Urologists perform a variety of in-office procedures to help aid in the diagnosis and treatment of urologic disease. Below you can find descriptions of various office treatments and diagnostic tests.
Bladder instillations are used to treat patients with various urologic problems including bladder cancer and Interstitial Cystitis. Instillations involve placing a catheter into the bladder through the urethra and instilling a solution into the bladder. This solution will remain in the bladder for a variable amount of time depending on the treatment. The bladder is then drained at the end of the procedure with a catheter or you are allowed to urinate the solution out on your own.
Instillations can be used to try to prevent recurrent tumors in the bladder or relieve debilitating bladder symptoms.
OnabotulinumtoxinA is a medication used to treat patients with Overactive Bladder and Neurogenic Bladder. This treatment is used after patients have tried other treatments and could not tolerate the treatments or did not have success with these other treatments. This therapy involves doing a cystoscopy (see below) and injecting the Botox® into the bladder muscle to help relax the bladder and prevent urinary leakage.
Patients who are unable to empty their bladder normally can learn to pass a catheter into the bladder as needed. Our nursing staff is trained to work with patients to teach them the correct techniques to safely and comfortably pass a catheter into their bladder.
Cystoscopy is a test that allows your urologist to look into the bladder and urethra to evaluate the inside of these organs that cannot be evaluated well with standard x-rays. A cystoscope is a small, lighted telescope that is inserted into the urethra and advanced into the bladder. Occasionally small instruments are passed through the scope to remove samples of urine or tissue (biopsy). Small stones or growths in the bladder may be removed through the cystoscope and possibly avoid a more extensive procedure.
InterStim Therapy helps your bowel, rectum and bladder function normally by implanting a small device to stimulate the nerves that control your bowel and bladder (sacral nerves), with mild electrical pulses. This type of therapy is used to treat overactive bladder, urinary retention and chronic constipation. Patients are given a small remote that will allows them to adjust the strength of the electrical pulses, including turning it on or off. This procedure is reversible.
Percutaneous Tibial Nerve Stimulation (PTNS)
Percutaneous Tibial Nerve Stimulation is a low-risk, non-surgical treatment for patients experiencing Overactive Bladder (OAB) and symptoms of urinary urgency, urinary frequency and/or urge incontinence. PTNS works by indirectly providing electrical stimulation to the nerves responsible for bladder and pelvic floor function. During PTNS treatment, your foot is comfortably elevated and supported, and a slim needle electrode is placed near the nerve at the tibial nerve (ankle). A device known as the Urgent PC Stimulator® is then connected to the electrode and sends mild electrical pulses to the tibial nerve. These impulses travel to the group of nerves at the base of the spine responsible for bladder function.
By stimulating these nerves through gentle electrical impulses (called neuromodulation), bladder activity can be changed. Because this change happens gradually, patients typically receive a series of 12 weekly, 30-minute treatments. After the 12 treatments, we will assess your response to the PTNS therapy and determine whether additional treatments will be needed occasionally to maintain the results.
Prostate biopsies are performed to diagnose prostate cancer. If a nodule is felt during a rectal exam or if there is an elevation in your PSA blood test, your urologist might recommend a biopsy of the prostate.
The biopsy involves placing a small ultrasound probe into the rectum and taking measurements of the prostate. Your urologist will then numb your prostate and then take samples of the prostate with a small needle. The biopsies are then sent to the pathologist to look for prostate cancer.
Urodynamics (UDS) testing is used for patients with various urinary symptoms including urinary incontinence (leakage), urinary urgency, urinary frequency, inability to urinate or empty the bladder, or patients with neurologic disorders that may affect the urinary tract. This test evaluates the bladder’s function.
For your urodynamic test, you will be asked to come into the office with a full bladder and urinate into a special container. A tiny catheter will then be placed into the bladder and the bladder will be filled until you have the urge to urinate. The test will give your urologist information on how to treat your symptoms.
Men who no longer desire to have children often undergo a vasectomy. This procedure interrupts sperm transportation from the testicle and the urethra by blocking the vas deferens. The procedure is performed by one or two small incisions in the scrotum with local numbing medication like novocaine. The procedure is intended to be a permanent form of sterilization.