Patient Education

Pioneer Valley Urology, P.C. would like to be your partner in health care. Feel free to ask your questions and share your concerns with us. We will work with you to develop a wellness program for the care and treatment you need.

We welcome you to our practice and look forward to caring for you.

Pioneer Valley Urology, P.C. provides a full range of medical and surgical services to address your urological condition, including those listed below:

 

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia, also known as BPH, is an enlarged prostate that commonly causes urinary problems in men aged 50 years and older. It is a common condition that occurs as men age, causing the gland to press against the urethra and cause problems with urination. BPH may also be due to an excess of certain hormones in the body. ...


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Benign Prostatic Hyperplasia Treatment

Benign Prostatic Hyperplasia, also known as BPH, is an enlarged prostate that commonly causes urinary problems in men over the age of 50. It is a common condition that occurs as men age, causing the gland to press against the urethra and cause problems with urination. ...


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Benign Urethral Lesions

The urethra is the tube that carries urine from the bladder to outside the body. Benign urethral lesions can develop in or around the urethra, causing bleeding or painful urination, or blocking the urinary tract. When lesions do block the flow of urine, they can cause infection. Some urethral lesions respond to conservative treatments, whereas others must be treated surgically. Men and women of all ages can be affected. ...


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Bladder Cancer

Bladder cancer is a disease that affects the bladder, the organ that stores urine. The most common type of cancer develops in the cells on the inner lining of the bladder wall. If the cancer spreads through the lining, it is considered an invasive cancer. The majority of cases of bladder cancer are diagnosed at an early stage when they are highly treatable. ...


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Bladder Prolapse

Bladder prolapse, also known as cystocele, is a common condition in women that involves a stretching or weakening of the pelvic floor muscles that support the bladder. Once this occurs, the bladder gradually sags into the vagina and may even protrude through its opening, causing urinary problems. Normally, in women, the bladder is held in position by supportive pelvic floor muscles and ligaments. When the muscles and tissues are stretched and weakened, the bladder can sag through the ligaments and into the vagina, resulting in bladder prolapse. ...


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BOTOX® Treatment for Overactive Bladder

Overactive bladder causes a sudden and frequent urge to urinate, which may be accompanied by urine leakage. It is caused by the bladder muscles' contracting at inappropriate times, regardless of how much urine the bladder contains. Overactive bladder is a common condition; it is estimated to affect more than 30 million adults in the United States. It can develop in anyone, at any age, although it is most frequently affects women and the elderly. ...


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Colporrhaphy

Colporrhaphy, also known as vaginal wall repair, is a surgical procedure performed to correct defects in the vaginal wall, or pelvic-organ prolapse, including cystoceles and rectoceles. The colporrhaphy procedure aims to effectively restore prolapsed organs back to their normal position and relieve symptoms such as urinary incontinence and pelvic pain. ...


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Cystectomy

Cystectomy is a surgical procedure that removes all or part of the bladder. It is performed to treat cases of bladder cancer that have not responded to more conservative forms of treatment and have spread to the bladder wall.

The Cystectomy Procedure

Invasive bladder cancer may require all or part of the bladder to be removed. The different types of cystectomy include: ...


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Cystitis

Cystitis is an inflammation of the bladder typically caused by a bacterial urinary tract infection (UTI). This disorder most often occurs in women because their anatomy includes a short urethra in close proximity to the anus. Bacteria found can too easily make their way into the urethra with incomplete genital hygiene or during sexual activity. Bacterial cystitis can usually be treated effectively with antibiotics, but, left untreated, can lead to kidney disease. Cystitis may also result from certain medications, allergies, or underlying disease conditions. ...


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Cystoscopy

A cystoscopy is a procedure used to examine the inside of the bladder and urethra with a tube known as a cystoscope. The cystoscope, which is inserted into the urethra during the test and carefully advanced into the bladder, is equipped with a special light and lens to assist the urologist in an accurate visualization. While minimally invasive, the cystoscopy enables the urologist to see the targeted area with much greater clarity than other commonly used diagnostic imaging techniques, such as X-rays. ...


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Ectopic Kidney

An ectopic kidney, also known as renal ectopia, is a congenital condition in which a kidney is not located in its normal position and is situated in an unusual position within the body. This condition is not common, only occurring in approximately one out of every 1,000 births. The function of the kidney is usually normal but because of its location and its proximity to other organs, it may have difficulty draining. While most individuals with an ectopic kidney have no problems, others may experience kidney failure, urinary stones, urinary tract infections, or other potentially serious complications. ...


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Epididymitis

Epididymitis is an inflammation of the epididymis, the tube behind the testicle responsible for storing and carrying sperm. Epididymitis is generally characterized by pain, swelling and tenderness in the scrotum. Epididymitis most commonly affects men in their 20s or 30s, although it can occur in males of any age. ...


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Erectile Dysfunction

Erectile dysfunction (ED) refers to the consistent inability to achieve or maintain an erection. For an erection to occur, a specific sequence of event needs to take place, allowing blood to enter the penis while restricting the outflow of blood. The pressure created by this "trapped" blood is what maintains an erection. If there is a consistent breakdown in any steps in the sequence, erectile dysfunction is the result. Erectile dysfunction may occur at any age, however, the occurrence of ED is increasingly common as a man ages. However, it should not be considered a natural part of aging. ...


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Hematuria

Hematuria is the presence of red blood cells in the urine. When blood is visible in the urine, it is called gross hematuria. Microscopic hematuria is visible only under a microscope and is most often discovered as part of a routine medical exam.

Causes of Hematuria

Bleeding can occur at any location along the urinary tract. This includes the kidneys, ureter, bladder, urethra and the prostate in men. While blood in the urine is not always the sign of a serious disease or condition, it may be an indication of any of the following conditions: ...


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Hydrocele

A hydrocele is a fluid-filled sac surrounding the testicle that results in swelling in the scrotum or groin. Common in newborns, in whom it usually disappears during the first year, it can also develop in older boys or men as a result of inflammation or injury. Between 1 and 2 percent of male infants have this problem and babies born prematurely are at increased risk. In men, hydroceles most often develop when patients are older than 40 years of age. Risk factors for hydrocele in adults include scrotal injury and infections, including sexually transmitted ones. ...


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Hydronephrosis

Hydronephrosis is a swelling in the kidney usually due to a blockage that prevents urine from flowing into the bladder. The blockage typically occurs in the upper section of the urinary tract as a result of an abnormal narrowing of the ureter. Complications from hydronephrosis may include decreased kidney function. Hydronephrosis is much more common in males than in females. ...


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Infertility Evaluation

An infertility evaluation is performed to determine the source of a couples inability to become pregnant. Such an evaluation is typically performed when a couple has been having difficulty conceiving a child for an extended period of time, usually a year, even though they regularly engage in unprotected sexual intercourse. Diagnostic tests are used to detect any conditions or abnormalities that may interfere with the ability of one or both partners to conceive offspring. ...


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InterStim® Therapy

InterStim® therapy involves the implantation of device to treat problems with urination. Urge incontinence, commonly known as overactive bladder, is a common condition that occurs when an individual experiences sudden, compelling urges to urinate, frequent urination, or urinary incontinence. These symptoms occur because the bladder muscles that control the release of urine contract at inappropriate times. The same neurological problem may also lead to urine retention. InterStim therapy stimulates the affected nerves with electrical impulses (neurostimulation) in order to overcome bladder issues. It is used when other methods of bladder control have been ineffective. ...


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Interstitial Cystitis

Interstitial cystitis is a chronic inflammation or irritation of the bladder and the surrounding pelvic area. People who are diagnosed with interstitial cystitis may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Also known as painful bladder syndrome, interstitial cystitis most commonly affects women. ...


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Kidney Cancer

Kidney cancer is characterized by a tumor that begins in the kidneys, the bean-shaped organs that help remove excess water and waste from the body through urine. Cancer that originates in the kidneys is common, with more than 60,000 people in the United States diagnosed with it each year.

Types of Kidney Cancer

There are several different types, classified by where they originate, of kidney cancer. The most common is renal-cell carcinoma, which begins in the small tubes found in the kidney. Typically beginning as a single mass, it can usually be identified before it spreads to other areas. ...


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Kidney Stones

A kidney stone, also known as renal calculi or nephrolithiasis, is a hardened mass of mineral and acid salts that separates from the urine and travels through the urinary tract. The urine normally dilutes and dissolves these substances, but when the composition of urine is unbalanced, crystallized stones can form. Kidney stones are a common but painful urinary-tract disorder; men are more likely than women to get them. Kidney stones can cause severe pain, but usually do not cause any permanent damage to the urinary tract or body. ...


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LeFort Colpocleisis

LeFort colpocleisis is a procedure to treat pelvic organ prolapse by narrowing and shortening the vagina. While the LeFort colpocleisis procedure is minimally invasive and low risk, it results in a surgically closed vagina, which prevents sexual intercourse.

Pelvic organ prolapse is a common condition in women that involves a pelvic organ such as the bladder, uterus or rectum, moving from its normal position to push against the vaginal walls, causing pressure, stretching and pain. Treatment for this condition may vary depending on the location and severity of the prolapsed organ. Patients with mild symptoms can often treat their condition conservatively by losing weight and through kegel exercises that strengthen the pelvic muscles. Cases of pelvic prolapse that do not respond to home treatments may require the insertion of a pessary, a small device inserted into the vagina to relieve pain and pressure and hold the organs in place. More severe cases may benefit from surgery to repair damaged tissue, close the vagina or remove the uterus. ...


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Low Testosterone in Men

Low testosterone, a form of hypogonadism, occurs when the body fails to produce an adequate supply of this hormone. This condition is more prevalent as men age, occurring in about 20 percent of men age 60 and older and increasing to as much as 50 percent in men age 80 and older. While testosterone is thought of as the male hormone, it is necessary for female functioning as well, and women may also suffer from low testosterone. ...


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Male Infertility

Approximately 15 percent of couples trying to conceive a child have infertility issues. In about one-third of these cases, male infertility, which may be due to a number of factors, is the sole cause of the problem. When a couple has trouble becoming pregnant, both partners have to be evaluated to determine where the problem is. In many situations, a combination of factors may be responsible for the difficulty. ...


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Nephrectomy

A nephrectomy is a surgical procedure to remove part or all of a kidney. Depending on the reason it is required, a nephrectomy involves removing only the damaged or diseased part of one kidney; all of one kidney; or the entire kidney, along with the surrounding adrenal gland and lymph nodes. All nephrectomies are performed under general anesthesia. ...


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Neurogenic Bladder

Neurogenic bladder is a condition characterized by the loss of bladder function, which prevents people from effectively emptying the bladder. Normal bladder function involves a complex communication system between nerves and muscles that work together to tighten or release the bladder muscles and allow urine to be released. Neurogenic bladder is often the result of problems with nerves in the body that control how the bladder stores or empties urine. ...


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Nocturia

Nocturia is a urinary condition that involves waking during the night because of an urge to urinate. This condition occurs as a result of excess urine production or low bladder capacity. Nocturia causes patients to wake frequently and may interfere with the ability to get a decent night of sleep. ...


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Overactive Bladder

Overactive bladder (OAB), or urge incontinence, occurs when a person experiences a sudden and frequent urge to urinate that may also be accompanied by urine leakage. This often occurs because the bladder muscles contract at inappropriate times, regardless of how much urine has collected in the bladder. This may be caused by various underlying conditions or certain medications. It can happen to anyone at any age, although it seems to be most common in women and the elderly. ...


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Pediatric Urology

Pediatric urology is the diagnosis and treatment of a wide range of urological and genital conditions that affect children, both male and female. The discipline concerns itself with conditions that affect the genitals or the organs of the urinary tract (kidneys, ureters, bladder). Some of these are congenital abnormalities or disorders, while others may arise throughout childhood or adolescence. ...


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Pelvic Organ Prolapse

Pelvic organ prolapse (vaginal prolapse) is a common condition in women, occurring when a pelvic organ shifts from its normal position to push against the vaginal walls. This movement causes pressure, stretching and pain. Most frequently, pelvic organ prolapse occurs after childbirth, menopause, or a hysterectomy when the muscles and ligaments supporting a woman's pelvic organs become more lax. ...


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Percutaneous Nephrostomy

Percutaneous nephrostomy is performed to drain urine from a kidney. It is usually performed when a ureter is blocked, and urine cannot leave the kidney as it normally does. A percutaneous nephrostomy allows the kidney to function properly, and protects it from further damage. It also helps to clear up infection. ...


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Peyronie's Disease

Peyronie's disease is characterized by the formation of a rigid, fibrous plaque under the skin of the penis, potentially altering the shape and firmness of an erection. This condition can have physical and psychological effects and lead to complications including painful erections and impotency. Peyronie's disease may occur at any age, but most frequently in men over the age of 40. Although uncommon, it is possible for younger men to develop the disease. ...


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Polycystic Kidney Disease

Polycystic kidney disease, also known as PKD, is a genetic disorder that involves the development of cysts within and around the kidneys. A cyst is a non cancerous, fluid-filled sac that can vary in size and sometimes grow extremely large. When these cysts form, the kidneys fill with fluid and may become enlarged, resulting in decreased kidney function and in extreme cases, kidney failure. ...


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Premature Ejaculation

A common sexual issue among men, premature ejaculation takes place when a man reaches orgasm too quickly. The man does not have voluntary control of the timing of his ejaculation and it may occur with very little stimulation. When this happens on a regular basis, it often results in both the man and his partner feeling unfulfilled. The timing of the premature ejaculation varies from person to person as well as by circumstances. Some men experience an orgasm before intercourse even begins, while for others it may occur immediately after vaginal penetration. ...


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Prostate Cancer

Prostate cancer is one of the most common types of cancer in men. It affects the prostate, the gland located under the bladder and in front of the rectum that, among other functions, helps produce semen, and allows sperm to move effectively. Although prostate cancer can be life-threatening, it often spreads slowly and requires minimal treatment. When confined to the prostate gland, it can usually be treated effectively, making early detection crucial. ...


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Pubovaginal Sling

A pubovaginal sling is a synthetic hammock-like device that is wrapped underneath the urethra to stop urine leakage. Women who suffer from urinary incontinence and cannot be effectively treated through exercise and medications may consider a pubovaginal sling. This procedure is used to support a weak pelvic floor and urethral sphincter muscles. ...


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Radical Prostatectomy

Prostate cancer is one of the most common types of cancer in men. This disease affects the prostate, the gland located under the bladder and in front of the rectum. This gland helps produce semen and allows for sperm to move more effectively, along with several other functions. The cancer cells develop in the prostate and invade the healthy tissues and multiply at a rate much faster than regular cells. When confined to the prostate gland, this disease can usually be treated effectively, making early detection crucial for handling prostate cancer. ...


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Robotic Urologic Surgery

Surgery is often used to treat a variety of conditions affecting the organs of the male reproductive system and urinary tract. Given the sensitive nature of this area, many men are apprehensive about undergoing major surgery to treat their condition. Traditional urologic surgery requires large incisions to access the pelvic organs and may cause severe pain and long recovery times. There may also be long-term effects on continence and sexual function. Robotic urologic surgery can help ease common concerns by providing a safer, less invasive alternative to traditional surgery. ...


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Spermatocele

A spermatocele, also known as a spermatic cyst, is a benign growth that develops on the epididymis, the coiled tube located on the upper side of the testicle in which sperm is stored. Most spermatoceles are small and contain a milky fluid that may or may not contain sperm. Although usually harmless, they may sometimes enlarge and cause pain, in which case they may require treatment. ...


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Stress Incontinence

Stress incontinence is a common condition involving an involuntary loss of urine that occurs when a physical movement places pressure or stress on the bladder. Patients with this condition may experience a leakage of urine while coughing, sneezing, laughing, jogging or lifting something heavy. This condition usually occurs as a result of weakened sphincter and pelvic muscles that cannot adequately support the bladder or urethra. ...


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Surgical Mesh

Surgical mesh is a synthetic, permanent material made from polypropylene. It is stronger than the body's natural tissue and is frequently used to repair weakened tissue. The insertion of surgical mesh is a minimally invasive treatment for pelvic prolapse that effectively relieves pain and pressure in the pelvic area by placing a piece of soft synthetic mesh in the affected area to restore organ support. As a result of this procedure, patients can engage in their everyday activities without the discomfort and inconvenience of prolapse symptoms. Surgical mesh has been used in the past to strengthen abdominal hernia repairs. More recently, doctors are using mesh products to repair pelvic organ prolapse (POP) and as a surgical treatment of stress urinary incontinence. ...


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Testicular Cancer

Testicular cancer is the growth of malignant cells in the testicle. It can occur at any age, but most frequently strikes men between 15 and 35 years of age. Typically, only one testicle is affected. With an early diagnosis, testicular cancer is highly treatable, but, left untreated, it can metastasize and become fatal. ...


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Ureteropelvic Junction Obstruction

Ureteropelvic junction obstruction (UPJ), is a blockage in the area that joins the renal pelvis to the ureters, which are responsible for sending urine into the bladder. A UPJ obstruction causes the kidneys to produce urine at a rate that exceeds the amount that is able to drain effectively causing urine to accumulate in the kidney. Left untreated, the build-up of urine in the kidneys may lead to infection, kidney stones, damage to the kidneys or kidney failure. ...


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Urethral Stricture

A urethral stricture is a narrowing of the urethra, usually due to injury, infection or inflammation. The urethra is the tube responsible for carrying urine out of the bladder. The narrowing of the urethra can severely restrict the flow of urine from the bladder, blocking it completely in some cases. Urethral stricture occurs more commonly in men, as they have a longer urethra than women. ...


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Urinalysis

Urinalysis is a test performed to analyze a patient's urine in order to assess overall health and to detect any possible disease conditions. It is normally administered in the doctor's office as part of comprehensive medical examination and may also be administered to diagnose the cause of a patient's symptoms. ...


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Urinary Incontinence

Urinary incontinence (UI) is the loss of bladder control. It is a common condition that involves the involuntary loss of urine. It may range in severity from occasionally leaking urine to a sudden urge to urinate that comes on very strongly. Although it is not usually a serious condition, UI can be embarrassing and affect a person's daily life. Urinary incontinence is most common in women, especially during and after pregnancy. It can, however, affect people of all ages. Being overweight or elderly may also increase the risk of urinary incontinence. ...


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Urinary Tract Infection

A urinary tract infection (UTI) is a common infection of the urinary system, which includes the kidneys, ureters, bladder and urethra. The urinary tract refers to just the bladder and the urethra, and an infection can develop in either of these areas. These infections occur much more frequently in women than in men and may cause intense pain and discomfort. ...


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Urodynamic Testing

Urodynamic testing is a series of urological tests that may be performed to diagnose urinary problems. A physician may recommend urodynamic testing to investigate the cause of any urinary difficulties and assess the function of the bladder and its ability to store and empty urine. Urinary problems such as incontinence or an overactive bladder may be the result of several different conditions, including bladder infections, urethra or sphincter problems, enlarged prostate, nervous system malfunctions, or the side effects of medication. ...


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Uroflowmetry

A uroflowmetry is a diagnostic test to measure the flow of urine released as well as the amount of time it takes to completely empty the bladder during urination. This test may be recommended for patients who are experiencing problems with urinary flow.

Preparing for the Uroflowmetry

This test provides the most accurate results when performed on a full bladder, so patients are advised to refrain from urinating for two hours before the test and to drink plenty of fluids in preparation. Patients are also advised to notify their doctor of all medications they are currently taking, as some of them may have to be stopped temporarily before the uroflowmetry. ...


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Uterosacral Ligament Suspension

Uterosacral ligament suspension is a procedure that is designed to restore support to the uterus and the vaginal vault, or the top of the vagina. Uterosacral ligament suspension is a minimally invasive surgical treatment for uterine or vaginal prolapse, that surgically lifts up the top of the vagina and holds it in place. ...


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Vaginal Fistulas

A fistula is an abnormal passageway between two organs within the body or between an organ and the skin. Fistulas can develop in various parts of the body, typically as a result of tissue damage caused by surgery, trauma or disease. Gradual erosion eventually causes the tissue to wear through, causing the fistula. Vaginal fistulas may occur after childbirth, surgery in the region, radiation treatment, or inflammatory bowel disease. ...


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Varicocele

A varicocele is an enlargement of the veins within the scrotum. Varicoceles are similar to varicose veins in the legs and form for similar reasons. The valves inside the veins become weak and ineffective, enabling a backflow of blood. Varicoceles are common, occurring in about 15 to 20 percent of all males. Almost all varicoceles affect the left testicle. Many varicoceles cause no symptoms, but they may result in discomfort and are a major, though reparable, cause of infertility. When and if varicoceles become troublesome, they can be corrected surgically. ...


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Vasectomy

Vasectomy is the most effective form of permanent contraception for men. A vasectomy is a minor surgical procedure that stops the flow of sperm between the testicle and the urethra by blocking the vasa deferentia, the tube-like structure that carries sperm to the testicle and through the urethra to the ejaculatory duct. ...


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Vasectomy Reversal

A vasectomy is a minor surgical procedure that stops the flow of sperm between the testicle and the urethra by blocking the vasa deferentia, the tube-like structure that carries sperm to the testicle and through the urethra to the ejaculatory duct. A vasectomy is performed as a permanent means of birth control. However, in some cases, due to personal reasons or changes in circumstances in a man's life, he may wish to have the vasectomy reversed. In rare cases, a vasectomy reversal may be performed to treat testicular pain that has developed as a result of the initial vasectomy procedure. ...


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Our Urologists

Kevin Asher, MD

Kevin Asher, M.D. graduated from Towson University and Columbia University Medical School. He completed his residency in Urology at Boston University and has completed a fellowship in Urologic Oncology at the Nati

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Aaron Berkenwald, M.D.

Dr. Berkenwald received his medical degree from the University of Massachusetts Medical School, and he completed his surgical and urological residency at Lahey Medical Center. He graduated summa cum laude from Nor

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Stephen Gallo, MD

Dr. Gallo received his BA Degree from Johns Hopkins University and his medical degree from New York Medical College. He completed his training in urology at New York Medical College. Dr. Gallo is the Chief of Urol

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Andrew Kim, MD

Dr. Kim received his medical degree from University of Maryland School of Medicine, and he completed his surgical and urological residency at University of Maryland Medical Center. He earned his BS degree in Mecha

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Joshua Pagar, MD

Dr. Pagar received his medical degree from St. Louis University School of Medicine, and completed his surgical and urological residency at University of Missouri Hospital and Clinics, Columbia, MO. He earned his M

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Joseph Sarcona, MD

Dr. Sarcona received his medical degree from New York Medical College, Valhalla, NY, and he completed his surgical and urological residency at Lenox Hill Hospital, New York, NY. He earned his BS degree in Neurosci

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Jonathan Starkman, MD

Dr. Starkman received his bachelor of science degree in molecular biology, from the University of Michigan and his medical degree from Wayne State University School of Medicine, Detroit, MI. He completed his train

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William Swanson, MD, MBA

Dr. Swanson received his bachelor of arts degree, with honors and in biology, from the University of Massachusetts, Boston, Massachusetts. He received his medical degree from Albany Medical College in 1995, where

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Michael Zavaski, MD

Dr. Zavaski received his medical degree from University of Connecticut School of Medicine, and he completed his surgical and urological residency at Harvard Program in Urology- Brigham and Women's Hospital in Bost

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