Urology Treatments

Urology Treatments

Cystoscopy

A cystoscopy is used to look inside and treat problems of your bladder and urinary system. It uses a thin tube with a light and camera at one end, called a cystoscope, which is inserted into your urethra and then into your bladder.

A flexible cystoscope is most commonly used and examines your bladder. A rigid cystoscope is used to pass small surgical instruments into your bladder if a sample tissue is required or to perform treatment.

A cystoscopy can investigate urinary symptoms such as: urinary incontinence, urinating often, intermittent urination, inability to urinate, feeling that your bladder isn't fully empty after going to the toilet, pain when you pass urine, blood in your urine and pelvic pain.

This procedure can detect and treat: bladder stones, polyps, urinary tract infections, narrowed or blocked urethra, ureter problems, urinary tract cancers and an enlarged prostate gland.

TURBT

Transurethral resection of a bladder tumour (TURBT) investigates and treats bladder tumours. A TURBT is normally recommended if you’ve had a cystoscopy that’s indicated a tumour in your bladder. Bladder tumours can be benign (non-cancerous) or malignant (cancerous).

In this procedure your urologist will remove the tumour or tumours from your bladder and send them away for further investigation. The results will show if the tumour is cancerous and it’s stage of the cancer. They’ll then offer advice on the best treatment.

Malignant tumours will continue to grow and may attack surrounding tissue and spread further into the body unless they’re removed. Benign bladder tumours also need removing as otherwise they’ll continue to grow and become very large, causing them to press on other organs.

Adult circumcision

Adult circumcision is the surgical removal of the foreskin from the penis under general anaesthetic.

It may be done for medical reasons such as: a tight foreskin called phimosis, if the foreskin and penis head are repeatedly inflamed or infected known as balanitis, the foreskin won’t go back to its original position after being pulled back resulting in the head of the penis becoming swollen and painful called paraphimosis, a dermatological skin condition that affects the male genitalia known as balanitis xerotica obliterans and, penile cancer.

Adult circumcision is also carried out for religious and cultural reasons.

Circumcisions are available on the NHS but with restrictions and waiting lists. Mount Stuart Hospital performs adult circumcision surgery with no restrictions or waiting.

Penile straightening

If a penis is too bent when erect to allow penetration during sexual intercourse, then penile straightening will be recommended.

Penile straightening corrects the curvature of a penis so that the penis is straightened. This is done under general or spinal anaesthetic using a plication procedure that shortens the longer side of the penis.

Prostate biopsies

A man’s prostate makes semen. It’s a small gland found under the bladder. A prostate biopsy is recommended if a man has signs of prostate cancer such as a lump in the prostate gland or high levels of prostate-specific antigen (PSA) in the blood. It involves removing a sample of prostate tissue so that it can be further examined.

A prostate biopsy is most commonly carried out by trans-rectal prostate biopsy (through the rectum). It can also be performed transurethral (through the urethra) or perineal (through the skin between the anus and the scrotum called the perineum).

Treatment of bladder cancers

Bladder cancer is diagnosed if malignant (cancerous) cells have been detected in your bladder.

The treatment will be dependent upon the cancer stage as well as other factors. Options at Mount Stuart Hospital include:

- Surgical removal of the cancer cells is part of the treatment for most bladder cancers. It can take away early-stage bladder tumours or the whole bladder, known as radical cystectomy. (Private pateints only)

- Intravesical therapy places a liquid drug directly into the bladder using a catheter or injecting it into a vein.

Often more than one treatment is advised to combat the cancer cells. You will also have follow-ups to check for new cancers in the bladder.

Treatment for stress incontinence

If you find your bladder leaks urine when you take part in physical exercise, sneeze or cough then you may find you’ve a common condition called stress urinary incontinence (SUI). This unintentional leakage of urine happens due to increased pressure on your bladder. It’s often because the muscles in your pelvic floor or urethral sphincter are weakened or damaged.

Initially lifestyle changes, pelvic floor muscle exercises and bladder training are suggested.

Your urologist may advise surgery if these don’t work. SUI surgical options include: tape procedures (plastic tape used to hold the urethra up in the correct position), colposuspension (lift and stitch the neck of the bladder), sling procedures (support of a sling around the bladder neck), bulking injections (thickening of the area around the urethra) and artificial urinary sphincter (replacement sphincter to stop urine leaking).

TURP

A transurethral resection of the prostate (TURP) involves cutting away a section of the prostate under general or spinal anaesthetic. A thin metal tube with a light, camera and loop of wire, called a resectoscope, is passed along your urethra to the prostate. The loop of wire is then heated so that it can cut a section of your prostate.

It’s performed if your prostate has become enlarged and it’s putting pressure on your bladder and urethra, affecting urination.

Vasectomy

A vasectomy is a method of male sterilisation or permanent contraception. It’s a simple minor procedure carried out under local anaesthetic. The vas deferens tubes are cut, blocked and sealed to stop sperm reaching a man’s semen.

Vasectomies are available on the NHS but there are often long waiting lists. Mount Stuart Hospital offers vasectomies without having to wait.

Vasectomy reversal

Vasectomy reversal as its name suggests aims to reverse a vasectomy and reconnect the vas deferens tubes that have been cut. It’s also known as vasovasostomy. The best chance of a successful reversal is if it’s carried out shortly after the vasectomy.

A vasectomy reversal is not available on the NHS as a vasectomy is seen as a permanent method of birth control. Here at Mount Stuart Hospital we understand some people may want to reverse this procedure and we perform vasectomy reversals if required.

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