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Holiday Hours!!!!!

  • The office will be closed the week of Thanksgiving (Nov. 20th at noon until Nov 30th at 7am.)  The practice will be covered for ER visits ONLY by another Urologist.   PLEASE PLAN AHEAD Prescriptions will not be refilled during this time as he will only be seeing patients in the ER with true emergencies. 
  • Our office will also be closed for the following holidays Dec. 24 & 25 and Dec 31 at noon, and Jan 1, 2016.
An article in the American journal of Kidney Diseases this month, showed that after studying men with kidney stones for 11 years, Supplemental Vitamin C of 500 -100 mg per day was associated with an increase in kidney stone production.   
Vitamin C intake in FOOD did not seem to increase the risk of stone formation in men or women.   So IF you are a kidney stone former, it is best if you do not take Vitamin C supplements! Get your Vitamin C in your FOOD 
So, why do some women get UTI and some women don’t?  We believe that the difference lies in the host factors.(Patient’s immunity)
1) Patient’s anatomy may be a factor.
2) Use of spermicides can increase the chance of UTI
3) Frequency of sexual activity (more than 9 sexual encounters/month correlated highly with UTI)
4) Genetics (a positive female family history for UTI is a strong risk factor) There are certain genes which correlate with a poor host response to UTI.
5) Recent use of an antibiotic, for any reason, can be a strong risk for development of UTI.
6) New sex partner increases UTI risk.(no known reason)
7)UTI increase with advancing age.

Methenamine salts: This has never been proven in good clinical trials. But, anecdotally, some patients report help. It is hydrolyzed to ammonia and formaldehyde. Theoretically , these compounds should be bacteriostatic.
1 gram of methenamine hippurate every 12 hours is the dose.

Cranberry: Proanthocyanidin(PAC) is the chemical that delivers the antimicrobial effect. PAC has a dose dependent effect on the inhibition of E. Coli adherence and displacement .Cranberry tablets are twice as cost effective as the juice and the weight gain from the juice does not happen with the tablets. If you choose to go this route, you must make sure that your pill has enough PAC in it as the response is definitely dose dependent. The pill must have the PAC level confirmed by the BL-DMAC method.
My recommendations are :  TheraCran® HP every 12 hours. This is made by an American company Theralogix. Or Ellura  every day. This is made by a French company. I have found them to be equally effective. Both must be gotten from the internet or by calling the company. Neither is sold in most stores. 
Sacral Neuromodulation Test Stimulation Days
Friday December 4th will be our next test days in the office. 
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