Adult Urology


Vasectomy is a form of male birth control that cuts the supply of sperm to your semen. Vasectomy is straightforward and has a low risk of complications. You need to be certain you don’t want to father a child in the future, as the procedure is considered a permanent form of male birth control.

  • Make a small cut (incision) in the upper part of your scrotum
  • With the “no-scalpel” technique, a small puncture is made in the scrotum instead of an incision
  • Locate the tube that carries semen from the testicle (vas deferens) on either the right or left side. Withdraw part of the vas deferens through the incision or puncture
  • Cut the vas deferens where it has been pulled out of the scrotum
  • Seal the vas deferens by tying it, sealing it with heat (cauterizing) or using surgical clips; return the ends of the vas deferens to the scrotum
  • Stitch up the incision at the surgery area; stiches aren’t necessary if the doctor has used the no-scalpel technique
  • Repeat the procedure on the other side
  • Surgery typically lasts 20–30 minutes

A vasovasostomy is a surgical procedure in which the effects of a vasectomy (male sterilization) are reversed.

  • The vasa deferentia, which are ducts that carry sperm from the testicles to the seminal vesicles, are cut, tied, cauterized (burned or seared) or otherwise interrupted
  • A vasovasostomy creates an opening between the separated ends of each vas deferens so that the sperm may enter the semen before ejaculation

Cystoscopy, or cystourethroscopy, is a procedure usually performed by an urologist that allows the physician to see the inside of the lower urinary tract (urethra, prostate, bladder neck, and bladder). Cystoscopy can be used to detect abnormalities of the lower urinary tract or to assist in transurethral surgery (e.g., prostate surgery).

  • A cystoscope (thin, telescope-like tube with a light and tiny camera attached) is inserted into the bladder through the urethra
  • Can be used to evaluate and diagnose the following conditions:
    • Bladder cancer
    • Blood in the urine (hematuria)
    • Chronic pelvic pain
    • Frequent urinary tract infections (UTIs)
    • Interstitial cystitis
    • Painful urination
    • Urinary blockage (e.g., enlarged prostate [BPH], narrowing of the urinary tract [stricture], polyps, tumors)
    • Urinary incontinence or overactive bladder
    • Urinary stones

Uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract and pass from the body. Often there are no symptoms of a kidney stone until it starts to move and blocks the flow of urine. Sedatives or local anesthesia may be used.

  • During the procedure the patient lies on a water-filled cushion and the surgeon uses X-rays or ultrasound tests to precisely locate the stone
  • High-energy sound waves pass through the body without injuring it and break the stone into small pieces
  • The surgery typically lasts one hour

Vasectomy reversals are nearly as old as vasectomies themselves but major technical improvements over the past 20 years have dramatically improved success rates as measured both by the return of sperm to the ejaculate and by pregnancies. A vasectomy reversal may be performed using general anesthesia or with sedation and local anesthesia.

  • The procedure begins with an examination of the two ends of the cut vas deferens through a tiny incision in the scrotum
  • If sperm are identified, the two ends of the vas deferens are then sewn together (vasovasostomy)
  • If absence of sperm in the fluid, the vas deferens is sewn to the epididymis (epididymovasostomy or vasoepididymostomy)
  • Once the decision is made to perform either a vasovasostomy or epididymovasostomy, the operating microscope is positioned over the scrotum.
  • Specialists join the two ends of the vas deferens in multiple layers (“multilayered anastomosis”) or with a modified one layer technique

Pediatric Urology


Circumcision is a procedure that removes the foreskin, the tissue covering the head of a boy’s penis.

  • May be required in a small number of uncircumcised boys when phimosis, paraphimosis or recurrent balanoposthitis occur
  • May be requested for ethnic and cultural reasons after the newborn period

Hydrocele repair is surgery to correct the swelling of the scrotum that occurs when you have a hydrocele. A hydrocele is the backup of fluid in a testicle. Sometimes they form when there is also a hernia (an abnormal bulging of tissue) present. Hydroceles are fairly common.

  • The surgeon makes a small surgical cut in the fold of the groin and drains the fluid
  • The sac (hydrocele) holding the fluid may be removed
  • The surgeon then strengthens the muscle wall with stitches