Conditions

Plain-language guides to the conditions I treat, what causes them, and what the options are.

Urethra

Urethral Strictures

A urethral stricture is scar tissue that narrows the urine channel. It can follow injury, catheters or instruments, infection, or lichen sclerosus. Evaluation usually includes a flow test and an X-ray dye study (retrograde urethrogram) to map the scar before planning repair.

Outpatient Day Surgery

Strictures of the Penile & Bulbar Urethra

Narrowing in the penile or bulbar urethra that causes a weak or spraying stream or trouble emptying. Urethroplasty repairs it, sometimes with a graft from inside the cheek.

Overnight stay

Posterior Stenosis & Pelvic Fracture Injuries

Narrowing deep in the pelvis after a pelvic fracture or prostate treatment. Repair is planned carefully around imaging of the scar.

Ureter & kidney

Ureter & Kidney Drainage Problems

Narrowing, scarring, or blockage between the kidney and bladder. Robotic reconstruction can restore drainage and protect kidney function, often without a long-term stent.

Robotic surgery

Ureteral Stricture

Scarring of the ureter from stone surgery, prior operations, or radiation. Robotic repair, sometimes with a cheek graft, can end the need for stents.

Robotic surgery

UPJ Obstruction

A blockage where the kidney drains into the ureter, causing flank pain and kidney swelling. Robotic pyeloplasty rebuilds the connection.

Erections & hormones

Erectile Dysfunction & Low Testosterone

Erectile dysfunction can have vascular, nerve, or hormonal causes. Evaluation may include penile Doppler ultrasound and hormone testing. Treatment ranges from medication and injections to an inflatable penile implant.

Office & surgery

Erectile Dysfunction

Trouble getting or keeping an erection firm enough for sex. Treatment steps up from pills to injections to a penile implant.

Office care

Low Testosterone

Fatigue, low sex drive, and weaker erections with low morning testosterone on repeat blood tests. Treatment depends on your symptoms and fertility plans.

After cancer treatment

After Prostate or Pelvic Cancer Treatment

Treatment for prostate, bladder, or colorectal cancer can leave problems with leakage, erections, and scarring. Rehabilitation and reconstruction can help restore function after radiation or surgery.

Office & surgery

ED After Prostate Cancer Treatment

Erection problems and length loss after prostatectomy or radiation. Options range from medication and injections to a penile implant.

Office & procedures

Urologic Side Effects of Radiation

Bleeding, urgency, pain, and scarring that can appear months or years after pelvic radiation. Treatment ranges from medication to reconstruction.

Testing

Elevated PSA & Prostate Cancer Screening

What a high PSA means, how PSA density and prostate MRI help decide on a biopsy, and when watching is reasonable.

Leakage & bladder

Male Incontinence & Bladder Problems

In men, leakage most often follows prostate surgery, but an overactive bladder or a narrowed bladder neck can also cause it. After testing, options include a male sling, sacral neuromodulation, or an artificial urinary sphincter.

Outpatient Day Surgery

Leakage After Prostate Surgery

Leakage with coughing, lifting, or standing after prostate surgery or radiation. Treated with a male sling or an artificial urinary sphincter.

Office care

Overactive Bladder (OAB) & Urgency

Sudden urges and frequent trips to the bathroom. Options include medication, bladder Botox, and nerve stimulation.

Outpatient Same-Day

Bladder Neck Contracture

Scar narrowing where the bladder meets the urethra after prostate treatment. Treated with an endoscopic incision, a drug-coated balloon, or reconstruction.

Implant problems

Penile Implant & Sphincter Problems

Penile implants and artificial sphincters can wear out, leak, move, or become infected. Most problems can be fixed with a revision or a replacement device. Bring your operative notes so we know exactly what was placed.

Revision surgery

Penile Implant Problems & Revision

Leaking, out-of-position, failed, or infected inflatable implants, repaired or replaced, in one operation when possible.

Revision surgery

Artificial Sphincter Problems

Leakage that comes back after an artificial sphincter, from a worn cuff, device failure, or erosion.

Enlarged prostate

Enlarged Prostate (BPH)

A non-cancerous enlargement of the prostate that slows the stream and causes urgency and night-time trips. Most men start with medication; procedures help when it isn't enough.

Office & outpatient

Enlarged Prostate

Weak stream, urgency, and getting up at night. How the medications work, how to take them, and when UroLift, Rezūm, TURP, or Aquablation make sense.

Penis & scrotum

Peyronie's, Buried Penis & Genital Repair

Conditions of the penis and scrotum can affect hygiene, cause painful erections, and get in the way of intimacy. Options include plication, plaque grafting, buried penis repair, and other reconstruction to restore form, function, and comfort.

Outpatient / 1 night

Adult Acquired Buried Penis

The penis becomes hidden under weight, scar, or lichen sclerosus, making urination and hygiene difficult. Repair releases it and removes excess tissue.

Outpatient Day Surgery

Peyronie’s Disease & Penile Curvature

Scar tissue in the penis causing curvature, indentation, or shortening. Options include traction, injections, plication, and grafting.

Outpatient Same-Day

Penoscrotal Webbing

Scrotal skin attached high on the shaft, making the penis look shorter. Corrected with an outpatient scrotoplasty.

Outpatient Same-Day

Curvature Present Since Birth

Curvature present since birth, corrected with plication, which straightens the penis without cutting into the erectile tissue.

In-Office / Outpatient

Tight Foreskin (Phimosis)

A foreskin that can't pull back because of scarring or lichen sclerosus. Treated with creams or an adult circumcision.

Reconstruction

Problems After Hypospadias Repair

Strictures, fistulas, and curvature after childhood hypospadias repair. Revision often uses a cheek graft.