Category Archives: Shu Procedure Clinic

Most Important Question to ask before Vasectomy in Minnesota

Posted on by

The practice of vasectomy was pioneered in 1900s, but for many years the vasectomy procedure was used sparingly, especially after oral contraceptives were invented for women in the 1950s; many men were uncomfortable with the idea of elective surgery on their sexual organs. But today, vasectomy is becoming more frequent among men in Minnesota and the US, and men are more comfortable with the vasectomy procedure as education about vasectomies becomes more widely available online. Men realize that the idea that vasectomies will lower sex drive or libido is a myth; two vas deferens are cut in the vasectomy, preventing any sperm from exiting the body through the penis. All other functions of the testes are still intact. Even sperm is still produced, but it is absorbed by the body.

The most popular vasectomy technique in the Minneapolis and St. Paul areas is no scalpel vasectomy, it requires work off for only 2- 3 days compared that of 1-2 weeks with traditional vasectomy, and it is also much less invasive and more affordable than tubal litigation on women.

No scalpel vasectomy is an affordable, reliable form of male contraception that is more practical than other permanent alternatives in Minnesota. But men must know that sterilization is not immediate after vasectomy. Even after the vas deferens are cut, there is still sperm lingering in your system that can be present in semen. It will take several months before sterility is complete. You should use birth control until your physician determines you are completely sterile.

Still, vasectomies are permanent, so it is important to be informed before you decide to get one. There is the most important question one must consider:

Do I want any more children in the future? Vasectomies are more or less permanent. Once the procedure is done, it’s done. It is possible to have vasectomies reversed in Minnesota, but to do so is prohibitively expensive, unreliable, not to mention that sperm production will never be the same as it was before. Do not getting vasectomies if you are not absolutely sure that you want it, and do not assume you can reverse it.

At What Age Should We Have a Colonoscopy in Minnesota?

Posted on by

After years public education from the family physicians, health insurance companies, and media exposure, more people in Minnesota know that average risk patients should have their first colonoscopy at 50 year old. Actually, the age at which we should have our first colonoscopy varies according to the level of risk for developing colon cancer. Recommended ages for a colonoscopy are based on risk levels from the national professional organizations. Our risk of colon cancer helps determine when to get a colonoscopy.

You are at average risk if you have no other risk factors besides age. Most people in Minnesota belong to this group. This group of people should have colonoscopy at age 50.

You have an increased risk if you have the immediate family members who have had colon cancer. This group of people should have a colonoscopy at age 40 or 10 years earlier than the age of that family member when diagnosed.

You are at high risk if you have a family history of certain colorectal cancer syndromes such as Familial adenomatous polyposis or if you have an inflammatory bowel disease such as ulcerative colitis. The recommended age for a colonoscopy for people in this category could be very young, as young as 20s years.

The above recommended ages for a colonoscopy are the general guideline for discussions with your doctor about your particular situation. Each case is different, and there is no set of recommendations right for every individual in the Minneapolis and St. Paul areas.

Hemorrhoid Treatment History Part 2

Posted on by

The word “Hemorrhoids” is probably derived from the combination of Latin “hæmorrhoida -ae” (haemo (blood), rhoidae (flowing) and the Greek “Haimorrhoos”. The original “a” has been dropped to give us “Hemorrhoids”.

In the 13th century, European surgeons such as Lanfranc of Milan, Guy de Chauliac, Henri de Mondeville and John of Ardene made great progress and development of the surgical techniques.

In the 19th and 20th centuries, many new surgical techniques were developed to treat the advanced hemorrhoids. In the meantime, several minimal invasive non-surgical modalities were invented to treat early stages of hemorrhoids.

1806; Using the modern era of endoscopy, Philip Bozzini, an Italian-German physician, used an aluminum tube to see the genitourinary tract. He then earned the title “The father of endoscopy”.

1835; St.Marks Hospital London was founded by Frederick Salmon providing modern hemorrhoids and fistula treatment.

1849; Introduction of anal dilation for hemorrhoids treatment.

1935; Doctors E.T.C. Milligan and C. Naughton Morgan in St.Marks Hospital London further studied the excision and ligation methods, which later became the gold standard in hemorrhoidectomy.

1950s;Ferguson modified the Milligan-Morgan procedure, and A.G. Parks’ developed his closed method surgical treatment.

1960s, Banding of larger hemorrhoids was introduced with rubber band ligation.

1970s; Non-surgical methods including cryotheraphy, diathermy, Infra-red and laser cauteries were developed for treatment.

1975; PH Lord developed his anal dilation hemorrhoid treatment method, whilst WHF Thompson postulated that hemorrhoids developed from anal cushions that are part of the normal anatomical structures.

1990s; Stapled Hemorrhoidopexy, also known as Procedure for Prolapse & Hemorrhoids (PPH) was first described by an Italian surgeon – Dr. Antonio Longo, and since then has been widely adopted to treat the grade 3 and 4 hemorrhoids. Moreover, the digitalized Infra-red coagulation (IRC) was getting popular for the treatment of early stage of hemorrhoids.

Biological implications After Vasectomy|Minneapolis & St Paul

Posted on by

The patients who had the vasectomy in Minnesota often ask where the sperms go after vasectomy. Here is the explanation for biological implication after vasectomy.

After a vasectomy, the path that sperm travels is interrupted because the vas tube running from testes to the penis is no longer connected. Sperm that is produced is broken down by the body. The epididymis’s membranes absorb the liquid created, while solids substances are further broken down by macrophages and absorbed into the bloodstream. With the increase of stagnant sperm, the membranes of the epididymis increase in size to absorb more liquid. The immune system increases the amount of macrophages to handle an increase of solid waste.

The testes are still very much alive and functioning; a group of cells with the special function, called Leydig cells, continue to produce a class of androgen hormones, including testosterone, androstenedione and dehydroepiandrosterone (DHEA), which continue to be absorbed into blood. These functional cells in the testes are not affected by vasectomy. Leydig cells are named after the German anatomist Franz Leydig, who discovered them in 1850.

Vasectomies are, for all intents and purposes, permanent. Reversal vasectomy in the Minneapolis and St Paul areas are costly, have a considerably lower success rate, and often do not restore the sperm count and/or motility to pre-vasectomy levels.

Confirmed, properly performed vasectomies ensure life-long sterility with almost no chance of making a woman pregnant. No scalpel vasectomy in Minnesota is a simple, safe office procedure done under the local anesthesia. It does not, however, prevent the transmission of STDs.

Eliminating Varicose Veins with Laser | Minneapolis

Posted on by

If you have varicose veins then you are familiar with the discomfort they can cause and the feeling that you don’t want anyone to see your legs. Many men and women in Minnesota will not even wear shorts due to how unsightly the veins can be. You probably have varicose veins if you suffer from these symptoms: Dark red, purple or blue veins close to the surface of the skin, veins in the legs with a bulging, ropy or knotty appearance, trouble walking more than a short distance without fatigue, restless leg syndrome, legs that throb, itch or burn, roadmap or cobweb like veins on the skin or your head, neck, chest or arms, discoloration of skin or edema in the ankles. The symptoms you see are from the veins not working properly.

In healthy veins, the blood will flow smoothly from the heart to the limbs through arteries and then the deoxygenated blood is pumped back out through veins. With varicose veins the valves are not working properly and the blood is pooling or is going in the reverse direction that it is supposed to. Causes could be from age, pregnancy, weight gain, physical stress, it could also be hereditary. Sometimes the valves can just weaken or fail working all together. Don’t worry, if you have varicose veins they can easily be treated today.

In the past treatment for varicose veins in the Minneapolis and St. Paul areas required ligation and stripping in hospital. It was uncomfortable, expensive and had much more downtime associated with it. Today a minimally invasive treatment called endovenous laser ablation (EVLA) is much faster and more comfortable to the patient with minimal downtime. EVLA is thermal ablation using a thin laser fiber in a targeted segment of the varicose vein. It will permanently collapse and shrink the vein without having to surgically remove it. A local anesthesia is used to keep the patient comfortable during the procedure. EVLA takes about an hour and is done right in our procedure clinic in Edina, MN. The patient is able to walk out after the procedure is done. The cosmetic results are amazing and the patient’s self-esteem is restored as well.

Hemorrhoid Treatment History Part 1 | Minneapolis

Posted on by

As early as 2250 BC hemorrhoids have been recorded in literature to some extent. It would probably be safe to say that it is one of the oldest ailments known to people. The Egyptians were the first people who medically recorded the remedies for hemorrhoids. In 1700 BC Egyptian papyrus advised to use a poultice of dried acacia leaves with a linen bandage to heal protrusions and inflammations of venous tissue.

A well-known Greek physician named Hippocrates wrote about hemorrhoids in his book, On Hemorrhoids, describing it as bile or phlegm which is determined to be the veins in the rectum. He treated the anal protusions very crudely advocating pulling the tissue off with the finger tips, or pulling the veins upward, while someone puts a hot iron to the hemorrhoid and burns it off. The first recorded endoscopy (use of speculum to inspect the rectum) can also be credited to Hippocrates. In 400 BC, the Hippocratic also discussed a treatment similar to modern rubber band ligation: “And hemorrhoids in like manner you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application, and do not forment until they drop off, and always leave one behind; and when the patient recovers, let him be put on a course of Hellebore”.

Even the bible has records of hemorrhoids in the earliest times from the Old Testament Book of Samuel 5:9 Philistines, “punished with emerods” and Samuel 5:12, “People who moved the Ark to Ekron were punished with emerods”.

One of the earliest known hemorrhoid treatments was with the aloe vera plant. Dioscorides, a Roman physician started using that to treat inflamed hemorrhoids. Celsus (25 BC – AD 14) described ligation and excision procedures, and discussed the possible complications. Then approximately 130-200 AD a Roman physician named Emperor Marcus Aurelius (Galen) prescribed ointment, laxatives, and leeches for hemorrhoids treatment. Galen advocated severing the connection of the arteries to veins, claiming that it reduced both pain and the spread of gangrene. The Susruta Samhita, (4th – 5th century AD), similar to the words of Hippocrates, but emphasizes wound cleanliness. During the same time period in India, the use of clamp and cautery was used to get rid of hemorrhoids and control bleeding.

Between the 5th and 10th Century, Byzantine physicians used thread to ligate the base of the hemorrhoid and then followed by its amputation.

Vasectomy in Minneapolis

Posted on by

With so many options available in terms of birth control for women, many men in Minnesota inquire regarding the availability of other options for male birth control excluding the usual abstinence, condoms, withdrawal before ejaculation, and vasectomy. We would predict that with the fast development of modern medical science in 21th century, just as women do, men will soon be able to simply take a pill to control the release of their sperm.

There are actually much medical research being done in this field; such a market has a high demand. A number of research groups across the globe have tried different alternatives to male birth control. These include injected plugs, heat methods, pharmaceuticals, hormonal therapy, and obstruction of the vas deferens. Despite promising developments, these treatments are experimental , and not approved by FDA. Reversible inhibition of sperm under guidance (RISUG) got more attention recently; phase III clinical trials are underway in India. RISUG works by injecting the polymer into the vas deferens, the polymer prevents the sperm from fertilizing an egg.

Many people in Minneapolis and St Paul areas are still misinformed about vasectomy; it is not as painful and inconveniencing as one may believe. Modern developments in vasectomy have reached a point where a vasectomy can be done in a doctor’s office in less than 20 minutes, using only local anesthesia. The procedure is incredibly simple and pain free- it involves making a small incision in the scrotum, where the vas deferens are severed and prevented from joining back together. Discomfort afterwards is minimal and patients can quickly return to their everyday lives. The patient who gets a “no-scalpel” vasectomy typically feel no change in libido, as vasectomies cause no physical change in sensation, testosterone levels, blood flow to the penis, amount of semen, or satisfaction of an orgasm. The only difference is that the semen has no sperm in it.

Simply put, no scalpel vasectomy is a safe, simple, and convenient method of male birth control with few drawbacks.

History of Varicose Vein Surgery Part 2 | Minnesota

Posted on by

The University of Cordoba in the Arabs produced one of the most famous surgeons. He was known to the western culture as Albucasis (930 AD to 1313 AD). He became a prominent surgeon during that era. He was appointed as the Court-Physician of King Abdel-Rahman III. Besides his practice of medicine he also did a lot of medical and surgical writings.

He wrote thirty volumes of a digest of vast medical knowledge called Tasrif. He is also known for writing the best medieval surgical encyclopedia on record. It dealt with all aspects of surgery and was the first textbook of surgery to include illustrations of instruments to be used in surgery. It became very famous as it was the standard textbook of surgery used up to the 17th century in prestigious western universities. His medical and surgical expertise was evident in his writings of exact details of clinical and surgical procedures. His writings described the binding of the arteries long before any other physicians. His descriptions of varicose vein stripping are almost like our modern day surgeries for the veins.

The progress of medical science and surgery stalled for about 350 years after 13th century when barber surgeons routinely performed surgeries. In 16th century, the ligation at the site of the varix became the preferred varicose vein surgery. A century later, the combination of bleeding, diet and application of bandages to the legs was recommended by a German surgeon, Lorenz Heister, to avoid varicose vein surgery.

In the mid 1600’s intravenous drugs were first introduced. Opium was put into the vein of a dog using a metal tube and was successful. The hypodermic syringe did not appear until 1851. The introduction of anesthesia and antiseptics, delivered by the hypodermic syringe, brought about great changes in the treatment of varicose veins. In the 1850’s injections really took off and the treatment of veins by injection was becoming popular. The injections were either perchloride of iron or iodine. The perchloride of iron seemed to cause inflammation and swelling. In order to help correct this, the use of compression was advised in order to prevent dilation of the veins. In 1894, due to the high numbers of complications from this treatment, treating varicose veins by injection was abandoned.

How to Treat Anal Tags in Minneapolis

Posted on by
Reply

An often frustrating and embarrassing condition, hemorrhoidal tags occur with variety of reasons in the Minneapolis and St. Paul areas. Besides the typical hemorrhoid symptoms such as itching, pain, and bleeding, the patients may use a lot of toilet paper because of pesky anal tags. Rest assured that these anal tags are harmless and very common in Minnesota. They are very similar to skin tags found in your armpit, neck, eyelids and sometimes groin.

A hemorrhoidal skin tags is typically a soft flap of skin or flesh found around the anus as a result of an existing hemorrhoid. The tags usually hang in the opening of the anus by a stalk or stem that supplies the blood to the tag. The individuals in Minneapolis may not even know they have hemorrhoidal skin tags unless they feel them while wiping.

If a thrombosed external hemorrhoid resolves without the incision & drainage or surgical excision, the residual external hemorrhoid may leave behind a skin tag. The skin tags can then lead to even larger skin tags or external hemorrhoids due to its close proximity to the original varicose veins.

Anal skin tags are usually not caused by anal intercourse or sexually transmitted diseases in Minneapolis. However, you need to be aware that anal skin tags are usually associated with other anorectal problems and may come about as a result of a hemorrhoid, an anal fissure, or an injury.

Causes of anal tags include:
● Hemorrhoids
● Anal fissures.
● Previous anorectal surgery
● Anal infection or injury
● Blocked anal gland
● Tight fitting clothing

Individuals suffering from hemorrhoidal skin tags in Minneapolis can treat the condition in the same way as treating hemorrhoids with anal care measures. These anal care measures include thorough cleaning of the affected area with gentle cleansers, such as witch hazel, washing and Sitz bath may help remove any trapped fecal matter and improve symptoms. If the skin tags cause persistent symptoms or complications, or if the skin tags lead to anxiety, individuals may opt to have them removed surgically. Anal tags can easily be removed in the office using local anesthetic and a radiofrequency device. The procedure only takes less than 10 minutes and you are able to drive yourself home afterwards.

Colonoscopy Preparation in Minnesota

Posted on by
Reply

In order to perform the colonoscopy properly the colon must be free of solid matter. The cleaner the better! In the past patients in Minnesota were required to drink terrible tasting flushing fluids such as Golytley. These days the colon cleansing process is much easier. Prior to the procedure the patient is required to follow a low fiber for three days and clear-liquid only diet for 24 hours. It is very important that the patient remain hydrated.

A typical colonoscopy regimen in the Minneapolis and St. Paul then would be as follows

• The day before the colonoscopy, the patient is given a laxative preparation (two bisacodyl 5 mg tablets at the noon time) and large quantities of fluid (Water, clear broth or bouillon, coffee or tea, Gatorade, Pedialyte, carbonated & non-carbonated soft drinks, Kool-Aid or other fruit-flavored drinks, strained fruit juices). Alcohol is not permitted.

• The night before colonoscopy, the patient start drinking the Mixture of 1 bottle of Miralax (8.3 oz, 238 grams) with 64 oz of Gatorade (approx. 8 oz. each 15-30 min. until finished).

• 3 hours before your procedure, drink 1 bottle of magnesium citrate (10 oz).
It may be advisable to schedule colonoscopy in the morning so the patient can have food right after the procedure. The patient must have a responsible driver to accompany him/her home. Once the bowel preparation with Miralax starts, the patient should stay at home in comfortable surroundings with ready access to toilet facilities.

The patient may be asked to skip aspirin and aspirin-like products such as salicylate, ibuprofen, and similar medications for up to ten days before colonoscopy to avoid the risk of bleeding. If a polyp is removed it is usually sent to a lab for a pathology report.