Dr. Alexei Wedmid

Incontinence: Bladder Control Issues

Approximately 25 million Americans are affected by bladder control issues; i.e. incontinence. Because incontinence is a symptom, as opposed to an actual disease, the method of treatment is completely dependent on a diagnosis of the underlying cause. Successful treatment is attainable and generally entails a combination of medication, behavior modification, pelvic muscle exercises, collection devices, and absorbent products. But, despite a very high success rates in treating incontinence, most people affected do not seek help, either due to embarrassment or from the mistaken notion that nothing can be done. For any urinary control issues, the first step is to find a knowledgeable physician, with whom you feel comfortable, to get a diagnosis. The clinicians and board-certified physicians and surgeons at the Urology Group of Princeton are highly trained and up-to-date on the latest advances in the field; they will attend to your condition with respect and understanding as they take the time to simply and completely explain the diagnosis and treatment options to you. If you are experiencing any of the conditions described below, please call our Urology Group, at 609.924.6487, to set up an appointment. Urinary Incontinence Overactive Bladder – The overwhelming need to go immediately. Urinary Retention – Difficultly starting urination, a weak and, once finished, the need to go again because the bladder isn’t fully emptied. Mixed Incontinence – A combination of stress incontinence, including muscle and sphincter related issues, and urgency incontinence. Stress urinary incontinence (SUI) – Because of weak pelvic floor muscles and/or a deficient urethral sphincter, the bladder can leak during exercise, coughing, sneezing, laughing, or any body movement that puts pressure on the bladder. Nocturnal Enuresis aka Bedwetting Persistent Primary Nocturnal Enuresis – this condition, which begins during childhood, is defined as the inability to achieve nighttime dryness for longer than 6 months. About 2-3% of adults older have this type of nocturnal enuresis. Adult Onset Secondary Enuresis – This condition is defined as bedwetting affecting people usually closer to 60 years of age. Nocturia – Generally defined as making two or more trips to the bathroom every night. Nocturnal Polyuria – This […]

Kidney Stones and Roller Coasters: Perfect Together?

After hearing stories, from several patients, of passing a kidney stone after visiting an amusement park, two researchers from Michigan State University College of Osteopathic Medicine began to suspect a connection. And after one patient in particular reported passing a stone on each of three consecutive rides (i.e. 3 rides, 3 kidney stones passed), they knew they were on to something. To test the assumption, the urologists used a 3D printer to create a life-size plastic replica of the branching interior of a human kidney into which they inserted three kidney stones, of the size that will generally pass on their own, along with human urine. Then, with permission from an amusement park official, they put the artificial kidney in a backpack and took it for a series of rides. The results showed that the forces and vibrations encountered on the coaster did indeed cause the kidney stones to dislodge from the replica kidney. The optimal place to be was in the back of the coaster; 64% of the kidney stones passed during rides in the rear car, as compared to only about 17% passing after a single ride in the lead car. Although this very preliminary study doesn’t prove that real kidneys with real stones will have the same results, coupled with the anecdotal evidence from patients, it is an intriguing possibility that should warrant further study. In the meantime, if you have questions or concerns about kidney stones, contact the Urology Group of Princeton to schedule an appointment. The board certified physician/surgeons at the Urology Group are highly trained to evaluate your symptoms, perform applicable tests, and develop the proper treatment plan.

Percutaneous Tibial Nerve Stimulation for Overactive Bladder (OAB)

The Urology Group of Princeton now offers percutaneous tibial nerve stimulation (PTNS) as an adjunct to patients with overactive bladder (OAB) for whom behavioral therapy or pharmacology has not sufficiently addressed the associated symptoms of urinary urgency, urinary frequency, and urge incontinence. PTNS, also known as posterior tibial nerve stimulation, is a minimally invasive form of neuromodulation used as a supplementary treatment option for overactive bladder. It has been found to be effective at reducing the number of times a person with OAB needs to urinate. Performed as an out-patient procedure, the process begins with the patient comfortably seated and the treatment leg elevated. A fine needle electrode is inserted near the ankle, where the tibial/sural nerve is located, and a surface electrode is placed on the arch of the foot. The needle electrode is connected to an external pulse generator which delivers an adjustable electrical pulse. This pulse travels through the tibial nerve to the sacral nerve plexus that, among other functions, regulates bladder function. The stimulation often causes involuntary toe flexing/fanning or an extension of the entire foot; however, for some patients, it may only result in a mild sensation in the ankle area or across the sole of the foot. In general, PTNS requires once-a-week 30-minute treatments for 12 weeks. Many patients notice improvements by the 6th week. Patients who respond favorably to treatment may require ongoing treatments, every 3-weeks or so, to sustain the improvements. PTNS is a low-risk procedure; the most common side-effects are temporary and minor. They include minor bleeding, mild pain, and skin inflammation resulting from the placement of the needle electrode. For more information on percutaneous tibial nerve stimulation and to find out if it is right for you, please contact the Urology Group of Princeton to schedule a consultation.

Advancements in minimally invasive surgery

The Urology Group of Princeton is pleased to announce that, this year, The University Medical Center of Princeton at Plainsboro (UMCPP), one of our primary outpatient surgical centers, secured its position on the leading edge of robotic surgery with an investment in the most state-of-the-art robotic console, the “da Vinci Xi” surgical system, which complements their existing “da Vinci Si” robotic console.