Most adults take the process of continence and urination for granted.  We have been urinating for so long that we no longer appreciate the highly coordinated process that needs to occur for us to remain continent (dry) while at the same time being able to empty our urinary bladder when we percieve it to be full.  Control of the urinary bladder is a complex and highly coordinated process.  The diagram below illustrates the different nerve pathways that need to be coordinated by the brainstem to allow ones bladder to function normally.  Failure of that process, or voiding dysfunction, may present in several ways.  The most common voiding problems we see in men are incontinence (leakage of urine), complete inability to empty the bladder (often seen with spinal cord injury or other neurologic disorders), or bothersome lower urinary tract symptoms (LUTS) such as having to go to the bathroom suddenly, urgently, with a decreased force of stream, or getting up several times at night to urinate.  Proper treatment relies on accurate assessment and diagnosis.  Most of the time this involves urodynamic testing.  With careful urodynamic testing we are able to accurately determine where the problem is and assess which surgial procedure would most likely improve their condition.

We offer several surgical treatment options for severe voiding dysfunction.  The typical patient that we see has already worked through and failed medical therapy (pills).  Surgical procedures always involve trade-offs.  With surgical therapy we hope to make, but cannot promise, a large improvement in your primary problem.  There will be some side effects, however.  If your primary problem is very severe and bothersome, then a substantial improvement in that problem is usually seen as a good trade for lesser side effects. Below you will find some of the voiding dysfunction conditions that we treat.  Please feel free to learn more by clicking on the hypertext links:

Urinary Incontinence (leakage) in men

Severe urinary frequency, urgency, and urge incontinence

Inability to empty the bladder, urinary retention (atonic bladder)

Severe lower urinary tract symptoms (LUTS) unresponsive to medication