Specialties

Biofeedback/Pelvic Muscle Therapy (for Women and Men)

Problems related to bladder control and discomfort certainly impact quality of life for both women and men and can prevent people of all ages from fully participating in their normal activities. Biofeedback/Pelvic Muscle Therapy for women and men is an office -based treatment that provides a safe, well tolerated therapy for bladder control problems. It is a treatment option for urgency and frequency bladder syndromes, stress urinary incontinence and mild to moderate pelvic relaxation. This treatment consists of a behavioral modification program to retrain the pelvic floor musculature with EMG or pressure directed pelvic floor exercises and electrical stimulation.

Our complete training program helps control bladder function by:

• Monitoring voiding patterns;
• Adjusting diet and fluid intake;
• Retraining voiding habits;
• Relaxation training;
• Avoiding environmental irritants;
• Attention to weight loss and physical fitness;
• Encouraging a home exercise regime; and 
• Facilitating clinical office sessions for muscle retraining (Biofeedback +  Electrical Stimulation).

Triangle Urology Associates, P.A.’s Pelvic Muscle Therapy program for women and men uses Hollister equipment and consists of Pressure Manometry, EMG and Electrical Stimulation. During the pelvic muscle retraining sessions a small sensor is placed either in the vagina or rectum and connected to the EVADRI Hollister System. The device is made to gently stimulate the pelvic floor muscles to contract at various intervals using a specific hertz frequency. Painless electrical signals are sent to the weakened pelvic muscles, causing them to contract effectively. The key to success is the correct identification, isolation and contraction of the pelvic muscles followed by a muscle relaxation phase. 

Our aim is to empower women and men to rediscover bladder control and comfort.

If you have any questions or comments do not hesitate to contact Gail Fuller at 919-313-3623.

Brachytherapy

Triangle Urology Associates, P.A. ("TUA") has been doing in hospital brachytherapy since 1997. We have helped over 600 patients during the past seven years using this procedure. In May 2006, we teamed up John Leung, MD from Piedmont Prostate Center to provide this service to our patients through an outpatient procedure in our Durham office. During the past year we have performed this procedure on over thirty patients with positive success. If you would like to see if this procedure may meet your needs, please review the attached presentation.

Our PowerPoint presentation on brachytherapy

Our brochure on brachytherapy

Prolieve

Prolieve™ Thermodilatation System Treatment  

As men age, millions suffer from the symptoms of BPH (benign prostatic hyperplasia), also known as enlarged prostate. The good news is that BPH is not life threatening and can be treated. Some of the symptoms of BPH are:

• Frequent and urgent need to urinate;
• Weak flow;
• Inability to completely empty the bladder; and
• Sleep disruption as a result of needing to urinate frequently at night.

While some men may feel embarrassed to talk about it, BPH is a significant quality of life issue that deserves frank discussion.  That is why we want you to know about a new option for men who suffer from BPH.  The U.S. Food and Drug Administration has approved a device called the Prolieve™ Thermodilatation System for the treatment of BPH symptoms.  During the past two years Triangle Urology Associates, P.A. (“TUA”) has done over 200 of these procedures. Treatment with this device:

• is safe and effective;
• provides significant symptomatic relief;
• is a minimally invasive procedure that can be performed in a single 45 minute office visit; and
• offers a viable alternative to treatment by medications or surgery.

While BPH typically does not pose a major health risk, it can affect a man’s quality of life and often significantly impedes even the simplest daily activities.  It is typical for men and their partners to feel tired due to the sleep disruption caused by the man’s need to urinate frequently at night.  At the same time some men may not even realize they have a treatable condition.

Moreover, many men are embarrassed to discuss BPH – sometimes even with a physician.  If you or someone you know experiences excessive BPH, please remember that there’s nothing to be embarrassed about, and that any urological condition should be thoroughly understood by the individual involved, and just as importantly, be discussed with a physician. Men suffering from this condition should know that there are effective treatment options available.

TUA want to let you know that as part of my commitment to providing the best in urological care, we now include the Prolieve Thermodilatation System as part of my practice.  If you are interested in learning more about your BPH and its treatment, please go to the website www.UnderstandingBPH.com or do not hesitate to call Cathy Stutts, TUA’s Head Nurse at 919-313-3609. We would also recommend you take the BPH symptom quiz at the website noted above.

Patient Consent Form

Patient Instructions for the Prolieve™ Thermodilatation System Treatment 

INDICATIONS: The Prolieve™ Thermodilatation System is a transurethral microwave therapy device for the treatment of symptomatic Benign Prostatic Hyperplasia (BPH) in men with a prostate size of 20 to 80 grams and prostatic urethra length between 1.2 cm and 5.5 cm and in whom drug therapy (Finasteride or Proscar) is typically indicated. CONTRAINDICATIONS: Patients who have significantly decreased pain responses, severe urethral stricture prohibiting catheterization, current urinary or prostatic infection, penile or urinary sphincter implants, prostate sizes <20 g to >80 g, peripheral arterial disease with intermittent claudication or Leriche’s Syndrome, protruding median lobe with obstruction, metallic implants, implanted cardiac pacemakers or defibrillators, previous transurethral prostatectomy, renal impairment, coagulation disorders, neurological disorders that may affect bladder function, bladder stones, evidence of prostate or bladder cancer or have an interest in the preservation of future fertility. WARNINGS AND PRECAUTIONS: The safety and effectiveness of the Prolieve System for men <50 and >80 years old has not been established in clinical studies. POTENTIAL ADVERSE EFFECTS: that may occur include but are not limited to bleeding, bowel irritation, urethral injury (irritation), chronic pain at site, bladder spasms, urinary retention (complete or incomplete), urinary incontinence, prostatitis, pressure sensation, urinary urgency, urinary tract infection, urethral tear, anal irritation, urethral stricture, infertility, retrograde ejaculation and erectile dysfunction. CAUTION: Federal (USA) law restricts this device to sale by or on the order of a physician.

CT Services

CT Scan

Computed axial tomography, also known as CAT scan or CT scan, is an imaging technique that is a widely regarded tool for evaluating the genitourinary tract. CT scanning combines X-rays and computer calculations to produce precisely detailed cross-sectional slices of images of the body's tissues and organs. More specifically, very small, controlled beams of X-rays, rotating in a continuous 360-degree motion around the patient, pass through the tissue as an array of detectors measure thousands of X-ray images or profiles. Computer calculations based on those multiple measures produce the detailed pictures reflected on a screen. These images can be stored, viewed on a monitor or printed on film. In addition, stacking the "slices" of images can also create three-dimensional images of the body's internal structures.

Since CT scans can distinguish between solid and liquid, it is extremely valuable in examining the type and extent of kidney tumors or other masses, such as stones or cysts, distorting the urinary tract. CT technology, however, is also enhanced by other factors. Intravenous injections of contrast agent (dye) intensify the images. CT scans have improved speed and accuracy by gathering volumes of continuous kidney and urinary data in seconds with no gaps between images.

Specialized applications of CT can be performed in specific clinical circumstances. For example, three-dimensional reconstructions of the kidney and blood supply may show vascular abnormalities and provide "road maps" for planning surgeries.

The patient will be asked to lie in a certain position on a narrow table that slides into the center of the scanner. Dye may also be administered into a vein in the hand or arm. The technician will issue instructions to the patient regarding body position and breathing during this test. Upon test completion, the patient can resume their normal daily activities.

CT scanning is a safe, efficient and effective technology that produces minimal risks. The major risk involves a reaction to any iodine-based dye that may be used. Minor reactions to the dye may include hot flashes, nausea and vomiting, which are usually treated successfully with antihistamines. In very rare circumstances, more severe complications — breathing difficulties, low blood pressure, swelling of the mouth or throat and even cardiac arrest — can occur.

There is relatively low radiation exposure during this test. However, a patient who is or may be pregnant should notify their physician prior to this examination as a fetus is susceptible to the risks associated with radiation.

Reviewed January, 2003 www.UrologyHealth.org

CT Scan Consent and History form

CT SCAN Preparation form

Note – If you are pregnant or think your pregnant, Triangle Urology Associates, P.A. will not do a CT scan on you.