Services
Evaluation: We offer medical evaluation for all conditions that pertain to urology. This include problems urinating such as urinating too often, urinating at night, leaking urine, blood in the urine, stones in the urine or bladder, or kidneys. Dr. Grotas treats both men and women. We also treat male sexual dysfunction including premature ejaculation, warts, sexually transmitted diseases, erectile dysfunction, and penile curvature. We screen for bladder, prostate and kidney cancer.
Surgery: We offer surgical treatments for a variety of urologic conditions. Circumcision, vasectomy, vasectomy reversal, kidney stone treatments, treatments for weak urinary stream and prostatic obstruction, greenlight laser, correction of bladder leakage or dropped bladder = pelvic prolapse, Da-Vinci robotic radical prostatectomy, laparoscopic nephrectomy, orchiectomy and testicular prosthesis, penile prosthesis insertion, artificial urinary sphincter, interstim neuromodulation of bladder.
Treatment: We offer Rezum and UroLift for Benign Prostatic Hyperplasia (BPH) and Medtronic Bladder Control Therapy delivered by the NURO system for overactive bladder. Read more about these minimally invasive procedures below.
Dr. Grotas performs HD-digital cystoscopy in the office using state of the art equipment. He also has state of the art urodynamic and ultrasound equipment to get immediate answers to patients urologic problems.
Our goal is to give you a painless state of the art evaluation for your condition.
Surgery: We offer surgical treatments for a variety of urologic conditions. Circumcision, vasectomy, vasectomy reversal, kidney stone treatments, treatments for weak urinary stream and prostatic obstruction, greenlight laser, correction of bladder leakage or dropped bladder = pelvic prolapse, Da-Vinci robotic radical prostatectomy, laparoscopic nephrectomy, orchiectomy and testicular prosthesis, penile prosthesis insertion, artificial urinary sphincter, interstim neuromodulation of bladder.
Treatment: We offer Rezum and UroLift for Benign Prostatic Hyperplasia (BPH) and Medtronic Bladder Control Therapy delivered by the NURO system for overactive bladder. Read more about these minimally invasive procedures below.
Dr. Grotas performs HD-digital cystoscopy in the office using state of the art equipment. He also has state of the art urodynamic and ultrasound equipment to get immediate answers to patients urologic problems.
Our goal is to give you a painless state of the art evaluation for your condition.
Rezum and UroLift
Rezum and UroLift are both minimally invasive treatments that we offer for Benign Prostatic Hyperplasia (BPH).
- What is BPH?
- BPH is the enlargement of the prostate gland that causes blockage of the urethra, which results in a reduced flow of urine from the bladder.
- Who is affected by BPH?
- 50% of men between the ages of 51 and 60.
- 70% of men over the age of 60.
- 90% of men by the age of 85.
- What are the symptoms of BPH?
- Urinary frequency, irregular flow, urgency, weak/interrupted stream, getting up at night to urinate, painful or burning urination, lack of control over urination, not feeling like the bladder is emptied after urination, inability to urinate when you feel the need.
- What is Rezum?
- Rezum uses the natural energy stored in water vapor and is a safe and effective treatment.
- It is a minimally invasive treatment that involves no chronic medications and has been studied in randomized controlled trials.
- The procedure is performed in a physician’s clinic or out-patient setting under local anesthesia or oral sedation and does not require general anesthesia.
- It targets prostate tissue with steam in a series of 9 second treatments.
- When the steam turns back into water, the stored energy is released, and the cells die as a result.
- Over time, the body’s natural healing response removes the dead cells and shrinks the prostate, which opens the urethra and reduces BPH symptoms.
- Most patients begin to notice symptom relief in as early as 2 weeks and maximum benefit within 3 months.
- Studies show that there is no significant change in ejaculation or erection quality after 3 years.
- What is UroLift?
- UroLift is a minimally invasive treatment that alleviates BPH symptoms.
- It provides low-risk, rapid symptom relief, preservation of sexual function, a quick return to normal activity, and an increased quality of life.
- Small, permanent implants are placed into the prostate to lift and hold the enlarged tissue out of the way, unblocking the urethra and allowing urine to flow.
Medtronic Bladder Control Therapy delivered by the NURO system
- Medtronic Bladder Control Therapy delivered by the NURO system is a treatment for overactive bladder that helps you regain control of your life by reducing the need to urinate frequently, and therefore, allows you to enjoy your activities with less worry and interruptions.
- This treatment restores bladder function by delivering gentle stimulation to the tibial nerve (located on shin).
- The therapy is delivered at your doctor’s office and lasts about 30 minutes. Initial treatment consists of 12 weekly, 30-minutes sessions.
- Medtronic Bladder Control Therapy is painless; you may feel a slight tingling in the heel.
- After the initial weekly therapy sessions, maintenance sessions are done in the same way as the first 12 but are every 3 to 4 weeks, instead of every week.
Testosterone Evaluations
If you checked the 1st or 7th or any 3 other questions, you may have low testosterone.
Testosterone Options
- Topical gels (Axiron, Androgel)
- Testosterone topical gels should be applied once daily as instructed.
- Transdermal patch (Androderm)
- Transdermal patches should be used and discarded every 24 hours.
- Clomiphene citrate pill
- Clomid is an oral medication that should be taken 3 times per week.
- It stimulates natural testosterone production by blocking the interaction of estrogen with the pituitary gland. This results in an increase in testosterone produced by the body, and is also used for fertility.
- Injection
- Testosterone injections should be taken weekly.
- Testosterone undecanoate injection (Aveed)
- Testosterone undecanoate injections should be taken every 10 weeks (5 times per year)
- TESTOPEL pellets - every 3 months+
- The pellets contain crystalline testosterone. When they are implanted subcutaneously, they slowly release testosterone for a long-lasting androgenic effect.
SpaceOAR Hydrogel
- SpaceOAR is a gel that is injected into the space between the prostate and the rectum that protects the rectum and surrounding nerves from radiation involved in the treatment of prostate cancer.
- This gel prevents damage to the rectum and associated side effects, allowing you to have an easier recovery and better quality of life after treatment.
- The injection is a minimally invasive procedure prior to the start of radiation treatment, during which the patient may be awake or asleep under general anesthesia.
- The hydrogel remains stable during radiation therapy and is gradually absorbed by the body after the completion of radiation therapy.
- Patients were reported to experience significantly less cases of decreased quality of bowel, urinary, and sexual activity with SpaceOAR.
Shockwave Therapy for Erectile Dysfunction
- Shockwave therapy is a safe and comfortable treatment for men to reverse the effects of Erectile Dysfunction (ED) due to poor blood flow and to improve sexual performance.
- More than 80% of ED issues are caused by poor blood flow.
- This treatment uses high frequency, low-intensity soundwaves to improve blood flow to the penis, remove micro-plaque, and stimulate the growth of new blood vessels.
- Shockwave therapy involves no medications or invasive procedures and has been reported to have a success rate of over 75% in treating ED.
- The procedure takes 20-30 minutes, is performed in-office, and provides long-lasting results.
Vasectomy
- Vasectomy is a popular and effective form of permanent birth control for men. In a vasectomy, the vas deferens are sealed off, preventing sperm from reaching the semen that is ejaculated.
- A vasectomy is a minor surgery that takes about 20 minutes and can be performed in-office under local anesthesia or in a hospital.
- In a standard vasectomy, two small cuts are made in the scrotum. Each of the two vas deferens tubes is cut and tied or sealed with heat and then replaced in the scrotum. The skin is closed with stitches that dissolve and do not need to be removed.
- An alternative popular option is a no-scalpel vasectomy, in which a small clamp with pointed ends is used to puncture the skin. Each vas deferens is lifted out, cut, and sealed and then put back into place. This option is equally as effective as a standard vasectomy and has less bleeding, swelling and pain. The hole in the skin is also smaller.
- There is a 30 day waiting period to have a vasectomy in New York State.
- Vasectomy has a short healing and recovery time and should cause no change in sexual performance.
Urodynamic Testing
- We offer urodynamic testing to evaluate bladder, sphincter, and urethra function and to find the cause of several common problems including urine leakage, frequent or painful urination, problems starting a urine stream, problems emptying the bladder fully, recurrent urinary tract infections, and strong, sudden urges to urinate.
- The most common tests we perform are Cystometry (CMG), Electromyography (EMG), Uroflowmetry, and Voiding Pressure Study (Pressure Flow Study).