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Urology

Urology addresses everything from reproductive problems in male patients to urinary issues in either sex; surgeons may operate on the bladder, kidneys, ureter, or genitals. At one extreme, full reconstruction of urinary or reproductive systems is an option. At the other, urology boasts a number of less invasive, technologically sophisticated methods to deal with delicate structures.

Some of the common Urology procedures performed at SSH are:
  • Circumcision
  • Cystoscopy 
  • Orchiectomy
  • TURBT (Transurethral Resection of Bladder Tumor)
  • Vasectomy
Circumcision
Circumcision is the surgical removal of the foreskin of the penis, or prepuce of the clitoris. This procedure is chosen for social, medical or cultural/religious reasons.

Some of the medical reasons for male circumcision are to protect against infections of the urinary tract and the foreskin, prevent cancer, lower the risk of getting sexually transmitted diseases, and prevent phimosis (a tightening of the foreskin that may close the opening of the penis).

After the procedure, the penis may be painful, but this will go away gradually. A topical anesthetic ointment or spray may be used to relieve this temporary discomfort. There may also be a bruise on the penis, which typically disappears with no particular attention. After a period of recovery, an adult male should be able to resume sexual intercourse normally.

Cystoscopy
Cystoscopy is a test that allows your doctor to look at the inside of the bladder and the urethra using a thin, lighted instrument called a cystoscope.

The cystoscope is inserted into your urethra and slowly advanced into the bladder. Cystoscopy allows your doctor to look at areas of your bladder and urethra that usually do not show up well on X-rays. Tiny surgical instruments can be inserted through the cystoscope that allows your doctor to remove samples of tissue (biopsy) or samples of urine. The results of a biopsy usually take several days to be available.

Small bladder stones and some small growths can be removed during cystoscopy. This may eliminate the need for more extensive surgery.

Cystoscopy may be performed due to:
  • blood in the urine (hematuria)
  • inability to control urination (incontinence)
  • urinary tract infections
  • signs of congenital abnormalities in the urinary tract
  • suspected tumors in the bladder
  • bladder or kidney stones
  • signs or symptoms of an enlarged prostate
  • pain or difficulty urinating (dysuria)
  • disorders of or injuries to the urinary tract
  • symptoms of interstitial cystitis
During the cystoscopy, a retrograde pyelogram may also be performed to examine the kidneys and ureters. A cystoscopy typically lasts from 1040 minutes. The urologist may also remove bladder stones or kidney stones, gather tissue samples, and perform x-ray studies. If necessary, the urologist may place a stent to help urine drain from the kidney to the bladder. The stent may remain in place on a short-term (days to weeks) or long-term (weeks to months) basis.
 
After the test, you may need to urinate frequently, with some burning during and after urination for a day or two. You should drink lots of fluids to help minimize the burning and to prevent a urinary tract infection.
 
 
 
Orchiectomy
Orchiectomy is the removal of the testicles. The penis and the scrotum, the pouch of skin that holds the testicles, are left intact. An orchiectomy is done to stop most of the body's production of testosterone, which prostate cancer usually needs in order to continue growing.

An orchiectomy is done to treat cancer or, for other reasons, to lower the level of testosterone, the primary male sex hormone, in the body. Orchiectomy may help relieve symptoms, prevent complications, and prolong survival for advanced prostate cancer. Radiation treatment is sometimes needed also.

Orchiectomy can be done as an outpatient procedure or with a short hospital stay. Regular activities are usually resumed within 1 to 2 weeks, and a full recovery can be expected within 2 to 4 weeks. Orchiectomy often causes the tumor to shrink and relieves bone pain.This surgery does not cure prostate cancer, although it may prolong survival.

Some men choose to have reconstructive surgery after an orchiectomy, in which the surgeon replaces the testicles with artificial testicles.
 
TURBT (Transurethral Resection of Bladder Tumor)
A bladder tumor is a growth that starts in the lining of your bladder. Bladder tumors can bleed, causing blood in your urine. Sometimes blood clots can form, which may stop your bladder from emptying. You may have a burning sensation when you pass urine or you may need to pass urine more frequently.
 
Bladder tumors are either:
  • Non-invasive tumors, which tend to stay in the lining of your bladder. This type of tumor isn't a cancer, but could change into a cancer
  • Invasive tumors, which are cancers that grow into and through the bladder wall. The cancer can spread to other parts of your body.

Your surgeon will remove tissues, and examine them under a microscope to find out the type of tumor you have. Your surgeon can also perform biopsies (removing small pieces of tissue) on areas of the bladder that appear normal, but are more likely to form tumors.

Resecting a bladder tumor is performed under a general or spinal anesthetic. Your anesthetist will discuss the options with you and will recommend the best form of anesthesia for you. The operation usually takes less than 30 minutes.

Vasectomy
A vasectomy is a surgical procedure performed on adult males in which the vas deferens (tubes that carry sperm from the testicles to the seminal vesicles) are cut, tied, cauterized (burned or seared), or otherwise interrupted. The semen no longer contains sperm after the tubes are cut, so conception cannot occur. The testicles continue to produce sperm, but they die and are absorbed by the body.

The purpose of the vasectomy is to provide reliable contraception. Research indicates that the level of effectiveness is 99.6%. Vasectomy is the most reliable method of contraception and has fewer complications and a faster recovery time than female sterilization methods.

Approximately 500,000 vasectomies are performed annually in the United States. About one out of every six men over the age of 35 has had a vasectomy.


 

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