Urology Division

Our advanced urology program

When you choose AHN Urology, you're choosing a team of experts dedicated to providing you with the best possible care. Our urologists have undergone extensive, specialized training, including fellowships that allowed them to focus on specific urologic conditions. This advanced training means you'll receive highly knowledgeable and skilled care tailored to your individual needs.

Urologic oncology

Urologic oncologists are surgeons who have completed specialized training in both urology and oncology (cancer care).

We offer the latest technological innovations, including da Vinci®* robotic surgery. When physicians use robotic technology during surgery, they make tiny incisions to access the affected area. A physician guides the robot’s movements, which allows for greater precision. Robotic technology also means fewer risks for you. Patients often experience less discomfort after surgery and shorter recoveries.

We use this minimally invasive approach to perform many types of urology procedures on adults, including:

• Nephrectomy (removal of the kidney)
• Partial nephrectomy
• Pyeloplasty (kidney surgery)
• Cystectomy (removal of the bladder)
• Prostatectomy (removal of the prostate)
• Sacrocolpopexy (treatment of pelvic organ prolapse)

Kidney surgeries

A kidney surgery can feel overwhelming. AHN Drs. Goutham Vemana and John Lyne have each completed more than 1,000 kidney surgeries in their careers and approach each new surgery with the same skill, attention, and dedication to excellence as the last. Your unique needs are taken into account, and your AHN care team will work with you to ensure you feel confident in your surgical plan. AHN offers different kidney surgery techniques so patient needs are met. These include:

• Laparoscopic radical nephrectomy: A minimally invasive surgery to remove the entire kidney and often surrounding tissue using a laparoscope (a thin telescope with a camera) and small incisions in the abdomen.
• Robotic radical nephrectomy: Similar to laparoscopic radical nephrectomy, but the surgeon uses a robotic system to control the surgical instruments with enhanced precision and range of motion.
• Robotic partial nephrectomy (multiport and single port, transperitoneal and retroperitoneal):  This is minimally invasive surgery to remove only the tumor and a margin of healthy tissue from the kidney, preserving the rest of the organ. It's done using a robotic system with either multiple small incisions (multiport) or a single incision (single port) in the abdomen. The transperitoneal approach means the surgery is performed through the abdominal cavity.
• Single port partial nephrectomy: AHN offers this procedure when many other providers do not. This procedure is the same as the robotic partial nephrectomy, but is performed through a single incision in the belly button, offering a potentially more cosmetically appealing result.
• Multidisciplinary surgery for advanced kidney cancer: When kidney cancer is advanced and complex, a team of specialists, including urologic oncologists, medical oncologists, and possibly other surgeons, collaborate to develop and execute a comprehensive treatment plan. This may involve a combination of surgery, chemotherapy, radiation, and other therapies.
• Robotic nephroureterectomy: A minimally invasive procedure using a robotic system to remove the entire kidney, ureter (the tube that carries urine from the kidney to the bladder), and a portion of the bladder cuff. This surgery is often performed for tumors in the ureter or renal pelvis (where urine collects in the kidney).
• Laparoscopic nephroureterectomy: Similar to robotic nephroureterectomy, this procedure removes the kidney, ureter, and part of the bladder using a laparoscope and small incisions in the abdomen.

Prostate surgeries

Prostate surgeries at AHN encompass a wide array of options that range from minimally invasive surgeries to precise biopsies that spare healthy tissue. Learn more about prostate cancer and treatment options.

• Robotic prostatectomy: A minimally invasive surgery using a robotic system to remove the entire prostate gland and often some surrounding tissues, usually to treat prostate cancer. The surgeon controls the robotic arms through small incisions in the abdomen.
• Focal therapy for prostate cancer: AHN is the only provider offering this unique treatment in Western Pennsylvania. This approach targets only the area of the prostate where the cancer is located, sparing healthy tissue. Various energy sources like high-intensity focused ultrasound (HIFU) or laser ablation can be used. It aims to reduce side effects compared to removing or treating the whole prostate.
• Transperineal prostate biopsies: A procedure to collect tissue samples from the prostate to diagnose prostate cancer. A needle is inserted through the skin between the scrotum and anus (perineum) and guided into the prostate using ultrasound imaging.
• MRI fusion biopsies for prostate cancer: A more precise biopsy technique that combines MRI imaging with real-time ultrasound. The MRI helps to identify suspicious areas, and the ultrasound guides the biopsy needle, improving the accuracy of targeting cancerous tissue. 

Adrenal surgeries 

Adrenal surgery aims to restore hormone balance and alleviate symptoms caused by the adrenal issue. At AHN, we design a specific approach to surgery that depends on the size and nature of the adrenal problem for both benign and cancerous adrenal conditions. Your options may include:

• Laparoscopic adrenal surgery
  • Transperitoneal: A minimally invasive procedure to remove one or both adrenal glands. Surgeons operate through small incisions in the abdomen, entering the peritoneal cavity (where the intestines are located) to reach the adrenal glands.
  • Retroperitoneal: Similar to the transperitoneal approach, but surgeons access the adrenal glands through the back, without entering the peritoneal cavity. This method may be preferable for certain patients and tumor locations.
• Robotic adrenal surgery
  • Transperitoneal: Uses a robotic surgical system to remove one or both adrenal glands. Surgeons control robotic arms with instruments and a camera inserted through small incisions in the abdomen, entering the peritoneal cavity to access the adrenal glands. The system provides enhanced visualization, dexterity, and precision.
  • Retroperitoneal: Similar to the robotic transperitoneal approach, but the robotic arms are inserted through incisions in the back, providing access to the adrenal glands without entering the peritoneal cavity. This may be preferred for specific cases based on tumor characteristics and patient factors.

Bladder surgeries

A bladder surgery at AHN aims to support your unique bladder needs. Whether you are facing bladder cancer or another condition, your AHN care team will tailor the treatment to your specific needs. Learn more about bladder cancer and treatment options.

• Robotic cystectomy: This minimally invasive procedure uses a robotic surgical system to remove the urinary bladder. Surgeons control robotic arms with instruments and a camera inserted through small incisions in the abdomen. Robotic cystectomy allows for precise removal of the bladder and surrounding tissues, often with faster recovery times compared to open surgery.
• Intravesical therapy: This treatment option for bladder cancer where medication is delivered directly into the bladder, rather than through the bloodstream. This allows for a concentrated effect on the bladder lining, where most bladder cancers originate, with fewer side effects compared to systemic therapies. AHN now offers multiple offices for this procedure so you can stay close to home.
• Robotic ureteral reimplantation: For adults, this procedure is most commonly used to treat ureteral stricture disease or repair injuries to the ureter. Reimplants for reflux are primarily performed in kids.
• Complex robotic ureteral reconstructions: These challenging surgical procedures performed using robotic assistance to repair or reconstruct the ureters, the tubes that connect the kidneys to the bladder. These procedures address complex urological conditions affecting the ureters, aiming to restore proper urine flow and preserve kidney function.

Testicular surgeries

AHN takes great care in testicular surgeries, employing the latest in technological advancements to ensure patients’ lives experience the least disruption possible. Learn more about testicular cancer and treatment options.

• Testicular cancer surgery: This is a general term referring to any surgical procedure performed to diagnose or treat testicular cancer. The most common surgery is a radical inguinal orchiectomy.
• Radical inguinal orchiectomy: This is the standard surgical procedure to remove a testicle suspected of having cancer. The surgeon makes an incision in the groin, removing the entire testicle through the opening.
• Retroperitoneal lymph node dissection (RPLND): This is a more complex surgery to remove lymph nodes in the retroperitoneum (the area at the back of the abdomen). This is done when there's a risk or evidence of cancer spreading to these lymph nodes.

Penile surgeries

A penile surgery may feel daunting, but AHN is here to support your care through using various surgical procedures and techniques. Depending on your specific needs, your options may include:

• Penile cancer surgery: A general term encompassing various surgical procedures aimed at removing cancerous tissue from the penis. The specific type of surgery depends on the stage and location of the cancer.
• Partial penectomy: A surgical procedure where only the part of the penis containing the tumor is removed. This option is typically considered for smaller, localized tumors in the early stages.
• Radical penectomy: A more extensive surgical procedure involving removing the entire penis and often the surrounding tissues, including lymph nodes. This is typically performed for larger tumors or cancers that have spread beyond the superficial layers of the penis.
• Inguinal lymph node dissection: This surgery involves removing lymph nodes from the groin area. It is often performed in conjunction with penile cancer surgery to check if cancer has spread to these lymph nodes and to help prevent its further spread.

High-intensity focused ultrasound (HIFU)

HIFU uses focused ultrasound waves to heat and destroy cancer cells. Learn more about high-intensity focused ultrasound procedures.

Cryotherapy (cryoablation)

This minimally invasive procedure is also known as cryotherapy. We use a transrectal ultrasound to guide hollow needles into your prostate. We pass cold gas through the needles to freeze and destroy the prostate cancer without damaging nearby tissue. This is often a same-day procedure, with less recovery time and pain than traditional surgery.

Focal laser ablation

Focal laser ablation is a minimally invasive treatment that uses laser energy to precisely target and destroy small, localized areas of diseased tissue. Using a pinpoint laser beam, only the problem area —like cancerous tissue — is treated, leaving the surrounding healthy tissue untouched. 

Female pelvic reconstruction

Our female pelvic medicine and reconstructive specialists specialize in fixing problems with the organs in a woman's pelvis, like the bladder, uterus, and vagina. They often help women who have trouble holding their urine or whose organs have shifted out of place.

Problems we treat include:

• Chronic pelvic pain syndrome: A persistent or recurring pain in the lower abdomen and pelvic region lasting for six months or longer. This could be musculoskeletal or nerve problems, prior infections, endometriosis, or issues in other areas.
• Painful bladder syndrome (Interstitial Cystitis): This is a chronic condition causing bladder pain and frequent urination.
• Complications from previous surgeries: Issues arising from previous pelvic surgeries, including mesh complications.
• After cancer treatment: Operations for pelvic cancers may involve removing part or all of the vagina, requiring reconstruction to restore function and appearance.
• Trauma or injury: Severe injuries to the pelvic region, such as those sustained during childbirth or accidents, can damage the vagina and require reconstructive surgery.
• Congenital anomalies: Some women are born with vaginal or uterine malformations, such as vaginal agenesis (absence of the vagina) or a septate vagina (a wall of tissue dividing the vagina). These conditions can cause pain, difficulty with intercourse, or problems with menstruation and fertility.
• Urinary incontinence: This refers to leakage of urine, which can happen when sneezing or coughing (stress incontinence), or from a sudden urge to urinate (urge incontinence).
• Fistulas: These are abnormal connections that form between the vagina and other pelvic organs, such as the bladder (vesicovaginal fistula) or rectum (rectovaginal fistula), causing leakage.

With a focus on female pelvic reconstruction, we provide the expertise to pinpoint the cause of your issues and create the best plan for your condition. Treatment options may include complex vaginal reconstructive surgery or robotic hysterectomy. You may be referred from one of your physicians for female pelvic reconstruction or for a second opinion on complications from other treatments.

Andrology and infertility

We have doctors focused on men's reproductive health. The AHN Center for Men's Health and Genitourinary Reconstruction focuses on helping those assigned male at birth and men who have problems fathering children, low testosterone, or other issues related to their reproductive organs including:

• Low testosterone (hypogonadism): Diagnosing and managing low testosterone levels through lifestyle changes, medications, or hormone replacement therapy.
• Erectile dysfunction (ED): Identifying causes of ED and recommending treatments, including medications, lifestyle changes, or penile implants.
• Prostatitis: Treating inflammation of the prostate gland, which can cause pain, urinary problems, and sexual difficulties.
• Male contraception: We offer counseling on male contraception options and procedures like vasectomies or reversing vasectomy procedures.

Our andrology and infertility specialist focuses on issues with infertility. They conduct thorough evaluations to determine factors contributing to infertility, which might include:

• Semen analysis: Examining sperm count, motility (movement), and morphology (shape).
• Hormonal testing: Checking levels of testosterone and other hormones involved in reproduction.
• Genetic testing: Identifying genetic conditions that can affect fertility.
• Physical examinations: Assessing the reproductive system for abnormalities.
• Imaging tests: Utilizing ultrasound or other imaging to visualize reproductive organs.
• Cross-collaboration: Working closely with other specialties focused on women’s fertility health to diagnose the root of the infertility problem.

Reconstructive urology

Reconstructive urology focuses on surgical procedures to repair and rebuild structures within the urinary tract and male reproductive system. It addresses both congenital (present at birth) and acquired (developed later in life) conditions. Reconstructive urology aims to improve urinary or reproductive function, restore anatomical normalcy, and enhance quality of life for patients.

Reconstructive urologists specialize in surgery on the urinary tract (kidneys, ureters, bladder, urethra) for both men and women including:

• Urethral strictures: Narrowing of the urethra, often due to scar tissue, infection, or injury, leading to difficulty urinating.
• Urethral injuries: Trauma to the urethra from accidents, falls, or medical procedures.
• Bladder injuries: Damage to the bladder from trauma, surgery, or radiation.
• Urinary fistulas: Abnormal connections between the urinary tract and other organs, like the vagina or rectum, causing leakage.
• Pelvic organ prolapse: Weakening of pelvic muscles leading to organs (bladder, uterus, rectum) pressing against the vaginal wall.
• Urinary incontinence: Loss of bladder control, treated with various procedures depending on the type and cause.

Reconstructive urologists also work on the male reproductive system including issues with:

• Hypospadias: A birth defect where the urethra doesn't open at the tip of the penis.
• Epispadias: A rare birth defect where the urethra opens on the top or side of the penis.
• Peyronie's disease: Curvature of the penis caused by scar tissue, often leading to painful erections.
• Erectile dysfunction: Difficulty achieving or maintaining an erection, sometimes addressed with reconstructive surgery like penile implants.
• Genital reconstruction: Rebuilding or repairing genitalia after cancer surgery, trauma, or gender-affirming procedures.

AHN Urologists

The AHN team of urologists are highly skilled, compassionate providers who undergo rigorous training that enables them to provide innovative treatments and procedures. Many of our urologists have also completed additional fellowships, so they can focus on specific sub sections of urology.

Urology oncology

New staff doing oncology procedures

How to get care

We are here to help you in your urologic needs. We offer multiple ways to schedule with AHN urologist:

• Find an AHN urologist near you.
• Schedule online with AHN urology.
• Call one of our urology practices.

If you are coming from an outside hospital, it is helpful to have the most recent records, including imaging, so we can determine the most accurate care plan. These could come from your previous doctor, or you can bring copies whether on a hard drive, CD, or PowerShare.

You can expect to have a conversation about what your care has included and what may be the next best course of action.

AHN urology practices

Our urology practices can be found throughout Western Pennsylvania, so you can find expert care closer to home.

St. Vincent Hospital locations

Refer your patient to an AHN specialist