Overactive Bladder
Overactive bladder can occur in both men and women, and is approached in a step-wise fashion. The first step includes things you can do for yourself, including fluid intake modification, avoiding bladder irritants, leg elevation, etc. Step two is the use of medications to control OAB symptoms. Third line therapies are used when medication and behavioral modification does not work. The following therapies are available at Gaia Urology:
Interstim Sacral Neuromodulation
Nerve stimulation implant for people with resistant overactive bladder.
Botox
Botox injection into the bladder muscle, a treatment for resistant overactive bladder
Posterior Tibial Nerve Stimulation
An acupuncture-like treatment, a very thin needle is placed behind the ankle, and an electrical current is applied, stimulating the posterior tibial nerve.
Stress Incontinence
There are multiple therapies aimed at correcting stress incontinence. At Gaia Urology, we can help you decide which therapy will work best for you.
Pelvic Floor Exercises
Kegels, or Pelvic Floor Exercises, can work if they're done correctly. We believe in the three C's: Correctly, Consistently, and in a Coordinated Manner. We use Pelvic Floor Physical Therapists to help people learn their Kegels.
Collagen Injections
Office based procedure for women with stress incontinence. Done under local anesthetic.
Sling Bladder Neck Suspension
Definitive surgical treatment for stress incontinence, often combined with surgery for pelvic organ prolapse.
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Prolapse
Women are often told that their "bladder has dropped." Prolapse occurs in differing degrees, and is associated with varying symptoms, or none at all. Treatment is aimed at the bothersome symptoms associated with prolapse.
Observation
If you have minor prolapse, or even more significant prolapse with no symptoms, you may not have to do anything. An exam and a consultation may be all that is necessary.
Pessary Insertion
A pessary is a rubber device, designed to push and hold prolapsed organs back into the vagina. They are somewhat like diaphragms used for birth control. If you desire a non-surgical approach, this may work for you.
Pelvic Floor Reconstruction
Significant prolapse can be definitively repaired with surgery. Depending on the defect, the bladder, the uterus, or the rectum can be repositioned into the pelvis.
Vaginal Rejuvenation
Women are all too familiar with the changes that come with menopause. Vaginal laxity and dryness, painful intercourse, or general discomfort all have treatments that can be helpful.
Medication
Treatment is aimed at restoring the vaginal mucosa. Estrogen cream and non-estrogen alternatives are offered.
Thermiva Radio Frequency Treatments
Vaginal laxity/dryness treatment given in a safe, private environment.
Nighttime Voiding
Up all night peeing? Recent research has introduced new medication for people who void more than two times at night. If you're up all night, despite simple behavioral changes, please consult about this new development.
Kidney Stones
A common and painful medical condition, Dr. Pursell has 22 years of experience dealing with both acute and chronic kidney stones.
Lithotripsy
Non-invasive procedure to break up kidney stones. Most useful in stones that are still in the kidney.
Holmium Laser Treatment
Using a telescope, a laser can be brought to the level of the stone, and used to break it into tiny pieces.
Medical Therapy
Often, small stones can be passed with the help of medications.
Long Term Management and Prevention
For people with recurrent stone episodes, blood and urine testing can help pinpoint correctable defects, and decrease future stone recurrences.
Urinary Tract Infections
Bladder infections are a common, painful, and irritating problem. We see patients with recurrent urinary tract infections to devise strategies of prevention and management.
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Blood in the Urine
Hematuria, or blood in the urine, is always a concerning symptom and usually needs a work up to rule out serious medical conditions. We see patients in clinics that offer radiology and lab services in the building, and can do a comprehensive work up for blood in the urine.
Hormone Replacement Therapy (Testosterone)
Many people find benefits in hormone replacement therapy—testosterone replacement can be used to treat fatigue, decreased libido, muscle weakness, weight gain, night sweats, and depressed mood. Testosterone can also be used to treat some of the symptoms of menopause. Dr. Pursell can advise patients if hormone replacement therapy is appropriate, and what type of treatment they can pursue.
Injections
A schedule of injections can be offered at both our offices.
BioTE Hormone Pellet Implants
Hormone pellets are implanted, and depending on the patient need to be replaced every 4 to 6 months.
Other Conditions
Urinary Retention
The inability to urinate. Can occur in both men and women. Treatments can range from medications to surgery. We focus on minimally invasive treatments for this problem.
Bladder Cancer
Dr. Pursell is well trained in the treatment of bladder cancer. The key to successful treatment is a complete removal of the tumor and careful surveillance. Invasive tumors are referred to tertiary care centers.
