For Referring Providers

This page is for primary care physicians, general urologists, and advanced practice providers considering a referral. The goal is to make sending a patient to Dr. Quarrier simple.

When to refer for HoLEP

Consider referral for any patient with bothersome benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) who would benefit from a surgical opinion — particularly:

Medication failure or intolerance — symptoms not controlled on an alpha-blocker (a common prostate medication that relaxes the bladder neck, e.g. tamsulosin) and/or 5-ARI (a prostate medication that slowly shrinks the gland, e.g. finasteride), or side effects the patient doesn’t want to continue accepting.
Large prostates — glands above ~80 mL, where HoLEP is size-independent and outperforms options with size ceilings.
Urinary retention (being unable to empty the bladder on your own) — acute or chronic, including catheter-dependent (a thin, flexible tube that drains urine from the bladder) patients and those who have failed trials without catheter.
Patients told they are “not surgical candidates” elsewhere because of prostate size, age, comorbidity (other ongoing medical conditions), or anticoagulation (blood-thinning medication) — HoLEP’s bleeding profile and size range make many of these patients candidates.
Recurrent gross hematuria (blood in the urine), bladder stones, or recurrent UTI attributable to bladder outlet obstruction (blockage of the bladder's outflow by the enlarged prostate).
Failed prior procedures — UroLift, Rezum, GreenLight photoselective vaporization (PVP), or prior transurethral resection of the prostate (TURP) that didn’t deliver durable relief.

Dr. Quarrier also accepts referrals for complex stone disease (PCNL, ureteroscopy).

What HoLEP offers your patient

HoLEP is size-independent, has the lowest retreatment rate of the major BPH procedures, has a favorable bleeding profile (often performed without stopping anticoagulation), and most patients go home the same day. See the comparison page for the evidence behind each of those points.

How to refer

UR Medicine Access Center (provider referral line): (585) 276-3000, or toll-free 1-844-876-6300 — Mon–Fri, 8:00 a.m.–4:30 p.m. ET. The fastest way to connect a patient to Dr. Quarrier.
Through your EHR: if you are on Epic, route a referral to UR Medicine Urology and flag for Dr. Quarrier (BPH/HoLEP or stone disease).
Referral guide: Refer a Patient — UR Medicine
Patient scheduling: your patient can also call UR Medicine Urology directly at (585) 275-2838.

What helps the visit go smoothly

If readily available, sending the following with the referral speeds evaluation (none are required to refer):

Recent International Prostate Symptom Score (IPSS) or a description of symptom burden
Prostate-specific antigen (PSA) with date
Any prior prostate imaging (TRUS or MRI) and prostate volume
Post-void residual (the amount of urine left in the bladder after you finish urinating) or uroflow (a simple test that measures how fast your urine flows) if measured
Current medications, especially anticoagulants/antiplatelets (a type of blood thinner, such as aspirin or clopidogrel)
Relevant comorbidities and any prior BPH procedures

What your patient can expect

A consultation (in person, or by video for distant patients), a discussion of options including HoLEP, and — for surgical candidates — a clear plan. Catheter management after surgery is handled at home for most patients, and routine follow-up is a phone touch point at ~2 weeks plus an in-person visit at ~3 months, which can often be coordinated with your office for out-of-area patients. You will receive operative and follow-up documentation per standard UR Medicine communication.

Clinic and operating locations

Clinic: 158 Sawgrass Drive, Suite 230, Rochester, NY
Operating hospitals: Strong Memorial Hospital and Highland Hospital