Urology focuses on diagnosing and treating disorders of the urinary tracts of males and females, and on the reproductive system of males. The branch of medicine encompasses management of non-surgical problems such as urinary tract infections and benign prostatic hyperplasia, as well as surgical problems such as the surgical management of cancers, the correction of congenital abnormalities, and correcting stress incontinence.
Vasectomy is a surgical procedure for male sterilization. It is the procedure for permanent birth control. During the procedure, the vasa deferentia (ducts responsible for carrying sperm) are severed, and sealed such as to prevent sperm from entering into the seminal stream (ejaculate). Vasectomies are usually performed in a physician's office or medical clinic.
Due to the simplicity of the surgery, a vasectomy usually takes less than 30 minutes to complete. After a short recovery period, the patient can be sent home to rest. Because the procedure is minimally invasive, many vasectomy patients find that they can resume their typical sexual behavior within a week, and do so with minimal discomfort.
There are several methods by which a surgeon might complete a vasectomy procedure, all of which occlude (seal) at least one side of each vas deferens. To help reduce anxiety and increase patient comfort, men who have an aversion to needles might opt for the "no-needle" application of anesthesia while the "no-scalpel" or "open-ended" techniques help to speed-up recovery times and increase the chance of healthy recovery.
Because the procedure is considered a permanent method of birth control (not easily reversed), men are advised to consider how the long-term outcome of a vasectomy might affect them both emotionally and physically.Vasectomy should not be confused with castration, which is the surgical removal of the testicles.
Ureteroscopy is a procedure used to remove stones that are stuck in the ureter and are closer to the bladder than the kidney (in the lower third of the ureter). But newer technology is allowing ureteroscopy to be used even for small stones in or near the kidney. Ureteroscopy is successful in more than 95 out of 100 people.
The procedure involves a small scope which is inserted into the bladder and ureter and it is used to diagnose and treat a variety of problems in the urinary tract. For ureteral stones, it allows the urologist to actually look into the ureter, find the stone and remove it. The tiny wire basket is passed into the lower ureter via the bladder, which grabs the stone and pulls the stone free. The procedure can be used for virtually any stone of a size appropriate for it. Fragmentation of stones using helium laser device ureteroscopy is more assured than with shock wave lithotripsy (SWL), which cannot be used in everyone. Most often ureteroscopy is used for stones in the ureter, especially for stones closest to the bladder, in the lower half of the ureter. It is the most common treatment of lower ureteral stones. For patients who are pregnant, morbidly obese, or have a blood clotting disorder, ureteroscopy is a good choice. For very large or oddly shaped stones, or stones that are very hard, other treatments such as percutaneous nephrolithotomy or, rarely, open surgery may be needed.
It is used to treat Invasive bladder carcinoma, ongoing incontinence due to paraplegia, where catheterisation results in infection and ongoing leakage. The procedure also treats refractory complications in a defunctionalized bladder, where urinary diversion is already established.
Laparoscopic cystectomy involves removing the bladder using small cuts (also known as 'keyhole surgery'). In women, the bladder is removed through the wall of the vagina. In men, the bladder is removed with the prostate gland, through a small cut in the wall of the abdomen. The tubes that carry urine from the kidneys to the bladder (the ureters) may then be connected to a bag worn outside the body, or parts of the bowel can be used to make an artificial bladder which is drained by a connection to the abdomen wall or to the tube that carries urine out of the body (the urethra).
Surgery for Benign Prostatic Hyperplasia (BPH)
Transurethral Resection of the Prostate (TURP) is the procedure to treat patients who are having difficulty urinating because of benign prostatic hyperplasia. The surgery may not be required unless the patient has the following issues-
- Unable to urinate. If the patient cannot urinate, then catheterization will be needed. In catheterization, a tube is passed up the penis into the bladder and urine is drained. Half of these men will be able to urinate again after catheterization. Those who do not improve may need surgery.
- Have a partial blockage in the urethra that is causing repeated urinary tract infections, bladder stones, or bladder damage.
- Have blood in the urine that is not getting better and is causing other problems such as clots that make it hard to urinate.
- Have kidney damage.
During transurethral resection of the prostate (TURP), an instrument is inserted up the urethra to remove the section of the prostate that is blocking urine flow. For men who have moderate to severe symptoms of prostate enlargement, TURP is more effective than watchful waiting in relieving urinary symptoms. Studies have found that:
- Men who had TURP had a lower symptom score compared with those who used watchful waiting.1
- Symptoms get better for 7 to 10 out of 10 men who have the surgery.
Surgery usually is not required to treat BPH, although some men may choose it because their symptoms bother them so much. Choosing surgery depends largely on the patient's preferences and comfort with the idea of having surgery. Things to consider include your expectation of the results of the surgery and the severity of the symptoms.