Madigan Urology Service
Urology Clinic
Physical Address
Madigan Army Medical Center
Second Floor, Hospital Tower
9040 Jackson Ave.
Tacoma, WA 98431
Hours
Monday-Friday 8:00 a.m. - 4:00 p.m.
Closed on Federal Holidays and Selected Training Holidays
About
The surgeons and staff of the Madigan Urology Service provide expert healthcare services for conditions of the urinary tract. We look forward to providing compassionate and comprehensive urologic care for eligible pediatric, adult, and geriatric patients at Madigan Army Medical Center. Madigan’s Urology Service is a fully staffed, state-of-the-art, 13,400 square foot clinic with the capability to perform the full range of diagnostic and therapeutic urologic procedures. Three urology procedure tables and four cystoscopy suites with full video capability allow us to perform procedures and surgery in our clinic to include laser lithotripsy, flexible cystoscopy and ureteroscopy, transurethral surgery, prostate biopsies, urodynamics, and penile ultrasounds.
Staff bios
Carolyn Salter, MD is a board certified and fellowship trained urologist. She is an Assistant Professor of Surgery at the Uniformed Services University. She obtained her undergraduate degree and her ROTC commissioning at Johns Hopkins University and attended medical school at the Uniformed Services University of the Health Sciences. Dr. Salter completed her urology residency at the Walter Reed National Military Medical Center and a fellowship in Male Sexual and Reproductive Medicine at Memorial Sloan Kettering Cancer Center.
She sees patients for general urologic conditions, such as kidney stones or urinary symptoms. She focuses on patients with erectile dysfunction, Peyronie’s disease, male infertility, and various other conditions pertaining to male sexual dysfunction. Her research interests are broad and include erectile dysfunction, Peyronie’s disease, infertility and oncosexology.
Ted Cristostomo-Wyn
ne, MD is board eligible general urologist. He is an Assistant Professor of Surgery at the Uniformed Services University. He attended medical school at the Uniformed Services University of the Health Sciences and obtained his undergraduate degree from the United States Military Academy at West Point. He completed his residency training in urology at Madigan Army Medical Center. Dr. Cristostomo-Wynne will be attending a fellowship in Andrology at the University of Washington.
He sees patients for a broad range of urologic conditions, from kidney stones and urinary symptoms to erectile dysfunction and cancer.
Scott Cuda, MD is a board certified and fellowship trained urologist. He is an Assistant Professor of Surgery at the Uniformed Services University. He obtained his undergraduate degree from Willamette University and his medical degree from the Uniformed Services University of the Health Sciences. Dr. Cuda completed his residency training in urology at Tripler Army Medical Center and his pediatric urology fellowship at Emory University.
He see patients for general urology conditions and focuses on pediatric urology patients.
Ryan Sp
eir, MD, MPH is a board certified and fellowship trained urologist. He is an Assistant Professor of Surgery at the Uniformed Services University. He obtained his undergraduate degree from William and Mary and his medical degree from George Washington University. Dr. Speir completed his residency training in urology at Madigan Army Medical Center and his urologic oncology fellowship at Indiana University during which he obtained his Masters in Public Health with an emphasis on Health Policy and Management. He is the Program Director for the Residency program and remains actively involved within the department and hospital in basic science and clinical research endeavors specifically relating to Urologic cancers.
Dr. Speir sees patients for general urology conditions, such as lower urinary symptoms. He clinically focuses on patients with cancer, to include bladder, kidney, prostate and testicular cancer.
Jonathan Wingate, MD is a board certified and 
fellowship trained urologist. He is an Assistant Professor of Surgery at the Uniformed Services University and a Clinical Assistant Professor in the Urology Clinic at Harborview Medical Center. He attended medical school at the Uniformed Services University of the Health Sciences and obtained his undergraduate degree from the United States Military Academy at West Point. He completed his residency training in urology at Madigan Army Medical Center and fellowships in Genitourinary Trauma/Reconstruction and Simulation Sciences at the University of Washington.
Dr. Wingate sees patients for general urology conditions such as kidney stones, lower urinary tract symptoms, and erectile dysfunction. He also specializes and is interested in genitourinary trauma and the application of reconstructive techniques in trauma and cancer survivorship.
Jeanine Sheeran, PA-C is a board certified Physician Assistant. She obtained her undergraduate degree at Purdue University and her Master of Science degree in Physician Assistant Practice at Rosalind Franklin University of Medicine and Science.
She sees patients for general urologic condition such as kidney stones, urinary symptoms, elevated PSA, erectile dysfunction. In addition, participates in multi-disciplinary prostate cancer clinic and runs the urinary retention pathway.
Patient instructions and what to expect:
- General
- Urology is a specialty clinic and requires a referral prior to evaluation. Patients cannot self-refer or walk-in for an initial encounter.
- Be prepared to provide a urine sample during your appointment. This is required for all patients with urinary symptoms and most patients who will undergo a urology procedure or surgery.
- Please arrive at least 15 minutes prior to your appointment for routine clinic visits. Some procedures require you to arrive even earlier.
- New patients will need to complete medical history forms and questionnaires prior to their initial evaluation.
- We request that all patients join the MHS Genesis portal. This is the quickest way to check your results, message your healthcare team and request prescription refills.
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- Prostate Biopsy
- You need to hold all blood thinners prior to your biopsy. Talk to your doctor about if it is safe to stop prescription blood thinners or doctor-prescribed aspirin. In general, aspirin should be held for 7-10 days prior to the procedure. If you do not stop taking these medications, we will likely postpone your procedure.
- You will be given an enema to use at home prior to arriving to clinic for your procedure.
- Patients scheduled for a prostate biopsy need to arrive an hour prior to their appointment so they can take an antibiotic pill.
- You have to provide a urine sample prior to the procedure.
- You cannot take any anti-anxiety medications prior to signing your surgical consent for the biopsy. Otherwise, we will have to cancel your procedure. We do not prescribe these medications for the biopsies.
- Vasectomy
- You cannot take any anti-anxiety medications prior to signing your surgical consent for the procedure. Otherwise, we will have to cancel your procedure. We do not prescribe these medications for the vasectomy.
- As escort is recommended to drive you home after the procedure.
- Cystoscopy
- A cystoscopy is an office-based procedure performed under local anesthetic. A small camera is inserted into your bladder.
- Patients with blood in their urine often undergo a cystoscopy during their initial urology appointment. We will discuss this with you on the day of the procedure.
- You cannot take any anti-anxiety medications prior to signing your surgical consent for the procedure. Otherwise, we will have to cancel your procedure. We do not prescribe these medications for the cystoscopy.
- Uroflow/Post void residual
- Be sure to come to clinic with a full bladder.
- If you are unable to provide enough urine for an accurate test, we will have to postpone.
- Penile ultrasound and/or penile injection training
- Your blood pressure must be normal at the time of your procedure.
- If your blood pressure is elevated, we will have to postpone your injections.
Research
- Madigan Urology is involved in award-winning medical research
- Please discuss with your providers if you are eligible for any of our research studies
- Below are links discussing our research projects that are currently or imminently recruiting patients:
- Evaluating the Impact of Prostate Cancer Therapy on the Sexual Quality of Life of Couples
- Penile Implant Satisfaction
- Meeting the Needs of Transgender patients at Madigan
GME Corner
- Madigan is home to one of the top urology residency programs in the DoD. Our residents meet all their required case numbers and participate in award-winning research. We have an exceptionally high board pass rate.
- Our residency is a 5-year program. While over half of the time is spent at Madigan, we have outside rotations at Harborview, Multicare, Seattle Children’s and Virginia Mason. Residents also have a 6-month research rotation.
- For more information or to schedule a rotation or interview, click here to visit the Urology GME webpage.
Civilian employee information
- Join the Madigan Urology team! We have multiple civilians who work in medical or administrative roles.
- Please look at USAJOBS for current positions and to apply: https://www.usajobs.gov/Search/?l=Tacoma%2C%20Washington&a=ARMC&p=1&s=enddate
- The Madigan Civilian Medical Recruiter is located in Civilian Human Resources off the ground floor of the Medical Mall along the East Corridor in Rooms G-57-02 and G-57-09. To contact the Medical Recruiter, please call (253) 968-3320 or (253) 968-3226, Monday through Friday from 7 a.m. to 3:30 p.m.