After using a Lumenis holmium laser with MOSES at my previous hospital in California and attending additional HoLEP training in Cambridge, England, I was so pleased and confident with the outcomes that I made MOSES technology a requirement for my next career move. My choice: Titus Regional Medical Center in Mount Pleasant, Texas, a small city of 16,000 people located about 120 miles outside of Dallas. Titus wasn’t a hub of urology—in fact, there was no local urologist—but my training in gold-standard procedures such as HoLEP motivated administrators to partner with me and start the Advanced Urology Institute (AUI). Now we draw urology patients to our center from a radius of 90 miles. The community has the urological care it needs, the medical center benefits, and I was able to choose the kind of family-friendly small city that my family wanted.

MOSES technology was central to this opportunity. I offer the full spectrum of urology care, and as a specialist in minimally invasive and robotic-assisted laparoscopic surgery, MOSES allows me to offer gold-standard surgeries for kidney stones and enlarged prostates. I can dust kidney stones with greater accuracy and efficiency and minimal complications¹, and I offer the HoLEP procedure for one-time treatment of prostates of all sizes, often with same-day discharge². Now we’re a HoLEP center for excellence, and I’m training visiting surgeons to conduct the procedure.

“Other urologists might think about how advanced surgery with MOSES technology can help other smaller markets where they’d like to live. At the same time, smaller hospitals can look at the MOSES holmium laser as a way to attract top surgeons to their area and draw exposure to the hospital as a regional hub for urology”

The AUI has changed how this community gets the urology care it needs. Here’s how:

  • In the past, patients traveled for care. For several years, the community had no local urologist, and no urologic surgeries were done at the hospital. Patients had to travel at least an hour for general urology care; if they needed advanced surgery, they drove two hours to Dallas. It was an inconvenience for everyone, as well as a serious challenge for people who didn’t have someone to drive them and arrange for accommodations.
  • We opened AUI and changed referral patterns. When we opened AUI, local doctors were accustomed to referring patients to out-of-town urologists. I had to introduce myself, explain my training and services, and encourage them to refer to AUI. The process of educating doctors in the surrounding area continues two-and-a-half years later, but word-of-mouth awareness has helped as well.
  • Now local residents are well served, and patients travel to see us. We’re very happy that patients in our community now have their own local urologist. In addition, because we offer advanced surgeries that are not available everywhere, we see referrals from a 100,000-person catchment area, particularly patients with very large prostates referred for HoLEP. It’s not unusual to treat several patients per week with prostates above 200cc, many of whom are catheterized, in dire need of treatment, and eager to avoid open simple prostatectomy.

My family and I are happy to be living in Mount Pleasant, Texas, and I’m grateful that Titus Regional Medical Center was open to partnering with me to offer advanced urology care.

The article is written in collaboration with Dr. Lance Patrick Walsh based on his own experience.

  1. Andonian S et al. Double-Blinded Prospective Randomized Clinical Trial Comparing Regular and Moses Modes of Holmium Laser Lithotripsy. J Endourology. 2020;34(5):624-628. doi:10.1089/end.2019.069
  2. Krambeck AE et al. Catheter Removal on the Same Day of Holmium Laser Enucleation of the Prostate: Outcomes of a Pilot Study. 2020;146:225-229. doi: 10.1016/j.urology.2020.09.038. Epub 2020 Oct 10.


*Risk information and laser safety label are available at Lumenis website, operator’s manual and brochure.