UROLOGY

TURP / TUEVP

TURP or TUEVP is known as transurethral resection of the prostate is a urological operation for the treatment of benign prostatic hyperplasia (BPH). It is performed by visualising the prostate through the urethra and removal of tissue by electrocautery or sharp dissection.

Benign prostatic hyperplasia (BPH), also called benign enlargement of the prostate (BEP), adenofibromyomatous hyperplasia, is an increase in size of the prostate.

BPH involves hyperplasia of prostatic stromal and epithelial cells, resulting in the formation of large, fairly discrete nodules in the periurethral region of the prostate. When sufficiently large, the nodules compress the urethral canal to cause partial, or sometimes virtually complete, obstruction of the urethra, which interferes with the normal flow of urine. It leads to symptoms of urinary hesitancy, frequent urination, dysuria (painful urination), increased risk of urinary tract infections, and urinary retention.

Trans Urethral Electric Vaporization of Prostrate (TUEVP) is a better method in terms of surgery than Trans Urethral Resection of Prostrate (TURP). Enlargement of the prostrate gland among males over 50 years is a common occurrence.

One of the methods used is Laser ablation. It is a simple process and the blood loss is relatively less. After the surgery, the patient is discharged from the hospital within a few days.

OIU (Optical Internal Urethrotomy)

BNI (Bladder Neck Incision)

Bladder Neck Incision is commonly known as BNI. This medical procedure is for men who have a decreased urinary stream and problems passing urine because of a bladder neck stenosis or a urethral stricture.

Scarring that occurs at the neck of the bladder where it joins the prostate is known as a ‘bladder neck stenosis’ and scarring within the urethra itself is called a ‘urethral stricture. Both of these forms of scarring cause a narrowing of the urethra. The aim of BNI is to resolve the narrowing and allow for an improved urinary stream.

The operation of BNI involves incision in the neck of the bladder. In the bladder neck, a telescope is inserted through the urethra. This way the obstruction is checked and then removed.

Bladder Neck Incision is done for free flow of urine, to remove stones from kidney and to cure serious urine infection.

Endopyelotomy

Endopyelotomy is done to treat the obstruction at Ureteropelvic Junction (UPJ). Ureteropelvic Junction (UPJ) obstruction is a blockage in the area that connects the renal pelvis (part of the kidney) to one of the tubes (ureters) that move urine to the bladder.

Obstruction of the ureteropelvic junction (UPJ) can be caused by congenital abnormalities, fibrous scarring, kidney stone, infection or surgical procedure etc. This damages the tissues of the kidney. Endopyelotomy is a medical procedure used to treat the ureteropelvic junction through either of the following approaches:

  • Antegrade Endopyelotomy
  • Retrograde Endopyelotomy

Radical Nephrectomy

Nephrectomy is the surgical removal of a kidney. Renal cell carcinoma (RCC), damaged or non- functioning kidney, congenitally small kidney etc can be a few indications to go for nephrectomy.

Nephrectomy can be complete (radical) or partial. Partial Nephrectomy is done to repair the injured or partially ruptured kidney. In simple Nephrectomy, the entire of one non-functioning kidney is replaced.

Radical Nephrectomy applies to patients diagnosed with RCC in stage I, II and III (completely damaged kidney tissue). There is both Laparoscopic and open abdominal approach to radical Nephrectomy.

In a donor nephrectomy, the surgeon removes a healthy kidney for transplant into a person who needs a functioning kidney.

Radical Prostatectomy

A prostatectomy is the surgical removal of all or part of the prostate gland due to abnormalities such as formation of tumor and enlargement mainly in the urethra. Radical Prostatectomy is surgery to remove all of the prostate gland and some of the tissue around it to treat.

There are four main types of radical prostatectomy surgery.

Radical Retropubic Prostatectomy

  • Laparoscopic Radical Prostatectomy
  • Robotic-Assisted Laparoscopic Prostatectomy
  • Radical Perineal Prostatectomy

Radical Prostatectomy is most often done when the cancer has not spread beyond the prostate gland. This is called localized prostate cancer. Other treatment options for prostate cancer are:

  • External beam radiation therapy
  • Implant radiation therapy (brachytherapy)
  • Hormone therapy (androgen deprivation therapy)
  • Cryotherapy of the prostate
  • Visits with your doctor and tests to check for changes in your prostate cancer (called active surveillance)

Penectomy

Penectomy is a medical procedure of removal of penis through surgery for medical purpose. The major reason for partial or total removal of the penis is penile cancer.

There are two types of Penectomy:

  • Partial Penectomy
  • Total (Radical) Penectomy

Prostrate Biopsy

The prostate gland is found only in males. It sits below the bladder and wraps around the urethra (the tube that carries urine out of the body). The prostate helps make semen.

A biopsy is a procedure used to remove a small piece of tissue or cells from the body so it can be examined under a microscope.

In a prostate biopsy, prostate gland tissue is taken out with a biopsy needle or during surgery. The tissue is checked to see if there are cancer or other abnormal cells in the prostate gland.

A prostate biopsy may be done in several different ways:

  • Transrectal method. This is done through the rectum and is the most common.
  • Perineal method. This is done through the skin between the scrotum and the rectum.
  • Transurethral method. This is done through the urethra using a cystoscope (a flexible tube and viewing device).
  • Ultrasound is usually used to look at the prostate gland and guide the biopsy needle.

A prostate biopsy is done after other tests show that there may be a problem with the prostate gland. It is the best method to diagnose prostate cancer.

There may be other reasons for your healthcare provider to recommend a prostate biopsy.

Bladder Biopsy

A bladder biopsy is a diagnostic surgical procedure in which a doctor removes cells or tissue from your bladder to be tested in a laboratory

A Bladder biopsy is done after other tests show that there may be a problem with the prostate gland. It is the best method to diagnose Bladder cancer.

Vasectomy

Vasectomy is a surgical procedure for male sterilization. The process involves prevention of sperm entering the seminal stream. This is a permanent solution to birth control. Vasectomy is executed in a medical clinic and it takes 30 minutes for the procedure to be completed. Within one hour of Vasectomy, the patient is sent back home.

Types of Vasectomy

  • No-Scalpel Vasectomy
  • Open-Ended Vasectomy
  • No-Needle
  • Fascial Interposition
  • Vas Irrigation

Cystoscopy

Cystoscopy, also called a cystourethroscopy or, more simply, a bladder scope, is a test to measure the health of the urethra and bladder. The procedure involves inserting a tube into the urethra through the opening at the end of the penis

Cystoscopy may be done to: Find the cause of many urinary system problems. Examples include blood in the urine, pain when you urinate, incontinence, frequent urinary tract infections, and blockages in the urinary tract. Remove tissue samples for testing (biopsy).

Nephrotic Syndrome

Nephrotic-range proteinuria is the loss of 3 grams or more per day of protein into the urine or on a single spot urine collection, the presence of 2 g of protein per gram of urine creatinine. Nephrotic syndrome is the combination of nephrotic-range proteinuria with a low serum albumin level and edema.

Nephrotic syndrome has many causes, including primary kidney diseases such as minimal-­change nephropathy, focal glomerulosclerosis, and membranous nephropathy. Nephrotic syndrome can also result from systemic diseases that affect other organs in addition to the kidneys, such as diabetes, amyloidosis, and lupus erythematosus.

Nephrotic syndrome may affect adults and children of both sexes and of any race. It may occur in typical form, or in association with nephritic syndrome. The latter connotes glomerular inflammation, with hematuria and impaired kidney function.

Amyloidosis

Amyloidosis is a rare disease that occurs when amyloid proteins are deposited in tissues and organs. Primary amyloidosis and dialysis-related amyloidosis are the types of amyloidosis that can affect the kidneys. The most common sign of primary amyloidosis of the kidneys is nephrotic syndrome.

Primary amyloidosis can occur with a bone marrow cancer of plasma cells called multiple myeloma (fewer than 20% of AL patients). Primary amyloid, including multiple myeloma cancer, is not associated with any other diseases but is a disease entity of its own, conventionally requiring chemotherapy treatment

Primary amyloid is now a treatable disease. The mainstays of therapy are the same agents used to treat a related bone marrow cancer, called multiple myeloma. Treatment options include chemotherapy, corticosteroid medicines, biologic agents, and in some instances, autologous stem cell transplantation.

In AL amyloidosis , treatment is directed towards the abnormal plasma cells (usually in the bone marrow ), which produce the abnormal light chains that form amyloid deposits. Treatment regimes are referred to as “chemotherapy”. The drugs used are similar to those used in the related condition of multiple myeloma.