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October 2019

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Recurrent Urinary Tract Infections

by Matthew E. Karlovsky, M.D. for Health

Recurrent urinary tract infections (UTIs) are defined as two or more UTIs within a twelve month period. They are bacterial infections that typical involve the bladder. Classic symptoms include lower abdominal pain or ‘pressure’, urinary burning, urgency, and frequency. If the kidney is also involved, back pain and fever may be present as well. The majority of UTIs in women are uncomplicated and involve only the bladder. Complicated UTIs are those involve the kidney or occur in pregnancy, diabetics, transplant patients, frail elderly, in weakened immune systems, or with urinary tract structural or anatomic abnormalities.
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Urinary Incontinence Treatment Options

by Matthew E. Karlovsky, M.D. for Health

There are a variety of ways to treat or even completely control urinary incontinence, but it depends on the cause. While there are sometimes multiple factors in play that cause this condition, treatment options are limited by patient motivation, cognitive level, physical impairment, or anatomic abnormalities of the urinary tract. For most, conservative management is the first line strategy and often is quite successful in decreasing the severity of leakage.
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Female Urology, Prolapse and Voiding Dysfunction

by Matthew E. Karlovsky, M.D. for Health

Pelvic organ prolapse is a very common condition – approximately 50% of women who have had even one childbirth will lose pelvic floor strength and about approximately 10 to 38% of these women, between 15 to 60 years of age will experience symptomatic prolapse. The incidence increases with advancing age. Every year close to 350,000 women undergo surgical interventions for the disorder. This places a severe social and economic burden on the society.  The lifetime risk for a woman to undergo surgery for a pelvic disorder is approximately 11%. Frequency of surgery will increase as women are living longer and the lifetime risk is projected to double for women between the ages of 30 and 89.
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A Brief Primer on Kidney Stones

by Matthew E. Karlovsky, M.D. for Health

Kidney stones, or calculi, can form at any age but are more common in adults. Stones represent an imbalance of certain byproducts in the urine that when high enough can form little crystals, or early stones. Once a crystal forms, stones then develop over months to years. Stone disease tends to run in families, and up to 10 percent of the adult population will develop kidney stones at some point in their life.

It’s important to remember that kidney stones are not related to gallstones. They can form on the inside of either kidney, usually at night while we sleep, and are silent when growing. There are multiple urine and digestive byproducts that can bind together to form stones if high enough in concentration. Other urinary byproducts can actually prevent stones, but if these are abnormally low in concentration, they can also lead to stone formation.
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What is Urinary Incontinence?

by Matthew E. Karlovsky, M.D. for Health

Urinary incontinence (UI) is the involuntary loss of urine. The problem afflicts an estimated 13 million adults in the United States, 85% of them being women. Because of the embarrassment of UI, only a 1/3 to ½ of people that have UI seek treatment, yet UI can be improved in approximately 8 out of 10 cases. Often, women with UI are reported to be depressed and/or embarrassed about their appearance and odor. Consequently, social interaction with friends and sexual activity may be avoided. In a survey of American women from 2002, 26% reported experiencing UI over the last year, and 37% over the past thirty days. UI begins to be reported by women in their thirties, but even women active into their eighties experience it.
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