I am a fellowship trained endourologist with experience in both academic medicine and private practice. I specialize in the treatment of lower urinary tract problems associated with benign prostatic hyperplasia (or BPH), overactive bladder, and urinary incontinence. The treatment options available to improve one’s quality of life for these urinary conditions include biofeedback, medical therapy, and minimally invasive surgical options. I am well known for my vast experience in holmium laser enucleation of the prostate, also known as HoLEP. HoLEP is regarded as the size independent minimally invasive procedure of choice for the treatment of BPH.
I rely on evidence-based medicine to make critical choices with you during diagnosis and treatment. I deliver urologic care with honesty, compassion, and thoughtfulness.
When you choose me for your care, I will ensure you will get the most up-to-date diagnostic testing and treatment options for your urologic condition. I communicate information simply and ensure that you understand the process of the medical care involved to treat the urologic condition.
You may know that you have BPH if you experience symptoms like an urgent or frequent need to urinate, difficulty starting urination, dribbling at the end of urination, needing to urinate more frequently at night (or nocturia), urinary tract infection, inconsistent or weak urine stream, inability to completely empty the bladder or urinate, or blood in the urine.
A urologist’s treatment plan for enlarged prostate is personalized according to the size of the enlargement, severity of symptoms, and the patient’s overall health. First steps in the treatment plan for BPH involves medications such as alpha blockers, 5-alpha reductase inhibitors, or combination drug therapy. If the symptoms worsen and disrupt patients’ quality of life, surgery may be recommended. Surgery may include laser therapy, prostate lift (or UroLift), or Rezum. Patients should speak to their urologist to find which surgery would be recommended for their situation.
The best treatment for BPH will entirely depend on the severity of symptoms, prostate size, medical history, and patient’s overall health. Minimally invasive surgery includes removing the tissue to ease pressure on the bladder, blocking the blood supply to the prostate to reduce size or prostatectomy to remove the obstructing tissue. HoLEP is one example where laser therapy is used to remove excess tissue. Therapies like UroLift involve compressing the sides of prostate and Rezum is a water vapor thermal energy that targets extra prostate tissue.
Patients have many options for the treatment of kidney stone disease. Patients may choose between a trial passage or surgical intervention for kidney stone disease. A trial passage involves the patient passing the kidney stone spontaneously or with the help of pharmacological therapy. Surgical intervention for small kidney stones includes shock wave lithotripsy, where shock waves break down the stone allowing for easier passage of stones naturally. Larger stones will require percutaneous nephrolithotomy through the back of patient.
Treatment options for urinary incontinence typically start with behavioral modifications like bladder training or scheduling bathroom visits. Other effective options are electrical stimulation that helps strengthen the pelvic floor muscles, transurethral bulking agents to control leakage, urethral inserts to minimize bladder stimulation during physical activity, Botox injections, nerve stimulators to control nerve impulses around the bladder, and protective garments. If non-surgical options fail, patients may undergo surgery including a sling, bladder neck suspension, prolapse surgery, and an artificial urinary sphincter.
Treatments for overactive bladder disorder may begin with minimally invasive options like Kegel exercises to help strengthen the pelvic floor, losing weight, medications, intermittent catheterization, Botox injections, or surgical intervention.
Diagnosing prostate cancer involves a rectal exam and blood test, also known as PSA, or prostate specific antigen. Further diagnoses may include collection of prostate tissue, ultrasound, and MRI fusion biopsy.
There are minimally invasive treatment options for prostate cancer that include active surveillance, where routine testing and observation of growth of cancer is observed. Often used with active surveillance is MRI or MRI fusion biopsy with the use of the ultrasound to help accurately biopsy the suspected area. Another option in active surveillance includes transperineal prostate biopsy, when ultrasound probe visualizes the prostate and biopsies are done through the perineum. Another option for minimally invasive therapy for treatment of prostate cancer is cryotherapy that involves using cold temperatures to freeze and kill the cancerous cells.