Endourology
Endourology deals with the diagnosis and removal of urinary tract disorders using endoscopic equipment.
Benign Prostatic Hypertrophy (BPH)
The human male prostate is a small gland located in the scrotum. It is the only organ in men that is adapted to impregnate females. Enclosed in a dense lymphoid capsule, the prostate is organized in lobes. It is located behind the anus and below the testicles. The prostate (the chamber around the urethra through which urine is transported from the bladder and the penis) is also shown in the image.
The prostate contributes to the fluid carrying the sperm produced by the testes. The prostatic fluid is also believed to offer nourishment for sperm. Because the prostatic gland contributes to ejaculation throughout most of the male’s life, many men are able to father offspring well into their seventies and eighties.
BPH is non-cancerous enlargement of the prostate gland in males. Thereafter, the prostate begins to expand, expanding to near twice its size. Growth slows with age.
The simple act of after a while the aggravation resulting from the enlargement of this condition might emerge it can continuously restrict the opening through which urine flows (a comparable thing happens when a straw is pulled close; this can be uncomfortable). This can lead to problems with urination and sleep.
BPH is usually diagnosed in the following manner:
Your medical provider will serve as a database for your complete medical history, including recent and future health problems. The prostate gland is inanimately examined by a finger that is greased and gloved.
A Urine Flow Measurement: A good way to assess your urine flow is by using a urine flowmeter. A flowmeter detects the flow of your urine and the degree of blockage.To determine you’ll void urine, how much urine is in the bladder, the effect of the prostate gland on the kidneys, and to examine the prostate gland with an Ultrasound Scan.
If a Urodynamic Study is necessary, this prenup will be performed.
- Assessment of Post-Voiding Residual Urine: urine remaining in the bladder after urination or voiding) by ultrasound or catheterization.
- A sonography imaging of the urinary tract.
- Procedures for the Peñalureivu (Examination of Vulva) with a special viewing tube.
Treatment for Benign Prostatic Hypertrophy (BPH):
Your Urologist will examine the severity of your symptoms to help you determine which treatment option is most appropriate:
Medical treatment options for BPH are suitable only for mild symptoms and when the degree of obstruction is not severe. While drugs like 5 alpha-reductase are known to reduce the size of an enlarged prostate over time, they may not be appropriate for all prostate types. Alpha-blockers, on the other hand, offer only symptomatic relief by relaxing the smooth muscle component in the prostate region. However, these medications need to be taken regularly and may result in minor side effects. Their proven efficacy is only around 20-30%.
Learn more about different forms of remedy here. A therapy method called TURP is currently used:
This procedure is known as TURP, and it can treat BPH and also use an endoscope that is inserted through the penis and the urethra to access the adenoma in the basement of the prostate gland.
By removing this tissue, the urethra is widened, and pressure on it is relieved. TURP takes about half an hour to two hours to complete and does not require any incisions on the skin.
After undergoing TURP surgery, some patients may experience post-operative effects such as failure to ejaculate after intercourse (in about 50% of cases), urine leakage upon straining or continuously (rarely), and transcend or permanent impotence (in about 2% of cases). Tissue removed during surgery will be examined to confirm the gland’s benign nature, but a surprise report of malignancy may be obtained. Therefore, men who have undergone surgery for benign prostate enlargement should still receive an annual evaluation. It’s important to note that not all enlarged prostates require treatment, and mild symptoms may not require any therapy. However, if symptoms are severe or if test results show significant urinary tract obstruction, early therapy is necessary.
Percutaneous Nephrolithotomy (PCNL) :
PCNL is a surgical procedure that is commonly used to remove kidney or upper ureter stones. During this procedure, a small incision, usually less than 1cm, is made in the flank and a guide wire is passed through it into the kidney. A nephroscope is then passed through a passage that is created around the guide wire by dilatation to visualize and remove the stones. The procedure is performed under fluoroscopy or x-ray control and larger stones can be fragmented and removed.
Compared to traditional open surgery, PCNL has the advantage of only requiring a small incision and enables stones to be removed in the same sitting. If a patient has stones larger than two centimeters, upper ureteric stones larger than one centimeter, or stones in the lower pole of the kidney that pose a unique challenge, this approach is recommended to assist them.
After the procedure, patients are generally hospitalized for 2-3 days and may require additional x-rays or ultrasound studies to check for residual stone fragments. The procedure has a success rate of 90-95%, but sometimes a second procedure may be required for complete clearance of the stones.
Similar to any treatment, PCNL has many risks, including bleeding and infection. Patients may develop prolonged loss of urinary flow or require ureteric stent placement, and a fever could necessitate a new antibiotic prescription. However, PCNL is generally considered a safe and effective treatment option for kidney or upper ureter stones.