Urology

Urology is a surgical specialty dealing with diseases of the male and female urinary tract and the male reproductive organs. Urologists at Temecula Valley Hospital can help patients experiencing the following conditions.

Temecula Valley Hospital Urologists

Tri Valley Urology

• Philip Brodak, MD
• Richard Conner, MD
• Monisha Crisell, MD
• Benjamin Larson, MD
• Sreenivas Vemulapalli, MD

Urology Center of Southern California

• Ken Takesita, MD
• Madhumitha Reddy, MD
• Sy Tsi, MD
• Edward Yun, MD
• Frank Kim, MD

United Medical Doctors

• Carl Walker, MD

Prostate Cancer

The prostate, a walnut-sized gland surrounding the male urethra, is responsible for producing the seminal fluid that transports sperm. More than 200,000 cases of prostate cancer are newly diagnosed in the United States each year with approximately 28,000 men dying from it, according to the National Cancer Institute.

Prostate cancer occurs when a malignant tumor is formed in the prostate gland. If left untreated, the cancer can grow and spread beyond the prostate into the surrounding tissues and lymph nodes, as well as to distant parts of the body such as the bones, lungs and liver.

Risk Factors

• Age (most patients are over 65)
• Family history
• African American men are more likely to get this type of cancer
• Diets heavy in red meat and high-fat dairy products, and low in vegetables and fruit
• Physical inactivity

Symptoms

• Frequent urination, particularly at night
• Difficulty starting or holding back urination
• Weak or unable to urinate
• Painful urination
• Painful ejaculation
• Difficulty having an erection
• Blood in semen or urine
• Pain in lower back, hips or upper thighs

Detection and Diagnosis

If a patient has a number of symptoms or risk factors, the following tests can diagnose prostate cancer.

• PSA (Prostate Specific Antigen): PSA has been employed as an indicator of early potentially curable prostate cancer. It can identify patients with prostate cancers not detectable by digital rectal examination with the aid of a blood test.
• CT Scan and MRI: Computed tomography scan (CT Scan) is a series of detailed pictures of areas inside the body taken from different angles; the pictures are created by a computer linked to an X-ray machine. Magnetic resonance imaging (MRI) is a procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These two tests are used to evaluate whether the tumor has extended outside the confines of the prostate gland or into the lymph nodes that are located around the prostate.
• Evaluation of Pelvic Lymph Nodes
• Radionuclide Bone Scan: A test that is used to see if prostate cancer has spread to the bones. This test is used to rule out metastasis in the bony structure of the body.
• Monoclonal Antibody Scan (ProstaScint): A new test that uses a compound that recognizes a protein on prostate tissue may be useful to detect the spread of prostate cancer outside the prostate area. This scan is similar to the bone scan where a solution containing very small radioactive particles is injected in the vein and then followed at various times as it goes through the body.

Enlarged Prostate

Many men over the age of 50 encounter the common problems of an enlarged prostate, or benign prostatic hyperplasia (BPH). BPH is a condition in which the prostate enlarges as men get older. Over 70 percent of men in their 60s have BPH symptoms. While BPH is a benign condition and unrelated to prostate cancer, it can greatly affect a man’s quality of life. As the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms such as:

• Frequent need to urinate both day and night
• Weak or slow urinary stream
• A sense that you cannot completely empty your bladder
• Difficulty or delay in starting urination
• Urgent feeling of needing to urinate
• A urinary stream that stops and starts

Urolift® System Procedure

Temecula Valley Hospital now offers the UroLift® System procedure for BPH, a straightforward procedure that is performed by a urologist. The urologist places tiny implants to hold the prostate lobes apart, like opening curtains on a window, to relieve compression on the urethra. This allows urine to flow normally again. The UroLift System treatment can be done in the physician’s office under local anesthesia. Typically, patients return home the same day without a catheter.

The UroLift System is an alternative for patients looking for something other than drug therapy or more invasive surgery. Treatment might be right for you if any of the following apply to you:

• You do not want to take another pill every day
• You have tried BPH medication but are unhappy with the side effects
• You do not want to undergo major surgery due to potential surgical risks of side effects and complications
• You want a BPH solution that preserves your sexual function
• You want to regain your quality of life with minimal downtime

Benefits of the UroLift System include:

• Straightforward procedure
• Minimally invasive
• Minimal downtime
• Typically no catheter or overnight stay required after treatment
• Preservation of sexual function
• Durable results
• Rapid symptom relief, as early as two weeks post-procedure

The urologists at TVH who perform the Urolift procedure are listed below:

• Carl Walker, MD
• Philip Brodak, MD
• Richard Conner, MD

While the UroLift procedure is most commonly performed in the office setting, there are some exceptions where it should be done in a hospital setting.

Bladder Cancer

Some of the risk factors for bladder cancer include increasing age, smoking or tobacco use, exposure to certain chemicals at work and a family history of bladder cancer.

Kidney Stones

Kidney stones, tiny crystalline masses that separate from the urine, are one of the most common disorders of the urinary tract. In most cases, kidney stones pass out of the body unnoticed, but sometimes they can become too large and lodge in the urinary tract, causing extreme pain.

Kidney Cancer

Genetic conditions, such as von Hippel-Lindau disease, tuberous sclerosis or hereditary papillary renal cell carcinoma, as well as long-term dialysis and a high fat diet are risk factors for kidney cancer. Anyone can develop kidney cancer, although it usually affects people over age 50.

Other Kidney Disorders

Urologists often work in conjunction with Nephrologists to care for patients with chronic kidney disease or an acute kidney injury.

Testicular Cancer

Occurring most often in younger men, testicular cancer is usually treatable and curable. Risk factors include undescended testicles, a family history of testicular cancer or Klinefelter's syndrome.

Pelvic Floor Disfunction

Urologists at TVH offer solutions for those dealing with leakage or loss of bladder control.