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Specialty Services

Sexual Dysfunction

Sexual dysfunction is a serious problem for male and female patients of all ages. In the United States more than 60 million patients suffer with this sensitive problem. This dysfunction may be the first sign of heart disease, diabetes, neuropathy, and high cholesterol; it also tends to lead to depression, loss of self esteem, and significant stress in patients lives.

At the Center for Advanced Urology, Dr. Diamond provides a confidential, caring and warm environment in which patients can feel comfortable discussing such a personal problem. Patients undergo the latest advanced work up. This includes a detailed history, physical, and sexual dysfunction diagnostic tools. This provides a comprehensive understanding of the underlying neurophysiologic defects as well as social psychological factors. Based on the individual work up, a treatment program is tailored to the patient’s goals and desires that include counseling, herbal therapy and a vast array of pharmaceutical options including oral, urethral and inject able therapies. If needed, Dr. Diamond is well versed in the latest surgical approaches. As a "thought leader" in sexual dysfunction, Dr. Diamond has been an invited speaker throughout the United States, and has the unique access to new and novel therapies which he can offer patients.

Kidney Stones

Unfortunately, 50% of patients who get kidney stones will get them again if a diagnostic and comprehensive approach is not taken. Dr. Diamond offers the latest advances in the surgical treatment of stones. These include percutaneous renal surgery, where a needle is placed into the patient's kidney through their back and, using a special scope, the kidney is examined and the stones are removed with ultrasound. When amenable, patients with stones can undergo outpatient Shock Wave Lithotripsy, which requires no incisions, and requires no time off from work or interference with normal life style.

As an expert in endourology, Dr. Diamond can also offer state-of-the-art minimally invasive surgery using a ureterscope, a small flexible instrument to examine the ureter or kidney under direct vision for stones, tumors, or any other abnormality affecting patients. Using lasers he can destroy, remove, or repair abnormalities that are visualized. Dr. Diamond has perfected this craft while a working at several leading academic centers where he served as Assistant Professor of Surgery/Urology.

The Center for Advanced Urology does not stop at treating the patient during the acute phase; they continue to treat the patient for future problems. Dr. Diamond believes in performing a comprehensive stone analysis and metabolic work up to uncover underlying electrolyte and metabolic abnormalities for each patient. Based on the workup, patients are offered individualized therapy. Whether it is diet adjustment, life style changes or medications, patients can feel comfortable that they obtaining the most comprehensive approach to stone management both acutely and long term.

Urologic Malignancies.

"I didn’t know that you could do that" is a typical response that patients have after meeting with Dr. Diamond. As a research fellow in urologic oncology at Memorial Sloan-Kettering Cancer Center, in New York, Dr. Diamond first became interested in Urologic Malignancy. He was involved in researching a “novel” prostate cancer biomarker named PSM ( Prostate Specific Membrane Antigen). It was there that he learned that in order to better treat patients that clinicians must incorporate basic science into clinical practice, in order to provide patients with state of the art care.

The laparoscopic techniques for kidney tumors have revolutionized the approach for patients. Laparoscopic radical nephrectomies, partial nephrectomies and nephrourterectomy are some of the procedures Dr. Diamond routinely performs. These procedures offer patients excellent cancer control with the minimal side effects compared to "traditional" open surgery. Patients have only 3 pencil tip size incisions, which offers patients less pain and discomfort, quicker hospital stay, with some patients going home the same day, less blood loss, scarring and quick return to work and loved ones. Although not for every patient, Dr. Diamond uses state of the art imaging to help assess patients disease, including PET (Positron Emission Testing), MRI (Magnetic Resonance Imaging), and 3D CT scans. Patients leaving his office are amazed by the techniques he can offer, and say "I didn’t know they could do that".

Dr. Diamond also offers minimally invasive therapy for adrenal problems, and urinary tract congenital problems. His newest option for small renal masses is Cryoablation. He was the first surgeon to perform this procedure in South Jersey. During the Laparoscopic procedure, the mass is isolated and visualized using ultrasound and than small 10 French Cryo probe is placed into the mass and frozen to -20 C. He plans on starting to perform this procedure through a percutaneous approach and as an outpatient procedure. He is also experienced in brachytherapy.

With his extensive background Dr. Diamond also has access to new and novel protocols for his patients. The Center also provides extensive and comprehensive follow up strategies for the various malignancies that they treat. Dr. Diamond is proud of the cutting edge approach to cancer that he can offer patients, but he is more proud of the environment in which he can provide the care. An environment of compassion and empathy for patients and their families during a difficult time. Dr. Diamond’s reputation and care for patients is reflected in the distance that patients will travel to see him.

Second Opinions

Having extensive experience and expertise in urology makes the Center for Advanced Urology an excellent choice for patient’s second opinions. One patient wrote about his experience: "During my initial consultation, while in Dr.Diamond’s waiting room, I read about his extensive training and experience. I immediately knew I had come to the right place."

Dr. Diamond works closely with his patients, primary care physicians, and specialists throughout every stage of diagnosis’s and treatment. His experience in academic medicine and leading edge technology enables him to offer patients comprehensive diagnostics and cutting edge therapies. He is able to offer pioneering therapies to patients in a caring and compassionate environment. You can be confident that each patient will be given the time and commitment of Dr. Diamond to insure the very best treatment outcome.

Voiding Dysfunction/Urinary Incontinence

What do these women
have in common?


Freedom - Freedom to be active, to laugh, sneeze or cough without the fear of unexpected urine loss. For millions of women worldwide, stress urinary incontinence (SUI) is a barrier that prevents them from living life to the fullest. Fortunately, there is a new treatment solution that requires only a 30-minute outpatient procedure. It involves the implanting of a "sling" or strip of material under the

Voiding dysfunctions can include, but are not limited to incontinence, over-active bladder, urgency/frequency problems, non-obstructive urinary retention, mechanical obstructions, and prolapse (bulging out of the bladder/rectum). Having a cutting edge approach to voiding dysfunction offers both male and female treatment options, which offer excellent curative results without significant interference in patient lifestyle. Dr. Diamond has extensive training in the intricacies of voiding dysfunction. For men and women who visit the Center for Advanced Urology, complex and simple work ups are performed right in the office, in our state of the art facility. These include detailed physical exams, histories, voiding diaries and questionnaires.

The exact etiology of the problem can be ascertained using the latest urodynamic equipment. This testing helps the team focus on and narrow the etiology of the neuromuscular issues affecting the patients voiding problem and which therapies will work best with the patient’s goals and lifestyle.

Over 80% of women suffer with voiding dysfunction and the majority with incontinence. Urologists are increasingly considered the best resources for women's health issues. Dr. Diamond is among the few urologists who have embraced this new evolving field of female urology.

Patients are offered pioneering therapies including the new Monarc Transobturator Sling procedure. This procedure creates a "hammock" to support the bladder and urethra to their normal position to correct incontinence. It is 15 minute outpatient procedure that is less invasive than traditional surgery and eliminates many of the complications. Patients can return to work and normal activities quickly. Dr. Diamond can also offer minimal invasive surgery for those women with Prolapse issues as well. And his latest addition to his surgical repertoire is a small single vaginal incision to correct urinary incontinence; he is the first surgeon in South Jersey to offer this innovative technique. The center also offers non-surgical therapy alternatives including medications and in office biofeedback.

Many male voiding problems are prostate-related, but are not caused by prostate cancer. Dr. Diamond combines his extensive expertise with his patient’s treatment goals to establish a treatment plan. Two treatments that have been providing excellent results for men because they minimize the need for hospitalization and the need for additional medicine are biofeedback and in-office microwave prostate therapy. Thermotherapy of the prostate performed in the office, offers the patient a safe procedure without the need for hospitalization and the complications associated with traditional surgery. Dr. Diamond also offers the Green Light Laser surgery. One of the centers patient’s was so excited after his in office therapy, he said "During the half hour prostate procedure, I had no pain or discomfort, and one week later I was urinating like I did when I was a kid, and I no longer take any medications."

Dr. Diamond sums it up this way: "When attending to patients with voiding dysfunction, having a cutting-edge approach can make all the difference. The key is to provide options for both male and female patients, with treatment options that can deliver excellent curative results without significant interference in patient lifestyle."

Terminology

Continence Care

Our office provides comprehensive urological services to the community. Patients are referred by their physicians for Urodynamics studies and/or bladder training and biofeedback. In addition, patients without a physician’s referral can be seen by one of the urology nurses for assessment and assistance with urinary incontinence.

What is Urodynamics?

Urodynamics refers to a series of diagnostic tests that evaluate the function of the bladder and urethra. These tests may be recommended if you have urinary incontinence (leakage of urine), recurrent bladder infections, slow or weak urinary stream, incomplete bladder emptying, or frequent urination. These tests provide important information in order for your physician to accurately diagnose and treat your bladder problems appropriately.

How to prepare for Urodynamics

Prior to your appointment you will be mailed a questionnaire to complete regarding your bladder problem. Please bring this with you to the appointment. At the beginning of the test you will be asked to urinate so please arrive for the study with a relatively full bladder. You may eat or drink anything prior to the study. Take your medications as normally scheduled, unless otherwise directed by your doctor. The tests typically take about two hours and are generally painless. No anesthesia is necessary. Your friends and family are welcome to accompany you but will be asked to remain in the waiting area. You will be able to resume all previous activities, including driving, at the completion of the Urodynamics studies. A catheter (soft, hollow tube) or special sensor will be carefully placed in your urethra and sometimes your rectum to perform the study. Your physician will decide which of the following tests need to be performed to help diagnose and treat your condition.

Uroflow

This test measures the speed and amount of urine you void. You should come to the test feeling as though you need to urinate. Try not to empty your bladder one hour before your test. You will be asked to urinate into a commode with a funnel attached to a computer that measures your urine flow.

Cystometrogram

This study evaluates how your bladder holds urine, measures your bladder capacity, and also determines how well you can control your bladder. Through a catheter your bladder is filled with fluid. In order to reproduce your bladder symptoms, you should report any sensations you feel during the study. In addition, you may be asked to cough, bear down, stand, or walk in place during the test. At the end of the study, you will be asked to urinate.

EMG

This test measures how well you can control your sphincter (outlet) muscles and determines if they are working in coordination with your bladder. Electrodes may be placed near the rectum to record muscle activity.

Pressure Flow Study

This test determines if there is an obstruction. After your bladder is filled through a catheter, you will be asked to urinate as you normally would. This test may be done sitting on a commode or standing. The study simultaneously records the bladder pressure and urine flow rate.

Videourodynamics

This study is a combination of the above tests with the addition of video pictures. If this study is prescribed, the doctor will be present to explain each step of the process. Your bladder will be filled with contrast fluid, and X-ray video pictures are taken to see your bladder in motion during filling and emptying. After the procedure, the doctor will discuss the study results with you. A detailed report will be sent to your physician including a summary of results, diagnosis, and suggestions for treatment. After reviewing the report, your doctor will talk to you about the findings and your options for treatment.

Biofeedback/Pelvic Floor-Muscle Exercise Therapy

This non-surgical therapy is used to treat incontinence. A nurse will educate, evaluate, and instruct you on proper isolation and exercise of your pelvic floor muscles for bladder control. Using biofeedback technology, a computer recorder monitors your progress and strength of pelvic muscles. Typically this therapy consists of weekly sessions for six weeks. The first session will last about one hour while the remaining sessions will last less than an hour.