The surgical specialty that deals with the treatment of conditions involving the male and female urinary tract and the male reproductive organs is known as Urology.

Urologists are doctors who specialise in the field of urology and they are sometimes referred to as healthcare professionals who are trained to diagnose, detect and treat this group of disorders and diseases in the males reproductive organ and fenale urino-renal organs.

 The diseases and disorders that may be treated by urologists include those involving the kidneys, the ureters (tubes connecting the kidneys to the bladder), the adrenal glands, the bladder and the urethra (the tube that passes urine out of the body from the bladder). In males, a urologist may also treat conditions of the testes, epididymis, vas deferens, seminal vesicles, prostate and penis. The field of urology involves the medical management of conditions such as urinary tract infection and prostate enlargement through to the surgical management of conditions such as bladder cancer, prostate cancer, kidney stones and stress incontinence.

In the case of certain conditions such as cancer of the urinary tract, urologists may need to work in conjunction with oncologists or radiotherapists. They may also need to collaborate with nephrologists who deal with kidney conditions, gynaecologists who deal with the female reproductive system and endocrinologists who are concerned with conditions of the endocrine system and hormone disorders. Urologists may also collaborate with practitioners of pediatric surgery and colorectal surgery.

Urologists undergo post-graduate training for five years, completing 12 months in general surgery and 36 months in clinical urology. The remaining time is spent training in general surgery, clinical urology or a discipline that is relevant to urology. There are several specialist areas that can be practised after completion of a urology degree. Some of these include:

Endourology

Endourology deals with the closed manipulation of the urinary tract. The field has grown to now include minimally invasive surgical procedures. Procedures are carried out using endoscopes inserted into the urinary tract and examples include prostate surgery, stone removal surgery and simple urethral or ureteral surgeries.

Urologic oncology

This deals with genitourinary malignancies such as cancers of the kidney, adrenal glands, prostate, bladder, ureters, testicles or penis.

Neurourology

Neururology concerns the management of conditions that involve the nervous control of the genitourinary system or abnormal urination. Examples of neurological conditions that may lead to these conditions include Parkinson’s disease, multiple sclerosis, stroke and spinal cord injuries.

Pediatric urology

This involves the correction of genitourinary problems arising in children such as undescended testes or cryptorchidism, underdeveloped genitalia and vesicoureteral reflux.

Andrology

Andrology focuses on disorders of the male reproductive system such as erectile dysfunction, ejaculatory disorders, infertility and vasectomy reversal.

Urological Procedures 

Urological problems are many and they affect both males and females alike.  So, there are many reasons to see an Urologist.   When people see an urologist they may perform a variety of urology procedures to diagnose and treat urological conditions such as:

1. Vasectomy

This is a common urology procedure that many men get. According to the Urology Society of the Association of Health Care Professionals (AHCP), over 33 million men get vasectomies each year globally. It is a surgical procedure used for permanent male birth control. During the procedure, the doctor cuts off the supply of sperm to the semen by cutting and sealing the vas deferens, which carries sperm from the testicles? It is an out-patient procedure that only takes about 10-30 minutes.

2. Vasectomy Reversal

If a man who has had a vasectomy decides he wants to try and father children again, a vasectomy reversal can be performed. However, vasectomy reversal is not a guarantee the man can conceive a child. Certain factors are necessary for the reversal to be successful. Microsurgical techniques are used to repair the vas deferens.

3. Cystoscopy

A cystoscopy is a urology procedure that allows a urologist to examine the lining of the bladder and the urethra. An instrument called a cystoscope is inserted into the urethra and guided to the bladder. The cystoscope is made up of a long, thin tube with a light and a camera at the end. This procedure is commonly used to diagnose and treat bladder conditions. It can also be used to diagnose an enlarged prostate.

4. Prostate Procedures

Urologists may perform a number of procedures to diagnose and treat prostate conditions. These include:

• Prostate biopsy: A procedure to remove samples of tissue from the prostate for examination in a lab. 
• UroLift: A minimally invasive procedure done in-office to treat mild to moderate prostate enlargement and benign prostatic hyperplasia (BPH).
• Transurethral needle ablation (TUNA): A procedure that uses radiofrequency ablation to shrink prostate tissue that is pressing into the urethra and causing urinary symptoms.
• Transurethral resection of the prostate (TURP): A minimally invasive procedure that uses a special instrument called a resectoscope to trim and seal prostate tissue when the prostate is enlarged and causing difficulty in urination.
• Transurethral incision of the prostate (TUIP): A procedure used to treat benign prostatic hyperplasia (BPH). A small endoscope is inserted through the urethra and special instruments create small openings in the bladder neck where it connects to the prostate. This opens the urinary channel so urine can pass.

5. Ureteroscopy

Ureteroscopy is a procedure used to diagnose and treat kidney stones. A special instrument called a ureteroscope (a long, thin tube with a light and camera) is guided through the urethra and the bladder and up the ureter to where the kidney stone is located. Small stones can be removed whole, while larger stones need to be broken up. The procedure used to break up the stones is called lithotripsy.

6. Lithotripsy

Lithotripsy is a urology procedure that uses shock waves or a laser to break down stones in the kidney, bladder, or ureter. The laser or shock waves break up large stones so that they can pass through the urinary system.

7. Orchiopexy

Orchiopexy is a surgical procedure performed to repair an undescended testicle. During the procedure, the testicle is moved from the abdomen or groin area and into the scrotum. Then it is attached to the scrotum with a “tacking stitch.”

8. Penile Plication

Penile plication is a surgical urology procedure that is used to treat curvature of the penis caused by Peyronie’s disease. It is an outpatient procedure in which permanent sutures are placed on the opposite side of the scarring that causes the curvature.

9. Penile Implants & Prosthesis

Penile implants or prostheses are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. These devices are usually only recommended after other ED treatments fail. For instance, a penile prosthesis may be recommended for men with severe Peyronie’s disease who cannot get an erection due to the curvature of the penis.

10. Male circumcision

Circumcision is a surgical procedure in which the skin covering the tip of the penis (foreskin) is removed. It is a procedure commonly performed on newborn boys in different places around the world, including the US. 

The IAHCP Medical Centre Urology Specialists is home to an expert team of urologists that are committed to providing comprehensive care to adults with urologic disorders as well as other men’s health issues. If you are experiencing the symptoms of a urological condition or have questions about urology procedures, contact us at: medicals@ijmjournal.org.uk or education@ijmjournal.org.uk  and iahcpacademycentre@gmail.com