Shepherd Center: Urology Services

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Appointments and General Information

Call the Urology Services at Shepherd if you would like to inquire about our program or schedule an appointment or follow-up visit.

Phone: 404-350-7355
Hours: 8:30 a.m. – 4 p.m. Monday – Friday
Address: 2020 Peachtree Rd., NW, Atlanta, GA 30309

Urology Services

Shepherd Center's Urology Services offers evaluation, treatment and prevention education for incontinence, male infertility and impotence for individuals with spinal cord injury or disease.

Incontinence Services
Shepherd Center offers screening and treatment options for men and women who experience incontinence, including people with spinal cord injuries and neuromuscular disorders. A wide array of treatment options is available, and in most cases conditions can be corrected or improved without surgery.

Male Fertility Services
Shepherd Center's male fertility services have helped men who want to become fathers, but are unable to ejaculate because of neurological impairment. The clinic works in conjunction with reproductive facilities and outpatient surgical centers that perform inseminations once the ejaculate is obtained.

Impotence Treatment
Because impotence is common in men with spinal cord injury, Shepherd Center has developed an expertise in treating erectile dysfunction. We offer a variety of treatment options, and have a sexual therapist on staff for confidential evaluation and counseling to all patients.

Incontinence Services
Shepherd Center offers diagnostic, surgical, and bladder management services to disabled and able-bodied men and women.

A variety of conditions can cause incontinence, including nerve damage from a spinal cord injury or neuromuscular disorders. In women, it also may be caused by pregnancy and multiple deliveries, frequent urinary tract infections, pelvic surgery or hormonal changes such as those that occur during menopause. In men, incontinence also may be the result of prostate problems.

Three types of incontinence have been identified as the most common:

Stress incontinence, an involuntary loss of urine not caused by obstruction or injury. Small amounts of urine leak from the bladder when a person coughs, laughs, sneezes, jogs or performs some type of physical activity.

Overflow incontinence, a condition that occurs when the bladder is too full and spills over. It can be caused by a blockage or obstruction of the bladder.

Urge incontinence, the result of an overactive bladder or unwanted bladder contractions.

When a patient contacts Shepherd Center about a bladder-control problem, a staff urologist conducts an initial exam and performs other tests as necessary. The physician will discuss treatment options, conduct a brief flow study and get the patient's history. Patients are asked to record intake and output of fluid for two days in a voiding diary.

Common diagnostic and treatment procedures performed at the clinic include:

Videourodynamics, a combination X-ray and bladder function test that shows how the bladder works and how well it stores urine

Electrical stimulation/pelvic floor exercises, an exercise program with biofeedback designed to increase the strength of the pelvic floor muscles and return bladder control

Water urodynamics, a diagnostic test that shows how the bladder works and how well it stores urine

Intermittent catheterization (I.C.) instruction, training on inserting a catheter into the bladder to empty urine

In most cases, incontinence can be controlled without surgery. Shepherd Center urologists may prescribe pelvic floor exercises, medication, urethral balking agents, behavioral techniques or biofeedback. In some cases, surgery may be necessary to remove an obstruction or to mend weakened muscle or tissue.

Treatment of incontinence is covered by most private insurers, Medicaid and Medicare. Our staff will assist patients to determine their medical coverage.

For more information about incontinence services at Shepherd Center or to make an appointment, call 404-350-7355.

Male Fertility Services
Shepherd Center provides fertility services to men with impaired ejaculation due to spinal cord injuries and related conditions, radical surgery for testes cancer and some forms of diabetes.

In the past, most men with spinal cord injuries and other types of paralysis were unable to father children due to impaired ejaculation and low sperm count. New developments in semen collection, however, have significantly improved fertility for these men.

Specialists at Shepherd Center's Urology Services evaluate male fertility potential, beginning with a comprehensive medical and physical assessment that includes laboratory tests. Patients may undergo vibratory or electroejaculation stimulation on subsequent visits to assess and improve fertility potential. Semen enhancement procedures are required in most cases. On occasion, however, ejaculate is not produced, and some men may never be able to father children.

Methods of collecting sperm include:

Vibrostim—a relatively new and inexpensive procedure that can be performed at home. A special vibrator on the penis stimulates ejaculation. The man collects the semen into a sterilized cup and the woman is artificially inseminated.

Electroejaculation stimulation (EES). Shepherd is one of the few centers in the nation to offer this procedure, which has allowed a number of paralyzed men to become fathers. In EES, probes are inserted into the man's rectum, and the nerves that trigger ejaculation are stimulated by a small regulated amount of current. The harvested sperm is then used in intrauterine insemination or in vitro fertilization.

Shepherd Center also helps facilitate artificial insemination. This requires an evaluation of the female partner for fertility, then coordinating of the EES procedure with the female partner's ovulatory cycle. If intrauterine attempts are unsuccessful, recommendations may be made for further procedures, such as in vitro fertilization, to increase the chance of pregnancy.

For more information about male fertility services at Shepherd Center or to make an appointment, call 404-350-7355.

Impotence Treatment
Shepherd Center knows impotence is a common problem in men who have survived a spinal cord injury. Our 25 years of experience in treating spinal cord injuries has provided us with a broad range of treatment options for poor erections resulting from neurological damage. These include:

Pharmacologic Erection Program. Medication injected into the penis relaxes the blood vessels and muscles so that the penis swells and traps blood, causing an erection that lasts one to two hours.

Vacuum erection device. This non-invasive device causes an erection by creating a vacuum suction on the penis, encouraging blood flow to the area.

Penile implant surgery. Shepherd Center offers initial evaluation, counseling, referrals and preoperative preparation for patients who choose penile implant surgery.

Penile Color Duplex Doppler Ultrasonography. A minimally invasive test that measures blood flow to the penis during an erection. It is used to evaluate organic impotence.

A sexual therapist is available for confidential evaluation and counseling to all patients.

For more information about impotence treatment services at Shepherd Center or to make an appointment, call 404-350-7355.