Radical Prostatectomy Surgery Miami

“Nerve Sparing Radical Prostatectomy in addition to providing the benefit of improved post operative erectile function for men with localized prostate cancer may improve the ability to achieve normal orgasm.   Miami urologist, David Robbins, MD is a regional expert in robotic assisted radical prostatectomy using the da Vinci surgical robot and offers patients the opportunity to have their prostate cancer treated with minimal effect on their quality of life with regard to measures such as erectile function and maintenance of continence.  This article shows evidence that nerve sparing prostatectomy may additionally result in improved ability to achieve normal orgasms.”  Miami urologist, David Robbins MD

Nerve-Sparing Prostate Surgery Helps Men Retain Sexual Function

Most men left with nerves on both sides of the gland can achieve orgasm, study shows

THURSDAY, Feb. 16 (HealthDay News) — Most men who have surgery for prostate cancer can still achieve orgasm if the nerves that surround their prostate gland are not removed, according to a new study.

Researchers from Cornell University say a man’s age and the number of his nerves that are spared will play a role in his ability to climax after surgery.

The study followed 408 men who underwent a procedure to remove their prostate, known as robot-assisted laparoscopic radical prostatectomy, between 2005 and 2007 for an average of three years. Men had mean age of 60 years and all were able to have an orgasm before the procedure.

Seventy-four percent of the men were able to have their nerves spared bilaterally, or on both sides. Of those men, 91 percent experienced no change in their ability to achieve orgasm following the surgery.

About 13 percent of the men had their nerves spared on only one side. Of this group, 82 percent of the men had the same ability to reach orgasm. Another 12 percent had little or no nerve sparing, with 62 percent of them were still able to achieve orgasm the same way they did before the operation.

The men’s age also played a role in their ability to orgasm. The study, published in the February issue of BJUI, showed orgasm rates were significantly higher in men younger than 60 who had their nerves spared on both sides. Orgasm rates dropped by 10 percent to 83 percent among men older than 60, even if their nerves were spared on both sides.

A questionnaire completed by 156 of the men who were able to achieve orgasm after surgery revealed 82 percent had high satisfaction rates. Another 10 percent said they had moderate satisfaction and 7 percent reported low satisfaction. Roughly 3 percent of the men said they experienced a painful orgasm.

“As far as we are aware, this is the largest analysis of orgasmic function in the robotic prostatectomy literature and will provide valuable information for surgeons talking to patients about what sort of sexual function they can expect after surgery,” study author Dr. Ashutosh Tewari, director of the Prostate Cancer Institute and the LeFrak Robotic Surgery Center at Weill Cornell Medical College, said in a journal news release.

More information

The U.S. National Institutes of Health provides more information on prostate cancer.

— Mary Elizabeth Dallas

SOURCE: Wiley-Blackwell, news release, Feb. 13, 2012

Last Updated: Feb. 16, 2012

Copyright © 2012 HealthDay. All rights reserved.

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Vasectomy Procedure Miami, Florida

Vasectomy procedures are on the rise in Miami and around the country.  As the economic slow down progresses, men are seeking a low cost solution to prevent unwanted pregnancies.  In our hight volume urology practice in Miami, we have seen a similar upward trend in patients requesting vasectomy procedures.  Miami urologists David Robbins, MD and Amery Wirtshafter, MD are available to provide low cost office based minimally invasive vasectomy procedures.  Please call our office to schedule an appointment or request further information”

David Robbins, MD

Contact Us
North Miami Beach Office:
Tel: (305) 944-0025
Fax: (305) 944 3624

Miami Beach Office:
Tel: (305) 672-4222
Fax: (305) 672-5461

 

(CNN) — Dr. J. Stephen Jones had seven vasectomies to perform in a day.

Some urologists around the country are reporting increased numbers of patients coming in for vasectomies.

Some urologists around the country are reporting increased numbers of patients coming in for vasectomies.

The schedule for Jones, a Cleveland, Ohio, urologist, has become more crowded during a recent boom in vasectomies.

“My staff came to me and said, what’s happening?” said Jones, the chairman of the Department of Regional Urology of Glickman Urological and Kidney Institute at the Cleveland Clinic. “Why are we suddenly having an explosion in guys asking for vasectomies?”

They looked at their statistics and realized the uptick started around November as the economic crisis deepened. October went down in the history books as one of Wall Street’s worst months.

Since then, the Cleveland Clinic has seen a 50 percent increase in vasectomies, an outpatient surgery that is the cheapest form of permanent birth control. Vasectomies are less invasive and cheaper than tubal ligation, which involves blocking, tying or cutting a woman’s fallopian tubes to prevent pregnancy.

“It’s unlikely that some guy read the Dow Jones numbers that day and said, ‘Why don’t we have a vasectomy?’ ” Jones said. “More likely, people have already been considering it and typically a guy and his wife have spoken a year or two about this.”

Jones was told by patients that they were getting vasectomies because they were losing their jobs and health insurance, or concerned about being out of work soon

“They realize they don’t have the financial security long-term with what’s going on,” Jones said. “Several of them have mentioned, ‘We can’t afford to have any more children in this economy.’ My perception is that it’s more of the concept of raising children in an uncertain economic future.”

Much like Jones, Dr. Marc Goldstein, surgeon-in-chief of male reproductive medicine and surgery at the Cornell Institute for Reproductive Medicine in New York, saw a 48 percent increase in vasectomy consultations compared with the same time last year.

“I have never seen anything like this,” said Goldstein, a urologist for the last 30 years. “When things started to go south in the stock market, then the vasectomy consults went north.”

Half of Goldstein’s New York patients work in the financial sector. New patients filed into his office in November.

“I think the situation of finance and the economy is the major reason,” Goldstein said. “Some of them have mentioned that, ‘It cost $30,000 a year to put my kids in private school and I can’t afford to have another one.’ It’s never the sole reason, but it’s certainly a contributing factor.”

During the vasectomy, the doctor cuts the two vas deferens, which are the tubes carrying sperm from the testicles to become semen. After the procedure, men can still have sex, but their semen does not contain sperm and therefore they can no longer father children.

Doctors can attempt to reverse the procedure, but vasectomy reversals are expensive and only work half the time in restoring sperm flow.

Carl Haub, a demographer with the Population Reference Bureau, a private research firm, said the National Center for Health Statistics’ data showed that, “During bad economic times, the Depression and the recession in the 1970s, the birth rate did go down.” See the chart on fertility rates in the United States from 1917 to 2007 »

“Some folks will postpone having kids,” he said. “If you had a vasectomy, you’ve made a bigger decision that you’re never going to have another child.”

When people stop having children, it implies a loss of confidence in their future employment prospects.

“Am I going to have a job in six months or a year from now?” Haub said. “If I’m concerned about that, people are not going to increase their financial obligations… It’s naïve to say the economy didn’t play a significant role in lowering the birth rate.”

It’s too early to tell whether this recession has crimped the birth rate, Haub said.

At this point, most of the evidence of increased vasectomies has been anecdotal from practicing urologists, because there is no national registry for sterilizations.

The number of appointment requests spiked 30 percent in January 2009 on the Web site vasectomy.com, which links people with local urologists. But throughout the last few months, appointment requests have been fairly level, said Dr. Ted Benderev, founder of the site.

Dr. Lawrence Ross, a professor of urology at the University of Illinois at Chicago and former president of the American Urological Association, said the school’s clinics have seen moderate increases in the last six months to a year and that vasectomies are growing popular among lower-income clients.

“My guess is that since economic times have worsened, people are concerned about their ability to raise larger families and are opting for more permanent birth control,” Ross said.

People who are concerned about losing their health insurance are trying to take advantage of the coverage for a procedure they’ve long considered.

“It may have something to do with the economy,” said Dr. Bryan Kansas, a urologist. “I can’t count on my hands, in the last three months, the number of times someone has said they’re about to lose their insurance and ask to squeeze them in.”

He and his colleagues have seen a similar uptick in their Austin, Texas, practice called The Urology Team.

Throughout March Madness, Kansas’ office has a special on vasectomies called, “Vas-Madness” to capitalize on their patient’s obsession with the college basketball tournament.

Patients “would love to have a procedure, go home and sit there when you’ve got all-day programming, watch basketball,” Kansas said.

After the lessthan-hourlong procedure, patients usually spend a day or two recovering, moving gingerly and icing the soreness. Some men time their vasectomies around the time of major sports events such as the Masters Golf Tournament and the NCAA basketball tournament to keep themselves entertained during recovery.

Vasectomies are likely to produce tenderness, discomfort and slight swelling and the patient is usually able to return to usual activities within a week.

Green Light Laser Surgery for Enlarged Prostate Miami

Green Light Laser Surgery for Enlarged Prostate

Green Light Laser Therapy is a minimally invasive surgical option for enlarged prostate (BPH) that combines the effectiveness of the traditional surgical procedure known as transurethral resection of the prostate (TURP), but with less painful recovery, decreased risk for side effects, less bleeding and shorter catheterizations.  Miami urologists David Robbins, MD and Amery Wirtshafter, MD routinely perform Green Light Laser procedures. 

Green Light Laser therapy to treat enlarged prostate tissue results in a wide open prostate channel for improved urine flow and a quicker return to normal life activities free from bothersome BPH symptoms.

Green Light Laser surgery is typicall performed in an outpatient setting; meaning patients return home within hours of the procedure.   After Green Light Laser surgery patients can typically return to normal non-strenuous activities within days.  The Green Light Laser system is able to deliver the ultimate treatment for enlarged prostate (BPH) with freedom from bothersome urinary symptoms.

Miami urologists Dr. David Robbins and Dr. Amery Wirtshafter have extensive experience with Green Light Laser surgery for BPH or enlarged prostate and have been providing this service to patients in the Miami region and surrounding areas since Green Light Laser surgery was first introduced. 

Greenlight Laser XPS

Miami urologists David Robbins, MD and Amery Wirtshafter, MD are now among a select group of urological surgeons who now offer therapy with the new and improved Green Light Laser XPS sytem which provides improved energy delivery and increased ability to treat patients with very enlarged prostates previously thought not ammenable to minimally invasive surgery. 

Click here to watch a video of Dr. Robbins performing Greenlight laser vaporization surgery for BPH (enlarged prostate)

Miami urologists David Robbins, MD and Amery Wirthshafter MD additionally provide a broad spectrum of urological services including treatment for prostate cancer via da Vinci robotic assisted surgery and cryotherapy, treatment for ED including penile implant procedures, treatment of kidney cancer, bladder cancer, testis cancer, management and treatment of female voiding dysfunction and incontinence, vasectomy services and much more.

Kidney Stone Surgery Miami

Kidney stone surgery can be performed using a minimally invasive approach known as ureteroscopy.  Miami urologist David Robbins, MD specializes in minimally invasive surgery for the treatment of kidney stones.  Ureteroscopy involes using a long thin flexible camera that is gently threaded into the ureter or kidney.  the end of the ureteroscopy has a camera that uses digital or fiberoptic technology to trasmit an image to a video screen.  This enables the treating urologist to directly visualize the kidney stones.  The stone can then be pulverized into tiny pieces using a small laser fiber 1/5th of a milimeter in thickness. 

Kidney stone surgery using ureteroscopy is considered more effective in terms of stone clearance than ESWL therapy.  Miami urologist Dr. David Robbins has extensive training and expertise in ureteroscopic mangagement of kidney stones.  

Dr. Robbins also specializes in Green Light Laser surgery for BPH, da vinci robotic prostate surgery for prostate cancer, penile implant surgery for erectile dysfunction, vasectomy procedures, incontinence surgery as well as surgery for bladder and kidney cancer.

Please contact us for further information or if we can be of assistance.

Robotic Prostatectomy Surgery Miami

Robotic prostatectomy for the treatment of prostate cancer is considered by many to be the standard of care for the treatment of clinically localized prostate cancer.  Miami urologist, David Robbins, MD is a local expert in the use of the da Vinci robotic system for the treatment of prostate cancer.   Dr. Robbins is performing robotic prostatectomy surgery at two convenient locations in Miami including Mount Sinai Medical Center on Miami Beach and Aventura Hospital in Aventura.  

Robotic prostatectomy provides the advantage of decreased blood loss, decreased post operative pain and a shorter hospital stay.  Outcomes including preservation of erectile function, maintenance of continence and cancer cure are considered a significant improvement over the open technique. 

 

Miami Vasectomy Procedure

Miami vasectomy specialist David Robbins, MD performs safe and effective vasectomy procedures in his offices located at two convenient locations in North Miami Beach and Miami Beach.  A vasectomy procedure is an excellent option for men seeking a permanent solution to prevent fertility.  A vasectomy procedure takes less than twenty minutes to perform and results in minimal discomfort and inconvenience.   Please visit our website or contact us to discuss this further.

We additionally specialize in the care of other urological problems including prostate cancer, kidney cancer, bladder cancer, incontinence, erectile dysfunction and placement of penile implants, BPH or enlarged prostate and more.

Best Robotic Prostate Cancer Surgeon Miami

David Robbins, MD is a board certified urologist in Miami and well known expert in the field of robotic prostate cancer surgery.  Dr. Robbins is currently performing robotic prostate cancer surgery out of Mount Sinai Medical Center in Miami Beach as well as Aventura Hospital and Medical Center in Aventura.  Miami urologist Dr. David Robbins received specialized training in robotic prostatectomy from experts in the field during his training at NYU Medical Center in New York.   He has an excellent track record with regard to prostate cancer cure, preservation of erectile function and maintenance of urinary continence.