FAQ

Frequently Asked Questions About Our Urological Services

The field of urology covers disorders of the male and female urinary tracts and the male reproductive tract. We are comfortable seeing the complete gamut of general urology presentations, including voiding dysfunction, incontinence, urinary tract infection, urologic oncology (cancers of the kidney, bladder, testicles, and prostate), erectile dysfunction, Peyronie’s disease, and inflammatory conditions of the urinary tract.

Urologists treat all of the common and uncommon urinary tract issues that women can present with, including kidney stones, infections, urinary frequency, urgency, incontinence, pelvic prolapse, and of course all of the various urological cancers that do not discriminate according to gender.

In general, we accept most private insurances and Medicare, as well as a select few HMOs. There are, however, some fairly restrictive HMOs and IPAs that have very rigid networks, including Medi-cal, with whom we are not contracted. You can refer to your insurance’s list of providers to see if our doctors are in-network, or are welcome to call our office, as we will be happy to investigate your coverage for you.

Though not optimal and avoided whenever possible, the nature of a surgical urologic practice is that the physicians may run late. We value your time as much as our own. Some surgical consultations will involve numerous questions from the patient, and it is our belief that no one should be swept out of a doctor’s appointment without having their questions answered. Additionally, there are occasions when an unexpected procedure is required that can delay downstream clinic appointment. Please know that we do not take such delays lightly. Unfortunately, delivering the comprehensive care we strive to provide does not always fit into a convenient schedule. We appreciate your patience and understanding should this ever occur. Rest assured that when we are seeing you, you will receive the same attention as did the patient that delayed your appointment.

During our office hours, the office staff will handle most of the phone calls so that our doctors can give their undivided attention to the patients in clinic. If the office staff is unable to give you the information you require and you need to speak to a doctor, your routine questions will be relayed to them and your call will be returned as soon as possible, usually at the end of clinic hours or the following day.

We are happy to refill prescriptions that have been generated by this office. We would request that you try to anticipate your medical needs so that the prescription refill (which sometimes takes a few days) can be authorized during office hours. We will call or fax your pharmacy with the prescription or send it electronically to the pharmacy. Our general practice is not to refill or prescribe new medication after hours, as the on-call doctor does not have the benefit of being able to evaluate you with testing or examination as part of the determination of whether a medication is appropriate.

We always attempt to accommodating patients with acute problems and get them into the office on an expedited basis, especially in the case of a lower urinary tract issue (for instance, suspected infection or inability to urinate). Sometimes, however, if we think that imaging and/or laboratory testing is indicated (for instance, a suspected kidney stone), the necessary workup can be accomplished in a safer and quicker fashion in the emergency room. We will be honest with you as to what we think the most prudent and efficient course of action is.

For our Medicare patients, we accept Medicare assignment and file your Medicare claim electronically for you. If you have supplemental insurance to your Medicare, please let us know so that we may file that claim for you as well. In most situations, Medicare “crosswalks” to your supplemental insurance.

Our physicians employ a team-based approach focused on their various expertise. In some cases, you may be “referred” from one doctor to another within the group to discuss a surgical approach or management option that falls more into the second doctor’s area of expertise. This will always be done in clear discussion with you and as to your preference; it is to ensure that your problem is being addressed with the best solutions that we have to offer.

We offer a full complement of ultrasonography as well as diagnostic endoscopy done in the office using local anesthesia, as well as urinalysis. All of our surgeons are well-versed in vasectomy. We additionally do a variety of injections and interventions, including Xiaflex and Urolift, and Interstim.

Xiaflex is a compound used in the non-surgical treatment of Peyronie’s disease. Dr. Chandrasoma worked closely in practice for many years with the medication’s pioneer, Dr. Martin Gelbard, and as such has a large body of experience with its administration.

Urolift is an office-based procedure for the management of symptoms associated with enlargement of the prostate. If appropriate, it provides a minimally invasive office-based alternative to the in-hospital “roto-rooter” procedures.

Interstim uses sacral nerve modulation to address the urinary frequency, urgency, and leakage associated with overactive bladder. Efficacy of Interstim can be predicted with a minimally invasive, office-based trial that can help determine if this intervention is right for you.

Vasectomy is a common office-based procedure that will render a male patient sterile. The first step is scheduling a consultation with one of our urologists to discuss the procedure in detail. Once that is complete, a vasectomy can be scheduled after a one-week period to ensure that the discussion does not precipitate a change of heart. The procedure itself takes about a half hour in the office, under local anesthesia.

No-scalpel vasectomy is a little bit of a misleading term often simply used for marketing purposes. The term implies the lack of a need to open the skin, when the truth is simply that the skin is not opened using a scalpel. Instead, a small sharp clamp is used to make a small puncture to deliver the vas deferens for clamping and segmental excision. The rationale is that the puncture will heal with a less noticeable scar. In short, we do perform vasectomy using this technique, as it is one of the more common techniques currently used.

After vasectomy, there will still be sperm present in the downstream reproductive tract that will need to be flushed out through the usual means. A post-vasectomy patient is declared as officially sterile on the strength of two negative semen analyses separated by a month. These are usually done six and ten weeks after the procedure.

This question is taken on a patient by patient basis, depending on a number of factors. Studies show that younger patients are 12 times more likely to seek a vasectomy reversal, with the majority meeting someone who wants children and realigning their views on parenting. Our physicians will talk to you at length about the decision, and we will be up front if anything about your particular situation makes us feel uncomfortable about performing the operation.

At this time, we do not sell sildenafil in this office. We do, however, prescribe through a compounding pharmacy that can dispense this medication via mail order at a reasonable cost.

If you require a surgery by one of our physicians, our surgery scheduling liaison will coordinate the process of authorization, preoperative surgical clearance and testing, and scheduling.

We understand that circumstances might limit the feasibility of an in-office consultation. We are happy to schedule virtual consultations with you by phone or by videoconference. We would appreciate your flexibility with regards to scheduling a “window” during which our office will contact you via the medium of your choice.