Urologic diseases affect more than 20 million men, women, and children in the United States. Yale Medicine Urology, named one of the nation’s best urology programs by U.S. News & World Report, cares for adults and children with conditions that affect the bladder, kidneys, pelvic floor, penis, testicles, and urinary tract. Some urologic conditions are present at birth, and others develop over time. Whether for a routine checkup or highly specialized care, our urologists and caregivers provide the most advanced treatment, grounded in research. Our urologists are leaders in the fields of female pelvic medicine and reconstructive surgery, as well as men’s health. Our oncology team has made key research breakthroughs in the treatment of metastatic bladder cancer and kidney cancer. In addition, we offer specialized care for kidney disease, incontinence, stone disease, sexual medicine, neurogenic bladder, transgender care, and reconstructive surgery after trauma. We use the most advanced technology and procedures to give our patients the best care available. Our urologists offer Artemis MRI-ultrasound fusion for prostate biopsy, advanced imaging, laparoscopic and daVinci Si robotic surgery, Holmium Laser Enucleation of the Prostate (HoLEP), as well as UroLift and GreenLight laser procedures. Our doctors and the hospitals where we provide care rank among the best in the country. In addition to providing treatment at Yale New Haven Hospital, Smilow Cancer Hospital, Yale New Haven Children’s Hospital, Greenwich Hospital, and Lawrence + Memorial Hospital, we also have offices located in communities across Connecticut. Above all, at Yale Medicine Urology, we believe in the importance of the patient-doctor relationship. It is the cornerstone of what we do—provide compassionate, quality urologic care to every patient, every day. A multidisciplinary team of urologists, specialty-trained nurses, caregivers, and support staff will take care of patients and their families. The urologist leads the care team, providing a diagnosis and treatment recommendations, as well as performing surgery, if needed, and overseeing the patient’s recovery and postsurgical care. The nurse coordinator is the patient’s advocate and care manager throughout care. Studies show that using nurse coordinators can reduce the length of hospital stays and enhance patient outcomes. Practice nurses provide the day-to-day care during clinical appointments or hospital stays. They administer medications, track vital signs, review general test results, respond to patients’ specific needs, and report to other members of the team. They are available around the clock to answer questions and to help patients through their care. The intake specialist helps to ensure patients are ready in advance of their appointment and have all forms and records completed and sent in advance. Intake specialists are experts at understanding the patient appointment and transfer process. If faced with a diagnosis o

Couples experiencing difficulty achieving pregnancy, despite trying for six months to a year (depending on their ages), should seek guidance from a fertility specialist. Male infertility contributes to about half of these cases. Still, numerous treatments are available that may enable men to become parents, even if they have been diagnosed with conditions such as a low sperm count. When a couple consults with a Reproductive Endocrinology & Infertility (REI) specialist, the clinician assesses the health of both partners. A comprehensive health history is obtained, and a semen sample is analyzed. Our Fertility Center employs computer-assisted semen analysis, one of the most advanced methods for evaluating semen quality. This analysis assesses sperm count, morphology (shape and structure), and sperm motility—crucial factors in fertilization. If abnormalities are detected, patients may be referred to a reproductive urologist for further evaluation and treatment. Our Fertility Center is among the few in the country to offer on-site consultations with a reproductive urologist. Poor semen quality is often the primary factor contributing to male infertility. Some patients may have insufficient sperm production or a complete absence of sperm. Others may produce enough sperm, but with abnormalities in morphology or motility. Anatomical abnormalities may also obstruct sperm passage or semen ejaculation. Following a diagnosis, our reproductive specialists collaborate with patients to enhance their chances of achieving parenthood. In cases with a reduced but sufficient number of motile sperm, intrauterine insemination (IUI) may be recommended. Here, ejaculated sperm is washed and directly injected into the uterus by a clinician. IUI is often combined with ovarian stimulation medications to increase the chance of achieving a pregnancy. If sperm quantity is insufficient for an IUI procedure, or if IUI proves unsuccessful, in vitro fertilization (IVF) may be employed to improve pregnancy success rates. A patient’s sperm is combined with their partner's egg in the IVF laboratory. Intracytoplasmic sperm injection (ICSI) is often utilized, in which a single sperm is injected directly into the egg to facilitate fertilization. Subsequently, one of the resulting embryos is transferred into the partner's uterus. For patients with complex male fertility issues, medications may be prescribed to enhance sperm production, or procedures may be performed to address physical barriers hindering sperm release. This may include repairing varicoceles , which are dilated blood vessels in the scrotum that impact sperm production. In cases of severely diminished or absent sperm, advanced sperm retrieval techniques may be necessary. Our reproductive urologists perform microsurgical procedures to locate and extract sperm from the testes, a procedure available at only select fertility centers. Extracted sperm is then used in conjunction with IVF, ensuri

The Sexuality, Intimacy, and Menopause Program is one of the only clinics of its kind in the country. By combining both medical and psychological interventions, it is designed to help women who experience sexual dysfunction after cancer. Sexual dysfunction after cancer is common; however, sexual side effects often go untreated after having successfully treated a patient’s cancer. Our doctors look to manage not only the physical issues, but also any psychological concerns that may arise. Founded by Elena Ratner, MD, MBA, associate professor of Obstetrics, Gynecology & Reproductive Sciences and co-chief for the Section of Gynecologic Oncology, and Mary Jane Minkin, MD, clinical professor of Obstetrics, Gynecology & Reproductive Sciences, the clinic began nearly a decade ago. Psychologist Dwain Fehon, PsyD, associate professor of Psychiatry and chief psychologist of Psychiatric Services at Yale New Haven Hospital, is a vital member of the team. He and his staff provide essential emotional care that helps improve our patients’ relationships and personal health. Many women have concerns related to intimacy and menopause because of cancer surgery or treatment. Our specialists consult with patients to address the difficult physical and emotional aspects of cancer care and treatment, and create a personalized care plan for each patient. We have developed a unique focus on menopause management for cancer survivors and “previvors”—healthy women who have their breasts or ovaries removed because of a genetic risk of developing cancer. What types of patients do we see? Women who experience: Changes in sexual function as a result of chemotherapy, radiation, or surgery for cancer Menopause symptoms as a side effect of cancer treatment Early menopause or sexual changes after surgery for cancer risk reduction What we provide: Menopause symptom management Resources for cancer survivors on maintaining sexual health Access to complementary and supportive services Access to individual and couples counseling What to expect from an appointment: Our team will first discuss each patient’s medical and cancer history, as well as what type of treatment they have had. They will be asked about symptoms of menopause and sexual problems, such as hot flashes, night sweats, changes in sexual desire, painful intercourse, vaginal dryness, or changes in mood or sleep patterns. Depending on their symptoms, patients may have a gynecologic exam. The team will then discuss options for symptom management and improving their sexual health. They will also have the opportunity to talk about emotional and relationship issues affecting their life. Women are welcome to bring their partners to the appointment.