Dr. Moses Kim Performs First Single Port Robotic Prostatectomy in SoCal


Hoag Performs First Robotic Prostatectomy in Southern California

IRVINE, Calif., February 26, 2020 – Hoag Hospital Irvine today became the first in Southern California to perform a robotic prostatectomy for the treatment of prostate cancer, using the new da Vinci® single port (SP) system, a cutting-edge robotic-assisted technology that few hospitals in the world have yet acquired.

Dr Moses Kim
Moses Kim, M.D., Ph.D.

“We have the privilege of being one of the first hospitals in the nation to obtain this fourth-generation robotic tool that allows us to perform ever more precise surgeries with less stress on the patient’s body,” said Moses Kim, M.D., Ph.D., President of Orange County Urology Associates and Chair of Urology at Hoag, who performed the recent surgery. “This is another example of how Hoag is a leader in the field of robotic surgery.”

“This advanced technology allows our physicians to consistently deliver the safest, highest-quality care to our robotic surgery patients,” said Robert T. Braithwaite, Hoag president and CEO. “While robotics is still just one tool in a surgeon’s tool box, minimally-invasive options are becoming the standard of care for many procedures in a variety of areas of expertise at Hoag, including cancer, women’s and heart programs, as well as general surgery.”

“Single port,” means that only one small incision is needed to insert all the tiny tools necessary to remove part or all of a person’s prostate. Previously, five incisions were needed for laparoscopic prostatectomies.

The new tool ensures faster recovery times and is less disfiguring, Dr. Kim said. The robotic system is approved by the U.S. Food & Drug Administration for use in prostate cancer, kidney cancer and advanced urinary tract reconstruction surgery.

The new tool helps Hoag’s efforts to minimize or reduce any possible side effects of surgery.

“The ability to perform these complex procedures through a one-inch incision will make a tremendous difference to our patients. Already, Hoag is a leader in robotic surgeries and the highest surgical volume center for prostate and bladder surgeries in Orange County,” Dr. Kim said.

Hoag is a Center of Excellence in Robotic Surgery (COERS), as designated by the Surgical Review Corporation. The designation recognizes the elite hospitals and surgeons nationwide who demonstrate an unparalleled commitment and ability to consistently deliver safe, effective, evidence-based care.

Surgeons at Hoag perform the fifth highest volume of total robotic cases annually in the country, which allows the hospital to deliver the safest, highest-quality care. This new tool will enhance that capability and further Hoag’s commitment to patient care.

“Robotic surgery improves outcomes, which is important for patient satisfaction,” Dr. Kim said. “We are not just focused on treating cancer, we are also dedicated to maintaining our patients’ quality of life.”


Hoag is an approximately $1 billion nonprofit, regional health care delivery network in Orange County, California, that treats more than 30,000 inpatients and 480,000 outpatients annually. Hoag consists of two acute-care hospitals – Hoag Hospital Newport Beach, which opened in 1952, and Hoag Hospital Irvine, which opened in 2010 – in addition to nine health centers and 13 urgent care centers. Hoag is a designated Magnet® hospital by the American Nurses Credentialing Center (ANCC). Hoag offers a comprehensive blend of health care services that includes five institutes providing specialized services in the following areas: cancer, heart and vascular, neurosciences, women’s health, and orthopedics through Hoag’s affiliate, Hoag Orthopedic Institute, which consists of an orthopedic hospital and two ambulatory surgical centers. Hoag has been named one of the Best Regional Hospitals in the 2019 – 2020 U.S. News & World Report. For an unprecedented 23 years, residents of Orange County have chosen Hoag as one of the county’s best hospitals in a local newspaper survey. Visit www.hoag.org for more information.

Dr. Spitz makes 50th appearance on The Doctors TV show

Dr. Spitz

Dr. Aaron Spitz

LAGUNA HILLS, Calif. (Oct. 16, 2018) – Dr. Aaron Spitz, a board-certified urologist with Orange County Urology Associates, is a frequent guest on the daytime health and medical TV show, The Doctors. He recently made his 50th appearance on the show to provide context and medical advice on a wide variety of health conditions.

Here are some links to Dr. Spitz’s recent appearances:

Good or bad idea? Cool air-flow underwear for men

Explain Peyronie’s disease

Unusual way to determine your risk of heart disease

Can fruit flies help us better understand sex?

Hack or whack?

Shingles: causes and best treatments

Are you a player?

Broken genitalia from self-pleasuring too much

Cause of messy urination


Dr. Meaglia now offers revolutionary Rezum® therapy to select BPH patients

Dr. James Meaglia is now offering Orange County Urology patients the Rezum® system, a minimally invasive treatment option for men with benign prostatic hyperplasia (BPH).


Designed to be performed in a clinical setting, Rezum is an FDA approved treatment that uses the stored thermal energy in water vapor (steam) to treat the extra prostate tissue that is causing symptoms such as frequency, urgency, irregular flow, weak stream, straining, and getting up at night to urinate.

BPH is a localized enlargement of the prostate gland in aging adult men. Nearly 12 million U.S. men suffer from BPH related symptoms that may require therapy, yet more than half choose not to do anything to address their BPH symptoms. Their reasons include not wanting to start new prescriptions, hesitations around the potential side effects of drugs, and concerns about the potential side effects or complications of current minimally invasive BPH treatments or surgical procedures.

“I am pleased to now offer select patients the Rezum® procedure as a treatment for benign prostatic hyperplasia (BPH). Rezum is administered on an outpatient basis and can be performed under oral sedation or local anesthesia. Research studies have shown that the Rezum treatment allows men to retain sexual function unlike many other existing BPH treatments,” Dr. Meaglia said.

Dr. James Meaglia is the first doctor at Orange County Urology Associates certified to perform the FDA approved Rezum therapy. For years, the primary options for treating BPH were through medications or surgery, making Rezum a new option for patients who are dissatisfied with their current choices for treating BPH.

How Rezum Works

The Rezum therapy is completed in a single visit; there is no need for ongoing therapy.

It works by delivering very small amounts of steam to the enlarged prostate. This process damages the cells causing obstruction, thus reducing the overall size of the prostate and the symptoms associated with BPH such as:

  • A weak urine stream
  • Trouble starting the flow of urine
  • Starting and stopping again when urinating
  • Not emptying your bladder completely
  • Urinating more often, especially at night
  • Sudden urges to urinate
  • Leaking or dribbling after you urinate
  • Straining to urinate.

Patient Education Video (English)

Patient Education Video (Spanish)

Next Step: Schedule an Appointment

Patients interested in a consultation with Dr. Meaglia to determine if they are a candidate for the Rezum® system should call appointment scheduling at (949) 855-1101.

Procedure Day

Treatment is a minimally invasive procedure conducted in-office that does not require general anesthesia. Patients need to be driven home after the procedure. Over the next several days, patients can gradually resume their regular activities.

Symptom Improvement

BPH symptoms may improve in as little as two weeks.

Rezum Procedure Quick Facts:

  • Using water vapor therapy, Rezum is a minimally invasive, single-visit, out-patient procedure shown to significantly reduce the symptoms of BPH.
  • Delivers small amounts of steam to obstructing prostatic tissue.
  • Treated tissue is reabsorbed into the body naturally, reducing the overall size of the prostate and the symptoms associated with BPH.
  • Rezum treatment is appropriate for small to medium prostate lobes, between 30g and 80g.

Benign prostatic hyperplasia (BPH), or an enlarged prostate, is a common condition that can cause bothersome urinary symptoms. As men age, their likelihood of experiencing the bothersome symptoms of BPH increases. Fifty percent of men age 50 and older have BPH, and eighty percent of men age 80 and older have the condition.

Frequently Asked Questions

Does an enlarged prostate improve without treatment?

Early on, enlarged prostate symptoms may come and go, so taking a “wait and see” approach to mild symptoms is reasonable. Over the long-term, however, symptoms tend to get gradually worse.

Is the Rezum therapy covered by insurance?

Rezum therapy is covered by most insurance plans to treat benign prostatic hyperplasia (BPH).

If the Rezum therapy is new, how do I know it is safe?

The Rezum therapy has undergone extensive clinical trials to evaluate the safety and efficacy of the treatment, and was approved by the FDA in late 2015.

Highlights of the therapy include:

  • Performed in-office and patients can be driven home afterward
  • Does not require general anesthesia
  • Relieves symptoms safely and effectively
  • Is an alternative to BPH daily medications
  • Provides noticeable symptom improvement within 2 weeks
  • Preserves erectile and urinary functions
  • Allows patients to return to regular activities within a few days
  • Is considered medically necessary by Medicare and is covered by most private insurance plans.

Illustration credit: Rezum® system

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland. The condition affects 12 million men in the U.S., with nearly 800,000 newly diagnosed each year. An enlarged prostate squeezes down on the urethra, causing lower urinary tract symptoms. After the Rezum® system therapy has been performed, over time the body’s natural healing response removes the dead cells, shrinking the prostate. With the extra tissue removed, the urethra opens, reducing BPH symptoms. Most patients begin to experience symptom relief in as soon as 2 weeks and maximum benefit will occur in about 3 months.

Dr. Meaglia performs his 150th UroLift® implant

LAGUNA BEACH, Calif. (January 15, 2017) – Dr. James Meaglia of Orange County Urology Associates has performed his 150th UroLift® implant on a patient suffering from benign prostatic hyperplasia (BPH), a condition in which the prostate enlarges as men age.

More than 500 million men worldwide suffer from BPH each year. One in four men experience symptoms of an enlarged prostate by the age of 55, and that rate increases to 90 percent in men over the age of 70. The most common symptom of BPH is difficulty voiding. Chronic lower urinary tract symptoms associated with BPH can cause loss of productivity and sleep, depression, and decreased quality of life.

Past treatments for BPH meant that men had a high risk of urinary incontinence, erectile dysfunction (ED), and retrograde (dry) orgasm. Today, UroLift is a surgical device approved by the FDA in the United States for the treatment of BPH that completely eliminates these potential risks.
Unlike previous BPH treatments, the UroLift system directly opens the urethra without cutting, heating, or removing prostate tissue. It uses tiny metal anchors (like staples) to compress the prostate gland, which opens up the urinary channel that runs through the middle of it.

“This allows urine to flow again normally. Using this new surgical approach, patients experience very rapid and durable relief,” Dr. Meaglia said. “I continue to see excellent clinical outcomes using the UroLift system.”

He added: “This treatment option has been very successful for many of my BPH patients who are unhappy with medication therapy and are concerned about the lengthy recovery and side effects common with other procedures to treat BPH.”
Dr. Meaglia pioneered UroLift in Orange County in November 2014.

He said in certain instances, the procedure can now be done as an in-office procedure. This eliminates the need for anesthesia and a brief hospitalization. An in-office UroLift procedure still takes about 15-20 minutes to complete.
“The risks of the procedure are the same whether it’s done in-office, or in the operating room with anesthesia. There still is no risk of incontinence or impotence,” Dr. Meaglia said.

Patients also experienced a significant improvement in quality of life. The most common adverse events reported include blood in the urine, a burning sensation during urination, urinary urgency, or pelvic pain. Most symptoms were mild to moderate in severity and resolved within two weeks after the procedure.

Medication is often the first line therapy for BPH, but relief can be inadequate and temporary. Side effects can include sexual dysfunction, dizziness and headaches, prompting many patients to quit using their drugs. For these patients, the classic alternative has been surgery that cuts or heats prostate tissue to open the blocked urethra. Although effective, patients often require an overnight stay with a catheter for up to a few days following these procedures. There is often a variable period of irritative voiding symptoms before the symptom relief is fully realized. Even the “gold standard” surgery, TURP (transurethral resection of the prostate), can leave a small percentage of patients with permanent side effects such as urinary incontinence or erectile dysfunction. The TURP does, however, have a high risk of retrograde ejaculation (dry orgasm).

In a two-year randomized controlled study of UroLift in 206 people, which was published in Urology Practice (a journal of the American Urological Association), symptoms, quality of life, and urinary flow improved rapidly and remained durable to two years, with only 7.5% of the men who had the UroLift system needing additional BPH procedures. Treated men returned to normal activity within eight days and showed significant improvement in symptoms by two weeks. While urinary symptoms were effectively treated, not a single patient lost ejaculatory or erectile function as a result of the treatment.

By comparison, 65% of men undergoing the standard surgery (transurethral resection of the prostate, TURP) lose the ability to ejaculate.

Important caveat: The UroLift is not appropriate for all men. Some men may have a prostate that is too large, or not ideally shaped, to allow the procedure to be truly effective. An evaluation will be performed by the urologist prior to recommending the procedure to ensure proper patient selection.

“The advent of the UroLift treatment system underscores the need for men with BPH to discuss male orgasmic dysfunction with their doctor prior to treatment,” Dr. Meaglia said.
The UroLift system is available in the U.S., Europe, Australia, Mexico, South Korea and Canada. Learn more at www.UroLift.com.

U.S. News selects Dr. Brower as a ‘Top Doc’

LAGUNA HILLS, Calif. – Dr. Paul Brower, President and Chief Executive Officer of Orange County Urology Associates (OCUA), has been selected by U.S.News as a “Top Doctor.”

OCUA_USNewsTopDoctorsU.S.News Top Doctors was developed in collaboration with Castle Connolly Medical Ltd., publisher of America’s Top Doctors® and other guides, and was built upon data from Castle Connolly’s Top Doctors™.

Continue reading