Paisley Prescriptions - May 2018

On the Right Tract: Urinary Tract and Kidney Health

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What is the treatment for Kidney stones and are there any preventative measures?
Kidney stones are a common occurrence in this area of the country. Our humid, subtropical climate can lead to dehydration, which is the most common cause of kidney stones. The easiest way to prevent kidney stones is to make sure you drink lots of fluids and stay hydrated.

The vast majority of kidney stones are calcium oxalate stones. It is not the calcium that is the problem, but the oxalic acid. Oxalate is an organic acid found in the kola nut, used for flavoring in many popular cola brands, and green leafy vegetables. Consider avoiding large quantities of foods containing oxalate such as colas, chocolate, green leafy vegetables—including spinach—and iced tea. On the other hand, citrus drinks such as lemonade contain a chemical called potassium citrate that helps prevent stones.

The vast majority of kidney stones will pass on their own. However, if a stone gets stuck in the urinary tract it will need to be treated. One way is to put a looking scope, called an ureteroscope, through the urinary tract up to the stone. A laser is then placed through the scope and the stone broken up into small pieces, and the particles are removed. If the stone is in the kidney, then the patient will usually have an extracorporeal shockwave lithotripsy treatment. This procedure breaks up the stone using shock waves. While both procedures are done on an outpatient basis and are minimally invasive, they do require anesthesia.

Occasionally, if a stone is too large, a small incision is made in the back, and a larger scope is placed into the kidney. The stone is broken up and then the particles are removed through the scope. With this procedure the patient usually stays in the hospital overnight.

Again, the easiest way to prevent kidney stones is to stay hydrated. Something to remember on those hot, sunny, summer days ahead!

David M. Kranc, M.D., Ph.D., Southeast Georgia Physician Associates-Urology. A board-certified urologist, Dr. Kranc’s expertise includes performing complex open and minimally-invasive urologic surgeries. He obtained his medical degree from the University of Tennessee College of Medicine, completed an internship at the University of Chicago Hospitals and Clinics, and his residency at the University of Chicago Medical Center. In 1997, Dr. Kranc moved to the Golden Isles and joined the Southeast Georgia Health System medical staff.


What can I do about recurring urinary tract infections?

Hygiene: One of the best ways to help prevent recurrent UTIs is to make sure you are wiping correctly after using the restroom. Always make sure you wipe front to back after both urinating and having a bowel movement. Always urinate and clean yourself after having intercourse.

Water: Increase your fluid intake. Studies of 140 women with recurrent UTIs showed that increased fluid intake reduces the risk of repeat infections. Drink enough to ensure your urine is pale in color. Consider taking showers and avoiding long baths. Bath water can quickly become contaminated with our own flora from the skin and can easily reach the bladder.

Medications: An estrogen vaginal cream may help increase resistance to bladder infections. An estrogen cream for the vagina may be suggested for women after menopause even if an oral estrogen supplement or patch has already been prescribed. The cream helps keep the tissues around the bladder healthy and more resistant to infection.

Can vaginal rejuvenation help with stress incontinence?
There are different kinds of vaginal rejuvenation available, and many are successful in treating urinary incontinence. The Geneveve uses deep heating and surface cooling to stimulate your body’s natural collagen formation process. This dual heating and cooling capability triggers the body’s natural regenerative process, which leads to new and stronger collagen, while maintaining patient safety and comfort. Thermiva works much in the same fashion.

The O-Shot nonsurgical procedure uses the growth factors each woman has in her body to stimulate vaginal rejuvenation, which decreases urinary stress incontinence. The O-Shot uses the patient’s platelet rich plasma (PRP) to stimulate stem cells to grow healthier vaginal tissue. Growth factors, derived from your own blood, are harvested with a simple in-office blood draw. They are then concentrated and activated in preparation to be injected back into your body. Activated growth factors are then re-injected into various anatomic sites, allowing for growth of new tissue by stimulating a stem cell response.

What causes stress incontinence and how can I prevent it?
One of the obvious answers to this question is having children. After giving birth, most women tend to suffer from this affliction. This is often caused by vaginal laxity and weakened pelvic floor muscles after childbirth. Stress incontinence may also be caused by weight gain, injury, and repeated sports activities, such as cycling.

In addition to this, in a recent study at the Medical University of Vienna in Austria, women with stress urinary incontinence were shown to have lower circulating levels of estradiol than their continent peers, meaning that estrogen deficiency after menopause may be associated with incontinence.
It is best to be evaluated by a healthcare provider to determine if your estrogen levels are contributing to your incontinence.

Can Kegel exercises make a difference in urinary stress incontinence?
Pelvic floor muscle therapy, including Kegel exercises, is, in fact, a recommendation of the Institute of Medicine to assist in managing urinary incontinence. Kegel exercises are done by contracting the pelvic floor muscle, followed by full relaxation. Kegel exercises can start with 3 sets of ten (10) daily for 3 to 5-second contractions, followed by a 10-second relaxation phase, eventually extending the contraction time to 10 seconds.

Kegels, in conjunction with bladder training, habit training and prompted voiding, may show beneficial results in managing urinary incontinence.

Serena Skinner, MSN, APRN, FNP-BC, is a nationally certified FNP with Academy of Nurse Practitioners with a background in emergency medicine. Serena received her MSN from Texas Tech Health Sciences Center in Lubbock, TX, and is trained in sexual health and BHRT from American Academy of Anti-Aging for Medicine (A4M). She is co-owner of Island Lotus Health and Wellness; 664 Scranton Road, Suite 101, Brunswick, Ga. Esthetics training: Botox, Derma Fillers, PRP for Aesthetics and Hair Loss. Certifications: Priapus Shot (P-shot), Orgasm Shot, (O-shot), Gainswave Therapy. Serena is certified member of The Cellular Medicine Association, The International Society for Sexual Medicine, A4M, AANP and UAPRN.

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