What is Urology?
The surgical specialty that mainly concentrates on the diseases of the female and male urinary tracts along with male reproductive organs is known as urology. An urologist is required to study gynecology, pediatrics, internal medicine and other specialties as there could be many clinical problems associated. The urinary tract in women opens in vulva while the urinary system in men overlaps with the reproductive system. In both men and women, the reproductive and urinary tracts are very close to each other and any disorder in one can also affect the other. This surgical specialty (urology) combines management of surgical problems like the correction of congenital abnormalities, cancers and also correcting stress incontinence, as well as non-surgical problems like benign prostatic hyperplasia and urinary tract infections. Urology also sometimes related to some medical fields such as gynecology, pediatric surgery, oncology, endocrinology, nephrology, gastroenterology and andrology.
It is primarily concerned with the surgical treatment of malignant genitourinary diseases such as adrenal glands, testicles, kidneys, cancer of the prostate, bladder, penis, testicles and ureters. An oncologist or a urologist manages the advance stage of genitourinary cancer that depends upon the cancer.
It is primarily concerned with different Urologic disorders in children such as congenital abnormalities, enuresis, cryptorchism, underdeveloped genitalia, vesicoureteral reflux and congenital abnormalities of the genito-urinary tract.
It is primarily concerned with urinary incontinence, overactive bladder and pelvic organ prolapsed. Proper knowledge of urodynamic skills along with female pelvic floor together is required for diagnosing and treating these disorders.
It is primarily concerned with the nervous system that affects the urinary system. Nerves, brain and spinal cord are very essential as they maintain the functions of the bladder. Parkinson’s disease, spinal cord injury and multiple sclerosis can disturb lower urinary tract and can also cause conditions like inability to urinate and urinary incontinence. Spina bifida which is a birth condition can also result in neurological dysfunction of the bladder control.
It is primarily concerned with the male reproductive system such as erectile dysfunction, ejaculatory disorders and male infertility. Andrology usually overlaps with endocrinology as male sexuality is majorly controlled by hormones. The implantation of penile prostheses, fertilization procedures and vasectomy reversals are the common surgeries included in this field.
The common urology procedures include –
- Bladder surgery
- Renal (Kidney) surgery
- Surgery to the penis
- Kidney removal (nephrectomy)
- Urethra surgery
- Surgery of the ureters such as removal of calculus in the ureters or ureterolithotomy
- Testicular surgery
- Removal of the prostate or prostatic surgery
- Pelvic lymph node dissection
When non-surgical treatments and medication are unable to relieve symptoms, then surgery is recommended for treating urologic condition. Some of the conditions are kidney or bladder cancer, prostate cancer, vesicoureteral reflux and ureteropelvic junction (UPJ). There are many less invasive surgical procedures are available for those people who are going through urologic surgery. Laparoscopy is the most common less invasive surgery. This surgery is performed by making several small incisions and it also makes use of long-handled surgical instruments along with a guided camera.
Robotic-assisted Laparoscopic Radical Cystectomy: This is a minimally invasive surgical procedure is primarily performed for bladder cancer. Da Vinci surgical system is utilized in this procedure where the movements of a surgeon are imitated by a robotic arm in order to increase their precision. This is considered as the effective surgery for those patients who are suffering from bladder cancer. During the procedure, small incisions are made without affecting vital muscle tissue and nerve. This procedure results in shorter hospital stays and faster recovery time.
Robotic-assisted Laparoscopic Radical Prostatectomy: This minimally invasive surgical procedure is performed for treating prostate cancer. This procedure involves the removal of the prostate for treating prostate cancer. The prostate gland is surgically removed with the help of few small incisions by using DaVinci surgical robot system.
Robotic-assisted Laparoscopic Pyeloplasty: This minimally-invasive surgical procedure is basically performed for repairing acquired or congenital scarring or narrowing where the ureter is attached with the kidney. This method is considered as an effective and safe method that also involves a short hospital stay and minimal incisions.
Robotic-assisted Laparoscopic Partial Nephrectomy: This minimally invasive surgical procedure is performed for removing small renal tumors and simultaneously it also preserves nearby kidney tissue. This procedure involves only a short stay at the hospital, much smaller incisions, less post-operative pain and quick revert to daily activities.
Bladder neck incision
This is a surgical procedure used for treating the problems of urine leakage, infrequent urination, and the inability to control urine. Bladder neck incision helps to treat the obstruction in the bladder neck that causes excessive pressure in the bladder and inappropriate flow of urine. The patients get recovered in 2 to 3 days after undergoing the bladder neck incision surgery.
Cystolithotripsy is used to remove the stones from the urinary bladder. Stones are formed in the urinary bladder due to a number of reasons. The main two reasons behind urinary stone formation are chronic bladder infection and inability to fully empty the bladder. With cystolithotripsy procedure, the bigger stones are fragmented into smaller parts with the help of a laser and then the stones are removed with the help of a cystoscope.
Sometimes excessive tissue cause narrowing of the renal pelvis where the urine is collected before it is passed to the urinary bladder. The narrowing down of this area create an obstruction in the Pelviureteric junction and urine cannot pass through the ureters. Endopyelotomy is used to treat the obstruction in the Pelviureteric junction by removing the excess tissue.
Greenlight laser prostatectomy:
Benign prostatic hyperplasia (BHP) is enlargement of the prostate that compresses the urethra. In green light laser prostatectomy, the green laser is used to vaporize the enlarged prostate and its tissues. After green light prostatectomy, the patients take one to two weeks to get recovered.
Laparoscopic pyeloplasty is a reconstruction surgery done on the Ureteropelvic junction. Here the urine is collected before it is transferred to the bladder through ureters. This procedure helps to remove any obstruction, or to treat the constriction, damage, scarring or narrowing of Ureteropelvic junction that may result in extensive pain in the abdomen and also cause urinary stones.
Laparoscopic radical cystectomy:
IThis procedure has the best use in the treatment of Urothelial carcinoma of the urinary bladder. Laparoscopic radical cystectomy is a surgical procedure where the whole bladder or a part of it is removed along with the prostate with the help of a laparoscope. Before going forward with this procedure, it is to ensure that the patient has no ling problem.
Enlargement of prostate creates pressure on the urethra resulting in a number of complications like urinary obstruction and infection. This problem is best treated with Laser prostatectomy by removing a part of the prostate that relieves the pressure on the urethra. After laser prostatectomy, it takes one to two weeks for a full recovery.
Optical internal urethrotomy:
This surgical procedure helps to examine the inside of the bladder and the urethra. Optical internal urethrotomy is used to check the urethra if it narrows down due to surgery or infection. Recurrence of stricture, infection of the wound and UTIs are some of the complications to be examined by optical internal urethrotomy.
Percutaneous nephrolithotomy is a surgical procedure used for the treatment of kidney stones. In this procedure, an incision is made on the back through which a tube is inserted to break the stones. After breaking the stones the fragments are removed with the help of the same tube.
Proximal urethroplasty helps in the treatment of damaged structure where the urethra is connected to the urinary bladder. During this surgery, an incision is made by the surgeon over the urethral stricture and where the damaged tissue is located. Also, sometimes, a catheter is used to widen the urethral stricture.
Radical nephrectomy is used in case of major kidney problem to remove the infected kidney by a major surgical procedure. This procedure is basically used in the case of patients suffering from kidney cancer. The procedure could be done by using both laparoscopic and open surgery technique to remove the kidney. It is associated with complications like Infection, bleeding, and leakage of urine after the surgery.
This surgical procedure is a specialized technique to remove kidney stones using the fiber optic endoscope. Retrograde intrarenal surgery also helps in the treatment of tumor in the kidney and bleeding disorders. The patient is given the general anesthesia to conduct this surgery.
Trans Urethral Resection of Bladder Tumor (TURBT):
This procedure is specially used to check if there is any cancerous growth in the urinary bladder or its surrounding area. The technique is also useful in the treatment of a tumor in the bladder. In this procedure, the bladder wall is examined by an instrument called cystoscope and if there is any tumor found it is heated to be separated from the wall.
Trans Urethral Resection of Prostate (TURP)
This specialized procedure is applied if there is any problem occurred in prostate like prostate enlargement. In this case, patients suffer from frequent urination, strained urination, and obstruction in the passage of urine. This is a surgical procedure and the patients are kept under the influence of anesthesia to conduct this surgery.
This is a major surgical procedure used to detach and then replant one or both of the ureters to the bladder wall. The aim is to set the ureter at a new position where it is attached to the bladder and prevent the urine from going back to the bladder. In ureteral replantation procedure, the patients are kept under the influence of anesthesia to conduct this surgery.
Ureteroscopic Removal of Stone (Bladder)
This procedure helps in the removal of stones from the ureter. The ureteroscopic removal of the stone procedure includes a cystoscope to look inside the ureter and break the stone. The stone fragments of which are later removed. The patients are kept under the influence of anesthesia to conduct this surgery.
Vasectomy is a surgical process used as a permanent birth control method in case of males. In this procedure, the vas deferens (the tube that transfers sperms to the semen) is cut and clamped or sealed. This stops sperms to pass on to and hence, acting as a birth control method.
In some cases, the individuals need to stop birth control earlier done with the Vasectomy. In this case, Vasectomy reversal is used to make way for the passage of sperms. The success of this procedure depends on the individuals and it takes weeks to get recovered after the vasectomy reversal procedure.