Longview Urology

Dr. Lassen Sets ED Forum for June 27th

Longview Urology — Fri, 11 May 2012 16:50:08 +0000

Longview Urology will host a forum on erectile dysfunction, featuring board certified urologist Patrick M. Lassen, M.D. The event is scheduled for 6:00 p.m. on Wednesday, June 27, at Pacific Surgical Institute at 625 9^th Avenue.

Dr. Lassen will first discuss causes of erectile dysfunction and then present treatment options available through Longview Urology.

“There are many options other than surgery,” Lassen said. “We typically begin with the least invasive and work from there.”

Recent studies indicate that 10 to 20 million American men suffer from erectile dysfunction. In addition to diminished sexual performance, ED may also cause stress, relationship problems, and a loss of confidence.

There is no charge for this event. Contact Longview Urology at 360.425.3720 for additional information.

Patrick M. Lassen, M.D., of Longview Urology

Longview Urology Hosts Female Incontinence Forum

Longview Urology — Mon, 30 Apr 2012 13:40:50 +0000

John Mansfield, MD, and Suzanne Box, PA-C, of Longview Urology presented options for treating female incontinence during a forum at Pacific Surgical Institute on April 26th.

The event was attended by nearly 40 area residents who gave Mansfield and Box high marks for their frankness and humor.

More than 15 million women in the U.S. suffer from female incontinence, which typically results when the urethra cannot close tightly enough to hold urine in the bladder. Childbirth and age are the two biggest contributors.

Mansfield said the embarrassment and anxiety associated with incontinence can significantly limit quality of life.

“There are numerous treatment options available, and we’ll be discussing those at the forum,” he said. “Our goal is to let women know they don’t have to continue to suffer with this problem.”

: John Mansfield, MD, of Longview Urology

Multiple Treatment Options Available for Incontinence Sufferers

Longview Urology — Wed, 11 Apr 2012 19:35:16 +0000

More than 15 million women in the U.S. suffer from bladder control problems. For those suffering the embarrassment and life-changing limitations of incontinence, a wide range of treatment options are available.

There are two primary types of incontinence among women – stress incontinence and urge incontinence. Some women have both; their condition is diagnosed as mixed incontinence.

Stress incontinence is caused by poor function of the muscles that support the bladder or control the release of urine. Physical changes related to pregnancy, childbirth, or menopause are the most frequent contributors.

Urge incontinence is typically the result of a neurological problem that causes the bladder to contract and release urine involuntarily. It can be triggered by sudden changes in position or activity, hearing or touching running water, or drinking even a small amount of liquid.

The following therapy options can be used to treat stress incontinence:

Kegel exercises can be very helpful in women with minor incontinence. Success rates are near 50 percent. No surgery or medications are required.
Periurethral coaptite injections are especially effective with minor to moderate incontinence. Success rates are approximately 50 to 70 percent, with the success lasting 6 to 12 months. No overnight stay is required following this 30-minute procedure and no catheter is involved. Repeat treatments may be needed.
The mid-urethral sling is most helpful for women with moderate to severe incontinence and prolapse of tissues. Several variations of slings exist. The procedure is completed in 30 minutes to two hours and is followed by a six-week recovery period. The success rate is 90 percent.

The following therapy options can be used to treat urge incontinence:

Lifestyle changes – including limiting fluids; avoiding bladder irritants, such as caffeine and spicy foods; and timed voiding (urinating by the clock) – produce positive results for 30 to 50 percent of women.
Anti-cholinergic medication is 60 to 70 percent successful in decreasing incontinence episodes. It is taken one to four times per day. Side-effects can include dry mouth and constipation.
Posterior tibial nerve stimulation therapy has a success rate of 70 to 80 percent. The treatment requires 12 weekly sessions of 30 minutes each. There are no medications and no side-effects. After the weekly sessions are completed, a single monthly treatment is often required.
Botox bladder injections are typically reserved for women who have failed to respond to other options. This option is especially effective for those patients with severe neurogenic bladder conditions and for those with multiple sclerosis or spinal cord injuries. The success rate is 80 to 90 percent.

For women with mixed incontinence, several of the treatment options above are used in combination.

Contact Longview Urology at 360.425.3720 for additional information.

Now Scheduling March Madness Vasectomies

Longview Urology — Mon, 23 Jan 2012 16:06:56 +0000

If you’ve been putting off the vasectomy your wife keeps mentioning, Longview Urology has a plan – schedule your procedure to coincide with the NCAA hoop tournament.

More than 500,000 vasectomies are performed annually in the United States, with a success rate of 99.8 percent.

During the procedure, the vasa deferentia are snipped and then sealed to prevent sperm from entering the seminal stream. Vasectomies do not affect a man’s sexual function.

The procedure takes only 30 minutes, and that includes check-in, preparation, and a discussion of aftercare instructions.

Vasectomies are minimally invasive, and patients are almost always able to drive themselves home. However, two days of rest are recommended before returning to normal activity.

Longview Urology surgeons Patrick Lassen, Chad Chesley, and John Mansfield have extensive experience with this procedure. With the NCAA basketball tournament fast approaching, now is the time to reserve an appointment so that you can enjoy the excitement of March Madness from the comfort of your recliner.

Contact Longview Urology today at 360.425.3720 to schedule a consultation, and our staff will check your insurance coverage as well.

Longview Urology is located at 625 9th Avenue at Pacific Surgical Institute.

New Treatment for Urinary Problems Now Available

Longview Urology — Wed, 14 Dec 2011 15:57:32 +0000

This excellent video illustrates the use of the Urgent PC Neuromodulation System, a non-drug, non-surgical method of treating overactive bladder and the associated symptoms of urinary urgency.

The physicians at Longview Urology utilize this new technology and have had a high level of success in treating urinary problems.

Call 360.425.3720 for additional information.

Billing

Longview Urology — Wed, 02 Nov 2011 23:36:59 +0000

Please come to your appointments with all necessary insurance forms and cards, so that we are able to bill your carrier in a timely and accurate manner. You will receive separate billings for laboratory, anesthesiology, radiology, and/or hospital or outpatient services.

We accept cash, checks, VISA, and MasterCard. Regardless of what amount your insurance company pays, you are responsible for full payment of all bills incurred at Longview Urology.

Non-insured patients are required to pay a $100 deposit. A member of our billing staff will discuss payment arrangements with you prior to your appointment.

If you have questions about billing, call 360.442.7923.

Traver Organizes Fundraiser for Breast Cancer Research

Longview Urology — Thu, 20 Oct 2011 14:04:36 +0000

When Danette Traver – clinic coordinator at Longview Urology – was working for Longview Surgical Group and the Lower Columbia Women’s Clinic, she witnessed the terrible impact that breast cancer has on the local community.

With that in mind, she decided to organize an event to generate money for breast cancer research. On Friday, October 14th, staff members at Longview Urology got the opportunity to wear jeans to work – provided they made a donation in recognition of Breast Cancer Awareness Month.

“It amazes me how many women do not have insurance that will cover routine mammograms for screening,” Traver said. “This event was a great way to help raise money for breast cancer research.”

Staff members at Longview Urology embrace Breast Cancer Awareness Month

Longview Urology is located at Pacific Surgical Institute at 625 9th Avenue.

Urinary Tract Infections Should Be Taken Seriously

Longview Urology — Fri, 07 Oct 2011 17:09:07 +0000

A urinary tract infection, or UTI, is an infection that can happen anywhere along the urinary tract. Urinary tract infections have different names, depending on what part of the urinary tract is infected.

The staff at Longview Urology advises that UTIs can be especially dangerous for the elderly because symptoms that are apparent in younger people do not manifest in those who are older. In some instances, the only symptom of a UTI in older people is extreme confusion and an inability to communicate.

Types of UTIs

Bladder – an infection in the bladder is also called cystitis or a bladder infection
Kidneys – an infection of one or both kidneys is called pyelonephritis or a kidney infection
Ureters – the tubes that take urine from each kidney to the bladder are only rarely the site of infection
Urethra – an infection of the tube that empties urine from the bladder to the outside is called urethritis

Causes

Urinary tract infections are caused by germs, usually bacteria that enter the urethra and then the bladder. This can lead to infection, most commonly in the bladder itself, which can spread to the kidneys.

Most of the time, your body can get rid of these bacteria. However, certain conditions increase the risk of having UTIs.

Women tend to get them more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI.

The following also increase your chances of developing a UTI:

Diabetes
Advanced age (especially people in nursing homes)
Problems emptying your bladder completely (urinary retention)
A tube called a urinary catheter inserted into your urinary tract
Bowel incontinence
Enlarged prostate, narrowed urethra, or anything that blocks the flow of urine
Kidney stones
Staying still (immobile) for a long period of time (for example, while you are recovering from a hip fracture)
Pregnancy
Surgery or other procedure involving the urinary tract

Symptoms

The symptoms of a bladder infection include:

Cloudy or bloody urine, which may have a foul or strong odor
Low fever (not everyone will have a fever)
Pain or burning with urination
Pressure or cramping in the lower abdomen (usually middle) or back
Strong need to urinate often, even right after the bladder has been emptied

If the infection spreads to your kidneys, symptoms may include:

Chills and shaking or night sweats
Fatigue and a general ill feeling
Fever above 101 degrees Fahrenheit
Flank (side), back, or groin pain
Flushed, warm, or reddened skin
Mental changes or confusion (in the elderly, these symptoms often are the only signs of a UTI)
Nausea and vomiting
Severe abdominal pain (sometimes)

Exams and Tests

A urine sample is usually collected to perform the following tests:

Urinalysis is done to look for white blood cells, red blood cells, bacteria, and to test for certain chemicals, such as nitrites in the urine. Most of the time, your doctor or nurse can diagnose an infection using a urinalysis.
Urine culture – clean catch may be done to identify the bacteria in the urine to make sure the correct antibiotic is being used for treatment.

The following tests may be done to help rule out problems in your urinary system that might lead to infection or make a UTI harder to treat:

CT scan of the abdomen
Intravenous pyelogram (IVP)
Kidney scan
Kidney ultrasound
Voiding cystourethrogram

Treatment

Your doctor must first decide whether you have a mild or simple bladder or kidney infection, or whether your infection is more serious.

MILD BLADDER AND KIDNEY INFECTIONS

Antibiotics taken by mouth are usually recommended because there is a risk that the infection can spread to the kidneys.

For a simple bladder infection, you will take antibiotics for 3 days (women) or 7 – 14 days (men). For a bladder infection with complications such as pregnancy or diabetes, OR a mild kidney infection, you will usually take antibiotics for 7 – 14 days.
It is important that you finish all the antibiotics, even if you feel better. If you do not finish all your antibiotics, the infection could return and may be harder to treat.

Commonly used antibiotics include trimethoprim-sulfamethoxazole, amoxicillin, Augmentin, doxycycline, and fluoroquinolones. Your doctor will also want to know whether you could be pregnant.

Your doctor may also recommend drugs to relieve the burning pain and urgent need to urinate. Phenazopyridine hydrochloride (Pyridium) is the most common of this type of drug. You will still need to take antibiotics.

Everyone with a bladder or kidney infection should drink plenty of fluids.

Some women have repeat or recurrent bladder infections. Your doctor may suggest several different ways of treating these.

Taking a single dose of an antibiotic after sexual contact may prevent these infections, which occur after sexual activity.
Having a 3-day course of antibiotics at home to use for infections diagnosed based on your symptoms may work for some women.
Some women may also try taking a single, daily dose of an antibiotic to prevent infections.

MORE SEVERE KIDNEY INFECTIONS

If you are very sick and cannot take medicines by mouth or drink enough fluids, you may be admitted to the hospital. You may also be admitted to the hospital if you:

Are elderly
Have kidney stones or changes in the anatomy of your urinary tract
Have recently had urinary tract surgery
Have cancer, diabetes, multiple sclerosis, spinal cord injury, or other medical problems
Are pregnant and have a fever or are otherwise ill

At the hospital, you will receive fluids and antibiotics through a vein.

Some people have urinary tract infections that keep coming back or that do not go away with treatment. Such infections are called chronic UTIs. If you have a chronic UTI, you may need antibiotics for many months, or stronger antibiotics may be prescribed.

If a structural (anatomical) problem is causing the infection, surgery may be recommended.

Outlook (Prognosis)

A urinary tract infection is uncomfortable, but treatment is usually successful. Symptoms of a bladder infection usually disappear within 24 – 48 hours after treatment begins. If you have a kidney infection, it may take 1 week or longer for your symptoms to go away.

Possible Complications

Life-threatening blood infection (sepsis) – risk is greater among the young, very old adults, and those whose bodies cannot fight infections (for example, due to HIV or cancer chemotherapy)
Kidney damage or scarring
Kidney infection

When to Contact a Medical Professional

Contact your health care provider if you have symptoms of a UTI. Call right away if the following symptoms develop:

Back or side pain
Chills
Fever
Vomiting

These may be signs of a possible kidney infection.

Also call if you have already been diagnosed with a UTI and the symptoms come back shortly after treatment with antibiotics.

Prevention

Lifestyle changes may help prevent some UTIs.

After menopause, a woman may use estrogen cream in the vagina area to reduce the chance of further infections.

BATHING AND HYGIENE

Choose sanitary pads instead of tampons, which some doctors believe make infections more likely. Change the pad each time you use the bathroom.
Do not douche or use feminine hygiene sprays or powders. As a general rule, do not use any product containing perfumes in the genital area.
Take showers instead of baths. Avoid bath oils.
Keep your genital area clean. Clean your genital and anal areas before and after sexual activity.
Urinate before and after sexual activity.
Wipe from front to back after using the bathroom.

CLOTHING

Avoid tight-fitting pants.
Wear cotton-cloth underwear and pantyhose, and change both at least once a day.

DIET

Drink plenty of fluids (2 to 4 quarts each day).
Drink cranberry juice or use cranberry tablets, but NOT if you have a personal or family history of kidney stones.
Do NOT drink fluids that irritate the bladder, such as alcohol and caffeine.

Longview Urology Salutes Suzanne Box

Longview Urology — Mon, 03 Oct 2011 15:50:03 +0000

Longview Urology and Pacific Surgical Institute are proud to recognize Suzanne Box, PA-C, during National Physician Assistant Week from October 6 through 12.

This week was chosen to commemorate the anniversary of the first graduating physician assistant class at Duke University in 1967 and also to celebrate the birthday of Dr. Eugene Stead, who founded the PA profession.

Box attended Philadelphia University, where she earned a Master of Science degree in Physician Assistant Studies. She joined Longview Urology in 2007.

According to projections by the American Academy of Family Physicians, the U.S. will face a shortfall of 40,000 family physicians in 2020, just as the number of older and underserved patients – and demand for care – is expected to be at its highest.

Suzanne Box

The shortage of family physicians nationwide is taking a toll on the availability of quality health care, as seen by increasingly longer wait times for doctor’s appointments, delays in filing and filling prescriptions and, sometimes, delays in lifesaving surgeries.

Experts say highly trained and certified PAs such as Maligro and Box make it possible for more patients to obtain needed health care.

Physicians assistants are licensed professionals who team with supervising physicians to deliver a wide range of medical and surgical services. They prescribe medication, conduct physical exams, diagnose and treat illnesses and conditions, order and interpret tests, and assist in surgery.

There are more than 74,000 PA’s in clincial practice in the U.S., with the number expected to increase by nearly 40 percent within the next decade.

Learn more.

Prostate Cancer Awareness Month – What You Should Know

Longview Urology — Fri, 19 Aug 2011 19:15:30 +0000

The following information is courtesy of the Centers for Disease Control and Prevention. In recognition of Prostate Cancer Awareness Month, the staff at Longview Urology encourages everyone to inform themselves about the disease, its symptoms and treatment options.

Cancer is a disease in which abnormal cells in the body grow out of control. When cancer starts in the prostate, it is called prostate cancer. The prostate is a walnut-sized organ located just below the bladder and in front of the rectum in men. It produces fluid that makes up a part of semen.

Prostate cancer is the most commonly diagnosed cancer in men, and second only to lung cancer in the number of cancer deaths. In 2007 (the most recent year for which statistics are available), 223,307 men were diagnosed with prostate cancer, and 29,093 men died from it.

Symptoms

Different people have different symptoms for prostate cancer. Some men do not have symptoms at all. Some symptoms of prostate cancer are—

Difficulty in starting urination.
Weak or interrupted flow of urine.
Frequent urination, especially at night.
Difficulty in emptying the bladder completely.
Pain or burning during urination.
Blood in the urine or semen.
Pain in the back, hips, or pelvis that doesn’t go away.
Painful ejaculation.

If you have any symptoms that worry you, be sure to see your doctor right away. These symptoms may be caused by conditions other than prostate cancer.

Risk Factors

There is no way to know for sure if you will get prostate cancer. Men have a greater chance of getting prostate cancer if they are 50 years old or older, are African-American, or have a father, brother, or son who has had prostate cancer.

Screening for Prostate Cancer

Not all medical experts agree that screening for prostate cancer will save lives. Currently, there is not enough credible evidence to decide if the potential benefit of prostate cancer screening outweighs the potential risks. The potential benefit of prostate cancer screening is early detection of cancer, which may make treatment more effective. Potential risks include false positive test results (the test says you have cancer when you do not), treatment of prostate cancers that may never affect your health, and mild to serious side effects from treatment of prostate cancer.

Most organizations recommend that men discuss with their doctors the benefits and risks of prostate cancer screening. CDC supports informed decision making, which encourages men to talk with their doctors to learn the nature and risk of prostate cancer, understand the benefits and risks of the screening tests, and make decisions consistent with their preferences and values.

Tests that are commonly used to screen for prostate cancer are—

Digital rectal exam (DRE): A doctor, nurse, or other health care professional places a gloved finger into the rectum to feel the size, shape, and hardness of the prostate gland.
Prostate specific antigen test (PSA): PSA is a substance made by the prostate. The PSA test measures the level of PSA in the blood, which may be higher in men who have prostate cancer. However, other conditions such as an enlarged prostate, prostate infections, and certain medical procedures also may increase PSA levels.

Is prostate cancer screening right for you? Contact your primary care physician for assistance in making this decision.