Procedures

Cryotherapy of the Prostate
Some patients choose prostate cryotherapy for treatment of prostate cancer. This procedure involves the freezing of prostate tissue to destroy the cancerous area of the prostate gland. You will be admitted to the hospital for an overnight stay. There is a prep that must be followed prior to your treatment.

Cystoscopy
Cystoscopy is a procedure which is usually performed in all of our offices. The physician uses a fiber optic scope to examine your bladder. This scope, which is made up of a long flexible tube, an eye piece, and a high intensity light is inserted into your urethra and makes its way into the bladder. A local anesthetic is inserted into the urethra. Most patients find cystoscopy uncomfortable but quite tolerable. We are able to identify bladder and urethral abnormalities such as bladder tumors by performing this procedure. There is no prep for this procedure. If you require antibiotics before dental work or other invasive medical procedures please let us know as cystoscopy is also considered an invasive procedure.

ESWL (Extra Corporeal Shock Wave Lithotripsy)
ESWL is performed to break up stones in your kidney(s) or ureter(s). It is performed at a hospital in the Same Day Surgery department. The hospitals at which we perform this procedure use a lithotripter which requires that you lay on a table (you are not submersed in a water tank). You will need to stop taking any blood thinning medications (non steroidal anti-inflammatory medications or warfarin, Coumadin, etc) at least seven days prior to ESWL as hematoma (bruising) of the kidney is a possible but unlikely side effect. There is a dietary prep that we ask that you follow the day prior to your procedure.

Prostatectomy (Radical Retropubic Prostatectomy)
Prostatectomy is performed to remove a cancerous prostate gland. It is one of several different treatments for prostate cancer. This surgery is performed in the hospital. You will be admitted several hours prior to your surgery time and will stay in the hospital a number of days (usually three to four). Your urologist will have counseled you on the possible outcomes of this surgery before you are even scheduled. For a link to our prostatectomy patient information and prep please click here.

Prostate Seed Implant (Brachytherapy)
Seeds are a minimally invasive therapy for patients diagnosed with prostate cancer. There are two parts to Brachytherapy; the volume study which is a measurement of your prostate is performed approximately six weeks prior to the actual seed placement. This allows the radiation physicist to plan the number of seeds and the actual placement of the seeds. The actual seed placement is performed in the same day surgery area of the hospital and you will go home on the day of your procedure. Your urologic surgeon performs this procedure in conjunction with a radiation oncologist.

PSA (Prostate Specific Antigen)
PSA is a blood test that determines the level of Prostate Specific Antigen circulating in your blood stream. There are several possible causes for elevation of PSA including prostatitis (inflammation of the prostate gland), recent rectal examination or prostate cancer. A small vial of blood is drawn from your arm and the test is usually run in our office. By avoiding sexual activity and bike riding 72 hours prior to your blood draw you will decrease your chance of having a falsely elevated PSA. A special note for Medicare patients: Medicare allows you to have one screening PSA per year. If you do not have a diagnosis that allows for more frequent PSA testing, payment for a second PSA in a year will be denied. Even one day less than a year between screening PSAs will result in a denied Medicare claim.

Pubovaginal Sling
The sling procedure is performed on female patients with specific types of urinary incontinence. It is performed in the hospital and you will be admitted for an overnight stay. A post operative visit will be scheduled for a voiding trial with a nurse approximately one week following your procedure. There is no dietary prep except to discontinue any blood thinning medications one week prior and to eat and drink nothing after midnight on the day of your surgery.

Stent (Ureteral Stent)
A stent is placed in the ureter (the tube between the kidney and the bladder) when there is an obstruction that won't allow the kidney to drain. Obstructions include a stone or stones in the ureter or a mass in the abdomen that presses on the ureter. A stent for a stone is usually in the ureter for a matter of days or weeks. Stents for chronic ureteral obstruction remain in the ureter indefinitely and are exchanged every three to four months. A stent may cause discomfort (flank pain) and blood in the urine. The best way to reduce or avoid these symptoms is to limit your activity, drink plenty of water and to take your pain medications as prescribed. To find out more about stents, click here.

Transrectal Ultrasound of the Prostate
TRUS is a procedure which is performed in our Edina office. It is used to measure and biopsy the prostate. A probe is inserted into the rectum which allows an image of the prostate to be shown on the ultrasound screen. If you need prostate biopsies a needle is guided using the ultrasound and biopsy cores are retrieved with a special needle. We inject the prostate with a local anesthetic so most men find this procedure easily tolerated. The biopsy cores are sent to a special urology laboratory for interpretation. You should discontinue non steroidal anti-inflammatory medications or warfarin, Coumadin (blood thinning medications) seven days prior to your biopsy. We ask that you use a Fleet’s enema one hour prior to leaving home to come to your ultrasound appointment. We will also provide you with a prescription or samples of antibiotics. We ask that you start this medication on the day prior to your TRUS and continue it until it is gone. For more information regarding this procedure, click here.

Prostiva (Transurethral Needle Ablation of the Prostate)
Prostiva is an office based, minimally invasive procedure to treat voiding symptoms caused by prostate enlargement. The technology is based on radio frequency waves which actually destroy tissue within the prostate. It can take several weeks for you to get the full benefit from TUNA. After the procedure, you will the office with a catheter and will return for it's removal after two days. There are medications that we prescribe preoperatively that will make the procedure easier for you. We ask that you discontinue any aspirin or blood thinning medications seven days prior to your procedure. You will be in our office for approximately two hours on the day of your Prostiva.

TURP (Transurethral Resection of the Prostate)
TURP is performed to help alleviate symptoms caused by an enlarged prostate. The procedure reduces the size of the prostate by lasering prostate tissue away from the urethra. There are possible side effects which your urologic surgeon will discuss with you before you schedule the procedure. You will be admitted to the hospital for a two day stay (approximately). We ask that you discontinue blood thinning medications seven days prior to your procedure.

Urodynamics (or urodynamic testing)
Urodynamic testing may be ordered if you have voiding problems, especially incontinence. This testing is performed in our office by a nurse who has special training to perform your urodynamic test. The test is performed after placing several electrodes on your abdomen, leg and near the rectum. Two catheters are placed; one in the rectum and the other in the urethra. These devices record different pressures and muscle responses that gives the interpreting physician information to make a specific diagnosis. The test usually requires that you be here an hour. There are certain medications that we ask that you discontinue prior to your test and we do want you to avoid all caffeine the two days before.

Uroflow
Uroflow is a test performed in all of our offices. This test measures the volume and force of your urinary stream. You will be asked to urinate into a special commode which electronically measures this information. The prep is to come to your uroflow appointment with a full bladder (at the point at which you would normally be looking for a restroom). This may require that you drink extra fluid to get the timing right. We suggest water because caffeinated beverages can make you feel like you are ready to urinate when the volume of urine in your bladder is not sufficient to get an accurate test.

Vasectomy
Vasectomy is a procedure for male sterilization. The procedure involves the ligation of (or removal of part of) the vas deferens (the tube that carries sperm to the ejaculatory ducts). This procedure can be performed in the office or the outpatient department at the hospital depending on your insurance coverage (see the business office section of this website). Special note for patients with Medical Assistance: Your coverage requires that you sign a consent form 30 days prior to your procedure. If we do not have a signature dated 30 days before your scheduled procedure we will reschedule. Most men prefer to have their vasectomy performed at the end of the week so that they have the weekend to recover. If you have a job that does not require lifting or physical labor you will have no problem returning to work after a two day recovery. You will be asked to return approximately six weeks after your vasectomy for an appointment with your doctor and to receive your post vas testing supplies. The post procedure testing is very important to determine the success of the procedure. You will be asked to use birth control until you have had two negative sperm counts. There is lots of information in our vasectomy handouts.

Vasovasostomy (Vasectomy reversal)
Vasovasostomy is the rejoining of the separated ends of the vas deferens in order to reestablish male fertility. The procedure is performed in the same day surgery department of the hospital. It requires the skills of two urologic surgeons and special microscopic equipment. Most insurance companies do not pay for vasectomy reversal. We ask that you speak to our business office before you schedule as we require prepayment. The hospital charges are not included in our pricing. Remember, there is also a charge for the anesthesiologist. Your surgeon will review success rates with you during your initial consultation appointment.

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