Urology Associates and the team celebrated with Dr. Snyder for being named a Center of Excellence for UroLift. Dr. Snyder received accolades for his surgical expertise and the excellent outcomes that have been reported in his patients. He has met or exceeded the benchmarks set by UroLlift and was honored to be recognized as one of the best in the country.
UroLift is a new, minimally invasive procedure that can be used to treat BPH or an enlarged prostate. It is performed by a urologist and it doesn’t require any heating, cutting or removal of tissue. Rather, it is a tiny implant that is used to lift and hold the tissue around the urethra, and gently expand the channel where the urethra passes through the prostate. Once in place, it relieves the compression on the urethra and re-opens the channel so that urine can pass through freely.
There are many benefits to the Urolift procedure:
Men can get treatment earlier
Can be done in the office or in a surgery center setting.
It is performed with light sedation
There is less bleeding which lessens the chance of clotting
It does not have any sexual side effects
A catheter is often not needed following the procedure and that reduces the risk of infection
The procedure itself takes 10 minutes or less
The recovery time is quick and patients generally see improvement in 2-4 weeks
The channel is now open when it was compressed
UroLift is considered as a treatment option for men who have prostate enlargement and the size of the prostate is 100 grams or less, which is why it is important to seek treatment early at the onset of symptoms.
Dr. Jeffrey Snyder has been designated as a UroLift® Center of Excellence (COE). Physicians achieving designation as a UroLift® COE have achieved a high level of training with the UroLift® System and demonstrated a commitment to care for men suffering from symptoms associated with Benign Prostatic Hyperplasia (BPH), also known as enlarged prostate.
UroLift® is a newer and minimally-invasive procedure designed to treat BPH. It doesn’t require any heating, cutting or removal of tissue. Rather, it is a tiny implant that is used to lift and hold the tissue around the urethra, and gently expand the channel where the urethra passes through the prostate. Once in place, it relieves the compression on the urethra and re-opens the channel so that urine can pass through freely.
The UroLift® treatment works best for people who are diagnosed with BPH in the early stages. The procedure itself takes 10 minutes or less and in as soon as 2 – 4 weeks the patient can start seeing improvement in urination. UroLift® also does not have any sexual side effects.
Learn more about the procedure and how it can help BPH.
On April 13, 2022, Governor Polis signed into law HB22-1008 on Implementation of Fertility Coverage.
In 2020, Colorado passed HB20-1158 Colorado Building Families Act requiring insurance plans under Colorado law to provide coverage for fertility diagnosis, preservation, and treatment. However, a provision of the law required an affirmative determination that the law would not trigger defrayal (a requirement that the state could be financially responsible for any increase in premiums) under the Affordable Care Act. That determination was not made and the law did not go into effect. However, defrayal is not an issue under the Affordable Care Act for large group market plans, but the Colorado Building Families Act did not distinguish between different insurance markets.
HB22-1008 requires large group plans (applicable to employers with over 100 employees) under Colorado law to provide coverage for fertility diagnosis, preservation for cancer patients and others at risk of medically-induced fertility, and treatment, including up to three rounds of IVF and unlimited transfers, for plans initiated in 2023 or later.
Note that HB22-1008 did not resolve coverage for individual and small group markets under Colorado law. Further, Colorado law does not affect insurance plans under federal law (self insured, Medicare, Medicaid, TRICARE, etc.) or the law of another state, which may or may not require or provide fertility coverage. Be sure to check whether your employer is self-insured or fully-insured and part of the large group insurance market subject to Colorado law.
Dr. Dan Mazur specializes in male infertility and is on the board of Colorado Fertility Advocates (CFA). CFA continues to work with the National Infertility Association to advocate for fertility rights for men and women across the country.
We are excited to announce a new partnership with Urology America, based out of Austin, Texas. We looking forward to great things ahead for Urology Associates, Anova Cancer Care and our patients with the support of Urology America!
January 18, 2022 – Urology America (“UA”) is pleased to announce a new partnership with Urology Associates of Denver (“UA of Denver”). Urology Associates of Denver has served patients for more than 30 years and is one of Colorado’s leading urology practices with seven urologists and two radiation oncologists across five locations in the Denver area. The group offers comprehensive urology services, including male and female urology, urologic oncology, robotic and laparoscopic surgery, and male infertility across the greater Denver area.
“We’re extremely excited to be partnering with the phenomenal team at Urology Associates of Denver. The team has a well-earned reputation in the Denver community for their commitment to clinical excellence and patient care, a core set of values we seek in all our partner practices. We are excited to welcome the UA of Denver team into the Urology America family, as one of several new partnerships we expect to announce in the coming months.” said Rich Goode, Urology America CEO.
“It was important for us to find an organization that shares our passion for patient care and would also provide us with the comprehensive support we need to continue growing our practice while spending more time with patients and less time on administrative tasks. After speaking with many of the potential partners, we felt Urology America was the best partner to meet those needs.” said Dr. Jim Fagelson, President of UA of Denver. “We’re excited to collaborate with the other outstanding urologists of Urology America to continuously improve the lives of our patients.”
Urology America, based in Austin, Texas, is one of the leading urology-focused management service organizations. Urology America supports more than 55 providers in Texas and Colorado. UA provides comprehensive business support services, which allows partner practices to spend more time caring for patients and less time on the administrative burdens of operating a urology practice. Urology America partners with leading urology practices that seek a partner with the resources and expertise to invest in their practice to ensure they continue to provide best-in-class patient care and continuously expand their practice. If interested in learning more about a partnership with Urology America, please contact Rich Goode (rich.goode@urologyamerica.com)
Tracey found that as she got older she started to feel the effects of childbirth, changing hormones and simply age. Incontinence is a common condition in women, in fact one in three women struggle with stress incontinence as they age. Often starting with small leaks when you cough or sneeze, for Tracey it progressed to happening regularily during exercise and hiking. Eventually, it became a problem that was happening every day, sometimes even with motions like bending over just to tie her shoes.
She knew she had to do something, it was affecting her lifestyle and the things she could do. She had tried a few non-invasive options first, but was unhappy with the feel or the function. Tracey was getting ready to book surgery when, she heard about the new Viveve treatment. She jumped at the opportunity to try a non-surgical solution that could potentially help her with her stress incontinence.
Once a resident in the Denver area, she flew to area from a small town, where she currently lives, to undergo the Viveve treatment at Urology Associates. Not knowing what to expect she was pleasantly surprised by her experience and the ease of the treatment. “It was comfortable, and other than a warm sensation, the 45 minute treatment was virtually pain-free,” she said.
“There really was no recovery time or pain following the procedure either.” She hopped on a plane that same day, following the Viveve treatment, went home and went to work the next day. “There really was no pain afterwards at all, but it felt like it tightened things up.”
The Viveve procedure works by using a gentle deep heating and surface cooling to stimulate the body’s natural collagen formation process. A treatment tip delivers pulses of monopolar radiofrequency energy, which results in the heating of the connective tissue which results in a tightening of the muscles in the pelvic floor.
Many women who have mild to moderate stress urinary incontinence are excellent candidates for the Viveve Treatment. People who:
Experience urine leakage while exercising, running, jumping, sneezing or coughing
Have been pregnant or experienced childbirth
Have hormonal changes such as, perimenopause or menopause
Have had significant weight loss
Had a hysterectomy (or any other surgery that affects your pelvic floor)
About a week after the procedure, Tracey began to notice, “I am not leaking when I sit down to tie my shoes, when I go hiking or when I lift my luggage overhead.” Tracey was thrilled! In the month following the procedure, she found it just continued to get even better with time.
“I would do it again – It was a little miracle for me!”
Peeing during sex is very common. Approximately 60% of women with urinary incontinence leak during sex. Dr. Tessa Krantz answers common questions that many women are embarrassed to talk about or discuss with their provider.
What is the Difference Between a Squirting Orgasm, Female Ejaculation and Sexual Incontinence?
All three involve fluid coming from the bladder during sex.
Squirting is the expulsion of a large quantity of liquid during sexual stimulation. This type of orgasm includes a rapid ejection of urine from the bladder.
Female ejaculation is a release of both urine and a substance from the skene’s glands; the secretion is of thick, milky fluid
Sexual Incontenence aka Coital Incontinence is when someone loses control of their bladder during sex.
Ejaculation in people with vaginas may include a small release of a milky white liquid that does not gush out. Squirting, on the other hand, is usually a higher volume. It is possible to squirt and ejaculate at the same time.
What Other Research is Available?
The results of a few studies have indicated that Squirting, FE, and CI are different phenomena.
What Treatments Are Available?
There are several treatments available for coital incontinence. The most commonly suggested treatments include: Strengthening the pelvic floor with pelvic floor exercises that can be done on your own or with the assistance of pelvic floor physical therapists , bladder retraining and lifestyle changes. Some of the changes we recommend are:
Understand your triggers, and learn patterns to avoid before sex, including avoiding caffeine and alcoholic
Try different sex positions that place less pressure on the bladder
Empty your bladder before sex
Weight loss if overweight may help
Decrease fluids before sex
Lubrication- this will place less pressure on the bladder
If these treatments do not help, seek help from your provider, there are more options available! Dr. Tessa Krantz is a UroGynecologist at Urology Associates. For more information on women’s health topics, visit her Instagram @pelvichelp
Dr. James Fagelson designated as a Center of Excellence for GreenLight™ Laser Therapy, a Treatment for Benign Prostatic Hyperplasia (BPH), or Enlarged Prostate
Center of Excellence Recognizes High Degree of Experience with New Technology
Dr. Fagelson has been designated as a Center of Excellence for GreenLight™ Laser Therapy treatment – a minimally invasive outpatient procedure for men looking to treat their benign prostatic hyperplasia (BPH), not just the symptoms. GreenLight Therapy can help provide immediate relief from enlarged prostate symptoms such as frequent urination—especially at night, weak urine flow, urgency and incomplete bladder emptying. In addition, GreenLight Laser Therapy requires no incisions and typically has no overall impact on sexual function. The Center of Excellence designation recognizes Dr. Fagelson’s high degree of experience with GreenLight Laser Therapy and commitment to delivering effective, long-lasting therapy to men suffering from benign prostatic hyperplasia (BPH).
BPH is a condition in which a man’s prostate enlarges and squeezes the urethra, causing frustrating symptoms such as frequent or urgent urination, a weak or interrupted urine stream, and the need to get up several times a night to urinate. It affects about 50% of men by age 60, and up to 90% of men by age 85.
“Being designated as a GreenLight Center of Excellence is a meaningful recognition for us, as we strive to provide the best possible treatment of urological conditions for patients in the Denver area,” said Dr. Fagelson. “For years, the primary options for treating BPH were through behavior modifications, medications or invasive surgery. However, medications may not work for everyone. With GreenLight Therapy, we’re able to provide relief of BPH for men who do not want to take medication or want to avoid more invasive surgery.”
GreenLight Laser Therapy uses laser energy to vaporize the enlarged tissue, creating an open channel for urine to pass through the urethra. In addition to typically experiencing immediate improvements in urine flow, many patients are pleased to know that GreenLight typically has no overall impact on sexual function. GreenLight Laser therapy is a long-term solution without the need for BPH medication.
GreenLight Therapy is currently being used in many leading urology practices throughout the United States. To date, more than 1 million patients around the world have been successfully treated with GreenLight Therapy.
When does the population consume more cranberries and drink more cranberry juice than during the holidays? For some who suffer from urinary tract infections (UTI’s) they have a little cranberry juice or even a cranberry pill every day.
Urinary tract infections are common, in fact, they are the second most common infection that people seek treatment for. Over a lifetime, a woman has a fifty percent chance of having a bladder infection. But it’s not just women at risk for these pesky infections, men get UTI’s too. It just happens to be more common in women because they have a shorter urethra, in comparison to men, and that makes it easier for bacteria to get into the bladder.
The most common cause of a UTI is bacteria, but viruses and even yeast can also travel through the urethra and into the bladder causing an infection. There are also several medical conditions that can put one at higher risk for a UTI. Individuals with diabetes are at a higher risk, as we age the risk goes up, and women in menopause can have a higher incidence. Sexual intercourse can increase the risk and bowel conditions such as constipation or loose stools can also increase the risk of a UTI. It’s important to be aware of the signs and symptoms of an impending bladder infection, because if you catch it early, you may not need medical intervention.
Early symptoms of a UTI include:
Urgency to urinate
Discomfort – painful or burning sensation during urination
Frequency – visiting the bathroom frequently even if there is little urine
Advanced symptoms include:
More severe urgency and frequency
Cloudy, dark, foul-smelling or bloody urine
Difficulty urinating and emptying the bladder fully
Fever
Nausea or back pain
The first line of treatment for a suspected UTI can start at home – start by increasing your consumption of fluids. Make sure you are emptying your bladder often and fully. And finally, add a little cranberry to your diet. It is a farce that cranberry will cure a UTI; it will not kill the bacteria. It is a fact, however, that cranberry juice can be a part of the cure because cranberry actually prevents the adhesion of bacteria to the bladder wall allowing the body to win the battle against the infection. Some studies show that it provides up to an 80% reduction of bacterial adhesion. So, while cranberry doesn’t kill the bacteria, it does make it unable to grab onto the bladder wall and bacteria can then pass through and out of the bladder easier. Therefore, cranberries have been shown to reduce the risk of a symptomatic urinary tract infection by about 40%.
There are a couple ways to add cranberry to your diet. You can drink one 8 oz glass of cranberry juice each day, or for those who don’t like cranberry juice or are watching their sugar intake, they can take cranberry tablets, one pill should be equilivent to one eight-ounce glass. Both contain the active ingredient proanthocyanidins. This is what helps to prevent infection. Bladder infections can go away on their own – especially if you catch them early enoughand if you can take enough cranberry to help fight it off. If following these steps, you are still unable to get relief from your symptoms, see your health care provider to have a urinalysis and possibly a culture. If you have more than three infections in a year you should consider an evaluation with a urologist.
Each year there are more than 30,000 prostate cancer deaths that could be prevented through prostate cancer screening, which helps to find prostate cancer early, before there are any symptoms. In fact, most prostate cancer does not have any symptoms at all. However, when prostate cancer is not caught early, often urinary changes are the first thing that men notice. While urinary problems can be a result of the normal aging process, it can also be a sign that something is wrong. For individuals with symptomatic prostate cancer, they may experience:
A painful or burning sensation during urination or ejaculation.
Frequent urination, especially getting up at night to go to the bathroom
Difficulty stopping or starting urination.
Slower flow of urine
Blood in urine or semen
As cancer advances people may also have:
Unexplained pain in the back or spine
Unexplained weight loss
Your role in prostate cancer screening
The time to diagnose, treat and cure prostate cancer is through good screening versus waiting until symptoms arrive. Sometimes patients wait for their primary care doctor to guide them, however, due to some confusion in the frequency PSA testing guidelines, many primary care doctors are not familiar with the current recommendations, so you should be your own advocate and let your urologist be your guide.
A PSA test is a simple and inexpensive blood test that is used to detect prostate cancer. PSA testing works. Prior to regular PSA screening, in the mid 90’s, 75% of men who were found to have prostate cancer had metastatic disease. Meaning the cancer had spread outside of the prostate. Today, with regular PSA testing, urologists can find prostate cancer while it is localized to the prostate and when that happens, the cure rate is in the mid 90% range.
Urologists recommend a PSA screening at least every other year and for some at higher risk – every year. Men should think about starting PSA testing at age 55 and continue at least until they are 70, and even after 70, if healthy. Some higher risk individuals may need to start screening earlier. For those individuals who have a primary relative who has been diagnosed with prostate cancer and those who are African American it is recommended that they begin screening in their 40’s.
Early diagnosis is important as finds cancer before it has spread, and that leaves more options for treatment. Men should know that like mammograms for women, prostate cancer screening is not something to fear and preventive care should be a top priority. If the cancer is caught early, many of the treatments available today are less invasive and have very few side-effects while still having high rates of curing cancer. Now, we even have non-invasive treatments like Cyberknife, which can treat and cure cancer in a matter of weeks, more advanced surgical techniques and many opportunities to mitigate unwanted side effects and still cure the cancer. So don’t wait until you have symptoms – find a urologist and get on a schedule to be proactive and keep yourself in good health.
If prostate-specific antigen (PSA) levels remain high or become elevated after prostate cancer treatment, these are indications of a prostate recurrence. The approach for treating a prostate cancer recurrence varies based on a number of factors including the following.
The type(s) of previous cancer treatment(s) received by the patient.
The extent and location of the cancer recurrence.
The age of the patient and other existing medical conditions.
Patients treated with traditional surgical, radiation and chemotherapy treatments often require follow-up treatment. CyberKnife can be used in conjunction with traditional cancer therapies, as well as immunotherapy and proton therapy, to manage and reduce prostate cancer recurrences.
Prostate cancer recurrence is often emotionally deflating for patients who have already endured treatment and their loved ones. Fortunately, Anova Cancer Care’s CyberKnife radiotherapy treatment may be an appropriate therapy option for recurrent cancers, with fewer side effects and less down time.
How oncologists diagnose prostate cancer recurrence
After prostate cancer treatment, the amount of PSA in a patient’s blood typically drops and remains stable. Following treatment, many men receive regular medical checkups that include routine PSA testing. If PSA levels begin to rise, it can be a sign of a prostate cancer recurrence.
Additional testing may be required to determine if rising PSA levels indicate a recurrence or the spread of the cancer to other parts of the body. Doctors may use X-rays, bone scans or perform an Axumin PET scan, which uses calcium-related radioactive substances to locate cancerous cells throughout the body. Unlike standard methods of screening, which require PSA levels in the 10-50 range to detect cancer, Axumin can identify cancerous tissue in patients with PSA levels under 10.
Types of prostate cancer recurrence
The two major types of prostate cancer recurrence that can be treated using CyberKnife are local and distant. Prostate cancer recurrences in the tissue surrounding the prostate, such as in the seminal vesicles, pelvic floor muscles or rectum, are known as local recurrences. Cancer recurrence outside the pelvis is known as a distant recurrence or metastatic cancer recurrence, for example, if a tumor has developed within distant lymph nodes.
In some cases, an individual may experience heightened PSA levels with no other clear indication of a cancer recurrence. For example, there may be no visible instances of cancer in the patient’s imaging tests. Patients with slow growing prostate cancers such as this may opt for active surveillance over treatment.
Likelihood of prostate cancer recurrence
Upon a patient’s initial diagnoses, several factors can point to an increased risk of prostate cancer recurrence. These include the size of the tumor, the stage/grade of cancer and whether the cancer has affected any of the lymph nodes.
Patients who have been diagnosed with more advanced stages of prostate cancer and patients who have higher Gleason scores (or grades of prostate cancer) are more likely to experience a recurrence. Patients who have larger tumors, or whose lymph nodes have been affected by prostate cancer, are also more likely to experience a recurrence.
CyberKnife for prostate cancer recurrences
CyberKnife offers patients precise treatment of recurring cancer tumors, with minimal side effects. CyberKnife stereotactic treatment is noninvasive, requires fewer sessions than traditional radiation, is often more effective than traditional treatments, and is often more comfortable for the patient than treatment alternatives. Unlike common treatments for prostate cancer recurrence such as radical prostatectomy and cryotherapy, CyberKnife carries little risk of causing incontinence, erectile dysfunction or lower sex drive.
Recurrent prostate cancer patients with hard to reach or inoperable distant tumors, and patients looking to avoid the harsh side effects and complications of other treatment options, should discuss CyberKnife with their physician. It’s important that these patients discuss their full medical history and previous cancer treatment protocols with their care team to determine an appropriate treatment plan.
CyberKnife after radiation therapy
CyberKnife can be a safe and effective alternative for patients who have previously undergone traditional radiation therapies, as these patients are often not eligible to undergo radiation therapy again due to an increased risk of severe side effects.
