Urologic Surgery NWI

  • 1101 Glendale Blvd., Unit 107 A, Valparaiso, Indiana, 46383
  • (219) 286-6888
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  • About Dr. Pinkhasov
    • About Dr. Pinkhasov
    • Patient Reviews
  • Conditions/Procedures
    • Conditions & Procedures We Treat
    • Erectile Dysfunction
    • Groin Pain
    • Hydrocele
    • Hydronephrosis
    • Kidney Stones
    • Low Testosterone
    • Vasectomy
    • Urethral Stricture
    • Scrotal Swelling
    • BPH/Enlarged Prostate
    • Prostatitis
    • Elevated PSA
    • Overactive Bladder
    • Urinary Tract Infection
    • Urinary Incontinence
    • Urinary Retention
    • Hematuria
    • Cancers
    • • ADRENAL MASS
    • • BLADDER CANCER
    • • URETHRAL CANCER
    • • URETERAL CANCER
    • • TESTICULAR CANCER
    • • KIDNEY CANCER
    • • PENILE CANCER
    • • PROSTATE CANCER
  • Patient Resources
    • Patient Forms
    • Supplemental Consent Forms
    • Surgery Instructions
    • Pay My Bill
    • Patient Portal
    • Links & Resources
Contact Us
  • 1101 Glendale Blvd., Unit 107 A, Valparaiso, Indiana, 46383
Request An Appointment
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  • (219) 286-6888

Supplemental Consent Forms

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(219) 286-6888

Conditions & Procedures Consent Forms

Adrenalectomy

Surgical removal of an adrenal gland.

CONSENT FORM

Bilateral Orchidopexy

Surgery to secure both testicles within the scrotum.

CONSENT FORM

Circumcision

Surgical removal of the foreskin of the penis.

CONSENT FORM

Cystoscopy

Viewing the inside of the bladder & urinary tract with a camera (scope).

CONSENT FORM

Cystoscopy Bladder Biopsy, Fulguration, Resection & Chemo

Viewing the bladder with a camera, taking a tissue sample, removing cancerous tissue & introducing chemotherapy medication.

CONSENT FORM

Cystoscopy, Dilation & Catheter Insertion

Viewing the bladder with a camera, dilating the urethra & inserting a urinary catheter.

CONSENT FORM

Cystoscopy, Retrograde Pyelogram & Ureteral Stent Insertion

Viewing the bladder with a camera, using x-ray to image the kidney(s) & stent placement in ureter(s).

CONSENT FORM

Cystoscopy Ureteral Stent Removal

Viewing the bladder with a camera & removing previously placed stent(s) in the ureter(s).

CONSENT FORM

Cystoscopy, Ureteroscopy, Retrograde Pyelogram, Laser Lithotripsy, Ureteral Stent(s) Insertion

Imaging of the bladder, ureters & kidneys; breaking up kidney stones & placing stent(s) in the ureter(s).

CONSENT FORM

Hydrocelectomy & Spermatocelectomy

Removing fluid around the testicles or fluid-filled cysts behind the testicles.

CONSENT FORM

Intravesical Instillation of BCG

Catheter insertion into the bladder to introduce a medication to fight bladder cancer.

CONSENT FORM

Intravesical Instillation of Chemotherapy

Catheter insertion into bladder to introduce chemotherapy medications to fight bladder cancer.

CONSENT FORM

Nephroureterectomy

Surgical removal of the kidney & entire ureter.

CONSENT FORM

Orchiectomy

Surgical removal of one or both testicles.

CONSENT FORM

Partial Cystectomy & Pelvic Lymphadenectomy

Surgical removal of part of the bladder & lymph nodes in the pelvic area.

CONSENT FORM

Penile Dorsal Slit

Making a small cut in the foreskin to allow the foreskin to slide along the penile shaft.

CONSENT FORM

Penile Injury "Fracture" Repair

Surgical repair of the injured penis.

CONSENT FORM

Radical Cystectomy, Pelvic Lymphadenectomy with Ileal Conduit Urinary Diversion (Female)

Surgical removal of the bladder, pelvic lymph nodes & possibly female reproductive organs (uterus, cervix, ovaries, vagina, etc.) with creation of a urinary diversion.

CONSENT FORM

Radical Cystoprostatectomy, Pelvic Lymphadenectomy with Ileal Conduit Urinary Diversion (Male)

Surgical removal of the bladder, prostate gland & pelvic lymph nodes with creation of a urinary diversion.

CONSENT FORM

Radical Prostatectomy & Pelvic Lymphadenectomy

Surgical removal of the entire prostate gland &  pelvic lymph nodes.

CONSENT FORM

Total & Partial Nephrectomy

Surgical removal of the entire kidney or part of a kidney.

CONSENT FORM

Transrectal Ultrasound Prostate Needle Biopsy

Taking a tissue sample of the prostate through the rectum.

CONSENT FORM

Transurethral Resection of the Prostate

Inserting a camera through the urethra & removing excess prostate tissue to make the urethra wider.

CONSENT FORM

Ureteral Catheter

Catheter insertion into the ureters with possible bladder repair.

CONSENT FORM

Ureteral Reconstruction

Repairing the ureter, the tube between the kidney & bladder.

CONSENT FORM

Vasectomy

Male birth control/sterilization procedure to prevent sperm from entering seminal fluid.

CONSENT FORM

Conditions & Procedures Consent Forms

Adrenalectomy Consent

Surgiacal removal of adrenal gland.

Bilateral Orchidopexy

Possible Orchiectomy of the torsed testicle consent.

Circumcision Consent

Removing penile foreskin.

Cystoscopy Consent

Insertion of endoscope or camera into bladder.

Cystoscopy, Bladder Biopsy, Fulguration

+/- transurethral resection of bladder tumor, +/-intravesical instillation of chemotherapeutic agent.

Cystoscopy, Possible Urethral Stricture Dilation

Foley catheter insertion, possible suprapubic catheter insertion consent.

Cystoscopy, Retrograde Pyelogram

Ureteral stent insertion or change consent.

Cystoscopy Ureteral Stent Removal

Insertion of endoscope or camera into the bladder and removing ureteral stent.

Cystoscopy, Ureteroscopy, Laser Lithotripsy

Stone extraction, retrograde pyelogram, ureteral stent insertion or change consent.

Hydrocelectomy +/- Spermatocelectomy

Removing fluid around the testicle and/or removing fluid filled cyst attached to the epididymis consent.

Intravesical Instillation of BCG

Insertion of temporary urinary catheter into bladder and introducing
bladder medication that helps fight bladder cancer

Intravesical Instillation of Chemotherapy

Foley catheter insertion consent.

Orchiectomy Consent

Surgical removal of testicle

Partial Cystectomy

Possible pelvic lymphadenectomy consent.

Penile Dorsal Slit Consent

Incising penile foreskin in one area to allow foreskin to slide along the penile shaft easier.

Penile Injury "Fracture" Repair Consent

Restore or maintain the ability to have erections and urinate.

Radical Cystectomy, Pelvic Lymphadenectomy

With ileal conduit urinary diversion in a female, possible hysterectomy, bilateral salpingo-oophorectomy and partial vaginectomy consent.

Radical Cystoprostatectomy, Pelvic Lymphadenectomy

With ileal conduit urinary diversion consent.

Radical Prostatectomy

+/- pelvic lymphadenectomy consent.

Total & Partial Nephrectomy

Surgical removal of whole or part of kidney consent.

Transrectal Ultrasound Prostate Needle Biopsy

Insertion of ultrasound probe into rectum to sample prostate consent.

Transurethral Resection of the Prostate Consent

Using an endoscope or camera in the urethra, resecting part of the prostate gland to make the urethra wider.

Ureteral Catheter Consent

Ureteral catheter insertion possible bladder injury repair.

Ureteral Reconstruction

Insertion of ultrasound probe into rectum to sample prostate consent.

Vasectomy Consent

A procedure to cut or tie the two tubes that carry sperm out of the testicles.

Find Comfort with Urologic Surgery of NWI

We are dedicated to compassionate and comprehensive urologic care, offering you necessary and appropriate evaluations and treatments that you may need to feel and be healthy. With years of experience in urologic care, we are the team that you can trust.

(219) 286-6888

Take Control of Your Health & Wellness

We will work together to jointly find the best treatment plan for you. We respect your wishes and are here to empower you to make your own decisions regarding your health and well being. Please contact our office to schedule a consultation.

(219) 286-6888

Request An Appointment

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contact information

  • (219) 286-6888
  • Fax: (219) 286-6909
  • office@urologicsurgerynwi.com
  • 1101 Glendale Blvd., Unit 107 A,
    Valparaiso, IN 46383

Office hours

  • Monday-Friday
  • 8am-4:30pm
  • Closed On Weekends

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Menu

HOME
About Dr. Pinkhasov
Patient Reviews
Conditions/Procedures

We Treat:

  • Erectile Dysfunction
  • Groin Pain
  • Hydrocele
  • Hydronephrosis
  • Kidney Stones
  • Low Testosterone
  • Vasectomy
  • Urethral Stricture
  • Scrotal Swelling
  • BPH/Enlarged Prostate
  • Prostatitis
  • Elevated PSA
  • Overactive Bladder
  • Urinary Tract Infection
  • Urinary Incontinence
  • Urinary Retention
  • Hematuria

Cancers:

  • • ADRENAL MASS
  • • BLADDER CANCER
  • • URETHRAL CANCER
  • • TESTICULAR CANCER
  • • KIDNEY CANCER
  • • PENILE CANCER
  • • PROSTATE CANCER
Patient Resources
  • Patient Forms
  • Supplemental Consent Forms
  • Surgery Instructions
  • Pay My Bill
  • Patient Portal
  • Links & Resources
CONTACT US