Hours of Operation

Main office hours are by appointment only. Our office hours are Monday through Thursday 9:00 am to 5:00 pm and Friday 9:00 am to 2:00 pm. We also have appointments available at our Philipsburg satellite office the 2nd and 4th Mondays of each month. Please contact us to schedule an appointment.

Insurances Accepted

• Advantra
• Blue Shield
• Geisinger Health Plan
• HealthAmerica
• HealthAssurance
• Keystone Health Plan Central
• Medicare
• Preferred Healthcare

Hospital Affiliations

• Centre Community Hospital - full privileges including admitting, consulting and surgical.
• Centre Community Surgical Center - out-patient surgeries.
• Hershey Medical Center - lithotripsy performed on an out-patient basis.
• Healthsouth Rehab - consulting only.

What to Bring on Your First Visit

Please bring your insurance card, list of medications, list of past surgeries, list of past admissions to hospitals and your identification. Try to come to your first visit a few minutes so you have time to fill out a medical history form.

Concerning Fees and Insurance

1. The primary concern of Urological Associates is with the delivery of high quality medical care. All services and treatments rendered are charged to you, the patient, and not to a third party carrier.

2. Our office participates with the following plans: Advantra, Blue Shield, Geisinger Health Plan, HealthAmerica, HealthAssurance, Keystone Health Plan Central, Medicare, and Preferred Healthcare. We will bill these companies for reimbursement on approved procedures. Blue shield patients will pay for office visits when rendered. We will submit labwork or surgery. All patients will be billed for deductibles and co-insurance balances after we have received an explanation of benefits: these balances at due immediately upon receipt of the statement from our office. We also submit claims for patients with PSU PLAN A. PLAN A patients will be billed for the total balance after we receive an EOB from HealthAmerica.

3. Patients with any other insurance coverage are expected to pay for services rendered at the conclusion of the office visit. We accept cash, check, Visa, MasterCard or a MAC card. Extended payment plans must be established prior to services being rendered. Credit application completion is required in some situations. Surgical bills are submitted directly to your insurance company following surgery and payment is expected one month thereafter. Payments not received within 30 days of billing are subject to interest charges. Accounts not paid within 60 days of billing, automatically qualify for transfer to Transworld Systems, Inc. for full collection.

4. At the conclusion of your office visit you may request a copy of your superbill. Attach a copy of the superbill to your completed insurance form. Your insurance company will reimburse you. Upon special request we can provide you with a completed 1500 Insurance form. This is a standardized form accepted by insurance companies. We do not fill out private insurance forms.
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5. Our office does not participate with any other insurance companies at this time. This means that you are responsible for the full amount of the bill regardless of insure coverage.

6. If there are any problems or questions concerning your account please schedule a time with our office personnel so that we may be of assistance. They can be reached by phone Monday through Thursday 9:00 am to 4:00 pm. Our phone number is 814.238.8418 or toll free 800.837.6062.

7. If you are unable to keep your appointment we require 24 hour notice. Missed appointments without notice will be charged an administrative fee which must be paid prior to rescheduling.

Vasectomy Payment Information

The cost of the vasectomy is $642.00 and must be paid at the time of the procedure because it is elective. Most insurance companies will reimburse you a portion of the cost of the procedure, but you must obtain this information from your insurance company - our office requires payment at the time of service and can make no exceptions.

If you need to cancel your procedure once it has been scheduled, we ask that you call us as soon as possible due to the limited number of openings. If you need to cancel your appointment for the vasectomy and you do not give a 24-hour notice, you will be charged $90.00 for the surgical tray and instruments that were prepared prior to your appointment time.

If you are a HealthAmerica HMO patient, you are responsible for a $50.00 co-payment at the time of the procedure. We will submit the balance to HealthAmerica for you.

There will be separate charges from Centre Community Hospital and Centre Pathology Associates for the portions of the vas deferens that we send to the hospital for analysis. Your insurance information is supplied to the hospital when the specimen is sent. Both Centre Community Hospital and Centre Pathology Associates will bill your insurance and then they will bill you for any balance due. Should you need any further information regarding these charges, you will need to speak directly with the Billing Office at Centre Community Hospital.

Your post-operative visit for a check-up and/or suture removal is included in the price of the procedure, as well as your post-vasectomy semen analysis.

Understanding Prostate Biopsies

Your prostate gland is located at the base of your urinary bladder. It is normally the size of a walnut and surrounds the tube (urethra) through which you pass your urine. It produces the liquid (semen) part of your ejaculate, which is added to your sperm during sex.

The prostate can be examined in two ways. First, a doctor can actually feel its rear surface during a rectal exam because it sits just in front of your rectum. Second, some abnormalities of the gland will cause an elevated PSA (prostatic specific antigen) blood test. Abnormalities of these exams may indicate prostate cancer, benign (non?cancerous) tumors, infection, or even the normal effects of getting older. In such cases, a biopsy is sometimes necessary to be sure of the exact problem.

The biopsy enables us to actually obtain small bits of prostate tissue which are sent to Centre Community Hospital. There, a pathologist from Centre Pathology Associates, will very carefully examine the tissue under a microscope. He or she can then report on whether the prostate cells appear abnormal, whether cancer is present or not, and to some extent, how dangerous the problem appears. This knowledge is essential in order for us to know if further treatment is necessary and if so, what kind will be most successful.

Procedure

A prostate biopsy can be safely done in our office. An overnight hospital stay is not necessary. The biopsy is done by inserting a needle into the prostate through the rectum. Ultrasound is used to enable more accurate placement of the needle. A tiny bit of the gland is then withdrawn through the needle and sent to the laboratory for diagnosis. Multiple biopsies from different parts of the gland may be taken in this way. You will remain awake during the biopsy. Though you may experience discomfort, most men do not complain of severe pain during the procedure.

After your prostate biopsy

There are rarely any severe after effects of a prostate biopsy. Occasionally men experience mild discomfort at the site of the biopsy. Should this occur, it usually does not last long and can be treated with your usual anti-pain medication. Some men will notice blood in their urine, semen, or bowel movements after a prostate biopsy, although serious bleeding is rare. Certainly you should contact us if you experience an elevated temperature, severe pain, severe bleeding, or the passage of clots, or other unexpected symptoms. We ask that you do no strenuous exercise until seen the following week.

Commonly asked questions

Is it all right to have a bowel movement following my prostate biopsy? Yes. Having a bowel movement is not dangerous and should not be painful.

Will the prostate biopsy affect me sexually? No. There will be no after effects of the biopsy that will change your sexual ability or enjoyment. Your semen may contain some blood for a while, but this is not harmful to you or your partner. We do not recommend sex until 10 days after the biopsy.

How can I have a prostate problem if I have no symptoms? Prostate problems usually do not cause symptoms in their early stages. During this "silent" stage, treatment is far more likely to be successful. Therefore, it is important to make the diagnosis now.

When will the results of my prostate biopsy be available? The report should be returned to our office within seven days.

MALE VOLUNTARY STERILIZATION
Bilateral Vasectomies

What Is Sterilization?
It is a surgical procedure for the controlling of conception. It is the most reliable means of birth control known today.

The procedure for a man is called a vasectomy. It only involves the closing of a narrow tube on each side of the scrotum (the vas deferens) which carry the sperm. Under local anesthesia, a small incision is made in each side of the scrotum. This is done so that the tube can be lifted out, tied off and cut, thus blocking the passage of sperm. This procedure does not involve the penis or testicle. Therefore, the testicle continues to form the sperm which is then absorbed into the body.

The procedure for a woman is called a salpingectomy. This usually means that a small incision is made wither abdominally or vaginally under general anesthesia and the tubes which carry the egg from the ovary to the womb are tied off and cut. This prevents the union of the sperm and the ovum (egg) and therefore, conception cannot occur. The operation for the female is more complex and requires hospitalization

Is Sterilization Permanent?
The operation is performed as a means of permanent sterilization Research is being done for the surgical restoration of fertility (reversal). but as of vet a successful reversal cannot be assured id any particular case.

Are Vasectomies Legal?
Yes, they are being performed in all states without restrictions except for Utah where there are limited reasons of "medical necessity".

What Are The Effects?
Is Sterilization The Same As Castration?
No, Castration involves the removal of the testicles in the male and the ovaries in the female. However, in sterilization the removal of the sex gland or organs are not involved. The passageways are merely closed that normally allow the sperm and ovum to meet.

Is There An Association Between Vasectomies And Increased Risk Of Cancer Of The Prostate?
Recent articles by Giovanucci et al in the February 17, 1993, Journal of the American Medical Association suggested an increased risk of developing cancer of the prostate following vasectomies. Early studies had demonstrated no such risk. No known biologic explanation exists to explain this possible association.

In 1979, an association between vasectomies and atherosclerosis (hardening of the arteries) was suggested. Many men were frightened out of having vasectomies at that time. It took 10 years to provide evidence that vasectomies did nothing to increase cardiovascular disease.

All methods of contraception carry some known and possible unknown risks. Vasectomies must be weighed against the risks of other forms of contraception and the risks of pregnancy.

Will Sterilization Make A Man Impotent, Prevent Him From Enjoying Sex Or Cause Any Change In His Health?
No. Having a vasectomy does not change a man's ability to have an erection, orgasm or full ejaculation. The male continues to enjoy sex as much as, or more than before since the fear of unwanted/accidental pregnancy is removed. The same amount of semen will be ejaculated as before the operation but it contains no sperm. The production of the male set; hormone remains unchanged.

Can A Man Be Sterilized At The Same Time Of Other Operations?
Yes, it is possible with certain types of operations. An example would be if he needed a hernia repair or an operation for a varicocele or hydrocele, a vasectomy may be easily performed at the same time.

Where Is The Procedure Done?
The vasectomy is usually performed under local anesthesia in the doctor's office.

How Long Will A Patient Be Inactive?
As in all types of surgery, the speed of recovery depends on the individual. Recuperative powers vary substantially from one person to the next. The recovery period when a woman has a tubal ligation is usually about one week. The recovery period when a man has a vasectomy is two or three days. However, six weeks are required to clear the ligated vas of the previously formed sperm. Contraceptive measures are necessary during this time only. As the end of six weeks a semen analysis is done by the operating surgeon to confirm azospermia (a complete absence of sperm).

Is It A Rare Operation?
No, authorities have estimated that about 2,000,000 living Americans have already obtained a voluntary vasectomy and each year well over 150,000 more will elect to have the operation. There is an increasing trend toward the operation for the male rather than the female.

Voluntary Sterilization Usually Produces:

• Often more love and care for the present family when the parents are freed from the fear of unwanted pregnancies.
• At time, marital tensions and anxieties are reduced when the fear of unwanted pregnancies have been removed.
• More enjoyment of sex by each partner.
• Avoidance of hereditary diseases in some cases.

VASECTOMY INFORMATION PRE-OP AND POST-OP CARE
Pre-Op

• The procedure and the permanence of sterility should be discussed with both the husband and wife.
• The consent form must be signed by the husband and wife.
• A physical exam is required to evaluate whether the procedure can be done in the office under local anesthesia. (Almost all cases are performed in the office.)

Post-Op

• It is suggested that the patient rest in bed for several hours after the vasectomy.
• An athletic supporter (jock strap) should be worn for at least three days; a week is more desirable.
• Ice should be applied to the scrotum when prescribed by the doctor.
• The incision should not be touched for the first 24 hours but then it should be washed daily with hydrogen peroxide.
• A shower should not be taken for the first 48 hours following the procedure.
• If sutures were used, the patient should return between 5 and 7 days for removal.
• After six weeks, the patient must return for a post-op semen analysis (sperm count).

Form

To save you time in our office you can download and complete our forms before your appointment:

• Medical History Form

Physical Therapy

What can State College Urologic Associates Physical Therapy Do for Urinary Incontinence?

We utilize state of the art biofeedback therapy.

• This allows us to help the patient isolate the pelvic floor muscles.
• It allows the patient to learn to coordinate muscle contractions appropriately when performing functional activities that would typically cause stress incontinence.
• It allows us to train the patient's muscles in the areas of strength and endurance.

We utilize pelvic floor electrical stimulation therapy.

• This helps improve urethral pressure.
• It facilitates bladder inhibition in patients who have urge incontinence.
• It stablizes bladder activity.
• It helps patients create a better awareness of their pelvic floor muscles.

We provide comprehensive training in home exercise programs.

• For the pelvic floor musculature, we provide training in the proper way to do Kegel exercises. Home biofeedback units are also available.
• We teach facilitory exercises such as PNF lower extremity diagonals, bridging, and isometric hip adduction.

We use specialized myofascial release techniques when patients are also having pelvic pain associated with incontinence, interstitial cystitis, or vulvodynia.

We educate patients in bladder trainng and timed toileting.

We teach patients proper body mechanics and posture that help better support the pelvic floor structures.

We educate the patients on certain diet changes that can be made to help decrease their incidents of incontinence (i.e., cutting out known bladder irritants).

How does someone go about getting physical therapy for urinary incontinence?

• The potential patient should be referred by his/her primary care physician. Please bring all pertinent medical history and examination records with you.
• The physician must then write an order for physical therapy evaluation.
• Patients can self-refer for evaluation by State College Urologic Associates. They will then in turn determine if the patient is an appropriate candidate for physical therapy.

For more information or for answers to your questions, please contact State College Urologic Associates at 814.238.8418 and ask for Wendy Curtis, Physical Therapist.