Departments

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

Kidney stones, which affect about 10% of Americans, can be an agonizing condition. Kidney stone disease can develop when urine contains unusually high levels of minerals and salts. Family history, as well as certain medical conditions, such as diabetes, obesity, or bowel disease, can increase a patient’s risk of developing a kidney stone. Yale Medicine Urology is a leader in providing the highest quality care for the diagnosis, treatment, and prevention of kidney stones. Our clinicians offer minimally invasive, state-of-the-art treatments. These include laser therapy, endoscopic surgery, or the delivery of energy (“shockwaves” or lithotripsy) to break up stones. Because there is a high chance of recurrent kidney stones—up to 50%—ours is one of the few programs in the country that also focuses on stone prevention. A team of urologists, nephrologists, and nutritionists will work with each patient, recommending individualized strategies, such as healthy dietary changes, that can help keep stones from developing in the future.

A variety of diseases can affect the health of the kidneys. We care for patients at every stage of kidney disease, offering scientifically proven treatments and a personalized care plan. The Department of Urology is part of the Living Donor Transplant Program at the Yale New Haven Transplantation Center where we care for patients with renal disease who are candidates for kidney transplantation. We have expertise in performing laparoscopic, living-donor nephrectomies, delivering the highest quality care to the kidney donor-patient team at Yale. At Yale Medicine, our patients have full access to leading physicians who can help with all aspects of renal disease. Patients also have access to world-class resources at Smilow Cancer Hospital at Yale New Haven. Our doctors are at the forefront of kidney disease and kidney cancer treatment and research, including novel immunotherapy approaches and the genetic characterization of kidney cancers. In addition, the Yale School of Medicine's Hereditary Kidney Cancer and Genetic Assessment Program investigates potential genetic causes of kidney cancer in young patients, including those with a family history and individuals with multiple tumors, to help family members determine if they carry a risk for kidney cancer.

Our nationally ranked team of caregivers are experts in diagnosing and managing a broad range of acute and chronic kidney diseases, both in the inpatient and outpatient settings. We offer around-the-clock primary care to patients with established renal disease or hypertension, and our physicians are readily available for consultation on newly referred patients. Our services are comprehensive. In some cases, we consult and collaborate with other doctors and work hand-in-hand with referring providers. In other circumstances, we are principal caregivers for our patients. In nearly all instances, our care is multidisciplinary, involving other physicians and specialists, nurse practitioners, physician associates, and skilled nurses. We are committed to: Being available 24/7 to our patients and referring physicians Open communication with patients, families and referring physicians Applying new approaches to treating and diagnosing renal diseases and their complications Advocating for our patients We offer: A dedicated nephrology floor at Yale New Haven Hospital A large outpatient peritoneal dialysis practice and home hemodialysis practice Clinical trials on the cutting edge of polycystic kidney disease (PKD) that attract patients from surrounding areas and states. Weekend seminars for patients with PKD and inherited kidney disease Dedicated subspecialty services for inherited kidney diseases, hypertension, cardio-renal syndrome, onco-nephrology, and kidney disease in pregnancy Our special services include evaluating and caring for patients with: Acute kidney injury Cardiovascular dysautonomia (e.g., orthostatic hypotension) Chronic kidney disease Diabetic kidney disease Dialysis therapies Electrolyte and/or acid-base disorders Glomerular diseases/Glomerulonephritis Hypertension Inherited kidney diseases Kidney disease and hypertension in pregnancy Kidney disease in cancer Kidney disease in heart failure Kidney transplantation Nephrolithiasis Polycystic kidney disease Largest—and rapidly expanding—kidney transplant program in New England with multidisciplinary care clinics Inherited kidney disease program, with coordinated access to multidisciplinary care for extra-renal disease, advanced genetic testing, and counseling Joint nephrology/urology kidney stone program for management of complex nephrolithiasis Multidisciplinary hypertension program for advanced diagnostic evaluation and management of complex hypertension and cardiovascular dysautonomia Advanced chronic kidney disease and end-stage renal disease program Dedicated nephrology floor at Yale New Haven Hospital Clinical trials and innovative research protocols in polycystic kidney disease, acute kidney injury, diabetic kidney disease, anemia in kidney disease, and peritoneal dialysis

Bone is a living tissue. It is not simply an 'erector set' that keeps us upright; it must renew itself throughout life. Bone health at any age requires a healthy lifestyle, a balanced diet with plenty of calcium, and regular exercise. These factors are important in childhood and adolescence to achieve the strongest bones possible and for maintaining bone health in adulthood. Our goal is to help our patients build and keep healthy bones. We specialize in the prevention, treatment, and comprehensive care for adults and children with bone diseases and disturbances in the metabolism of calcium and phosphorus, a mineral that helps build bones. Our highly skilled team cares for patients through a multidisciplinary approach. Specialists and caregivers include endocrinologists, orthopaedists, physical therapists, nurses, and nutritionists. Bone Center physicians are all faculty at Yale School of Medicine with nationally recognized expertise in the diagnosis, prevention, and treatment of bone disorders. Our state-of-the-art diagnostic laboratory aids in the treatment of the most difficult disorders. Although normal levels of sex hormones are important throughout life, the decision about hormone replacement therapy is especially important during menopause in women. Hormones are not right for everyone, and other treatments to protect bones are now available. Our services include: Osteoporosis Screening: Osteoporosis, a common bone disease, is an area of particular expertise at the Bone Center. Measuring bone density is recommended to determine a patient’s risk for this condition. We offer a screening program and provide the patient’s doctor with a complete report that includes information about individual risk factors for bone loss.

Polycystic kidney disease (PKD) causes fluid-filled sacs called cysts to grow in the kidneys. The cysts can become large and cause scarring, eventually harming the organs’ function. This disease is caused by a gene mutation, usually passed down by a parent. Polycystic kidney disease is typically diagnosed using imaging studies, such as ultrasound, which will show the cysts in the kidneys. A genetic test performed on a blood or saliva sample can detect the gene mutations that cause the disease. The Yale Medicine Polycystic Kidney Disease Program, recognized as a Center of Excellence by the PKD Foundation, offers patients the opportunity to receive care from experts who can explain the nuances of inherited disorders to patients and skillfully manage the illness. Yale Medicine offers opportunities for patients with polycystic kidney disease to take part in clinical trials, which aim to help doctors better understand the disease and evaluate new treatment approaches. The experts at Yale Medicine are also at the forefront of basic research into the mechanisms underlying cyst formation. By seamlessly combining clinical expertise with research engagement, we provide patients with the best care and knowledge the PKD field has to offer.

Urologic cancers include prostate, bladder, kidney, urothelial upper tract, testicular, penile, and urethral cancer. The Smilow Cancer Hospital Prostate and Urologic Cancers Program at Yale Medicine is uniquely qualified to treat these cancers. Our program utilizes the most advanced technology and techniques available to diagnose, manage, and treat urologic cancers. We are leaders in the use of MRI/US Fusion prostate biopsy (which blends MRI and ultrasound for increased accuracy), utilizing the ExactVu and Artemis systems across the region. This technology allows us to detect the cancer early and closely monitor it. When surgery is needed, our urologists provide extensive expertise in nerve-sparing laparoscopic and robotic surgery, traditional open surgery, and novel targeted or “focal“ treatments. Our patients also benefit from the expertise of a collaborative approach to cancer care, which personalizes treatment. We engage experts who specialize in medical oncology, radiation oncology, surgical oncology, pathology, and diagnostic imaging. Patients also have access to caregivers who can help with the physical, emotional, and psychological issues related to these cancers. The extended team includes health educators, social workers, dieticians, and complementary therapists. Our goal is to ensure the highest standard of care to support our patients and their families. Imaging and Interventional Radiology Our radiologists are experts in magnetic resonance imaging (MRI), ultrasound, computed tomography (CT), and fluoroscopy, and combine their clinical expertise with advances in technology including MR-US fusion for prostate imaging, as well as positron emission tomography (PET) scans and advanced nuclear medicine scans. In addition, Blue Light™ Cystoscopy, an advanced endoscopic technology, is employed to improve bladder cancer detection and reduce risk of cancer recurrence. Surgery Our experienced urologic surgeons are committed to achieving optimal cancer outcomes, emphasizing organ preservation and the safeguarding of sexual and urinary function as much as possible. Through advanced techniques including minimally invasive and robotic surgery, our urologists are able to optimize both cancer care and surgical recovery. Cryoablation (tumor freezing) may be a good option for some patients with prostate or kidney tumors. Focal therapy is also available for appropriate patients with prostate cancer, as it is able to treat the cancer without the use of radiation or surgery, preserving the prostate, as well as urinary and sexual function. Similarly, for some patients with cancers of the ureter or upper urinary tract, a laser can be used to treat the tumor and preserve kidney function. Medical Oncology Chemotherapy is an important component of cancer care for many patients, as it can delay or prevent tumors from recurring when used before surgery. It can also help patients with advanced or metastatic disease. As a major national

Diagnosing and managing many urologic conditions, including kidney stones and prostate cancer, depend on having up-to-date imaging of the pelvic area and abdomen. Our urologic care team includes radiology experts who specialize in identifying disorders of the genitourinary tract. Highly trained radiologists and urologists work together to detect and monitor our patients’ conditions using a variety of diagnostic techniques, including magnetic resonance imaging (MRI), ultrasound, computed tomography (CT) and fluoroscopy. We believe in teamwork. Our urologists and radiologist work together to provide the care from diagnosis to monitoring and treatment of each patient’s urologic condition.

Many urologic problems can affect sexual and/or reproductive health. Urologic conditions may be common, but they should not negatively impact patients’ quality of life, confidence, or relationships. Our urologists are here to discuss patients’ concerns, find solutions that work with their lifestyle, and meet their current and future goals.

Our specialists treat a diverse range of benign (non-cancerous) urinary tract conditions, including male urinary issues (enlarged prostate, difficulty urinating, overactive bladder, urinary incontinence), female pelvic floor disorders (urinary incontinence, overactive bladder, pelvic organ prolapse), urinary tract reconstruction, and penile and scrotal reconstruction. Genitourinary tract reconstruction Our fellowship-trained specialists offer a wide range of options to address congenital or acquired issues of the urinary tract and male genital tract. We partner with patients to achieve their goals, restore urinary and sexual function, and improve quality of life. Benign prostatic hyperplasia Benign prostatic hyperplasia (BPH) is one of the most common reasons patients have bothersome voiding symptoms or difficulty with urinating. Our specialists can help get to the root cause and offer several treatments, including minimally invasive surgeries such as Urolift. We were also the first in Connecticut to offer Holmium Laser Enucleation of the Prostate (HoLEP). Neurogenic bladder We expertly treat those experiencing loss of bladder control after an injury to the nervous system. Our specialists serving those with neurogenic bladder help deliver treatments that can restore independence and make symptoms more manageable. Urogynecology / Female Pelvic Medicine and Reconstructive Surgery [FPMRS] More than 50% of women report bladder issues, such as urine leakage or overactive bladder (urinary urgency or frequent urination). Another common issue is pelvic organ prolapse, a condition in which the uterus and vagina can drop, causing a feeling of a vaginal bulge. There are nonsurgical treatments, such as pelvic floor physical therapy, as well as effective office procedures and minimally invasive surgeries that can treat many of these symptoms. Our specialists will work with our patients to develop an individualized treatment plan and get them back to their active lifestyle, restoring their quality of life.

When conditions or injuries cause damage to the bladder, urethra or penis, patients need a highly skilled microsurgeon. Ours perform delicate procedures to reconstruct the bladder so it can hold sufficient volume, remove urinary blockages caused by urinary tract infections or injuries, or straighten penial curvature from Peyronie’s disease. We offer the latest treatment options to help improve our patients’ urinary function and everyday life.

We treat women with urogynecological disorders, which arise from pelvic floor dysfunction, such as urinary and bowel incontinence, pelvic organ prolapse, interstitial cystitis, and related sexual dysfunction. These symptoms are caused by damage to the muscles of the pelvic floor. Our specialists help women understand their condition, recognize their symptoms, and match them with the treatment that best suits their comfort level and lifestyle. Many people assume pelvic floor disorders only affect a small number of elderly or disabled women, or are an unavoidable consequence of aging. However, they are actually very common—one in three adult women suffer from incontinence or prolapse—and are treatable. Our patients receive care and treatment at our Pelvic Medicine and Continence Center. The center offers a wide range of treatment options, both surgical and nonsurgical. Our doctors are active researchers working to further advance understanding of pelvic floor dysfunction. One of our primary research goals is to develop minimally invasive treatment options so that our patients are the first to benefit from these advances.