My name is Amar J. Raval and I’m with Advanced Urology Institute. So one of the few things I specialize in my particular practice would be BPH or enlarged prostate. Whether it’s minimally invasive surgery like Urolift where you
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My Name is Yaser Bassel, I’m a Board-Certified Urologist with Advanced Urology Institute. Low testosterone at this point has come to the forefront a lot of times because of the advertising done by manufacturers of Testosterone. But for men
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Dr. Brian D. Hale is a board-certified urologist in Tampa, FL, who is part of the Advanced Urology Institute. In this article, we will discuss Dr. Hale’s approach to bladder cancer treatment, including the types of procedures he uses to treat the disease.
Fortunately, most patients with bladder cancer are diagnosed with early-stage cancer that can be cured with a simple outpatient procedure. Dr. Hale will typically remove the tumor using a transurethral resection of bladder tumor (TURBT) procedure. This is a minimally invasive procedure that involves using a cystoscope to remove the tumor through the urethra.
If the cancer has advanced or is too large to be removed through a TURBT procedure, Dr. Hale may need to perform a more aggressive surgery. In some cases, he may need to remove the entire bladder in a procedure called a radical cystectomy. During this procedure, the bladder is removed along with nearby lymph nodes and the prostate or uterus in men and women, respectively. The urine is then diverted into a bag outside the body or into a new reservoir made from a piece of the small intestine.
Dr. Hale works closely with oncologists to provide comprehensive cancer care for his patients. He may recommend additional treatments, such as chemotherapy or radiation therapy, depending on the stage and type of bladder cancer. He also provides ongoing monitoring to ensure that the cancer does not return.
Advanced Urology Institute is the largest urology practice in Florida, with multiple locations throughout the state, including Tampa. Their team of experienced urologists, including Dr. Brian Hale, is dedicated to providing high-quality care to their patients. If you are in need of urological care, we highly recommend scheduling an appointment with Advanced Urology Institute.
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My name is Brian Hale, I’m a board certified urologist working with Advanced Urology Institute.
So fortunately most of the patients that we find with bladder cancer have early stage
cancer that we can cure with a simple outpatient procedure.
If we find the cancer later or the cancer is too large or so large that it’s evading
into the bladder muscle, then we have to do a more aggressive surgery removing the entire bladder.
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My name is Amar J. Raval and I’m with Advanced Urology Institute.
I love urology. I am privileged to be part of this community of urologists in the United States, and especially with Advanced Urology Institute. I think there are tremendous technological platforms that are available and we’re certainly unique in that field of surgery. From open [surgery] to robotics to laparoscopic to even prosthesis: whether it’s penile prosthesis or Interstim devices in the back to help control urinary incontinence, [and] urethral slings, there’s so much technology available in urology. It’s just a pleasure to be able to treat those patients.
Dr. Brian D. Hale is a board-certified urologist in Tampa, FL, who is part of the Advanced Urology Institute. In this article, we will discuss the symptoms of low testosterone, according to Dr. Hale. Low testosterone, also known as hypogonadism, is a common condition that affects men as they age. It can cause a range of symptoms, including fatigue, low sex drive, and erectile dysfunction.
According to Dr. Hale, the most common symptoms of low testosterone are fatigue and a loss of sex drive. Men with low testosterone may also experience erectile dysfunction, or difficulty achieving or maintaining an erection. Other symptoms of low testosterone can include decreased muscle mass, increased body fat, and mood changes, such as depression and irritability.
If you are experiencing symptoms of low testosterone, it is important to see a urologist like Dr. Hale for an evaluation. To diagnose low testosterone, Dr. Hale will perform a physical exam and order a blood test to measure your testosterone levels. If your testosterone levels are low, Dr. Hale may recommend testosterone replacement therapy to help restore your levels and relieve your symptoms.
Testosterone replacement therapy is a common treatment for low testosterone. This involves taking testosterone in the form of injections, gels, patches, or pellets to raise your testosterone levels. Testosterone replacement therapy can help improve energy levels, sex drive, and erectile function, and can also improve mood and cognitive function.
It is important to note that testosterone replacement therapy is not suitable for everyone, and there are potential risks and side effects associated with this treatment. Dr. Hale will discuss the risks and benefits of testosterone replacement therapy with you and help you decide if this treatment is right for you.
Advanced Urology Institute is the largest urology practice in Florida, with multiple locations throughout the state, including Tampa. They offer a wide range of urological services, including the diagnosis and treatment of low testosterone. Their team of experienced urologists, including Dr. Brian Hale, is dedicated to providing the highest quality care to their patients. If you are experiencing symptoms of low testosterone, we highly recommend scheduling an appointment with Advanced Urology Institute.
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My name is Brian Hale, I’m a board certified urologist working with Advanced Urology Institute.
Yeah, the men with low testosterone usually have either fatigue or a loss of sex drive. That’s the thing that would prompt me to check a testosterone level. A lot of times they come in with erectile dysfunction and I have to kind of bring that out of them. You’re also having symptoms of low testosterone and if they do, then we try to address that first before we treat the erectile dysfunction.
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Dr. Amar J. Raval, is a urologist in Tampa, FL, specializing in advanced surgical techniques, including laparoscopic and robotic surgery. With the ever-evolving field of urology, these minimally invasive procedures have become increasingly popular for their numerous benefits, including reduced pain and faster recovery times. In this article, we will explore the advantages of laparoscopic and robotic surgery as explained by Dr. Raval.
Laparoscopic and robotic surgeries are minimally invasive techniques that offer several advantages over traditional open surgery. As Dr. Raval explains, these methods involve small incisions, leading to less pain and shorter hospital stays for patients. This translates to a quicker recovery, with minimal discomfort during the healing process.
One of the most significant benefits of laparoscopic and robotic surgery is the enhanced visualization these techniques provide. Dr. Raval emphasizes the importance of being able to see small anatomical structures in great detail and in 3D, which ultimately leads to improved surgical outcomes.
The precision offered by robotic surgery, in particular, allows for more refined movements during the procedure, resulting in better surgical results. This level of accuracy can be vital when working with delicate structures in the urinary tract or reproductive system.
In addition to the benefits already mentioned, laparoscopic and robotic surgeries are also associated with a lower risk of complications and less scarring compared to traditional open surgery. Due to the smaller incisions and the minimally invasive nature of these procedures, there is typically less blood loss and a reduced chance of infection.
Furthermore, the reduced scarring not only offers cosmetic benefits but can also decrease the likelihood of complications related to adhesions, which are bands of scar tissue that can form after surgery.
Dr. Amar J. Raval is a skilled urologist in Tampa, FL, who is dedicated to providing the best possible care for his patients. As a member of the Advanced Urology Institute, the largest urology practice in Florida, Dr. Raval works alongside a team of experienced urologists who share his commitment to excellence in patient care.
By offering state-of-the-art laparoscopic and robotic surgeries, the Advanced Urology Institute ensures that their patients receive the most advanced and effective treatments available in the field of urology.
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My name is Amir J. Raval and I’m with Advanced Urology Institute. Laparoscopic and robotic surgery is unique because it minimizes your pain, has small incisions, and results in a shorter hospital stay. These three benefits are a big deal and patients recover faster with minimal pain and discomfort. Additionally, with robotic and laparoscopic techniques, the visualization is significantly improved. You’re able to see small anatomy in great detail and in 3D, and make fine movements for a better outcome and surgery.
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The good news is that there are various treatments and management options for prostate cancer, even if it is found at a later stage. When detected early, the cancer is highly treatable, and most men with the disease survive.
“Prostate cancer is quite complex, which makes it difficult to predict how fast or slow it will grow and the risk associated with it,” says Dr. Jonathan Jay. “That is why, during diagnosis, we evaluate several factors to determine the aggressiveness of the tumor. After we determine the risk associated with the cancer, we are better placed to recommend the right treatment for our patients, which can yield great results,” he affirms.
The cancer is categorized as low risk, intermediate risk, or high risk depending on its ability to grow and spread to other areas of the body. Low risk prostate cancer is slow-growing and unlikely to spread quickly. In contrast, a high risk cancer is likely to spread rapidly outside the prostate.
One recent advance in prostate cancer research is the proper use of the prostate-specific antigen (PSA) test. Although the PSA test has had its limitations, it is still valuable for identifying and categorizing cancer as high risk or low risk, aggressive or indolent. When correctly used, it shows with accuracy those patients who have the aggressive type of cancer. This finding effectively guides the doctor to develop a more targeted treatment plan.
“The PSA got a bad reputation because it was used wrongly,” says Dr. Jonathan Jay. “But today, urologists understand that the PSA is still a very valuable tool in prostate cancer diagnosis and treatment. And it is now known that the significance of the PSA is not in whether it is elevated relative to the average, but in how it changes over time,” he asserts.
Studies have shown that the PSA is not abnormal just because it is elevated compared to the average. If the PSA of a man is stable over time, it doesn’t show prostate cancer, let alone an aggressive type of the disease. But if the PSA of a man has been stable for a prolonged period and then changes suddenly, it shows that something is wrong.
“If your PSA is one over the years, but changes to 3, then something is wrong, regardless of the fact that 3 is still within the normal range,” explains Dr. Jonathan Jay. “And if you’ve had a PSA of 6 over the past many years, then it’s not abnormal since it remains stable, regardless of the fact that it’s not within the normal range,” he adds.
Significant progress has been made in prostate cancer research in the area of biopsies. Traditionally, prostate cancer has been confirmed and graded through a biopsy. To confirm a diagnosis, a urologist takes 8-12 needle biopsies along the prostate in a random sample and examines the cells under a microscope. However, while a biopsy tends to provide more accuracy than a typical PSA, it doesn’t give a perfect picture of the cancer.
“It is difficult to detect an aggressive cancer through the way cells look or behave,” says Dr. Jonathan Jay. “Besides, a biopsy may miss the specific areas of the prostate that would help to distinguish an aggressive from an indolent cancer,” he adds.
Advances in this area have ensured more accuracy and reduced the risk of misdiagnosis. For instance, abnormal prostate cancer genes can now be used to identify high risk cancer. The look of genes, occurrence of virulence factors, behavior, and other features are studied to better understand how likely it is that a cancer will grow and spread.
“Nowadays, we look at genes to determine the aggressiveness of prostate cancer,” says Dr. Jonathan Jay. “For example, genes of cancer cells may contain virulence factors or show how fast the cells will multiply and spread to other areas. This helps determine which cancer should be treated faster, and which categories of patients may benefit from therapeutic interventions,” he adds.
Apart from genomics, urologists can now use magnetic resonance imaging (MRI) technology before a biopsy to look for areas in the prostate that are suspicious of the cancer. This is possible thanks to new technology that fuses MRI images with real-time ultrasound to guide prostate needle biopsies to areas of specific concern.
At Advanced Urology Institute, we understand that prostate cancer is highly treatable when detected early and accurately.
We offer comprehensive prostate cancer care that includes the use of the latest research knowledge and techniques. With the advances in prostate cancer research, we can know who has aggressive or indolent cancer with greater accuracy, minimizing the chances of overtreatment and unnecessary biopsies.
Moreover, our urologists are acquainted with up-to-date prostate cancer knowledge, tools, and techniques. All of this helps guide treatment and enables us to develop more targeted treatment plans for our patients.
When you come to see us at our Naples, Florida office for diagnosis or treatment, we will consider your unique situation from a point of knowledge and recommend the best possible treatment for you.
For more information on prostate cancer treatment and diagnosis, visit the Advanced Urology Institute website.
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I’m Jonathan Jay. I’m a board-certified urologist with Advanced Urology Institute.
Listen, I’m excited about all facets of urology. You know, cancer is a big thing. Remember, prostate cancer didn’t have a chance when we died of our heart attack at 60 and 70, but it lived to be 90 and 100. Prostate cancer has got a big chance. We’re going to see a lot of patients, actually, their lives being affected by this disease.
So, one of the things that I like is that our ability to define the disease is improving. For instance, not only do we have PSA, PSA stands for prostate-specific antigen. This is a protein excreted by the prostate that can be detected at certain numbers, and there should be a certain number within the serum at a certain age. And if it’s elevated, or if it’s different than it used to be, then we know something’s wrong. And that’s important to understand. PSA got a bad reputation. Why was that? Because we used it wrong, not because it was a bad test.
The significance of PSA is not what it is in you relative to average, but what it is in you over time. For instance, my PSA for the past 10 years has been one. If my PSA is 3, which is considered normal, something’s wrong. Mr. Jones has a PSA of 6 for the past 10 years. This is above average. But he doesn’t have prostate cancer because his PSA is stable. So, again, we use this PSA in a wrong manner. That’s been one of the great evolutions of understanding this. And understanding, too, there’s some molecular biology. Again, we used to grade prostate cancers by looking at a prostate cancer under a microscope to understand the pattern and what it looked like.
You can’t really tell the aggressiveness of a prostate cancer by looking at it in its morphology. For instance, you’ve got two people walking down the street. You’ve got a young kid with a hoodie on. You’ve got a well-dressed man with a trench coat. Who’s your bank robber? Well, the guy with the trench coat has a machine gun under his trench coat. You can’t tell the behavior of something by the way it looks. So what we’ve done with prostate cancer is we have the ability to take that cancer and look at the genetics and define if it can multiply fast, can it move to other places. We can look at the virulence factors of these cancers to tell which cancer should be treated and which cannot. This is early in the process of looking at molecular biology and making decisions on how to treat and who to treat for prostate cancer. But it’s the light that we need as we hone this in and become more, be better at defining it. We’re going to make better decisions on who to treat and not to treat.
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So patients who have kidney stones usually complain of flank pain, which is where the pain would be behind the lower ribs and sometimes it wraps around towards the front [and] down towards the groin area. Those are the most common symptoms, [sometimes] they’ll also have blood in the urine on our testing in the office.
Usually we’ll get an ultrasound or CT scan that diagnoses the stone, it’ll tell us the size and location. If the stones are smaller [about] less than 4 millimeters in size, ninety (90) percent of those times it will pass on their own. So on those patients, I give them a chance to try to pass the stone before we operate on them. When they’re bigger, they’ll be more than 6 millimeters in size, the less of a change of passing [the stone], less than ten (10) percent. For those patients, we look at the scheduling surgery for.
My name is Yaser Bassel. I’m a board certified urologist with Advanced Urology Institute.
When we counsel patients before they get a vasectomy, we do tell them that this is considered a permanent form of sterilization. However vasectomies can be reversed. The vasectomy reversal process is typically one that is not covered by insurance so it can be expensive but it is possible and typically with seventy-five to eighty percent (75-80%) success rates. [While], I do not personally perform the vasectomy reversals themselves, I do have a partner that specializes in that area. So if that is something men are interested in, that is something that is offered by our practice.
My name is Yaser Bassel. I’m a board certified urologist with Advanced Urology Institute.
Most patients that come to us with regards to prostate health issues, the majority of them are dealing with benign disease, in particular something called Benign Prostatic Hyperplasia or BPH. Oftentimes those types of diseases and those types of symptoms can be addressed with medication and then beyond that, there are treatments for BPH that include in-office procedures and then beyond that, surgical procedures as well.
The other spectrum is malignant prostate disease which is prostate cancer. Typically that is found with prostate cancer screening. We use the Prostate-specific Antigen (PSA) blood test for that and also digital rectal exam (DGA) to detect prostate cancer oftentimes in asymptomatic men. Typically treatments range from robotic prostatectomy, radiation therapy and now there are some newer technologies such as high intensity frequency ultrasound at our disposal. Beyond that, there are also new advanced prostate cancer therapies for prostate cancer that have gone out of the prostate as well.
My name is Brian Hale, I’m a board certified urologist working with Advanced Urology Institute.
When I first started urology we had injection therapy and surgery, so we did a lot of surgery for erectile dysfunction. When Viagra came out in the late 90s that obviously changed everything, and now we have a lot of options besides Viagra, medically. So the treatment of erectile dysfunction transitioned from a surgical problem to a medical problem. We still do treat men with surgery if they fail the medical options but the numbers now are very low for patients who undergo surgery for erectile dysfunction.
Amar J. Raval, MD, is a urologist in Tampa, FL, specializing in the diagnosis and treatment of prostate cancer. With a range of treatment options available, deciding between surgery and radiation can be a challenging process for patients. In this article, we explore Dr. Raval’s insights and recommendations for making this important decision.
When it comes to treating prostate cancer, surgery and radiation are two of the most common treatment options. Each method has its own set of benefits and drawbacks, making it crucial for patients to carefully consider their individual needs and circumstances before making a decision.
Surgery, specifically radical prostatectomy, involves the complete removal of the prostate gland and surrounding tissues. While surgery can be an effective option for treating prostate cancer, it is an invasive procedure that carries its own set of potential complications. These may include infection, bleeding, and urinary incontinence, among others.
Dr. Raval emphasizes that surgery is not without risks, and patients should be aware of these when weighing their options. However, for some patients, surgery can offer the best chance for long-term cancer control.
Radiation therapy, on the other hand, involves the use of high-energy X-rays or particles to kill cancer cells within the prostate. Dr. Raval often recommends radiation therapy for older patients or those with other medical conditions that may limit their ability to undergo surgery successfully.
Although radiation therapy can be a less invasive alternative to surgery, it is not without potential side effects, such as urinary and bowel issues or erectile dysfunction. However, for some patients, radiation therapy may provide a more suitable option given their overall health and age.
While Dr. Raval provides his expert opinion and guidance during the decision-making process, he ultimately leaves the choice of treatment up to the patient. Each individual’s unique circumstances, preferences, and values must be taken into account when determining the best course of action for treating prostate cancer.
Dr. Amar J. Raval is a skilled urologist in Tampa, FL, who is dedicated to providing the best possible care for his patients. As a member of the Advanced Urology Institute, the largest urology practice in Florida, Dr. Raval works alongside a team of experienced urologists who share his commitment to excellence in patient care.
By offering comprehensive treatment options and personalized guidance for patients with prostate cancer, the Advanced Urology Institute ensures that their patients receive the most advanced and effective treatments available in the field of urology.
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My name is Amar J. Raval and I’m with Advanced Urology Institute. You know surgery is surgery at the end of the day and it does have its own complications and you’re you know making incisions. With radiation I like to give it to patients who are older who want treatment and also have medical comorbidities or different things that may limit them from being successful from a surgical outcome. But I think it’s again it’s a big conversation to have and ultimately I you know give my thoughts but I leave it up to patients to decide what they want to do.
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My name is Brian Hale, I’m a board certified urologist working with Advanced Urology Institute.
Certainly any man over the age of 50 should be screened for prostate cancer, it is the #2 cause of cancer death in men. There’s a lot of controversy about the PSA because of its lack of specificity: a lot of men who have elevated PSA do not have prostate cancer, but unfortunately we don’t have a better task. We have a rectal exam but that misses more cancer than the PSA, so to stop screening for prostate cancer was a mistake and they actually only reversed that recommendation on screening for prostate cancer based on what was happening. We were seeing a lot of men with Metastatic disease.
I started private practice in 1995, and from 1995 until the last five (5) years or so, I didn’t have any metastatic prostate cancer patients in my practice, and now I have a lot, and a lot of it was from a lack of screening. I have patients that were trying to do everything right: watching their weight, exercising and they stopped screening for prostate cancer because of the recommendations. They would have symptoms like blockage from their prostate or blood in their urine. We would check a PSA and we would find it to be extremely high and later find they have metastatic disease because of lack of screening. I have several patients I know on the top of my head that have had that problem, unfortunately. So I would definitely recommend that they continue screening for prostate cancer. [While] it is true, we need a better test than PSA, but just because we don’t have a better test doesn’t mean we should stop screening and I think the government is coming back around to that because the treatment of metastatic prostate cancer is a lot more expensive than the treatment of early prostate cancer.
Urology is a wonderful specialty, being at the same time a surgical and medical practice. It offers an interesting mix of work in both the office and the operating room.
“For many of us, we enjoy spending time in the operating room—after all, we are surgeons by trade,” says Dr. Scott B. Sellinger, FACS, a board-certified urologist at Advanced Urology Institute. “But for many of us, we also enjoy interactions with our patients in the office. I love to see my folks, especially the ones I’ve been seeing for the past 25 years. They come back every year and we can chat about all kinds of things.”
While most urology patients are followed long-term with medical interventions, at least half of them are surgical patients. The subspecialty of urology offers great opportunities to practice the surgical side of the profession, which includes the hands-on application of the latest technology, such as robots and lasers. “I enjoy the surgical side of our profession, and urology offers innovative techniques and technology that makes surgical procedures even more interesting,” says Dr. Sellinger.
The opportunity to build lasting doctor-patient relationships makes urology gratifying.
“As a urologist, you get to care for the entire spectrum of age groups of patients, such as children with congenital problems and patients in their declining years, when a lot of urologic problems tend to set in.” says Dr. Sellinger. “I like the fact that I see different patients every day, delve into their emotional problems, and with empathy, provide the support and solutions they need. I also enjoy speaking with the patients I see every year for several years since every time they come in they have something great to share,” he adds.
Urology brings relief to patients with personal and sometimes embarrassing medical problems. Through surgery, medications or both, urologists resolve these issues and improve the quality of life of their patients, which is quite appealing.
“As a urologist, not only do I treat life-threatening conditions like cancer, I also improve the quality of life of patients by freeing them from sexual dysfunction or incontinence,” says Dr. Sellinger.
Unlike some other specialties, the treatments offered by urologists often provide quick relief and good outcomes. In fact, most patients treated by urologists do well and get better.
“Nowadays, urology is quite advanced, and we have at our disposal medicines, surgery, and the combination of both treatments that render our patients improved soon after they interact with us,” says Dr. Sellinger. “So we feel satisfied and secure in the knowledge that we can solve most, if not all, of the urologic problems,” he adds.
Because of consistently great results, urologists are held in high regard by their patients, who are usually grateful for the care. In turn, this gives a kind of satisfaction to urologists.
“I am happy that I chose urology. I’m always filled with joy every time patients come back to thank me for what I’ve achieved for them,” says Dr. Sellinger. “If I were to start all over again, I would still choose to become a urologist.”
Want to have your urological problem treated by an effective urologist? AUI is a medical group with a long history of providing comprehensive, high-quality care. The urologists at AUI find it a joy to work in an environment that brings out the best of their knowledge and experience for the benefit of their patients.
Whether you have kidney, urinary tract, prostate, pelvic or other urological needs, at AUI you will find a urologist who can deliver the right treatment for you. For more information on the diagnosis and treatment of urological conditions, visit the Advanced Urology Institute website.
