Specialties
Urological Procedures
At Riverstone Urology Specialists, you have access to a focused set of urologic procedures performed by a board-certified urologist. Dr. Russell Libby offers options for a wide range of conditions from benign to malignant. We have a strong focus on minimally invasive treatment options and advanced technologies for care when appropriate.
How Dr. Libby Helps You Choose A Procedure
Most people do not start with a procedure. You start with an evaluation.
A Typical Path Looks Like This:
Evaluation
Dr. Libby listens to your symptoms, reviews your health history, and checks any lab work or imaging you already have.
Testing
When needed, he orders blood work, urine tests, imaging, or in office procedures such as cystoscopy to understand the problem.
Choosing A Treatment
You review your options together. That may mean watchful waiting, medication, or a procedure. The goal is relief of symptoms and protection of long term health with a plan you understand and accept.
The sections below show where each procedure fits.
Men’s Sexual Health And Erectile Dysfunction Procedures
Erectile dysfunction and Peyronie’s disease affect daily life and relationships. Riverstone Urology offers several procedure based options when pills alone are not enough or not appropriate.
Wave Therapy For Erectile Dysfunction
Wave therapy uses low intensity sound waves aimed at erectile tissue to improve blood flow and support natural erections over time.
Inflatable Penis Prosthesis (IPP)
IPP surgery places inflatable cylinders inside the penis and a small fluid pump in the scrotum. You control erections by squeezing the pump, which moves fluid into the cylinders. This option is usually for men whose erectile dysfunction has not responded to other treatments.
Bio-Identical Testosterone Pellets
Testosterone pellets are small cylinders placed under the skin that slowly release bio-identical testosterone over several months. This can be an option for some men with confirmed low testosterone levels and matching symptoms.
TRT Alternatives
TRT alternatives include other forms of testosterone delivery and supportive treatments that work alongside lifestyle changes and weight management.
Your individual procedure page will explain who qualifies, expected benefits, and safety checks.
Prostate And BPH Procedures
Enlarged prostate, or benign prostatic hyperplasia (BPH), causes weak stream, slow flow, and frequent trips to the bathroom. Riverstone Urology offers several modern options once medication is not enough or side effects are a concern.
Transurethral Resection Of The Prostate (TURP)
Endoscopic approach to resect and remove prostate tissue to open the prostatic urethral channel.
Transurethral Laser Vaporization Of The Prostate (TULVP)
Endoscopic approach to vaporize and remove prostate tissue to open the prostatic urethral channel.
Aquablation Therapy For BPH
Aquablation uses real time imaging and a robot guided high pressure waterjet to remove extra prostate tissue and open the urinary channel, while protecting important structures as much as possible and limiting the risk of retrograde ejaculation and ED.
Urolift
The Urolift system uses small permanent implants to pull prostate tissue away from the urethra, like opening curtains, so urine can flow more freely, and does not cut or remove tissue.and supportive treatments that work alongside lifestyle changes and weight management.
Prostate Biopsy
Prostate biopsy takes small tissue samples from the prostate when PSA levels, exam findings, or imaging raise concern for cancer. The samples go to a pathologist who looks for cancer cells and grades them.
Prostate Cancer Genetic Screening
Genetic and molecular tests on blood or tissue can help estimate the risk that prostate cancer will grow or spread. These results can guide decisions about surveillance, treatment, or follow up.
Each of these procedures has its own detailed page where you can learn about preparation, the day of the procedure, and recovery.
Permanent Birth Control
Vasectomy is a permanent birth control procedure for men who feel certain they do not want more children. Dr. Libby closes the tubes that carry sperm so future ejaculations no longer contain sperm. Most patients go home the same day and return to light activity in a short time, with a follow up test to confirm success.
Women’s Health And Procedures
Women may require surgery for urological conditions such as overactive bladder, interstitial cystitis, stress urinary inconitnence and pelvic organ prolapse.
OAB Treatments
Offers sacral nerve modulation and intravesical agents to reduce the symptoms of OAB including bladder Botox.
Interstitial Cystitis (IC)
Hydrodistension and bladder instillations.
Stress Urinary Incontinence (SUI)
Offers slings such as the retropubic midurethral sling and transobturator sling, as well as bulking agents such as Bulkamid
Pelvic Organ Prolapse (POP)
Offers robotic sacrocolpoexy to restore vaginal anatomy and function of the urinary tract.
Kidney Stone and Urinary Tract Procedures
Kidney stones and bladder problems are some of the most painful reasons to see a urologist. The right procedure depends on stone size, location, and how sick you feel.
Extracorporeal Shock Wave Lithotripsy (ESWL)
ESWL uses focused sound waves from outside the body to break some kidney stones into smaller pieces so they can pass more easily through the urinary tract.
Ureteroscopy With Laser Lithotripsy (URS)
ESWL uses focused sound waves from outside the body to break some kidney stones into smaller pieces so they can pass more easily through the urinary tract.
Cystoscopy
Cystoscopy uses a small camera passed through the urethra into the bladder to look for strictures, tumors, stones, and other causes of bleeding or repeated infections. Many cystoscopies happen in the office with numbing medicine.
Intravesical Botox For Overactive Bladder
Intravesical Botox involves tiny injections of botulinum toxin into the bladder muscle through a small scope. This helps calm overactive contractions and can reduce urgency and leakage when pills have not worked well enough.
On each procedure page, you will see when these options make sense and how they compare with medicine only approaches.
Hormone And Metabolic Treatments
Hormone balance and weight play a role in energy, sexual health, and overall wellness. Riverstone Urology includes options that support those areas when appropriate.
Biote Hormone Therapy
Biote uses bio identical hormone pellets and a structured dosing method to support hormone balance based on lab results and symptoms.
Semaglutide And Tirzepatide
Semaglutide and tirzepatide belong to a class of injectable medications that help with weight management and metabolic health for selected patients. Your page for this service will explain who these medicines fit, how they work, and how they tie in with your broader health plan.
Bladder Cancer Treatments
Urothelial carcinoma of the bladder and other variants.
Transurethral Resection Of Bladder Tumor
Endoscopic approach to resect and remove bladder cancers transurethrally without requiring an incision. This is often followed by intravesical chemotherapy to reduce the risk of cancer recurrence.
What To Expect Before And After A Procedure
No Matter Which Procedure You And Dr. Libby Choose, The Process Follows A Clear Pattern:
Before The Procedure, You Can Expect
- Plain language explanation of why the procedure is recommended
- Written instructions on food, drink, and medications
- A realistic idea of time off work, activity limits, and follow-up timing
After The Procedure, You Can Expect
- Guidance on pain control and common side effects
- Instructions on warning signs and when to call
- A scheduled follow-up visit or phone call
You will not leave a visit with open questions about what comes next.
Urologic Cancer Procedures
We offer minimally invasive and robotic procedures for GU malignancies. We utilize the Intuitive Da Vinci robots to assist with surgery. We use the latest platforms available on the market.
Robot Assisted Radical Prostatectomy
Offerings include the standard robotic approach and a retzius sparing approach to minimize the risk of incontinence. Full and partial nerve spares performed as needed to preserve erectile function.
Robot Assisted Radical Nephrectomy | Robot Assisted Partial Nephrectomy
Questions You Might Have
Do all patients need a procedure?
No. Many people do well with lifestyle changes, monitoring, or medicine. Procedures are usually for situations where symptoms stay severe, risk is high, or you want a more durable solution.
Where will my procedure take place?
Some procedures happen in the office. Others take place at an outpatient center or hospital in the Cypress or greater Houston area. Your procedure page and your visit notes will spell this out clearly.
How do I know which option is right for me?
You and Dr. Libby decide together after a full evaluation. He will walk through each reasonable option, what recovery looks like, and how each choice lines up with your goals.
If you are dealing with kidney stones, urinary symptoms, enlarged prostate, or sexual health concerns, start with a visit. From there, you and Dr. Libby can decide whether one of these procedures is the right next step for you.