Frequently asked questions.

It depends on your insurance plan — some plans require a referral and some do not. The office can quickly confirm what your plan needs. New consultations are typically scheduled within 1–2 weeks.

Typically around 30 minutes. Cancer and complex consultations may run longer.

Recent labs, imaging reports, biopsy or pathology reports, and a list of medications. If you have CT or MRI images on a disc or accessible through a portal, bring those too — reviewing the actual images, not just the reports, often changes the conversation.

Yes, routinely. Second opinions are appropriate and welcomed, particularly for cancer.

No — and the threshold itself is individualized. The traditional cutoff of 4.0 is a guideline, not a universal rule; for some men, especially younger ones, a PSA above 2.5 or 3 may already be abnormal. PSA also varies for many reasons besides cancer — age, prostate size, recent ejaculation, urinary infections, even bicycle riding. The trend over time and the PSA density (PSA relative to prostate size) usually matter more than any single number. A first elevated PSA almost always warrants a careful look, not panic.

Not always. The first step is usually a careful history, exam, possibly a repeat PSA, and a prostate MRI. The MRI changes the plan in a large fraction of cases — some men go straight to biopsy, some can be watched, and some need no further evaluation at all.

No. Many low-risk prostate cancers are safely managed with active surveillance — careful monitoring with PSA, MRI, and periodic biopsy, treating only if the cancer shows signs of becoming more aggressive. This is the right answer for many men.

Both are effective curative treatments. Surgery provides a surgical specimen and final pathology, and keeps radiation in reserve. Radiation avoids an operation but is harder to deliver again if cancer recurs. The right answer depends on the cancer, other medical conditions, and personal priorities. Both are discussed in detail at the consultation.

Yes, more likely than not, unless the cause is identified and addressed. About half of stone-formers form another stone within 5–10 years without intervention. A 24-hour urine collection and a few targeted blood tests can identify what is driving your stones — and almost always points to changes that lower future risk dramatically.

Many stones pass on their own with hydration, medication, and patience. Surgery is reserved for stones that are too large to pass, that are causing obstruction or infection, or that are causing intractable pain. The decision depends on size, location, your anatomy, and your situation (job, travel plans, comorbidities).

Not immediately. Sperm remain downstream of the vasectomy for several weeks. Sterility is confirmed with a semen analysis at about 12 weeks. Use other contraception until that test is clear.

No. Vasectomy does not affect testosterone, libido, erections, or the volume or feel of ejaculation in any noticeable way. Sperm make up a tiny fraction of semen.

Most major insurances are accepted. The fastest way to confirm coverage is to call the office.

Call the office or send a message through the patient portal. Records requests are typically completed within a week.