Cystoscopy - a small, flexible scope with a camera on the end that is inserted into the bladder, allowing a urologist to perform procedures within the bladder.
Diagnostic - to either find bladder tumors or watch (surveillance) to ensure a tumor has not returned.
Bladder Biopsy - the ability to take small amounts of tissue for diagnosis.
Bladder Fulguration - the ability to stop bleeding in the bladder.
Botox Injection - a specialized procedure to insert botox for overactive bladder.
Stent Removal - removing a temporary stent placed previously for a stone removal procedure.
Urethral Dilation - to stretch open a narrowed urethra.
Difficulty Catheter Placement - used to navigate a damaged or narrowed urethra when a catheter is needed to drain urine.
Urethral Bulking Agents (macroplastique) - for minor incontinence.
Urodynamics - specialized testing that can help your urologist diagnose complicated issues surrounding your urinary complaints. These tests are varied, but include:
- Post Void Residual (PVR) testing - a small, bedside ultrasound to determine how much urine is retained in your bladder after you complete urination.
- Uroflow - a test that measures how quickly you urinate to determine urinary flow.
- Cystometrogram (CMG) - a test that determines how your bladder fills. This helps your doctor determine how to proceed when you are having multiple urinary complaints.
Urologic Ultrasound - a technology using sound waves (no radiation) to visualize portions of the urologic tract. Specific procedures include:
- Prostate ultrasound – for measurement of prostate volume
- Ultrasound guided biopsy of the prostate (TRUS biopsy) – for prostate cancer diagnosis
- Kidney ultrasound – to evaluate swelling (hydronephrosis), a back-up of urine in the kidney
- Scrotal ultrasound – to evaluate for flow to the testicle or lesions in the scrotal cord or testicle
- Penile ultrasound – used in evaluation of erectile dysfunction
Catheter Changes - urgent or routine placement or changing of catheters.
- Urethral catheters (a catheter through the natural channel used for urine flow)
- Supra pubic catheters (a catheter through your abdomen)
- Self-catheterization teaching
Bladder Instillations - placing medicine in the bladder for various causes.
- Bladder cancer – BCG or other chemotherapy for bladder cancer treatment
- Intersitial cystitis / Bladder pain syndrome – to help manage this painful condition
- Antibiotic instillation – for troublesome chronic infections
Hormone Injections for Prostate Cancer
- For erections, either in conjunction with ultrasound for diagnosis of erectile dysfunction, or teaching for home use to obtain injections
- For penile curvature
Nerve Stimulation - procedures to help complex urinary difficulties.
- Percutaneous Tibial Nerve Stimulation (PTNS)
- Percutaneous Nerve Evaluation (PNE) – testing for preparation for OR placement of permanent device
Removal of Genital Lesions
- Removal / destruction of genital warts
- Removal of scrotal cysts
Vasectomy - We perform the minimally invasive "no-scalpel" vasectomy in office. This short (15- to 30-minute) procedure is used for permanent male sterilization.
Dr. Smith performs advanced robotic surgery including laparoscopic, endoscopic and lasers, providing patients with a minimally invasive approach and faster recovery time.
Endoscopic Procedures (using scopes)
Bladder, Prostate and Urethra
- Cystosocopy – to diagnose cancers and abnormalities of the lower urinary tract
- Bladder and urethral biopsy
- Removal of bladder tumors (TURBT)
- Destruction of bladder lesions (fulguration)
- Opening of narrow urethra (DVIU)
- Bladder chemotherapy instillation (Mitomycin)
- Removal of enlarged prostate tissue (TURP)
- Bipolar TURP
- Laser TURP (Photovaporization)
- Urethral bulking agents
- Botox injection
- Ureteroscopy – visualizing the upper urinary tract (kidney and ureter) for stone procedures as well as to diagnose strictures or masses in these areas
Stone Removal Procedures
- Removal of stones in bladder (cystolithalopaxy)
- Removal of stones in ureter and kidney
- Shock Wave treatment (ESWL)
- Ureteroscopy - using a laser to break up and remove stone
- Percutaneous stone removal – using a small hole in your back to remove larger stones
Scrotal / Penile Procedures
- Circumcision (young boys [older than 6 months] through adulthood)
- Revision circumcision (typically in young boys with an incomplete circumcision at birth)
- Penile exploration – for trauma to the penis
- Testicular removal (orchiectomy) for cancer
- Hydrocele removal
- Removal of epididymal cysts or entire epididymis
- Removal of tumors in spermatic cord
- Varicocele repair
Urologic Implant Surgery
- Penile implants for erectile dysfunction
- Artificial sphincter for severe incontinence
- Sling surgery (men and women) for incontinence
- Prostatectomy (prostate cancer)
- Nephrectomy (kidney cancer)
- Full removal (radical), as well as partial removal (kidney-sparing surgery)
- Adrenalectomy (removal of adrenal glands)
- Orchiectomy (removal of testicular tumor)
*** The above surgery can be performed robotically in most situations.
- UPJ obstruction repair (pyeloplasty)
- Ureteral stricture repair
- Ureteral re-implant
- Bladder diverticulum
*** The above surgeries are performed robotically in most situations.