Low Testosterone Symptoms with Dr. Brian Hale

My name is Brian Hale. I’m a board certified urologist working with Advanced Urology Institute. Men with low testosterone usually have fatigue or loss of sex drive. That’s the thing that would prompt me to check a testosterone level. Lot of times they come in with erectile dysfunction and then I have to kind of bring that out of them [and ask] “Are you also having symptoms of low testosterone?”. If they do, we try to address that first before we treat erectile dysfunction.

What is Vasectomy Recovery Like?

The no-needle no-scalpel vasectomy is a quick, minimally invasive outpatient procedure that takes 10-15 minutes. It is fail-safe on a majority of patients and highly unlikely to cause complications.

“At Advanced Urology Institute, we conduct no-needle no-scalpel vasectomies with very high success rates,” says Dr. Yaser Bassel, a board certified urologist at Advanced Urology Institute, Tampa, Florida. “It’s basically a 10-15 minute office procedure done under local anesthesia,” he adds.

What does the procedure involve?

During a no-needle no-scalpel vasectomy, you undress from the waist down and cover yourself using a sheet. Your skin is sterilized with antiseptic, and then sterile drapes are placed around your scrotum.

With the surgical site—the scrotum—numbed using an external agent, your urologist uses a device called a hemostat to expose your vas deferens through the skin of your testes. The vas deferens is then sealed to prevent sperm flow into semen. After sealing off your vas deferens, the surgeon bandages your scrotum—no closing of sutures is necessary.

Is the procedure painful?

The sensation associated with the procedure is comparable to a rubber band snapped at the entry site. You will feel some tugging as the vasectomy is done, but you should not expect to have any sharp pain.

Soon after the procedure, you can expect some mild discomfort. The discomfort may intensify as the anesthesia wears off, usually one or two hours after your procedure.

“The tenderness and soreness can be managed effectively with over-the-counter pain medication and cold compresses,” says Dr. Yaser Bassel. “It is advisable that you speak with your doctor about any pain, redness, soreness, or discomfort you may experience after the procedure.”

Likewise, you should make sure to read your urologist’s written instructions, review them thoroughly with your spouse, and ask questions regarding any concerns.

You should also not drive yourself home. Make sure to arrange for your transportation in advance. Your doctor will determine when you are ready to go home, and you should not speed up the process.

Once you leave the doctor’s office, you should go directly home to rest. Wear a snug scrotal garment or jockey shorts immediately after your surgery, and for up to one week, to avoid stretching the wound.

What should you expect during recovery?

You will need to follow basic self-care procedures to keep yourself comfortable and reduce the risk of infection or stretching your wound. Immediately after the procedure, you should take a day or two from work to rest.

“Once you arrive home, lie down and apply some ice on your scrotum, and rest for at least 20 minutes. You’ll then apply the ice periodically for the rest of the day,” says Dr. Yaser Bassel. “The ice will reduce the swelling and block your pain receptors to minimize the pain,” he adds.

A cold compress applied for the first 24-48 hours will minimize your pain and prevent swelling, but you will still need to monitor the progress of your surgical site. Should the pain, bruising, redness, and swelling worsen the first few days after your procedure, you should contact your physician for help.

With good scrotal support, you can ease into regular non-strenuous activity the day after your vasectomy procedure. However, it would be best if you avoid heavy lifting, working out, and other strenuous activities until at least the third day after your procedure. Lifting any weight above 10 pounds may stretch and reopen your wound. Plus, you should not shower or bathe for one or two days after the procedure.

“If any activity causes pain, put it off and rest some more before trying it again,” says Dr. Yaser Bassel. “Likewise, you should avoid having sexual relations soon after your no-needle no-scalpel vasectomy,” he affirms.

Since sperm will not immediately diminish in your semen, you will temporarily have to use external birth control when having sexual intercourse. It usually takes up to 3 months for sperm to be completely absent in semen.

You should also have your semen analyzed for the presence of sperm before you engaging in sex without using contraception.

Why Advanced Urology Institute?

At Advanced Urology Institute, we offer the no-needle no-scalpel procedure that takes less than 20 minutes and guarantees that you will enjoy contraception with the lowest complication rate, least amount of pain, and shortest recovery period.

Our urologists have been performing this procedure for years. Your safe and effective surgery will allow you to enjoy your sex life without worrying about an unintended pregnancy. We will also guide you through the recovery process to help you achieve the best possible outcome.

Are you thinking of getting a vasectomy? Schedule your consultation today with one of our knowledgeable and experienced urologists.

For additional information on vasectomy, vasectomy reversals, and other contraception issues, visit the Advanced Urology Institute website.

The Advantages of Laparoscopic and Robotic Surgery with Dr. Amar Raval

My name is Amar J. Raval and I’m with Advanced Urology Institute.Laparoscopic and robotic surgery is unique because it minimizes your pain, it [does] small incisions, and less hospital stay. So those three things are a big deal and patients recover faster and can go home with minimal pain and discomfort.

Let alone with robotic and laparoscopic techniques, the visualizations are significantly improved. You’re able to small anatomy in great detail, in 3D and also make fine movements to have a nice outcome and surgery.

Kidney Stones Symptoms with Dr. Brian Hale

My name is Brian Hale. I’m a board certified urologist working with Advanced Urology Institute.

So patients who have kidney stones usually complain of flank pain, which is where the pain would be behind the lower ribs and sometimes it wraps around towards the front [and] down towards the groin area. Those are the most common symptoms, [sometimes] they’ll also have blood in the urine on our testing in the office.

Usually we’ll get an ultrasound or CT scan that diagnoses the stone, it’ll tell us the size and location. If the stones are smaller [about] less than 4 millimeters in size, ninety (90) percent of those times it will pass on their own. So on those patients, I give them a chance to try to pass the stone before we operate on them. When they’re bigger, they’ll be more than 6 millimeters in size, the less of a change of passing [the stone], less than ten (10) percent. For those patients, we look at the scheduling surgery for.

Vasectomy vs Tubal Ligation – Dr. Yaser Bassel

My name is Yaser Bassel. I’m a board certified urologist with Advanced Urology Institute.

I do perform no-needle, no-scalpel vasectomies and that is an easy in-office procedure for sterilization. For men, that oftentimes is the better option than for women undergoing a tubal ligation. In that case, women oftentimes will have to have general anesthesia and require a surgical procedure. For men this is typically a ten to fifteen (10-15) minute procedure that’s performed in the office and oftentimes we can give patients a Valium tablet so that they are relaxed during the procedure. Afterwards, as long as the patient is compliant with no strenuous activities for one (1) week, they typically do not have any issues with regards to healing. Oftentimes men are concerned that a vasectomy can affect their libido or affect their erectile function [but] there is absolutely no correlation with that and there’s no effect on erectile function or libido for men.

When Should You Get a PSA Test – Dr. Yaser Bassel

My name is Yaser Bassel. I’m a board certified urologist with Advanced Urology Institute.

In particular it’s important for men with a family history of prostate cancer or Afrtican-American males to start screening at age forty (40). That’s typically done with an annual PSA blood test and also a digital rectal exam (DGA). For the general population, the American Urological Association now recommends screening at age fifty-five (55)

How is a PSA test done?

It’s pretty simple. It involves a simple blood test that’s done once a year and also a prostate exam or a digital rectal exam

How effective is a vasectomy reversal?

My name is Yaser Bassel. I’m a board certified urologist with Advanced Urology Institute.

When we counsel patients before they get a vasectomy, we do tell them that this is considered a permanent form of sterilization. However vasectomies can be reversed. The vasectomy reversal process is typically one that is not covered by insurance so it can be expensive but it is possible and typically with seventy-five to eighty percent (75-80%) success rates. [While], I do not personally perform the vasectomy reversals themselves, I do have a partner that specializes in that area. So if that is something men are interested in, that is something that is offered by our practice.

Common Prostate Health Issues – Dr. Yaser Bassel

My name is Yaser Bassel. I’m a board certified urologist with Advanced Urology Institute.

Most patients that come to us with regards to prostate health issues, the majority of them are dealing with benign disease, in particular something called Benign Prostatic Hyperplasia or BPH. Oftentimes those types of diseases and those types of symptoms can be addressed with medication and then beyond that, there are treatments for BPH that include in-office procedures and then beyond that, surgical procedures as well. 

The other spectrum is malignant prostate disease which is prostate cancer. Typically that is found with prostate cancer screening. We use the Prostate-specific Antigen (PSA) blood test for that and also digital rectal exam (DGA) to detect prostate cancer oftentimes in asymptomatic men. Typically treatments range from robotic prostatectomy, radiation therapy and now there are some newer technologies such as high intensity frequency ultrasound at our disposal. Beyond that, there are also new advanced prostate cancer therapies for prostate cancer that have gone out of the prostate as well.

Advances in ED treatment

My name is Brian Hale, I’m a board certified urologist working with Advanced Urology Institute.

When I first started urology we had injection therapy and surgery, so we did a lot of surgery for erectile dysfunction. When Viagra came out in the late 90s that obviously changed everything, and now we have a lot of options besides Viagra, medically. So the treatment of erectile dysfunction transitioned from a surgical problem to a medical problem. We still do treat men with surgery if they fail the medical options but the numbers now are very low for patients who undergo surgery for erectile dysfunction.

Surgery or Radiation for Prostate Cancer – Dr. Amar Raval


My name is Amar J. Raval and I’m with Advanced Urology Institute.

Surgery is surgery at the end of the day and it does have its own complications [such as] when making incisions. With radiation, I like to give it to patients who are older, who want treatment and also have medical comorbidities or different things that may limit them from being successful from a surgical outcome. It’s a big conversation to have and ultimately I give my thoughts but I leave it up to patients to decide what they want to do.