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Urology - An Overview

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Urology (aka: genitourinary surgery) is a surgical subspecialty that tackles a wide spectrum of diseases involving the male and female urinary tract, the male reproductive system, and the female pelvic floor. Urologists manage afflictions ranging from genitourinary malignancies (renal cell carcinoma, prostate carcinoma, transitional cell carcinoma, testicular carcinoma, etc. . .) and renal stones to congenital genitourinary defects, perineal reconstruction, and male infertility.

Although Urologists are surgeons, a significant part of the urologic practice also involves medical management of disease (i.e. no knife).

The American Urologic Association (AUA), the governing body for the specialty, divides Urology into seven subspecialties:

  • Oncology: Surgical management of neoplasms involving the Adrenals, Kidneys, Ureters, Bladder, Prostate, Urethra, Testes, External Genitalia

  • Calculi: Medical, endoscopic, extracorporeal, percutaneous, and surgical management of stones of the urinary tract.

  • Female Urology: Medical and surgical management of incontinence and pelvic outlet relaxation disorders.

  • Infertility: Medical and surgical treatment of male infertility.

  • Pediatrics: Medical and surgical treatment of urological disease in the pediatric population.

  • Transplant: Renal transplantation.

  • Neurourology: Urodynamic evaluation of patients; medical and surgical management of voiding disorders and erectile dysfunction.

Below is a list of surgical procedures that are performed by urologists (visit the video library page):


             
         

Kidney and Adrenal

       
         
  Partial nephrectomy      
    open        
    laparoscopic      
    transperitoneal    
    retroperitoneoscopic    
    robotic      
    transperitoneal    
    retroperitoneoscopic    
  Nephrectomy        
    simple        
    donor        
    radical (with caval thrombectomy)  
    laparoscopic      
    robotic      
  Nephroureterectomy      
    laparoscopic      
    robotic      
  Renal transplantation      
  Renal arterial grafts      
  Splenorenal and hepatorenal arterial bypass procedures
  Adrenalectomy        
    open        
    laparoscopic      
    robotic      
  Pyeloplasty        
  Pyeloureteroplasty      
  Symphisiotomy of horseshoe kidney    
  Repair of lacerated kidney      
  Surgery for renal abscesses    
  Excision of renal cyst      
  Nephrostomy        
  Pyelostomy        
  Nephroscopy        
  Endopyelotomy        
  Pyelonephrolithotomy      
  Percutaneous Nephrolithotomy    
             
       

Retroperitoneum and Ureter

     
         
  Ureterocalicostomy      
  Ureterolithomoty        
  Psoas hitch        
  Boari flap        
  Ureterovesical anastomosis, reimplantation  
  Ureterocolic anastomosis      
  Ileoureteral substitution      
  Ureteroileal conduit      
  Ureteroureterostomy      
  Transureteroureterostomy      
  Ureterovaginal fistula repair    
  Repair of ureteral injuries/transections  
  Ureterectomy        
  Ureteral reimplantation      
  Megaureter repair      
  Ureteroscopy        
    basket extraction of stone  
    laser lithotripsy      
    ultrasound lithotripsy    
    electrohydraulic lithotripsy  
    ureteral stenting    
  Laparoscopic surgery of the ureter    
  Retroperitoneal Lymph Node Dissection (RPLND)
    open        
    laparoscopic      
  Ureterolysis for retroperitoneal fibrosis  
  Intracorporeal Lithotripsy      
  Extracorporeal Shock Wave Lithotripsy (ESWL)
  Endoscopic management of ureteral strictures / fistulas
  Lower tract surgery for ureterocele and duplication anomalies
  Prune Belly Syndrome management    
             
             

Bladder

           
           
  Cystectomy        
    partial        
    radical: includes hysterectomy and anterior vaginectomy in female and prostatectomy in men
    urinary diversion    
      ileal conduit      
      Indiana pouch    
      orthotopic continent diversion (e.g. Studer pouch)
  Bladder extrophy repair      
  Excision of urachus and repair of bladder  
  Repair of ruptured bladder      
  Vesical diverticulectomy      
  Vesical fistula repair      
  Cystolithotomy / lithalopaxy    
  Closure of fistula        
  Cystoscopy        
    flexible      
    rigid        
  Transurethral Resection of Bladder Tumor (TURBT)
  Laser Treatment of Bladder Cancer    
  Augmentation cystoplasty      
  Sacral nerve stimulation      
             
             

Urethra

           
         
  Meatotomy and repair      
  Excision of stricture      
  Diverticulectomy        
  Excision of posterior urethral valves    
  Artificial urinary sphincter implant    
  Urethroplasty        
  Urethrectomy        
  Repair of urethral fistula      
  Repair of urethral diverticula    
  Peri-urethral collagen injection for incontinence
  Fistula repair        
  Dilation of stricture      
  Biopsy          
  Endoscopy        
  Endoscopic Treatment of Urethral Strictures  
             
       

Prostate and Seminal Vesicles

     
   
  Radical Prostatectomy (radical procedure includes excision of seminal vesicles) 
    retropubic       
    perineal       
    laparoscopic       
    robotic       
  Pelvic Lymph Node Dissection     
    open        
    laparoscopic       
  Suprapubic Prostatectomy     
  Trans Urethral Resection of the Prostate (TURP) 
  Needle biopsy of the prostate     
  Ablation of prostatic tissue    
    RF Energy      
    Microwave      
    Laser        
    Ultrasound      
  Prostatic stenting      
             
             

Testes

           
           
  Orchiectomy        
    simple        
    radical      
  Orchiopexy (repair of congenital undescended testicle)
  Herniorrhaphy        
  Hydrocelectomy        
  Varicocelectomy        
    open        
    laparoscopic      
  Spermatocelectomy      
  Vasectomy        
  Microscopic vasovasostomy    
  Microscopic vasoepididymostomy    
  Epididymal sperm retrival      
  Management of male factor infertility  
  Management of testicular torsion    
             
         

External genitalia

       
     
  Penectomy with inguinal lymphadenectomy  
  Surgery for priapism      
  Surgery for Peyronie's disease    
  Resection of Fournier's gangrene    
  Vascular surgery for treatment of impotence  
  Repair of penile fracture      
  Implantation of penile prosthesis for treatment of impotence
  Hypospadias repair      
  Epispadias repair        
  Circumcision        
  Congenital urethral duplication management  
  Ambiguous genitalia management    
  Colovaginoplasty for vaginal recontruction  
             
           

Pelvic floor

         
   
  Urethrovesical suspension for stress incontinence
    Burch colposuspension    
    Pubovaginal slings    
  Artificial sphyncter      
  Paravaginal repair      
  Cystocele repair        
  Rectocele repair        
  Enterocele repair        
  Laparoscopic surgery for stress incontinence  
  Periurethral injection for intrinsic sphincter dysfunction