The subject of ‘Urology’ deals with the surgical diseases of urinary tract and kidneys which result in the obstruction, stasis or aberration in the flow of urine from kidneys to the urinary bladder and its final exit from the body. The following diseases are treated by a urologist:
Enlarged prostate gland
Prostate gland has been the focus of research for a long time. This gland is the internal sex organ in men and contributes to the volume of semen. As the age advances, degenerative changes take place in the human body affecting almost all organs. The Prostate gland is no exception to this. A complex and delicate balance of hormones that control this gland tends to trip with age and results in an in ordinate growth of Prostate gland.
Cancer of prostate gland and Robotic surgery
Cancer of prostate is the most common cancer in men. Almost 80%of men over 80 years of age may have cancerous tissue in their prostate glands. If the diagnosis is made early, when the disease is still confined to the prostate gland, then robotic surgery could be curative for a patient. However, due to lack of awareness, a large majority of men who are diagnosed as cancers of prostate are actually in late stages when the disease has already spread to other organs like bones, lymph nodes or other parts of the body. The prostate cancer can be picked up by getting a simple blood test “PSA or Prostate Specific Antigen”. This can be done in men above 50 years of age with.
Urinary (Kidney, Ureteric, Urinary bladder) Stone disease
In the era of advanced ultrasound scanning, most renal stones (kidney stones) are diagnosed without any symptoms. Renal stone disease is a significant health problem in men. It is mostly found in persons whose diet is low in vitamins. The pain typically starts in your side or back, just below your ribs, and radiates to your lower abdomen and groin (the area where the abdomen ends and the legs begin).
Cancers of the urinary tract
Cancers affecting the urinary organs are fairly common. Most of these cancers require a well planned and executed surgical extirpation as this forms the primary determinant of outcome for the patient.
Infections of the urinary tract including tuberculosis
Urinary tract infections can be very disabling entity, especially for women, who sometimes learn to live with this disorder as part of life. Detailed investigation and treatment of these patients can give them back the quality of life that they deserve.
Birth Defects (Congenital Malformations) of the organs of the urinary tract
Some unfortunate children are born with abnormalities of the structure and function of the urinary tract organs. These children need careful evaluation and planning of surgical correction of such abnormalities.
As per the prevalent myths, in case of an infertile couple the blame would be on the woman irrespective of the scientific cause. However, it is now well known that over all in about half the number of such couples, males are equally responsible for the failure to reproduce.
Male sexual dysfunction
Male sexual dysfunction can be devastating not only for the mental and physical health of any man, but also for the overall relationship with his spouse. Male sexual dysfunction could be of following types: Inability to achieve erections( Hardness of Penis), Erectile dysfunction ( ED), Rapid ejaculation (Premature Ejaculation), Inability to ejaculate ( Retarted or Anejaculation), Reduced desire to have sexual activity ( Loss of Libido)
Andropause is a condition similar in nature as Menopause in women, only difference being that it is gradual in nature and is difficult to pin poin at times. Blood levels of Testosterone, the male hormone gradually decline causing difficulty in handling stress, reduced muscle mass, weak bones, reduced mental abilities, irritability, central abdominal obesity, lethargy and sexual dysfunction.
Surgery for impotence (sexual dysfunction)
Sexual dysfunction can be devastating for any man and his partner. Not only does it impair the quality of life, but also exposes the individual to a horde of psycho social problems. Erectile dysfunction is typically treated with oral medication, Sildenafil (Viagra) being the first of such drugs approved by the FDA for such use. However, use of medical treatment of erectile dysfunction (or more commonly known as Impotence) has a certain failure rate which ranges from 30 – 45%.
Neurogenic bladder /Bladder dysfunction ( as in spinal cord injury)
Damage to the nerves carrying sensation from the urinary organs to the brain could result in difficulty in controlling the act of urination voluntarily. Such situations frequently occur in patients with spinal injuries.
Incontinence of urine
Incontinence of urine is defined as loss of urine without voluntary control. Incontinence may be
- Stress incontinence: Urine leaks urine due to sneezing ,coughing or any other stressful activity
- Urge incontinence: Urine leaks before the individual can respond to the urge to pass urine
- True incontinence :Weakness of the control mechanism, The urine may just leak continuously
- Mixed incontinence: A combination of any of the above
- Overflow incontinence: The bladder is always full and keeps leaking whenever there is stress or change of posture
Bladder pain syndrome( Interstitial cystitis)
Urinary symptoms in women could be confusing for any doctor. A range of urinary symptoms e.g. increased frequency of urination urgency of urination, incontinence, leakage of urine on coughing and straining, painful urination etc need to be evaluated in detail to arrive at a definitive diagnosis.
Laparoscopic techniques are often utilized for performing urological surgical procedures. As the technology has been evolving, so are the techniques. Therefore it is an important part of Armamentarium for any urologist.
The tube carrying Urine from the bladder to the exterior is called Urethra. Injury or infection in this tube can result in scarring of urethra called Stricture of Urethra. The scar tissue being tough, does not allow free flow of urine from the bladder outwards.
Indraprastha Apollo Hospitals, New Delhi
Gate No. 10, Room No. 1019, Ground Floor,
Mathura Rd, Sarita Vihar, New Delhi – 110076