Expanding Access to Specialty Care

By Carrie Anna Strange

McLeod Urologist Dr. Kelly Maloney always had an interest in the medical complexities of the human body. This inspired her to become a physician. During her rotation as a medical student at Dalhousie Medical School, Dr. Maloney’s Chief Urologist performed a procedure using a dilator to make the urethra wider for a patient with a urethral stricture.

“This moment led me to a career in Urology,” explained Dr. Maloney. “Seeing this patient feel immediate relief showed me that through medical practice, we can make acutely ill patients acutely better.”

“I find Urology to be a great combination of medicine and surgery. I follow many of my patients long-term, with medical interventions as needed, and slightly more than half of my patients are treated with surgery. Urology gives a physician unique perspective on both aspects of clinical treatment,” said Dr. Maloney.

Caring for patients at McLeod Urology Associates, Dr. Maloney brings an extensive knowledge of advanced treatment skills for a wide range of urological conditions in both men and women. Three commonly treated conditions include elevated PSA, kidney stones and urinary tract infections.

Elevated PSA
The prostate gland is found only in men and is part of the male reproductive system. “Normally, a healthy prostate produces only small amounts of prostate specific antigen (PSA), a protein produced by both cancerous and noncancerous tissue in the prostate,” explained Dr. Maloney. “An elevated PSA can point to developing prostate cancer, but also can be triggered by other causes such as an enlarged prostate.”

The CDC recommends men ages 55 to 69 make individual decisions with their doctor about prostate cancer screening.

One of the most common prostate procedures performed routinely at McLeod Regional Medical Center is the Transurethral Resection of the Prostate (TURP), a surgery used to treat urinary problems caused by an enlarged prostate. During the procedure, the urologist utilizes a resectoscope (visual and surgical instrument) to trim away excess prostate tissue that is restricting urine flow.

Kidney Stones
While kidney stones are not typically life-threatening, they can be extremely painful.

Kidney stones form inside the kidneys from deposits made of minerals and salts and then travel to the bladder through the urinary tract. In some instances, patients pass kidney stones naturally. However, if the stones become lodged or are too large to pass on their own, medical intervention may be necessary.

One of these interventions employs the use of sound waves to break up stones. During the procedure, called extracorporeal shock wave lithrotripsy (ESWL), kidney stones are crushed into small pieces that can be passed in the urine.

For larger stones, Holmium Laser Lithrotripsy allows Dr. Maloney to remove the stones without any incisions using a flexible fiber laser.

Often, once stones have been broken into smaller fragments, Dr. Maloney performs a ureteroscopy to extract the stones from the urinary tract. Additionally, a stent may be inserted after extraction of the kidney stones to prevent infection and keep the urinary tract open.

Urinary Tract Infection
“Studies show that 40 percent of women will have symptoms associated with urinary tract infection (UTI) at least once in their lifetime,” said Dr. Maloney.

“UTIs occur in both men and women but are four times more common in women due to their anatomy,” said Dr. Maloney. “When a patient presents with the symptoms of a UTI, I immediately obtain a urine culture to determine if bacteria is present and, if so, what type. This important step helps determine the appropriate treatment or therapy.”

Most patients will respond to a course of antibiotics; however, the treatment type and duration depend upon results of the culture and associated medical conditions the patient may have.

Some patients require further evaluation with an imaging scan of the kidneys (X-ray, ultrasound or CT scan) in addition to an in-office test, called a cystoscopy, to look inside the bladder.

In some cases, a UTI will be caused by conditions other than bacteria and will not require antibiotics.

Prompt evaluation by a doctor should be performed if an individual has signs or symptoms of a UTI. Failure to treat a UTI can result in more serious conditions.

Many urological conditions can be prevented or caught early with regular check-ups and appropriate screenings. It is important to talk to your doctor about these options as well as any symptoms or changes you may be experiencing.

In addition to seeing patients in Florence, Dr. Maloney provides care in Sumter, South Carolina at 540 Physicians Lane. To schedule an appointment, call (803) 340-5100.

“We are excited to meet the needs of patients locally by offering specialty care for Urology in Sumter,” said Rachel Gainey, Administrator of McLeod Health Clarendon. “With increased access to specialty care such as Urology, McLeod Health continues to fulfill our commitment to provide the highest quality health care in our region.”