Testosterone Deficiency

Testosterone Deficiency (Low T)

Dr. Pugach no longer treats men with Low T and refers patients to USC Institute of Urology at Keck Medicine USC.


Testosterone DeficiencyOne of the most common conditions treated at Pacific Coast Urology’s Male Health & Hormone Center of Excellence is Low Testosterone. Also know as Low T, andropause and male menopause, Low T is being diagnosed with increasing frequency. Largely ignored in the past, Low T is now recognized as one of the most important issues in men’s health today. Not only does it cause symptoms ranging from low libido to depression, it also has been linked to many serious medical conditions (see below for medical conditions that may be associated with low testosterone).

Dear Dr. Pugach,

I would like to share what a difference your "Pelvic Floor Rehabilitation" has made for me. As you know, I underwent a Radical Proctectomy 5 years ago. Following the procedure, I never fully recovered with the irritating incontinent side effects. I was then diagnosed three years following with a recurrence of Prostate Cancer, only to have to undergo Radiation Therapy and ADT. All of this was performed by other doctors and facilities. All of which increased my struggle with incontinence.

What brought me to Pacific Coast Urology was a bladder issue which you took care of. What I didn't know was that you would prescribe a procedure that would stop my incontinence and give me some self- esteem back while letting me feel like a man again. At this point, I trusted you and I was willing to try anything! When you offered to have me undergo a non-surgical, non-medication based Pelvic Floor Rehabilitation, I thought "Good Luck", but boy was I wrong!

Your team made me feel comfortable, answered all of my questions, dealt with my concerns and motivated me to really give the rehab a try. Within the first week, of just a one-hour appointment, I was able to reduce my pad use from 2 a day to 1 a day. By the second week of PFR, I was able to notice a reduction in the need for even 1 pad a day. By the third week of PFR, I was no longer in need of a pad at all. When I reached my 4th week of PFR, I realized that I could cough, laugh, sit/stand and move freely without any more concern of incontinence!

Thank you Dr. Pugach and your amazing team who helped give me back my freedom and dignity. I don't know if you ever get to hear about the after effects of your PFR, so I felt I should let you know what it's meant for me. Everyone should use Pelvic Floor Rehabilitation as their first treatment for the control and reversal of incontinence and get their lives back.

Sincerely yours,

Marc W. April 21, 2021

The procedure was fast and easy. Everyone in the office was nice and informative.

WV ( January 2021) February 8, 2021

No pain!

MV (January 2021) February 8, 2021

Very friendly, funny and professional.”

TS (January 2021) February 8, 2021

The professional nature and the way they put the patient at ease is fantastic.

KL (January 2021) February 8, 2021

Everything was great. I was nervous going in but coming out I realized there was no need to be. Expectations exceeded!

TS (December 2020) February 8, 2021

Clean, friendly and very professional.

AB (December 2020) February 8, 2021

I had a great experience. 5 stars on Yelp.

RR (November 2020) February 8, 2021

Great service, very easy and painless.

AG (November 2020) February 8, 2021

The overall experience was wonderful.

TJ (June 2020) July 9, 2020

Very professional and very thorough.

ANONYMOUS (June 2020) July 9, 2020

I would absolutely recommend. Everything from the virtual consult (which was amazingly convenient) to the skillfulness of Dr. Pugach, exceeded my expectations.

SM (May 2020) July 9, 2020

Quick and easy. Very lowkey surgery. Keep doing what you do. Great service equals happy patient!

AG (May 2020) July 9, 2020

Super easy and no pain!

RV (May 2020) July 9, 2020

Awesome staff...friendly and professional.

RT (May 2020) July 9, 2020

Very easy quick procedure. The entire staff is a pleasure to work with.

MS (April 2020) July 9, 2020

The entire experience was very professional. Painless and would recommend to anyone.

JE (March 2020) July 9, 2020

If you want a vasectomy, then come on down to Dr. Pugach!

AO (February 2020) July 9, 2020

All aspects explained, super great and easy procedure. I was completely relaxed. Great team!

DA (February 2020) July 9, 2020

Extremely easy and fast. Now I won’t worry about any accidents.

MS (February 2020) July 9, 2020

The experience was very pleasant. It was not as bad as I had thought. The doctor made me feel really comfortable.

ANONYMOUS (January 2020) July 9, 2020

Dr. Pugach made it easy to understand and the procedure was straight forwarded and painless.

JJ (January 2020) July 9, 2020

I had been suffering with fecal incontinence for about 3 months. It made me feel like I didn't want to go out or even eat. My GI doctor first tested me to see if I was acandidate for an Interstim (implant). He said I was, so he sent me to Dr. Pugach for surgery.
My surgery was a week ago. It was an outpatient procedure and I went home right afterwards, no hospital stay. I had a little bit of pain the first day and then I was fine. Two days later I started resuming my normal activities, cleaning the house, eating, cooking. I didn't have to stop in between to use the bathroom. That was a great feeling!
I've just had my 1-week post op appointment and I'm happy to say I'm feeling good and back to normal. What a relief! My whole family is happy for me! I do recommend this procedure for anyone suffering from fecal incontinence.



July 9, 2020

Dr. Pugach, Evans, Marcela,

I want to thank everyone on your staff for all you have done for me. Starting two days after the Superbowl this nightmare has constantly been on my mind. One of the most fear instilling words is “cancer”, we all know friends or family who have battled the disease. When Evans told me I had cancer, that was the last thing I wanted to hear but I accepted it and listened to your treatment plan. When Evans first described the HIFU procedure it seemed impossible, how could my tumors be destroyed with ultrasound, it appeared too simple and easy. I am ecstatic the procedure and recovery went so well. By no means was this an easy ordeal but it was manageable and now I am optimistic about the future.
Four hours after my surgery I went walking outside and enjoyed a wonderful meal at home. The following day I walked a mile and since have gone further each day. My recovery has been so much better than I could have hoped for.
I was concerned about the catheter, when the nurse explained how it worked, I felt I couldn’t deal with it and thought about calling off the surgery. How could I live for two weeks with a tube in my stomach? Wearing a catheter was mentally straining and I was concerned something was going to go wrong. These fears were unfounded, nothing went wrong, the catheter was fairly simple to deal with and my healing went faster than expected. Friday, only 11 days after my HIFU procedure, I felt so elated when the catheter was removed. Leaving your office, I was on top of the world, Saturday I mowed the lawn and yesterday I replaced the broken garbage disposal. There was no way I could crawl under the sink with a catheter on and the job needed to be done. It is nice to get back my normal life so quickly and it feels fantastic.

Again, thank you all, dealing with cancer was truly an emotional nightmare but your team got me through every step of the way and for that I am grateful.

-Ken K (April 2020)

May 1, 2020

Dear Evans, Dr. Pugach and Office Staff,

I just felt lead to jot of a little note of appreciation for all of you – especially now during these uncertain and unsettling days.  I wasn’t sure if your office is closed or partially staffed (like so many), but whatever the case, please accept my thanks for taking such good care of me, all these months!  It’s been almost 4 weeks since my last visit (!) and I’m feeling/doing GREAT, with no reoccurrence of infection!!  This has not been the norm all these months.  As you know, I’d either take 7 to 10 days-worth of meds, then within 4 days (!), my symptoms would return and I’d be back in the office, with my little plastic cup (!), ready for a new Rx!!
I never knew when I was originally referred to you (and your staff), what a loving and caring environment I would become part of – yet the unselfish and committed care/assistance I have received from each of you has truly touch my life.  And not to sound corny, but I truly feel God has blessed me, and all your patients because of this sincere and dedicated concern that is reflected in ample measure in each of your lives.

Thank you ever so much,

-Linda N.

April 2, 2020

I had HIFU almost 3 years ago. I flew to Puerto Vallarta on a Sunday, had HIFU with Dr. Pugach on Monday, flew home on Tuesday and went back to work on Wednesday! I felt then, and I still feel now, like a young man again! My energy is great and I can't wait to go to work every day.


April 2, 2020

I was recently referred to Dr. Robert Pugach, Urologist, by my primary physician due to a swollen prostate. How lucky was I! Dr. Pugach is a personable, authentic, precise, and thorough specialist. His attention to detail was meticulous and by the time I left his office, I truly had a thorough understanding of my ailment and what it would take to make me well. It was determined I needed a Urolift, a somewhat new procedure. Beginning with the preparation through the procedure and recuperation period, Dr Pugach and his staff went above and beyond, in the most kind, empathetic manner that truly made a very unpleasant experience manageable. For those needing to decide between medication or a procedure for a swollen prostate, I cannot recommend more highly Dr. Robert Pugach for he is simply ‘the best of the best’.

G July 29, 2019

From scheduling to surgery to aftercare instructions, the team stayed professional and informative

R.K. July 22, 2019

Easy process. Painless. Comforting dealing with staff.

M.T. July 22, 2019

Friendly staff and caring. All was excellent.

P.A. July 22, 2019

Great info, quick procedure. Staff is friendly, engaging and they make you feel important.

M.H. July 22, 2019

Doc and staff were excellent.

C.G. July 22, 2019

I thought it was going to be very complicated and painful but after the procedure, I was surprised it was easy and pain free.

D.S. July 22, 2019

Doctor has a great bedside manner and he was quick and efficient.

M.K. July 22, 2019

Everyone was perfect and very professional.

I.A. July 22, 2019

Dr. Pugach was very good at keeping me relaxed and calm.  Super professional.

R.A. July 22, 2019

Very helpful and comforting

R.L. July 22, 2019

Great staff and doc!

M.V. July 22, 2019

It was as pleasant as one could hope for in an outpatient procedure. I thank the team for their skillful work and care.

S.S. July 22, 2019

Great job and patient service.

C.M. July 22, 2019

Doc was kind, walked and talked me through the whole procedure! He helped me to stay calm. 

Z.M. July 22, 2019

Quick, easy, painless procedure that worked well with my schedule.

C.M. July 22, 2019

Great staff and very professional. Highly recommend Dr. Pugach

D.M. July 22, 2019

Not painful like I thought it would be.  Dr. Pugach was awesome and kept me at ease.

S.B. July 22, 2019

Was greatly impressed with services all around.

M.A. July 22, 2019

It went very smoothly. No discomfort of pain.

M.M July 22, 2019

All good if you follow the instructions for post-op recovery.

S.D. July 22, 2019

Guys, if you are considering alternate prostate procedure solutions to deal with prostate issues, then let this 80 year ‘old’ man give you some advice.
Over the last 20 years, I have had to deal with prostate matters 3 separate times (nothing lasts). The least stressful procedure that I have undergone is the “UroLift” procedure performed by Dr. Robert Pugach, at the Pacific Coast Urology Center in Los Alamitos. Compared to the other two procedures with which I have experience, the UroLift” procedure was the least invasive, easiest to recover from and has definitely helped with my prostate issues.
Before deciding, do yourself a favor and be sure to get informed by Dr. Robert Pugach about the advantages of UroLift”.

DC March 20, 2019

Guys, if you are considering alternate prostate procedure solutions to deal with prostate issues, then let this 80 year ‘old’ man give you some advice.
Over the last 20 years, I have had to deal with prostate matters 3 separate times (nothing lasts). The least stressful procedure that I have undergone is the “UroLift” procedure performed by Dr. Robert Pugach, at the Pacific Coast Urology Center in Los Alamitos. Compared to the other two procedures with which I have experience, the UroLift” procedure was the least invasive, easiest to recover from and has definitely helped with my prostate issues.
Before deciding, do yourself a favor and be sure to get informed by Dr. Robert Pugach about the advantages of UroLift”.

DC March 20, 2019

After undergoing a biopsy, Dr. Robert Pugach explained treatment options ranging from watchful waiting to HIFU. Even though my prostate cancer was in the early stages, I decided to be treated with HIFU. I’m not the type of man that can wait and watch. My HIFU procedure was performed in June 2014 in Puerto Vallarta. I'm very thankful that I was in the hands of one of the most experienced HIFU Doctors in the country. Also, thanks to the HIFU Prostate Services team, and a HIFU patient that I spoke with, who is now a good friend, for guiding me through the entire procedure. I’m a strong advocate for prostate cancer screening and will do all I can to help educate men about HIFU.

Tony March 14, 2019

I was very lucky when I was diagnosed with prostate cancer to be introduced to Dr. Pugach. He gave me all of the options possible for my treatments. After my research and talking with my Doctors, I decided to go with Dr. Pugach for the HIFU surgery. This was the best decision of my life. Dr. Pugach and his office staff have knowledgeable, patient, caring, and just took care of me. Dr. Pugach is the best in his field and I would strongly recommend him.

JV March 14, 2019

I studied HIFU for about ten years before it became legal in the USA. I was told by my Urologist that I was not a candidate for HIFU my Gleason score was #7 and that I had cancer on both sides of my Urethra. I Made an appointment with Dr. Pugach. They did an MRI and a Bone Scan and said I was a candidate. I made an appointment for the HIFU procedure It was done at 2:30 pm on 03/28/2018 I was done at 7:30 PM I had dinner at a restaurant at 8:30 PM everything went as he discussed with me. No cutting No Bleeding No Pain we stayed at the local Marriott and drove home 270 miles 2 days after the procedure two weeks later doing great. I would recommend highly this procedure to any one that has prostate cancer. Dr Pugach can give my contact Information for reference on request.

PS March 14, 2019

My brother was diagnosed 5 years ago with metastatic prostate cancer. He was the type of guy who didn’t visit the doctor and when he finally did, he found that he had stage 4 colon cancer and has his tumor removed. He now lives with a colostomy bag. He was lucky to survive that.

After dealing with the colon cancer, he learned he had prostate cancer which had travelled to his bones in the pelvic area and spine.

When Dr. Pugach heard about all of this 5 years ago, he said he was going to monitor me carefully because he thought it would be inevitable that I would also get prostate cancer. After 5 biopsies over 5 years and 3 MRI’s, Dr. Pugach found my prostate cancer.

Unlike my brother, I chose to have HIFU early and get rid of my cancer so that I could continue to live a long and healthy life. Five days before Christmas 2018, I had my HIFU treatment and enjoyed Christmas with my family. No one knew I was wearing a leg bag (catheter) and no one knew I even went through this procedure over the holidays except for my immediate family.

Today I had my catheter removed and I feel great! All I can say is, I hope your will get a doctor like Dr. Pugach who will be persistent in your situation and will take care of you the way he did for me. He had first hand experience with his brother and himself, so I knew I was in good hands.

Thank God for Dr. Pugach.

RF March 14, 2019

Five years cancer free!
Five years ago at the age of 62 I had a routine blood test that indicated my PSA was elevated to the point that further tests would be required.  I had no symptoms and felt normal.  One risk factor that was important was that my father had been diagnosed with prostate cancer in his 60's.  After discussing the situation with my wife, we decided further investigation was warranted.

As a retired firefighter of 30 plus years I was well aware of the issue of prostate cancer as it had affected numerous friends that I had worked with.  The majority had been less than satisfied with the treatment and results post-surgery.  Incontinence and loss of sexual function seemed to be the norm.  After numerous conversations with people I trusted I was really in a quandary as to how to proceed.  Fortunately, I ran into a good buddy who is a retired police officer with the City of Long Beach.  He had recently had been diagnosed with prostate cancer and had been referred to Dr. Pugach in Los Alamitos.  Following his diagnosis and ultimate treatment he was ecstatic with the results.  He was back to pretty much normal within a couple of months and most importantly cancer free.

I made the decision to put myself in the hands of Dr. Pugach and hope for the best.  Five years later I am cancer free and have full sexual function, no incontinence and pretty much lead a normal life.  HIFU was something I had never heard of but because of word of mouth from people I trusted I decided to give it a try.  It worked and I have been very pleased with the results.  Dr. Pugach and his staff have been exceptional.  I highly recommend HIFU as a treatment option for prostate cancer.  Dr. Pugach has an extensive history with HIFU and is considered one of the preeminent urologists in his field.  He's also a good guy.

DT March 14, 2019

Quick, easy, friendly staff and doctor. 

January 6, 2019

Already recommended to a friend.

MA January 6, 2019

Not a big deal. Everything was awesome, quick and smooth.

JM January 6, 2019

Very professional and attentive.

AT January 6, 2019

Quick, easy and painless.

RI January 6, 2019

Easy, friendly, informative. Made me very comfortable. I feel that my experience was perfect.

EL January 6, 2019

Simple, easy and convenient.

BY January 6, 2019

Everything was better than expected. I was comfortable during the entire process.

RR January 6, 2019

Everyone was helpful and easy to work with.

RR January 5, 2019

Doctor and staff are amazing! Very informative and procedure was painless.

SS January 5, 2019

Extremely easy and pain free. IW

IW January 5, 2019

Almost pain-free. Office and staff are fantastic.

CB January 5, 2019

Moderately painless and quick. Doctor was very informative.

RP January 5, 2019

Procedure was very fast and almost pain-free. CB

CB January 5, 2019

Very informative. Easy procedure and I felt at ease.

AB January 5, 2019

Very helpful, informative and efficient. Everything went as described.

CO January 5, 2019

The TV on top of the ceiling is a good idea.

RR January 5, 2019

My friends (who referred me) and I have nothing but good things to say.

JM January 5, 2019

Easy procedure. Little to no discomfort.

LL January 5, 2019

Everyone was very professional.

JC January 5, 2019

Procedure was painless and quick.

FQ January 5, 2019

Everything was very easy! My experience was very enjoyable. No improvements needed.

FQ January 5, 2019

Friendly professional and just awesome.

SH January 5, 2019

My experience was very pleasant due to the very professional staff as well as the experienced Dr. Pugach.

MT January 5, 2019

My experience was very pleasant due to the very professional staff as well as the experienced Dr. Pugach.

MT January 4, 2019

It was quick and easy.

A.C. January 4, 2019

Most convenient and friendly staff.

PL January 4, 2019

Easy, no pain. I would recommend to all.

M.T. January 2, 2019

The staff was friendly helpful and made my visits comfortable. 

SH January 2, 2019

Easy and fast procedure.

SB January 2, 2019

Pacific Coast Urology was great and eased my tension and anxiety about my vasectomy. I would highly recommend this office to all my friends and family.

SM January 2, 2019

All Good! Excellent experience.

BF January 2, 2019

It was a pleasurable experience and everyone was comforting and accommodating.  Overall, it was as good of an experience as I believe a vasectomy could be.

PT January 2, 2019

Very easy procedure to deal with. Great patient service.

VA January 2, 2019

Great! A friendly service.

MM January 2, 2019

Doctor was amazing!

DH January 2, 2019

Professional Staff. Friendly and easy to speak with as they explained the procedure and follow up.

DJ January 2, 2019

Overall experience was good. Very little post-op pain or discomfort.

EC January 1, 2019

It wasn’t painful and easy in and out procedure. Doctor was great.

YK January 1, 2019

Everyone took their time in explaining all aspects of the procedure which was very comfortable.

DD January 1, 2019

Easy and painless.

TG January 1, 2019

Overall a great experience. Quick, convenient and simple. A lot easier than I thought.

WB January 1, 2019

Doctor and staff were accommodating and helpful. Dr. Pugach explained each step during the procedure. I had a pleasant experience.

PT January 1, 2019

Fast and affordable.

JA January 1, 2019

This was a close to an enjoyable event as a medical procedure can be.

DF July 30, 2018

Easy, painless and staff that wants to help.

ANONYMOUS July 30, 2018

It was a pain free, good experience and everything was explained. Through and very professional. Would highly recommend.

ANONYMOUS July 30, 2018

You were great. Thumbs up for all your help.

GW July 30, 2018

Easier than expected.

NS July 30, 2018

Everything went smoothly.

RW July 30, 2018

I was very relaxed after doing research and talking to Dr. Pugach during the procedure.

EB July 30, 2018

Very good care

RK July 30, 2018

Very professional. Easy procedure and everything was great.

JO July 30, 2018

Everything was excellent.

BR July 30, 2018

For a scary procedure it ended up being so easy.

DV July 30, 2018

Had virtual consult. Very convenient and easy.

JL July 30, 2018

Easy procedure and great staff.

AC July 30, 2018

Everything was great!

SW July 30, 2018

Friendly, courteous and very professional.

MD July 30, 2018

As comfortable as it could be

RC July 30, 2018

Fast and painless.

ANONYMOUS July 30, 2018


TL July 30, 2018

Experience was outstanding.

BW July 30, 2018

They provide high quality service with compassion and grace.

HJ July 30, 2018

Painless, I was well informed and satisfied.

SW July 30, 2018

Very professional, quick and pain free.

SS July 30, 2018

Everything went smoothly.

AC July 30, 2018

Very easy and fast. All was great.

JC July 30, 2018

Great experience!

DS July 30, 2018

Fast, easy and painless.

J.C. July 30, 2018

Professional, minimal pain, quick and easy.

AP July 30, 2018

Great overall experience and easier than expected.

AN July 30, 2018

Great procedure and great staff.

MF July 30, 2018

Dr. Pugach is one of the best doctors I have seen. I have recommended him to all my co-workers.

RG July 30, 2018

I was very lucky when I was diagnosed with prostate cancer to be introduced to Dr. Pugach. He gave me all of the options possible for my treatments. After my research and talking with my doctors, I decided to go with Dr. Pugach for the HIFU surgery. This was the best decision of my life.
Dr. Pugach and his office staf have been knowledgable, patient, caring, and just took care of me. Dr. Pugach is the best in his field and I would strongly recommend him.

-Jeff V. June 4, 2018

It was a great experience. CA

CA March 26, 2018

Awesome. Very helpful and clear.

DC March 26, 2018

Great very nice people!

SR March 26, 2018

Doctor and staff are very friendly and easy to talk to.

KH March 26, 2018

Easy, Professional and mellow. Doctor Made me feel at ease and all of my concerns were mostly mental.

MA March 26, 2018

It was amazing. Dr. Pugach is incredible!

HE March 26, 2018

Great people. Great doctor.

MR March 26, 2018

Very informative and professional. Everything was great.

March 26, 2018

More than comfortable experience. Virtual consult was very convenient and informative.

DG March 26, 2018

Very profession and comfortable environment.

WS March 26, 2018

Very easy and quick as well as pain free. Unexpected easy procedure.

DS March 26, 2018

Everyone involved made this a pleasant experience.

BE March 26, 2018

It was perfect.

JC March 26, 2018

Everything was great!

KW March 26, 2018

Excellent wait times and very well informed staff.

WP March 26, 2018

Procedure explained throughout. Staff is great.

JA March 26, 2018

No pain and easy procedure.

KB March 26, 2018

Just as I was told, it was painless. One less thing to worry about!

DY August 26, 2017

The process was painless. Staff was helpful and polite. I drove 50 miles for a Saturday appointment. These people are awesome!

PR August 26, 2017

Minimally invasive…No Pain! Quick recovery and TV was genius!

TS August 26, 2017

It was quick and relatively painless. Staff was friendly and helpful.

AG August 26, 2017

It was very easy and fast. Made me feel very comfortable.

MP August 26, 2017

Everything was thoroughly explained. I knew exactly what to expect. Staff is friendly and knowledgable.

AS August 26, 2017

No pain. Staff was helpful and they do a good job.

JS August 26, 2017

It’s fast and easy. Staff and Dr. Pugach are way beyond anything I imagined. Experience was perfect.

JR August 26, 2017

Peace of mind.

LK August 26, 2017

Very efficient, fast and Dr. Pugach was very informative and calmed my nerves. No pain. It was perfect.

BH August 26, 2017

A lot easier than I expected. You guys did a great job. Thank you!

GG August 26, 2017

Easy and convenient. No pain!

DJ August 26, 2017

Easy all the way through.

JZ August 26, 2017

Went as well as it could. Quick, no pain. 

MS August 26, 2017

The process couldn’t have been easier. There’s nothing like light joking with a doctor as he his ending your baby making career.

DG August 26, 2017

Procedure as advertised. Virtual consult at home very convenient.

EH August 25, 2017

Everything was well organized. Thank you.

RB August 25, 2017

Great experience.

PB August 25, 2017

I didn’t feel a ting.

MF August 25, 2017

Helpful and friendly staff. Dr. Pugach is very detailed in explaining his procedure and is very professional.

ER 4.2017 August 25, 2017

I didn’t feel a thing.

MF August 25, 2017

Everyone was very pleasant and helpful. Always made sure I was well informed. Everything went well.

DJ August 25, 2017

Great experience and no pain on the procedure. I will recommend. Thanks Dr. Pugach

3.2017 August 25, 2017

Absolute bliss!

CM August 25, 2017

Easy, comforting and non-invasive Staff and doctor made me feel exceptionally comfortable. JM

JM August 25, 2017

Very comfortable and doctor easy to talk to.

MA August 25, 2017

I will recommend to all of my friends who want a vasectomy. It is totally painless. Big worry for nothing.

AM August 25, 2017

Simply outstanding service from the whole staff. I was referred by my internal medicine doctor to see Dr. Pugach and could not be more happy about the referral. Dr. Pugach and Evans, his PA went over and beyond the last couple of months to help me with a very stubborn kidney stone. Fast forward a couple of surgeries later, I feel like a new man and have not felt this good since the beginning of the year. The entire staff is very outstanding and willing to help explain everything to make you feel comfortable. Highly recommend Dr. Pugach and his entire staff.

TT August 15, 2017

I had the cooled thermal therapy procedure done on April 5, 2017. I was set free from my catheter on the 19th. I was on the catheter for 6 weeks. Well this week I have been able to urinate better than I have been able to for years (maybe 20 years!). I know that my prostate hasn't fully healed yet. However, I am a new man! Thank you!

RC June 6, 2017

I am Eric N and for the last 3 years, I have been visiting Dr. Pugach for the symptoms of men low Testosterone level. In the first year, I was getting T-shots once every 3 weeks, but I noticed that it was too time consuming so I was requesting self-control T-shots but monitoring through Dr. Pugach and the P.A (Evans Tran).
They are very professional and very supportive through the years. I am more active at working out at the gym and toned up my muscles. They recommended and provided the right medication for men's E.D symptom which in a way, helps me in my case. My sex life style changes to better, etc. Overall, I highly recommend to men getting fatigue all the time and sex drive is not performing well. I recommended to visit Dr. Pugach for a consultation. Thank you.

Eric N. April 17, 2017

Friendly environment. Great staff. Doctor was great and made me feel very comfortable. Everything was great. Fast, efficient. Thank you.

EMD January 19, 2017

Excellent process from beginning to end.

CC January 19, 2017

It was extremely easy and virtually painless and I felt extremely comfortable with everyone in the office. JH 12.2016

JH January 19, 2017

Yes, explained everything. I’m a returning patient from a circumcision. Felt no pain at all.

SS January 19, 2017

So much easier than I thought. The Doctor joked with me during procedure. Explained everything in detail. I didn’t feel a thing. I highly recommend.

ME January 19, 2017

Easy to make appointment. No waiting time. Painless procedure.

12.201 January 19, 2017

Released stress associated with birth control.

CP January 19, 2017

Everyone was great.

CB January 19, 2017

I had a wonderful experience. I will surely recommend this Doctor for others looking to get a vasectomy done.

CG January 19, 2017

I was nervous before coming here but they made me feel so relaxed and comfortable as we went through the procedures. Thanks. Great job.

CF January 19, 2017

A lot easier than I thought. Painless.

DM January 19, 2017

Very easy procedure, no pain, nice staff, very helpful with everything.

KC January 19, 2017

Great service and easy procedure. Makes you feel at home!

MA January 19, 2017

I have wanted this procedure for years and was nervous. This experience makes me wish I did it earlier.

AL January 19, 2017

All logistics were handled by my wife. All I had to do was show up!

JR January 19, 2017

I was planning to do multiple consultations but it was not needed after meeting with the staff of Pacific Coast Urology. They are experts in their field. Friendly and professional. Easy and painless.

M.B. January 19, 2017

My vasectomy experience with Pacific Coast Urology was outstanding. Dr. Pugach and his team were very professional and efficient. I couldn't have asked for more. My particular circumstances had me coming back to Orange County for a few weeks in between overseas work assignments.
At the age of 41, I have decided I don't want to have a teenager under my roof or college bills when I retire and a vasectomy was the obvious answer. I came across Pacific Coast Urology's No Needle No Scalpel procedure and was sold. I contacted Pacific Coast Urology and Kim worked with me and the time difference between the U.S. and Italy to get my insurance benefits confirmed, my paperwork in order, and my virtual consult completed.
All I had to do was show up for my scheduled appointment wearing a scrotal support (jock strap) once I returned back to the U.S. The procedure was amazingly quick for something I thought would be more complex. There was one rubber band snap type of feeling at first and then a little tugging here and there then the procedure was over. During the procedure I was talking with the doctor and his assistant about travel and scuba diving as well as laughing at jokes on Family Guy which I was watching on the TV above me.
Post procedure caring instructions were explained multiple times and were extremely clear. Everything went just like the Pacific Coast Urology staff said it would. I'm very grateful for how smooth this procedure went. I can now enjoy the rest of my life without worrying about unplanned pregnancies.
I would highly recommend Pacific Coast Urology for this simple procedure. It would be even be worth coming from out of town if you live outside the area because they are that awesome. Most importantly, I was not compensated for this review. I am just very happy to give credit where it's due because this was a scary procedure for me going into it even though hindsight shows Pacific Coast Urology over prepared me for everything. Thank you Pacific Coast Urology!!!
RW, Thailand (January 2017)

Read about RW’s Vasectomy Experience…Virtual Consult in Italy! January 11, 2017

TV is great!

Randy November 16, 2016

No pain. Minimal discomfort.

BM November 16, 2016

Great staff, very informative. Felt very little pain.

Paul November 16, 2016

Great staff, very informative. Felt very little pain.

Paul November 16, 2016

Everyone was very professional and friendly.

Gary November 16, 2016

Dr. Pugach was great!

James November 16, 2016

Easy, relatively painless.

Charles November 16, 2016

You have great customer service!

RR November 16, 2016

It’s the least a guy can do for his wife.

Corey November 16, 2016

Both the mechanical aspects of the procedure and personal attention made this easy. Looking forward to the increased peace of mind that comes with a successful vasectomy.

Keith November 16, 2016

Six and 1/2 years ago I was diagnosed with prostate cancer by Dr. Pugach.  I had come in for a couple of years for urology check- ups.  After a high PSA, he did a biopsy and confirmed the diagnosis.
Dr. Pugach discussed all of my options with me.  At the time, he was doing HIFU in Puerta Vallarta, Mexico.  I chose HIFU because it was the best I could do.   Mexico was great, I came home a couple days later.  I returned to work feeling great, the same as I did before surgery.  I work on my own so I was able to work when I was ready.
Today I feel great.  I feel like I never had surgery.  I would recommend HIFU to anyone considering treatment of their prostate cancer.  I am happy with everything he did and I’m grateful to have a great quality of life. Thank you Dr. Pugach
Hace 6 años ½ me diagnosticaron con cáncer de próstata por el Dr. Pugach . Yo había sido objeto de un par de años para copias de urología check.
Después de un alto nivel de PSA, me hizo una biopsia y se confirmó el diagnóstico . El Dr. Pugach discutido todas mis opciones conmigo . En ese momento, él estaba haciendo HIFU en Puerto Vallarta , México.
Elegí HIFU porque era lo mejor que podía hacer. México era grande , llegué a casa un par de días más tarde. Volví a trabajar sensación grande, lo mismo que lo hacía antes de la cirugía. Yo trabajo por mi cuenta, así que era capaz de trabajar cuando estaba listo.
Hoy me siento muy bien . Siento como si nunca hubiera tenido la cirugía . Yo recomendaría a cualquiera que esté considerando HIFU el tratamiento de su cáncer de próstata. Estoy contento con todo lo que hizo y estoy agradecido de tener una gran calidad de vida. Gracias Dr. Pugach - Abel

Abel August 25, 2016

Surprisingly easy and comfortable.

Matthew March 22, 2016

Very comfortable and helpful. March Madness Themed Goodies!

PP March 22, 2016

Great staff and Dr. P was excellent. Minimal stress.

CP March 22, 2016

Very easy, quick, painless. The virtual consultation was incredibly convenient. The staff and doctor were very friendly.

AM March 22, 2016

It was a great experience and made me feel comfy.

Glenn March 22, 2016

You guys are amazing.

David March 22, 2016

Fast, easy and funny.

Joel March 22, 2016

The staff was courteous. Evans, the Physician Assistant was informative and sweet. Dr. Pugach you could tell during the initial feel and how quick it was great at his job. This was an awesome experience for what you would think is very scary.

Robert March 22, 2016

The procedure is very thorough as well as thought out. No improvements are needed.

JM March 22, 2016

Hello my name is Carol and I am 84 years old. I have been self-catheterizing since 2002. I have dealt with multiple urinary tract infections because of the catheterization over  all these many years.
About 3 months ago, a nurse at my care center recommended that I might want to see Dr. Pugach to see if he could help get me off catheters.
I am happy to report that I recently had an Interstim implant by Dr. Pugach and can tell you that I am now catheter-free! I feel great. I can urinate on my own and don’t have to run to the bathroom every time I turn around. 
I always thought this issue was just a “part of life,” but now I know, it doesn’t have to be. Thank you so much Dr. Pugach!!

Carol S. March 18, 2016

It is very rare these days in the medical field to find a Doctor that has been able to organize his office and practice to the extent that amazing, kind and attentive medical service is provided to each and every patient.  I can speak first-hand with great pride about the wonderful work that is done in your Pacific Coast Urology office.  From the moment you check in with the highly competent and friendly front desk personnel to the time spent with Dr. Robert Pugach there is an extraordinary effort put forth by EVERYONE  to make sure all details administratively and medical are taken care of.  The amazing feature that you offer patients to be able to e-mail Dr. Pugach and within in hours to receive a response is totally unheard of these days.
Keep up the great work and please pass along to everyone working in your office how much I appreciate their attentive service and compassion.
Take care,

Steve L March 14, 2016

Not being circumcised was becoming a problem for me. I had discomfort and irritation. I decided to have a circumcision to alleviate these discomforts. I am very comfortable with the procedure that was done on me. 
I was pretty nervous at first, but after I met with Dr. Pugach, I was very confident about getting this done.  I had my procedure at the Los Alamitos Surgery Center. They explained everything to me and waited for me to be completely out of anesthesia before they sent me home. Everyone was really nice.
I am here today for my 3 week post – op appointment.  I feel a lot better and definitely look forward to final result.  Thanks Dr. P!

Gustavo March 14, 2016

When I experienced my first bout with kidney stones. I had no idea what was wrong, the pain was overwhelming and I kept passing out and waking up on the floor. I finally ended up in the ER, who referred me back to my family doctor. However, I did not have a great experience with the first urologist I was referred to, which was very unfortunate. This doctor could not see on my test results that I had a huge stone that was descending, so he gave me samples of Flomax for my symptoms, scheduled me for a regular follow up in two weeks and sent me home.
That weekend, I had two separate attacks of excruciating pain each sending me to the ER. This time, a different ER physician suggested I follow up with Dr. Pugach.  When I mentioned that I already had a urologist I was seeing, the ER doctor leaned over and said, “I heard you, but you really need to see Dr. Pugach - he's the best." And, after making an appointment to see Dr. Pugach, I learned why.
Dr. Pugach's staff worked me into his schedule immediately, where he quickly assessed my situation and I was scheduled for a procedure soon thereafter to get rid of my existing and very painful stones. Also, I have a very sensitive system with little tolerance for prescription pain medication, so he really got me back on the road to recovery as quickly as possible.
Like most people, I have experienced high pain levels from injuries over the years, but I had never experienced the intense level of pain created by kidney stones. I was beside myself and quite fearful of the situation repeating over and over. But, Dr. Pugach had a better idea - to go forward thinking positively and make some changes for a better outcome.
He also introduced me to a terrific nutritionist who visited me at my home to assess my situation and made wonderful recommendations on how to adjust my food intake and also started me on more meaningful vitamins and supplements. I could feel the different almost immediately, because with the changes I became more energized and balanced. I have become a "water baby" and view my new appreciation of water and proper nutrients as part of my personal arsenal to avoid developing new stones.
As a patient predisposed to generating stones. I am still seeing Dr. Pugach regularly. I have learned to love water and a healthier lifestyle. My test results continue to come back as excellent, and if I ever need help with stones in the future, I know that Dr. Pugach and his staff will be there to help me. Kidney stones are far from fun, but the fear and anxiety of having them come back (if they do) is lessened from knowing that I have the best of the best to help me with Dr. Pugach and his staff.

Catherine October 30, 2015

Thank you Dr. Pugach for all your help with my kidney stones and following me through my pregnancy to ensure a healthy and safe one. So far so good after the lithotripsy and your staff has always been so kind and helpful. You are amazing!!!

Jennifer October 30, 2015

I have been a patient of Dr. Pugach for several years. I initially saw him concerning prostate issues as my current urologist was not working out for me. In viewing some film he noticed I had a kidney stone that went undetected. He took care of that and he's treated me for my prostate as well as kidney stones that I pass with regularity. The staff is professional and they go the extra mile to make you feel welcome and comfortable while you are being treated. These first impressions go a long way in making your visit as pleasant as possible.
Today was unusually busy and as I waited in the examination room I could hear Dr. Pugach greeting each patient in an upbeat manner as he walked them through their appointment. I can't tell you how many times I have seen doctors who make minimal effort to connect with or educate their patients as Dr. Pugach does. Finally, I suffer with severe anxiety and many doctor's appointments are a struggle for me. Maybe you're one of those people? Don't be afraid to let the staff or Dr. Pugach know if you are anxious. They will do their best to meet you where you're at. So go ahead and make your appointment. You'll be glad you did.

Allen October 30, 2015

I live in the San Francisco Bay Area. About a year ago, my wife and I decided that we wanted another child, but I had a vasectomy about 7 years ago. I spent numerous hours researching physicians/urologists that had expertise in vasovastomy. I researched on the internet and by contacting physicians throughout the San Francisco Bay Area. Based on my research, there was no better qualified physician than Dr. Pugach. He was highly recommended by both previous patients and professional reviews. Although I reside over 400 miles away from his office, communication was excellent (both detailed and timely). I never had any questions or concerns that were not answered immediately. On February 16th, 2012, Dr. Pugach performed the surgery (vasectomy reversal) at the Los Alamitos Surgery Center. I could not have asked for a better experience. The surgery went very smooth and the recovery went better than I could have ever hoped for. Other than a few days of as expected mild discomfort (which ice and bed rest took care of), I was back to normal quickly. My family and I want to personally thank Dr. Pugach and his staff for being so professional and making this a wonderful experience. Respectfully, 

Matthew H. October 30, 2015

I have already spoken to multiple men about the doc. Couldn’t be happier!

Eric October 30, 2015

No pain, fast recovery time, friendly staff. I made the right decision by having my vasectomy done by Dr. Pugach. Highly recommend Dr. Pugach to anyone looking to have a vasectomy done.

Victor October 30, 2015

Very easy and up front, made the process very easy and comfortable. Thanks again

Jon October 30, 2015

I have told several friends about Dr. Pugach as they are considering a vasectomy . Great Experience, thank you.

Rob October 30, 2015

If I had to do it again I wouldn’t mind with Dr. Pugach. I thought it would be painful but it only felt like a rubber band snap. Staff was very professional and courteous.

Johnny October 30, 2015

Appreciated the time, speed of procedure and recovery.

Gus October 30, 2015

Everything was simple, fast, and painless. Entire staff is friendly and supportive.

Keoka October 30, 2015

Very quick and relatively painless procedure.

Michael October 30, 2015

Dr. Pugach has been very professional and sensitive to my needs. Especially when attention to details were important in my case. I trust him and his staff with my continued care, and would recommend Dr. Pugach to those I care about.

Lester October 30, 2015

I had the same good experience that my co-workers did who recommended Dr. Pugach . It was refreshing to hear the staff address patients as Mr./Mrs. I have already spoken with multiple men about the doc. Couldn't be happier!

Jonathan October 30, 2015

I was attracted by the idea of low-pain, fast recovery surgery. That turned out to be true. The office staff were great. Very responsive, accurate, and communicative. The modern office equipment also was attractive.

Jonathan October 30, 2015

Painless and quick. Very quick recovery. Dr Pugach was one cool dude. Entire staff was friendly and warm.

Quinn October 30, 2015

Absolutely! I've already referred a couple of my co-workers to Dr. Pugach. The procedure and the recovery process far exceeded my expectation! You made me feel comfortable each step of the way. It was a pleasure and I would do it again without hesitation! Thank you Dr Pugach!

Ronald October 30, 2015

Every visit was conducted in a professional, yet relaxing manner. I never once felt like anything "bad" would happen and was always imbued with a sense of trust and confidence in Dr. Pugach's skills.

David October 30, 2015

Made a scary as heck experience very tolerable and pleasant. Dr Pugach and staff were outstanding.

Eric October 30, 2015

Quick and easy. Every concern, fear and misconception was answered in a professional manner.

Scott October 30, 2015

Friendly care and professional, was no pain and fast recuperation time full all my expectations Thanks.

Julio October 30, 2015

If I had to do it all over again, I would. That's how painless it was. Dr.Pugach and his staff are very professional. They answered all my questions and concerns . I had my vasectomy done on a Friday afternoon and was back to work the following Monday. To all you guys out there, stop thinking about it and go see Dr. Pugach!!!

George October 30, 2015

From the front office staff to the staff that directly assists Dr. Pugach, the care, concern and patient attention could not be better. Everyone seems to take a personal interest and that surely comes from Dr. Pugach, who exemplifies all of those qualities.

Howard G October 30, 2015

Dr. Pugach is a fantastic, understanding doctor. His staff relates to him and they are very efficient and professional, which makes me feel very comfortable. Dr. Pugach operated on my prostate 18 years ago! I would recommend him to anyone.

Stanley Y. October 30, 2015

Dr. Pugach and the folks at Pacific Coast Urology made my No Needle No Scalpel  vasectomy procedure and process very smooth and easy. It was a friendly and relaxed atmosphere complete with the TV on the ceiling to watch my favorite show. I was out of there in no time and on my way to a very quick and painless recovery. If you want to get it done, this is definitely the way to go.

Matt K. October 30, 2015

I am pleasantly surprised with no pain throughout the whole process of the No Needle No Scalpel Vasectomy. I just got through the first 24 hours with no pain what so ever! Dr. Pugach was very professional and personable. His staff is top notch and very helpful. I still can’t believe how easy, painless and quick the whole process was. I would highly recommend Dr. Pugach and the No Needle No Scalpel Vasectomy to any guy contemplating a Vasectomy.

Stan October 30, 2015

Since I was quite pleased with my vasectomy from Dr. Pugach I've told several friends about the no needle, no scalpel vasectomy he offers when they were researching getting a vasectomy. I'll continue to talk up the vasectomy Dr. Pugach offers because I feel it is the best procedure and recovery on the market.  

Tom H October 30, 2015

Thanks PCUMC. My vasectomy was actually a wonderful experience. It was good and calming talking or chewing the fat with Dr. Pugach during my procedure. I have recommended him to friends. Thanks for making an uncomfortable situation a pleasant experience.

Maurice H October 30, 2015

I just wanted to say what a great experience! I was nervous about getting a vasectomy due to stories from family members who had it done. None of them had the no scalpel no needle. After Dr. Pugach explained to me how it worked, I made my appointment. It has been 4 days since getting the operation and I would recommend it to everyone! I didn't have any pain at all during the procedure. The only discomfort I felt was the following day and I think that was from laying in bed all day!. I also didn't have any of the black and blue bruising I heard about. My wife would agree that it was the best money we have ever spent!

Jeff K. October 30, 2015

As the wife of Dr. Pugach's patient receiving the non-invasive vasectomy (no scalpel, no needle), I would recommend the procedure AND Dr. to everyone. The office staff was wonderful! They helped my husband feel comfortable and confident in our decision about the procedure. Recovery went as described.

Janis October 30, 2015

I had a lot of apprehension to have a vasectomy. After consulting with Dr. Pugach, I felt comfortable due to his experience and knowledge to do the no needle, no scalpel. I was nervous on the day of the procedure, but it turned out to be great experience and I am really glad I did it. I would highly recommend it.

Tom L. October 30, 2015

I have nothing but great things to say about Dr. Pugach and his staff. I had the no needle/scalpel vasectomy today and everything went perfect. I am now referring a few of my closest friends to Dr. Pugach for the procedure. A+!!!

Scott D. October 30, 2015

Literally just had the no needle/no scalpel vasectomy with Dr. Pugach about 30 mins ago, and I have to say that it was quite the experience! Absolutely no pain at all. The whole staff was wonderful and Dr. Pugach is simply amazing. The entire procedure from the minute you walk in the door to when you leave is streamlined like you wouldn't believe. My first impression on how they treated me was very good; therefore, I felt confident that everything would go well and it did! It is in my opinion that Dr Pugach is THE Urologist to see for your needs, especially, for this scalpel-less/needle less vasectomy.

JR October 30, 2015

I am pleasantly surprised with no pain throughout the whole process of the No Needle No Scalpel Vasectomy. I just got through the first 24 hours with no pain what so ever! Dr. Pugach was very professional and personable. His staff is top notch and very helpful. I still can’t believe how easy, painless and quick the whole process was. I would highly recommend Dr. Pugach and the No Needle No Scalpel Vasectomy to any guy contemplating a Vasectomy. 

Stan October 30, 2015

WOW! What an awesome procedure. I had my No Needle No Scalpel Vasectomy yesterday. The procedure took about 15 minutes and I didn’t feel a thing. There was no pain or discomfort before, during, or after the procedure. They even have a ceiling mounted TV in the room so you can watch TV. Hardest part for me has been being a couch potato post procedure. I haven’t had to take any medication since the procedure and slept great last night. I took a shower this morning and can’t even see where the procedure was done!  I have no pain or discomfort urinating. I would definitely recommend Dr. Pugach.  His office is clean, his staff is very professional, and Dr. Pugach is a friendly doctor with great bedside manners.  

Chris C. October 30, 2015

I had a No Needle No Scalpel Vasectomy performed by Dr. Pugach. Overall it was an excellent experience and pretty low pain considering the sensitive part of my anatomy he was working on. The procedure was less than half an hour long, probably more like 10 minutes of actual doctor time after waiting a few minutes for the topical anesthetic to take effect. The procedure itself was easy from my perspective. Just a bit of pushing and pulling sensation on some parts that rarely get treated that way. The first two to three days after the procedure I was a bit sore, though I never felt the need to take Tylenol and I was able to drive myself home. Any time lying on my back, all felt fine. Getting up and moving around caused a bit of discomfort. Recovery took about a week and a half to get to the point of feeling totally normal again. The office and medical staff were all quite friendly and helpful. I received good answers to questions and fast replies to phone calls. The office seems to be well managed and organized. All of the equipment in the office is modern and looking good. The location is easy to get to. The price is reasonable. I’d recommend this to anyone.

Jon October 30, 2015

Four years ago I was diagnosed with early stage of prostate cancer. Dr. Pugach explained my options and after research I chose cryoablation.  The procedure was easier than I expected and my recovery was short. I was back to normal quickly and four years later I'm cancer free. I would recommend Dr. Pugach to anyone. 

Peter October 30, 2015

I had a bad experience with a previous urologist two years ago. He misdiagnosed me and performed a procedure that was not necessary and extremely painful. It took me two years to get up the courage to see another urologist. My internist referred me to Dr. Pugach in April of this year. I took the first appointment I could get. I told Dr. P of my previous experience and he assured me we wouldn't do the same thing again. He examined me and asked me a number of pointed questions. After new tests I had not had before, the doctor confirmed that I had an enlarged prostate, not a urethral restriction. Dr. P explained my treatment options for inpatient surgical procedures and a less invasive outpatient procedure called CoolWave, which I chose. I would definitely advise anyone else with the same issue to consider this procedure. I'd also like to mention that I used to need the bathroom at least a dozen times in a 12 hour work shift. Now I go maybe twice! After 40 years of happy marriage, this procedure renewed my confidence in intimacy with my wife. I feel like a newly married man! I really appreciate my referring doctor sending me to a smaller practice. Its more personalized care and I can get to know my doctor and his staff. I thank Dr. Pugach as does my wife! 

Bob C. October 30, 2015

Dr. Pugach is a fantastic, understanding doctor. His staff relates to him and they are very efficient and professional, which makes me feel very comfortable. Dr. Pugach operated on my prostate 18 years ago! I would recommend him to anyone.  

Stanley Y. October 30, 2015

Good morning Gladys, Dr. Pugach and your entire team,
I wanted to take a minute to tell you how grateful that Jane and I are for your quick action, logical diagnosis process, recommendations and general responsiveness to our diagnosis of prostate cancer, Gleason 4+5. In the end, we decided on removal of the prostate at City of Hope as opposed to the HIFU process. I think it might be helpful for you to know our decision making process. I was concerned about the aggressive type of cancer, the odds of reoccurrence in five years, and the risk that insurance would not stick with me once HIFU was performed. I was also very concerned about the method the body cleans up the detritus created by HIFU and bladder and urethra issues associated with it. All this considered, I just wanted the prostate out. I would deal with the known consequences. You were all fantastic, but in the end run, I took your advice and called City of Hope. It was clear to them that we needed to move quickly. Surgery using the DaVinci microsurgery was performed Saturday, January 22, by Dr. Lau. One week later, I have been diagnosed "cancer free." There was no cancer on the periphery and none in the lymph nodes. While we will watch this carefully over the next months and years this is as good an outcome as might be expected with my Gleason score. I have no incontinence, and, well, the rest, we will see. Thank you again for your role in this process. Without your expert testing and guidance, I could not be sitting here today giving this report. Regards,

Ron October 30, 2015

I wish that all doctors were like Dr. Pugach, knowledgeable, listens, friendly well organized staff and available when needed. I was having some urinary problems and was diagnosed by another doctor and I did not think it was correct. I met with Dr. Pugach and he listened carefully and indicated to me that he did not agree with the other diagnosis. As it turns out, I had prostate cancer. Dr. Pugach spent time and described all the various solutions and presented the pros and cons of each procedure. He patiently answered all my questions then and each time I met him both before and after the procedure, and always asked if he addressed all my questions. I chose to do the HIFU,  Intensity Focused Ultrasound which is not yet approved in the USA; however is approved in most of the world. Dr Pugach performs the procedure in Puerto Vallarta, Mexico. He was scheduled to be there in July 2011; however he did not want me to wait until then and made a special trip for me (missing a Urology convention) in May. I am very pleased with the outcome of the procedure and, especially, the fine treatment by Dr. Pugach who I unreservedly recommend to anyone with Urological needs.   

Duke O.  October 30, 2015

Deciding what kind of prostate cancer treatment to get is a critical decision. Every man is different. But do your research and get all the facts. I’m happy that I explored all options before deciding on a new procedure.  I’m so pleased that I selected  HIFU and wouldn’t hesitate to recommend this procedure.

Donald T. October 30, 2015

I found out that I had Prostate cancer in mid May 2008. I made an appointment with Dr. Pugach and he explained all the procedures available, after some thought I chose High Intensity Focused Ultrasound or much easier to say HIFU. I had the procedure done July 20, 2008 and I have been cancer free now going on 4 years. I cannot express the excellence in which the Dr. handled the procedure not just from the beginning but also follow-ups He Specializes in minimally invasive treatments. Anyone who reads this that thinks they have a Urologic condition of any kind make an appointment now. Also the caring does not stop with this Great Dr. it goes also to the Nurses and Staff they CARE about their patients more than the norm we all have experienced, I feel the rating system should allow for A+++++ I think you get the picture. I owe my Life to this Man, and I cannot say Thank You enough, there are no words that are good enough but Thank You Again. 

Bill D. October 30, 2015

My general practitioner (GP) diagnosed me with a high Prostate-Specific Antigen (PSA) score in March of 2012. With good intent, he referred me to a urologist. However, my wife, who is a registered nurse did some research, and found the highly regarded Dr. Robert Pugach. 
Dr. Pugach performed a biopsy procedure, which showed that I had prostate cancer (9 out of 10 cores of the biopsy were positive for cancer and all of them had a Gleason Score between 6 and 7). He explained all of the options that were available to me, and gave me an injection (Lupron) to stop the growth of the tumors for three months.
Then Dr. Pugach ordered a bone scan and MRI so that he could ensure that my cancer had not spread to my bones or the rest of my body. Thankfully, the results of the bone scan and the MRI came back negative, and Dr. Pugach determined that I was eligible for a variety of treatments, but I chose High Intensity Focused Ultrasound (HIFU). The FDA had not yet approved the HIFU procedure in the United States. As such, I elected to have my HIFU done in Puerto Vallarta, Mexico in May of 2012.
Dr. Pugach has an incredible network of doctors and caretakers in Mexico to assist him with the procedure, including the local urologist in Mexico, and the HIFU team from Charlotte, North Carolina. They helped me feel at ease during the procedure, and they ensured that everything went smoothly. The procedure itself was painless, as I was under anesthesia, and I had a very quick recovery. I walked out of the hospital with very little discomfort on the same day that Dr. Pugach performed my procedure. My speedy recovery validated my confidence in the abilities of Dr. Pugach and his team. Three months after my procedure, I went for my first PSA test, where my PSA was <0.01. This is the lowest possible PSA score that an individual can get, which means that my HIFU treatment worked, and I am cured of prostate cancer. Additionally, Dr. Pugach has been treating me for a frequent urination issue that I’ve had for about 10 years, and he is making incredible strides. My urination is becoming less and less frequent. I have a tremendous amount of respect for Dr. Pugach and his entire team, and I highly recommend him to anyone that has prostate or urinary problems.   

Adolph A. October 30, 2015

After doing much research about who I should see regarding my circumcision, I had come to the conclusion that Dr. Pugach was the most qualified person in my area. I was amazed at how professional he is and his extreme skill in the practice. I already knew that Dr. Pugach was the right choice, but after meeting him and after my circumcision was complete, it was obvious that he performs above and beyond what most are able to. I think it's safe to say that I would recommend him to anyone! In addition, the surgery center has a warmth that one would not find in a hospital setting. People being there with me all the time made it no so utilitarian, more friendly.

Nathan M. October 30, 2015

After finally making the decision to get a circumcision, I had decided to do a lot of research before committing to someone to perform the surgery. After coming across Dr. Pugach's website and reading his bio and other patient comments in depth on several different procedures, I was very impressed. What had drawn me to him was his passion to consistently obtain the most up to date knowledge and technology for everything regarding urology.I also liked how he takes great pride in conducting minimally invasive techniques. 

Now onto what you want to know and putting the cards on the table about the procedure. After setting up my appointments and paying in full the price for the surgery, I was completely comfortable and was not nervous at all about the surgery mainly because I trusted him after talking to him previously about my procedure in my consultation. The staff at the surgery center was really friendly and make me feel comfortable. I was put under general anesthesia, which is the only way to go and later found myself waking up and getting discharged and heading home on the road to recovery.  That very same day I was able to walk comfortably with the bandage on for two days with no pain. On the second day, I removed the bandages in the bath, had cleaned it and had re-dressed it and was ready to take on my weekend plans. Yes, it was a little odd with the sensitivity but it wasn't anything I couldn't tolerate. Rather or not I was in pain, I took the meds he had prescribed to me. That was probably a key factor in me continuing not to receive any mild pain. Urinating was a little tough but as long as I sat down, took my time and urinated, it was fine.  I expected that to happen considering the surgery. 

Finally after removing the dressing and allowing my penis to be free, to be free, the only mild pain I had felt was the stitches rubbing against my underwear, to which if that was the only problem I had with this whole procedure, that that's nothing! Trust me! After the stitches had fallen out, the swollenness had gone done and had I had gone back for the post OP appointment, I couldn't have been more satisfied! In conclusion, if the price is of concern, don't let it be! You get what you pay for and you want to treat yourself into letting a real professional take care of you. Also, remember time and you will not be in bandages or stitches forever! I hope by writing this, this will help you make the decision to get the procedure done with Dr. Pugach.  Since Dr. Pugach did an incredible job with me, owe it to him to write this personal letter of commendation, he deserved it. 

D.L. October 30, 2015

I needed to take a few minutes to personally thank the entire staff at Pacific Coast. The work that Dr. Pugach is engaged in has essentially given me back some freedoms that frankly disappeared over a long period of time. The TUNA procedure provided relief from my urinary discomfort within a week and a half of the actual visit to your office. The short amount of time spent in your procedure room frankly shocked me. I expected a more aggressive procedure that would have provided far more discomfort to have received the type of results I currently enjoy. I am now able to travel from Long Beach to Santa Monica for business meetings without planned visits to Starbucks' never locked restrooms. It was not the coffee that brought me there although
I am now able to enjoy the facility for exactly what it was designed for due to your medical assistance. The ability to go in and out of multiple conference calls, dictation of emails, review of contract details and enjoying many cups of coffee that I require through the course of a morning, has been an absolute pleasure. The normal course would be for me to make certain breaks between each phone call, conference call, contract review, etc., for visits to our restroom here in our business office. My fiancée is quite pleased as I am also able to spend more time freely with her and not require our travel or social visits to be altered based upon my frequent need to previously obtain access to various restrooms regardless of where or what we were doing.
Unfortunately sometimes outdoor techniques were required in order to make certain that there were no accidents. Please know that the above mentioned trips are not being exaggerated. Here it has been approximately 3 months and the gratitude I feel for this new found freedom is extremely valuable to me personally. Please be advised, Dr. Pugach, that there have also been improvements in my sexual activities which I had not expected. It was simply the ability to relieve myself without the frequency and discomfort that each trip to the restroom required. It is important that you all know that this is greatly appreciated and I wish I would have discovered this miracle procedure 6 or 7 years back. Again, thank you all,

Ed October 30, 2015

I cannot believe all the positive differences in my life since receiving treatment for my BPH issues from Dr. Pugach. Dr. Pugach and his staff always treated me with such dignity and respect no matter how embarrassing or how stupid my questions were or what position I was in. I am still surprised at what a full stream is. Plus being able to sleep through the night without having to get up and go to the bathroom is truly a blessing and this is coming from a person that used to get up at least three times per night. Before Dr. Pugach, a full night's sleep, for me, was a mythological concept. Not anymore. Even better than that, since being treated by Dr. Pugach, I can even write my name in the snow. From my personal experience, I can only say Dr. Pugach and his staff are the very best and I highly recommend them.

TherpoTherapy Patient October 30, 2015

I had thermal therapy for BHP about 14 years, had no side effects and still have normal flow. I am sure glad I found out about Dr. Pugach since a close friend of mine had scalpel type surgery for the same thing and wound up with retrograde ejaculation. I am impressed with Dr. Pugach's skill and how he keeps up with state-of-the-art procedures. 

Joe October 30, 2015

After years of problems with urination because of BPH I made an appointment with Dr. Pugach and he explained BPH and the treatments available.  I elected the non-invasive thermotherapy method of treatment.  This was the best decision I have ever made!!  No more slow stream urination or getting up six to eight times a night to urinate. Thanks Dr. Pugach for greatly improving the quality of my life.

Glenn October 30, 2015

My father had a problem for three years. I took him to another doctor and they didn't do anything for him except to say just continue medicine or send him to the ER so we could urinate. A friend recommended Dr. Pugach, so we made our appointment right away. Dr. Pugach said my father’s medicine wouldn't work as his prostate was too big and her recommended Coolwave Therapy which did on my Dad a month ago. We've been back to Dr.Pugach two times for follow up. Dad can urinate now and he is comfortable and happy. No more catheter! With our last doctor, we would wait almost an hour in the waiting room and another 45 minutes in the exam room. This doesn't happen at Dr. Pugach's office. Within 10 minutes we were in to see the doctor. Thank you Dr. Pugach for a great job. 

Joe October 30, 2015

I cannot believe all the positive differences in my life since receiving treatment for my BPH issues from Dr Pugach. Dr Pugach and his staff always treated me with such dignity and respect no matter how embarrassing or how stupid my questions were or what position I was in. I am still surprised at what a full stream is. Plus being able to sleep through the night without having to get up and go to the bathroom is truly a blessing and this is coming from a person that used to get up at least three times per night. Before Dr. Pugach, a full night's sleep, for me, was a mythological concept. Not anymore. Even better than that, since being treated by Dr Pugach, I can even write my name in the snow. From my personal experience, I can only say Dr Pugach and his staff are the very best and I highly recommend them.

David October 30, 2015

After receiving the InterStim® device on February 24, 2011, Kathleen, age 86, noticed an immediate and dramatic relief of her symptoms, proclaiming, “I am so delighted to be free of the burden of a catheter.”  

Kathleen October 29, 2015

Getting the Interstim therapy has created a new life for me. I don’t have to make as many trips to get pads, I just keep them around for “insurance” purposes. It’s terrific to be able to go out and run errands without having to plan “pit stops.” It’s truly wonderful being back to normal, to walk to the bathroom, particularly when I’m out in public. It gives me a great sense of security to no longer be obsessed with the need to control my bladder. Dr. P is a gift. It took me a couple years to get to him, just because of all the travel I do with my husband. I’m sorry I hadn’t come sooner. This has totally changed my life. My family sees it and they are very happy too. They love that I don’t make them stop for me with constant need for a bathroom. It’s great!   

MaryAnn K. October 29, 2015

I had struggled with the increasingly troublesome physical problem of incontinence for several years before consulting with Dr. Pugach. I truly appreciated Dr. Pugach’s sensitivity when discussing this very personal matter with me. He explained that I did not have to accept incontinence as an inevitable part of aging and suggested several viable options to correct his problem.
I opted for a minimally invasive surgical procedure that was unexpectedly painless and from which I experienced a surprisingly swift and uncomplicated recovery. Both the office and nursing staff have always been unfailingly pleasant and helpful. My place of employment required a Physician’s Note confirming the date of my surgery and the time necessary for recovery so that my sick leave could be scheduled.  In addition, “Curves”, a women’s fitness facility) upon receipt of my physicians note, would waive the membership fees while I was in recovery.  The office staff was extremely accommodating, faxing these notices in a timely manner to both concerned parties.
All in all, my experience with Dr. Pugach and his remarkable staff was outstanding. I would confidently recommend Pacific Coast Urology Medical Center to all my family and friends.   

Margot H. October 29, 2015

I had a life changing experience on October 3rd, 2011. My bladder was finally controlled! Now I can urinate like anyone else, especially like someone much younger than myself. I'm 66 and I looked for the rest of my life to be free from any sudden urges. This new technique is fabulous! My trouble started 10 years ago and gradually got worse and worse. My GP gave me medication which did not work. It actually hurt in my abdomen when I swam. My husband had seen Dr. P for his enlarged prostate about 2 years ago. My husband is remarkable now and thinks he may consider the same procedure sometime in the future. 

Carol S. October 29, 2015

Dr. Pugach is amazing in my book. He was able to get my daughter scheduled for the surgery right away so that we could go on our two week vacation in April without any issues. Dr. Pugach is compassionate, and total understands the issues with the bladder and is able to explain so that I could understand. Dr. Pugach office staff is just as helpful and compassionate. Thank you.  

Regina October 29, 2015

I continue to see Dr. P about 1-2 times a year. He has solved my urgency problem without medication for long periods of time. Thank you so much!

K.B. October 29, 2015

I am more then happy to write a testimonial to tell anyone who is considering being treated by Dr. Pugach that they could not make a wiser choice. I must admit that making an appointment with a urologist because you’re having problems with your urination habits is not something you look forward to especially when you are healthy and  active man under forty.
Moreover, saying that I anticipated an uncomfortable process is an understatement. However, Dr. Pugach and his staff have such a pleasant and profession manner about them that I was anything but uncomfortable. I have known my fair share of doctors but I have never met a more affable and concerned doctor. He has by far the best listening skills that are combined with a sense of empathy that most doctors are completely void of. And I am not just saying that because he is thoughtful enough to put a TV on the ceiling for the patients to watch while they are having a procedure done. After my first examination I left his office confident that whatever problem I did have he would be able help.
And yes he did help but in more ways than one. My initial problem was diagnosed accurately and treated with prescription. I was very pleased that and all my symptoms were relieved, however, that was not all Dr. Pugach did for me, all be it enough. It was during one of my follow up appointments when I mentioned to Dr. Pugach that my wife and I were trying to have a baby. Just to be safe he sent me for some tests and adjusted my medication to a drug that would still treat my symptoms but help better facilitate the reproductive process. I am happy to say that soon thereafter I joyfully called Dr. Pugach’s office to report that we had conceived our first child. And you know what? A couple weeks later they sent us a congratulations card.
There are many doctors who are competent and will be able to treat you effectively. Although I believe that Dr. Pugach and his staff go way beyond that and in a way that does not feel contrived in any way. I believe they are all just very nice, caring and thoughtful people who are considerate of your time and care. I would not have ever thought that going to the urologist was my favorite doctor’s office to visit but IT IS.

Josh October 29, 2015

Thanks PCUMC. My vasectomy was actually a wonderful experience. It was good and calming talking or chewing the fat with Dr. Pugach during my procedure. I have recommended him to friends. Thanks for making an uncomfortable situation a pleasant experience.

Maurice H October 29, 2015

I met Dr. Pugach while I was hospitalized at Los Alamitos Medical Center more than three years ago. I have seen him several times since then. Of all the physicians I have ever had, I find him to be the most competent, friendly and caring. He always has given me plenty of time to ask my questions and address any concerns that I might have. I wholeheartedly recommend him to anyone who is in need of treatment for urologic conditions.  

Cheryl M. October 29, 2015

I can’t speak highly enough of Dr. Pugach and the team at Pacific Coast Urology Medical Center.  They were the most professional, caring, and informative during what can be a very stressful time.  My care was always their utmost priority, even today, years after having my procedure.  Dr. Pugach is at the forefront of technology and care options for his patients and offers nothing but the best care available.  I enjoy seeing them for my annual checkups and would highly recommend Dr. Pugach and the team over at Pacific Coast Urology Medical Center to anyone and everyone.  I am extremely lucky to have been cared for by Dr. Pugach and his team and my family and I can’t thank him enough!  I only wished that more people were aware of Dr. Pugach, his team, and the various treatment options that they offer.  

David H. October 29, 2015

Everyone in this office, including Dr. Pugach, does a great job in a professional way.  One example: when I came in to get a biopsy result, after talking to the doctor, I went out to schedule a follow up a year later. The young lady just smiled and said “yes,” which means she knew I had just gotten good news.  I thought that was very nice of her.  

Larry W October 29, 2015

All the staff and doctor are very friendly, helpful and informative.  Dr. Pugach is also able to complete tests right in his office that other urologists had to use outsourcing for.  Very satisfied. 

Thomas R. October 29, 2015

I am very satisfied with treatments by PCUMC – couldn’t’ be happier!   

John R October 29, 2015

I am very well pleased with all of my dealings with Pacific Coast Urology Medical Center.  They did all they could do for me.  I would recommend them to any of my friends. 

Alberta October 29, 2015

Service is great! 

Doug S October 29, 2015

From the front office staff to the staff that directly assists Dr. Pugach, the care, concern and patient attention could not be better. Everyone seems to take a personal interest and that surely comes from Dr. Pugach, who exemplifies all of those qualities. 

Howard G October 29, 2015

Dear Dr. Pugach;
Just wanted to express our appreciation for your care and prompt response to our needs. We feel truly blessed that YOU are our doctor (and somehow), find time to "squeeze" us into your demanding schedule. Thank you and warm regards,

Millard and Nancy October 29, 2015

Even before my surgery - every office visit I had was very friendly, professional and everyone tried to make each visit as pleasant as possible for me. With this type of office visit/surgery you as a patient are a little nervous and embarrassed and with the pleasant professional environment I was made to feel comfortable and well taken care of! My surgery and my follow up appts were also very professional. I was never in any pain - very surprising to me! I would recommend Dr. Pugach to anyone - male or female! Thank you so very much! 

Jeanette D. October 29, 2015

Dr. Pugach is one fine physician and cares deeply for his patients. He spends time with his patients and explains clearly what the alternatives are and how the best way to cure the problem is. The front office team always has a smile and is extremely efficient. In fact, today I was able to see Dr. Pugach even though my appointment was for tomorrow because I had concerns about my bladder and prostate. Earlier this year I was in Europe and contacted a bladder infection and I was able to communicate with Kim Pugach who gave me support and the approach as to how to deal with this problem in a foreign country.  

Steve L. October 29, 2015

"I suffered a chronic problem that affected my ability to work out rigorously.  I saw several urologists who minimized it and weren’t interested in seeking a solution.  Dr. Robert Pugach listened to what I had to say and proceeded with diagnostic analysis.  In the end he identified the root problem and corrected it with minor surgery.  He gave me back the ability to keep myself fit and feeling great.  His willingness to listen to his patients sets him apart." 

Rick H. October 29, 2015

I could not be happier with all the Great Service and Medical Knowledge that made me well, Thanks Again.

Bill October 29, 2015

I can't speak highly enough of Dr. Pugach and the team at Pacific Coast Urology Medical Center. They were the most professional, caring and informative during what can be a very stressful time. My care was always their utmost priority, even today, years after having my procedure. Dr. P is at the forefront of technology and care options for his patients and offers nothing but the best care available. I enjoy seeing them for my annual checkups and would highly recommend Dr. Pugach and the team over at Pacific Coast Urology Medical Center to anyone and everyone. I am extremely lucky to have been cared for by Dr. P and his team and my family and I can't thank them enough! I only wished that more people were aware of Dr. Pugach, his team and the various treatment options that they offer.

Sonny H. October 29, 2015

After doing a considerable amount of research on methodologies, and practitioners in my area I made a consultation appointment with Dr. Pugach. I was very impressed with his staff's professionalism, and also with the office and its facilities. After speaking with Dr. Pugach I knew that this was where I wanted to have my procedure performed. Dr. Pugach was professional, knowledgeable and able to communicate his insights very well. I left knowing exactly what to expect the day of the procedure. The procedure itself was just a promised, quick and painless. It has now been almost two weeks and my recovery, what little there was, has been problem and issues free. If you've decided it’s time to take this step in life I can't recommend Dr. Pugach any higher.

Vernon October 29, 2015

Dr. Pugach is in the true meaning of the word a physician. I have been his patient for several years and could not think of anyone else who would have treated me as effectively and well. His practice staff is exceptional and efficient. Dr. Pugach and his practice are AAAA+.

John October 29, 2015

Dr. Pugach is an excellent physician. He provided optimal care in a professional manner. He was also available anytime for my follow-up appointments and was very flexible. Dr. Pugach and his staff were amazing and made me feel comfortable enough to trust them. I truly recommend them and I will definitely return if I ever need to in the future. 

Benjamin October 29, 2015

Thank you for the great news and the information. No apologies needed. It looks like the information breakdown was with the insurance company. I greatly appreciate you resolving this matter so quickly and so professionally. I truly wish that every business had a billing department as professional as yours.  You guys (and ladies) have been awesome since day 1, and I greatly appreciate all that you have done for me. 

Euclid October 29, 2015


Just as women go through menopause as they age, men go through andropause. Men’s testosterone levels peak between the ages of 25 and 35. From that point on, three is a gradual decline of approximately 1% to 3% per year. By age 40, estimates are that as many as 15% of men may have a testosterone deficiency! That number increases year after year.


The principal cause of Low T levels is a decrease in the number of functioning Leydig cells in the testicles. These cells are responsible for testosterone production. Simply stated, the testicles gradually burn out. That’s why many advertised remedies that claim to boost testosterone production don’t work – there aren’t enough Leydig cells to stimulate as men get older.

Other causes include disorders of the hypothalamus, the pituitary gland and certain brain tumors. In some men, dilated veins in the scrotum cause low testosterone levels and these can often be corrected with a short, outpatient surgical procedure.

Another cause of Low T symptoms is a decline is bioavailable, or “free”, testosterone. Most of a man’s circulating testosterone can’t be metabolized. Only testosterone that is not tightly bound to proteins in the blood stream is available. One circulating hormone, called SHBG (or Sex Hormone Binding Globulin) binds testosterone tightly so it can’t be utilized. For reasons not clearly understood, SHBG levels increase as men get older so the percentage of free, useable testosterone declines.

How much does it decline? Part of that depends upon when a man’s testosterone level peaks. As noted previously, that’s usually between the ages of 25 to 35. From then on, testosterone levels drop by 1% to 3% per year. By age 40, 15% of men have Low T; by age 55, 40% of men have Low T. Testosterone levels continue to decline every year.

Whether you call the condition Low T, andropause, male menopause or hypogonadism, the significance of decreasing testosterone levels can’t be overstated. Testosterone is important for a number of reasons. Read below to learn about some of them.


Testosterone is an anabolic steroid hormone that is actually made from cholesterol. In men the vast majority of testosterone comes from the testicles. In women a very small amount of testosterone is made by her ovaries. The adrenal glands also contribute a small amount. The normal value of total testosterone in males varies considerably during a 24 hour period. It peaks in the early morning hours and declines by approximately 35% as the day goes on. That’s why it’s important to have an experienced professional like Dr. Robert Pugach evaluate your testosterone blood levels to determine what replacement therapy may be right for you.


In men, testosterone is important for many functions, including:

  • Development and maintenance of reproductive tissues
  • Promotion of secondary sexual characteristics like a deep voice and hair distribution
  • Stimulation of sperm production
  • Creation of sexual desire (libido)
  • Prevention of mood swings and depression
  • Development and increases in muscle mass and strength
  • The ability to multi task and maintain good memory
  • Maintenance of bone strength and prevention of bone thinning (osteoporosis)
  • Prevention of diabetes
  • Maintenance of good cardiac (heart) function
  • Preservation of good eyesight


In adult men low testosterone has been linked to the following symptoms:

Decline in sexual function. This can take many forms including a reduction in sexual interest and desire (libido), erectile dysfunction(ED), or a decline in fertility (infertility).
Changes in body and physical characteristics. Muscle mass may decline and body fat my increase. Specifically, abdominal fat may become more prominent and noticeable and be difficult to lose. Loss of hair may also occur.

Change in energy level. Some men report a decrease in energy levels and may fatigue easily, especially in the afternoon and early evening hours. Being exhausted at the end of a work day or taking afternoon of after dinner naps are common symptoms.

Change in sense of well being and mental ability. Low T is a cause of male depression, irritability, mood swings and loss of confidence.
Disruption in sleep patterns. Low testosterone has been reported as one of the causes of sleep disturbances, including insomnia.
Changes in concentration and memory. Low testosterone may contribute to changes and declines in memory, concentration and the ability to multi-task. In some cases, it can actually be mistaken for dementia or Alzheimer’s disease.


Decreased testosterone levels have also been implicated in a number of serious health conditions such as:

  • Bone Diseases such as thinning bones (osteopenia) or brittle bones (osteoporosis)
  • Diabetes
  • Congestive Heart Failure
  • Visual problems
  • Coronary Artery Disease


Because of the staggering number of men who suffer from Low T, a number of products have come to the marketplace for treatment. Some of these can be very beneficial while some are a waste of money despite aggressive marketing campaigns. At the Male Health and Hormone Center of Excellence we understand that we have a very important role – to advise and guide you through the confusing number of treatments to find the one that’s best for you. Some of the available treatments are:

  • Custom compounded creams
  • Gels
  • Injections given in the office or in your home
  • Pellets that require replacement every 3 to 4 months
  • Nasal sprays


Before beginning any type testosterone therapy, an appropriate examination must be made to ensure that there are no more serious causes of Low T such as testicular growths, abnormalities of the pituitary gland or a part of the brain called the hypothalamus, and some other medical conditions, as indicated in the aforementioned sections.

Despite the many television commercials and magazine ads for various types of over-the-counter gels and pills for Low T, Dr. Robert Pugach strongly advises men to consult with a physician before beginning any type of testosterone replacement therapy. It is important that blood tests are done to determine the levels of both total and free testosterone. At Pacific Coast Urology’s Male Health & Hormone Center of Excellence, we provide a thorough evaluation including a medical history, thorough medical exam and appropriate blood tests. We use only reputable laboratories for your testing to ensure that we get the most accurate results possible. In addition, we screen patients for prostate cancer. This must be done because there may be a link between testosterone administration and prostate cancer in later years.

A lot of research and work has been done to develop new, easier and safer treatments for Low T. However, before you begin treatment for low testosterone schedule an appointment with Dr. Robert Pugach to obtain a proper medical evaluation, accurate diagnosis, an individualized treatment plan and follow-up visits to monitor your testosterone levels. (See Low T Treatment Options for more information)


If you think you have low testosterone and are suffering from the symptoms described above, call the Male Health & Hormone Center for a confidential appointment. There‘s no need to suffer from Low T anymore! At Pacific Coast Urology Medical Center we’re proud to have a Center of Excellence for Male Health & Hormone diagnosis and treatment.   CALL: 888-735-4336 or Email us via our Contact Us form for your consultation.