Micro Blog Articles by Henry Rosevear, MD

So, you’ve got a stone. Not the best news you’ve heard this week but, well, it could be worse.

Now you need to decide what to do about it.  The good news is that whatever modality you chose to treat your stone, you will most likely be rendered stone free with nothing more than a simple outpatient procedure.

For most patients, the decision of how to treat a stone comes down to undergoing shockwave lithotripsy vs ureteroscopy and laser lithotripsy.  Yes, there are other options including percutaneous (through the skin) approaches for very large stones but for most stones, a minimally invasive procedure will work very well.

With that in mind, I thought I would walk everyone through the pros and cons of shockwave lithotripsy vs ureteroscopy and laser lithotripsy.

Shockwave lithotripsy involves a patient going to sleep (general anesthesia) and the surgeon then applying concentrated sound waves to the stone to break it up.  To be a candidate for this procedure, the stone should be in the kidney, it needs to be visible on fluoroscopy and the distance between the stone and your skin cannot be excessive.  The advantages of this procedure include its noninvasive technique and its high success rate.

An alternative is to use ureteroscopy and laser lithotripsy.  All stones and all patients are candidates for this procedure though it tends to work best on smaller stones in the ureter.  The advantages of this procedure include its higher stone free rate as compared to shockwave lithotripsy but it does have the disadvantage of being more invasive.

Here at Pikes Peak Urology, we offer all treatment options for stones and we understand that passing a stone is an incredibly painful experience and we strive to treat all of our patients in a safe and expeditious fashion. If you have any questions, please call my office at 531-7007 to make an appointment.

Continuing my effort to provide access to the latest and greatest in cutting edge research, a group from Iowa (my alma mater for what that is worth) just published research showing that eating fried food increases your risk of heart disease.

A truly amazing conclusion worthy of an Ig Nobel.

For those who have any question on what a heart healthy diet is composed of, I recommend reading this website from the Mayo Clinic. Staying healthy isn’t hard, diet, exercise and have fun!

Diagnosing someone with kidney cancer (otherwise known as renal cell carcinoma) that has left the kidney (known as metastatic) is one of the worst parts of this job. 

Luckily, a new study just showed that patients with metastatic renal cell carcinoma benefit greatly from a combination of upfront chemotherapy followed by aggressive removal of any remaining tumor.

The SURTIME trialed randomized almost 100 patients who presented with metastatic renal cell carcinoma to either surgery then sunitinib (a strong chemotherapy) or upfront sunitinib followed by surgery in those patients that responded and found that those patients who were given chemotherapy upfront survived longer.

The details of the study though raise questions about the effectiveness of this protocol on overall survival though so if you or a loved one was recently diagnosed with metastatic renal cell carcinoma and want to learn more, please call my office for an appointment.

I recently saw a young man in clinic who presented with a large testicular mass.  As I was explaining the situation to the patient and his family, I could clearly sense a feeling of regret as the patient and his family realized that there had been a long delay in diagnosis due to the patient simply not being aware of the signs of testicular cancer.

As such, I thought it would be worth the time to review the most common (though certainly not an all-inclusive) signs of testicular cancer.

Signs or symptoms of testicular cancer:

Painless lump or swelling on either testicle. This is the most common symptoms of localized disease and all hard lumps in the scrotum demand immediate evaluation by a urologist. 

A change in the way a testicle feels. I’ve heard this described as a “heaviness in the scrotum” or a “dull ache in the lower abdomen or groin.

Breast tenderness or growth. This is much less common but some testicular tumors make hormones that cause breast tenderness or growth of breast tissue.

Other symptoms such as back pain, shortness of breath, chest pain, swelling of one or both legs and bloody sputum or phlegm can be symptoms of late stage testicular cancer.

If you have any doubts, please call and make an appointment. Testicular cancer is one of the most curable types of cancer assuming that it is diagnosed early.

It’s that time of year again, the time when people make New Year’s resolutions and what more common resolution is there than to lose weight?

But does weight loss help you urologically?

YES!  Obesity is the number one cause of kidney cancer. In addition to that, weight loss has strong links to urinary leakage, erectile dysfunction, infertility and kidney stones.

No one is says that losing weight is easy and if I knew of a magic pill, I’d be home spending more time with my daughters than I currently do, but losing weight is possible.  And let’s be honest, while there are certainly urological advantages to staying fit, the major benefit of losing weight is better cardiovascular health which is the number one killer of Americans.

Whatever your resolution for 2019 is, I wish you the very best and brightest over the upcoming year. Happy New Years everyone!