Conditions We Treat
Several muscles and ligaments in your pelvis support your bladder and keep it in place. Stress from having a baby, lifting heavy things or being overweight can weaken those supports. When these muscles get too weak, they can’t support the bladder and it drops down and bulges into the vagina. Signs of bladder prolapse include a full feeling or pressure in your pelvis, feeling pain when you cough or lift, frequent bladder infections and pain during sex.
Blood in Urine
Blood in urine can be, but is not always, a symptom of an underlying medical condition and can be visible or not visible.
An enlarged prostate, or benign prostatic hyperplasia (BPH), occurs when prostate cells multiply and can inhibit the movement of urine through, and out of, the body.
Up to 30 million men experience erectile dysfunction (ED) according to the Urology Care Foundation. Men with ED can’t get or keep an erection more than half the time they want to have sex. Treatment options include counseling to help deal with stress or anxiety that may be causing ED, pumps that help increase blood flow to the penis, medications to make it easier to get and keep an erection and surgery or implants to help you get an erection.
Kidney failure happens when your kidneys can't filter the waste from your blood. As a result, dangerous levels of substances like potassium build up in the blood. It can be caused by injuries or diseases like diabetes or high blood pressure, which damage the kidneys over time. Symptoms may include going to the bathroom more frequently, feeling like you can't catch your breath, chest pain or discomfort and swollen legs, feet or ankles.
Kidney stones are small, pebble-like deposits that form when salts and minerals crystallize in the kidneys.
The main symptom of an overactive bladder is having an intense, frequent need to urinate that is hard to control.
Peyronie’s disease is caused by a buildup of scar tissue inside the penis. This scar tissue causes a curvature when the penis becomes erect. Although a curved erection isn’t abnormal, it may cause pain. It can also cause erectile difficulties. Doctors aren’t sure what causes it. In some cases, a man may have a history of injury. Mild cases don’t usually need treatment. In severe cases, doctors prescribe medication or surgery.
Prostatitis or Prostatism
The prostate is the gland that produces semen in men. Prostatitis occurs when that gland becomes inflamed and swollen.
Ureteropelvic Junction Obstruction
A ureteropelvic junction (UPJ) obstruction happens when there is a jam at the exit door of the kidney. The kidney leads into the ureter, or the tube that brings urine from the kidney to the bladder. When that connection is blocked, it can cause backup of urine and kidney damage. Some children are born with a blockage. Sometimes, severe UPJ obstruction is treated with surgery.
Urinary incontinence, or bladder control, is characterized by an inability to control the bladder, and can be momentary or chronic.
Vaginal atrophy happens when the tissues in the vagina start thinning out. It can make having sex painful. Other symptoms include dryness, itching and bleeding. Hormone changes during menopause, while breastfeeding or after having a baby are the main causes. These changes thin the lining of the vagina, making it drier and more fragile. It's a common condition but doesn't affect everyone. Having sexual activity regularly (with or without a partner) can help prevent this condition.
Your body naturally creates a clear fluid that keeps the tissues in your vagina stretchy and healthy. A drop in hormone levels often causes your body to make less of that fluid. This change in hormones is common during and after menopause. You might feel pain during sex. Dryness can happen to women of all ages but it’s most common in older women. Doctors often treat it with hormone therapy or over-the-counter products.
Varicoceles are veins inside a man’s scrotum that are bigger than normal. They often form while you're young and they grow larger over time. Most men have no symptoms, but sometimes the vein can cause pain. This pain might worsen as the day progresses, improve when you're lying on your back and worsen after standing for a long time.
Most men don't need treatment for varicoceles.
Treatments We Offer
Doctors use cystometrograms to look for problems in your bladder. This test looks at how it fills and empties. It measures details like how much your bladder holds, and the amount of pressure in your bladder. The procedure involves inserting a pressure sensor into your bladder through your urinary opening. The test can help doctors diagnose problems including frequent urination, inability to hold your urine or feeling like you can’t urinate. Also, doctors may use this test for people with spinal cord injuries and other conditions.
Doctors perform cystoscopy procedures by inserting a special scope into your urethra. This is the tube your urine comes out of. It's usually done in the doctor's office and it usually only takes 10 minutes. Your doctor will ask you to empty your bladder before numbing the area and inserting the cystoscope into it to find the source of any problems like blockages or bleeding. If they find anything suspicious, they can take a sample to look at under a microscope.
Your kidneys filter waste from your body. This keeps levels of things like sodium and potassium in check. When you have kidney disease, your kidneys can’t effectively do their job. Doctors recommend dialysis for patients with end stage kidney failure. It removes wastes from your body when your kidneys can't. Some people have the treatment at home. Others go to outpatient centers for their treatment.
Digital Rectal Exam (DRE)
A digital rectal exam is a procedure used to examine the organs in the lower pelvis. A provider inserts a gloved and lubricated finger into your rectum. In men, the provider is feeling for the prostate. In women, the provider may be examining the ovaries, uterus or vagina. A DRE can also tell a doctor about the tone of the muscles in your pelvis. The doctor can use it to help diagnose hemorrhoids or cancerous growths.
Implantable Nerve Stimulator
Implantable nerve stimulators are small devices that send electrical pulses to your nerves or your spinal cord. These pulses change the way your brain recognizes pain signals. Before implanting a nerve stimulator, your doctor will use a temporary version to see if it helps. If it does, your doctor will implant the permanent device under your skin using a mild sedative and a local anesthetic. It's typically an outpatient procedure.
Inflatable Artificial Sphincter
An inflatable artificial sphincter is used to treat urine leakage in men. Urine leakage is most common in men who have had surgery on their prostate. An artificial sphincter is a rubber cuff that is put below the exit to the bladder, around the urine tube. When the cuff is inflated, urine won’t leak out. When it’s time to urinate, the cuff can be deflated with a control pump that is put in your scrotum.
Laser ablation of the prostate is a surgery for prostate cancer. In this procedure, a surgeon uses laser heat to kill cancer cells that live in the prostate. They insert a small tool into the tip of your penis so the laser can reach the cancer cells. Sometimes, surgeons will use an MRI to help guide the laser, which can make the procedure safer and more effective.
MonaLisa Touch Laser Therapy
MonaLisa Touch Laser Therapy is a treatment used to treat vaginal symptoms women may experience after menopause. It is a medical treatment that can improve vaginal dryness and discomfort by improving moisture levels. The procedure is fairly simple and can usually be done in the doctor’s office. It involves putting a probe in your vagina and using painless, mild laser energy to improve blood flow.
A pelvic exam is a procedure done in a doctor’s office to examine your reproductive organs. It can be part of a normal check-up, or it can be done if you’re having symptoms in your pelvis. Your doctor will examine both the outside and the inside of your pelvis. To examine the inside, the doctor may insert a gloved finger or speculum into your vagina to see your cervix and to do a pap smear.
A pelvic sling is a surgery that can treat urine leakage in women. This type of leakage generally occurs with straining, laughing, or sneezing. In this procedure, your surgeon will place a sling to support your urine tube, like a hammock. This will make sure the exit of your bladder stays closed with activity. The sling is usually made out of a synthetic mesh, your own tissue, or animal tissue. Ask your doctor which type might be right for you.
A penile implant is a device placed into the penis to help men who have erectile dysfunction (ED). ED is a condition where a man can’t get or maintain an erection. There are two types of implants: semi-rigid and inflatable, and there are pros and cons to both. A penile implant requires a surgery. ED is often treated with medication as an alternative to surgery.
Percutaneous embolization is the gentlest type of surgery used to treat a varicocele. A varicocele is a collection of veins in a man’s scrotum. It's sometimes painful. In this procedure, your surgeon inserts a wire into a vein in your leg. They snake the wire through your vessels into the collection of veins in your scrotum. The surgeon then uses the wire to pack the veins with solid and/or liquid substances (embolic agents) to fix the varicocele.
Plication is a surgery that treats Peyronie's disease. This is a condition that means your penis has a significant curve to it. A surgeon opens up the skin on your penis and cuts away some of the tissue on the long side of the curve. This straightens your penis, but usually your penis becomes shorter after the surgery. There is a low risk of the curve coming back after this surgery.
A prostate biopsy is a procedure that a doctor does to diagnose prostate cancer. A surgeon cuts out a small piece of your prostate so they can look at it under a microscope. There are two ways to get a biopsy. More often, the surgeon will pass a needle through the wall of your rectum to get the tissue. Sometimes, the surgeon may insert a long needle into the area between your scrotum and your anus to get a tissue sample.
A prostatectomy is a surgery where some or all of your prostate is removed. Your entire prostate will be removed if you have had prostate cancer. A small portion of your prostate can be removed if you have urinary issues from your prostate being too large. There are a few approaches to a prostatectomy, but they all involve making one or more incisions on your lower abdomen.
Pyeloplasty is a surgery on part of your kidney. This is done because there is a blockage in your kidney’s attachment to the tube that brings urine to your bladder. When this part of the kidney is blocked, urine can back up into the kidney. In this procedure, a surgeon will make an incision in your abdomen or on your side. The surgeon will go in and remove the blockage and reattach the urine tube to your kidney.
Surgical Bladder Suspension
Surgical bladder suspension is a process used to treat urine leakage in women. The surgery helps move your bladder back into a normal position. Your bladder may have moved due to childbirth, menopause, or previous surgery, causing urine leakage with laughing or coughing. There are different types of surgery for this condition depending on the cause and severity.
Transurethral Incision of the Prostate (TUIP)
A transurethral incision of the prostate (TUIP) is a procedure used to treat urinary symptoms in men. These symptoms occur when a man’s prostate gets too big and presses on his urine tube. A surgeon inserts a tool into the tip of the penis and makes a small cut where the prostate is pressing on the tube. This loosens the tube and relieves urinary symptoms.
Transurethral Microwave Thermotherapy (TUMT)
Transurethral microwave thermotherapy (TUMT) is a procedure that treats urinary symptoms in men. These symptoms occur when a man’s prostate gets too big and presses on his urine tube. It is a simple procedure that usually takes place in the doctor’s office. A surgeon inserts a microwave antenna into the tip of the penis until it reaches the enlarged tissue. The microwaves cause the prostate to shrink, ensuring the symptoms will get better.
Transurethral Needle Ablation of the Prostate (TUNA)
Transurethral needle ablation of the prostate (TUNA) is a procedure that treats urinary symptoms in men. These symptoms occur when a man’s prostate gets too big and presses on his urine tube. It is not a big procedure, and a surgeon can do it in the office. A surgeon inserts a tool into the tip of the penis and puts a hot needle into the enlarged tissue. The heat causes the prostate to shrink, improving the symptoms.
Transurethral Resection of the Prostate (TURP)
Transurethral resection of the prostate (TURP) is a procedure doctors do to treat urinary problems in men caused by having an enlarged prostate gland. During the surgery, a doctor inserts a device through the tip of your penis. This device removes some of the enlarged prostate tissue that's causing your symptoms. Doctors generally choose to do TURP for men whose enlarged prostates have not responded to other medical treatments.
Urethral Bulking Injection
A urethral bulking injection is a procedure that can help treat bladder leakage. A doctor injects a material, such as collagen, into the tissue around your urethra. This thickens the tissue walls around your urethra to make it easier for you to hold your urine. The procedure is most commonly done in women. You can see immediate results from these injections. However, urethral bulking eventually wears off. Many people have to have the procedure done several times.
A urinalysis is a lab test done on your urine. It can give doctors information about common health conditions. During this test, you provide a sample of your urine in a sterile cup. Then, a doctor examines your urine. A urinalysis consists of three parts: a visual inspection, a chemical analysis and evaluation under a microscope. A urinalysis is often part of routine lab work to assess your health. It's helpful in diagnosing infections, diabetes and kidney conditions.
A vaginal pessary is a device that's inserted into your vagina to help manage incontinence — a lack of control over urination. It can also provide relief if your bladder, rectum or uterus bulges into your vagina. It is an alternative to surgery which is often needed with these conditions. Different types are used for varying degrees of severity of the condition. Some are inserted by a doctor, while others can be inserted by the patient.