Surgical Specialist, Urologists
28 years of experience
Video profile
Accepting new patients
Urological Associates of Lancaster
175 Martin Ave
Ste 300
Ephrata, PA 17522
717-738-4700
Locations and availability (5)

Education ?

Medical School Score Rankings
Indiana University (1982)
  • Currently 3 of 4 apples
Top 50%

Awards & Distinctions ?

Associations
American Board of Urology
American College of Surgeons
Society of Urologic Oncology
American Urological Association

Affiliations ?

Dr. Sieber is affiliated with 6 hospitals.

Hospital Affilations

Score

Rankings

  • Ephrata Community Hospital
    169 Martin Ave, Ephrata, PA 17522
    • Currently 4 of 4 crosses
    Top 25%
  • Lancaster General Hospital
    Urology
    555 N Duke St, Lancaster, PA 17602
    • Currently 3 of 4 crosses
    Top 50%
  • Lancaster Regional Medical Center
    Urology
    250 College Ave, Lancaster, PA 17603
    • Currently 2 of 4 crosses
  • Lancaster General, Women & Babies Hosp.
    690 Good Dr, Lancaster, PA 17601
  • Lancaster Rehabilitation Hospital
  • Ephrata Comm Hosp, Ephrata, Pa
  • Publications & Research

    Dr. Sieber has contributed to 16 publications.
    Title Toremifene to Reduce Fracture Risk in Men Receiving Androgen Deprivation Therapy for Prostate Cancer.
    Date October 2010
    Journal The Journal of Urology
    Excerpt

    Androgen deprivation therapy is associated with fracture risk in men with prostate cancer. We assessed the effects of toremifene, a selective estrogen receptor modulator, on fracture incidence in men receiving androgen deprivation therapy during a 2-year period.

    Title Treatment of Bicalutamide-induced Breast Events.
    Date March 2008
    Journal Expert Review of Anticancer Therapy
    Excerpt

    Bicalutamide is a competitive nonsteroidal androgen receptor antagonist. In the European Union and a number of other countries, bicalutamide 150 mg per day is approved as an adjuvant to primary treatments (radical prostatectomy or radiotherapy) or as monotherapy as an alternative to surgical or medical castration in men with locally advanced, nonmetastatic prostate cancer. The ongoing bicalutamide Early Prostate Cancer (EPC) program has shown that breast events, defined as gynecomastia, breast pain or both, are a significant limitation of bicalutamide. Nearly 90% of patients experienced one or both symptoms and nearly 16% of patients withdrew from the EPC program as a consequence of bicalutamide-induced breast events. Tamoxifen, anastrozole and radiotherapy have all been studied as options for the treatment of breast events. To date, tamoxifen appears to be the superior agent in terms of outcomes; however, further studies are still required to determine the optimal dose and timing of tamoxifen administration for both prophylaxis and treatment. In addition, the impact on prostate cancer control remains uncertain. An ongoing clinical trial using toremifene to prevent morphometric vertebral fractures in men undergoing medical and/or surgical castration will provide some additional data on the effects of selective estrogen receptor modulators in men with prostate cancer.

    Title Contemporary Prostate Biopsy Complication Rates in Community-based Urology Practice.
    Date October 2007
    Journal Urology
    Excerpt

    OBJECTIVES: To evaluate whether the increased number of rectal perforations associated with contemporary transrectal ultrasound-guided, 12-core prostate biopsy, with a periprostatic block, is associated with a greater rate of postprocedural complications. METHODS: We prospectively studied 1000 patients undergoing contemporary transrectal ultrasound-guided prostate biopsy and compared the rates of complicated urinary tract infection and significant rectal bleeding with the rates in our previous report of complications using a then-standard, 6-core biopsy technique, without a periprostatic block. RESULTS: Three patients developed complicated urinary tract infections, two of which were with ciprofloxacin-resistant organisms. This was not a significant different statistically from our earlier report. Seven patients had significant rectal bleeding requiring endoscopic intervention. This rate also was not significantly different statistically from our earlier report. CONCLUSIONS: Our infection and rectal bleeding complications associated with contemporary transrectal ultrasound-guided prostate biopsy were low. We experienced a small, nonstatistically significant, increase in the complicated urinary tract infection rate and a small, nonstatistically significant, increase in the rectal bleeding rate in association with the transition from an eight-core, no periprostatic block, technique to the contemporary technique.

    Title Histoplasma Phimosis: an Uncommon Presentation of a Not Uncommon Pathogen.
    Date July 2007
    Journal The American Journal of Dermatopathology
    Excerpt

    Infection from Histoplasma capsulatum is usually subclinical, but it also can be disseminated in patients with a compromised immune status. Involvement of the external genitalia is a rare finding, occurring by direct contact or hematogenous spread. We present a case of histoplasma posthitis in a 71-year-old man, manifesting with the extremely unusual presentation of phimosis. The diagnosis was confirmed using an immunohistochemical stain.

    Title Bicalutamide 150 Mg Maintains Bone Mineral Density During Monotherapy for Localized or Locally Advanced Prostate Cancer.
    Date July 2004
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We evaluated changes in bone mineral density (BMD), fat-free mass (FFM) and serum lipid levels during bicalutamide 150 mg monotherapy compared with medical castration for 2 years. MATERIALS AND METHODS: A total of 103 men with localized or locally advanced prostate cancer (T1-T4, Nx, M0) for whom immediate androgen deprivation was indicated were enrolled in this prospective, multicenter, open-label, parallel group study. Patients were randomized to bicalutamide 150 mg once daily (51) or medical castration with a luteinizing hormone releasing hormone analogue (52) for 96 weeks. Primary end points were mean percent change from baseline in lumbar spine BMD, hip BMD and FFM at 96 weeks. Mean changes in lipid parameters with time were also evaluated. RESULTS: BMD was maintained during bicalutamide 150 mg monotherapy (+2.42% for lumbar spine BMD and +1.13% for hip BMD at week 96), while castration was associated with a progressive loss in BMD (-5.40% and -4.39% at week 96, respectively, both p <0.0001 at week 96). There was no significant difference between bicalutamide 150 mg and castration in mean percent change from baseline in FFM (-1.56% and -3.86%, respectively, at week 96, p = 0.31), although there was a trend for greater progressive loss over time with castration. Mean changes in lipid parameters were small and similar in the 2 groups. CONCLUSIONS: Bicalutamide 150 mg monotherapy may offer an important advantage compared to castration in terms of bone loss and body composition for patients who require long-term androgen deprivation for localized or locally advanced prostate cancer.

    Title The Treatment of Gross Hematuria Secondary to Prostatic Bleeding with Finasteride.
    Date April 1998
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We evaluate the use of finasteride to control gross hematuria secondary to prostatic bleeding. MATERIALS AND METHODS: We reviewed retrospectively 42 patients treated with finasteride to treat gross hematuria. RESULTS: There were 28 evaluable patients who had taken finasteride for at least 6 months to control gross hematuria and hematuria ceased in 25 (91%). In 1 patient clot retention developed requiring transurethral resection of the prostate and 2 patients had 1 or more minor episodes of bleeding that resolved spontaneously. CONCLUSIONS: Finasteride appears to be an effective agent for controlling gross hematuria secondary to prostatic bleeding.

    Title Is Heparin Contraindicated in Pelvic Lymphadenectomy and Radical Prostatectomy?
    Date September 1997
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We initiated a prospective study to verify or refute the complications of lymphocele formation and excessive blood loss associated with heparin prophylaxis in pelvic lymphadenectomy and radical prostatectomy. MATERIALS AND METHODS: A prospective study was completed on 579 men undergoing pelvic lymphadenectomy usually in association with radical prostatectomy. Patients were assigned to group 1 (given preoperative and postoperative subcutaneous heparin) and group 2 (no heparin). All patients were evaluated 2 to 3 weeks after surgery with ultrasound for pelvic lymphocele. RESULTS: There was no statistically significant difference in the number or size of pelvic lymphoceles or blood loss in group 1 versus group 2. CONCLUSIONS: The use of heparin prophylaxis to prevent thromboembolic complications in conjunction with pelvic lymphadenectomy and radical prostatectomy is not associated with increased blood loss or increased rate of lymphocele formation.

    Title Antibiotic Prophylaxis in Ultrasound Guided Transrectal Prostate Biopsy.
    Date June 1997
    Journal The Journal of Urology
    Excerpt

    PURPOSE: A retrospective review of a large group of transrectal ultrasound guided biopsies was performed to determine the symptomatic urinary tract infection rate associated with a consistent and defined antibiotic prophylaxis regimen. MATERIALS AND METHODS: A total of 4,439 biopsies was performed using an 18 gauge needle with ultrasound guidance. Patients were treated with 500 mg. ciprofloxacin twice daily for 8 doses beginning the day before biopsy. RESULTS: Of 5 symptomatic urinary tract infections noted 3 were complicated. CONCLUSIONS: These data demonstrate the low infection rate associated with this prophylaxis regimen.

    Title The Incidence and Management of Rectal Injury Associated with Radical Prostatectomy in a Community Based Urology Practice.
    Date October 1995
    Journal The Journal of Urology
    Excerpt

    PURPOSE: We assessed the use of combination bowel preparation before radical prostatectomy. MATERIALS AND METHODS: We reviewed 533 radical prostatectomies performed from 1984 to 1994. All patients underwent preoperative combination bowel preparation. The incidence, management and sequelae of rectal injury were determined. The literature addressing the management of rectal injuries was reviewed. RESULTS: Rectal injury occurred in 8 patients (1.5%). Injury was recognized intraoperatively and repaired primarily in 6 cases, and repair included colostomy in 2. Injury was recognized postoperatively as recto-urinary fistula in 2 cases and initial management was conservative. No fistula closed with conservative management. There were no pelvic abscesses and no deaths. CONCLUSIONS: Combination bowel preparation permits safe closure of rectal injury at radical prostatectomy without the necessity of routine colostomy. In the event of recto-urinary fistula, conservative management is not warranted.

    Title Bladder Necrosis Secondary to Pelvic Artery Embolization: Case Report and Literature Review.
    Date February 1994
    Journal The Journal of Urology
    Excerpt

    Bladder necrosis is a rare entity in the urological literature. We report a case of bladder necrosis secondary to pelvic artery embolization to control intractable hemorrhage from a pelvic fracture.

    Title The Use of Prostate Specific Antigen and Prostate Specific Antigen Density in the Diagnosis of Prostate Cancer in a Community Based Urology Practice.
    Date January 1994
    Journal The Journal of Urology
    Excerpt

    Since 1989 we have used serum prostate specific antigen (PSA) levels as an indication for ultrasound guided systematic biopsies of the prostate. Realizing that the PSA level in part reflects prostatic glandular epithelial volume, we reviewed the accumulated data on our last 2,340 biopsies to determine if the quotient of PSA and prostatic volume, prostate specific antigen density, provided any further diagnostic information. There were evaluable data for 2,020 patients. Prostate specific antigen density levels are shown to have a strong correlation with the diagnosis of prostate cancer and provide a more reliable indication for ultrasound guided biopsy of the prostate than PSA alone.

    Title The Syndrome of Inappropriate Secretion of Antidiuretic Hormone Following Carotid Endarterectomy. A Case Report and Review of the Literature.
    Date October 1989
    Journal The Journal of Cardiovascular Surgery
    Excerpt

    The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) has not been reported as a complication of carotid endarterectomy. We present a case of SIADH in a patient who underwent carotid endarterectomy four weeks after a completed stroke with good recovery. The presence of this syndrome was associated with the development of a neurological deficit.

    Title Desmopressin Control of Surgical Hemorrhage Secondary to Prolonged Bleeding Time.
    Date May 1988
    Journal The Journal of Urology
    Excerpt

    Desmopressin has been used as a hemostatic agent in numerous hematological and nonhematological diseases. We report a case of surgical hemorrhage secondary to prolonged bleeding time of unexplained origin controlled with desmopressin.

    Title Sarcoidosis and Testicular Tumors.
    Date March 1988
    Journal Urology
    Excerpt

    A thirty-five-year-old white man presented with hilar adenopathy and elevated alpha-fetoprotein after retroperitoneal node dissection and chemotherapy for mixed embryonal seminomatous testicular tumor. A biopsy completed by mediastinoscopy demonstrated sarcoidosis.

    Title Importance of Acid Phosphatase in Response Criteria for Prostate Cancer.
    Date November 1987
    Journal Urology
    Excerpt

    The role of acid phosphatase in the definition of response to treatment for prostate cancer is unclear. To better define its predictive value, especially regarding survival rate, we reviewed the clinical course of 76 men with Stage D2 prostate cancer who were treated with combination chemotherapy.

    Title Cystic Hygroma of the Breast.
    Date April 1986
    Journal Archives of Pathology & Laboratory Medicine
    Excerpt

    Cystic hygroma is a common benign lymphatic tumor that presents at birth or during infancy. We report an unusual case of a cystic hygroma of the breast, which was discovered in a 49-year-old woman on screening mammography.


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