Top10MD Blog


 6 months ago    Leave a comments (0)

Urinary incontinence or stress incontinence is a common and often embarrassing issue that no one likes or wants to talk about; if you’re experiencing urinary incontinence, you are not alone. Nearly 25-million people in the United States have the same problem. Men don’t get off, either approximately 10% of men are susceptible to this condition. When urinary incontinence prevents you from going places, participating in sports activities, and enjoying that belly laugh it’s time to do something about it. Common among post-menopausal women it’s not limited to the older generation; urinary incontinence also affects young adults as well, especially new mothers. Many women neglect to inform their doctor, due to the embarrassment of the issue. Beforehand, it seemed as if there was no hope for you outside of surgery, but now, a new device InTone is a treatment that is changing the lives of people everywhere with no surgery.

What Is Urinary Incontinence?

Urinary incontinence is bladder leakage. It happens when we run, jump, and even laugh; this occurs when the muscles that hold urine weaken causing you to urinate when you’re not supposed to. That muscle is a voluntary muscle; which means, you have control over it. The problem occurs when that muscle becomes lack, or you lose total control over it. Your symptoms can be mild meaning you leak occasionally, or they can be severe meaning you are always leaking. It may feel as if you cannot make it to the bathroom in time and if you do, your bladder may never feel empty. If you are experiencing these symptoms, it’s time to get help.

Treatments for Urinary Incontinence

Treatments for urinary incontinence depend on several factors:

  • What type of incontinence you are suffering from
  • Your age
  • Your general health
  • Your mental health

By exercising your pelvic floor with Kegel exercises; these exercises help to strengthen the urinary sphincter and muscles that contribute to control urination; thereby, reducing your stress incontinence.

Bladder training is another method, and there is also medications along with botox or a sacral nerve stimulator. When all else fails, surgery is your best option. If you plan on having children or not through having children, you will need to discuss this with your doctor. If you are finished having children, or you have had a hysterectomy that eventually caused your bladder to drop you may be a candidate for the following non-surgical or surgical procedures:

Non-Surgical Treatment for Urinary Incontinence

Intone– a device developed to stop urinary leakage. Intone is the most effective, nonsurgical treatment available today to prevent urinary leakage. Intone takes you through 12-minutes of voice-guided pelvic floor exercises, visual biofeedback, and muscle stimulation.  Office visits will be required to customize your device to your specific needs. These exercises are completed once daily for six days a week for 90-days in the privacy of your home.

Surgical Procedure Options for Urinary Incontinence

  • Sling Procedure: There is a new mesh that is inserted below the neck of the bladder to support the urethra and stop urine from leaking out.
  • Colposuspension: This procedure lifts the bladder neck and has shown to help patients with stress incontinence.
  • Artificial Sphincter: This procedure involves inserting an artificial sphincter or valve to control the flow of urine from the bladder into the urethra.

What’s My Next Step?

If you’re struggling with incontinence, you don’t have to suffer in silence any longer. You don’t have to be afraid to talk to your doctor about it as there are options for you. Call today, and you will be off to a better quality of life including your ability to laugh without fear.

Dallas Gynecologist and Functional Medicine Specialist Maryann Prewitt, MD is Director and Founder of HealthWellnessMD. Dr. Prewitt is Fellow and Board Certified by the America College of Obstetricians and Gynecologists. Dr. Prewitt holds a Master’s Certification in the da Vinci Surgery System – this minimally invasive technology has revolutionized the way surgery is performed today. Dr. Prewitt has been named 2016 | 2017 Top10MD an honor only 1-in-3 doctors succeeds with this recognition in the United States. Call Dr. Prewitt’s office today and schedule an appointment at 469-619-1066.


 8 months ago    Leave a comments (0)

If you’re scheduled for a prostate biopsy, you will receive a Gleason score, which is a measure of how aggressively your cancer might behave. Pathologist Dr. Donald Gleason discovered this system in the 1960s. He founded the five different types of prostate cancer cells, ranging from least aggressive to most aggressive.

To begin, your doctor examines tissue samples from your prostate biopsy under a microscope. Your cancer tissue pattern will be compared with healthy tissue and assigned a grade on the Gleason scale of any number in the set 1 through 5.

  • Grade 1 – The least aggressive type of cancer cell; it looks the most like normal tissue.  
  • Grade 2, 3, 4 – The most common tumor patterns on the scale; much like Grade 1, these tissues pose little danger of spreading quickly.
  • Grade 5 – The most aggressive type of cancer cell and is recognized when the cancer tissues have spread through your prostate and differ widely from the features of healthy cells.

Many men have more than one prostate cancer cell type.

Every prostate cancer biopsy is assigned two numbers: the first is called the primary grade, it represents the most common type of cancer cell present. The second (or secondary grade) accounts for the second most common type of cancer cell present.  The sum of these two numbers is your Gleason score, a number between 2 and 10. The best score you can get is two (1 + 1). The lower your Gleason score, the less dangerous your cancer and the most reasonable a conservative approach would be.

  • Men with high Gleason scores (8 or greater) have a more dangerous and aggressive type of cancer. Their cancerous cells look very different from normal tissue, described as being “poorly differentiated.” This is still an early-stage prostate cancer since it has not spread, but if you are high-risk, it means your cancer is likely to grow or spread within a few years.
  • A Gleason score of 6 or lower is considered low-risk. This means your prostate cancer is unlikely to grow or spread to other tissues and organs for some years.  It is important that you know both of the numbers in your Gleason score. Discuss both your primary and secondary grade numbers with your doctor.  

To help guide you to understanding your Gleason score and the significance of it and lead you to the best treatment for your condition, make sure you talk to your board certified urologist about things other than your Gleason score.

  • Gleason scores predict the rate your cancer will grow, not your prognosis.
  • Make sure you also understand your cancer stage and your PSA level.

Understanding the whole picture is the key to zeroing in on the best treatment that suits your current condition.


 10 months ago    Leave a comments (0)

Back in the good old days, life was different for women. Childbirth was a game of heads and tails if the mother was going to survive, PMS was considered by others as an imaginary problem or women were crazy, and menopause was just another stage of life that every woman had to endure. Thanks to advancements in medicine and science, women don’t have to accept the results of hormone imbalances.

Women across the country now have an improved quality of life thanks to hormone replacement therapy. There’s no need to have to endure the struggles of menopause if the remedy is simple, just replacing your missing hormones.

Estrogen Pellet Therapy

The most important hormone for women is estrogen. Without proper levels of estrogen, woman are at risk for serious health consequences such as osteoporosis, heart disease, colon cancer, impaired vision, premature ovary failure, Alzheimer’s disease, Parkinson’s disease, diabetes and tooth loss.

Estrogen receptors are located throughout the body and brain when estrogen levels are low, or our body is not manufacturing estrogen such as when you have a hysterectomy the symptoms of hormonal imbalance such as moodiness, bone loss, loss of skin elasticity, and cognitive functions decline. Working with a physician than understands the consequences of low estrogen can help women avoid the trouble hormone imbalances can cause.

Testosterone Pellet Therapy

The testosterone hormone provides a woman with muscle tone and mass, mental clarity, and libido. When testosterone is low, women often complain of brain fog, weight gain, and even with regular exercise, poor muscle tone. Low testosterone can also be dangerous to a woman’s overall health. When a woman lacks testosterone, she can suffer from anxiety, insomnia, anger, sadness, and depression. Without hormone therapy, the imbalance of testosterone can lead to osteoporosis, muscle atrophy, and muscle and joint pain.

Bio-Identical Hormone Pellet Therapy

Hormone deficiency can have severe effects on the brain, muscles, bones, heart, and metabolism. Without balanced testosterone and estrogen levels, women suffer more than need be. To gain back your vitality, to avoid or prevent the pains of menopause, and to stay healthy for the long-term bioidentical hormone therapy can be your best friend.

Dallas Gynecologist and Functional Medicine Specialist Maryann Prewitt, MD is Director and Founder of HealthWellnessMD. Dr. Prewitt is Fellow and Board Certified by the America College of Obstetricians and Gynecologists. Dr. Prewitt holds a Master’s Certification in the da Vinci Surgery System – this minimally invasive technology has revolutionized the way surgery is performed today. Dr. Prewitt has been named 2016 | 2017 Top10MD an honor only 1 in 3 doctors in the United States succeeds with this recognition. Call Dr. Prewitt’s office today and schedule an appointment at 469-619-1066.


 1 year ago    Leave a comments (0)

Surgeries that some consider routine can still sometimes cause serious complications. No matter how straightforward you think your surgery might be, you still want to be in the absolute best surgical hands.

Today, your surgeon and hospital are especially important for procedures that are new or complex or even routine. You should be concerned and research but your surgeon and the hospital for that matter as most errors happen in a hospital setting according to John Hopkins report in May noting the third leading cause of death is medical errors. In your search for the best surgeon one indicator is how often your surgeon performs the procedure you’re seeking. For example, a study by researchers at New Hampshire’s Dartmouth-Hitchcock Medical Center of people undergoing surgery for pancreatic cancer found that annual death rates were nearly four times higher for those treated by surgeons who performed the fewest operations.

With that being said, how should you choose a surgeon, someone with whom you’ll be sharing some of your most personal information and entrusting with life-and-death decisions? Communication with your surgeon is essential.

Ask your prospective surgeon these questions before going under…

Are you board certified, and is your certification current?

  • Look for a surgeon who has the necessary board certification(s), necessary training, and has maintained their certification(s) in the specialty they are practicing.

Is this surgery necessary?

  • Avoiding surgery entirely is the only sure way to avoid a surgical complication; understanding the effectiveness of the surgery and having exhausted alternatives you then need to compare the results of your alternatives with the possible risks of the surgery. 

What are your success, failure, and complication rates?

  • Not all surgeons are willing to be upfront with this information, but a good surgeon will.

What is your experience with this surgery?

  • Ask your surgeon how many of these procedures he or she has performed and compare that number with other surgeons performing the same procedure. The best surgeon is not necessarily the busiest surgeon; it’s about avoiding the surgeon who has not performed the procedure as much or as often or as well.

What’s the hospital’s infection rate?

  • Seventeen states now make that information public, and many hospitals report their rates voluntarily. Kudos to them! After asking these questions and others relating to your needs, likes, and dislikes, do your homework and make your choice. Your final decision could be one of the most important you’ll make for you and your family.

To locate a Top10MD Surgeon you can trust visit and schedule your appointment today.


 1 year ago    Leave a comments (0)

The World Health Organization has released safe sex guidelines for those who are returning from Zika-affected areas. The report recommends doubling the abstinence time from having sex; the initially suggested four weeks to eight weeks. Scientists have come to this conclusion from finding that the Zika Virus lingers longer in blood and other bodily fluids than previously thought. To ensure your partner’s safety and the safety of a potential pregnancy, seriously consider the following recommendations.

What You Should Know About Zika

  • If you and your partner are trying to get pregnant, it’s crucial that you consider delaying pregnancy until the recommended abstinence time has passed.
  • If the male partner in a couple is planning pregnancy has symptoms of the Zika Virus, the period of abstinence is increased to six months.
  • Evidence points to male semen as the source of transmission between partners. It is important to practice safe sex by using a condom if your partner is currently pregnant or abstain from sex altogether for the remainder of the pregnancy.
  • Tests are still inconclusive as to how long the Zika Virus stays in the saliva.
  • For those living in Zika zones, it is important to continue your use of insect repellents such as DEET, covering up, and stay inside as much as possible.

Healthcare professionals are more concerned than ever about Zika Virus link to an epidemic of brain defects known as microcephaly. The Zika virus has now hit 52 countries to date according to the World Health Organization.

To learn more about Zika and how it can affect your unborn child, visit ZIKA or our blog.


 1 year ago    Leave a comments (0)



 3 years ago    Leave a comments (0)

8 Facts About Sperm

There are a lot of rumors out there about sperm but what are the facts? We share 8 facts about sperm every man and woman should know and put the confusion to rest!

1. Yes, temperature does affect his sperm count. Think of this in relation to the changing seasons. During the summer, the sperm count is the lowest and during the winter, it is the highest. Whether it’s a hot shower or sitting in a hot tub, these things can lower his sperm count dramatically. One doctor said, “If you’re trying to have kids, don’t go in hot tubs.”

2. Masturbation does not affect sperm count. Unlike women, men do not have a limited number of swimmers that can get used up. Endocrinologist Carrie Wambach says that so long as he has a normal sperm count, frequent ejaculation should have little impact on the sperm count other than maybe lessening the volume.

3. Pineapple and other foods won’t necessarily make him taste better. Board certified urologist, Harry Fisch, acknowledges that sperm does have fructose content, but there has yet to have been a study on the correlation between foods a guy eats and the taste of his semen. On another note, there is still a lot of anecdotal evidence with pineapples, so it doesn’t hurt to try!

4. The X & Y chromosomes are created equal. It is a myth that either the male or the female sperm is more resilient than the other, or swims faster than the other.

5. Sperm is speedy little fellows and concentrated right from the start. Yes, the first moment of ejaculation is when the sperm is the most concentrated and moves the most quickly.

6. Sperm can stick around for as long as five days. Don’t be misled; sperm doesn’t remain in the body for only 48 hours, it can hang inside the body for almost a week, this depends mostly on how healthy the mucus lining of your cervix is. During ovulation, the lining is the most fertile and can foster the environment of the sperm.

7. No, women are not allergic to sperm. Contrary to popular opinion, it is very rare for women to be allergic to sperm. Although inflammation and redness are evidenced, these factors are more likely to be caused by a vaginal infection.

8. Sperm has a long journey in the male’s body before ejaculation. Sperm is prepped for over two months in the male’s body before being released. It begins in the testicles, moves to the epididymis, then through the vas deferens, and finally, mixes with a fluid in the seminal vesicles to form semen. Lastly, it travels through the prostate before ejaculating.


 3 years ago    Leave a comments (0)

Imagine you’ve just been diagnosed with a condition requiring major surgery.  In theory, it could be a big ordeal. A large open incision often can mean more time in surgery and a painful and long recovery. But imagine getting that same surgery done, with the smallest incisions possible and very little invasion. That means less hospital stay and quicker recovery with a fast return to daily activities.  Well, da Vinci robotic surgery is making all this possible as it changes the face on modern day surgical care.

The behemoth of robotic-assisted surgery, Intuitive Surgical, just got FDA approved clearance on the Da Vinci XI system. Gary Guthart, president of Intuitive Surgical, states, “Our goal is to develop technology that enhances surgical performance. The da Vinci Xi System’s new overhead architecture means that multi-quadrant surgery can be performed without repositioning the system, an innovation long sought by surgeons who perform complex procedures.”

Intuitive Surgical strives to provide the lease invasive and most advanced option for complex procedures in the cardiac and thoracic areas. With this new headway in technology, surgeries become less expensive and have fewer complications that can come with open procedures.

The da Vinci Xi System for robotic surgery includes 3D-HD visualization, ergonomic design, and intuitive motion. It is capable of bringing a highly magnified view to doctors allowing them to virtually extend their eyes and hands into the patient, thereby gaining greater anatomical access.  It is important to note that this robotic surgery does not replace the doctor with a robot, but rather, the doctor is using this robotic system as his surgical platform to enhance surgical performance.

It is exciting to see how da Vinci is changing the experience of surgery for the patient, the doctors and even the hospitals.



 3 years ago    Leave a comments (0)

Can some of the most common urinary problems for males over 50 be avoided? You used to get a solid 7 hours of uninterrupted sleep a night, but now, you’re awakened by that nagging urge to need to visit the bathroom. Unfortunately, this may be a sign of an enlarged prostate.  Further symptoms include trouble starting a stream of urine, leaking, or dribbling. Unfortunately, this enlarged prostate is simply a byproduct of getting older.

The most common prostate problem for men over 50 is prostate enlargement. By age 60, over one-half of men have benign prostate hyperplasia, BPH; by age 85, the number climbs to 90%, according to the American Urological Association (AUA).

In men, urine flows from the bladder through the urethra. With an enlarged prostate the flow of urine through the urethra is blocked. And the enlarged prostate cells multiply, putting pressure on the urethra. Over time, the bladder muscles have to push more forcefully to push urine through the body. The bladder muscles become stronger and more sensitive to trying to push urine out of the bladder even when the bladder is not very full, and thus, causing the urge to urinate more frequently.

Symptoms of enlarged prostate can include:

  • A feeling of incomplete bladder emptying
  • Difficulty starting urination
  • Frequent urination
  • Urgency to urinate
  • Getting up frequently at night to urinate
  • Dribbling of urine
  • Returning to urinate again minutes after finishing

One becomes at risk for urinary tract infections, when the bladder cannot empty itself completely.  Other complications that can arise are bladder stones, blood in the urine, urinary retention, and incontinence.  Should these conditions develop and worsen, you should see your doctor immediately.



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