Urology Services



Urology is the branch of medicine dealing with the treatment of disorders of the male reproductive organs and urinary tract, including the bladder, prostate, urethra, kidneys, and male genital organs a specialist who is trained to evaluate the urinary and reproductive system, and to perform corrective surgery when necessary.

You may be referred to a urologist for conditions such as: infertility, urinary incontinence, prostate cancer, bladder prolapse, prostatitis, erectile dysfunction, painful bladder syndrome, and more. Our specialists at Flagstaff Surgical are highly competent urologists who can accurately assess your condition and determine the best treatment protocol. Call our Urology department at (928) 773-2222 to schedule an appointment.


Benign Prostate Enlargement

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:

  • Frequent need to urinate both day and night
  • Weak or slow urinary stream
  • A sense that you cannot completely empty your bladder
  • Difficulty or delay in starting urination
  • Urgent feeling of needing to urinate
  • A urinary stream that stops and starts

If you suffer from the above symptoms, you are not alone. BPH is one of the leading reasons for men to visit a urologist.

Bladder Cancer

  • Bladder cancer is the sixth most common cancer in the United States. For the year 2014 it is estimated that more than 74,000 Americans will be diagnosed with bladder cancer and more than 15,000 will die of the disease. In recent decades there has been a steady increase in the incidence of bladder cancer. However, doctors are making progress in treatment, and survival rates are improving. But what are its symptoms? How should it be treated? The following information should help you talk to an urologist about this condition.
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Erectile Dysfunction

  • ED affects as many as 30 million men. Most men have problems with erections from time to time. In some men, these problems are regular and more severe. ED, or erectile dysfunction, is when it is hard to get or keep an erection that’s firm enough for sex.
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Kidney Blockage/UPJ

  • 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. 

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Kidney Cancer/Masses

  • It is important to realize that with timely diagnosis and treatment, kidney cancer can be cured. If found early, the survival rate for patients with kidney cancer ranges from 79 to 100 percent. More than 100,000 survivors of kidney cancer are alive in the United States today. The following information addresses the most common questions about kidney tumors and serves as a supplement to the discussion that you have with your physician.
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Kidney Stones

  • Stone disease is among the most painful and prevalent urological disorders.  More than a million kidney stone cases are diagnosed each year with an estimated 10 percent of Americans destined to suffer from kidney stones at some point in their lives.  Click Here to learn more
  • Dietary Considerations

Overactive Bladder

  • Overactive bladder (OAB) is a common condition that affects millions of Americans. About 33 million Americans have overactive bladder. Thirty percent of all men and 40 percent of all women in the United States live with OAB symptoms.
  • Bladder Irritants

Click here to learn more.

Prostate Cancer

  • Prostate Cancer is the second-leading cause of cancer deaths among men in the United States and a significant health-care problem due to its high incidence. It is estimated that in the United States (U.S.), there will be more than 230,000 new cases and 29,000 deaths from prostate cancer in 2014. The natural history and progression of this disease is not clearly and consistently understood. An analysis of autopsy studies has shown that approximately one in three men over the age of 50 years had histologic evidence of prostate cancer, with up to 80% of these tumors being limited in size and grade and, therefore, clinically insignificant. However, a recent study of incidental prostate cancer diagnosed in organ donors found prostate cancer in 1 in 3 men age 60-69, and this increased to 46% in men over age 70.The number of men diagnosed with prostate cancer remains high. However, 5-year relative survival rates have increased dramatically over the years.  There also has been at least a 25% reduction in the age-specific prostate cancer mortality rate since the beginning of the PSA era. It is estimated that 99 % of men diagnosed with localized or regional prostate cancer survive at least five years, while only 33% of those with metastases at diagnosis survive 5 years.
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Urinary Incontinence

  • 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

  • Behavioral Therapy

  • Urodynamics

Urinary Tract Infection (UTI)

  • Urinary tract infections (UTIs) are responsible for more than 8.1 million visits to physicians’ offices per year and about five percent of all visits to primary care physicians. Approximately 40 percent of women and 12 percent of men will experience at least one symptomatic urinary tract infection during their lifetime. How do you know if you have one? What is the best treatment? The following information should help you.
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  • Properly performed neonatal circumcision prevents phimosisparaphimosis 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.

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  • 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.

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da Vinci® Prostatectomy

  • 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.

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da Vinci® Pyeloplasy

  • 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).

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  • 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.

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  • 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.

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Prostate Biopsy

  • 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.

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Shock Wave Lithotripsy

  • 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.

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  • 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).

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Transurethral Resection of the Bladder Tumor (TURBT)

  • 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.

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Transurethral Resection of the Prostate (TURP)

  • 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.

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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:

  • Frequent need to urinate both day and night
  • Weak or slow urinary stream
  • A sense that you cannot completely empty your bladder
  • Difficulty or delay in starting urination
  • Urgent feeling of needing to urinate
  • A urinary stream that stops and starts

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.


Rezūm is a treatment for BPH that can be performed in a clinic or out-patient setting. Rezūm uses the stored thermal energy in water vapor (steam) to treat the extra prostate tissue that is causing symptoms such as frequency, urgency, irregular flow, weak stream, straining and getting up at night to urinate.

Rezūm provides the following benefits:

  • Potential alternative to BPH medications
  • Relieves symptoms safely and effectively.
  • Provides noticeable symptom improvement within two weeks.
  • Simple in-office/out-patient therapy
  • Does not require general anesthesia
  • Preserves sexual and urinary functions1
  • Allows patients to return to regular activities within a few days.

Urgent PC

The Urgent PC system delivers a specific type of neuromodulation called percutaneous tibial nerve stimulation (PTNS). During treatment, a small, slim needle electrode is inserted near your ankle. The needle electrode is then connected to the battery-powered stimulator. During your 30-minute treatment, mild impulses from the stimulator travel through the needle electrode, along your leg and to the nerves in your pelvis that control bladder function. This process is also referred to as neuromodulation.

Medtronic Interstim for Overactive Bladder

Medtronic InterStim Therapy for urinary control is indicated for the treatment of urinary retention and the symptoms of overactive bladder, including urinary urge incontinence and significant symptoms of urgency-frequency alone or in combination, in patients who have failed or could not tolerate more conservative treatments.

MonaLisa Touch

The MonaLisa Touch procedure is a unique treatment that uses a medical laser that delivers controlled energy to the vaginal tissue so cells make more collagen.

This procedure is:

  1. A virtually painless, in-office treatment.
  2. Performed without requiring anesthesia.
  3. Quick (it takes <5 minutes), resulting in virtually no down time.
  4. Able to yield results after the first treatment! (Three treatments are recommended)


Can I send the doctor emails?

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

Where will my surgery be done?

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. 

Will I be able to eat or drink before my surgery?

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.

Why does it take so long to schedule my surgery?

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.

How do I know if my surgery is healing normally?

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.

When should I make my postoperative, follow up appointment?

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.

How long does it take until I receive my pathology results?

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.


1. 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.

2.  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.

3.  Wait for all the water to trickle out. When it stops, the balloon inside your bladder has been deflated.

4.  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.

5.  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.