A urologist is a physician who specializes in diseases of the urinary tract and the male reproductive system.
Patients may be referred to a urologist if their physician suspects they may need treatment for a condition relating to bladder, urethra, ureters, kidneys, and adrenal glands.
In men, urologists treat disorders related to the epididymis, penis, prostate, seminal vesicles, and the testes.
Kidney disease: Damage to the kidneys can lead to swelling in the hands and ankles, high blood pressure, and other symptoms. If the kidneys no longer work effectively, this is kidney failure. Ultimately, it can be fatal.
Cancers: the bladder, kidneys, prostate gland, testicles, and any other cancer that affects the urinary system or, in men, the reproductive system.
Enlarged prostate: Benign prostatic hyperplasia (BPH) affects around 1 in 3 men over the age of 50 years. An overgrowth of cells in the prostate gland causes the urethra to constrict, leading to problems with urination.
Cystoscopy is aprocedure to examine the inside of the bladder and urethra, the tube that carries urine from the bladder to the outside of the body.
Cystoscopy is used to diagnose, monitor and treat situations that have an effect on the bladder and urethra.
Reasons for performing a cystosocopy include:
•Hematuria – blood in the urine
•Assessing an enlarged prostate
•Monitoring and treatment of bladder tumors
•cure of stones in the bladder, urethra or kidneys
Cystoscopy is usually well tolerated as a day procedure. Potential risks include:
•Bleeding: it can reason some blood in the urine for up to one week after the procedure, serious bleeding is very rare.
•Pain: you may notice a burning sensation during urinating after the procedure, but these symptoms are mild and will usually resolve after 24-48 hours
•Infection: there is a less than 5% risk of a urine infection after cystoscopy. Please let your doctors know if burning during voiding is not improving or persists after 48 hours. Drinking abundance of water following the cystoscopy will reduce the risk of having a urine illness.
Circumcision is the surgical removal of the skin covering the tip of the penis called the foreskin. Circumcision is fairly common for new born boys in certain parts of the world for religious and social reason. Circumcision after the newborn period is sometimes performed for medical reasons, but it’s a more difficult procedure.
Circumcision is commonly performed for religious reasons. It can also be performed for social reasons such as keeping of family tradition, personal hygiene or preventive health care.
There are medical reasons when circumcision has to be performed, including:
•Phimosis – very tight foreskin where is cannot be retracted over the head of the penis
•Recurrent tears or bleeding of the foreskin during sexual activity
•Reducing risk of sexually transmitted infections in certain parts of the world where the risk is very high
circumcision is usually performed with a Plastibell circumcision ring in newborns. The ring and sutures are applied to remove the foreskin.
The procedure is more difficult in adults and older children. Redundant foreskin is carefully measured out to make sure the accurate amount is removed. The foreskin is removed and 10-15 sutures are used to approximate the wound. A penile nerve block is performed to reduce post-operative pain.
The most common complications associated with circumcision are bleeding and infection. Other rare complications include an unsatisfactory cosmetic appearance of the foreskin where it is cut too short or too long or tearing of the foreskin wound.
Kidney cancer — also called renal cancer — is a disease in which kidney cells become malignant (cancerous) and grow out of control, forming a tumor. Almost all kidney cancers first appear in the lining of tiny tubes (tubules) in the kidney. This type of kidney cancer is called renal cell carcinoma. The good news is that most of kidney cancers are found before they spread (metastasize) to distant organs. And cancers caught early are easier to treat successfully. However, these tumors can grow to be quite large before they are detected.
The kidneys are two bean-shaped organs, each about the size of a fist. They lie in your lower abdomen on each side of your spine. Their main job is to clean your blood, removing waste products and making urine. The kidneys are a pair of bean-shaped organs, each about the size of a fist. They are attached to the upper back wall of the abdomen and protected by the lower rib cage. One kidney is just to the left and the other just to the right of the backbone.
Green Light Laser Surgery
Green light laser prostatectomy is a secure and efficient treatment to remove the prostate gland and ease urinary symptoms in patients with benign prostatic hyperplasia (BPH), which is the enlargement of the prostate gland. It is a minimally invasive procedure that utilizes a 532nm wavelength laser to vaporize and remove excess prostate tissue blocking the urethra. The laser with this specific wavelength is chosen as it is selectively wrapped up by the hemoglobin in red blood cells and not absorbed by water, so it provides excellent homeostasis. The procedure is also known as photo selective vaporization of the prostate.
Green light laser prostatectomy is performed under general or spinal anesthesia. Laser is delivered through a flexible fiber passed through a cystoscope, a tube-like instrument with a light and a camera at one of its ends. Real-time images from the cystoscope are display on the monitor in the operating room, which helps your surgeon to control the way and delivery of the laser energy. The cystoscope along with the flexible fiber is inserted through the urethral opening of the penis, and slowly manipulated through the urethra, removing the obstructing prostate tissue, enlarging the space within the urethra and restoring normal urine flow. Laser energy is delivered to vaporize the prostate tissue.
Continuous flow of irrigation fluid is maintained to remove the vaporized prostate tissue, keep the fiber tip cool and to maintain a clear outlook of the operative area. At the end of the procedure a catheter is placed in the bladder and is usually removed the next day after surgery. You are usually discharged the next day.
Green light laser prostatectomy has several advantages over other treatment procedures for benign prostatic hyperplasia, including:
•Minimal blood loss
•Safer for patients on anticoagulation therapy who cannot safely stop these medications such as warfarin and clopidogrel
•Quicker recovery than the traditional TURP
The UroLift System consists of a delivery device and small permanent implants. The implant is made up of standard surgical implantable materials: a nitinol capsular tab, a stainless steel urethral tab, and polyester suture that holds the two tabs together. It works by directly opening the prostatic urethra the implants are designed to hold the enlarged prostate tissue out of the way, like tiebacks on a window curtain. There is no cutting, heating, or ablating of prostate tissue.
The implants can be removed at any time by cutting the sutures in the prostatic urethra. It does not preclude from future prostatic surgery.
Urolift is designed for patients with symptomatic BPH who are looking for an alternative to drugs, but want to avoid the fertility and ejaculatory side effects of permanent BPH surgery.
The implants are not suitable for everyone it works best for patients with inflamed prostate lateral lobes, but is not suitable for patients with an enlarged prostate median lobe. It is also no suitable for patients with very big prostates.
Urolift surgery will recover flow rate by about 4ml/sec, this is usually better than the improvement from medical therapy (2ml/sec), but not as good as HOLEP or TURP (11ml/sec). There may be blood in the urine and pain passing urine in the first week after the operation.Micturition urgency, pelvic pain, and urge incontinence has also been reported. These symptom can last for 2-4 week after the operation.
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