Prostatitis
Inflammation of the prostate gland. It is often due to a bacterial infection or other agent. It is a common urologic diagnosis. Diagnosis and treatment are tailored to the man’s needs. It includes long term antibiotic treatment, medications to decrease the intensity of the discomfort, in severe cases that do not improve with medical management, individuals may be candidates for minimally invasive surgery. Honest, confidential consultations are available by appointment.

Kidney Stones
Some of the most common urologic problems are caused by kidney stone disease. These stones (calculi) are associated with living in a warm climate, inadequate fluid consumption, diets high in meats and salt, certain genetic pre-dispositions and urinary tract abnormalities. There are several substances that form kidney stones but the majority of stones contain the metal calcium. Kidney stones cause extremely severe, sudden pain when passing (renal colic). They can also be responsible for recurrent urinary tract infections, kidney failure, blood in the urine (hematuria). Fortunately, kidney stones have proven themselves to be effectively treatable with minimally invasive surgical techniques. The technique for treatment is chosen based on location, size and sometimes the chemical composition of the stone.

Benign Prostatic Adenoma (BPH)
This is an extremely common cause of lower urinary tract dysfunction in men over 50 years of age. It is defined as the increase in number of prostatic cells around the area of the urethra (water channel).

Symptoms include getting up at night to urinate (nocturia), urinating often (frequency), strong sudden desire to urinate (urgency), difficulty starting urination (hesitancy), dribbling of urine after completing urination and urinary tract infections. The majority of people can have significant relief from their symptoms with medications.

Minimally invasive surgery and laser surgery is reserved for the more symptomatic patients not responsive to medical treatment. At the New York Urologic Institute laser surgery for BPH is performed on premises. The surgery is performed on an ambulatory basis and minimal anesthesia is required. For the more severe cases a transurethral resection of the prostate is performed (TURP). Usually a 24-48 hour hospitalization is required after this procedure.

Erectile Dysfunction
Few things can negatively affect a personal relationship like erectile dysfunction. This is an extremely common condition that affects millions of men in the United States. There are many causes for this condition. They include: atherosclerosis, diabetes mellitus, high blood pressure, hormonal abnormalities or injury to the nerves or blood vessels to the penis as a result of urologic surgery (radical prostatectomy). All forms of erectile dysfunction are treatable. Medications are available that can produce erections firm enough for penetration in the majority of men. If medical therapy fails surgical implantation of erectile prosthetic devises is advocated. These are highly sophisticated devices that lead to a satisfying sex life in 95% of patients. The surgeons at the New York Urologic Institute are skilled and experienced in the treatment of erectile dysfunction irrespective of its cause. Honest, confidential consultations are available by appointment.

Extracorporeal Shockwave Lithotripsy (ESWL) - This is an effective treatment method of stones in the kidney. It requires no incisions and minimal anesthesia.. This is procedure is performed on an outpatient basis.

Percutaneous Nephrolithotomy (PCNL) - This procedure is reserved for large kidney stones often referred to as Staghorn Calculi. It is performed through an incision approximately 10mm (1/2 inch) in length. Several days of hospitalization are usually required.

Ureteroscopy - Excellent for treating stones stuck in the structure that connects the kidney to the bladder (ureter). No incisions are necessary. A laser is often used to completely obliterate the stone. This procedure is performed on an outpatient basis.

Ureteral Stent - No discussion of kidney stone disease is complete without discussing this device. It is a soft silastic tube that is placed without incision into the structure that connects the kidney to the bladder (ureter). This devise helps to relieve the pain associated with kidney stone passage and can facilitate the passage of the kidney stone. Often it is used in combination with the treatment modalities discussed above. The stent is removed a short time after the stone has passed or is successfully treated.

Sexually Transmitted Diseases (STD)
A group of bacterial or viral diseases that are spread during genital contact. Symptoms are usually related to burning on urination, discharge from the penis, unsightly bumps on the penis or scrotum. These diseases are highly contagious. Once they are diagnosed all sexual contacts of the person with the disease need to be examined and treated. Examples include: genital warts, herpes, HIV, gonorrhea, chlamydia and syphilis. These conditions are either curable or treatable depending on the organism involved. Consequences of these diseases can be tragic and include: infertility, ectopic pregnancy, cervical cancer.

Urethral Stricture
This urologic problem can result in urinary tract dysfunction. Scar tissue forms in the water channel (urethra) that obstructs the flow of urine from the bladder through the penis.

This can occur as a result of trauma to the urinary tract, prior urologic surgery or procedures and sexually transmitted diseases. The stricture can form many years after the initial injury or infection. Instruments that are specially designed to do surgery through the water channel (urethra) that can incise the stricture. Laser could also be used to obliterate the stricture. No incisions are needed and bleeding is minimal. A soft rubber catheter is left in the bladder for several days while the surgical site heals.

Urinary Incontinence
This very common symptom affects millions of Americans. In men this problem is usually caused by benign prostatic hyperplasia, neurologic dysfunction of the urinary tract or most commonly by changes in the urinary tract due to urologic surgery (radical prostatectomy, transurethral resection of the prostate (TURP)).

Incontinence after urologic surgery is an unfortunate, sometimes devastating complication of prostate surgery. Men are typically wet with physical activity, coughing, sneezing, straining. A smaller percentage of men are wet constantly, requiring continent pads to be worn every day. The surgeons at the New York Urologic Institute are experienced in addressing the needs of men with this challenging problem. Treatments include: medications to limit bladder function, bulking agent injection into the bladder neck, placement of a sophisticated prosthetic urinary sphincter. The majority of men with urinary dysfunction can achieve an acceptable level of social dryness. Honest, confidential consultations are available by appointment.

Circumcision
Having a circumcision performed is a personal choice. Men who have infections of their foreskin often elect to undergo this simple procedure for easier personal hygiene. Some undergo this procedure as part of a religious ritual. If a child is found to have excess foreskin after a hospital circumcision many parents wish to have it revised for a better cosmetic result.

Infertility
Infertility is defined as the inability to conceive a child after one year of regular unprotected intercourse. Millions of couples fall into this category. Fortunately, the majority of these couples are able to conceive a child with the aid of assisted reproductive techniques (ART). If the cause of the couples infertility caused by a problem with the male partner (male factor infertility), the surgeons at the New York Urologic Institute are available to help. Techniques include: interpretation of semen analysis, vasectomy reversal with the assistance of a surgical microscope (vasovasostomy), varicocele ligation with the assistance of a surgical microscope, repair of vasal injury after inguinal hernia surgery, testis biopsy or epidydimal sperm aspiration for intracytoplasmic sperm injection (ICSI).