Urology

Urological diagnosis

Doctors diagnose urological diseases based on taking a medical history, physical examination, blood and urine tests and imaging. Laboratory tests are mandatory and include the following:

• Blood tests show signs of inflammation.
• A specific PSA test (prostate-specific antigen) helps diagnose prostate cancer.
• Urinalysis reveals blood in the urine and an excess of bacteria.
• Spermogram is done to prepare children or find out the cause of infertility.

Endoscopy involves studying urological organs using a thin tube with a camera.

Ultrasound of the urogenital organ is the most common method. It shows organs' location, size and shape of stones, tumours, and cysts.

Additional imaging methods are the following:

• X-ray methods (urography and cystography) with and without contrast reveal the structure of organs, congenital abnormalities, trauma or inflammation.
• Renal angiography uses X-rays to examine kidney vessels (arteries and veins). Doctors may look for an aneurysm, stenosis (narrowing), or vessel blockage.
• Computer or magnetic resonance tomographies are more accurate and informative procedures. Typically, urologists prescribe these techniques to assess the stage and extent of tumours and show vascular disorders.

The puncture mainly clarifies tumour malignancy. Then, the doctor takes a small piece of tissue (kidney, bladder, prostate) and examines it under a microscope.

How are urology problems treated?

Depending on the disease severity, urologists prescribe medication or reserve surgical solutions.

Drug therapy involves the use of various medicines to reduce symptoms:

• Antibiotics relieve bacterial infections;
• Antispasmodics relieve pain when urinating or with renal colic;
• Blood pressure-lowering drugs are helpful in the development of renal hypertension.
• Certain drugs facilitate urination in benign prostatic hyperplasia (alpha-blockers).
• Diuretics relieve the body of excess fluid and swelling.

Extracorporeal shock wave lithotripsy (ESWL) is a suitable alternative to the surgical removal of a kidney stone. ESWL removes kidney stones that do not pass on their own. The shock waves break the stones into small pieces, easily excreted with urine. Surgery is recommended to remove huge stones.

Transurethral resection involves inserting a cystoscope (thin tube) into the urethra, which cuts away diseased tissue and bumps and cauterizes the wound. It is a minimally invasive medical procedure and has lower risks.

Robotic laparoscopic surgery uses da Vinci technology. The mechanical device removes prostate cancer, corrects ureteral defects, and restores urination.

Laser therapy is widespread and uses a high-energy laser to remove overgrowth tissue. Immediately after the procedure, the symptoms are relieved. Laser ablation vaporizes excess tissue to enlarge the ducts.

In severe cases, urologists remove the entire organ or part of it (nephrectomy, prostatectomy, cystectomy.). Usually, doctors perform such operations on advanced cancer.

Reconstructive (plastic) surgery restores organs after injuries, surgeries, and malformations.

Organ transplantation is the replacement of damaged urinary organs with healthy ones. With a successful transplant, patients enjoy a near-optimal quality of life.