Urology Services

Urology is classified as a surgical subspecialty which diagnoses and treats patients with conditions that affect male and female urinary tracts as well as the male reproductive organs. Due to the variety of clinical problems encountered, knowledge of internal medicine, gynecology, and other specialties is required of the urologist. Dr. Rauch has years of experience treating a wide range of urological conditions. He works with his patients to diagnose problems and discuss treatment options.

Urological Conditions and Diseases Treated:

Surgical Procedures Performed/Offered

Dr. Rauch has been a leader in the field of urologic surgery. He has performed hundreds of the most common procedures. He believes in the minimally invasive approach and works with patients to determine the best course of care including non-surgical alternatives. Dr. Rauch performs surgery at Boca Raton Regional Hospital and the Boca Raton Outpatient Surgery & Laser Center.

  • Bladder Cancer
    • Transurethral Resection of Bladder Cancer (TURBT)
    • Radical Cystectomy
    • In office instillation of BCG or Mitomycin
  • Hydrocelectomy
  • Kidney Cancer Treatment
    • Laparoscopic Radical Nephrectomy
    • Laparoscopic Partial Nephrectomy
    • RF Ablation of Renal Tumors
  • Kidney Stone
    • ESWL (Shock Wave Lithotripsy)
    • PCNL (Percutaneous Nephrolithotripsy}
    • Ureteroscopy and Stents
    • Bladder Stone Removal
  • Penile Implants for Impotency
  • Prostate Surgery for Cancer of the Prostate
    • Radical Prostatectomy
  • Prostate Surgery for Non-cancerous Growth (benign)
    • Photovaporization of the Prostate (PVP/ Green Light Laser)
    • TURP (Trans Urethral Resection of the Prostate)
    • Bipolar TURP
    • Urolift
  • Spermatocelectomy
  • Testicular cancer
    • Radical Orchiectomy
  • Testopel
  • Urethral stricture surgery
  • Varicocele Repair
  • Vasectomy

 

Bladder Cancer

Bladder cancer is the fourth most frequently diagnosed cancer in men and the 10th most frequently diagnosed cancer in women. Bladder cancer is most common in older adults – less than one percent of cases occur in people under 40.

Bladder cancer that is limited to just the inner lining of the bladder is called superficial and is the easiest form of bladder cancer to treat. About 75 percent of all bladder cancers are detected at this early stage, and the survival rate is greater than 90 percent. Treatment becomes more difficult and the survival rate decreases if the cancer has spread beyond the bladder’s inner lining. Surgical removal of the bladder (radical cystectomy) is the most effective treatment for bladder cancer that has invaded the muscle wall of the bladder.

Bladder cancer signs and symptoms may include:

  • Blood in urine (hematuria) — urine may appear bright red or cola colored, or urine may appear normal, but blood may be detected in a microscopic examination of the urine
  • Frequent urination
  • Painful urination
  • Back pain
  • Pelvic pain

Dr. Rauch performs the following surgeries for Bladder Cancer:

  • Transurethral resection of bladder cancer (TURBT)
  • Radical cystectomy
  • In office instillation of BCG or Mitomycin

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BPH (Benign Prostatic Hyperplasia)

Benign prostatic hyperplasia (BPH) is an enlarged prostate. The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a man’s life. As you age, your prostate may get larger. Benign prostatic hyperplasia often occurs with the second growth phase.

As the prostate enlarges, it can then squeeze down on your urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and urinary retention–the inability to empty the bladder completely–cause many of the problems associated with benign prostatic hyperplasia. BPH is benign, meaning it is not cancer. It does not cause nor lead to cancer. But BPH and cancer can happen at the same time.

BPH is common in aging men. About half of all men between the ages of 51 and 60 have BPH. Up to 90% of men over age 80 have BPH.

Symptoms of BPH can include:

  • The need to urinate often, especially at night
  • Feeling that the bladder is full, even right after urinating
  • Feeling that urinating “can’t wait”
  • Weak urine flow
  • Dribbling of urine
  • The need to stop and start urinating several times
  • Trouble starting to urinate
  • The need to push or strain to urinate

A wide variety of treatments are available for enlarged prostate, including medication, minimally invasive therapies and surgery. The best treatment choice for you depends on several factors, including:

  • The size of your prostate
  • Your age
  • Your overall health
  • The amount of discomfort or bother you are experiencing

Dr. Rauch performs the following surgeries for BPH:

  • Photovaporization of the Prostate (PVP/ Green Light Laser)
  • TURP (Trans Urethral Resection of the Prostate)
  • Bipolar TURP
  • Urolift

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Erectile Dysfunction/Impotence

Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex. Having erection trouble from time to time isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection also can be a sign of an underlying health condition that needs treatment and a risk factor for heart disease down the road. If you’re concerned about erectile dysfunction, talk to Dr. Rauch. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

Erectile dysfunction symptoms might include persistent:

  • Trouble getting an erection
  • Trouble keeping an erection
  • Reduced sexual desire

See Dr. Rauch if:

  • You have concerns about your erections or you’re experiencing other sexual problems, including ejaculatory dysfunction, such as premature or delayed ejaculation
  • You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction
  • You have other symptoms along with erectile dysfunction

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Kidney Cancer

As with all cancers, early diagnosis of kidney cancer dramatically improves the chance for survival. Although the prognosis of kidney cancer is relatively poor for kidney cancer that is advanced (metastasized), promising new treatments are improving the outlook for patients. These statistics include adults and children and include renal cell carcinoma and transitional cell carcinoma of the renal pelvis. The majority of patients diagnosed with kidney cancer are over the age of 45 with the highest incidences between the ages of 55 and 84.

Signs and Symptoms of Kidney Cancer:

Unfortunately, kidney cancer rarely causes visible signs or symptoms in its early stages. In the later stages, the most common sign of both renal cell and transitional cell cancers is blood in the urine (hematuria). Most of the time RCC is now found incidentally, during physical examinations for other problems, by imaging studies such as ultrasound, CAT scan or MRI. You may notice the blood when you urinate, or your doctor may detect blood from a urinalysis, a test that specifically checks the contents of your urine.

Other possible kidney cancer symptoms may include:

  • Flank pain – pain on one side of the body between the upper abdomen and the back
  • Abdominal Mass – a mass in the area of the kidneys discovered during an examination
  • Anemia – a condition in which the number of red blood cells is below normal
  • Fever – not due to cold or flu
  • Unexplained weight loss, often rapid
  • Fatigue and general feeling of poor health

Dr. Rauch performs the following surgeries for Kidney Cancer:

  • Laparoscopic Radical Nephrectomy
  • Laparoscopic Partial Nephrectomy
  • RF Ablation of Renal Tumors

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Overactive Bladder

Overactive bladder is a problem with bladder-storage function that causes a sudden urge to urinate. The urge may be difficult to stop, and overactive bladder may lead to the involuntary loss of urine (incontinence).

If you have an overactive bladder, you may feel embarrassed, isolate yourself, or limit your work and social life. The good news is that a brief evaluation can determine whether there’s a specific cause for your overactive bladder symptoms.

Management of overactive bladder often begins with behavioral strategies, such as fluid schedules, timed voiding and bladder-holding techniques using your pelvic floor. If these initial efforts don’t help enough with your overactive bladder symptoms, second line and third line treatments are available.

You may experience the following symptoms with an overactive bladder:

  • Feel a sudden urge to urinate that’s difficult to control
  • Experience urge incontinence — the involuntary loss of urine immediately following an urgent need to urinate
  • Urinate frequently, usually eight or more times in 24 hours
  • Awaken two or more times in the night to urinate (nocturia)

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Prostate Cancer

Prostate cancer is the most common cancer in men in the United States, after skin cancer. It is the second leading cause of death from cancer in men. Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer.

Almost all prostate cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Prostate cancer often has no early symptoms. Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions.

Prostate cancer usually grows very slowly. Most men with prostate cancer are older than 65 years and do not die from the disease. Finding and treating prostate cancer before symptoms occur may not improve health or help you live longer. Talk to Dr. Rauch about your risk of prostate cancer and whether you need screening tests.

Dr. Rauch performs the following surgery for Prostate Cancer:

  • Radical Prostatectomy

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Testicular Cancer

Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis. The testicles produce male sex hormones and sperm for reproduction.

Compared with other types of cancer, testicular cancer is rare. But testicular cancer is the most common cancer in American males between the ages of 15 and 35.

Testicular cancer is highly treatable, even when cancer has spread beyond the testicle. Depending on the type and stage of testicular cancer, you may receive one of several treatments, or a combination. Regular testicular self-examinations can help identify growths early, when the chance for successful treatment of testicular cancer is highest.

Signs and symptoms of testicular cancer include:

  • A lump or enlargement in either testicle
  • A feeling of heaviness in the scrotum
  • A dull ache in the abdomen or groin
  • A sudden collection of fluid in the scrotum
  • Pain or discomfort in a testicle or the scrotum
  • Enlargement or tenderness of the breasts
  • Back pain

Cancer usually affects only one testicle.

See Dr. Rauch if you detect any pain, swelling or lumps in your testicles or groin area, especially if these signs and symptoms last longer than two weeks.

Dr. Rauch performs the following surgery for Testicular Cancer:

  • Radical Orchiectomy

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Urinary Tract Infection (UTI)

A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.

Women are at greater risk of developing a UTI than men are. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.

Doctors typically treat urinary tract infections with antibiotics.

Urinary tract infections don’t always cause signs and symptoms, but when they do they may include:

  • A strong, persistent urge to urinate
  • A burning sensation when urinating
  • Passing frequent, small amounts of urine
  • Urine that appears cloudy
  • Urine that appears red, bright pink or cola-colored — a sign of blood in the urine
  • Strong-smelling urine
  • Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone

UTIs may be overlooked or mistaken for other conditions in older adults.
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Content Resources:

http://www.mayo.edu/research/departments-divisions/department-urology/bladder-cancer?_ga=1.18112889.1568789928.1413898220

http://www.mayoclinic.org/diseases-conditions/bladder-cancer/basics/symptoms/con-20027606

http://www.urologyhealth.org/urologic-conditions/benign-prostatic-hyperplasia-(bph)

http://www.urologyhealth.org/urologic-conditions/benign-prostatic-hyperplasia-(bph)/symptoms

http://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/basics/treatment/con-20030812

http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/basics/definition/con-20034244

http://urology.ucla.edu/body.cfm?id=439

http://www.mayoclinic.org/diseases-conditions/overactive-bladder/basics/definition/con-20027632

http://www.cancer.gov/types/prostate

http://www.mayoclinic.org/diseases-conditions/testicular-cancer/basics/definition/con-20043068

http://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/basics/definition/con-20037892