The branch of surgery that deals with the treatment and cure of the urinary tracts of both males and females and the reproductive system of males is called Urology. Doctors who specialize on Urology are known as Urologists.
The following are included in Urological Procedures:-
- Endoscopic Surgery
- OIU (Optical Internal Urethrotomy)
- BNI (Bladder Neck Incision)
- Radical Nephrectomy
- TURB (Endoscopic)
- Radial Prostectomy
- Partial Penectomy
- Total Penectomy
- Prostrate Biopsy
- Bladder Biopsy
Endoscopic Surgery in urology is a procedure in which kidney stones, obstruction of ultrapelvic junction, ureteral strictures and tumors are removed. Given below are the two methods to perform Endoscopic Surgery.
'Retrograde' is a method in which the patient is made to lie down. Then his legs are tied up. After this, the surgeon inserts an ureteroscope which is connected to a camera, into the patient's bladder. The camera enables the surgeon to watch the patient's bladder on a TV screen. Sometimes, (depending upon the situation), the surgeon inserts a device called 'stent' into the ureter and the kidney. This is done to break kidney stones, blockages, strictures or drain urine.
b) Antegrade (Percutaneous)
'Antegrade' or 'Percutaneous' is the 2nd method used in Endoscopic Surgery. It means reaching the kidney through the skin and the process is a bit painful. So, the patient is anestheticized before the process. Normally, a 'nephrostomy tube' is inserted into the patient's affected kidney by an intervening radiologist.
The kidney and its strictures is examined by the urologist with the help of a fiberoptic scope. The surgeon usually leaves a tube in the kidney for draining out the urine. A few days later, he injects a dye into the tube followed by an x-ray. If the kidney functions normally, then the patient is discharged.
Patients who undergo the ureteroscopic surgery can resume normal work within 2 weeks and those who undergo the percutaneous surgery can resume their daily activities within 2-3 weeks.
TURP is known as Trans Urethral Resection of Prostrate and TUEVP is called Trans Urethral Electric Vaporization of Prostrate. The latter is by far a better method than TURP. This is performed on men who have an enlarged prostrate gland and it is common among males who are more than 50 years age.
Laser ablation is one of the latest methods used for the process. In this, blood loss is comparatively less and the patient is discharged from the hospital within a few days after the surgery.
OIU (Optical Internal Urethrotomy)
When the patient has many strictures in the urethra (male), OIU is performed. An intermittent catheter is used along with an active urethral dilation. This is done to prevent the chances of a possible recurrence of strictures.
OIU (Optical Internal Urethrotomy) is a safe method. However, OIU is preceeded by internal urethrotomy or urothroplasty.
BNI (Bladder Neck Incision)
BNI (Bladder Neck Incision) includes involving telescopic removal, incision or obstructing sections of the prostrate. The prostrate is temporarily fitted with a catheter for irrigating the bladder.
2 weeks preceding the operation, the patient has to be admitted to the hospital. After the operation, the patient may show symptoms in which he discharges blood along with his urine. This is accompanied with a burning sensation in that area for some days. After he urinates normally, the catheter is removed.
In an alternate procedure, medication, use of catheter, laser surgery or open surgery may be performed. After being discharged, the patient resumes his normal activities within 4-6 weeks.
The medical process that is used to treat the ureteropelvic junction is called Endopyelotomy. It is of 2 types; Percutaneous Nephrostomy (Antegrade Endopyelotomy) and Retrograde Endopyelotomy. The first procedure involves reaching the kidney (by the surgeon) while the 2nd process involves the urethra or the urinary bladder.
If the patient is suffering from horseshoe kidney, fibrous scarring, kidney stone and other symptoms then 'Endopyelotomy' is performed. Post operation, the patient can resume his daily work routine from 2-4 weeks.
The medical procedure which involves the removal of the entire kidney along with its adrenal gland and lymph gland is called 'Radical Nephrectomy'. Generally patients who have reached renal cell carcinoma (Stages 1, 2 or 3) of kidney or polycystic kidney are eligible for this procedure.
2 methods are used to perform 'Radical Nephrectomy'. These are; Open Abdominal Approach and Laparoscopic Approach. 4 small incisions each 3 inches wide are made in the abdomen. These incisions extend up to the rib cage. The entire process may take up to 3 hours.
The 1st week after the operation is extremely painful and the patient may experience discomfort. Normal activities can be achieved after 4-6 weeks.
The process in which the penis is removed (due to cancer) partially is known as Partial Penectomy. In this method, the tip of the penis is removed by the surgeon. However, the surgeon tries to keep the shaft of the penis as much as possible. The patient does not face any problems in urinating or leading a normal sexual life.
Total Penectomy means total removal of the penis which includes the part of the penis that extends to the pelvis. In these cases, the patient urinates through a new aperture created for the urethra and the tube carries urine from the urinary bladder. Patient's who have undergone Total Penectomy has to forsake their sexual life after the surgery.
The medical procedure which includes the removal of small samples from patient's prostrate gland is called Prostate Biopsy. It is a test to detect cancer. Patients undergoing this test may urinate blood in case of complications.
Prostate Biopsy is performed transrectally either through the urethra or the perineum. It involves insertion of 12 needles (6 on either side) into the prostrate gland for obtaining samples. The surgeon inserts an ultrasound device into the patient's rectum for guiding the biopsy needles.
The patient might experience discomfort during the process. Blood may accompany ejaculation for a few weeks. This is why, the doctor prescribe antibiotics to prevent any infection due to transrectal Prostate Biopsy.
In Bladder Biopsy, small pieces of tissue are removed from the bladder for medical examination. This is done to ascertain any abnormalities of the bladder or any tumor or cancer.
Usually considered to be a part of Cystoscopy, Bladder Biopsy requires the patient to sign a consent form prior to the test. Through the patient's urethra, a Cystoscope is inserted into his bladder. The patient may suffer from a burning sensation and a strong urge to urinate.
The abnormalities which require to be examined by Bladder Biopsy are given below:-
The risks involved include urinary tract infection or excessive bleeding or rupturing of the bladder wall during biopsy. In such cases, the patient must consult a physician if he experiences pain, chill or fever or if the urine output is low (also called 'Oliquria').
- Bladder Diverticula
Vasectomy involves the tying up of the vas deferens (two tube carrying sperm) to prevent sperm from reaching the woman's egg (via urinary tract) and thus fertilize it during sexual intercourse.
The patient might suffer from initial complications like bleeding, infection and sperm granuloma or sperm conjestion near the epididymitis. But on consumption of anti-inflammatory medicines and taking rest, these disappear.
Vasectomy is in fact, the best method (of contraception) during coitus. The patient's sexual life remains absolutely unaffected (as he used to do earlier) except for the fact that his orgasm would not show any sperm count. This accounts for safe contraception.
(In US $)
(In US $)
|1) TURP / TUEVP
|2) OIU (Optical Internal Urethrotomy)
|3) BNI (Bladder Neck Incision)
|5) Radical Nephrectomy
|6) TURB (Endoscopic)
|7) Radial Protatectomy
|8) Partial Penectomy
|9) Total Penectomy
|10) Bladder Biopsy
|11) Prostate Biopsy
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