Treatment for Men's Urination Challenges in NJ | Hackensack Meridian Health Urology   

Men's Urination Problems

If you are having trouble with urination, you can trust the experts at Hackensack Meridian Health to diagnose and treat your condition so you can regain your quality of life.

You should see a urologist if you’re experiencing changes to your urinary habits, such as:

  • Frequent trips to the bathroom
  • Incontinence or leaking urine
  • Weak urine stream
  • Trouble getting your urine stream started and completely stopped
  • Inability to completely empty your bladder

Diagnosing Urination Problems

Your urologist will conduct an exam and tests to determine if you have a urinary condition.

A urine sample is checked for signs of infection, traces of blood or other problems.
 
You keep a record over several days of how much you drink, when you urinate, the amount of urine you produce, whether you had a sudden urge to urinate and the number of times you leak urine.
After you urinate into a container, your doctor will measure the urine left in your bladder using ultrasound. A large amount of leftover urine in your bladder may mean you have a blockage in your urinary tract or a problem with your bladder nerves or muscles.
This advanced tool is important for diagnosing incontinence. A small, pediatric-sized catheter gently inserted through your urethra is used to fill your bladder with water while a pressure monitor measures the pressure within your bladder.
This test measures the amount of PSA in your blood and helps rule out prostate cancer.
 

Treatment Options for an Enlarged Prostate

Your urinary problems may be caused by an enlarged prostate. Enlarged prostate or benign prostatic hyperplasia (BPH) occurs in almost all men as they age and is common starting at age 40 and older. Symptoms usually begin slowly and then suddenly become more bothersome.

Your urologist will assess your condition and the severity of your symptoms before developing a personalized treatment plan for you. If surgery is recommended, our urologists are skilled at performing the latest, most minimally invasive procedures.
Your doctor may prescribe medication that relieves symptoms or reduces the size of your prostate. Depending on your condition, your doctor also may prescribe a combination of medications.
 

AquaBeamAquablation® therapy is an option for men whose prostate enlargement cannot be effectively treated using prostate-shrinking medications. Aquablation therapy is performed using the AquaBeam Robotic System, guided by real-time imaging to deliver treatment with extraordinary precision. Aquablation therapy is indicated for any man whose prostate is causing an obstruction, and who cannot achieve relief with medication or do not want to take these drugs. Learn more about Aquablation.

"Aquablation therapy is as effective as these other treatments but with fewer side effects, including only a 10-15% risk of retrograde ejaculation," explained Ravi Munver, M.D., vice chair of Urology at Hackensack University Medical Center. "Because it is performed using the surgical robot with ultrasound guidance, it can be completed more rapidly, and with a level of precision that is reproducible from surgeon to surgeon. You can see where the prostate capsule ends and remove more excess tissue. Aquablation therapy is the only heat-free ablation approach available to treat BPH."

Here's how it works: The patient is asleep under anesthesia. An ultrasound probe is inserted into the patient's rectum to produce clear real-time images of the prostate. The addition of ultrasound imaging enables the surgeon to map the parts of the prostate to remove and the parts to avoid. The Aquablation scope is inserted into the urethra. When ready to begin, the surgeon presses on a pedal and the Aquablation system advances to the prostate, delivering a heat-free waterjet so intense that it can remove the prostate tissue that has been mapped out.

Using minimally invasive techniques, small incisions are made in your prostate to relieve pressure on your urethra.
Using the GreenLight™ laser therapy system, pulses from a high-powered laser vaporize your overgrown prostate cells.
Typically performed only if the prostate is very large or if there are other complications, the inner part of your prostate gland is removed using robotic technology, leaving the outer part of your prostate intact. The procedure is performed through several small incisions in your abdomen and a small opening in your bladder neck.
UroLift® is an advanced procedure that uses permanent implants to hold enlarged prostate tissue out of the way so it no longer blocks the urethra.

Incontinence Causes, Types and Treatments

Incontinence, or leaking urine, can be embarrassing and affects your ability to participate in normal activities. Once we have established a diagnosis of the cause and type of incontinence, our team will create a treatment plan specifically for you.
  • Previous prostate treatment
  • Urinary tract infections
  • Bowel problems
  • Prostate problems
  • Kidney or bladder stones
  • Neurological problems, such as Parkinson’s disease or stroke
 
  • Stress incontinence: urine leakage caused by pressure on your bladder when coughing or sneezing
  • Urge incontinence: when you feel a strong need to urinate
  • Overflow incontinence: when your bladder becomes too full 
  • Behavior and bladder training: This may include delaying urination to lengthen the time between trips to the toilet, learning to fully empty your bladder, and managing the amount and types of fluids you drink.
  • Pelvic floor therapy: Our specially trained nurse will teach you to perform specific exercises such as Kegels that strengthen the muscles that control urination.
  • Medications: A number of medications are available to help manage incontinence and overactive bladder.
  • Percutaneous tibial nerve stimulation (PTNS): PTNS works by indirectly providing electrical stimulation via a nerve in your ankle to the sacral nerves responsible for bladder control. The stimulation gradually improves bladder activity. This outpatient treatment is delivered in weekly 30-minute sessions for about 12 weeks.
  • Botulinum toxin type A (Botox®): Botox is injected into the bladder muscle to relax it and allow the bladder to fill with more urine before you have the urge to go to the toilet.
  • Sacral nerve stimulation: A device like a pacemaker is implanted under your skin to deliver ongoing, painless electrical pulses to the sacral nerves involved in bladder control. Stimulating these nerves can control incontinence. This device may be implanted under the skin in your buttock and connected directly to the sacral nerves or may deliver pulses to the sacral nerves via a nerve in your ankle.
  • Artificial sphincter: A device made of silicone rubber is placed around your urethra. The device can be inflated or deflated to control urination.
  • Male urethral sling: A synthetic mesh-like surgical tape is placed under the urethra to provide support and prevent leakage of urine.
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