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Urology

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Overview

The Center for Reconstructive Urology provides comprehensive care of all diseases of the urinary tract. Our staff enjoys a national reputation for innovative surgical and non-surgical treatment of bladder control problems, urinary tract injuries and urinary cancers.

Urinary Incontinence – People of all ages suffer from urinary incontinence. And while more women than men are affected, men can have urinary problems, too. There are many effective treatments for urinary incontinence. If behavioral and medical treatments for urinary incontinence don’t provide enough relief, surgery may help. One procedure works by supporting the bladder so that it returns to its normal position. Another surgical treatment for urinary incontinence, called a sling procedure, is done through a vaginal incision and uses a strap of synthetic mesh or natural tissue to support the urethra, the urine-carrying tube.

Pelvic Prolapse – Many women who have pelvic organ prolapse do not have symptoms and do not require treatment. Treatment decisions should take into account which organs are affected, how bad symptoms are, and whether other medical conditions are present. Other important factors are your age and sexual activity. Many women are able to reduce pain and pressure from a pelvic organ prolapse with nonsurgical treatment, which may include making lifestyle changes, doing exercises, and/or using a removable device called a pessary that is placed into the vagina to support areas of prolapse.

If pelvic prolapse is causing pain or problems with bowel and bladder functions or is interfering with sexual activity, patients may want to consider surgery. Surgical procedures used to correct different types of pelvic prolapse include repair of the supporting tissue of the prolapsed organ or vagina wall. Another option is the removal of the uterus (hysterectomy) when it is the prolapsed organ or if it is causing the prolapse of other organs (such as the vagina).

Minimally Invasive Prostate Therapy – Minimally invasive and surgical procedures are available to treat moderate-to-severe enlarged prostate symptoms. These procedures are also used if tests show that urinary function is seriously affected. Minimally invasive procedures for an enlarged prostate are often performed in a doctor’s office.

Transurethral microwave therapy (TUMT). This procedure uses a microwave antenna attached to a flexible tube that is inserted into the bladder. The microwave heat destroys excess prostate tissue.

Transurethral needle ablation (TUNA). This procedure uses a heated needle inserted into the prostate through the urethra to destroy excess prostate tissue.

No-Needle No-Scalpel Vasectomy – New, “no-scalpel” vasectomies have made male sterilization simpler. A vasectomy cuts a piece out of the tube — the vas deferens– that allows sperm to leave the testicles and enter the semen. “No-scalpel” utilizes an ultrasound device with three parts. One is a water balloon that covers the skin. Chilled water runs through the balloon to keep the skin from burning. The second part is a clamp that holds the vas deferens in place. The third part is an ultrasound machine that focuses sound waves on the vas deferens. At the point of focus, the ultrasound energy creates intense heat which causes the vas deferens to close. Healing creates scar tissue that further blocks the vas deferens.

Procedures

Our Physicians

   
   

In Depth Data:

AP Repairs

Colporrhaphy (also vaginal wall repair, anterior and/or posterior colporrhaphy, anterior and/or posterior vaginal wall repair, or simply A/P repair or A&P repair) is a surgical procedure in humans that repairs a defect in the wall of the vagina. It is the surgical intervention for both cystocele (protrusion of the urinary bladder into the vagina) and rectocele (protrusion of the rectum into the vagina).The repair may be to either or both of the anterior (front) or posterior (rear) vaginal walls, thus the origin of some of its alternative names.

Pelvic Prolapse

A prolapse is a weakening in the web of muscles at the base of the pelvis. These muscles, called the pelvic floor muscles, hold the organs of the pelvis in place. If these muscles are weakened in one area, the organ they support will shift position and begin to press against the vagina. This is called a prolapse. The organs that can be affected include the bladder, urethra, uterus, vagina, small bowel and rectum.Weaknesses in the pelvic floor muscles are most often caused by strain during a vaginal birth. This is more likely if the baby was very large, or if the labour was long and difficult.Pelvic prolapse can also result from a hysterectomy (an operation to remove the uterus). After the uterus is removed, other organs, such as the bladder, may drop.Although it is possible for a younger woman to have a prolapse, a woman is most likely to experience a prolapse after menopause. Lower levels of the hormone estrogen can make the ligaments and muscles of the pelvis weaker and less elastic, which makes prolapse more common in post-menopausal women.

The muscles of the pelvic floor may also be damaged by:
1. obesity
2. chronic coughing
3. chronic constipation
A prolapse can cause pain during intercourse and can also affect the functioning of the organ involved. For example, if the bladder is prolapsed, it can cause urinary incontinence or difficulty emptying your bladder and/or bowel. It may also increase your risk of urinary tract infections. Women with any kind of prolapse often report a feeling of heaviness in the pelvis or a sensation that they are sitting on something. In severe cases, the prolapse may push tissue out through the vaginal opening.

Cystoscopy

Endoscopy of the urinary bladder via the urethra is called cystoscopy. Diagnostic cystoscopy is usually carried out with local anaesthesia. General anaesthesia is sometimes used for operative cystoscopic procedures.When a patient has a urinary problem, the doctor may use a cystoscope to see the inside of the bladder and urethra. The urethra is the tube that carries urine from the bladder to the outside of the body. The cystoscope has lenses like a telescope or microscope. These lenses let the doctor focus on the inner surfaces of the urinary tract. Some cystoscopes use optical fibres (flexible glass fibres) that carry an image from the tip of the instrument to a viewing piece at the other end. Cystoscopes range from between the thickness of a pencil, up to approximately 9mm and have a light at the tip. Many cystoscopes have extra tubes to guide other instruments for surgical procedures to treat urinary problems.There are two main types of cystoscopy – flexible and rigid – differing in the flexibility of the cystoscope. Flexible cystoscopy is carried out without the use of local anaesthesia on both sexes. Typically, xylocaine gel (such as the brand name Instillagel) is used as an anaesthetic, instilled in the urethra. Rigid cystoscopy can be performed under the same conditions, but is generally carried out under general anaesthesia, particularly in male subjects, due to the pain caused by the probe.

A doctor may recommend cystoscopy for any of the following conditions:
1. Frequent urinary tract infections
2. Blood in the urine (hematuria)
3. Loss of bladder control (incontinence) or overactive bladder
4. Unusual cells found in urine sample
5. Need for a bladder catheter
6. Painful urination, chronic pelvic pain, or interstitial cystitis
7. Urinary blockage such as from prostate enlargement, stricture, or narrowing of the urinary tract
8. Stone in the urinary tract
9. Unusual growth, polyp, tumor, or cancer

No needle vasectomy

No needle approach offers patients new, less-invasive option for vasectomy A new surgical approach called “no needle vasectomy” is now offering men a new, less-invasive treatment option for permanent male birth control.The no needle jet anesthetic technique, originally pioneered in North America, was introduced to the U.S. urological market at the 100th annual meeting of the American Urological Association (AUA) in San Antonio May 21-26, 2005. In a traditional vasectomy, an anesthetic is delivered via a needle into the scrotum to numb the area before the surgical procedure. With this new procedure, the anesthetic is delivered into the target area with a no needle jet injection – decreasing the fear of needles and removing needle injection pain.
Key Benefits of No Needle Vasectomy

According to physician experts in this field, the three key benefits of the no needle approach to vasectomy are that it:
1. Simplifies the surgical technique,
2. Lowers patient fears, and
3. Reduces pain in men undergoing the procedure.

 
 
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