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  3. Urology - An Overview

Urology - An Overview

Urology (aka: genitourinary surgery) is a surgical subspecialty that tackles a wide spectrum of diseases involving themale and female urinary tract, themale reproductive system, andthe 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 aresurgeons, a significant part of the urologic practice also involvesmedical management of disease (i.e. no knife).

The American Urologic Association (AUA), the governing body for the specialty, divides Urology intoseven 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 proceduresthat 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
 

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