College Point Medical Group: Bruder Jack T MD: NY

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Diagnosing UTIs

The first step in diagnosing a UTI is usually a simple urine test called a urinalysis. It looks for bacteria, as well as abnormal counts of white and red blood cells. The dipstick test provides quick results. Your doctor may also send your urine to a lab for culture to confirm the type of bacteria. At-home test kits can help detect a UTI, but are not 100% accurate. Be sure to go over the results and your symptoms with your doctor.

How Do UTIs Begin?

Many types of bacteria live in the intestines and the genital area, but this is not true of the urinary system. In fact, urine is sterile. So when errant bacteria, such as the E. coli shown here, is accidentally introduced into the urinary system, it can start a UTI. Typically, bacteria travel up the urethra to the bladder, where an infection can take hold. Women are more susceptible than men, probably because they have shorter urethras.

What Is a Urinary Tract Infection?

About half of women will get a urinary tract infection or UTI at some point in life. It happens when germs infect the system that carries urine out of your body -- the kidneys, bladder, and the tubes that connect them. Bladder infections are common and usually not serious if treated promptly. But if the infection spreads to the kidneys, it can cause more serious illness.

Dr. Bruder

Dr. Bruder is a board certified urologist with over 25 years in practice serving New York City. He offers treatments for most urological conditions and specializes in treating erectile dysfunction and premature ejaculation. Dr. Bruder is dedicated to providing patients with the highest level of healthcare available. This is why he co-established the Luzato Medical Group, which brings his patients the combined expertise of board certified cardiologists, internists and neurologists. Dr. Bruder welcomes all patients who have problems relating to his field of medicine to make an appointment.

Dr. Bruder, MD is a board certified urologist practicing in New York City. Bruder graduated from the New York Medical College in 1982. He completed his surgical residency training at New York Medical College, final leaving the institution in 1988 as Urology Chief Resident. Since 1988, Dr. Bruder has maintained his own practice.

Recently, he co-established the Luzato Medical Group combining his urology practice with board certified cardiologists, internists and neurologists to give patients the comprehensive coverage they deserve. Additionally, Dr. Bruder retuned in 2004 to his alumarter, New York Medical College, as a Clinical Assistant Professor of Urology.

Please bring the following to your first visit:

Your insurance card
Current prescription or over-the-counter medications
The patient forms listed below if you wish to fill them out in the privacy of your home before the appointment.

Insurance:

Dr. Bruder is committed to making sure that all those who require treatment receive the care they need. Dr. Bruder accepts most types of insurance coverage and also has a number of financing options available to make sure that you receive the best care possible. For more specific questions about your personal insurance and money matters, please call our office at (212) 661-7003

Patient Forms

For your convenience, you may download and fill out these patient forms before your visit.

To schedule an appointment call the telephone number listed below.

(212) 661-7003

50 East 42nd Street, Suite 407
New York, NY 10017

ED Questionnaire:

In order to fully understand your type of ED, your doctor will want to know your medical history. Here are some questions that he may ask:

Do you have trouble getting or keeping an erection or both?
How often does this problem occur?
How long have you been having trouble with your erections?
Did this problem arise suddenly or slowly?
Was there a major event that occurred before the onset of this problem?
Has this occurred with all your partners, if more than one?
Do you wake up in the night or early morning with an erection?
Do you get hard with stimulation, either visual or physical?
When you get an erection, are you able to penetrate your partner?
How often does your erection last for successful completion of intercourse?
Do you have any pain or have any curvature of your penis?
Do you smoke?
Do you drink alcohol? If so, how much?
Have you had surgery in your upper leg or abdomen region?
Do you have any medical conditions?
What medications are you taking?
Do you feel stressed or depressed?
Is your trouble with erections causing you to feel stressed?

Your First Visit

The Luzato Medical Group, P.C. realizes that for most men, talking about their penis and sexual activity in this way is new. However, our specialists have had this conversation many times before, and are very knowledgeable. You are not going to be the first to ask a potentially embarrassing question – so just ask. When you are more open, our doctors are better able to find an appropriate solution for you.

Types of quotations asked
You may be asked very personal questions regarding your medical, social and sexual history. These questions are essential for finding the appropriate strategy to deal with your issues.
Please answer all of our doctor’s questions as honestly as possible. If you feel uncomfortable at any time during visit, tell us and we will explain how the question is important to finding the diagnosis and treatment plan.

Before the Appointment
The Luzato Medical Group, P.C. recommends coming to the appointment with a quick list of issues or questions that you would like to discuss. Our doctors are happy to talk through your concerns to make this process easier for you. Additionally, you can download the ED questionnaire and give it to your doctor in order to ease your way into the discussion.

Premature Ejaculation

Premature ejaculation is defined as the inability for a man to control his ejaculation before he and his partner are satisfied. This can mean ejaculating before penetration, shortly after penetration or consistently before your partner achieves an orgasm – however long that may be. The definition is vague since everyone has a slightly different idea of how long sex should last.

Premature ejaculation is typically seen in younger men under 40. It is a common problem affecting 25%-40% men sometime during their lives.
There are many causes of premature ejaculation:
Oversensitive glands
Hormonal imbalance
Neurotransmitter abnormalities
Abnormal reflex activity of ejaculatory system
Inflammation and infection of the prostate or urethra.
Thyroid issues
Performance anxiety
Excessive masturbation intending to orgasm as quickly as possible.
Lack of experience controlling ejaculations
A symptom of erectile dysfunction
PE treatments vary depending on the symptom or combination of symptoms. Take control of your sex life by making an appointment with Luzato Medical Group, P.C. today.

How the penis forms an erection.

The most important elements involved in achieving an erection are the two chambers called corpora cavernosa. The corpora cavernosa runs the length of the penis and consists of spongy tissue comprised of smooth muscles, fibrous tissues, spaces, veins and arteries.

When a man receives sensory or mental stimulation, his brain sends a signal to his penis making the muscles in the corpora cavernosa relax. This allows blood to flow into the corpora cavernosa and flood the spaces, making the penis expand. As more blood rushes in, the pressure created makes the penis feel hard and the corpora cavernosa tubes press against the veins that carry blood out of the penis. The blood then becomes trapped in the tubes and the penis stays erect. To reverse the erection, the muscles in the penis contract, blocking the inflow of blood and opening the outflow channels.

Dr. Bruder practices nearly all areas of urology. He welcomes all patients who have problems relating to his area of medicine to make an appointment. Dr. Bruder delivers cutting-edge evaluation and treatments for:

Bladder cancer
Circumcision
Cystoscopy
Erectile dysfunction (ED)
Hematuria (blood in urine)
Interstitial cystitis
Kidney stones
Male infertility
Pelvic pain
Pelvic prolapse (cystocele, rectrocele)

Male voiding dysfunction
Neurogenic bladder
Premature Ejaculation
Prostate cancer
Prostate enlargement (BPH)
Urethral stricture disease
Urinary incontinence
Urinary tract infection
Urodynamics

Erectile dysfunction is defined as the consistent problem getting and/or keeping an erection. There may be some men who have occasional or temporary erectile problems because of nervousness or one too many drinks. However, if the problem of getting and/or keeping an erection occurs regularly, then you must see Dr. Bruder.

Quick Facts on ED:
ED usually has a physical cause, which is good, since it can be easily treated.
ED is treatable in all ages of men.
ED affects up to 30 million American men. It is very common.
Treatments for ED include psychotherapy, drug therapy, vacuum devices, and surgery; all of which Dr. Bruder has vast knowledge and experience treating.

There are many reasons responsible for erectile dysfunction and nearly all are easily treatable. Over 90% of ED cases are simply physical problems. A majority of the time, ED is caused by health conditions that restrict blood flow throughout the body, including the penis. Damage to blood vessels, nerves, smooth tissue or fibrous tissue may also cripple a man’s ability to produce and maintain an erection. Additionally, some medications can cause ED. In fact, medical side effects induce 25% of all ED cases. If you are taking one of the drugs below, tell Luzato Medical Group, P.C. and getting rid of ED may be just as easy as switching your medication:

Blood pressure drugs
Antihistamines
Antidepressants
Tranquilizers
Appetite suppressants
Cimetidine (ulcer drug)
Health conditions that are associated with ED are:
High Blood Pressure – This causes blood vessels to stiffen and narrow.
Heart Disease and High Cholesterol – Men with heart disease are twice as likely to get ED.
Diabetes – 35-50% of men with diabetes experience ED.
Prostate Surgery – Prostate surgery can injure the nerves and arteries that run near the prostate and act upon the penis.
Smoking – Smoking damages arteries.
Drinking Alcohol – Men who drink more than 2 drinks a day are at a higher risk of developing ED.
Depression (along with stress and anxiety) can cause ED. In turn, ED can also cause depression, stress and anxiety.
Other Health conditions include:
Other Health conditions include:
Kidney disease
Chronic alcoholism
Multiple sclerosis
Atherosclerosis
Vascular disease
Neurologic disease

Procedures to correct Erectile Dysfunction

Luzato Medical Group, P.C. tries to treat ED with the least invasive procedures first. Some treatment options that he may suggest include:

PDE5 Inhibitors
These are prescription-only pills that relax smooth muscle tissue in the penis during sexual stimulation and allow for increased blood flow. They do not trigger an immediate erection. Users simply take a pill shortly before sex activity. Viagra, Levitra and Cialis are all PDE5 inhibitors. The only drawback to this drug is that patients who take nitrates for chest pain cannot take PDE5 inhibitors.
Injection Therapy
These prescription-only needles give the patient an erection quickly; however, the side effects can include prolonged erections and possible scar tissue.
Urethral Insertion
These prescription-only pellets are inserted an inch deep into the urethra of the penis. The erection begins within 8-10 minutes and lasts for 30-60 minutes.
Apomorphine
This drug influences the part of the brain that controls sex drive.
Vacuum Devices
This procedure is done by the patient immediately before sex. The vacuum tube is placed over the penis and the air is pumped out of the cylinder, creating an erection by suction. The patient will then place a ring around the base of his penis in order to trap the blood and sustain the erection once the cylinder is removed. This should only be used for 30 minutes so as to avoid injury.
Surgical
There are three basic types of surgical procedures that are available:
Implants – Implants can be placed inside the penis. The silicone cylinders can be either semi-rigid or inflatable.
Reconstructive – Luzato Medical Group, P.C. can increase blood flow to the penis by reconstructing the arteries.
Restrictive – Luzato Medical Group, P.C. can constrain the blood flow from the penile tissue by severing the veins

Psychotherapy
Talking to psychiatrist.

Recently, he co-established the Luzato Medical Group combining his urology practice with board certified cardiologists, internists and neurologists to give patients the comprehensive coverage they deserve. Additionally, Dr. Bruder retuned in 2004 to his alumarter, New York Medical College, as a Clinical Assistant Professor of Urology.