Entries by agile

Trans-Urethral Cauterization of Bladder Bleeders + Evacuation Clots

 Why is it done? Primary management of: Continuous or intermittent bleeding from bladder vessels More prominent after radiation therapy with neo-vascularisation Induced or aggravated by blood thinning and anti-platelet therapy   Risk factors: Anti-coagulation therapy: Warfarin, Xaralto etc Anti-platelet therapy Radiation to bladder prostate or bowel These need to be stopped prior to the procedure […]

Trans Urethral De-Roofing of Prostate Abscess

Non invasive opening of an abscess found in the prostate, Very similar to a TURP with the exception that the bladder neck is preserved Why is it done? This procedure is performed when you have been diagnosed with a prostatic abscess, usually after an MRI investigation. You would have had a history of swinging low […]

Trans-Urethral Resection of Bladder Tumour – TURBT

Trans Urethral resection of bladder tumour with/without MMC An endoscopic procedure where bladder tumours are excised via the urethra. Why is it done? Primary management of: Resect a bladder lesion suspicious of bladder cancer Three Types of bladder cancer: Urothelial Carcinoma (85%) Squamous Cell carcinoma Adeno carcinoma Metastatic cancer to the bladder – i.e. Breast, […]

Ureteric Injury

Infrequently ureteric injuries can occur with other abdominal surgery i.e.: Hysterectomy. Ovarian mass resection. Bowel resections. Sacro Colpopexy. If the injury is below the pelvic brim, then a re-implantation with is recommended with Boari-flap, otherwise a primary end-to-end anastomosis Why is it done? Stricturing or narrowing of the ureter causing significant hydronephrosis. Injury to ureter […]

Ureteric Reimplantation

Surgical repair of VUJ obstruction, robotic or open Mainly a procedure for pediatric urology to correct grade 4-5 vesicoureteral reflux Distal ureteric injuries. Why is it done? Grade 4-5 Vesical-Ureteric Reflux where conservative management has failed with a progressive deterioration in renal function. Distal ureterectomy due to stricture disease. Iatrogenic injury to lower ureter during […]

Urethral Dilatation

Dilatation of urethral stricture. Dine in combination with urethroscopy and placement of IDC is advocated on daily basis at home as management of urethral stricture. Why is it done? To treat a narrowing in the urethra which has formed due to previous damage/injury to the urethra. Causes: after bypass surgery where a drop in blood […]

Urethrectomy

Removal of urethra. Usually in adjunct to a radical cystectomy. Occasionally done some time after a cystectomy where recurrences occur in urethra.   Why is it done? As part of the treatment for aggressive localized Urothelial carcinoma of the bladder. T1G3, > T2 disease. Primary Urethral disease with: Urothelial Carcinoma. Squamous cell carcinoma. Secondary metastatic […]

Ureteroscopy and Fulguration Lesion

Why is it done? Viewing suspicious lesions in upper urinary tracts (ureter and renal pelvis) Flexible uretero-renoscopy to review inside of the renal pelvis and renal calyces Removal of the lesion using laser Rigid is better for the ureteric inspection   How is it done? Patients will receive general anaesthesia. Prophylactic antibiotics are given. The […]

Ureterotomy

What is it? Opening up of a very narrowed/ obstructed ureteric opening. Either by cold knife or laser. Where a congenital / acquired narrowing in the ureteric opening occurs. This procedure is used to open the ureter and ease the urine flow. It can cause Vescio ureteric reflux. Why is it done? Congenital narrowing of […]