Urology

 

Urology is the Surgical speciality of disorders of the urogenital tract. Consultant Urologists see patients with conditions affecting the kidneys and bladder in both sexes, and the prostate and genitalia in men. (Female genital tract problems are usually seen by Gynaecologists). Urologists are surgeons, and while there is some overlap, they do not usually see sexually transmitted infections, or uncomplicated cystitis (‘bladder infection’) in women.

Modern Urology is a large speciality, within which most Consultants sub specialise. The principle areas of subspecialisation are;

  • Oncology; the surgery of Urological cancer. These patients are assessed and treated for cancer of the urinary tract. The common tumours seen are those of the prostate (in men), bladder, kidney and testis. Consultant Urologists with an interest in Oncology will usually work closely with an Oncologist who specialises in radiotherapy and chemotherapy for these tumours.

  • Male Urinary Outflow Disease. Non-cancerous enlargement of the prostate gland happens in all man over 35. A large number of man have significant symptoms as they get older; typically after 60, although younger men may also be affected. Consultant Urologists will investigate these symptoms and advise on treatment. Other common causes of outflow symptoms include strictures, where scarring of the urethra (tube out of the bladder) causes narrowing.

  • Andrology; the study of male sexual function. Urologists with an interest in Andrology will investigate and treat Erectile Dysfunction (Impotence) and also male factor infertility. Male infertility treatment is usually undertaken in conjunction with specialists in assisted fertility techniques, such as IVF.

  • Female Incontinence. Although there is common ground with Gynaecology, at least half of female incontinence results from disorders of the bladder. Urologists will investigate the specific causes in an individual patient, and will offer appropriate treatment.  At Bupa Cromwell Hospital we offer patients a Urodynamic Study which is a test that assesses the function of the bladder and the bladder outflow tract (urethra). This test aims to replicate bladder symptoms, which allows them to be studied to determine their cause.  For further information on Urodynamic Study please download the Urodynamic Test Information Leaflet provided by Consultant Urologist Mr Mohamed Hammadeh.

  • Endourology / Stone Disease. This urological subspecialty deals with the treatment of kidney / ureteric obstruction secondary to benign or malignant causes. Benign causes such as stones or strictures (narrowing) can cause pelviureteric obstruction (PUJO) or ureteric obstruction. This can be treated conservatively or with surgery which may involve endoscopic, keyhole (laparoscopic) or open stone surgery.

    The treatment of malignant causes will depend on the site, the type of malignancy and the extent of the disease. Kidney stones usually cause pain if they move out of the kidney and into the ureter (tube running between the kidney and the bladder. The treatment of a kidney stone will depend on its size, its position, the anatomy of the kidney, whether there are symptoms and also on whether the patient is fit for a certain procedure or not.

    The same applies for stones in the ureter and bladder. Some patients may require no treatment. Treatment modalities include medical treatment, shock wave treatment (ESWL), endoscopic laser stone surgery, percutaneous nephrolithotomy (PCNL), keyhole or open stone surgery. For further information please download the Kidney Stones Information provided by Consultant Urological Surgeon Mr Asif Raza.