Urology Procedures & Surgical Options in Tustin, CA | Prestige Medical Group
In-Office Procedures · Tustin & Santa Ana, CA

Advanced procedures.
Minimally invasive.

At Prestige Medical Group, Dr. Lamia Gabal offers a comprehensive range of in-office procedures and surgical options — using the most advanced, evidence-based techniques to deliver the best outcomes with the least disruption to your life.

Minimally Invasive First
We prioritize the least invasive approach — shorter recovery, lower risk, better quality of life outcomes
Most Procedures In-Office
The majority of our diagnostic and treatment procedures are performed in our comfortable office setting — no hospital stay required
Patient Comfort is a Priority
PRO-NOX nitrous oxide analgesia is available for in-office procedures to reduce anxiety and discomfort throughout your visit
In-Office Procedures

Diagnostic & treatment
procedures

Performed with precision in our state-of-the-art Tustin and Santa Ana offices. Most require no general anesthesia and allow you to return home the same day.

Diagnostic

Cystoscopy

A thin, flexible camera is passed through the urethra to visually examine the bladder and urethra. Used to evaluate hematuria, recurrent UTIs, bladder cancer, interstitial cystitis, and other conditions. Performed with local anesthetic — PRO-NOX available for comfort.

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Diagnostic

Urodynamics

A comprehensive series of tests that evaluate how well the bladder, sphincter, and urethra store and release urine. Essential for diagnosing incontinence, overactive bladder, and voiding dysfunction. Guides targeted, effective treatment planning.

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Diagnostic

Uroflow

A simple, non-invasive test measuring the speed and volume of urine flow during voiding. Provides objective data on urinary obstruction, bladder outlet problems, and prostate enlargement. Often performed alongside post void residual measurement.

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Diagnostic

Post Void Residual

An ultrasound measurement of the urine remaining in the bladder after voiding. Elevated residual urine can indicate obstruction, neurogenic bladder, or poor detrusor function. Quick, painless, and performed immediately after urination.

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Diagnostic

Transrectal Ultrasound Prostate Biopsy

Ultrasound-guided needle biopsy of prostate tissue to diagnose or rule out prostate cancer. Performed under local anesthesia with real-time imaging guidance for precision. An essential tool when PSA levels or physical exam raise concern.

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Diagnostic & Therapeutic

Catheterization

Urinary catheter placement for diagnostic evaluation or therapeutic drainage of the bladder. Used in cases of urinary retention, post-surgical monitoring, or when patients are unable to void independently. Short-term and long-term options are available.

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Bladder & Kidney

Botulinum Toxin (Botox) Injection

Botox is injected directly into the bladder wall to relax overactive detrusor muscle contractions — significantly reducing urgency, frequency, and urge incontinence episodes. Effects last 6–12 months. FDA-approved for OAB and neurogenic bladder.

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Bladder & Kidney

Intravesical BCG Instillation

Immunotherapy instilled directly into the bladder via catheter to treat non-muscle-invasive bladder cancer and reduce recurrence risk. BCG stimulates the immune system to attack cancer cells. A well-established gold-standard treatment for early-stage bladder cancer.

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Bladder & Kidney

Heparin Cocktail Instillation

A compounded bladder instillation solution used to relieve pain, urgency, and frequency associated with interstitial cystitis (painful bladder syndrome). Heparin helps restore the bladder’s protective lining, reducing nerve irritation and discomfort.

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Bladder & Kidney

Interstim Sacral Neuromodulation Trial

A percutaneous trial of the Interstim device to evaluate whether sacral nerve stimulation will relieve overactive bladder, urgency incontinence, or non-obstructive urinary retention before committing to permanent implantation. Typically a 1–2 week outpatient evaluation period.

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Patient Comfort

PRO-NOX (Nitrous Oxide Analgesia)

A patient-controlled, inhaled nitrous oxide and oxygen blend that provides rapid pain relief and anxiety reduction during in-office procedures. Patients self-administer as needed and recover quickly — no IV or sedation required. Safe, fast-acting, and highly effective.

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Bladder & Kidney

Rezum Water Vapor Therapy

An FDA-cleared, minimally invasive in-office treatment for BPH (enlarged prostate) using steam to destroy excess prostate tissue. Preserves sexual and urinary function, provides durable symptom relief within weeks, and avoids the risks of major surgery. No general anesthesia required.

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Sexual Health

Shockwave Therapy for ED

Low-intensity acoustic wave therapy that stimulates neovascularization (new blood vessel growth) to improve penile blood flow and erectile function. A drug-free, non-invasive treatment with no downtime. Especially effective for vasculogenic erectile dysfunction. Often combined with P-Shot for optimal results.

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Sexual Health

P-Shot® (Priapus Shot)

Platelet-rich plasma (PRP) injected into the penis to stimulate tissue regeneration, improve sensitivity, and enhance erectile function. Uses your own growth factors — no synthetic chemicals. Clinically shown to improve ED, Peyronie’s disease, and overall sexual performance.

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Sexual Health

O-Shot® (Orgasm Shot)

PRP injected into targeted areas of the vagina and clitoris to improve sexual arousal, orgasm intensity, and urinary incontinence. Safe, natural, and performed in-office in under 30 minutes. Addresses female sexual dysfunction, low libido, and stress urinary incontinence simultaneously.

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Sexual Health

Bocox™ (Priapus Toxin)

A novel, in-office treatment using botulinum toxin injected into the bulbospongiosus muscle to delay ejaculation and treat premature ejaculation (PE). A discreet, highly effective option for men seeking improved ejaculatory control without systemic medications.

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Sexual Health

P-Long® Male Enhancement

A non-surgical penile enhancement protocol combining evidence-based techniques to improve penile length, girth, and function. Performed in-office with minimal downtime. A discreet, physician-supervised option for men seeking enhancement without surgery.

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Sexual Health

Laser Vaginal Rejuvenation (MonaLisa Touch®)

Fractional CO₂ laser therapy delivered to the vaginal walls to stimulate collagen production, restore moisture, and improve elasticity. Treats vaginal atrophy, GSM, painful intercourse, and mild urinary incontinence. Non-hormonal and highly effective for menopausal women.

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Hormone & Wellness

BioTE® Bioidentical Hormone Replacement

Pellet-based bioidentical hormone replacement therapy (BHRT) for men and women experiencing symptoms of hormonal imbalance — fatigue, low libido, mood changes, weight gain, and brain fog. Pellets are inserted under the skin every 3–6 months for consistent hormone delivery.

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Surgical Options

Advanced surgical solutions

When in-office procedures aren’t sufficient, Dr. Gabal offers the full spectrum of urological surgeries — including robotic-assisted and laparoscopic approaches for faster recovery and better outcomes.

01
Bulkamid
Injectable urethral bulking agent for stress urinary incontinence — a simple, effective office-based surgical option
02
Combination LVR & DLV
Combined laser vaginal rejuvenation and designer laser vaginoplasty for comprehensive vaginal restoration
03
Cystolitholapaxy
Minimally invasive endoscopic procedure to break up and remove bladder stones without open surgery
04
Designer Laser Vaginoplasty
Precision laser-based procedure to reshape and rejuvenate vaginal tissue, improving aesthetics and function
05
Elevate Cystocele Repair with Mesh
Surgical repair of anterior vaginal wall prolapse (cystocele) using a supportive mesh for durable anatomical correction
06
Extracorporeal Shock Wave Lithotripsy (ESWL)
Non-invasive kidney stone fragmentation using focused acoustic shock waves — no incisions, no anesthesia required
07
Interstim Sacral Neuromodulation Implantation
Permanent implantable device that modulates sacral nerve signals to treat overactive bladder and non-obstructive urinary retention
08
Laparoscopic Nephrectomy
Minimally invasive removal of a kidney for kidney cancer or non-functioning kidney using small incisions and a laparoscope
09
Laser Vaginal Rejuvenation (Surgical)
Surgical-grade laser tightening and rejuvenation of vaginal tissue to address laxity and improve function and satisfaction
10
Mini Arc Suburethral Sling
A small mesh sling placed under the urethra to treat stress urinary incontinence — minimally invasive with fast recovery
11
Robotic Laparoscopic Radical Prostatectomy
Robotic-assisted removal of the prostate gland for prostate cancer — offering precision, less blood loss, and faster recovery than open surgery
12
Transurethral Resection of Bladder Tumor (TURBT)
Endoscopic removal of bladder tumors through the urethra — used for diagnosis, staging, and treatment of bladder cancer
13
Transurethral Resection of Prostate (TURP)
Standard surgical treatment for severe BPH — removes obstructing prostate tissue through the urethra to restore urine flow
14
Ureteral Stent Placement
Placement of a flexible tube in the ureter to maintain urine flow around obstructions from stones, tumors, or post-surgical swelling
15
Ureteroscopy
A thin scope passed through the urethra and bladder into the ureter or kidney to diagnose and treat stones, tumors, and strictures
Your Experience Matters

Designed around your comfort & confidence

We know that urological procedures can feel daunting. That’s why every aspect of our practice — from our technology to our team — is built to make your experience as comfortable, dignified, and reassuring as possible.

PRO-NOX Pain Management
Patient-controlled nitrous oxide analgesia is available for all in-office procedures — reducing anxiety and discomfort without IV sedation or lengthy recovery
Robotic Surgical Precision
Robotic-assisted surgery delivers exceptional precision, reduced blood loss, smaller incisions, and faster recovery compared to traditional open surgical approaches
Complete Privacy & Discretion
All procedures — especially sensitive sexual health treatments — are performed with the utmost discretion in a private, welcoming, judgment-free environment
Same-Day Discharge
The vast majority of our procedures allow you to return home the same day — minimizing disruption to your work, family, and daily routine
Common Questions

Frequently asked questions

Have a question not answered here? Call us at (949) 825-7650 — we’re happy to help.

Accepting New Patients
Same-day & next-day appointments available
Most private insurance and Medicare accepted. Tustin & Santa Ana.
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What urology procedures are done in-office? +
The majority of our diagnostic and treatment procedures are performed in-office — including cystoscopy, urodynamics, uroflow, Botox bladder injections, BCG instillation, heparin cocktail instillation, Interstim neuromodulation trial, PRO-NOX, Rezum water vapor therapy, O-Shot, P-Shot, shockwave therapy for ED, Bocox, P-Long, MonaLisa Touch, and BioTE hormone therapy. Most allow same-day return home.
Does a cystoscopy hurt? +
Most patients experience mild pressure or brief discomfort rather than significant pain during a cystoscopy. Local anesthetic gel is used, and PRO-NOX nitrous oxide is available for patients who feel anxious. The procedure typically takes just a few minutes and you can drive yourself home afterward.
What is Rezum and who is it for? +
Rezum uses steam to destroy excess prostate tissue causing BPH (enlarged prostate) symptoms like weak urine stream, urgency, and frequent urination. It is FDA-cleared, performed in-office under local anesthesia, preserves sexual function, and provides lasting relief within weeks. It’s ideal for men who want to avoid major surgery or long-term medication.
Is shockwave therapy for ED covered by insurance? +
Shockwave therapy for erectile dysfunction is considered elective and is not currently covered by most insurance plans. However, covered diagnostic evaluation for ED (blood work, urologic exam) may be billed to insurance. Call (949) 825-7650 to discuss costs and payment options including our Enhanced Access Membership which includes a 10% discount on elective treatments.
What surgical procedures does Dr. Gabal perform? +
Dr. Gabal performs 15 surgical procedures including robotic laparoscopic radical prostatectomy, Bulkamid urethral injection, cystolitholapaxy, extracorporeal shock wave lithotripsy, Interstim sacral neuromodulation implantation, mini arc suburethral sling, cystocele repair, laparoscopic nephrectomy, ureteroscopy, ureteral stent placement, TURBT, TURP, laser vaginal rejuvenation, and designer laser vaginoplasty.
Do you accept insurance for urology procedures? +
Yes. Most covered urology procedures are billed to Medicare and most private insurance plans. Elective procedures such as the O-Shot, P-Shot, shockwave therapy, and cosmetic treatments are not typically covered. Call (949) 825-7650 to verify your coverage before your appointment.

Ready to discuss your procedure options?

Accepting new patients across Orange County. Same-day appointments available. Most insurance and Medicare accepted.