Urology

Advanced diagnosis and treatment of urological conditions

Urology is the branch of medicine that treats diseases of the male and female urinary tract system (kidneys, ureters, bladder and urethra) and the male reproductive organs.

Our offices provide general urology services and the treatment of complex urological conditions; including a urodynamics lab for testing and diagnosis of urinary conditions. Our providers are also experienced in minimally invasive robotic surgery for the treatment of genitourinary malignancy, such as prostate cancer, kidney cancer and bladder cancer, as well as female pelvic organ prolapse and other urological disorders and conditions.

Some common urologic conditions include:

  • prostate cancer
  • bladder cancer
  • kidney cancer
  • bladder prolapse
  • kidney and ureteral stones
  • hematuria (blood in the urine)
  • interstitial cystitis (also called painful bladder syndrome)
  • overactive bladder
  • prostatitis (swelling of the prostate gland)

Help for Overactive Bladder
Overactive bladder can be disruptive to everyday living. The good news is that overactive bladder can be treated often with oral medication.  Many patients are also helped by Botox injected into the muscles of the bladder; this therapy typically lasts for six to eight months and then is re-injected.   

For persons who have not found success with these treatments, these are other solutions available:

Minimally Invasive Percutaneous Tibial Nerve Stimulation (PTNS)

Patient Receiving PTNS

PTNS is a minimally invasive form of neuromodulation used to treat overactive bladder and the associated symptoms of urinary urgency, urinary frequency and urge incontinence.  Simply put, this device sends an electric current to a nerve in the ankle and it interrupts the electrical impulses that are over stimulating the bladder.

Implantable Device

A device like a pacemaker for the bladder – for both men and women to help with urinary incontinence and frequency.

The small device is implanted under the skin close to the tailbone.  It’s programmed to emit electrical impulses that interrupt poor communication between the brain and the sacral nerves.  By regulating the communication between the brain and the bladder, neuro-stimulation can reduce urinary leaking and urgency feelings.

Robotic Procedures
Because it is minimally invasive, the precision of robotic technology is ideal for delicate and complex urologic surgeries.

Robotics permits a three-dimensional view of the operative field—compared with laparoscopic surgery’s two-dimensional view—and allows for a much wider range of motion of the surgical instruments and scaling of motion, facilitating the precise suturing techniques required to perform these extremely delicate and precise procedures. These advantages are borne out in the extensive data gathered to date showing excellent symptomatic improvement for patients undergoing these robotic procedures.

Some of the robotic procedures include:

 Partial Nephrectomy provides patients with a safe and effective way to remove a small renal tumor, while preserving the remainder of the kidney. The robot offers two main advantages over conventional laparoscopy. First, the binocular camera allows the surgeon depth perception to easily operate in 3 dimensions. Second, the “wrist” of the robotic arms has 7 degrees of freedom, which allow the surgeon better control over certain aspects of the operation, most importantly precise suturing with minimal tissue manipulation. This is a minimally invasive technique, which provides patients with less discomfort and equivalent results when compared to the traditional open surgery.

Radical nephrectomy
For some patients with kidney cancer or a benign kidney tumor, a partial nephrectomy may not be possible due to the tumor’s size or location. In these cases, a different type of robotic kidney surgery known as a robotic radical nephrectomy may be performed, in which the entire kidney is removed. This minimally-invasive procedure offers patients many of the same advantages as a robotic partial nephrectomy, including less trauma on the body and a shorter recovery time than open surgery.

Prostatectomy is a minimally invasive surgical procedure, called robotic prostatectomy, uses finely controlled robotic instruments to perform the prostatectomy safely, while enhancing patient recovery and outcome. Unlike laparoscopic surgery, robotic surgery instruments used in robotic prostatectomy can turn in all directions with 90 degrees of articulation and 7 degrees of freedom. During robotic prostate surgery the robot provides the surgeon with improved visualization, dexterity, and precision compared with open or laparoscopic surgery, while enabling operation through 1-2 cm incisions. This allows the doctor  to perform fine computer-controlled movements and a more precise and minimally invasive robotic prostatectomy. During this prostate cancer treatment, his patients’ delicate prostate nerves that control bladder and sexual function are spared.

Sacral colpopexy for female pelvic organ prolapse
Pelvic prolapse occurs when a pelvic organ, such as your vagina or uterus slips out of its normal position. Surgery to correct this condition is called sacrocolpopexy. During surgery, doctors use surgical mesh to keep the pelvic organ(s) in the correct spot and ease your symptoms. Since this procedure avoids the need for the large abdominal incision used in open surgery, most patients are able to resume normal activities within 3 to 4 weeks, compared to 6 to 8 weeks for an open sacrocolpopexy.  The superior precision and visualization of operative dissection offered by the robot enhances the surgeon’s ability to perform sacrocolpopexy with reduced blood loss and more accurate placement of suspension sutures.

Ureteral reconstruction / reimplantation – This robotic urinary reconstructive procedure, which requires extremely delicate dissection and suturing technique, is performed when there is an obstruction of the ureter in the distal (bottom) portion where it meets the bladder. The surgeon cuts the ureter directly above the blockage and then reimplants the unobstructed portion of ureter into the bladder by creating a new opening in the bladder and suturing the end of the ureter to the opening.

Performing urinary reconstruction through a traditional open incision requires a large incision to access the ureter, which extends from the kidney (located behind the ribs) to the bladder (located under the pubic bone). Robotic surgery requires only four small, quarter-inch incisions to access the same area, resulting in minimal scarring.

Data gathered from numerous procedures shows excellent results in terms of minimal blood loss with robotic urinary tract reconstructive surgery.  Smaller incisions result in less pain than an open incision following surgery, and also heal more quickly, leading to a shorter hospital stay and faster return to normal activity.

To Make An Appointment, please call:  940-764-5400

Watch the videos below for detailed information about specific procedures:

Cystoscopy



Botulinum Toxin (BOTOX) Injections for Overactive Bladder



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