The votes are in and Dr. Edward (Ted) Eigner has once again been recognized as one the Denver/Boulder 5280 Top Docs in the field of Urology. The Top Doctors recognition is a unique honor, because each doctor on the list has been nominated and chosen by other doctors across the metro area. The annual Top Doctors nominating and voting process is an opportunity for doctors across Denver to nominate their favorite and most respected doctors – those that they would trust to provide care for themselves or their family. Often 5280 Top Doctors are chosen for their compassionate care, excellent communication skills and their expertise in specialty care.

“My greatest strength is my commitment to individualized care. I treat all my patients in a caring and compassionate manner through the evaluation and treatment of their urologic problems,” says Dr. Eigner.

Dr. Ted Eigner has had the honor of being chosen as a 5280 Top Doc twelve times during his career as a urologist. He is a specialist in general urological care, robotic surgery, advanced care for prostate cancer and kidney stone disease. He trained at Stanford University and came to Denver in 1992 where he joined Urology Associates.

Urology Associates is honored to continue to have our doctors chosen as 5280 Top Doctors and our whole team stands ready to care for patients across the metro area and beyond.

A big congratulations to the entire team of leaders at Urology Associates and Anova Cancer Care for completing the Lean Facilitator training. This training focuses on lean concepts including creating robust standard work, reducing waste from our daily processes and driving sustainable change.
A common misconception is that “lean” is just a way to reduce costs. That is not the case. Instead, lean process improvement is a way of thinking and operating as an organization – a way to evaluate every process and continuously look for ways to improve. Lean process improvement takes a team and together we seek to:
• Increase patient satisfaction
• Minimize waste
• Reduce inventory
• Increase productivity
• Improve quality of care
• Reduce costs
With the guidance of our CEO, Rebecca Israel (LSS Master Black Belt) who has implemented lean process improvement in some of Colorado’s largest hospitals and healthcare organizations, our team completed several months of training.

A big congratulations to Patti Moyer, Cindy Maytorena, Tracey Hutchison, Marissa Flood, Erin Pade, Nicole Romero and Holly Harmon for their hard work and dedication in completing the training. Some of their favorite takeaways included:

• Take what you learn and use it in your daily work
• Every problem should be viewed as an opportunity
• Waste is disrespectful
• Changing processes takes trial and error and continuous improvement (Kaizen)
• Use the poka yoke method to mistake proof your work
• Don’t swallow the whole elephant – you can improve small pieces of the process

Our whole leadership team is excited to use lean guiding principles to reduce cost, improve productivity and most importantly, deliver exceptional patient care outcomes to those we serve.

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.

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

 

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.