Comprehensive Urology of Los Angeles Welcomes Dr. Cristina Palmer to Its Team

Comprehensive Urology of Los Angeles employs a team of friendly, knowledgeable urologists who are happy to assist patients in any way possible. As part of our ongoing commitment to our patients, we are proud to announce the addition of Dr. Cristina Palmer to our team.

Dr. Palmer is currently associated with several globally recognized medical organizations. These organizations include:

  • University of California, Irvine
  • Long Beach Memorial Medical Center
  • Long Beach VA Hospital

Dr. Palmer earned her undergraduate degree at Villanova University in 2005. She then entered medical school at the Chicago College of Osteopathic Medicine; here, she earned her doctorate in osteopathic medicine in 2011. Dr. Palmer remained in Chicago for her urologic surgery residency at Cook County Hospital, where she became proficient in endourology (a minimally invasive procedure used to address kidney stones), as well as open, laparoscopic, and robotic treatment modalities. Upon successful completion of her urologic surgery residency in 2016, Dr. Palmer began a two-year fellowship at the University of California, Irvine. At this time, Dr. Palmer studies female urology, complex voiding dysfunction, and pelvic reconstruction.

Today, Dr. Palmer helps patients treat many urological conditions, including:

  • Urinary Incontinence: Involuntary loss of urine or bladder control. Dr. Palmer helps patients identify and address stress, mixed, overflow, and urge incontinence.
  • Pelvic Organ Prolapse: A condition that affects women and may cause a bulge at the opening of the vagina. Dr. Palmer helps patients treat cystocele, rectocele, procidentia, and other forms of pelvic organ prolapse.
  • Urinary Tract Infection (UTI): An infection of the kidney, ureters, bladder, or urethra. Dr. Palmer helps patients identify the underlying cause of a UTI and take the necessary steps to address UTI symptoms before they get out of hand.
  • Urinary Fistula: An abnormal opening that forms in a urinary tract organ or occurs due to an abnormal connection between a urinary tract organ and a nearby organ. Dr. Palmer provides surgery and other treatment options to help patients address vesciovaginal, enterovesical, and other types of urinary fistulas.
  • Interstitial Cystitis: A bladder infection that causes severe pain and pressure below the belly button. Interstitial cystitis may be difficult to diagnose, but Dr. Palmer performs extensive testing to properly diagnose and treat this type of infection.
  • Benign Prostatic Hyperplasia (BPH): Prostate gland enlargement that is commonly associated with bladder, urinary tract, and kidney problems. Dr. Palmer uses traditional transurethral resection of the prostate (TURP) surgery and green light laser ablation of the prostate to help patients address BPH.
  • Vaginal Dryness: A problem that occurs due to menopause and decreased estrogen to the vaginal tissues. As a female pelvic medicine and reconstructive specialist, Dr. Palmer helps patients determine the best course of action to alleviate vaginal dryness.
  • Male Incontinence: Palmer is trained in several surgical treatments for male incontinence, which may occur following prostate cancer treatment, including male slings and artificial urinary sphincter placement.
  • Overactive Bladder: Palmer is able to offer all treatment modalities for the treatment of overactive bladder, including Botox, Interstim, and Percutaneous Tibial Nerve Stimulation.

Additionally, Dr. Palmer administers a wide range of urological treatments, and these treatments include:

  • Lifestyle Modification: In some instances, certain foods or ingredients may trigger urological conditions. Dr. Palmer helps patients identify foods or ingredients that cause urological problems and implement assorted lifestyle changes so they can put their urological issues in the past.
  • Neuromodulation: Electrical nerve stimulators have been shown to help some patients alleviate pain in the bladder, lower back, and pelvis. Dr. Palmer knows how to use neuromodulation devices to internally or externally stimulate patient nerves that connect to pain sources and help patients alleviate pelvic pain and tension.
  • Surgery: Surgical treatments are available to help patients address urinary incontinence and other urological conditions. Dr. Palmer understands how to administer assorted pelvic and urethral support procedures and customizes each surgery to help a patient achieve his or her desired results.
  • ThermiVa: ThermiVa treatments involve the use of radiofrequency (RF) energy to address excessive stretching of the vaginal muscles following vaginal birth or due to the natural aging process. Dr. Palmer teaches each patient about ThermiVa and how ThermiVa treatments work. She also helps a patient determine if ThermiVa is a good treatment option based on the patient’s vaginal rejuvenation goals.

In her free time, Dr. Palmer enjoys running, hiking, downhill skiing. She also enjoys spending time with her dog and cat.

Schedule a Urological Consultation with Dr. Palmer and the Rest of the Comprehensive Urology Team

Comprehensive Urology employs Dr. Palmer and other highly trained urologists who take a multispecialty approach to treat urological conditions. Our approach ensures patients always receive in-depth evaluations and personalized treatments. Plus, we offer preventative and screening therapies to help a patient maintain a healthy, active lifestyle following treatment.

Finding the right treatment for a urological condition is sometimes difficult. Thankfully, Dr. Palmer and the rest of the Comprehensive Urology team is available to help patients alleviate urological conditions. Our team works with each patient, learns about his or her urological condition, and offers a custom treatment. We also respond to patient concerns and questions and ensure our patients feel comfortable with their treatment decisions. To find out more about how our team helps patients treat urological problems, please contact us today at (310) 499-2756 to schedule a consultation with one of our expert urologists.

The post Comprehensive Urology of Los Angeles Welcomes Dr. Cristina Palmer to Its Team appeared first on Comprehensive Urology.


What’s the Difference Between Surgical and Laser Vaginal Rejuvenation?

There are two types of vaginal rejuvenation procedures: labiaplasty and ThermiVa. Both treatments have been shown to help women enhance the shape and size of female genitalia, reduce pain or pinching of physical tissue, and provide other long-lasting benefits. However, there are many differences between labiaplasty and ThermiVa. As such, it is important for a woman to understand the differences between these procedures to make the best-possible vaginal rejuvenation treatment decision.

Now, let’s take a look at surgical and laser vaginal rejuvenation, how both procedures work, and their pros and cons.

What is Surgical Vaginal Rejuvenation (Labiaplasty)?

A labiaplasty is a surgical vaginal rejuvenation treatment that involves the removal of excess labial tissue. It helps women improve the size and shape of the female genitalia, and the procedure makes it more comfortable for women to walk, sit, or engage in sexual intercourse.

Surgical vaginal rejuvenation is performed under local anesthesia with oral sedation or under general anesthesia. The surgery takes about one to two hours to complete, and it is usually performed as an outpatient procedure.

Most patients can return home the same day a labiaplasty is performed. The total recovery time associated with a labiaplasty is about six weeks, and it varies depending on the patient. During the labiaplasty recovery period, patients may need to avoid strenuous exercise or sexual activity.

The patient satisfaction rate of labiaplasty surgery is greater than 90%, and the risks associated with surgical vaginal rejuvenation are minimal. Additionally, there are many reasons why a woman may choose to receive a labiaplasty, and these include:

  • Labial asymmetry
  • Difficulty wearing tight-fitting clothing
  • Pain or discomfort during sexual intercourse or physical activity
  • Labial hypertrophy (enlarged labia)

Women sometimes choose to undergo a labiaplasty for cosmetic reasons, too. For example, if a woman is self-conscious about the female genitalia or wants to improve its appearance, a labiaplasty may be ideal.

The decision to undergo a labiaplasty may be difficult. Prior to treatment, a urologist meets with a woman to determine if she qualifies for surgical vaginal rejuvenation. If so, the urologist then outlines all aspects of a labiaplasty surgery and responds to a patient’s treatment concerns and questions.

What is Non-Surgical Vaginal Rejuvenation (ThermiVa)?

ThermiVa is a non-surgical vaginal rejuvenation treatment. It may provide a viable labiaplasty alternative for women who want to avoid going under the knife.

A ThermiVa treatment involves the use of radio-frequency (RF) technology to promote natural collagen production and tissue rejuvenation. During a ThermiVa procedure, a specially designed handpiece is used to administer gentle thermal energy to the vaginal area. This handpiece features an active tip that heats the vaginal tissue via the emission of RF energy. It is carefully moved over the labia and inside the vagina and heats these areas in a controlled manner. As a result, the handpiece delivers a gentle sensation similar to a warm massage.

Following a ThermiVa procedure, women often see a noticeable improvement in the appearance of the vagina. Other benefits associated with ThermiVa treatments include:

  • Tighter vagina
  • Improved vaginal lubrication
  • Enhanced sexual orgasms
  • Improved urinary control

A typical ThermiVa session lasts about 30 minutes, and no anesthesia or incisions are required. Patients usually see immediate vaginal tissue tightening after their first ThermiVa session, and more significant results occur over the course of three to four months. To achieve the best-possible ThermiVa treatment results, patients may require at least three sessions over a period of three to four months.

Patients can receive ThermiVa as an outpatient procedure. There is no downtime, pain, or discomfort after a ThermiVa procedure. Instead, women can resume their everyday activities or engage in sex following a ThermiVa session.

ThermiVa helps increase the body’s collagen production in the treated area, and patients may enjoy up to two years of vaginal tissue tightening from treatment. Follow-up ThermiVa treatments may be needed after one to two years.

The ideal candidates for ThermiVa include women who experience vaginal dryness, lack of friction or sensation during sex, or painful intercourse. Although ThermiVa is not designed to treat female incontinence, patients who are dealing with mild stress incontinence sometimes report leaky bladder symptom improvements following ThermiVa treatments, too.

ThermiVa may also prove to be a great addition to a mommy makeover, which involves one or more procedures to help a woman address any post-pregnancy body concerns. A ThermiVa treatment can be administered approximately six weeks after a woman gives birth or between pregnancies.

Those who are interested in ThermiVa should find a skilled urologist to administer treatment. By doing so, a patient can work with a urologist who provides a personalized ThermiVa treatment plan.

Initially, a urologist requests a patient consultation to learn about a woman and her non-surgical vaginal rejuvenation treatment goals. He or she then performs a physical examination, as well as evaluates a patient’s medical history. A urologist may also request specialized testing to determine if ThermiVa can help a patient achieve her desired results.

If a woman qualifies for ThermiVa, a urologist will explain how the procedure is performed. He or she allocates time and resources to help a patient prepare for ThermiVa treatments. That way, a patient can determine if ThermiVa is the right choice based on her individual needs.

Which Is Better: Labiaplasty or ThermiVa for Vaginal Rejuvenation?

Many women pursue labiaplasty and ThermiVa for vaginal rejuvenation, and both treatments offer safe, effective results. Yet the ideal vaginal rejuvenation procedure depends on the individual. In some instances, women prefer labiaplasty because the procedure usually requires just a few hours to complete and delivers long-lasting vaginal rejuvenation results. On the other hand, some women prefer ThermiVa because it offers no downtime, quick treatment sessions, and no surgery.

At Comprehensive Urology, our team of friendly, knowledgeable urologists is happy to teach patients about labiaplasty and ThermiVa. Our urologists meet with patients, learn about their vaginal rejuvenation goals, and develop custom treatment plans. We are committed to patient satisfaction, and we are happy to help patients determine if labiaplasty or ThermiVa is the best option to provide long-lasting vaginal rejuvenation. To find out more about our labiaplasty and ThermiVa treatments, please contact us today at (310) 499-2756 to schedule a consultation with one of our urologists.

The post What’s the Difference Between Surgical and Laser Vaginal Rejuvenation? appeared first on Comprehensive Urology.

Incontinence Before and After Pregnancy: What You Need to Know

The hormones involved in pregnancy can cause significant physiological changes to a woman’s body. In addition to nausea (morning sickness) and fluctuating emotions, many women experience what can feel like a near constant urge to urinate, as well as leaks following simple motions like sneezing, laughing, and coughing. Even walking can trigger stress incontinence for some pregnant women.

Why are Pregnant Women More at Risk of Developing Incontinence?

Surging hormones and pressure on the bladder can interfere with the natural urination process. These make pregnant women and women who have given birth more susceptible to some form of stress and urge incontinence.

Stress Incontinence in Pregnant Women

Occurs when there is pressure on the bladder from movements like walking, coughing, sneezing, or laughing. In pregnant women, the surge in hormones and additional weight can contribute to added stress on the bladder.

Urge Incontinence in Pregnant Women

This type causes a very sudden and overwhelming need to urinate, with little to no warning, which can sometimes lead to leaks and possibly emptying the bladder before the person can get to a bathroom.

Some people in LA experience what is known as mixed incontinence, which causes urine leakage and loss of bladder control as a result of both stress and urge incontinence.

Learn more about incontinence during pregnancy at

Tips to Help Prevent and Manage Pregnancy Incontinence

Most if not all pregnant women are likely to experience some form of urine leakage and bladder control problems during and after pregnancy. While the problem is not always preventable, there are steps that all women can take to help minimize the risk.

  • Maintain a healthy weight during pregnancy – The health dangers of excessive weight gain and obesity for pregnant women and the general population have been gaining increasing attention in recent years, and for good reason. From heart disease to diabetes, obesity has become a national health epidemic that puts the lives of millions of American children and adults at risk. For pregnant women, obesity can lead to potentially serious conditions like gestational diabetes, preeclampsia, infections, and complications with labor. It can also increase the risk of incontinence.
  • Plan ahead – The thought of scheduling bathroom breaks may sound pointless or counterintuitive when dealing with incontinence, which can feel uncontrollable under normal circumstances but especially during pregnancy, can actually help to manage the risk of accidents.
  • Strengthen the pelvic muscles – Urological problems like urinary incontinence and vaginal prolapse after childbirth result from weakening of the pelvic floor muscles. Practicing contracting the muscles that control the flow of urine (Kegel exercises) can be helpful in some cases.
  • Don’t be afraid or embarrassed to ask for help – Incontinence can be a delicate and awkward condition to discuss, even with a doctor. With women twice as likely to be affected as men, seeking help from a urologist is the first step in finding relief. The Los Angeles urologists at the Institute for Incontinence, Vaginal Reconstruction & Women’s Health specialize in urology care for female patients and their unique needs and concerns. Diagnosis and treatment in a compassionate, understanding environment can help ease the stigma and reluctance to seek treatment for the millions of women estimated to suffer in silence from some form of urinary incontinence.

Does Incontinence End After Pregnancy?

The symptoms and duration vary from person to person and depend on the anatomy and health of each person. If symptoms persist after pregnancy, schedule an appointment with a urologist to discuss appropriate incontinence treatment options, which can range from behavior modification to urological devices and surgery, depending on each patient’s individual circumstances.

Can Urine Leakage Be Treated?

The urology team at the Institute for Incontinence, Vaginal Reconstruction & Women’s Health in Los Angeles has designed a comprehensive, multi-faceted approach to helping women get their lives back and return to normal activities without the fear or anxiety involved with bladder control problems. There is a range of incontinence treatment options for female patients, ranging from medication, surgery, non-surgical treatments like physical therapy and strength training, and holistic treatments, which can be especially of interest to pregnant women suffering from urine leakage. In addition to potentially helping to ease the symptoms of an overactive bladder during pregnancy, holistic treatments like meditation and acupuncture can help to relieve feelings of stress, depression, and anxiety for expectant mothers.

Contact a Beverly Hills Urologist for Female Incontinence Treatment

The anxiety, discomfort, and inconvenience that often accompany bladder control problems can be disruptive, and compromise daily routines and overall quality of life. Because of the sensitive nature of the condition, many women can feel ashamed or embarrassed to ask for help. To learn more about the symptoms and treatment options for incontinence and other female urological conditions, contact the Institute for Incontinence, Vaginal Reconstruction & Women’s Health by calling 310-307-3552 to schedule a consultation with a board certified urologist today.

Next, read What are the Treatment Options for Female Urinary Incontinence?

The post Incontinence Before and After Pregnancy: What You Need to Know appeared first on Comprehensive Urology.

Patient’s Guide to a Robotic-Assisted Laparoscopic Prostatectomy (RALP) for Prostate Cancer

Patients Guide to RALP for Prostate Cancer
Robotic-assisted laparoscopic prostatectomy (RALP) is used to treat prostate cancer. It is minimally invasive and involves the removal of a man’s prostate gland. Additionally, a surgeon uses a robot to control instruments during a RALP procedure.

Comprehensive Urology offers RALP and other prostate cancer treatments. Our team of expert urologists meets with prostate cancer patients, learns about their symptoms, and helps patients determine whether RALP is a viable treatment option.

In this guide, we’ll take a closer look at RALP, how it works, and its benefits. We’ll also provide an FAQ to teach patients about RALP and help them weigh the pros and cons of robotic-assisted prostate surgery.

What Is RALP?

RALP involves the use of the da Vinci Surgical System, a sophisticated robotic platform. The da Vinci System includes an ergonomic surgeon’s console, patient side cart with four interactive robotic arms, 3D high-definition vision system, and proprietary EndoWrist instruments. It scales, filters, and translates all of a surgeon’s hand movements via EndoWrist instruments. As a result, the da Vinci System enables a surgeon to perform advanced prostate cancer surgery faster and more efficiently than ever before.

In some instances, a RALP procedure feels like an “open” surgery similar to a traditional prostate cancer removal. Yet RALP surgeries are more advanced that most traditional prostate cancer procedures.

The da Vinci System allows a surgeon to magnify a patient’s anatomy like never before. A surgeon can use the da Vinci System to review a patient’s anatomy at a high magnification, in brilliant color, and with natural depth of field. That way, a surgeon can quickly identify and treat prostate cancer tissue.

During a RALP procedure, a surgeon uses the da Vinci System’s master controls to maneuver the four robotic arms on the patient s/yjAGc5lExgside cart; these arms hold EndoWrist instruments and a high-resolution endoscopic camera in place. The EndoWrist instruments feature a distinct jointed-wrist design that surpasses the natural range of motion of the human hand. Therefore, a surgeon can refine the instruments’ movements for unparalleled control and stability.

Furthermore, the da Vinci System boasts a fail-safe design. It includes many safety features to reduce the risk of human error in comparison to other prostate cancer surgery treatments.

Benefits of Robotic Prostate Surgery over Traditional Open Prostate Surgery

benefits of RALP for prostatectomy

Robotic prostate surgery is an FDA-approved and minimally invasive surgery, and it requires only small incisions to treat prostate cancer. Also, the surgery involves the use of a 3D endoscope and high-intensity illuminators that provide a surgeon with high-definition images of a patient’s anatomy; this ensures a surgeon can identify malignant tissue and leave surrounding muscle, tissue, and organs intact.

Other benefits of robotic prostate surgery include:

  • Exceptional Accuracy: The da Vinci System has flexible wrists to help a surgeon make slight, careful movements for improved accuracy during prostate cancer surgery.
  • Fast Recovery Time: Because robotic prostate surgery requires small incisions, the healing time tends to be quicker in contrast to traditional open prostate surgery.
  • Short Hospital Stay: Most robotic prostate surgery patients can leave the hospital and return to their everyday activities more quickly than those who undergo traditional open prostate cancer procedures.
  • Reduced Risk of Infection: Robotic prostate surgery often results in less pain and bleeding for patients, as well as reduces a patient’s risk of infection.
  • Improved Urine Control and Sexual Function: Studies show prostate cancer patients who undergo a RALP procedure recover from urinary continence and erections at superior rates relative to patients who receive traditional laparoscopic or open surgeries.

There is no guarantee that a prostate cancer patient is eligible to receive robotic prostate cancer surgery. And in some instances, traditional open prostate surgery may prove to be ideal.

To determine whether a patient should undergo robotic prostate cancer surgery or a traditional open retropubic radical prostatectomy treatment, it is important to consult with an expert urologist. During a urological consultation, a patient will receive a full medical assessment, and a urologist will learn about this individual’s prostate cancer symptoms. Then, a urologist can offer a proper diagnosis and determine whether a patient is a viable candidate for robotic prostate surgery.

Robotic Assisted Laparoscopic Prostatectomy vs Conventional Laparoscopic Prostatectomy

The da Vinci System generally proves to be a top alternative to conventional laparoscopy too. A conventional laparoscopy requires a surgeon to stand while operating and use handheld, long-shafted instruments on his or her own. Meanwhile, a conventional laparoscopy involves the use of a 2D monitor to view a patient’s anatomy; this monitor is typically placed a few feet away from a surgeon, and he or she must look up and away from instruments to view it. A conventional laparoscopy usually requires a surgeon and a patient-side assistant to work closely to position the camera correctly as well. Because if the camera is out of position, the surgery may fail to provide a patient with his or her desired results.

RALP Surgery Process

RALP Surgery Process Steps
RALP surgery involves the following steps:

Step 1: Robotic Port and Instrument Setup
The da Vinci System is docked, and the robotic instrument ports and camera port are attached to the system’s arms. This step requires about 10 to 15 minutes to complete.

Step 2: Bladder Release
The surgeon controls the da Vinci System instruments and uses robotic “scissors” in one hand and a grasper in the other to cauterize tissues and cut them with the scissors. He or she slowly “mobilizes” the bladder and separates it from the abdominal wall. This allows the surgeon to visualize and reach the prostate gland.

Step 3: Prostate Dissection
The surgeon carefully frees the prostate gland from tissues, and he or she uses a medical “stapler” device to divide and seal prostate gland tissues and blood vessels.

Step 4: Separation of Prostate and Bladder
The surgeon cuts and cauterizes the prostate away from the bladder until he or she reaches the urethra, which is separated to free the prostate from the bladder.

Step 5: Separation of Prostate from Remainder of Urethra
The surgeon releases the prostate from the remainder of the urethra, and the urethra will later be reattached to the bladder. It is critical for the surgeon to preserve the urethra tissue to ensure a complete “repair” when he or she sews the urethra back to the bladder.

Step 6: “Bagging” of Prostate
The surgeon places the prostate gland in a specimen bag that is inserted through a da Vinci System assistant port. The bag is deployed, and once the prostate is inside the bag, this bag can be closed by pulling its strings. The bag stays inside the abdomen until the surgery is complete and the da Vinci System is moved away from the patient.

Step 7: Attachment of Cut-End of Urethra to Bladder
The surgeon uses sutures to perform anastomosis, an attachment process that involves sewing the bladder neck and suturing it to the urethra in one spot. The surgeon ensures tissues are connected correctly to minimize the risk of urine leakage and scar tissue.

Following RALP, a surgeon will insert a special catheter that will remain in place for about a week. A patient should also expect surgical sutures to dissolve on their own shortly after treatment.

Am I a Good Candidate for Robotic Prostate Surgery?

Each prostate cancer patient is different, and even though robotic prostate surgery is the right choice for some patients, it may not be the best treatment option for others.

A urologist evaluates potential RALP surgery candidates based on a variety of criteria, including:

  • Patient’s age and life expectancy
  • Patient’s size
  • Physical condition
  • Surgical history
  • Weight

A urologist always allocates time and resources to teach each patient about RALP surgery and determine whether an individual can reap the benefits of this procedure. If the risks associated with a RALP procedure outweigh its benefits, a urologist will recommend alternative prostate cancer treatment options.

What Types of Robotic-Assisted Prostate Surgery Options Are Available?

The da Vinci System is used to perform two prostate cancer procedures:types of robotic assisted prostatectomy surgery

1. Robotic-Assisted Laparoscopic Radical Prostatectomy

Robotic-assisted laparoscopic radical prostatectomy requires only five stitches, and each stitch is no larger than 1.5 cm in size. It allows a surgeon to dissect and remove the prostate and sew the bladder to the urethra – all without requiring the surgeon to place his or her hands inside of a patient’s body. Depending on a patient’s condition, robotic-assisted laparoscopic radical prostatectomy may be used to remove a patient’s lymph nodes as well.

2. Robotic-Assisted Surgery for Benign Prostatic Hypertrophy (BPH)

BPH refers to an enlarged prostate. When the prostate grows, it begins to squeeze down on the urethra, and the bladder wall becomes thicker. This causes the bladder to weaken and lose the ability to empty completely.

Robotic-assisted surgery has been shown to help prostate cancer patients address BPH. A surgeon uses the procedure to remove portions of an enlarged prostate via the da Vinci System. First, a surgeon determines incision placement based on the size of the prostate and evaluates a patient’s symptoms and overall health. He or she next uses the da Vinci System to make precise incisions to remove enlarged portions of the prostate and sew the prostate gland back together. Best of all, surgeons often use the da Vinci System to ensure the urethra is untouched throughout the procedure.

A urologist is happy to teach patients about both types of robotic-assisted prostate surgeries. He or she will explain how each surgery is performed, along with what patients should do to prepare for surgery and what patients should expect during each treatment recovery period.

How Should Patients Prepare for RALP Surgery?

preparing for robotic prostatectomySometimes, patients will need to stop taking daily medications prior to surgery, but patients can resume taking these medications immediately after surgery. A urologist will let a patient know whether it is safe to continue with daily medications leading up to surgery, and patients should always disclose all medications to a urologist prior to treatment.

A urologist performs a preoperative bowel preparation on a patient prior to RALP surgery. This includes both antibiotic and mechanical bowel cleansing and reduces the potential for infection.

On the day of surgery, a preoperative enema is administered to a patient. This individual also receives sequential compression stockings, and a large-bore intravenous line is inserted that provides preoperative antibiotics.

What Should Patients Expect During Recovery from Robotic-Assisted Prostatectomy?

Recovery from robotic-assisted prostate surgery is short in comparison to conventional prostate cancer treatments. Robotic-assisted prostate surgery patients often spend one to two days in the hospital before they return home after surgery; comparatively, a traditional prostate cancer surgery patient may require a week or more in the hospital following treatment.

After robotic-assisted prostate surgery, a patient should expect some pain and swelling. These symptoms generally disappear on their own. The symptoms can also be managed with rest, or a patient may be prescribed pain medication.

Once a robotic-assisted prostate surgery patient can retain liquids and obtains acceptable laboratory tests, this individual will receive authorization to return home from the hospital. Patients are discharged with a special catheter that is held in place by a balloon inside the bladder. The catheter provides continuous drainage of the bladder into a small external collection bag, and this bag will need to be emptied periodically. A patient should not remove the catheter bag; instead, a patient requires an outpatient visit approximately five to seven days after surgery to ensure proper removal by a urologist. If a catheter comes out before a follow-up appointment, a patient should contact a urologist immediately.

RALP prostatectomy recoveryPhysical Activity After RALP
Patients should avoid vigorous activity like golfing, running, or exercising for at least one week after RALP surgery, and they should refrain from driving and sitting in one position for too long (45 minutes or longer). Patients should also avoid bathtubs, swimming pools, and hot tubs for as long as the catheter is in place; conversely, patients can shower as soon as they return home.

Returning to Work Post-RALP
Most patients can return to work within a few days of surgery. If a patient’s day-to-day job requires strenuous activity, this individual may need additional time to recover before returning to work.

Medication After RALP
Ibuprofen or acetaminophen initially may be used to help a patient address pain following surgery. If pain persists, stronger pain medication may be prescribed. Patients are prescribed an oral antibiotic after a catheter is removed, and a urologist will provide instructions about how often to take this antibiotic. A stool softener may be used to help a patient limit constipation as well.

Diet After RALP
A bland diet often is recommended after surgery. Patients should avoid carbonated beverages, and in some instances, may prefer a temporary liquid diet. After a patient experiences a bowel movement, this individual can start consuming soft foods like oatmeal and soup. Patients should spread out eating throughout the day with small meals and snacks and avoid large meals for the initial days following treatment.

The recovery process following robotic-assisted prostate surgery usually lasts about two to three weeks, depending on a patient’s age and overall health. A urologist is available to provide support throughout the recovery period to ensure a patient can achieve the optimal treatment results.


How long does a RALP procedure take to complete?
On average, a RALP surgery requires two to three hours to perform. Also, the procedure is often completed under general anesthesia.

Does the da Vinci System perform the actual RALP procedure?
The da Vinci System is always controlled by a surgeon – without exception. A surgeon uses the da Vinci System’s robotic arms to operate within small spaces in the abdomen.

Does blood loss occur during RALP surgery?
The da Vinci System helps a patient minimize the risk of bleeding, but it does not stop blood loss altogether. A surgeon uses the da Vinci System for precise and minimally invasive dissection to control possible sources of bleeding. Moreover, pressure generated by the gas used to inflate the abdomen during surgery simultaneously provides a surgeon with an expansive view around the prostate and reduces a patient’s risk of blood loss.

Are there risks associated with RALP surgery?

Like any surgery, there are risks associated with a RALP procedure. Common RALP surgery risks include heart attack, stroke, and death. Prior to performing a RALP surgery, a urologist conducts a comprehensive patient evaluation to identify any potential risks. If there is any chance of health complications, a urologist will forego a RALP surgery recommendation and offer alternative prostate cancer treatment options.

Should I undergo RALP surgery?

There is no right or wrong answer to this question, and the answer depends on the patient. Before a patient decides to undergo RALP surgery, it is essential to meet with a urologist. An initial consultation is the first step of the RALP surgery process. It enables prostate cancer patients to obtain RALP treatment insights and determine whether the procedure is the right choice based on their personal needs.


RALP is an advanced surgical procedure that has been shown to help patients address prostate cancer symptoms. It is not right for everyone, however, and it is important for a prostate cancer patient to understand the pros and cons of the surgery.

Comprehensive Urology teaches patients everything they need to know about RALP and other prostate cancer treatments. To find out more about our prostate cancer treatment options, please contact us today at (310) 499-2756 to schedule a consultation with one of our friendly, knowledgeable prostate cancer experts.

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What Are the Best Prostate Cancer Treatments?


The best prostate cancer treatment varies depending on a patient’s age, their overall health status, the cancer’s grade and stage, and other factors. Both surgical and non-surgical treatments are available to address prostate cancer, and a urologist provides each patient with a personalized prostate cancer treatment plan.

There are several common prostate cancer treatments used to address stage 1 prostate cancer (i.e. disease still confined to the gland). These include:

  • Active Surveillance: Involves regular monitoring of a patient’s prostate cancer measures including PSA over a set amount of time. Active surveillance usually requires a patient to receive rectal examinations and blood tests every six months, as well as an annual prostate biopsy to closely monitor for cancer progression.
  • Radiation Therapy: Uses high-energy rays or particles to kill prostate cancer cells. Radiation therapy is commonly used to treat cancer that is still in the prostate gland and is low grade. Or, it may be used as part of an initial treatment for cancer that has spread beyond the prostate gland.
  • Radical Prostatectomy: Involves the removal of the entire prostate gland and sometimes surrounding tissues.

The aforementioned treatments may be used to address stage 2 prostate cancer too. Other stage 2 prostate cancer treatments include external beam radiation therapy and brachytherapy. External beam radiation therapy involves the use of X-rays, protons, or other high-energy beams to destroy cancer cells. Meanwhile, brachytherapy involves the placement of radioactive seed implants into the prostate gland. Brachytherapy localizes radiation treatment to the prostate and limits its effects on the bladder, rectum, and surrounding organs. Additionally, in some instances, external beam radiation therapy and brachytherapy may be used together to treat stage 2 prostate cancer.

External beam radiation therapy, radical prostatectomy, and brachytherapy are among the treatments used to treat stage 3 prostate cancer. Hormone therapy may be used in combination with external beam radiation treatments as well.

Hormone therapy reduces a man’s level of testosterone, a hormone that accelerates the growth of prostate cancer cells. It is generally used to target prostate cancer that spreads beyond the prostate gland.

For older men or men who are dealing with severe medical problems, hormone therapy or active surveillance may be used to treat stage 3 prostate cancer. Hormone therapy and active surveillance are less aggressive than other prostate cancer treatments, and as such, may prove to be viable treatment options for these individuals.

With stage 4 prostate cancer, men may require one or more treatments. Common stage 4 prostate cancer treatments include hormone therapy, external beam radiation therapy, brachytherapy, and radical prostatectomy.

Sometimes, hormone therapy is used in conjunction with chemotherapy to treat stage 4 prostate cancer. Chemotherapy involves the use of anti-cancer drugs that are injected into a vein or give to a patient to take orally. Next, chemotherapy drugs enter the bloodstream and travel throughout the body.

Stage 4 prostate cancer treatment may also include options designed to alleviate pain and other symptoms such as urinary obstruction. For example, transurethral resection of the prostate (TURP) helps men address benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate. TURP involves the “shaving” and removal of the inner part of the prostate gland that surrounds the urethra, and it enables men to alleviate bleeding, urinary obstruction, and other prostate cancer symptoms.

There is no guarantee that the initial treatment a man uses to address prostate cancer will work. However, a revolutionary prostate cancer treatment is now available that has been shown to help patients address newly diagnosed prostate cancer or cancer that has returned to the prostate – high intensity focused ultrasound (HIFU).

HIFU: Here’s What You Need to Know

HIFU involves the use of high-frequency ultrasound waves that are used to heat and destroy cancer cells in the prostate. With HIFU, a surgeon targets cancerous tissues in the prostate and ensures nearby tissues remain intact.

During a HIFU procedure, a surgeon inserts a small probe into the rectum that provides easy access to the prostate gland. Then, the surgeon uses computer imaging to place the probe near the prostate gland. The HIFU probe delivers ultrasound waves to an area that is no bigger than a grain of rice, and the probe heats up to almost 100°C (212°F) in about 3 seconds.

HIFU enables a surgeon to adjust the number of ultrasound waves and their intensity and carefully select the areas that the energy will be applied to (i.e cancer regions). This ensures a surgeon can heat prostate cancer cells until they can no longer survive. It also guarantees ultrasound waves have no effect on tissues outside the treatment zone.

What Types of HIFU Are Available?

Not all HIFU procedures are identical, and a HIFU treatment can be used to target the whole prostate or certain areas of the prostate. There are four common HIFU treatment options:

  • Whole Prostate Gland HIFU Therapy: Involves treatment of the entire prostate gland. Whole prostate gland HIFU therapy is performed as an outpatient procedure and takes about 3 hours to complete.
  • Partial Prostate Gland HIFU Focal Therapy: Combines HIFU with magnetic resonance imaging (MRI) perfusion of the prostate. Partial prostate gland HIFU focal therapy enables patients to address localized cancer that is less than half the volume of the prostate.
  • Post Radiation HIFU: Involves treatment of prostate cancer that recurs. Post radiation HIFU has been shown to help patients who have struggled to effectively treat prostate cancer with radiation therapy.
  • Post Cryotherapy HIFU: Involves treatment of prostate cancer after cryotherapy, which is used to freeze the prostate with liquid nitrogen. Post cryotherapy HIFU is a minimally invasive outpatient procedure that has fewer side effects than those associated with prostate cancer surgeries.

Prior to undergoing HIFU prostate cancer treatment, a patient receives a prostate-specific antigen (PSA) blood test, digital rectal examination (DRE), and other tests. Proper prostate cancer screening enables a urologist to provide an accurate patient diagnosis and determine if a patient is eligible for HIFU.

Benefits of HIFU Prostate Cancer Treatment

HIFU is FDA approved, and to date, many men have reaped the benefits of this state-of-the-art prostate cancer treatment. Some of the benefits of using HIFU to treat prostate cancer include:

  • Minimally Invasive: HIFU is a targeted ultrasound treatment that does not require a patient to undergo prostate cancer surgery.
  • No Hospital Stay Required: HIFU is an outpatient procedure, and patients usually can go home immediately following treatment.
  • Fast Procedure: A typical HIFU treatment requires between 1 and 4 hours to complete.
  • Quick Recovery: Most patients can return to their normal activities just a few days after a HIFU procedure.
  • Limited Side Effects: There is no blood loss due to HIFU, and patients who receive HIFU procedures face reduced risk of erectile, sexual, and urinary side effects in comparison to other prostate cancer treatments.

HIFU is an advanced prostate cancer treatment, and a patient should meet with a urologist prior to a HIFU procedure. During a urological consultation, a prostate cancer patient can learn about the different types of HIFU, the benefits of HIFU procedures, and much more. As a result, a urological consultation enables a prostate cancer patient to learn about all aspects of HIFU and make an informed treatment decision.

Schedule a Prostate Cancer Screening at Comprehensive Urology Today

Comprehensive Urology Medical Group in Los Angeles employs a team of friendly, highly trained urologists, and we are happy to teach prostate cancer patients about HIFU and other treatment options. Our team responds to patients’ prostate cancer concerns and questions and helps them determine the best course of action to address prostate cancer symptoms. This way, we enable patients to address prostate cancer for years to come. To find out more about our prostate cancer treatment options, please contact us today or call us at (310) 499-2756 to schedule a consultation with one of our urologists.


The post What Are the Best Prostate Cancer Treatments? appeared first on Comprehensive Urology.

Stay Healthy – Know the Top 5 Causes of Incontinence

LA Female Bladder Leak Urinary ConditionBladder control problems can be particularly embarrassing, which typically causes people to remain silent about their suffering. Unfortunately, what most people don’t understand is that they don’t need to suffer in silence and that incontinence can be improved or cured in many cases.

The first step towards finding effective incontinence treatment is gaining an understanding of the causes behind the condition and consulting with a board-certified urologist such as the acclaimed physicians at Comprehensive Urology.

What is Urinary Incontinence?

Urinary incontinence or urine leakage occurs when the muscles of the bladder that control the flow of urine either contract or relax involuntarily. Incontinence causes problems for millions of men and women, affecting 1 out of 10 people over the age of 65. Due to differences in the urinary anatomical structures, women tend to suffer from bladder issues more often than men.

Bladder leakage is characterized by specific ranges and types. The ranges of bladder issues are:

  • Mild incontinence
  • Occasional bladder leakage
  • Chronic uncontrolled urination

Five Common Types of Urinary Incontinence

Stress Incontinence

This is the most common type of urinary incontinence and is caused by pressure or sudden muscle contractions on the bladder. Stress incontinence can happen when pressure on the bladder increases during common daily activities — such as when you exercise, laugh, sneeze, or cough. Incontinence of this type is often due to an inherent weakness of the pelvic floor muscles, which may occur as a result of stress during pregnancy or childbirth, or due to the beginning of menopause.

Urge Incontinence

Urge incontinence is sometimes called an overactive bladder and occurs when a person feels the urge to urinate but is unable to hold back the urine long enough to make it to the bathroom. This type can be experienced by people who have had a stroke or suffer a chronic disease like diabetes, Alzheimer’s disease, Parkinson’s disease or multiple sclerosis. In some cases, urge incontinence may be an early sign of bladder cancer.

Overflow Incontinence

Overflow incontinence is characterized by the inability to empty the bladder completely and the remaining urine in time increases and eventually overflows and leaks out of the full bladder as new urine is produced. Loss of bladder sensations (nerve damage such as in diabetics) and weakening of bladder muscles by chronic overfilling are the most common cause of overflow incontinence in women and can be found in people with diabetes and spinal cord injuries.

Functional Incontinence

This is one of the few types of incontinence that have less to do with a bladder disorder and is more a problem with navigating the logistics of getting to the bathroom in time. Functional incontinence is most commonly found in elderly or disabled people who may have normal bladder control but suffer from mobility limitations or confusion that interferes with their ability to empty their bladder in a typical fashion.

Gross Total Incontinence

Gross total incontinence refers to constant urine leakage from the bladder and may be the result of an anatomical defect, spinal cord injury, an abnormal opening in the bladder (fistula), or as a result of an unsuccessful urinary tract surgery.

These are common causes:

  • Overactive bladder muscles
  • Weakened pelvic floor muscles
  • Nerve damage
  • Interstitial cystitis or other bladder conditions

While urinary incontinence itself is not a disease, it can be a symptom of an underlying problem. Educating yourself about the risk factors can help reduce the possibility of developing incontinence and help promote lasting urinary health.

Five Risk Factors to Watch Out For

Being Female

Females are twice as likely as men to experience stress incontinence. This is due to childbearing but can also be experienced with the onset of menopause and the weakening of the pelvic floor muscles over time.

Advancing Age

Contrary to popular belief, urinary incontinence isn’t considered a normal part of aging. However, as we get older, our bladder and urinary sphincter muscles weaken, which may result in frequent urination or even unexpected urges to urinate that can contribute to the condition.

Excess Body Fat

Obesity and excess body fat can cause a whole range of health problems including stress incontinence as a result of increasing pressure on the bladder, which can lead to bladder leakage during typical activities like exercise, coughing or sneezing.


Cigarette smoking can cause chronic coughing, which in turn can create urine leakage. This is because a constant cough can damage the muscles of the pelvic floor, leading to a weak bladder. What’s more, smoking is a known bladder irritant, which could cause overactive bladder symptoms.

Other Chronic Diseases

Many conditions can increase the risk of urinary incontinence including vascular disease, kidney disease, diabetes, prostate cancer, Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, etc.

Learn more about potential causes of urinary leakage and incontinence treatment at

In a Nutshell: Incontinence Causes
What is Urinary Incontinence? Incontinence is characterized by a weak bladder and/or the inability to control urine leakage.
What are the Most Common Types of Urinary Incontinence? Stress, Urge, Overflow, Functional, and Gross Total Incontinence
What are the Most Common Incontinence Causes? Sex, Age, Obesity, Smoking, or other chronic diseases

Contact Our Urology Experts Today!

If you have concerns about incontinence treatment or are looking for more information on bladder control, schedule a consultation with one of our talented urologists in Beverly Hills today.

Next, read Surgical vs Non-Surgical: Which Incontinence Treatment is Right for You?

The post Stay Healthy – Know the Top 5 Causes of Incontinence appeared first on IncontinenceDr.

Surgical vs. Non-Surgical: Which Incontinence Treatment Is Right for You?

Beverly Hills Bladder Weakness Treatment SpecialistsUrinary incontinence may not be a physically debilitating condition but it can be emotionally devastating. At Comprehensive Urology, we understand the impact it can have on your life. We talk to patients every day about incontinence issues such as an overactive bladder or urinary leakage. One of the most common questions we get is, “Which urinary incontinence treatment is right for me?”

There are many factors that go into determining which type of urinary incontinence treatment is suitable for each patient. One major factor is the type of incontinence you have:

  • Stress Incontinence
  • Urge Incontinence (overactive bladder)
  • Overflow incontinence
  • Functional Incontinence
  • Mixed Incontinence (a combination of the above)

In general, though, the best way to get an answer that specifically addresses your unique situation is to consult with a board-certified urologist.

However, let’s take a look at the variety of urinary incontinence treatment options available so that you have a better understanding of what to expect before you have that consultation.

Non-Surgical Urinary Incontinence Treatment Options

Before deciding on and undergoing treatment, a diagnosis must be made to understand your medical history as well as the type and cause(s) of your incontinence.

Once the proper diagnosis is made, then the correct treatment – or combination thereof – will be discussed and determined.

Modification of Habits and Behaviors

One of the worst feelings of incontinence is the loss of control. It’s a helpless feeling that can be difficult to bear. By changing some of your habits and behaviors, you can reclaim control of an overactive bladder.

By adjusting how much fluid you ingest, you have control over the amount of urine that builds up in your bladder. Also, creating a schedule of when to go to the bathroom can help keep mild urges under control.

Physical Therapy and Rehabilitation

With the proper physical therapy, you can regain control over your bladder to help regulate your urges.

One of the primary goals of physical therapy is to help patients avoid incontinence surgery. To make this happen, physical therapy helps incontinence patients strengthen their pelvic floor muscles and sphincter so they can “hold it in” more easily.

Before undergoing such therapy, a biofeedback machine is often employed to measure the activity and strength of the pelvic floor muscles. This technique helps discern which areas physical therapy can address and monitor.

An office procedure to place a removable device called a vaginal pessary in the vagina is also an effective type of incontinence treatment. Made of silicone, rubber, or plastic, pessaries are inserted into the vagina or anus to support areas affected by pelvic organ prolapse by working out your muscles to hold the device in place. The devices can fortify your pelvic floor muscles.

Learn more about vaginal pessaries at

Incontinence Medications

Many times, urinary incontinence treatment involves medications prescribed alongside behavioral modifications.

Anticholinergic medications are effective at relaxing overactive bladder muscles, which can help you have better control. Other treatments, such as topical estrogen medications, help limit urine linkage by rejuvenating vaginal tissue.

Holistic Therapies for Incontinence

Holistic therapies offer a variety of benefits, including the fact that they treat your body as a whole instead of simply focusing on one issue, condition, or area. Some beneficial holistic therapies we suggest include the following:

Everyone loves massages, but in this case, a body massage can mitigate the physical stresses and help relax the muscles that controlling your urges.

The ancient practice of acupuncture also helps reduce incontinence symptoms by correcting imbalances in your body via stimulation of carefully selected acupuncture points.

Have you tried meditation? It can help make you stress-free and relaxed, increasing your ability to maintain control of your urge to urinate.

You can also help your cause by eating well and exercising, among other lifestyle tweaks, as well.

Incontinence Surgery

Incontinence surgery is often the last resort, but if nothing else works, it’s a viable option. The following surgical incontinence treatment options are effective.

A bladder neck suspension procedure reinforces the neck of your bladder so that it won’t sag and make your urges difficult to control. Recovery time is 2-6 weeks, during which time you may have to urinate using a catheter for a number of days.

Sling surgery for incontinence is also a popular choice. Using a synthetic material or your body’s own tissue, a sling is fashioned to help keep your urethra supported and closed when you cough, sneeze, or laugh. Slings come in various types – tension-free slings, adjustable slings, and conventional slings. These procedures are generally done on an outpatient basis but involve 2-6 weeks of recovery.

A very effective surgical incontinence treatment involves bulking agent injections into the urethral tissue with the intent of reducing leakage. The procedure is an outpatient one. The following materials are commonly used in bulking agents:

  • Collagen
  • Silicone implant
  • Carbon coated beads made of zirconium

Contact an Incontinence Specialist Today to Find Out Which Option is Right for You

If you’re dealing with incontinence issues, a variety of urinary incontinence treatment options can relieve your symptoms and give you your life back, not to mention control of your urges. To learn more about your non-surgical or surgical incontinence treatment options, contact the Los Angeles incontinence specialists at Comprehensive Urology for a consultation by visiting us online or calling 310.307.3552.

Next, read These 4 Factors Could Mean Urinary Incontinence is in Your Future

The post Surgical vs. Non-Surgical: Which Incontinence Treatment Is Right for You? appeared first on IncontinenceDr.