Our board certified surgeons all perform state of the art minimally invasive techniques including laparoscopic, robotic and endoscopic surgery. By using these techniques and clearly communicating surgery expectations, we are able to minimize recovery and get you back to doing the things you love.
We treat a broad range of conditions with the latest evidenced based techniques. Click below to learn about some of the conditions we treat.
Properly performed neonatal circumcision prevents phimosis, paraphimosis and balanoposthitis, and is associated with a decreased incidence of cancer of the penis among U.S. males. In addition, there is a connection between the foreskin and urinary tract infections in the neonate. For the first three to six months of life, the incidence of urinary tract infections is at least ten times higher in uncircumcised than circumcised boys. Evidence associating circumcision with reduced incidence of sexually transmitted diseases is conflicting. Circumcision may be required in a small number of uncircumcised boys when phimosis, paraphimosis or recurrent balanoposthitis occur and may be requested for ethnic and cultural reasons after the newborn period. Circumcision in these children usually requires general anesthesia.
Cystoscopy, or cystourethroscopy, is a procedure that enables a urologist to view the inside of the bladder and urethra in great detail. It is commonly used to diagnose bladder tumors, identify obstruction of the bladder and look for any abnormalities of the bladder and its lining.
With the da Vinci System, surgeons operate through a few small incisions instead of a large open incision – similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. da Vincienables your doctor to operate with enhanced vision, precision, dexterity and control.
If you or a loved one are diagnosed with urinary obstruction, surgery to remove the blockage may be recommended. This type of surgery is called pyeloplasty. Doctors remove the blockage in the urinary system and reattach the healthy part of the kidney to the healthy part of the ureter (tubes that carry urine from the kidneys to the bladder).
Nephrectomy (nephro = kidney, ectomy = removal) is the surgical removal of a kidney. The procedure is done to treat kidney tumors as well as other kidney diseases and injuries. Nephrectomy is also done to remove a healthy kidney from a donor for transplantation. Thousands of nephrectomies are performed every year in the U.S.
The decision to proceed with a vasectomy is a very personal one. So it is important that you have a clear understanding of what a vasectomy is and what it is not. The following will provide you with information that will assist you in deciding whether or not a vasectomy is an appropriate form of contraception for you.
If cells in the prostate change abnormally, cancer may form. Cancer often appears in the outer area of the prostate (near the rectum) before spreading to the inner areas of the gland. Usually, there are no symptoms unless the growth begins to press on the urethra.
Shock Wave Lithotripsy (SWL) is the most common treatment for kidney stones in the U.S. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment. SWL is nonsurgical technique for treating stones in the kidney or ureter (the tube going from the kidney to the bladder) using high-energy shock waves. Stones are broken into “stone dust” or fragments that are small enough to pass in urine. lf large pieces remain, another treatment can be performed.
It is a procedure in which a small scope (like a flexible telescope) is inserted into the bladder and ureter and it is used to diagnose and treat a variety of problems in the urinary tract. For ureteralstones, it allows the urologist to actually look into the ureter, find the stone and remove it. The surgeon passes a tiny wire basket into the lower ureter via the bladder, grabs the stone and pulls the stone free. This is an outpatient procedure with or without a stent inserted (a tube that is placed in the ureter to hold it open).
Ureteroscopy can be used for virtually any stone of a size appropriate for it. Fragmentation of stones using holmium laser device ureteroscopically is more assured than with shock wave lithotripsy (SWL).
TURBT is a surgical procedure performed where a lighted tube is inserted through the urethra into the bladder. It serves as a diagnostic and therapeutic role in the treatment of bladder cancer.
Transurethral resection is the most common surgery for BPH. In the United States, approximately 150,000 people have TURPs performed each year. This can be done using electric current or with laser light. After the patient receivesanesthesia, the surgeon inserts an instrument called a resectoscope through the tip of the penis into the urethra. The resectoscope contains a light, valves for controlling irrigating fluid and an electrical loop that cuts tissue and seals blood vessels. The removed tissue pieces are carried by the irrigating fluid into the bladder and then flushed out and sent to a pathologist for examination under a microscope. At the end of the procedure, a catheter is placed in the bladder through the penis. The bladder is continuously irrigated with fluid through the catheter in order to monitor bleeding and prevent blood from clotting and obstructing the catheter. Since there are no surgical incisions with this procedure, patients normally stay in the hospital only one to two days. Depending on surgeon preference, the catheter may be removed while the patient is still in the hospital or the patient may be sent home with the catheter in place, attached to a leg bag for convenience and removed several days later as an outpatient procedure.
What is BPH? Benign Prostatic Hyperplasia, or BPH, is a condition in which the prostate enlarges as men get older. Over 70% of men in their 60s have BPH symptoms so it is very common1. While BPH is a benign condition and unrelated to prostate cancer, it can greatly affect a man’s quality of life. The prostate is a male reproductive gland, about the size of a walnut, that produces fluid for semen. The prostate surrounds the urethra, which is the tube that carries urine from the bladder out of the body. As the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms such as:
If you suffer from the above symptoms, you are not alone. BPH is one of the leading reasons for men to visit a urologist. What is the UroLift® System? The UroLift® System is a new, minimally invasive approach to treating BPH for patients looking for an alternative to drug therapy or more invasive surgery. The UroLift System is a straightforward procedure that utilizes tiny implants to lift and hold the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue. Clinical data has proven that the UroLift System treatment is safe and effective and can improve BPH symptoms 3 to 4 times greater than with medication1. Results have shown durability to two years with no impact to sexual function2. The goal is to relieve you of bothersome urinary symptoms so you can get back to your life and resume daily activities. Most common adverse events reported include hematuria, dysuria, micturition urgency, pelvic pain, and urge incontinence. Most symptoms were mild to moderate in severity and resolved within two to four weeks after the procedure. Visit uroliftforbph.com for more information.
Benign Prostatic Hyperplasia, or BPH, is a condition in which the prostate enlarges as men get older. Over 70% of men in their 60s have BPH symptoms so it is very common1. While BPH is a benign condition and unrelated to prostate cancer, it can greatly affect a man’s quality of life.
The prostate is a male reproductive gland, about the size of a walnut, that produces fluid for semen. The prostate surrounds the urethra, which is the tube that carries urine from the bladder out of the body. As the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms such as:
If you suffer from the above symptoms, you are not alone. BPH is one of the leading reasons for men to visit a urologist.
The main job of the kidney is to filter the blood, remove waste products and deliver waste products (urine) through the ureter to the bladder. But what happens when the area where the ureter and the renal pelvis meet becomes blocked in children? The following information should help you recognize this problem before it causes serious damage.
Urinary incontinence is the uncontrollable loss of urine. The amount of urine leaked can vary from only a few drops when you cough or sneeze to entirely emptying your bladder without warning. It is far more than a physical problem with many people suffering emotional consequences such as depression, isolation, and loss of dignity. Fortunately there are successful treatment options to help control incontinence. Click Here to learn more.
Exercises to Help Incontinence
You are able to communicate with our office through our patient portal. It is a great way to communicate on non-emergent issues, such as: prescription refill, appointment request, billing questions or medical records requests. You should have been provided a paperwork with portal registration information including a PIN number. If you don’t have this call our office to obtain you PIN and follow this link to get started! FSA Patient Portal
Flagstaff Surgical Associates work with the hospital and several surgery centers. We will schedule at the facility that best fits your surgery needs is contracted with your insurance carrier.
It is important to have an empty stomach before surgery to minimize the chance of vomiting during or after surgery to avoid complications. You will generally be instructed not to eat or drink after midnight the night before surgery. This is extremely important and your surgery will be cancelled if these instructions are not followed.
On average, surgery takes 7 to 10 days to schedule. Insurance often requires precertification and/or authorization. There is usually preoperatively testing that the patient must have and patient, surgeon and surgery facility schedules need to be coordinated. We know that waiting for your surgery is not easy but we will do our best to get your surgery scheduled as soon as possible.
It is normal for your incision to appear discolored or slightly swollen. Call our office if you are having excessive pain, increased swelling or drainage or if you just have questions or concerns.
If you are not given a follow up time when you are discharged after surgery, please call our office to schedule an appointment as soon as possible after returning home. Typically, the postoperative appointment should be 7 to 10 days after surgery unless your doctor tells you something different.
We usually receive pathology results in 3 to 5 working days. If special stains are required or specimens are sent to outside facilities, the results may take up to 2 weeks longer. We will do our best to have the results to you as soon as possible
The urinary catheter is frequently called a “Foley.” This is because it is named after its inventor, the famous Minnesota Urologist Dr. Frederick Foley. There are many different varieties and sizes, but the basic principles are the same. It is a rubber or silicone drainage tube with retention balloon on the tip. The retention balloon holds it in the bladder so urine can drain out and collect in a collection bag (see diagram below). It is a closed system to decrease the chances of infection developing. Most patients are able to remove his or her catheter at home. Most patients are able to remove his or her catheter at home. This is perfectly safe and avoids an unnecessary trip to the office.
Identify the “Balloon Port” at the end of the catheter (see the diagram). It has a colored valve on the end and has several numbers printed on the colored valve. This is the part of the catheter that holds the water in the retention balloon at the tip, which inside your bladder.
Cut the valve off the “Balloon Port”. Do this by cutting the neck of the tube just behind the valve. The valve will come off and water will trickle out of the tube. This is clean water that was inside the balloon at the tip of the catheter.
Wait for all the water to trickle out. When it stops, the balloon inside your bladder has been deflated.
Pull the entire catheter out with a steady pull. Do not jerk it or yank it out – if you do, it will come out but will be more uncomfortable.
Throw all the tubing and the collection bag away.
Lubricating the catheter with KY jelly helps reduce discomfort.
Removing the catheter in the shower with warm water running on you makes it much less uncomfortable (and it make less of a mess). If you do this, we suggest doing it seated to avoid falling or injury.