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The Urology Center Treatments

Extracorporeal Shock Wave Lithotripsy (ESWL)

ESWL is the non-invasive treatment of kidney stones (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse. The lithotriptor attempts to break up the stone with minimal collateral damage by using an externally-applied, focused, high-intensity acoustic pulse. An overview of the procedure is as follows:

  • You lie on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to precisely locate the stone. High-energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone.
  • The patient may receive sedatives or local anesthesia.
  • Your surgeon may use a stent (a small, short tube of flexible plastic mesh that holds the ureter open) when your stones are larger than 2.5 cm. This helps the small stone pieces to pass without blocking the ureter.
  • ESWL is an outpatient procedure. After the procedure it may take a few days for all the stone fragments to pass from your body. The treatment usually starts at the equipment's lowest power level, with a long gap between pulses, in order to accustom the patient to the sensation. The frequency of pulses and the power level are then gradually increased to break up the stone more effectively.

Fertility

Fertility is the natural capability of giving images. Both women and men have hormonal cycles which determine both when a woman can achieve pregnancy and when a man is most virile. The female cycle is approximately twenty-eight days long, but the male cycle is variable. Men can produce sperm at any time of the month, but their sperm quality reduces occasionally, which scientists guess is in relation to their internal cycle.

In men, Erectile Dysfunction increases with age, but fertility does not decline in men as significantly as it does in women, however, evidence suggests that increased male age is associated with a decline in semen volume, sperm mobility, and sperm morphology.

In women, age plays a specific role in fertility. Although women can become pregnant at any time during their menstrual cycle, peak fertility occurs during just a few days of the cycle, usually two days before and two days after the ovulation date. This fertile window varies from woman to woman, just as the ovulation date often varies from cycle to cycle for the same woman. The ovule is usually capable of being fertilized for up to 48 hours after it is released from the ovary. Sperm survive inside the uterus between 48 to 72 hours on average, with the maximum being 120 hours (5 days).


Minimally Invasive Surgery

Laparoscopic surgery, also known as minimally invasive surgery (MIS), band-aid surgery or keyhole surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5 - 1.5 cm) as compared to larger incisions needed in traditional surgical procedures. Each incision is called a “port.” At each port a tubular instrument known as a trochar is inserted. Specialized instruments and a medical camera known as a laparoscope are passed through the trochars during the procedure. With minimally invasive surgery, there are a number of advantages to the patient versus a traditional open procedure including:

  • Reduced hemorrhaging, which reduces the chance of needing a blood transfusion.
  • Smaller incision reduces pain and shortens recovery time, resulting in less post-operative scarring.
  • Less pain, leading to fewer pain medications needed.
  • Reduced hospital stay / quicker return to everyday images.

 


 

Free Uroflowmetry: measures how fast the patient can empty his/her bladder.

The tests are most often arranged for men with enlarged prostate glands, and for women with incontinence that have either failed traditional treatment or requires surgery.


Vasectomy

One of the most common and popular means for contraception around the world is vasectomy – a brief, surgical procedure used for male sterilization. It is a popular means of birth control for couples that have decided that their family is complete. It is nearly 100% effective and is intended to be permanent. Whether it is a traditional surgical or the less-invasive No-Scalpel vasectomy procedure, a successful vasectomy blocks the vas deferens, preventing sperm from becoming part of the seminal fluid that leaves the body at sexual climax. The vas deferens are the thin tubes in the scrotum that would normally carry sperm from the testicles to become part of the ejaculate. When the sperm channel is interrupted, the man becomes sterile and can no longer father a child.

No Scalpel Vasectomy (NSV)

NSV is an office procedure that some feel have advantages over traditional vasectomies. A no scalpel vasectomy is safe, effective, comparatively faster, and has a quicker recovery time. As the name suggests, the "No Scalpel" method does not involve a scalpel, but a small opening is still necessary. The major key to the No Scalpel Vasectomy is the special instruments that allow the procedure to be done with generally less manipulation of the patient's tissues. In an NSV procedure, the doctor usually locates the patient's vas deferens under the skin of the scrotum by hand, and holds the tiny tube in place with a small clamp. Small pointed forceps separate the layers of tissue and then creates a tiny opening in the skin to form an opening for the vas deferens to be gently lifted out, then cut, tied, clipped and/or cauterized and put back into place. The surgeon may choose to close the opening in the skin with sutures. However, because the skin opening is much smaller than a conventional incision, it can close quite quickly without the necessity of suturing.


Vasectomy Reversal

Vasectomy reversal is a surgical procedure that re-approximates the cut ends of the vas deferens, restoring the flow of sperm from the testicle to the prostate. This procedure generally requires an experienced microsurgeon using an operating microscope to achieve the best success rates. A vasectomy reversal can be accomplished in two ways: a vasovasostomy or vasoepididymostomy.

With a vasovasostomy, the surgeon sews the severed ends of the vas deferens back together.

A vasoepididymostomy attaches the vas deferens directly to the epididymis, the coiled tube on the back of each testicle where sperm matures. A vasectomy can cause blockages or a break in the vas deferens or the epididymis. This surgery is used when a vasovasostomy won't work because sperm flow is blocked. The vas deferens is connected to the epididymis above the point of blockage.

Essentially any man who has had a vasectomy is a candidate for vasectomy reversal. The advent of microsurgical techniques makes possible vasectomy reversal at any time after vasectomy. Discomfort is quite variable but typically is not much more severe than the original vasectomy. A Vasectomy Reversal is typically an out-patient procedure (patient goes home the same day).

 
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