in-office procedures

There are a number of treatments and procedures that can be performed right in our urology office for your convenience. Please Contact us or call the office to schedule a consultation, a friendly member of our staff will be happy to assist you.

vasectomy for sterilization

A vasectomy works by cutting the vas deferens, the tubes that carry sperm from the testes to the penis. This prevents the sperm from exiting the penis during ejaculation. After a vasectomy, your body will continue to produce sperm, but they will die and be re-absorbed. A vasectomy will not noticeably affect the seminal fluid; your ejaculate will still look and feel the same. A vasectomy also will not affect your testosterone (male hormone) levels or your ability to have an erection. It should also be noted that a vasectomy will not affect a man’s libido, or sexual pleasure.

Vasectomies should be considered a permanent form of birth control; it is not advisable to have one if you think you may change your mind at a later date. Understandably, some men are apprehensive about the vasectomy procedure because it involves such a delicate area of the body. The vasectomy yields very little pain or discomfort after the procedure.

Your procedure will be performed in our office using local anesthesia. Patients are able to return home immediately following the procedure. Your doctor will give you instructions for resuming work. Vasectomy is normally covered by health insurance. Although, deductibles, coinsurances and copayments may apply.

You may have intercourse a few days after your procedure, once you are feeling better. However, it is essential that contraception is used until a post-vasectomy semen analysis is obtained, to confirm that there are no sperm present in the ejaculate. At least 2 post-vasectomy semen analysis are required at 60 and 90 days following the procedure to ensure the absence of sperm in the semen.

pre-vasectomy information and consent form download        sperm check home test kit download

prostate biopsy for psa

Prostate biopsy is best performed under transrectal ultrasound guidance using a spring-loaded biopsy device coupled to the transrectal probe. The patient is prepared with an enema and an antibiotic. The lubricated ultrasound probe is inserted into the rectum. Patients are positioned on their side for this procedure. The physician will first image the prostate using ultrasound noting the prostate gland’s size and shape and whether or not any other abnormalities exist, the most common of which are shadows which might signify the presence of prostate cancer. However, not all prostate cancers are visible. Using the spring-loaded biopsy device attached to the ultrasound probe, the physician performs multiple biopsies of the prostate gland. Each biopsy removes a cylinder of prostate tissue approximately 3/4 inch in length and 1/16 inch in width. The entire procedure takes 15 to 20 minutes. The biopsy tissue taken will then be examined by a pathologist (a physician who specializes in examining human tissue to determine whether it is normal or diseased). The pathologist will be able to confirm if cancer is present in the biopsy tissue. If cancer is present, the pathologist will also be able to grade the tumor. The grade indicates the tumor’s degree of aggressiveness – how quickly it is likely to grow and spread. The Gleason grading system is the most widely used system. In this system, because often several different tumor patterns are seen, the most common tumor pattern is assigned a score from 1 to 5 and the second most common pattern is similarly assigned a score, using the same scale. The two scores are added together to give a Gleason sum ranging between 2 and 10. Scores of 2 to 6 designate mildly aggressive, 7 moderately aggressive and scores of 8 to 10 highly aggressive.

The transrectal ultrasound guided prostate biopsy is usually well tolerated. Blood in the ejaculate (hematospermia) and blood in the urine (hematuria) occur in most patients, but resolves within a few days for the urine and a few weeks for the semen. High fever is rare, occurring in only 1 to 2 percent of patients. The antibiotic is continued for at least 48 hours after the biopsy procedure.

prostate biopsy instructions 


A cystoscope is a thin tube with a camera and light on the end. During a cystoscopy, this tube is inserted through your urethra and into your bladder so the doctor can visualize the inside of your bladder. Your urethra is the tube that carries urine out of your bladder. Your doctor might order this test if you have urinary problems, such as a constant need to urinate or if you find urination painful. Your doctor might also order the procedure to investigate reasons for blood in your urine, frequent urinary tract infections (UTIs), an overactive bladder, or pelvic pain.


A cystometric study is done to determine the size of your bladder and how well it functions. Cystometric studies are also called cystometrograms or CMGs. The procedure measures how much fluid your bladder can hold, how full it is when you begin to feel the need to urinate, and the pressure of your urinary flow. Your doctor may want you to have this procedure if you have trouble completely emptying or controlling your bladder.

cystoscopy/cystometrogram (cmg)  download

Contact us when you are in need of medical assistance from a skilled urologist. Our office is equipped to perform a number of different in-office procedures for patients located throughout Midlothian, Virginia and surrounding areas.