Services and Treatments
The department of Urology at Montefiore Medical Center provides state-of-the-art diagnostics and treatment for the entire spectrum of urologic disorders. The faculty is comprised of internationally recognized, board-certified adult and pediatric urologists who collectively specialize in all urologic subspecialties including:
- Urologic oncology
- Minimally invasive surgery including laparoscopic and robotic surgery
- Erectile dysfunction and Infertility
- Urinary stone disease
- Benign prostatic hyperplasia (enlarged prostate or BPH)
- Urinary incontinence and voiding dysfunction and urodynamics
- Female urology gynecology
- Pediatric Urology
We work in a multidisciplinary manner and place great emphasis on patient education, so each patient is aware of his or her treatment options and is comfortable with the approach to attain the best outcome. The expert faculty is at the forefront of surgical innovation. The most advanced medical, surgical and noninvasive treatments are offered by our department. Several of these procedures are highlighted below:
- Robotic surgery including robotic radical prostatectomy, robotic cystectomy and urinary diversion and robotic renal surgery
- Laparoscopic renal surgery including complex laparoscopic partial nephrectomy
- Minimally invasive stone surgery
- Advanced reconstructive surgery for erectile dysfunction including penile prosthesis, and microvascular penile revascularization
- Minimally invasive treatments for BPH including microwave therapy and green light laser treatment of the prostate
- Advanced genitourinary reconstructive surgery
- Advanced pediatric reconstructive surgery
As one of the first hospitals in the state of New York to establish a laparoscopic prostate cancer program in 2001, Montefiore is consistently at the forefront of cutting edge therapies and treatment solutions. As one of only 300 hospitals nationwide employing the da Vinci Robotic Surgical System for treating prostate, bladder and kidney cancer, the department of urology provides tertiary care services that are second to none in the tri-state area.
Some of the most common conditions we treat include:
Urologic Oncology and Minimally Invasive, Laparoscopic, and Robotic Surgery
The division of urologic oncology is one of the most comprehensive Urologic Oncology (Cancers of the Kidney, Ureter, Bladder, Urethra, Prostate,Penis and Testes) programs in the nation and is led by Reza Ghavamian, M.D. Fellowship trained in Urologic Oncology at the Mayo Clinic, Dr. Ghavamian treats the full spectrum of urologic cancers in conjunction with other members of the department of urology, radiation oncology and medical oncology. The full array of traditional/open, laparoscopic, and robotic surgery is employed. The work is done in a multidisciplinary fashion in concert with radiation oncologists, medical oncologists, radiologists, and our genitourinary pathologist, to develop a customized treatment plan for each individual patient to optimize his or her outcome.
In 2001 Dr. Ghavamian established one of the first laparoscopic radical prostatectomy programs in the U.S. Since then, he has performed more than 600 minimally invasive prostate cancer operations. The established prior experience and expertise with minimally invasive laparoscopic surgery before the adoption of the robotic prostatectomy technique allowed for a smooth transition for the adoption of the robotic technique. For the last several years, the majority of radical prostatectomies in the department have been performed robotically.
The robotic technique is also utilized for the appropriately selected patient with invasive bladder cancer. Dr. Ghavamian performed the first laparoscopic radical cystectomy at Montefiore in 2002. Since the acquisition of the Da Vinci robotic system, most bladder cancer operations are performed with robotic assistance.
We have recently started our robotic renal surgery program. Laparoscopic partial nephrectomy for the removal of renal cancers have been performed in our department since 2002. Since then more and more complex cases are performed with this technique. We are currently looking to explore and compare the utilization of the robotic technique for complex renal cancer excisions and reconstruction.
Why choose robotic surgery? Patients experience less blood loss, less pain, a faster discharge and recovery, and less scarring. For the surgeon it provides the advantage of the Da Vinci robot's magnified 3-D view of the operation, which offers more accurate visualization during the procedure. Click on "Urological Oncology" to the left to learn more about our various cancer services.
Other cancer services include brachytherapy and cryotherapy.
Endourology and Stone Disease
The endourology and stone disease program is led by Dr. David Hoenig. We offer complex management of all kidney, ureter, and bladder stones, as well as scars of the kidney, ureter, and bladder and congenital abnormalities of the ureteropelvic junction. These are addressed with state-of-the-art minimally invasive stone extraction techniques, such as percutaneous renal stone removals, endourologic and laser treatment, as well as extracorporeal shockwave lithotripsy (ESWL), which eliminate the need for open surgery. Dr. Hoenig, a fellowship trained endourologist, specializes in all facets of endoscopic treatment of urologic diseases and leads one of the most active stone programs in the northeast.
Erectile Dysfunction (Impotence) and Infertility
Under the leadership of Dr. Ghavamian, Montefiore is recognized as the leading center in New York for erectile dysfunction. The full range of solutions, such as: oral therapy, injection therapy, penile implant surgery, penile reconstruction, and penile revascularization surgery is offered.
Benign Prostatic Hyperplasia (BPH)/Enlarged Prostate
Our team of physicians provide the most state of the art treatment for BPH. These include medical therapy, minimally invasive thermotherapy (microwave treatment) and surgical treatment including transurethral resection of the prostate, green light laser treatment and open prostate surgery.
Neuro-urology and Incontinence
Numerous conditions and diseases such as multiple sclerosis, Parkinson disease, diabetes mellitus, strokes, spinal cord injuries, herniated discs, and brain and spinal cord tumors can adversely affect the lower urinary tract, causing incontinence, infections, and even kidney failure. Our team of physicians address complex voiding dysfunction and incontinence issues. State of the art urodynamic evaluation is provided in the appropriate patient.
Female Urology/Voiding Dysfunction
Our team of physicians address all women's incontinence and pelvic floor dysfunction issues, including: overactive bladder, urinary tract infections, incontinence (related to trauma, pregnancy, aging, and surgery), pelvic organ prolapse, and sexual dysfunction. Once the diagnosis has been determined, we treat each patient with the latest non-surgical and surgical therapies, such as: neuromuscular re-education, strengthening of pelvic floor muscles, electrical stimulation, myofascial relief techniques, and minimally invasive procedures such as the injection of urethral bulking agents for stress incontinence and injection of botox for overactive bladder.