Urology
Introduction
Urology treatments based on the diseases of the urinary tract in both men and women. In this treatment doctors diagnose and treat anything involving the reproductive tract in men. In some cases, they may perform surgery. For example, they may remove cancer or open up a blockage in the urinary tract. The urinary tract is the system that creates, stores, and removes urine from the body.major organs include in urological treatements:
a) kidneys, which are the organs that filter waste out of the blood to produce urine
b) ureters, which are the tubes through which urine flows from the kidneys to the bladder
c) bladder, which is the hollow sac that stores urine
d) urethra, which is the tube through which urine travels from the bladder out of the body
e) adrenal glands, which are the glands located on top of each kidney that release hormones
Urologists also treat all parts of the male reproductive system.
Types of Urological Disease
There are many types of Urological disease that affect different parts of the organ and occur in different ways:
- Benign Prostatic Hyperplasia (BPH) Benign prostatic hyperplasia (BPH) is an enlarged prostate. It is an increase in the size of the prostate gland. BPH is very common in older men. It is not directly connected to prostate cancer. The symptoms of BPH are caused by the pressure that a larger prostate can place on the urethra. The urethra is the narrow tube that carries urine from the bladder and out of the body. Men with BPH may experience a frequent urge to urinate. They may also have a weak stream of urine when they do go and a feeling that the bladder is not empty after urination. Your doctor may choose to just monitor this condition or prescribe medications such as alpha-blockers for treatment. Severe cases can be treated with surgery.
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Urinary Incontinence- Urinary incontinence is a loss of bladder control. It results in the unwanted leakage of urine. This condition can be inconvenient and embarrassing, but it is far from uncommon. There are a number of things that can cause incontinence. A few of the most common causes include:
a) diabetes
b) pregnancy or childbirth
c) enlarged prostate
d) weak bladder muscles
e) weak sphincter muscles (muscles supporting the urethra)
f) overactive bladder
g) urinary tract infections
h) diseases including Parkinson’s and multiple sclerosis
i) injury to the spinal cord - Urinary Tract Infections (UTIs) - UTIs are the result of pathogenic bacteria or viruses that invade the urinary tract and cause infection. They are much more common in women, although men can get them too. According to the AUAF, roughly 40 percent of females and 12 percent of males will have a UTI that causes noticeable symptoms at some point in their lives. A burning sensation during urination is one of the symptoms of a UTI. Others include a frequent urge to urinate and the feeling that the bladder is not completely empty after urinating. Antibiotics can usually clear up most UTIs within five to seven days.
- Kidney and Ureteral Stones- Stones develop in the kidneys when there are crystals in the urine and small particles surround and collect on these crystals. Ureteral stones are ones that move from the kidney into the ureter (the tubes that carry urine from the kidneys to the bladder). These stones can block urine flow and cause a considerable amount of pain. Many people end up expelling small stones from the body without medical help, but larger stones may result in blockage, which is problematic. Medical or surgical procedures may be needed in some instances, to remove large stones. Extracorporeal shock wave lithotripsy (ESWL) is one of the most commonly used techniques. The procedure involves using sound waves to break stones into smaller pieces so that they can more easily exit the body.
- Myocardial infarction. This is also known as a heart attack, cardiac infarction, and coronary thrombosis. An interrupted blood flow damages or destroys part of the heart muscle. This is usually caused by a blood clot that develops in one of the coronary arteries and can also occur if an artery suddenly narrows or spasms.
- Prostate Cancer - For men, prostate cancer can often be a fatal diagnosis. In fact, it is the second-leading cause of death of men. Getting screened is of great importance. Discussing your family history with your physician, examining the other risk factors in relation to your own situation and educating yourself about this important topic can help you survive. Our outstanding urologists will outline the tests you'll need to help them make a diagnosis. And, if you need treatment, we offer the latest in robotic surgery, radiotherapy, cryotherapy and other treatment modalities.
- Urethral Cancer - This rare form of cancer can affect both men and women. In fact, more women than men are diagnosed with urethral cancer. After a review of the patient's family and medical history, other diagnostic screening tools may include a tissue biopsy under local anesthesia, or a cystourethroscopy (using a cystoscope). Treatment options include surgery, radiation and chemotherapy.
Risk Factors
Risk factors include:
- Urologic diseases encompass a wide variety of diseases that can be subdivided into three broad classes, developmental abnormality such as hypospadias, functional deficiency such as incontinence and male impotence, and abnormal or cancerous growth in kidney, urethra, bladder, ovary, testis and prostate. Many of these diseases have underlying genetic bases. Traditionally, disease causing genes are identified by positional cloning of the inherited disease genes through family pedigrees. The bigger the family pedigrees are, the easier it is to identify the associated disease causing genes. The availability of large numbers of families with polycystic kidney diseases have allowed the identification of the PKD1 and PKD2 genes that account for majority cases of autosomal dominant polycystic kidney diseases . Pedigrees for nephronophthisis are generally smaller, however, causal genes have also been identified. The success in these cases is largely due to clear-cut linkage of the diseases to germline mutations that can be repetitively identified in successive generations of the same family. However, many urologic disease conditions are caused by spontaneous mutations that occur in cells within the affected tissues in individual patients. These mutations also have tremendous values in diagnosis, prognosis and drug developments.
- Recently, scientists, with more advanced technology, have made encouraging success in identifying prevalent mutations in various forms of urologic cancers, many of which are caused by somatic mutations.
- Urologic diseases include developmental and functional deficiencies, fibrosis, abnormal cell proliferation and cancers. Each type of these diseases is likely to have specific genetic as well as environmental risk factors. Besides genetic and environmental risk factors, there seems to be a general risk from chronic inflammation in urologic organs as adverse consequences of sexually transmitted diseases or frequent urinary tract infections. Future work is required to establish causal relationship between specific infective agent and specific urologic aliment. Such effort is warranted as exemplified by the identification of human papillomavirus (HPV) as the infective agent for causing cervical cancer.
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Factors which increase the risk of developing kidney stones are:
a) Family history of kidney stone disease
b) Dehydration
c) Diet rich in animal proteins, salt and sugar
d) Obesity
e) Weight Loss Surgery
f) Hyperparathyroidism
g) Cystinuria
h) Urinary tract infections - Tacrolimus toxicity (>15 µg/l), suspected acute tubulus necrosis (ATN), treatment for rejection (methylprednisolone and/or ATG), lymphoceles, surgical site infections and urinary tract infections were scored during the first 3 months after transplantation. Besides ureteral revisions, all other re-interventions were documented: re-interventions because of re-bleeding, lymphocele drainage, transplantectomy and re-exploration because of vascular complications. Graft failure was defined as primary non-function or loss of function requiring dialysis.
Procedure
Procedure include:
- Urinary tract infections (UTIs): These often arise when bacteria migrate from the digestive tract to the urethra. Symptoms include abnormal urination, pain, incontinence, nausea, vomiting, fevers, and chills. It mostly affects women.
- Incontinence: A malfunction in the urinary system can lead to involuntary loss of bladder control. In women, this may result from a weakening of the pelvic floor muscles during pregnancy.
- Male infertility: This can result from damage to the male reproductive tract and a variety of sperm disorders. One common cause is varicoceles, an enlarged vein in the sac beneath the penis. Surgery can sometimes help.
- Kidney disease: Damage to the kidneys can lead to swelling in the hands and ankles, high blood pressure, and other symptoms. If the kidneys no longer work effectively, this is kidney failure. Ultimately, it can be fatal.
- Urologic oncology: Treatment of cancers that relate to the urological or male reproductive system, such as bladder cancer and prostate cancer.
- Bladder prolapse: when the tissues and muscles of the pelvic floor are no longer able to support the organs in the pelvis, the organs can drop from their usual position.
- Enlarged prostate: Benign prostatic hyperplasia (BPH) affects around 1 in 3 men over the age of 50 years. An overgrowth of cells in the prostate gland causes the urethra to constrict, leading to problems with urination.
- Renal transplantation: A person may require kidney transplants following kidney failure.
- Erectile dysfunction: The penis is unable to attain sufficient rigidity to fully participate in sexual intercourse. This is often a symptom of an underlying condition.
- Peyronie's disease: A fibrous layer of scar tissue develops beneath the skin of the penis. This can lead to bending or curving in the penis (phimosis) during an erection that can cause pain and lead to difficulties with sexual intercourse.
- Interstitial cystitis or painful bladder syndrome: A chronic inflammatory bladder condition can produce discomfort ranging from mild to severe.
- Kidney and ureteral stones: Small, hard deposits made from mineral and acid salts form in the kidneys but can pass through into the ureters. They can affect urination and cause pain, nausea and vomiting.
- Undescended testes, or cryptorchidism: Normally, the testicles form inside the abdomen of a fetus and descend into the scrotum before birth. If one or both does not descend, sperm production can be impaired, and there is a risk of complications.
Range of Treatment Cost
| Procedure | Duration In Hospital(Days) | Min Cost ₹(INR) | Max Cost ₹(INR) |
|---|---|---|---|
| Trans Urethral Resection of Prostrate (TURP) | 4 | 135000 | 170000 |
| Green Light Laser Prostratectomy | 3 | 220000 | 270000 |
| Bladder Neck Incision | 3 | 110000 | 170000 |
| Optical Urethrotomy (Cold Knife) | 2 | 82500 | 120000 |
| Optical Urethrotomy (Laser) | 2 | 130000 | 200000 |
| Cystolithotripsy (Laser) | 2 | 130000 | 245000 |
| Trans Urethral Resection of Bladder Tumor (TURBT) | 4 | 130000 | 170000 |
| Laparoscopic Radical Cystectomy | 7 | 290000 | 350000 |
| Uretroscopic Removal of Stone (Bladder) | 2 | 120000 | 168000 |
| Uretric Reimplantation | 5 | 170700 | 200700 |
| PCNL (Kidney) | 3 | 176400 | 250000 |
| Laser Prostate Surgery | 4 | 300000 | 600000 |
| Non-Surgical Treatment for Urinary Stones | 4 | 150000 | 250000 |
| Percutaneous Nephrolithotomy (PCNL) Surgery | 4 | 150000 | 200000 |
| Radical Prostatectomy Surgery | 4 | 300000 | 500000 |
| Robotic Prostate Cancer Surgery | Depends upon the treatment | 540000 | 640000 |
| Laproscopic Radical Prostatectomy Surgery | Depends upon the treatment | 420000 | 620000 |
| Vasectomy | 1 | 96000 | 126000 |
| Laparoscopic Cholecystectomy Surgery | Depends upon the treatment | 70000 | 120000 |
