Urology
Urology is the medical department that examines the urinary tract in both sexes and all age groups, and the reproductive system in men. The department of urology, also known as the surgical specialty, provides health services together with the departments of internal medicine, pediatrics, gynecology and oncology.
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What is a urologist?
Doctors specializing in urology who deal with the urinary tract and urinary system in women, men and children are called urologists
What organs does urology cover?
In the Department of Urology, kidney, ureter (urinary channels between the kidney and bladder), bladder (urinary bag) and urethra (the channel where urine is carried from the bladder to the outside of the body) and all the testes, penis, scrotum and prostate organs that form the male reproductive system. diagnosis and treatment of diseases are carried out. In the urology department, diseases diagnosed by specialist physicians can be successfully treated with drugs and surgical methods by using appropriate medical and modern surgical equipment. Memorial Health Group Urology Departments serve with experienced specialists, modern technologies and multidisciplinary approaches in the diagnosis and treatment of urological diseases and problems.
What does urology look for in men?
Department of Urology in men; It deals with the diagnosis and treatment of kidney, bladder, ureter, urethra, testicular, penile, scrotum and prostate cancers and diseases as well as erectile dysfunction, male infertility, vasectomy, low testosterone, overactive bladder, pelvic pain, urinary incontinence. Especially in cases of urinary incontinence seen after prostate surgery, suspension surgeries and artificial urinary clamp (artificial urinary sphincter) are applied in our clinic.
What does urology look for in women?
Department of Urology in women; He deals with the diagnosis and treatment of problems such as urination disorders, urinary incontinence problems, insufficiency of pelvic floor muscles, especially organ prolapse problems and neuromuscular dysfunctions of the bladder that can be seen together with neurological diseases. Procedures such as urodynamic examination, pressure-flow study, and botox application to the bladder are included in this area. Bladder pacemaker (sacral neuromodulation) is one of the procedures applied with high success in patients (bladder-urinary disorders (inability to urinate, urinary incontinence, overactive bladder, painful bladder syndrome).
What does urology look for in children?
The treatments of diseases in the field of urology in children are applied using different techniques than adults. Pediatric urology, which deals with urological problems especially in childhood; He is interested in the diagnosis and treatment of diseases such as circumcision, hypospadias, undescended testis, urinary tract infections, kidney stones, bladder stones, tumors and infections, voiding disorders, renal outlet stenosis, vesicoureteral reflux.
What are urological tests and surgical interventions?
HoLEP (Holmium Laser)
HoLEP (Holmium Laser Enucleation of Prostate), which is a closed prostate surgery method, is removed by separating from the capsule of the enlarged prostate inner tissue (adenoma) with the help of laser. Benign Prostatic Enlargement (BPH) is a condition in which the prostate enlarges with age, obstructing the outlet of the bladder (urinary bag) that it surrounds and preventing the urine flow. The HoLEP method is used in the treatment of benign prostate enlargement. This method is used very effectively in the treatment of prostate enlargements of all sizes. The HoLEP method is more preferred, especially in prostates with a size of 80 grams and above, since the effectiveness of other closed prostate surgery methods is low.
Thulep (Thulium Laser)
The Thulium laser system is the ultimate in laser technology in medicine. With this laser system, the most prone to bleeding tissues can be cut without bleeding and the tissues can be evaporated. While doing all these, it damages the surrounding tissue in an area of less than 0.1 mm. This margin of safety is the best compared to other lasers.
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Benign prostate enlargement, which is one of the most important health problems seen in men in advancing age, is successfully treated with ThuLEP, the most up-to-date and most advanced laser surgery, in a comfortable way. Prostate enlargement and treatment options are determined by both prostate size and the patient's degree of complaint. With the Thulium Laser method, patients can be treated endoscopically with the ThuLEP method, regardless of how large their prostate is, and the catheters of the patients are removed within 48 hours and the patients are sent home without a probe.
Another area of use for the Thulium laser is the treatment of superficial bladder cancer and ureteral cancers. Bladder cancers are cut en bloc with Thulium laser to make an optimal pathological evaluation and an accurate treatment planning.
Robotic Surgery
Robotic surgery is mostly used in prostate cancer operations in urology. In addition, robotic surgery, which is used in cases of kidney, bladder, testicular cancers, benign prostate enlargement, adrenal gland tumors, urinary incontinence and stenosis of the kidney outlet (UPJ stenosis), and provides successful results, provides important advantages to the patient. In prostate cancer surgeries performed with robotic surgery, the erection nerves leading to the penis and the urinary retention muscles can be better protected and the risk of urinary incontinence and loss of sexual function of the patient after the surgery is minimized. However, in kidney tumor surgeries performed with the “da Vinci” technique, cancer control is achieved in the best way and only tumor tissue can be removed. With the robotic surgery method, which can also be used in testicular cancer, the surgery is performed through several holes completely closed and the large incisions applied in open surgery are replaced by 4 millimetric incisions. With the robotic surgery technology used in bladder cancer, the surgery is performed completely closed and the entire surgical process, including the construction of an artificial bladder from the intestine, is completed robotically. The experience of the surgical team is the most important factor in the success of the robotic surgery technique, which is not a completely robotic surgical application. Our hospital has the latest model da Vinci Xi model robotic surgery system.
HIFU
It is a method used in urology, especially in the focal treatment of prostate cancers. When the prostate of men with prostate cancer is completely removed, these patients may experience postoperative side effects such as urinary incontinence, erectile dysfunction and dry ejaculation. Instead of removing the entire prostate, only the areas with cancer can be destroyed by the HIFU method. Intensified ultrasound waves are used in the HIFU method. The procedure is performed under anesthesia in the operating room. There is no risk of bleeding in this procedure. Not every prostate cancer patient is suitable for this method. If a person has prostate cancer and is looking for a minimally invasive treatment method, he should consult his doctor.
What are the urology diagnosis and treatment methods?
Our diagnosis and treatment methods, which are frequently encountered in urology diseases, can be listed as follows:
PSA Test
Prostate Specific Antigen (PSA) is an enzyme produced by the prostate that regulates the consistency of semen. Some of this enzyme can circulate in the blood. In benign prostatic enlargement, the value of PSA in the blood increases to a certain extent as the prostate enlarges. Abnormal PSA increases are seen in conditions such as prostate cancer, prostate inflammation, prostate biopsy, prostate infarction, urinary tract surgeries (TUR), ejaculation, urinary retention (globe vesical), Prostate Massage.
Prostate Health Index
It is a blood test used to detect especially aggressive prostate cancer patients at an early stage. It is the test with the highest sensitivity among the prostate cancer markers examined from blood.
Genetic Tests
The role and importance of genetic tests in the diagnosis and treatment planning of urological diseases is gradually increasing. It is used to determine the risk of prostate cancer in patients, to follow high-risk patients more closely, and to decide on the treatment method for prostate cancer patients caught at an early stage. Again, genetic tests are routinely used before in vitro fertilization methods.
MR (Magnetic Resonance Imaging)
The role and importance of genetic tests in the diagnosis and treatment planning of urological diseases is gradually increasing. It is used to determine the risk of prostate cancer in patients, to follow high-risk patients more closely, and to decide on the treatment method for prostate cancer patients caught at an early stage. Again, genetic tests are routinely used before in vitro fertilization methods.
Computed Tomography (CT)
Computed Tomography (CT) is an imaging technique used to create detailed pictures and scans of areas within the body using special x-ray beams. Computed Tomography (CT) technique is known as a technique most commonly used by Urology units for the examination of tumors related to the male reproductive organs and traumas related to these organs, the diagnosis of stone disease and the determination of stone types.
Ultrasound
Ultrasound is an imaging technique that uses high-frequency sound waves. It is preferred in urology units for the examination of prostate enlargement, cancer caused by the prostate gland and all kinds of diseases related to the urinary system. Since it is a radiation-free method, it is usually used for initial examination. Since the experience of the person performing the ultrasound is very important, it must be performed by experienced radiologists.
Urodynamics Test
The general name of the tests that investigate the disorders of organs that play an important role in urination and storage functions is explained as urodynamics. The urodynamic test is a dynamic test performed with two pressure gauge thin catheters inserted through the urinary canal into the bladder and anus without any incision in the body. During this procedure, all movements of the bladder and surrounding muscles are recorded and examined, and a diagnosis is made by considering all these data.
Voiding Cystourethrography (VSUG)
Voiding cystourethrography can also be described as a probe film among the people. In the urology unit, it is used in cases where urine escapes from the urinary channels towards the kidney.
Cystoscopy
It is an endoscopic diagnosis method that allows us to examine the inside of the bladder. It is an examination performed under local anesthesia with an instrument called a flexible, flexible cystoscope with a camera system at the end, in outpatient clinic conditions. It is a method that helps us to diagnose diseases in the voiding canal and bladder, bladder cancers, and urinary tract strictures. In order not to miss any detail, cystoscopy procedures are performed in our hospital using digital instruments with very clear images. Optionally, it can be performed under sedation for patients who want it.
Prostate Biopsy
Prostate biopsy is the process of taking a piece of the prostate using a special needle. The diagnosis of prostate cancer is determined by prostate biopsy. The biopsy taken from the prostate is examined under a microscope after processing with special dyes. After this procedure, the pathologist reports whether the patient has prostate cancer. In our hospital, all prostate biopsy procedures are performed under sedation, with the participation of radiology and urology instructors, using a high-end MR fusion device (Uronav) as MR fusion prostate biopsy. In our hospital, prostate biopsy procedures can be performed by perineal route.
Immunotherapy
It is known as a new generation treatment approach that rebuilds the immune system and enables the body to defeat cancer cells on its own. Immunotherapy has fewer side effects than chemotherapy and targeted therapies used for cancer. Immunotherapy treatment can be applied against cancer types caused by urology diseases.
Both Closed Surgery and Robotic Surgery Are Successfully Applied at Uniqacare
The Department of Urology has many sub-branches such as andrology, female urology, functional urology, neurourology, reconstructive urology, endourology, urooncology and pediatric urology. At Uniqacare, the diagnosis and treatment methods of all urological subspecialities are applied within the framework of the latest updated approaches in accordance with the world standards in the field of medicine. Almost all of the surgical interventions in the field of urology are now performed with closed surgery (laparoscopy, endoscopy) and robotic surgery. One of the fields in which robotic surgery is most commonly used is urology. In today's technological age, laser energy is actively used in many medical branches, and laser energies are applied in our urology clinics in many treatments in urology.
Urologic Subspecialities
We have highly experienced specialist physicians at Uniqacare dealing with all subspecialities of urology, and here are these subspecialities listed below:
Andrology
It covers male sexual function problems, infertility and assisted reproductive treatments. Male genital aesthetic applications such as congenital penile curvature, Peyronie's disease, treatment of cosmetic disorders of the penis after congenital and circumcision procedures, penile injection and penile prosthesis (happiness stick) applications in erection problems, penis enlargement-thickening and scrotum rejuvenation have an important role in male infertility. Microsurgical method in the treatment of varicocele that causes the disease, MicroTESE and TESA procedures to obtain sperm from the testicles in cases of azoospermia (no sperm in the semen), premature ejaculation (premature ejaculation), decreased sexual desire, male contraception (vasectomy) and genital warts (condyloma). treatments are applied with high success rates. ESWT (out-of-body shock wave therapy) is applied in our clinic, which improves the blood flow of the penis, reduces the complaints in cases of chronic prostatitis, and in inflammatory conditions of the penis such as Peyronie's disease.
Female Urology, Functional Urology, Neurourology
Reconstructive Urology
Open surgery (urethroplasty), which is the definitive treatment of urethral strictures in men and women, surgical treatment of fistulas developing between the bladder, urinary tract and adjacent organs, treatment of renal outlet and ureteral strictures, bladder expansion (augmentation) surgery, penile curvature, penile lengthening, penis and ureteral strictures. Scrotal aesthetic surgeries can be applied. Corrective surgeries and physiotherapy process plans are made for all diseases (stenosis, injuries) that develop in the urinary tract after trauma. Bladder neck stenosis after prostate surgery can be corrected with robotic surgery
Endourology
Endourology is the field of diagnosis and treatment of urinary system stone diseases and urinary system tumors with minimally invasive (laparoscopy, robotic surgery, endoscopy) approaches in both genders. It has completely replaced open surgery in the diagnosis, treatment and reconstruction of urinary tract strictures. Today, completely closed endoscopic methods are preferred, regardless of prostate size, in the treatment of benign prostate enlargement (BPH) with the use of laser technology. Thulep surgery with Thulium laser in benign prostate enlargement and its effects on sexual health is one of the most frequently applied treatments with high success. There are Bipolar TUR and TUR Plasmakinetic systems in our hospital. It can be applied to patients with benign prostatic enlargement less than 40 grams.
Ureterenoscopy, retrograde intrarenal surgery (RIRS), percutaneous nephrolithotomy holmium laser, which are the main treatments for stone diseases, can be performed with closed methods, accompanied by modern technology. In addition, successful results are obtained with extracorporeal shock wave therapy (ESWL) applied in the treatment of stone diseases. Small-sized tumors in the kidney and urinary tract can also be destroyed by endoscopic laser ablation treatments. All these up-to-date treatments are applied in our institution by our specialist physicians.
Urooncology
Diagnosis and treatment of all urological cancers such as bladder, prostate, kidney and testicular tumors are carried out at the high standards of modern medicine, with the joint treatment of the physicians of our urooncology department, when necessary. 99% of urooncology surgeries are performed with robotic surgery, laparoscopic surgery or endoscopic surgeries in the urology deaths.
Bladder Cancer
Bladder cancer often presents as painless, clotted bleeding in the urine. Again, complaints in the form of straining and burning during urination can also be seen. In particular, smokers are at the highest risk, and it is more common in men than in women. Endoscopic evaluation of the bladder with a camera, taking samples from suspicious-looking areas or tumoral formations encountered during this procedure, pathological evaluation is provided by TUR-MT (transurethral resection of the bladder) operation.
The main follow-up and treatment depend on the result of this pathology. At Uniqacare, systems called SPIES are used to detect invisible bladder cancers, and a more optimal pathological staging is performed by en bloc resection of bladder cancers with Thulium laser. Depending on the pathology result, drug applications into the bladder, radical cystectomy (removal of the entire bladder) or chemotherapy-radiotherapy treatments are planned jointly with our medical oncology and radiation oncology physicians. Today, radical cystectomy and artificial bladder can be performed with open surgery, laparoscopic surgery and robotic surgery depending on the characteristics of the case. In artificial bladder cancer surgeries performed with robotic surgery, there is no bleeding and the hospital stay is shorter.
Prostate Cancer
Although there are many risk factors, they develop mainly due to the exposure of the male hormone (testosterone) with aging of the prostate gland, which is present in men. It is recommended that every man over the age of 45 if there is a family history of prostate cancer, or over the age of 50 if he does not, should have an annual examination and a blood PSA test. Prostate health index, multiparametric prostate MRI and advanced genetic examinations are performed in suspicious cases. MRI-USG (Magnetic resonance imaging-ultrasound) fusion biopsy is performed rectally or perineally under sedation for patients for whom biopsy decision is made. Thanks to this method, which is routinely applied in our clinic, cancers that cannot be detected under ultrasound guidance become visible with the help of MR, and it allows targeting and sampling of suspicious images. Today, surgical treatment is applied with robotic prostatectomy in prostate cancers. Considering the risk factors of the disease, the necessity of additional treatments according to the pelvic lymph node dissection and pathology results is decided by your urology physician. For patients who want to be protected from the side effects of surgery (for example, dry discharge); if cancer aggressiveness and prevalence allow; Focal treatments such as HIFU, in which only cancerous areas are destroyed without removing the prostate, can be applied.
Kidney Cancer
In the past, patients were admitted to health institutions with findings such as side pain, blood in the urine and palpable swelling in advanced stages of kidney tumors; Today, with the widespread use of imaging techniques such as ultrasound, computed tomography and magnetic resonance imaging, the diagnosis is made very early and without causing any complaints. In this way, removal of the mass by preserving the healthy part of the kidney with nephron-sparing surgery (partial nephrectomy) is now a very common form of surgical treatment. Thanks to robotic surgery, our specialist physicians shorten the hospital stay without the need for open surgery, and these treatments are applied with high success with less pain and bleeding. Again, robotic surgery can be applied in cases where the kidney cannot be preserved and there is lymph node involvement. While cryoablative treatments are applied for small masses in patients who are not suitable for surgery, up-to-date treatment protocols such as immunotherapy with targeted agents are applied together with the Medical Oncology department in metastatic cases that are not suitable for surgical treatment.
In the treatment of large kidney cancers, laparoscopic or open surgery and nephrectomy operations can also be performed at Uniqacare.
Testicular Cancer
Testicular cancers, which are common especially in young-middle-aged men, often present as a result of a painless enlarging mass in the testis. Although ultrasound is important for diagnosis, investigation of tumor markers in the blood and physical examination are also important. In cases with suspected testicular tumor, it is recommended to remove the testis from the inguinal region without wasting time and to evaluate the whole body with imaging methods such as high-quality computed tomography, together with the pathology result. Testicular tumors often spread (metastasize) to lymph nodes adjacent to the main vessels of the back (aorta and vena cava). For this reason, it is appropriate to carry out follow-up and, if necessary, additional treatments such as chemotherapy, radiotherapy and removal of lymph nodes in highly equipped centers after diagnosis. If the lymph nodes in question are involved, surgery can be very risky and difficult. Robotic surgery can be performed very safely and successfully in experienced hands. In our clinic, the closed method of removing the lymph nodes in question with robotic surgery, and the treatments of cases in need of chemotherapy and radiotherapy with our oncology department doctors are carried out at world standards.
Pediatric Urology
Pediatric urology is a separate branch from adult urology, which deals with urological problems especially in the childhood age group. Circumcision, hypospadias, undescended testis, childhood urinary tract infections, voiding disorders, enuresis nocturna (nocturnal urinary incontinence), neuromuscular dysfunctions of the bladder, renal outflow (ureteropelvic junction) strictures and vesicoureteral reflux (urine leakage from the bladder to the kidneys) are among the main topics of pediatric urology takes place.
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