Surgical Procedures

Kidney Stones

Extracorporeal Shock Wave Lithotripsy (ESWL)

This procedure uses shock waves to break up larger kidney stones into smaller fragments. These fragments are then passed through the urinary tract. This process take about an hour and a light sedative is used to keep you comfortable.

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Ureteroscopy and stone extraction

This procedure is used to remove stones within the ureter or the kidney. This is done as an outpatient procedure with general anesthesia. Using a small, flexible scope (camera), we enter the bladder and then the ureter to the level of the stone and use a wire basket to remove the stone. A small, temporary stent (tube to keep ureter open) is left in place and will be removed in the office in one week.

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Erectile Dysfunction

Penile Prosthesis

A Penile Prosthesis is surgically implanted into the penis through a small incision in the scrotum. We use this method when the other forms of ED treatments have failed. This is done as an outpatient procedure under general anesthesia.

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About Your Prosthesis

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Phimosis / Paraphimosis

Phimosis is an inability to retract the foreskin (skin covering the tip of the penis) behind the tip of the penis. Paraphimosis is the inability to reduce the foreskin back to a resting position after it has been retracted. Either of these circumstances can warrant a circumcision or a dorsal slit procedure.

Circumcision

Circumcision is an outpatient surgical procedure done under general anesthesia. The foreskin is removed from the penis.

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Dorsal Slit

A Dorsal Slit procedure involves a single incision along the top of the foreskin, exposing the head of the penis without removing any tissue.

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Enlarged Prostate (BPH)

When the prostate enlarges enough to cause significant urinary symptoms, we recommend a surgical reduction in the size of the prostate. This is done by two different methods. The method that is best for you will be determined by a cystoscopy in the office prior to one of these procedures.

Greenlight Laser

Greenlight Laser of the Prostate is a laser vaporization of prostatic tissue. This is done through a cystoscope (camera) and generally takes between 30-45 minutes to complete. After the procedure, a catheter will drain the urine from the bladder for a short 5 days and will be removed at home.

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Transurethral Resection of the Prostate (TURP)

Transurethral Resection of the Prostate (TURP) is done when the prostate is significantly enlarged. A resectoscope is used to gently carve away prostate tissue and reduce the obstruction caused by the prostate. A catheter will be placed in the bladder during the procedure and will drain the urine for 5-6 days post-operatively. This is removed at home. You will stay overnight one night in the hospital for continuous bladder irrigation and be discharge home the morning after the procedure.

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Prostate Cancer

There are many options when it comes to treating prostate cancer. Some of the options we provide at Coastal Urology are listed below.

Cryotherapy

Cryotherapy of the prostate uses cold or freezing temperatures to freeze and kill prostate cancer cells. This is done under general anesthesia and is an outpatient procedure.

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Brachytherapy

Brachytherapy of the prostate is an internal radiation of the prostate gland. This procedure is done in conjunction with a Radiation Oncologist. Radioactive “seeds” are placed within the prostate gland and will emit radiation over a period of weeks or months.

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Radical Perineal Prostatectomy

Radical Perineal Prostatectomy is used to completely remove the prostate gland. This is done with a small incision in the perineum (skin between the scrotum and anus). You will stay in the hospital for a few days after the procedure and your activities will be modified for several weeks while you recover. A catheter will be placed in the penis to drain the urine for 1-2 weeks while you heal.

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Bladder Cancer

Transurethral Resection of a Bladder Tumor (TURBT) is used to diagnose bladder cancer and remove bladder cancer. This is done by placing a resectoscope (camera) in the bladder while you are under anesthesia and a wire loop is used to remove the abnormal tissue. This tissue is sent to a pathologist for analysis. A medicine called mitomycin- C will be placed in the bladder after the resection is complete to help prevent recurrences. A small catheter will be placed in the bladder for 1 day only and will be removed at home the day after the procedure.

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Bladder Instillations of BCG

See information on our In Office Procedures page

Radical Perineal Prostatectomy

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Kidney Cancer

Cryotherapy

Cryotherapy of Renal Mass is a localized treatment of kidney cancer. This procedure is used for smaller tumors in the appropriate location. An interventional radiologist will use CAT scan guidance to pass probe into the tumor and apply freezing temperatures to this area, killing cancer cells.

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Nephrectomy

Nephrectomy is removal of the kidney. Depending on the size and location of the tumor, a partial or full nephrectomy can be performed. This procedure is done under general anesthesia and with coordination of a general surgeon. You will stay in the hospital for 2-3 days postoperatively while you heal. Your activities will be modified for a few weeks while you recover.

Testicular Cancer

Orchiectomy

Orchiectomy is removal of a testicle. This is typically done in a patient with testicular cancer. The testicle is sent to a pathologist for analysis after removal. A pathology report will tell us the type and stage of the testicular cancer. After the procedure, your activities will be modified.