicular cancer is usually treatable.

The American Society of Clinical Oncology (ASCO) reports roughly 68% of testicular cancer patients are diagnosed during its initial stage. Comparatively, 11% of testicular cancer patients are diagnosed after cancer has spread to the lymph nodes in the back of the abdomen (retroperitoneal lymph nodes). The survival rate of testicular cancer patients who experience cancer that has spread to the retroperitoneal lymph nodes is about 96%. However, for men who experience testicular cancer that has spread beyond the retroperitoneal lymph nodes, the survival rate drops to 73%. This indicates the longer testicular cancer goes unaddressed, the greater the risk becomes that cancer could spread throughout the body and become fatal.

Monthly self-exams help men identify the initial signs of testicular cancer. Men can use testicular cancer self-exams to reduce the risk that testicular cancer will spread throughout the body.

What Are the Signs of Testicular Cancer?

If one testicle appears slightly larger than the other during a testicular cancer self-exam, there is no need to worry. It is normal for a man to have testicles of varying sizes. Keep in mind that it is normal for one testicle to hang lower than the other, too.

For those who identify a testicular lump or irregularity during a testicular cancer check, it’s important not to panic. However, it is crucial to go to a doctor right away.

Remember, not all lumps on testicles or irregularities are cancerous. Meet with a doctor to receive a proper testicular cancer diagnosis.

Consulting with a urologist is also beneficial after a testicular cancer self-exam. A urologist can provide insights into all stages of testicular cancer diagnosis and treatment.

How Is Testicular Cancer Diagnosed?

A urologist performs a series of tests to analyze a patient and provides an accurate testicular cancer diagnosis. Common testicular cancer tests include:

• Testicular Ultrasound: Involves the use of sound waves that are bounced off internal organs to produce echoes to capture an image of the testicles. This image then helps a doctor to verify whether a cancerous mass is present.
• Serum Tumor Markers: Involves the use of blood tests to identify substances that are released by different types of testicular cancer.
• Radical Orchiectomy: Involves the use of a small incision in the lower groin to evaluate and remove a testicle that may harbor cancer. If cancer is discovered, additional testing is performed to determine the exact cancer cell type(s).

After a urologist provides a patient with a testicular cancer diagnosis, he or she uses additional tests to determine the stage of cancer and find out whether the cancer has spread to other areas of the body. The two most common tests following a testicular cancer diagnosis are:

• CT Scan: Captures detailed images of a patient’s chest, abdomen, and pelvis. A CT scan enables a doctor to see whether testicular cancer has spread into a patient’s lymph nodes.
• Repeat Tumor Markers: Allows a doctor to determine whether tumor markers have normalized in a patient’s blood. If tumor markers have not normalized after a set amount of time, this indicates a patient may be dealing with persistent cancer in the body.

Following the aforementioned tests, a urologist can determine the stage of testicular cancer in a patient. There are three stages of testicular cancer, and these are:

• Stage 1: Cancer is discovered within the testis.
• Stage 2: Cancer is found within the abdominal lymph nodes.
• Stage 3: Testicular cancer has moved to the chest, bones, brain, or other areas of the body.

A full diagnosis from a urologist is paramount for men who notice testicular lumps or irregularities following a self-exam. After testicular cancer and its stage are confirmed, a patient and urologist then can work together to identify the best treatment option.

How Is Testicular Cancer Treated?

There have been many testicular cancer treatment advancements in recent years. Today, some of the most common testicular cancer treatment options include:

• Retroperitoneal Lymph Node Dissection (RPLND): Involves the removal of the lymph nodes. RPLND may be performed after cancer spreads beyond the testis.
• Chemotherapy: Involves the use of medications to attack cancer cells. Chemotherapy is an early-stage testicular cancer treatment and may be performed in combination with RPLND.
• Radiation Therapy: Involves the use of high-energy radiation beams to target cancer in the groin. Radiation therapy has been shown to be one of the most effective testicular cancer treatments.

The goals of testicular cancer treatment are to help a patient cure the cancer and preserve his quality of life. Additionally, the optimal testicular cancer treatment varies depending on the patient and how much his cancer has progressed.

In certain instances, a doctor may recommend a multi-modal approach to treat testicular cancer as well. The use of surgery and chemotherapy or radiation therapy sometimes helps a testicular cancer patient achieve the best-possible treatment results. For testicular patients who plan to undergo chemotherapy, freezing and storing sperm samples (sperm banking) is strongly recommended.

Receive Expert Testicular Cancer Diagnosis and Treatment from Comprehensive Urology

Testicular cancer is problematic, but this form of cancer is treatable. Yet many men who suffer from testicular cancer fail to diagnose the problem correctly. And in this scenario, the consequences could be fatal.

Comprehensive Urology employs a team of friendly, knowledgeable, and highly trained urologists who are happy to teach patients about all aspects of testicular cancer. Our urologists help patients identify testicular cancer, treat the issue, and determine the best way to prevent it from recurring. To find out more, please contact us today at (310) 499-2756 to schedule a testicular cancer consultation with our one of our expert urologists.

The post How to Do a Testicular Cancer Self-Exam appeared first on Comprehensive Urology.

Differences Between Labiaplasty and ThermiVa for Vaginal Rejuvenation

When considering whether to undergo a labiaplasty or ThermiVa treatment, it is important to note that both vaginal cosmetic procedures can provide similar results. However, labiaplasty (cosmetic vaginal surgery) or ThermiVa (non-surgical vaginal rejuvenation) can offer a range of benefits that may be more appealing to some patients than others.

Labiaplasty is a vaginal cosmetic treatment designed to reduce the size or adjust the symmetry of the labia. It addresses labial protuberance, asymmetry, or excess skin.

Comparatively, ThermiVa is a vaginal cosmetic treatment that uses thermistor-regulated RF energy waves to gently heat the skin. The non-surgical procedure stimulates the body’s natural collagen production. As a result, ThermiVa helps vaginal tissues become tighter and firmer than ever before.

	Labiaplasty	TermiVa
Overview	Vaginal cosmetic surgery	Non-surgical vaginal tightening using radiofrequency
Treatment time	Fast Treatment: A labiaplasty is an outpatient procedure that usually requires less than 60 minutes to complete.	Fast Treatment: A ThermiVa treatment is administered as an outpatient procedure and takes 15 to 30 minutes to complete. Most patients require three ThermiVa sessions per month for a four-month period to achieve optimal treatment results.
Recovery time	Quick Recovery: Labiaplasty patients can return home the same day as their surgery. On average, labiaplasty treatment recovery time ranges from two to three days.	Immediate Recovery: There is no downtime associated with ThermiVa treatments.
Side effects	Minimal Side Effects: Labiaplasty patients may feel nauseous or drowsy for approximately 24 hours following surgery; this is generally linked to general anesthesia. Other potential labiaplasty side effects include bleeding, infection, bruising, swelling, and temporary numbness; these side effects are temporary and typically disappear on their own.	No Side Effects: ThermiVa is a non-surgical procedure, and as such, patients won’t have to worry about pain, scars, or other side effects of traditional surgery. Plus, after a ThermiVa session, a patient can immediately return to his or her regular activities.
Results	Long-Term Results: For most patients, the final results of labiaplasty become visible within six to 12 months of surgery.	Long-Lasting Results: Most patients notice nerve function and muscle tone improvement within nine to 12 months of a full ThermiVa treatment.

 

Fortunately, our dedicated urologists at Comprehensive Urology in Los Angeles can help restore and revive your feminine wellness. Both options help women eliminate the embarrassment and discomfort commonly associated with a large labia. We invite you to contact us to see if ThermiVa is the right alternative to cosmetic vaginal surgery for you.Over the course of a woman’s life, factors like age, childbirth, weight changes, and various medical conditions can cause the muscles of the vagina and surrounding tissue to become stretched or loose, often leading to discomfort (e.g., twisting and tugging), urinary incontinence, and reduced sexual satisfaction. If you experience any of the aforementioned problems, have had one or multiple children, or are nearing menopause and want a tighter vaginal canal and/or labia, you may want to consider labiaplasty or ThermiVa for vaginal rejuvenation.  

 

The post Differences Between Labiaplasty and ThermiVa for Vaginal Rejuvenation appeared first on Comprehensive Urology.