Urology Treatments
Urology
Urology is a medical field that focuses on the diagnosis and treatment of diseases affecting male reproductive organs and the urinary tract in both men and women. This specialty addresses conditions involving organs such as the kidneys, bladder, urethra, ureters, scrotum, and prostate gland. Urology offers a broad spectrum of medical care, ranging from the treatment of urinary tract infections to surgical interventions.
Main Areas of Urology
- Kidneys: Treatment of kidney stones, infections, and tumors.
- Bladder: Management of bladder infections, bladder cancer, and incontinence issues.
- Urethra: Addressing urethral strictures and infections.
- Ureters: Treatments for blockages and stones in the ureters.
- Scrotum: Treatment of testicular cancer and varicocele.
- Prostate: Management of benign prostatic hyperplasia (BPH) and prostate cancer.
Urological Procedures
Urology encompasses various treatments and procedures, including:
- Medical Therapy: Medications for infections, chronic conditions, or hormonal imbalances.
- Surgical Interventions: Procedures such as cystoscopy, nephrectomy, prostatectomy, and lithotripsy.
- Minimally Invasive Techniques: Techniques like laparoscopic surgery and robotic-assisted surgery for conditions affecting the urinary and reproductive systems.
- Diagnostic Tests: Imaging studies, urine analyses, and biopsies for accurate diagnosis of urological conditions.
This field provides essential healthcare services for a wide range of conditions, significantly improving the quality of life for both men and women.
Kidney Cancer
Kidney Cancer
Kidneys are bean-shaped, fist-sized organs located on either side of the spine. Their primary function is to filter waste from the blood and produce urine. Kidney cancer is a disease caused by the formation of cancerous cells in the kidneys. Renal cell carcinoma is the most common type of kidney cancer in adults.
Causes of Kidney Cancer
The exact causes of kidney cancer are not fully understood, but several risk factors can increase the likelihood of developing the disease. Smoking can double the risk of kidney cancer. Men are more likely than women to develop this cancer. Other risk factors include obesity, age, family history of kidney cancer, hypertension, and long-term use of certain medications.
Diagnostic Methods for Kidney Cancer
Kidney cancer is often diagnosed through imaging tests and other diagnostic tools:
- Ultrasound: To detect masses or abnormalities in the kidneys.
- CT and MRI scans: Provide detailed images of the kidneys to identify tumors.
- Biopsy: A sample of kidney tissue may be taken to confirm the presence of cancer cells.
Stages of Kidney Cancer
Staging is determined through imaging tests to understand the extent of cancer's spread:
- Stage I: The tumor is smaller than 7 cm and confined to the kidney.
- Stage II: The tumor is larger than 7 cm but still confined to the kidney.
- Stage III: The tumor may have spread to nearby tissues and lymph nodes.
- Stage IV: The tumor has spread to nearby lymph nodes and organs.
Treatment of Kidney Cancer
Radiotherapy and chemotherapy are generally not effective in treating kidney cancer. Surgery to remove the cancerous area is the primary treatment method, which can involve removing the entire kidney or just the tumor-affected area.
- Radical Nephrectomy: The entire kidney, surrounding cancerous tissues, lymph nodes, and adrenal glands are removed.
- Partial Nephrectomy: Only the tumor is removed, preserving the rest of the kidney. This method is preferred for tumors smaller than 7 cm and is advantageous in maintaining the patient’s quality of life.
Surgical Techniques
- Robotic Surgery: The Da Vinci Robotic Surgical System provides 3D HD imaging and precision, allowing surgeons to access areas unreachable by the human hand. Radical and partial nephrectomy procedures are performed more safely and effectively using this method. Robotic surgery involves smaller incisions, speeding up recovery time and enabling patients to return to daily life more quickly.
Kidney Transplant
Kidney Transplant
Kidney transplant is a life-saving treatment method for patients who have lost kidney function. This procedure involves transplanting a healthy kidney from a living or deceased donor to a patient whose kidneys are no longer functioning. Candidates for kidney transplant include patients with end-stage renal failure caused by conditions such as diabetes, hypertension, and chronic kidney diseases.
Types of Kidney Transplants
Deceased Donor Kidney Transplant:
This involves transplanting a kidney from a deceased donor to the recipient. Maintaining the kidney's viability requires a very short transfer time between the donor and recipient. Typically, the process is facilitated when the donor and recipient are in the same region. Deceased donor transplants are an important alternative for patients reliant on dialysis.Living Donor Kidney Transplant:
This method uses a kidney donated by a close relative or a voluntary donor. Living donor transplants generally yield better outcomes than deceased donor transplants. The process involves two stages: removing the kidney from the donor and transplanting it into the recipient.
Surgical Techniques
- Robotic Surgery (Robot-Assisted Minimally Invasive Surgery):
Advanced technology is used in kidney transplant surgeries with robotic assistance. Robotic surgery allows access through small incisions and provides surgeons with 3D HD imaging, enabling precision in delicate areas. Surgeries performed using this technique offer faster recovery, reduced pain, and lower infection risks.
Post-Transplant Care
Following the transplant, immunosuppressive drugs are administered to help the body accept the new kidney. These medications reduce the risk of organ rejection and help prevent complications such as infections. Kidney transplantation improves the patient's quality of life and significantly extends life expectancy.
Da Vinci Robotic Prostatectomy
Da Vinci Robotic Prostatectomy
Radical prostatectomy performed with the Da Vinci robotic technique is a minimally invasive surgical method aimed at completely removing the cancerous portions of the prostate gland and surrounding tissues. Robotic technology provides surgeons with enhanced precision, a wider range of motion, and three-dimensional visualization, improving the accuracy of the procedure and speeding up recovery. This method also offers numerous benefits, including less post-operative pain, smaller scars, lower infection risks, shorter hospital stays, and quicker recovery.
Advantages
- High Precision: Enhanced accuracy and a wider range of motion during surgery.
- Elimination of Tremors: Robotic arms eliminate natural hand tremors.
- 3D Visualization: Realistic three-dimensional imaging for better surgical outcomes.
- Improved Access: Greater accessibility to deep anatomical areas.
- High Success Rate: Effective tumor removal with superior results.
- Reduced Error Risk: Minimized likelihood of surgical errors.
- Less Pain: Reduced post-operative discomfort.
- Lower Complication Risks: Minimal risk of infections and complications.
- Aesthetic Benefits: Smaller, less visible scars.
- Fewer Side Effects: Lower rates of urinary incontinence and impotence.
- Shorter Hospital Stay: Reduced need for extended hospitalization.
- Quick Recovery: Faster return to daily activities.
- Reduced Bleeding: Lower risk of blood loss and decreased need for transfusions.
Functionality of the Da Vinci Robot
The Da Vinci Robot is one of the most advanced surgical platforms available today. It allows surgeons to perform complex surgical procedures minimally invasively, enhancing precision and maximizing the success of the operation. The robotic system's capabilities contribute significantly to improved outcomes and patient satisfaction.
HIFU Prostate Treatment
HIFU Prostate Treatment
In recent years, the increasing number of prostate cancer diagnoses is linked to advancements in diagnostic tests, implementation of screening programs, and increased participation in health check-ups.
HIFU Prostate Treatment
In addition to advancements in diagnosis, new treatment approaches have improved patients' hopes and quality of life. Among recent developments in treating this type of prostate tumor, focal therapy using high-intensity focused ultrasound, better known as HIFU, has come to the forefront.
What is HIFU Focal Therapy?
With this technique, prostate cancer can be treated less invasively by focusing heat to eliminate the tumor's focus while preserving the prostate. The procedure is performed transrectally until it reaches very small therapeutic targets (up to 3 mm in diameter).
The distinguishing feature of the HIFU technique is its ability to go a step further, selectively destroying cancer within the prostate while preserving healthy tissue. Protecting the prostate significantly improves patients' quality of life. It allows men to maintain their functions and, in many cases, avoid issues such as urinary incontinence or erectile dysfunction associated with traditional prostate cancer treatments. Erectile function is preserved in patients treated with HIFU.
Additionally, this intervention is minimally invasive. Patients undergoing focal therapy with high-intensity ultrasound spend only two hours in the operating room and can return home 24 hours later. Recovery is also associated with these factors. Postoperative recovery is typically less severe, and patients can quickly return to their normal routines.
Who Can Opt for HIFU Treatment?
Not all patients are suitable for focused HIFU treatment. To identify ideal candidates, professionals must first clearly determine the tumor's location.
To achieve this, doctors may request additional tests such as MRI. Once the specialist confirms the tumor's location, a targeted biopsy will be conducted to verify that the suspected cancerous cells are indeed a tumor. Additionally, the biopsy will confirm that the rest of the prostate consists of healthy, cancer-free tissue.
Regarding who can benefit from this safe technique, experts note that it is suitable for several male profiles, including the following:
- Individuals at risk during surgery.
- Low-stage prostate cancer patients who want to maintain continence.
- Patients who wish to preserve sexual function.
- Older men.
- Patients with other associated diseases where more aggressive treatments are not indicated.
Bladder Cancer
Bladder Cancer
Bladder cancer occurs when cells in the muscular hollow structure of the bladder grow abnormally and form tumors. It is commonly seen in older adults and is one of the most prevalent types of cancer.
What Are the Symptoms?
Bladder cancer symptoms include blood in the urine, painful urination, pelvic pain, frequent urination, and back pain. These symptoms may also arise due to other causes.
What Are the Causes?
Factors that increase the risk of developing bladder cancer include:
- Advanced age
- Being male
- Previous cancer treatments
- Smoking and tobacco use
- Exposure to chemicals
- Past radiation exposure
- Bladder irritation and chronic infections
Diagnostic Methods for Bladder Cancer
Bladder cancer is diagnosed through urine tests, imaging studies, cystoscopy, and biopsy.
- Urine test: Examines a urine sample to detect cancer cells.
- Imaging studies: Methods like computed tomography urography (CTU) or retrograde pyelogram.
- Cystoscopy: Uses a narrow tube with a lens (cystoscope) to examine the urethra and bladder.
- Biopsy: Examines tissue samples taken during a cystoscopy.
Determining the Stages of Bladder Cancer
Once cancer cells are confirmed, additional tests are conducted to determine the cancer stage:
- Stage 1: Cancer cells are confined to the inner wall of the bladder.
- Stage 2: Cancer cells have spread into the bladder's muscular wall.
- Stage 3: Cancer has spread to tissues surrounding the bladder.
- Stage 4: Cancer has spread to lymph nodes and other organs.
Grading Bladder Cancer Cells
Bladder cancer cells are categorized under a microscope into two groups:
- Low grade: Resemble normal cells, grow slowly.
- High grade: Appear abnormal, grow rapidly, and tend to spread.
Treatment Options for Bladder Cancer
Bladder cancer treatment is determined based on the patient’s health, type of cancer, cell grade, and stage. Treatment methods include surgery, chemotherapy, radiation therapy, and immunotherapy.
- Surgical methods: Used for removing early-stage tumors.
- Intravesical Chemotherapy: Chemotherapy drugs are injected directly into the bladder.
- Systemic Chemotherapy: Administered throughout the body when surgery is not an option.
- Radiation Therapy: Used when surgery is not possible or not desired.
- Immunotherapy: Helps the immune system destroy cancer cells.
Surgical Methods Used in Bladder Cancer Surgeries
- TURBT (Transurethral Resection): Removes or lasers cancer cells that have not reached the bladder's muscle layer.
- Cystectomy: The surgical removal of the bladder.
- Bladder Reconstruction: Creating new pathways for urine to exit the body.
Robotic Surgery (Robot-Assisted Minimally Invasive Surgery)
- Procedure: Small incisions are made, and the surgeon operates robotic instruments from a console. The bladder and necessary tissues are removed, followed by the creation of a new urinary pathway.
- Advantages: Allows precise surgical intervention in narrow areas without damaging surrounding tissues, preserving sexual functions, particularly in men. Additionally, small incisions lead to faster recovery and a quicker return to daily life.
Nephrectomy
Nephrectomy
Nephrectomy is a surgical procedure involving the removal of all or part of a kidney. This operation is performed in cases where the kidney is damaged due to various diseases or injuries. Typically carried out under general anesthesia, nephrectomy can be classified into three main types:
- Partial Nephrectomy: Removal of only a portion of the kidney.
- Simple Nephrectomy: Removal of the entire kidney.
- Radical Nephrectomy: Removal of the entire kidney along with surrounding fatty tissue, the adrenal gland, and lymph nodes.
The procedure can be performed using laparoscopic or open surgery techniques. Open surgery involves larger incisions, while laparoscopic surgery requires smaller cuts and generally offers a faster recovery.
Why Is Nephrectomy Performed?
Nephrectomy is necessary in several situations, such as:
- Kidney Tumors: Especially in cases of cancerous tumors.
- Kidney Damage: Due to infections, stones, or severe trauma.
- Organ Donation: For the removal of a kidney from donors.
- Congenital Defects: When the kidney is nonfunctional from birth.
How Is Nephrectomy Performed?
Simple Nephrectomy:
The patient is positioned on their side, and the surgeon makes a 30 cm incision above the ribs to remove the kidney.
Radical Nephrectomy:
The surgeon makes a 20–30 cm incision in the front of the abdomen to remove the kidney along with surrounding fatty tissue. If necessary, the adrenal gland and lymph nodes are also removed.
Laparoscopic Nephrectomy:
This minimally invasive method involves smaller incisions to remove the kidney. Using a camera and surgical instruments, this approach results in less pain and faster recovery compared to open surgery.
Conclusion
Nephrectomy is performed based on the condition of the kidney and the patient’s overall health. The choice of surgical method—partial, simple, or radical nephrectomy—depends on the underlying medical needs and desired outcomes.
Urological Check-Up
Urological Check-Up
A urological check-up is a comprehensive screening designed to evaluate men’s overall urological health. It is especially recommended for men over 50 years of age to facilitate the early detection of serious conditions such as prostate cancer. This examination aims to identify potential issues in the male reproductive organs and urinary tract at an early stage.
Tests Conducted During a Urological Check-Up
Physical Examination:
- The urologist examines the abdomen, kidneys, bladder, penis, scrotum, and testes.
- A digital rectal examination (DRE) is performed to assess the prostate. This step is crucial for the early detection of prostate enlargement or prostate cancer.
Urological Ultrasound:
- For patients with symptoms such as difficulty urinating, an ultrasound is used to investigate the prostate.
- Transrectal prostate ultrasound provides a clearer view of potential signs of prostate cancer.
- Testicular ultrasound evaluates masses or tumors in the testes.
Urine Flow Measurement (Uroflowmetry):
- This test measures the volume, duration, and flow rate of urine during urination.
- It helps detect blockages in the urinary tract or weakness in bladder muscles.
Laboratory Analyses:
- Urine analysis checks for urinary tract infections, blood presence, or conditions like kidney and bladder tumors.
- A PSA (Prostate-Specific Antigen) blood test measures PSA levels, assessing the risk of prostate cancer.
How Often Should a Urological Check-Up Be Done?
Men over the age of 50 should undergo an annual urological check-up. For individuals with a family history of prostate cancer or symptoms of urinary difficulties, these screenings are particularly crucial. Regular check-ups enable the early detection and treatment of many urological diseases and cancers.
Importance of Regular Check-Ups
This comprehensive examination provides urologists with valuable insights into the patient’s general urological health, allowing for timely preventive measures. Early detection of serious health issues like prostate cancer significantly improves treatment outcomes and helps maintain patients' quality of life.
