Gwen Roesel MD - The Cincinnati Urologist

Testicular Cancer

2011-10-16T16:00:00.000-04:00

Uh oh.

Lump felt in testicle.

Let me feel it again

And again.

Now it hurts.

Uh oh. Better call the doctor. Uh oh.

Just as many women are taught to examine their breasts for lumps, men are told to examine their testicles for lumps. Lumps could be cancer and if detected early, testicular cancer is one of the most curable cancers around.

Problem is, not too many men have actually been taught what is normal to feel and what is not. (Any of Dr. Roesel's male patients who have been through her testicle tumor teaching moment may skip this next part.)

Unlike other organs found in the trousers, HARD is BAD in the testicles. If you feel a hard lump that feels like a rock, see a urologist right away. Cancer tends to be hard and painless (unless you have felt it so much it is now hurting).

On the other hand, soft and squishy is usually okay but any lump should be checked out. There are many things that are benign that can cause lumps in the scrotum, remember that. But always err on the side of caution and get it checked out.

The treatment for testicular cancer has one of the highest success rates of any cancer, if the cancer is detected and treated early. For some types of testicular cancer surgery alone is curative. Sometimes radiation and/or chemotherapy are needed.

If a testicle is has be removed, prosthetic (replacement) testicles are available. The funny thing is, they are available for dogs too. Those are called "Neuticals". (I am not joking.) The clear one in the photo is filled with saline, the opaque one is solid silicone, in case you were wondering.

There are reports linking smoking marijuana to the development of testicular cancer. Just so you know.

Call us if you feel a lump or something. We're here to help.

Oops I Did It Again - A Quick Post About Premature Ejaculation

2011-10-08T17:00:00.000-04:00

Premature ejaculation brings feelings of shame, frustration, inadequacy and embarrassment to many people every year.

What exactly is premature ejaculation? The American Urologic Association defines it as follows: "Ejaculation that occurs sooner than desired, either before or shortly after penetration, that causes distress to one or both partners." Wow. That's pretty vague.

The key to determining if it is a problem or not is if it bothers you or your partner. If it doesn't, it's not a problem. And until sex becomes an Olympic sporting event, it's not a competition, either. Just because your friends may say they take 45 minutes to ejaculate doesn't mean it's the standard.

There you have it. (Or maybe you don't). But it's common. There are a number of things that can be done to help improve it.

The "squeeze technique" is a very well known trick. When you feel yourself getting too aroused you stop and squeeze the penis just behind the head. May work, may be too late.

Thinking distracting thoughts may help. Garbage, the Bengals and hockey statistics are examples of things people think about.

Avoid desensitization creams and lotions. If you look closely you can see the active ingredient is a powerful topical anesthetic. If it gets onto your partner's genitals, your partner will feel..... nothing. Your partner's genitals will be asleep.

Now there are some oral medications which can help. Call for an appointment to see if they might be right for you. In this case, don't delay!

What's Wrong With This Picture?

2011-03-15T19:20:00.010-04:00

A) This woman's bustier is too tight

B) This woman has a bad dye job on her hair

C) This woman forgot to put on her nail polish

D) This woman is SMOKING

A) This woman's shirt is too short

B) This woman needs to go on a diet

C) This woman's upper arms aren't very toned

D) This woman is pregnant and SMOKING

A) Grandma has dirty fingernails

B) Grandma needs an eyelid lift

C) Grandma is not sharing

D) Grandma is SMOKING

A) Penises do not have arms or eyes

B) Scrotums do not have legs

C) Scrotum legs do not wear boots

D) The penis is SMOKING

The correct answer in each case is of course, D. Smoking.

Smoking has been positively linked to bladder cancer. Not possibly, definitely.

And smokers who continue to smoke after a diagnosis of bladder cancer have a very large risk of developing metastatic disease within 2 years. Once bladder cancer has become metastatic life expectancy is usually less than 3 years.

Many bladder cancers start as superficial lesions that can be treated if caught early. Unfortunately, bladder cancer isn't always very obvious so if your doctor tells you that you have blood in your urine even if you can't see it, follow your doctor's recomendations to have it checked out.

Common risk factors for bladder cancer are age (over 40), being male and smoking.

If bladder cancer is caught early before it becomes invasive, treatment is much simpler. If it is invasive, then the discussions change dramatically to options such as removal of the bladder and/or radiation and chemotherapy.

People often fear quitting smoking for fear of gaining weight.

You can lose weight. It is much harder to lose cancer.

Other people fear becoming irritable if they stop smoking. There are lots of good ways to help cope with this, though.

There is hope and help if you want to quit.

And each time you try to quit, one day you really will.

The saddest part of Christmas this year was going to the funeral of one of my favorite patients who died of bladder cancer. She never stopped smoking.

Please try. For everyone who loves you but most of all for yourself.

We can help. Talk to us.

Mea Culpa - the blog has grown stale

2011-03-15T18:49:00.003-04:00

Mea maxima culpa

It's not for lack of time

Since most of my last three months have been spent like this outside of work

Let's see if we can bring this thing back to life, shall we?

Happy Holidays 2010!

2010-12-16T19:54:00.009-05:00

Whether it is Christmas

Or Hanukkah

Or Kwanzaa

Or anything you celebrate this time of year

We wish you all the peace, love and happiness in the world.

(Our favorite Christmas present was Obama signing the bill that prevents any further Medicare cuts to physician payments for one year.)

We look forward to helping you achieve optimal urinary and sexual function in 2011.

Post Op Vasectomy Advice

2010-11-14T12:15:00.001-05:00

Hear me now and believe me later!

The second hardest part about having a vasectomy is doing what you are supposed to do for the first week afterwards.

(The hardest part is deciding to have it done.)

(Unless you were not the one who made the decision)

But if you do the following things that Dr. Roesel recommends, your recovery will be much smoother than if you insist on "doing it your way".

Dr. Roesel goes over these things with you before you leave, and you also have written instructions that you are given. But when you are in a pleasant Valium haze you may forget what she says or where you put those instructions.

So let's go over them.

1. Wearing supportive underwear for the first week is a MUST.

This is an example of supportive underwear. Yours do not have to be so extreme.

Regular "tighty whities" are fine. Just don't buy them too big. Remember, we are talking support.

Boxers, boxer briefs, sweatpants, pajama bottoms and longjohns are not supportive. Put them back in the drawer.

2. Take it easy for 2-3 days after the procedure

Remember, you have had surgery and things need time to heal.

This means lying around and keeping your scrotum protected from the forces of gravity.

I like to tell my patients to only do things that they can do wearing a pair of bedroom slippers.

I have never seen anyone playing tag football or moving a big screen TV in slippers.

This is a really bad idea on many levels.

3. Use an ice pack as needed for comfort. We give you a gel pack but frozen vegetables work well, too.

4. Do not suffer.

You are not a "girlie man" if you need to take painkillers.

Be careful about taking too many, though.

5. Abstain from ejaculation for the first 7 days. If you have wet dream, you get a pass. You can't help that.

6. Stay out of the pool or the hot tub until your incisions heal.

7. And don't hesitate to CALL with ANY questions or problems.

Top 10 Reasons Why People Like To Come To Our Office

2010-11-03T21:00:00.000-04:00

1. We do not weigh you

2. We give you candy if you would like some, or a rubber mouse or frog if you prefer

3. We absolutely don't believe in causing pain

4. We have quiet pets in the waiting room, not fish with running water sounds that make you need to urinate

5. We always have a smile for you

6. Our magazines are up to date

7. We have warm baby wipes for clean up, not cold scratchy paper towels.

8. We have toilet seat covers and grab bars in the restroom.

9. We make you laugh

10. We can give you an appointment SOON, not weeks from now, and even SOONER if you are in pain.

Our office is more fun than a ride on a piglet. Come see us!

The Matter of Size

2010-06-23T18:00:00.001-04:00

Let's talk about something many people (men AND women) wonder about. Size. Penis size, that is.

Does size really matter?

What is normal?

Normal is defined in infants as 2.5 cm stretched length. That is about an inch. Reassuring so far, right?

The average adult erect penis size is around six inches. However, normal ranges go all the way from three inches to nearly eleven inches.

The anatomy of the penis is interesting. A large portion of it is actually inside the body, providing support and stability for an erection.

The penis is made up of three parts. The two larger parts fill with blood during an erection. There can be a dramatic difference in size between a soft penis and an erect penis depending on how much blood the parts can hold.

Wow! Who knew?

But the key to "being all that you can be" is healthy blood vessels. Since erections are dependent upon a good blood supply, anything that is bad for blood vessels is bad for an erection. These things include smoking, high cholesterol, high blood pressure and even lack of use.

That is why Dr. Roesel is a fan of the penile pump. This is a device that draws blood into the penis by way of a gentle suction. This helps bring fresh oxygenated blood to the penis tissues and helps keep the blood vessels healthy.

Dr. Roesel recommends the use of the pump along with nearly every treatment for erectile dysfunction. With consistent use, many men have noticed a return to their "best state" of size and girth. The pump isn't magic, though. It won't make anyone's original equipment any larger than it was at it's peak.

We have a representative from a medical pump company who comes to our office once a month. If you'd like to find out more about the pump, consultations with him are free of charge. They are private, do not involve any nakedness and take about 30 minutes.

Call us for more information about the penis pump and the various other treatments that are available for ED.

We're here to help.

513-271-2862

Medicare Cuts

2010-06-10T07:15:00.003-04:00

On Tuesday March 2, 2010 the Senate voted to temporarily halt the 21% cut in Medicare payments to physicians. This meant the cut was put off until April 1, 2010 with the hope that a long term solution could be found and made permanent. However, this did not happen. The cuts were delayed once again until June 1, 2010. The Senate was supposed to make some sort of decision when they returned from their Memorial day holiday around June 7. This did not happen.

So as of right now, June 10, 2010 all Medicare payments to physicians have been cut by 21%. This is devastating news to all physicians who accept Medicare, and even more devastating to patients who rely on Medicare for their health care. Not all physicians can continue to see Medicare patients with this kind of cut in reimbursements. The costs of running a medical practice are not going down, they continue to go up. It becomes a matter of economic necessity to have to make a business decision to see Medicare patients or not.

Our practice is new and cannot survive if our expenses exceed our reimbursements. We are sorry to say that at this time, we are no longer accepting any new Medicare or managed Medicare patients.

We are happy to take your name and number and put you on our list of patients to call if and when these cuts are reversed.

Thank you for your understanding.

The Ads That Were NSFN (Not suitable for the newspaper)

2010-05-20T21:37:00.022-04:00

Many of you may have enjoyed seeing our recent ads in the Cincinnati Enquirer newspaper or the online version. Just in case you forgot, here they are:

The online ad. This one was animated and linked to this blog.

The print ad.

But there were a few we thought might not be quite so suitable for general viewing. See if you agree:

Time for Khaki Pants and Light Colored Clothes

2010-05-13T22:00:00.013-04:00

It's getting warm and people are slowly shedding their layers of winter clothes and trading them for lighter fabrics and lighter colors.

But not everyone.

If you have a problem with urine leakage you will immediately know what I am talking about.

You will not be pulling out your tight pants, your tan pants, your light blue skirt... or anything else that would show a wet spot.

And you may be paranoid that despite all your best intentions, you smell like urine.

No matter how many times you change your pad. Or your clothes.

YOU ARE NOT ALONE.

Urine leakage is a very common in almost 50% of women of all ages. It can range from mild to severe.

It can take the form of leaking with coughing, sneezing or laughing (stress incontinence) or leaking with the sudden urge to urinate. Many people who have urge incontinence can relate to the experience of having their hand on the bathroom door handle or almost getting to the toilet on time... but not quite.

Most people are embarrassed about urine leakage and don't want to talk about it. As a urologist, it is my job to ASK about it. My intent is not to humiliate you but to help you if leaking bothers you and you want to be dry. And you have a right to be dry!

Urine leakage is not something that is a "normal aging change" and it is not something you "just have to live with". There are many different treatments available but all of them depend on the correct diagnosis of exactly why you leak.

We can help. If you are ready to make the journey from the land of the wet to the land of the dry, give us a call. (271-2862 M-F 9-5)

And get ready to rock those khaki pants again!

(Idea for using up pads you don't need any more)

Now is a Good Time for a Vasectomy

2010-05-04T18:00:00.002-04:00

If you've been thinking about having a vasectomy but just couldn't pick up the phone to make an appointment to come in and find out more, now is a great time to do it.

It's not warm enough yet to swim.

It's not quite yard work time yet.

There are lots of sports events on television.

You will not have to worry about another baby sired by you*.

*(If you follow up as instructed to have your semen checked and are told no sperm are present.)

Just get three of your friends to get a vasectomy too. Things are always better when done in groups.

Call now. Immediate appointments available.

Just a reminder: Call your insurance company to see if you are covered for a vasectomy. Some policies do not provide coverage for this service. We do have self pay packages as well. Just call 271-2862 for more information.

No need to do this.

513-271-2862 M-F 9-5

So true, Nick!

Your Doctor is Now Board Certified

2010-03-14T13:00:00.000-04:00

Dr. Roesel is now certified by the American Board of Urology.

What does this mean?

According to the American Board of Urology (ABU) it demonstrates a physician's expertise in urology. The entire process of becoming certified takes approximately 2 years after finishing an approved residency program.

Certification by the ABU involves rigorous testing and evaluation designed and administered by urologic specialists. The certification process evaluates a urologist's clinical skills based on education, examination (both written and oral), review of actual surgical cases, peer review and other criteria.

Dr. Roesel is very happy not to have to spend so much time studying so hard for a while!

Your Insurance Coverage - Read the Fine Print...

2010-02-12T20:42:00.001-05:00

Insurance plans are confusing.

Unless you have read your plan handbook from cover to cover it's not always clear what your plan will cover.

And if you happen to be seen for a condition your insurance does not cover then you are responsible for the bill.

Here are the things that usually are a surprise to patients:

Vasectomies: many plans will not pay for vasectomies at all

(But please don't resort to doing it yourself...)

ED: This is often not covered

A routine check up including a prostate exam and PSA from a urologist (considered a specialist) may not be covered.

How do you avoid getting caught in this trap?

Call your insurance company and ASK specifically if they cover the service and if so, what is your responsibility for the bill. If you have not yet met your deductible you may be responsible for the whole cost.

Please Bring Your New Insurance Card and a Picture ID to Your Appointment

2010-02-10T22:12:00.001-05:00

Our policy is that you must present a valid insurance card and a photo ID at the time of your visit.

Believe it or not,medical insurance theft/fraud is a bigger problem than identity theft.

We are not trying to be difficult.

We need your card to verify your benefits and eligibility at the time of your visit.

We keep a copy of your photo ID scanned into your chart in case there is ever a question of who is using your insurance card.

Insurance cards generally do not have a picture on them so we do ask for another form of identification. We realize that many people do not have a driver's license but any photo ID that clearly shows your picture and your name will be fine.

A work identification badge.

A student ID.

You can get an identification card at any Ohio Bureau of Motor Vehicles location for people who do not drive. These can be obtained for any age person from children to senior citizens. This will have their photo and address on it. Follow the link below for more information.

http://www.dmv.com/oh/ohio/apply-id-card

Your privacy and security are very important to us.

Wednesday Februrary 10, 2010: Closed Due to Weather

2010-02-10T08:43:00.005-05:00

With the last few days of unpredictable snow fall, traffic problems and bitter cold we decided it was safer to close the office on Wednesday to let the weather and the roads improve.

Everyone who was scheduled for an appointment on Wednesday has been contacted and rescheduled. We still have openings on Friday February 12 available.

An emergency number is provided on a recording if you call the office (513-271-2862). We will have access to our office computer system remotely and will be checking labs and other results. If you have test results that require further treatment you will contacted by telephone today and we'll get it taken care of.

In the meantime, stay warm, be safe and remember, spring is just a few weeks away!

Why Do I Have To Pee More When It's Cold?

2010-01-29T19:29:00.001-05:00

Did you ever come inside from the cold and almost immediately need to urinate?

When it is cold your body tries to keep your "core" warm. The core is your heart, lungs and brain. The way the body does this is by constricting blood vessels in your extremities like your hands and feet.

The end result is you have the same amount of blood circulating in a smaller area. This is good for keeping your core warm but your kidneys sense too much fluid so they start making more urine.

By the time you get inside you might have a very strong urge to urinate. This is normal.

If you find that you are more thirsty later that is also normal. Your body wants to replace the water it lost in that extra urine you made.

So now you know.

Good Urinary Habits and Bad Urinary Habits

2010-01-09T20:00:00.003-05:00

Many of us remember Goofus and Gallant helping us learn good and bad habits, courtesy of Highlights magazine. Unfortunately they did not teach good urinary habits. Many of the problems we see in the office have their roots in some bad habits... but often they can be helped by adopting some good habits.

Here is a short list of "good" and "bad" habits. See how many you have... and if you should make any changes.

GOOD HABITS

1. Drinking at least 6 glasses of fluid a day

2. Urinating at least every 4-5 hours

3. Taking your time while urinating. Relax, close your eyes.

4. Avoiding constipation

5. Urinating before exercising

BAD HABITS

1. Going all day without urinating

2. Hurrying to urinate

3. Putting off urination when you feel the urge

4. Exercising (especially lifting weights) with a full bladder

5. Driving with a full bladder. It can rupture in an accident if it is full.

Make one of your 2010 New Year's Resolutions to try to adopt at least one good habit and get rid of at least one bad habit!

Happy New Year 2010!

2010-01-01T07:06:00.030-05:00

It's been a while since we posted any updates.

Here is the latest news from 4460 Red Bank Road:

1. Our practice is now one year old. We have grown more than we had ever anticipated in such a short time and are as committed as ever to providing you with the best possible experience you could have visiting a urologist.

2. We now have a full time nurse who is charming, sweet, funny and very kind. Many of our patients have mentioned how much they like her and how she puts them at ease.

3. As insurance reimbursement changes and as Medicare continues to make cuts in payments to doctors we have been examining what we are able to offer our patients and at this time, there will be no changes in the services we currently offer.

4. Insurance companies are increasingly shifting more of the cost of healthcare to the patient and this can come as a rude surprise. We not only verify your coverage when you come in for an appointment, we also can check your decuctible and see how much you have met. Many people are not aware of how this works and are surprised that they may be required to pay more in addition to their copay.

5. Our office policy is to collect copays and unmet dedectible amounts that will be due for your care at the time of your visit. What we collect is based upon the negotiated fees with your particular insurance company and the percent you are responsible for. If for any reason we have collected too much, the excess amount is promptly returned to you in a check. Alternatively, if you know you will be back you may keep the amount as a credit towards future visits.

6. All elective surgeries will require a surgical deposit prior to scheduling the surgery. This amount will be based up on your individual policy's negotiated fees for elective surgery.

7. We will be asking everyone for updated information about insurance, medications and any new health problems or changes that have occured over the last year. It is important for us to keep your record as up to date as possible.

Your allergy list is especially important to keep up to date.

8. As always, we welcome your comments and suggestions. Last year we made some significant changes based on patient comments which we feel were all good. For instance, we now have toilet seat covers in the rest room, babywipe warmers in the rooms for comfortable "clean up" and we have better candy, all thanks to patient suggestions.

9. And finally, we are very proud to have been listed in the January 2010 issue of Cincinnati magazine as one of the "Top Docs" in Urology. Check it out on page 188.

10. We hope your new year is happy, safe and healthy. Best wishes!

New Books in the Waiting Rooms

2009-12-13T23:37:00.015-05:00

Everyone hates to wait. Especially in a urologist's office where patients dread coming in, dread what might happen and dread that it might hurt or be embarrassing.

We try to have as short a wait time as possible for our patients. We know your time is valuable and many of you have had to take off work or make arrangements for child care so you could come for your appointment.

As you know, we have the usual waiting room magazines: Oprah, Time, Architectural Digest, National Geographic, Reader's Digest Large Print, Self, Good Housekeeping, and the occasional Car and Driver.

Recently we added a few small books that have a wealth of information about some things you might have wondered about but didn't know exactly who to ask or where to find out.

And since we are plumbers, after all, it only seemed appropriate that we have these two books not only in the waiting room but in each exam room as well.

These are both really funny but very informative books. We hope you enjoy them.

Why No E-mail?

2009-09-22T19:36:00.007-04:00

Lately we have had a number of patients who would like to be able to ask questions or communicate with Dr. Roesel via e-mail. Our practice does not use e-mail as a form of communication with patients except for sending blank forms such as registration or medical history forms which are nice if they are completed and returned before your first appointment.

The reasons for this are several. First, and most importantly, e-mail communications are not secure. There are privacy laws that protect your medical information from being released to anyone but yourself and your designated individuals. If we send medical information to you via e-mail we have no control over who could access your account and potentially see private information.

Second, all communications are considered to be part of the permanent medical records. It is important that all questions and concerns are recorded in the record as well as the answers. We use an electronic medical record system which allows us to track calls, questions and answers and make them part of your medical record. Although e-mails theoretically could be scanned into the record, it would be easy to forget or lose an e-mail.

We understand that many physicians now offer a special level of service to patients who wish to pay an additional fee each year and this gives them wider access to the physician via e-mail or telephone. Our practice gives each patient the best service possible and does not charge any additional fees. When a call with a question or a problem comes into the office it is sent to the person who is best suited to answer it. Many medical calls are handled by Dr. Roesel's nurse. Billing questions are handled by Dr. Roesel's office manager. Scheduling questions are handled by our receptionist. Please rest assured that Dr. Roesel is aware of your calls but may not be the one who answers them.

We appreciate that everyone's time is very valuable and understand fully that convenience is an important part of saving time. We make every attempt to help you obtain care in an efficient and timely manner. We are sorry that we cannot use e-mail for important, and private medical information. Please remember that you are always welcome to call us at 513-271-2862.

New Guy In Town

2009-08-26T19:18:00.005-04:00

We have a new tenant in our waiting room. He is a Fire Belly Toad and used to live with our nurse but heard our office is a pretty nice place to live so he moved in this month.

The underside of Fire Belly toads is very colorful. Our guy usually hides in his den behind the plant in his cage or takes a soak in his private pool. He is not too shy so you have a pretty good chance of seeing him the next time you come to the office.

Free Prostate Cancer Screening - It's a Man Thing

2009-06-27T17:30:00.001-04:00

The purpose of prostate cancer screening is to detect prostate cancer at its earliest stages before any symptoms have developed. As with any cancer, early detection is key.

The screening process involves a digital rectal exam (DRE) and a PSA blood test. PSA stands for prostate specific antigen and it is a substance released in small amounts from prostate gland cells. Other things besides cancer can cause an elevated PSA so the combination of the lab test and the DRE is used to determine if a man needs further work up.

During the month of July you can get a free prostate cancer screening if you mention that you read about it on this blog. Your exam will be free and we will bill your insurance company for the PSA test. Just call for a time: it doesn't take long, you can even run in on your lunch hour if that works for you.

It's better to know.

Father's Day

2009-06-21T08:40:00.000-04:00

For all the fathers who are no longer with us

And all the fathers who are

And all the fathers-to-be

Happy Father's Day with love.

First Day of Summer

2009-06-21T08:15:00.008-04:00

Today is officially the first day of Summer. It is also known as the Summer Solstice and is the day of the year with the longest period of daylight and the shortest night. This marks the first day of the season of Summer and will last until the first day of Autumn which falls on September 22 this year. After the first day of Autumn the period of daylight will get shorter each day as the earth moves in its rotation around the Sun.

"Solstice" is derived from two Latin words: "sol" meaning sun, and "sistere" meaning to cause to stand still. This is because, as the summer solstice approaches, the noonday sun rises higher and higher in the sky on each successive day. On the day of the solstice, it rises an imperceptible amount compared to the day before. In this sense, it "stands still."

People around the world have observed spiritual and religious seasonal days of celebration during the month of June. Most have been religious holy days which are linked in some way to the Summer Solstice. Some of these Summer Solstice celebrations are: Alban Heflin, Alben Heruin, All-couples day, Feast of Epona, Feast of St. John the Baptist, Feill-Sheathain, Gathering Day, Johannistag, Litha, Midsummer, Sonnwend, Thing-Tide and Vestailia just to name a few.

And of course, there are many different forms of celebration of the Summer Solstice that have no religious connection at all. These range from art festivals, parades, concerts and all kinds of parties. Some of these parties involve quite a bit of nakedness. There is a famous celebration at Stonehenge in England that brings thousands of visitors each year. This is the only time that visitors are allowed to park for free, get free access to the monument and spend the whole night at Stonehenge.

We are happy to see the sun in the sky for so long these days. We'd like to wish everyone a very wonderful first day of Summer and leave you with a little "mom-like" list of things to do to stay happy, healthy and safe:

1. Wear sunscreen

2. Wear your seatbelt

3. Wear clean underwear if you are going out

4. Drink lots of water

5. Don't smoke

6. Be kind to one another

7. Tell the people you love that you love them every chance you get

Father's Day thoughts.... to snip or not to snip?

2009-06-11T19:03:00.001-04:00

Vasectomy. This word can make a grown man nervous and instinctively reach down to protect "the boys". Totally understandable. The idea of somebody cutting on your scrotum doesn't rank very high on many lists of favorites. But it doesn't have to be terrifying thing. Here is a short "True or False" quiz to take to see how much you know about a vasectomy. The answers follow below.

1. A vasectomy is the same thing as a neuter. The dog had a neuter and he came home with no testicles. T or F

2. If I have a vasectomy it will make my voice high and ruin my sex drive. T or F

3. A vasectomy is very painful. I will certainly suffer post traumatic stress disorder. T or F

4. You can resume sexual relations immediately after a vasectomy. T or F

5. Having a vasectomy is 100% effective in preventing pregnancy. T or F

And here are the answers:

1. False: A vasectomy involves the removal of a small part of each tube that carries sperm from each testicle to the penis. The testicles are NOT removed.

2. False: Testosterone is produced by the testicles and is responsible for sex drive and thickening of the vocal cords at puberty (leading to a deeper voice). Because the testicles are not removed, the amount of testosterone produced before the vasectomy will be the same afterwards. The vocal cords will stay the way they are and your voice will remain as it was.

3. False: A vasectomy does not have to be painful - before, during or after. There are many very effective pain medications that are used to ensure your comfort. Dr. Roesel believes strongly in making any procedure as painless as possible and will explain this to you during your vasectomy consultation visit.

4. False: You must refrain from ejaculation for one week after the vasectomy to let things heal, and then you must continue to use another form of birth control until your semen is tested and found to be free of sperm. Men who do not follow this advice may possibly be called "Dad" 9 months later.

5. False: Other than abstinence, there is no method of birth control that 100% effective. Vasectomy failure rate is between 0.5% and 1%. It is possible for the cut ends to grow back together and "recanalize" or reform a channel that sperm can get through. This is why the postop semen checks are so important.

If you are interested in having a vasectomy we encourage you to make an appointment to talk to Dr. Roesel. She will explain the procedure to you and if you like, she will put you in contact with patients who are willing to talk about their experience having their vasectomies done in our office.

Most insurance companies cover vasectomies but it is always a good idea to check your specific policy to see if this is a covered benefit for you. Our office is always happy to check for you and if needed, will obtain precertification or provide a letter of medical necessity to the insurance company. We can make the entire process as painless as possible... just give us a call.

We Have Made the Change to Electronic Medical Records!

2009-06-06T10:50:00.013-04:00

No more this.

Our office is now using electronic medical records. There are many reasons for this change and we hope that after we get past our initial learning curve it will make everything more effcient and convenient for everyone.

For all our current patients, everything in your paper chart is scanned into your electronic chart and can be retrieved with the click of a mouse. If another doctor needs your records we can easily send them to him or her and if you would like a copy of your records we can easily transfer them to a CD for you.

For our new patients, we will continue to have you fill out the initial paperwork which will help us get your record started in the new system. If we have your paperwork prior to your appointment we can have it already loaded into the system and ready when you arrive.

The system we are using is called Meridian. It has a number of excellent safety measures for patients built into the program. For instance, the medication checking feature allows us to make sure any new medicine we prescribe for you does not interact dangerously with anything you are already taking or allergic to. Soon we will be able to transmit your prescriptions from our office to your pharmacy electronically as well.

For those of you who remember the movie 2001: A Space Odyssey - look how far we've come!

Two liters a day helps keep kidney stones away

2009-06-05T07:12:00.003-04:00

One of the biggest risk factors for developing kidney stones is chronic dehydration. We are not talking about this kind of dehydration:

We are talking about mild, chronic dehydration. This type of dehydration does not result in a parched and thirsty feeling. However, your body knows how much fluid it needs to function correctly and will adjust the amount of urine you produce in order to make sure it gets enough water for the basic life processes. The end result is if you do not drink enough fluid or get enough fluid through the food you eat, your urine will be more concentrated and in turn, the minerals that cause stones will be more concentrated in your urine.

When minerals are more concentrated in urine it is easier for them to form crystals by sticking together. Calcium and oxalate make up the majority of kidney stones and these two things love to bind together in concentrated urine. Usually the crystals are washed out with urine flow but if they are lodged in the kidney they can stay there and act as a place for more crystals to be deposited, eventually resulting in a visible stone. Small stones may pass on their own with urine flow. This could be something you are totally unaware of, or if the stone is big enough and gets stuck, you would be VERY aware of it.

Working or playing outside when it is hot will cause sweating and increase your fluid requirements. A good rule of thumb is for every hour you are sweating you should increase your fluid intake by at least 16 ounces or one pint. Drinking alcoholic beverages speeds up urine production and can make dehydration worse, so if you are out in the sun enjoying a cocktail (or two... or three...) you should drink extra water as well.

Concentrated urine is obviously yellow and may have a strong odor. Here is an easy chart to look at to tell if you are dehydrated or not based on the color of your urine:

If you make around 2 liters of urine a day this will help protect you against dehydration. The problem is, in order to make that much urine you need to drink a lot. Very few people really do drink enough to do this. A little more realistic goal may be to try to drink at least 2 liters of water or other fluid a day. This will ensure a good production of urine unless you are sweating heavily, have a fever, diarrhea or other source of fluid loss.

Drinking at least two liters (about 2 quarts) of water a day can be difficult. It is better to drink it gradually than all at once, and preferably not just before bed unless you don't mind getting up at night to go to the bathroom.

We recommend starting out slowly, adding a glass of water to each meal and one or two in the midmorning and midafternoon. Work up to the two liters a day slowly and you will be more likely to be able to continue to do this on a regular basis. Drink up!

Memorial Day

2009-05-25T08:00:00.000-04:00

Thanks to all the men and women who gave their lives serving our country, then and now.

The right way to take "those pills"

2009-05-23T18:24:00.013-04:00

Drugs like Viagra, Levitra and Cialis are often prescribed for men with erectile dysfunction. Unfortunately, sometimes you don't get the "owner's manual" with them that tells you how to take them correctly. To maximize success with these medicines here are a few pearls of wisdom and a few tips to follow:

1. These pills are not "after dinner" mints. They work best if taken on an empty stomach. Empty like the first thing in the morning, not empty like one hour after eating Chinese food. Food in the stomach interferes with absorption of the drug. High fat foods delay stomach emptying - so even waiting the recommended four hours after eating may not guarantee that your stomach is empty.

2. It takes time for the drug to be absorbed from the stomach and into your bloodstream. If you take one of these pills and have a nice erection 5 minutes later, it's YOU, not the drug. In some ways this can be very reassuring... the equipment works on its own. It may just be having temporary technical difficulties for some other reason. Absorption takes 30 to 45 minutes.

3. You must have some kind of stimulation to help get an erection. These pills are not magic. They do not result in an instant flawless erection. The stimulation can be anything that you find arousing: touch, visuals, fantasy... the list is endless.

4. If the quality of the erection you are able to get with the drug is not satisfactory, talk to your doctor. You may need a different dose. You may have better success with a different drug.

5. Remember that it may take 6 or 8 tries before you have the success you want. Don't give up if the first time doesn't work.

6. If you have an erection that lasts more than 4 hours after you have an orgasm or ejaculate, call your doctor. This condition is called "priapism" and although rare, needs to be treated to avoid lasting damage.

7. As with everything else, if you are using these pills with a partner, communication is key. Many men are nervous or anxious when trying these drugs for the first time. Make it shared experience with your partner. Maintain a sense of humor. Set aside time when both of you are not rushed or have another commitment.

8. Relax and enjoy!

Erectile Dysfunction

2009-05-17T23:32:00.015-04:00

Erectile dysfunction (ED) means the penis does not get erect or stay erect long enough for satisfactory sexual function. It is safe to say that nearly every man will experience erectile dysfunction at some time in his life. It may be transient and due to anxiety or anger, certain medications, fatigue, overconsumption of alcohol or drugs (especially cocaine and valium) or idiopathic which means unexplained.

An evaluation for erectile dysfunction includes a careful history and physical exam as well a review of medications and a thorough discussion about medical problems and social or relationship problems.

Sustained ED is usually due to medical problems such as diabetes, injury to the blood vessels to the penis, vascular disease, heart disease as well as smoking. Diabetes and smoking are two of the worst things for erections. Smoking causes small blood vessels to constrict which makes it difficult for the penis to fill with blood, which is what makes it hard. Diabetes causes damage to small blood vessels so if you are diabetic, do your very best to keep your blood sugar under control.

ED can lead to all kinds of issues with self confidence, self esteem and relationship problems. Men may be very upset by an episode of ED and lose confidence in the ability to get or sustain an erection. The partner may feel that the ED is their fault (I'm not sexy enough, I've gained weight, he doesn't find me attractive any more) or that it is a sign that the man is seeing someone else. The man may feel like a failure and then not want to try again.

Communication with your partner is an essential part of treating ED. This is not an easy thing to do. Your partner may have problems with vaginal dryness or pain with intercourse. These are things that can be treated as well. Dr. Roesel sees many women with this type of problem.

The treatments for ED vary from medicine to injections and/or mechanical devices to surgery. In order to determine what is the right treatment for you, it's important to find out what is causing your particular problem. Don't be afraid to discuss ED with your doctor. We are here to help.

Saturday appointments now available!

2009-05-16T13:05:00.007-04:00

If you are like a lot of people these days... you are BUSY. All the time. Every day. Work. School. Home. Time gets away from you and it's easy to put off getting things done that you would probably rather not do. Like go to the doctor. Especially if it's a urologist you need.

In an effort to make things a little easier for those of you who are busy, or who hate weekday traffic, or have long work hours during the week, we are now offering Saturday appointments once a month. The office hours will be shorter, from 9 AM until 3 PM but all regular office services including cystoscopy, prostate biopsy, vasectomy, urodynamics and ultrasound will be available.

Dates for future Saturdays are May 23, June 6 and July 11. Call 271-2862 for your appointment and we'll see if we can help you get just one more thing off your "to do" list.

Happy Passover and Happy Easter

2009-04-11T18:22:00.010-04:00

We wish you a safe and happy holiday surrounded by those you love and care for.

Spring has arrived!

2009-03-21T02:33:00.007-04:00

March 20 is the first day of spring this year. The first day of spring is also known as the vernal equinox. On the first day of spring, the sun's light is directly over the equator. There are an equal number of hours of daylight and darkness. The number of hours of daylight will increase every day until the first day of summer which will be June 21 this year. The first day of summer is the longest day of the year. As summer progresses to fall, the days become shorter as the sun moves farther away from the equator.

We are happy about the new season and hope yours is filled with all kinds of good things. We'd also like to take this opportunity to remind you to be healthy and safe: wear sunscreen, drink plenty of water and be sure to take the time to stop and smell the flowers.

Happy first day of spring!

Bladder cancer

2009-03-14T13:05:00.019-04:00

Bladder cancer is a scary disease. It is more common in men, and more common in people over the age of 40. Cigarette smoking is a known risk for developing bladder cancer. At present, there is no recommended routine screening test for bladder cancer but certain symptoms or problems suggest the need to be checked. These are:

Blood in the urine

Pain during urination

Urinary frequency

If you have any of these symptoms, your doctor will check your urine and look for other causes besides cancer. If your doctor suspects bladder cancer, you will likely have a CAT scan or other test to examine your kidneys and you will also need to have a cystoscopy. A cystoscopy is a test where your doctor will look inside your bladder with a special camera that can examine the lining of the bladder. If anything abnormal is found, biopsies are taken to make a diagnosis.

Probably the best advice we can give you at this time to prevent developing bladder cancer is not to start smoking, or if you do smoke, STOP. It is difficult to stop smoking, in fact, the nicotine in cigarettes is one of the most addicting substances known. Your doctor can help you stop smoking with a variety of methods if you want to stop. At our office Dr. Roesel will be happy to talk to you about quitting smoking. Just ask. We are happy to help.

The Prostate...

2009-03-14T07:35:00.021-04:00

The prostate is a little like your car - as long as it's not causing any problems you don't think about it much. But when it does, it can be a small problem that is easily fixed, or a big problem that requires a lot of time and energy to fix... but either way it becomes something you have to think about a lot.

Unlike a car, a prostate is free. Men are born with a prostate gland. It starts to enlarge around the age of 45 or 50 and may cause bothersome symptoms such as needing to get up more at night to urinate or a weak urine stream as it gets bigger. Some men never have any problems with this until they are much older. Chances are if your dad or brothers had an enlarged prostate you probably will, too but whether or not you will have symptoms is completely unpredictable.

Prostates can also get inflamed or infected in any age man. If this happens, you might experience pain with urination, pain in around your rectum or pain with ejaculation. This can be pretty severe pain accompanied by a fever or even inability to urinate in really bad cases. You will definitely need to see your doctor for any problems like this, the sooner the better.

Besides getting larger with time, prostates can also develop cancer. The two main risk factors for prostate cancer are being male and age, neither of which can be controlled. A close relative such as your father or brother with prostate cancer makes it more likely that you could develop cancer as well.

Just like preventative maintenance on a car, there are certain recommendations for "prostate maintenance". The American Urological Association recommends yearly screening for prostate cancer in men with no symptoms at age 50. This is involves a digital rectal exam and a PSA test which is performed on a blood sample. Men at higher risk, such as African American men or men with a family history of prostate cancer should be screened earlier, often starting at age 40. The decision when to start screening should be discussed with your doctor as many factors besides just age go into the decision.

Your urologist is the best person to have a detailed discussion about specific questions you may have about your prostate. The Mayo clinic has an excellent page about prostate cancer screening which you might want to read. You can access it at the following address:

www.mayoclinic.com/health/prostate-cancer/HQ01273#

Only one more week until spring!

Kidney Stones

2009-02-28T19:16:00.019-05:00

If you've recently had a kidney stone you might want to skip this post to avoid painful memories...

Cincinnati is considered to be in the "Stone Belt" of the United States. For some unknown reason, kidney stones are common in this area. Men get stones approximately 3 times more frequently than women do, and once you have one stone, your chance of having another one rises.

Kidney stones that do not cause complete blockage may cause dull or intermittent pain, usually in the flank area or high up in your back. If a stone is blocking farther down the ureter (tube between the kidney and bladder that carries urine made by the kidney) it can cause a complete obstruction. This means PAIN and SUFFERING. This pain may be sharp and excruciating. It can be bad enough to cause vomiting and it may seem you can't find a comfortable position to lie in. The pain can radiate down into your groin or into the scrotum or genitals.

If you are having pain like this, the best thing to do is go to the nearest emergency room. If the doctors suspect a kidney stone, you will get a CAT scan. The upper left picture shows a CAT scan with an arrows pointing to stones in the kidney. Of course, pain can be caused by other things so the doctors will certainly check you out for other possibilities.

If you have a stone, your treatment will likely involve control of pain, IV fluids and anti-inflammatory medicines as well as medicines that may help you pass the stone. Being admitted or sent home depends on a number of factors such as whether or not the pain can be controlled with oral medicines, if you can drink enough fluids to stay hydrated and whether or not you have a urinary tract infection.

If you are discharged from the ER, follow up as soon as possible with a urologist. We hold open appointment times every day for urgent visits such as these. The correct treatment for your particular stone will be discussed with you at the time of your visit.

If you know you have a stone here are the warning signs to call your urologist and then go immediately to the closest ER:

1. Pain that cannot be controlled with oral medicines at home

2. Nausea or vomiting that prevents you from drinking and eating

3. Fever over 101 degrees

4. If you have a single kidney or have a transplanted kidney.

The best source of general information on the web for more information about stones is from the NIH. Here is the link:

http://kidney.niddk.nih.gov/Kudiseases/pubs/stonesadults/

Just 21 more days until spring!

Our terrarium and its inhabitants

2009-02-21T19:20:00.016-05:00

You may have noticed the terrarium in our waiting room. It has a small fountain, live plants and is home to five little tree frogs. These tree frogs are not poisonous.

There are three marbled tree frogs who look like this:

Their scientific name is Hyla marmorata. They are found in Central and South America.Marbled tree frogs are often called"bird dropping tree frogs" due to their color and shape. This camouflage protects them from predators.

They have very bright orange colors and spots on their undersides so if you catch them while they are sticking to the side of the terrarium glass you might see something like this:

There are two little green tree frogs that look like this:

The green tree frogs can change color. Sometimes they are green, sometimes they are brown and sometimes they are almost white. Their scientific name is Hyla cinerea. They are native to the United States and can be found in Cincinnati in the summer time. The females are typically larger than the males.

Both these species of frogs are nocturnal so when you see them in the office they are likely to be sleeping. They are very good at hiding. Children have the best eyes for spotting them it seems. The marbled tree frogs like to sit around the fountain or stick to the back of the cage. The green tree frogs hide under or on leaves or high up near the top of the terrarium.

We hope you enjoy looking at our little tree frogs as much as we do!

Patient Suggestions

2009-02-21T08:44:00.009-05:00

We LOVE them!

Good or bad, we want to hear your suggestions. Your satisfaction with your care in our practice is extremely important to us. If you have had an unsatisfactory experience, we want to know about it right away so we can make it right for you and also never have it happen again.

As a patient, you have lots of rights. You have a right to prompt, courteous service. You have a right to have your questions answered. You have a right to understand the plan of care or treatment Dr. Roesel has reccomended for you. You have a right to being treated in a clean and modern facility.

If you ever feel something is not right, please feel free to talk to Dr. Roesel or one of our staff. We will do everything to "make it right".

We have had several recent suggestions from patients which we have immediately implemented. Here are two:

1. Give lollipops after a procedure

2. Use wiper warmers for the baby wipes we provide for patient use after exams

Many thanks to those patients who gave us ideas to make things more pleasant for everyone!

Just 28 days until spring!

Deductibles - Sorting out the confusion

2009-02-21T08:12:00.009-05:00

Deductibles can be confusing. Most insurance holders know they have one... but what does it mean? In the simplest terms, it means the amount of money the policy holder must pay out of pocket prior to the health benefits being used to pay for medical bills.

Early in a new calendar year or a new insurance plan year most people have not yet met their deductibles. At our office, when we verify your insurance we also verify the amount of your deductible you have met to date. If you have not met your deductible, our office bill will be used in full or part to satisfy it. This means we will collect your deductible (or portion of it) along with any copay you may be responsible for at the time of your office visit.

Then as a courtesy to you, we bill your insurance company. Your benefits are then calculated by the insurance company and an explanation of benefits is sent to you. Once the insurance company has calculated your portion of the responsibility for our bill if there is additional money you owe, we will send you a bill. If you have overpaid, we will immediately and cheerfully refund the amount we owe you.

With Health Savings Accounts (HSA) this can be a new and shocking experience to pay for your care to meet a deductible which can be very, very high. HSAs have money in a special savings type account which is used to meet your deductible. Most people with HSAs have a special debit-type card which is used to pay the bills from that savings account.

The reason we collect your unmet deductible at the time of your visit is twofold. One, it reduces the amount of paperwork involved in sending out bills and two, it reduces time spent trying to collect from patients who choose not to pay the part of the bill they are responsible for.

Trying to keep the lid on burgeoning health care costs is a goal we are committed to. Please feel free at any time to ask to speak to Dr. Roesel about concerns you have about your bill or if you have questions about your insurance coverage. We will do everything we can to help answer your questions to the best of our ability, and if we don't have an immediate answer, we will contact your insurance company and get an answer.

Only 28 days left until spring!

Happy Valentine's Day

2009-02-14T07:06:00.008-05:00

A valentine for you from Dr. Gwen Roesel and her staff.

Very important HUMANA UPDATE

2009-02-12T21:56:00.009-05:00

We won!

After the recent awful discovery that we were not in-network with Humana as we had been told, we decided that we were not going to accept "too bad" as an explanation for our practice or any of our patients. To make a long story short, Humana has agreed to back date all claims filed from January 1, 2009.

What this means to you is that our billing company will resubmit all claims that have been denied. Many of you have been surprised to get copies of the explanation of benefits from Humana - especially if it says that you are responsible for the entire bill. The cost of health care is indeed shocking.

The amount billed is rarely the amount that is paid by the insurance company. Insurance companies have predetermined amounts they pay for each service or procedure. Each insurance company also determines how much responsibility the patient has for that amount. In some cases the patient has no further responsibility after the copay has been made.

More commonly, the patient is responsible for a percentage of the cost after a certain deductible has been met. Usually this percentage is around 20% but it can be more or less.

Check your insurance card or look online at your insurance company's website if it has one to learn more about your coverage.

This was good, good news for us and we could not wait to share it with our Humana patients!

Only 36 more days until spring...

Important information for Humana insurance holders

2009-02-07T08:27:00.012-05:00

We had been told that we were fully credentialled with Humana as of January 1, 2009 and have been seeing patients. On Friday January 6 we found out that we are actually not yet an in-network provider for Humana.

Needless to say, this was not good news. Here is how it will impact those patients we have already seen and what we will do until we are truly in-network.

1. For patients with out-of-network benefits, we will accept Humana's out-of-network reimbursement for care that has already been provided.

2. For patients without out-of-network benefits (meaning Humana will reimburse our practice nothing at all for your care) we will reduce your bill to a portion that you will be responsible for.

We are truly sorry that this miscommunication has occurred. We try hard to be able to provide our patients with as much information as possible regarding their insurance coverage and responsibility for the cost of their health care.

Having insurance is not a guarantee that your health care will be fully covered. We file claims with your insurance company as a courtesy but ultimately the patient is responsible for the charges incurred. In this case, because we incorrectly told our Humana patients that we were in-network we will accept reduced rates of reimbursement.

We are not able to provide care free of charge, however. When you get a statement from Humana, please feel to contact us to find out the amount you should pay. We will advise our billing company of the change as well.

Health insurance has changed so much over time. Many of us remember small office visit copays, free prescriptions and low premiums to pay. Now everything is more expensive and more of the cost is being passed on to the patient. Doctors are being reimbursed less, sometimes even less than the actual cost of providing care. This is one reason why some doctors do not accept particular insurance plans.

When you call for an appointment, our receptionist will ask you what insurance coverage you have. This is not meant to sound "greedy" but rather to help make sure you know what your responsibility will be for your care. Another way to check if a particular doctor is participating in your plan is to call your insurance company and ask. Many insurance companies have websites you can access from home to find participating providers as well.

We'll let everyone know when we are TRULY in-network with Humana just as soon as it happens.

Stay warm and safe, only 42 days left until Spring!

Snow...Ice... My Appointment...?

2009-01-26T07:33:00.012-05:00

It's that time of year when the weather is unpredictable - 55 degrees one day and then bitter cold with snow and ice just a few days later. As of today, January 26th there are only 53 days until the official first day of spring but that hardly seems real as we are facing some snow and ice over the next few days here in Cincinnati.

So what does that mean if you have an appointment or need an appointment when the weather is like this?

We will make every attempt to be open as long as it is safe to travel on the roads but please call first (513-271-2862) just in case we have decided it is not safe and we are closed. We will have current information available for you, including a later opening time if this is the case. If there is a statement issued by Hamilton County indicating that essential travel only is permitted, we will be closed.

If you decide you would like to reschedule your appointment please give us as much advance notice as you can. We do understand that this is not always possible, of course and are just happy to hear from you - that you're okay. We will be happy to reschedule your appointment at your convenience.

If you have an emergency and the office is closed, please use the emergency room at the hospital closest to you. If you need an appointment you may leave a message with our answering service and we will contact you as soon as we are open again.

So, stay warm... be safe... and stay off the snowy icy roads as much as you can.

Something common... something FIXABLE

2009-01-24T04:00:00.013-05:00

Urinary incontinence affects millions of men and women in the United States yet it is one of the least talked about problems. Too many people "suffer in silence" because it is embarrassing to admit to this problem and often difficult to bring the subject up to a doctor.

It doesn't have to be this way. There are many very effective treatments for incontinence. There are different reasons people lose urine when they don't want to, so the type of incontinence must be determined in order to choose the right solution.

Stress incontinence is one of the most common types. It can occur in both men and women but is more common in women and can happen at any age. Typically a person with stress incontinence loses urine with coughing, laughing, sneezing or activities such as dancing and exercising.

Urge incontinence is the "Gotta go, gotta go RIGHT NOW" type of incontinence. Many people with this type of incontinence are extremely inconvenienced by having to plan their activities around knowing where the closest restroom is. It is difficult to enjoy going to movies or sports events if you have to get up frequently to urinate! And often people with this kind of incontinence make it to the bathroom only to lose urine before actually getting to the toilet.

Of course, there are other reasons for incontinence as well. Dr. Roesel has a special interest in treating incontinence because she feels it is such an important quality of life issue. No one should have to go through life wet.

There are a variety of effective treatments available for different kinds of incontinence. Dr. Roesel can diagnose the specific type of problem you have using a combination of history, physical exam and specialized testing if needed. Our office is set up to provide a full diagnostic work up including urodynamics which is a study of how well the bladder is able to store urine to prevent leakage.

Once a diagnosis has been made, your treatment options may include medication, physical therapy or surgery. Treatment is individualized and Dr. Roesel works with each patient to make sure they understand the plan and feel comfortable with her recommendations.

If you are having trouble staying dry, don't suffer in silence. Give us a call at 271-2862.

In-network with United Healthcare

2009-01-14T21:20:00.009-05:00

We are happy to announce that we are now in-network with United Healthcare. Many thanks to all of you who waited patiently for Dr. Roesel to become a participating provider! We'll be calling everyone who left his/her name to be notified as soon as we had the "go ahead" to start seeing UHC patients.

Happy New Year!

2009-01-03T09:30:00.007-05:00

2009 promises to be an exciting year for our practice. In keeping with our goal of providing convenient, comprehensive urologic care we are happy to announce that we have added new equipment to be able to offer the following procedures in the office:

Cystoscopy (looking inside the bladder)

Prostate biopsy

Scrotal, kidney and bladder ultrasound

Urodynamics (study of how well the bladder works)

Genital wart removal

Insurance updates: We are still waiting for Great West and Cigna but are now able to see patients with Aetna, Anthem, Healthspan, Humana, Medical Mutual, Medicare with Dr. Roesel as an in-network provider. United Healthcare is allowing prior authorization only at this time.

Our office staff is always happy to verify your benefits for you at any time, just give us a call at 271-2862.

We hope this year is a happy, healthy year filled with all kinds of good things for you and your loved ones.

Our New Business Card!

2008-12-12T10:49:00.005-05:00

Insurance plan updates

2008-12-06T13:20:00.013-05:00

Dr. Roesel is a participating provider for the following plans effective on the dates listed below:

Aetna December 1

Anthem December 10

Cigna TBD

GreatWest TBD

Healthspan December 15

Humana TBD

Medical Mutual January 1

Medicare December 1

United Healthcare Prior authorization allowed

We are happy to see any patient as an out of network provider if you'd like to make an appointment prior to the effective date. Please call the office at 271-2862 so we can help determine your level of responsibility with your plan if you use out of network benefits.

If you'd like to be notified when Dr. Roesel is a participating provider in your plan please call us at 271-2862 and leave your name, insurance plan name and phone number. We will contact you as soon as we have the updated information.

Insurance coverage can be confusing! Please feel free to call 271-2862 if you have questions about your coverage, copay, and plan responsibilities. We are happy to help you obtain any necessary referral authorizations, preauthorizations and other precertifications you might need for your medical care.

Please remember to bring your insurance card and a photo identification with you to your appointment. We look forward to seeing you soon.

Have warm, safe and happy holidays!

Opening Day December 1, 2008!

2008-11-13T09:33:00.007-05:00

We are pleased to announce that the office will open on December 1, 2008. New patients as well as patients from Dr. Roesel's previous locations at Hyde Park and Anderson are all welcome. Dr. Roesel sees both men and women.

Location: 4460 Red Bank Road Suite 124 Cincinnati OH 45227

Phone: 513-271-2862

Hours: 9:00 AM to 5:00 PM Monday -Friday

Insurance plans accepted: Aetna, Anthem, Cigna, Healthspan, Humana, Medical Mutual, Medicare, United Healthcare

Hospitals: The Christ Hospital, Bethesda North, Mercy Anderson, Good Samaritan

Appointments are being taken now at 513-271-2862.