Prostate laser surgery is used to relieve moderate to severe urinary symptoms caused by an enlarged prostate — a condition known as benign prostatic hyperplasia (BPH).

During prostate laser surgery, the doctor inserts a scope through the tip of the penis into the tube that carries urine from the bladder (urethra).  A laser passed through the scope delivers energy that shrinks or removes excess tissue that is preventing urine flow.

Laser surgery can offer several advantages over other methods of treating BPH, such as transurethral resection of the prostate (TURP) and open prostatectomy. The advantages can include lower risk of bleeding, shorter or no hospital stay, quicker recovery, less need for a catheter, faster results, compared with several weeks to months to see a noticeable improvement with medications.

Deep brain stimulation (DBS) treatment is a common surgical treatment for Dystonia.

Dystonia symptoms result when excessive signaling from the brain causes involuntary muscle contractions and movements. The stimulation delivered to the brain by the DBS stimulator suppresses theses excessive signals, thereby lessening the dystonia symptoms.

Based on the research to date, individuals who have isolated (primary) dystonia are likely—but not guaranteed—to have the best outcomes from DBS, and perhaps those who are younger, test positive for the DYT1 dystonia gene mutation, and are treated relatively early on in the dystonia progression. Individuals with severe cervical dystonia or dystonia acquired by drug exposure (tardive dystonia) may also be good candidates for DBS. Individuals with other forms of acquired (secondary) dystonia should be evaluated on a case by case basis. There are also promising data on the use of DBS to treat myoclonus dystonia and focal dystonias, include cranial dystonias such as blepharospasm and oromandibular dystonia.

Ultimately, DBS may be considered if medications and other treatments have failed, and if the symptoms negatively affect quality of life to the extent that the surgical risks are justified. The first step in the evaluation process for DBS is to meet with a DBS-trained movement disorders neurologist.

In DBS surgery, thin wires called electrodes are placed into one or both sides of the brain in specific areas (either the subthalamic nucleus or the globus pallidus interna) that control movement. Usually a person remains awake during surgery so that he or she can answer questions and perform certain tasks to make sure that the electrodes are positioned correctly. Once the electrodes are situated, they are connected to a battery-operated device (similar to a cardiac pacemaker) that is typically placed under the skin below the collarbone. This device, called a neurostimulator, delivers continuous electrical pulses through the electrodes to decrease Parkinson’s symptoms.

A few weeks after surgery, a movement disorder specialist uses a handheld programmer to set parameters, tailored to each individual’s unique symptoms, into the neurostimulator. The DBS settings are gradually tweaked over time and medications are simultaneously adjusted. Most people are able to decrease (but not completely discontinue) Parkinson’s drugs after DBS. Determining the optimal combination of drugs and DBS settings — that which gives the most benefit and the least side effects — can take several months and even up to a year.

You may be surprised to learn that a heart bypass operation actually includes two different surgical procedures.

First, one or more healthy blood vessels are removed (or harvested) from your chest, leg, or arm to be used in creating the bypass or bypasses.

Next, the surgeon uses this healthy vessel to create the bypass, or detour, around the damaged or blocked artery or arteries in the heart to restore blood flow.

Endoscopic vessel harvesting, known as EVH, can be used to remove the saphenous vein from the leg or the radial artery from the arm.

EVH uses special instruments to view and remove a blood vessel through a small incision. EVH not only causes much less pain and scarring, but it also means that patients can recover more quickly, return to normal mobility, and begin their cardiac rehabilitation program sooner.

When compared to the older techniques for vessel harvesting, EVH offers:
– Significantly less risk of infection and wound complications.
– Less postoperative pain and swelling.
– Faster recovery with minimal scarring.

EVH is a good option for many patients. However, since each person is unique, you should discuss your choices with your doctor.

Hydrocephalus is the result of an imbalance of the distribution of cerebrospinal fluid.

The three types of hydrocephalus include:
– Non-communicating (obstructive) hydrocephalus – Occurs when cerebrospinal fluid flow is blocked within the ventricular system.
– Communicating (non-obstructive) hydrocephalus – Occurs where there is inadequate cerebrospinal fluid absorption.
– Normal pressure hydrocephalus (NPH) – An increase in the amount of cerebrospinal fluid in the brain’s ventricles with little or no increase in the pressure inside the head; most often seen in adults over age 60

Both non-communicating and communicating hydrocephalus can be either “congenital” (existing before or at birth) or “acquired” (developing after birth due to trauma or disease).

Symptoms
In infants and toddlers, the bones of the skull are not yet closed, and hydrocephalus may be obvious. The child’s head will enlarge, and the fontanel (soft spot) may be tense and/or bulging. The skin may appear thin and shiny, and the veins of the scalp may appear full or engorged.

Symptoms may include:
– Vomiting
– Poor feeding
– Listlessness
– Irritability
-Constant downward gaze of the eyes
– Occasional seizures

In older children and adults, the bones of the skull have closed. These individuals have symptoms of increased intracranial pressure due to ventricular enlargement from the extra cerebrospinal fluid, which causes compression of the brain tissue.

Symptoms may include, but are not limited to:
– Headache
– Nausea
– Vomiting
– Visual disturbances
– Poor coordination
– Personality changes
– Lack of concentration
– Lethargy

The signs and symptoms of increasing intracranial pressure are likely to change over time, as the cranial sutures (the joints between the bones of the skull) begin to close in the infant and toddler and become fully closed in older children.

Treatment
Shunts may let people with hydrocephalus enjoy full and active lives.
Shunts typically consist of two catheters and a valve that redirect excess fluid from the brain’s ventricle to another part of the body. A shunt, is usually implanted in less than an hour, and provides lasting relief to people with hydrocephalus.

Like any open surgery, however, the procedure carries certain risks that you need to discuss with your doctor.

The Intraoperative Radiation Therapy (IORT) method is a simplified alternative to traditional six-week radiation therapy for early-stage breast cancer treatment.

The IORT device delivers low-energy, high-dose radiation directly to the tumor bed (the cavity left after the tumor has been removed from the breast) in the operating room, right after the tumor has been removed.
After the lumpectomy, a spherical applicator on the IORT device is placed directly into the tumor bed and delivers a smaller dose of x-rays than is delivered in standard radiation therapy. The IORT treatment usually takes about 30 minutes. This helps significantly reduce the risk of damage to nearby healthy tissue including the heart, lungs, and ribs.

A patient must be a surgical candidate in order to be eligible for breast cancer IORT. This treatment is generally suitable for patients with early-stage disease.

An ischemic stroke is caused by a blockage of blood flow within a blood vessel in the brain. The brain cells downstream of the blockage are deprived of oxygen and nutrients and will quickly die if left untreated. The death of enough brain cells can result in permanent disability or death.

Carotid artery disease is a narrowing of the carotid arteries. The disease decreases the amount of blood flow to the brain and increases the risk of stroke.

Signs you may be having a stroke include:
– Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
– Sudden confusion, trouble speaking or understanding.
– Sudden trouble seeing or blurred vision in one or both eyes.
– Sudden trouble walking, dizziness, loss of balance or coordination.
– Sudden severe headache with no known cause.

To help spot a stroke we use the acronym FAST:
– Facial drooping – one side of the face droops when the person tries to smile.
– Arm weakness – one arm drifts downward when the person tries to hold both arms up.
– Speech difficulty – the person exhibits slurred or strange speech.
– Time to call an ambulance.

Carotid artery disease may not cause signs or symptoms until it severely narrows or blocks a carotid artery. Signs and symptoms may include:
Bruit: During a physical exam, your doctor may listen to your carotid arteries with a stethoscope. He or she may hear a whooshing sound called a bruit. This sound may suggest changed or reduced blood flow due to plaque buildup. Not all people who have carotid artery disease have bruits.

TIA or IS:
– A sudden, severe headache with no-known cause.
– Dizziness or loss of balance.
– Inability to move one or more of your limbs.
– Sudden trouble seeing in one or both eyes.
– Sudden weakness or numbness in the face or limbs, often on just one side of the body.
– Trouble speaking or understanding speech.
– Even if the symptoms stop quickly, call for emergency help. Do not drive yourself to the hospital. It’s important to get checked and to get treatment started as soon as possible.

Kidney stones can become trapped anywhere in the urinary tract, including the kidney and the ureter. If a stone gets stuck in the ureter it can cause a blockage and the back-up of urine into the kidney. They can also be quite painful.

Laser lithotripsy may be chosen if other non-surgical treatments have failed or if kidney stones are:
– Too large to pass
– Irregular in shape
– Causing bleeding or damage to surrounding tissue.

Laser lithotripsy is typically performed as a same-day procedure with the patient under general anesthesia. During the procedure, the urologist passes a small scope through the urinary opening into the bladder and from there up into the ureter, the small tube that drains urine from the kidney to the bladder. Once the stones are located, they are targeted with a laser that breaks the stone into smaller pieces, which are then extracted, or into tiny pieces of dust that wash out of the kidney with normal urine flow.

Advantages of the laser lithotripsy treatment include:
– Excellent results for small- and medium-sized kidney stones
– No incisions
– Easy and fast recovery (often within the same day)
– Minimal risk of infections and post-operative complications
– Can be performed without long and complicated preparation of the patient (fast and effective).

Deep brain stimulation (DBS) is a surgery to implant a device that sends electrical signals to brain areas responsible for body movement. Electrodes are placed deep in the brain and are connected to a stimulator device. Similar to a heart pacemaker, a neurostimulator uses electric pulses to regulate brain activity. DBS can help reduce the symptoms of tremor, slowness, stiffness, and walking problems caused by Parkinson’s disease, dystonia, or essential tremor. Successful DBS allows people to potentially reduce their medications and improve their quality of life.

In deep brain stimulation, electrodes are placed in a specific area of the brain depending on the symptoms being treated. The electrodes are placed on both the left and right sides of the brain through small holes made at the top of the skull. The electrodes are connected by long wires that travel under the skin and down the neck to a battery-powered stimulator under the skin of the chest (Fig. 1). When turned on, the stimulator sends electrical pulses to block the faulty nerve signals causing tremors, rigidity, and other symptoms.

You may be a candidate for DBS if you have:

– a movement disorder with worsening symptoms (tremor, stiffness) and your medications have begun to lose effectiveness.
– troubling “off” periods when your medication wears off before the next dose can be taken.
– troubling “on” periods when you develop medication-induced dyskinesias (excessive wiggling of the torso, head, and/or limbs).

Postpartum hemorrhage is excessive bleeding following the birth of a baby. About 1 to 5 percent of women have postpartum hemorrhage and it is more likely with a cesarean birth. Hemorrhage most commonly occurs after the placenta is delivered. The average amount of blood loss after the birth of a single baby in vaginal delivery is about 500 ml (or about a half of a quart). The average amount of blood loss for a cesarean birth is approximately 1,000 ml (or one quart).

There are many techniques delivery specialists use to reduce the incidence of postpartum hemorrhage. However, if such incidence occurs there is a solution that is considered a “gold standard” in preventing complications with postpartum hemorrhage.

Bakri® Postpartum Balloon is used to provide temporary control or reduction of postpartum uterine bleeding when conservative management is warranted. Bakri® can be used following vaginal or cesarean delivery.

Ask your birth clinic how they manage postpartum hemorrhage incidents.

Treatment via InterStim is a reversible therapy used to treat urinary incontinence, frequency and incomplete bladder emptying. Bladder incontinence is commonly regulated using non-invasive pharmaceutical measures that target the bladder muscles themselves.

InterStim is recommended for those patients who have not responded well to other forms of bladder treatment or who cannot tolerate the side effects.

An implantable device is used and sends mild electrical pulses to the sacral nerves. Located near the tailbone, the sacral nerves control the bladder and the muscles related to urinary function. If the brain and sacral nerves don’t communicate correctly, the nerves can’t tell the bladder to function properly. This communication problem can lead to symptoms of overactive bladder.

What types of bladder control problems does InterStim therapy help?
– Urge Incontinence: loss of urine when you feel a strong need to go to the bathroom.
– Urinary retention: Not being able to empty the bladder and having to use a catheter to empty.
– Urgency, frequency: feeling like the bladder is not emptying, passing only small amounts of urine and urinating frequently.

During the InterStim procedure, a surgeon makes two small incisions: one in the lower back, where an electrode is inserted next to the sacral nerves, and one just above the waistline, where the neurostimulator is implanted beneath the skin. The neurostimulator sends electrical pulses to the electrode, where it controls the nerve that is responsible for bladder and bowel control.