Technology
CT Scan | Radiation | da Vinci® Robotics | HIFU |Microsurgery |Lithotripsy | Laparoscopy | Cryotherapy | Urodynamic | Minimally Invasive Surgery | BPH Therapy
CT Scan
What is a CT scan?
A CT scan creates 3D images of the body from x-rays taken at a variety of angles. This creates cross-sectional images of the body that can be used to detect infections, tumors, blood clots and cysts.
How are CT scans used in urology?
CT scans allow us to view organs in your abdomen and pelvis. These scans can be used to diagnose kidney stones, recurrent urinary tract infections, renal cysts and prostate, bladder and renal cancers.
What type of CT scan do you use?
We use the GE LightSpeed® CT scanner. Introduced in 1998, this was the world?s first multi-slice scanner. This system provides us with a special feature of variable-speed scanning, which allows greater flexibility to customize patient procedures and perform new types of exams. CT scans that used to take three minutes can now be completed in twenty seconds!
What are the benefits to the patient of using this machine?
- Better cross-sectional displays and 3D images
- Fast, accurate scan times
- Breathing lights assist patients in remaining motionless for the exam
- Automated dose-reduction
Radiation
What is radiation?
Radiation therapy is a common treatment for a variety of cancers. By focusing high doses of radiation on the areas being treated, the genetic material of the cells is no longer able to grow. Radiation damages both normal and cancer cells, but the normal cells are often able to repair themselves, while the cancer cells cannot.
What are the side effects of radiation therapy?
Side effects include:- Loss of appetite
- Hair loss near the treated area
- Fatigue
- Skin darkening in the area exposed to the radiation beam
- Nausea
- Diarrhea
- Vomiting
- Painful urination
- Erection problems in men
- Vaginal dryness in women
Side effects generally go away once treatment is completed, but some possible effects are long-term, such as:
- Abdominal cramps
- Diarrhea
- Chronic rectal or bladder irritation
- Skin changes
- Vaginal scarring
- Bowel obstruction
How long does radiation therapy last?
It depends on the type of the radiation therapy, the stage of the cancer, and other personal factors. Normally it lasts for at least a couple months with several treatments per week.
da Vinci® Robotics
What is the da Vinci® Surgical System?
The da Vinci® Surgical System is a computer-enhanced surgical tool. We have six surgeons trained to use this system.What is my surgeon’s role if the “robot” is operating?
The robot doesn’t really perform the operation, the surgeon does. The surgeon manipulates the robotic arms of the da Vinci® Surgical System to execute the necessary steps of the procedure. Your surgeon will sit at the console, right next to you, and manipulate the ergonomically designed controls that move the robotic arms.What are the benefits of using this robotic surgical system?
There are many benefits to using the da Vinci® Surgical System. The controls are ergonomically designed, reducing fatigue during long procedures. The InSite® Vision System magnifies the operating area and provides 3-D visualization, improving your surgeon’s visual field. Also, the mechanical arms have a greater range of motion than the human wrist, which make their movements more precise.
These technical advances can help with your post-operative recovery. By reducing blood loss and creating smaller incisions, you may experience less post-operative pain and scarring, as well as a shortened hospital stay and quicker recovery.
HIFU
What is HIFU?
HIFU stands for high intensity focused ultrasound. This noninvasive treatment uses precision-focused ultrasound waves to heat and destroy targeted prostatic tissue without bothering healthy surrounding tissue. HIFU has been used effectively to treat BPH (Benign Prostatic Hyperplasia) and localized prostate cancer.What can I expect during treatment?
HIFU can be performed on an outpatient basis while under anesthesia. Each treatment takes 1-3 hours. Following treatment, a catheter is necessary for about one week. Within a few days, you are able to resume normal activity.
Microsurgery
What is microsurgery?
Microsurgery is a general term for procedures using a surgical microscope.Laparoscopic surgery is an example of the type of microsurgery that our practice performs.
Lithotripsy
What is lithotripsy?
Lithotripsy is a procedure to relieve kidney stones by using an instrument, probe or machine to break up the stones into tiny pieces so they may pass naturally.When is a lithotripsy performed?
Lithotripsy is an effective means of treating kidney stones depending on the size of the stones, their location and your medical condition. This procedure is most successful for stones located in the upper ureter or kidney. A different procedure is typically recommended if you have very large stones.What different forms of lithotripsy may be performed?
Ultrasonic lithotripsy breaks up the kidney stones using high-frequency sound waves sent through an electronic probe into the ureter. Afterward you may pass the fragments or they may be removed surgically.Electrohydraulic lithotripsy (EHL) breaks up smaller kidney stones using shock waves generated by electricity. EHL can be used on stones anywhere in the urinary system. This procedure does require general anesthesia. Afterward you may pass the fragments or they may be removed surgically.
Extracorporeal shock wave lithotripsy (ESWL) breaks up kidney stones with highly-focused impulses projected from outside the body. This procedure works on stones anywhere in the urinary system. The stones are usually broken up enough to pass naturally, although multiple treatments may be necessary. ESWL is not recommended for pregnant women, stones over one inch in diameter, or struvite stones.
What can I expect during treatment?
Your doctor will give you a sedative and general or regional anesthesia for the procedure. Lithotripsy takes over an hour and may require multiple treatments.
Laparoscopy
What is laparoscopic surgery?
Laparoscopic surgery is a modern surgical technique that allows the procedure to be performed through a small incision with the aid of a laparoscope. The laparoscope, which normally carries a cold light source, allows the surgeon to clearly see into the surgical field. CO2 is used to inflate the inside of the abdomen to allow the surgeon more working room during the procedure.What are the risks associated with laparoscopic surgery?
As with any surgical procedure, there are several risks involved. Some of the particular risks with laparoscopic surgery are hypothermia, electrical burns and hemorrhaging. If certain complications arise during surgery, your surgeon may decide to switch to open surgery.What are the advantages associated with laparoscopic surgery?
Laparoscopic surgery has the potential to minimize post-operative pain and decrease recovery times. This procedure also provides an improved visual field for the surgeon.
Cryotherapy
What is cryotherapy?
Cryotherapy is a method for treating prostate cancer in which the cancer tissue and cells are frozen and destroyed by exposing them to extreme icy temperatures.How is cryotherapy done?
An ultra-thin metal probe or needle is inserted into the prostate gland. Next, a freezing liquid (liquid nitrogen or argon gas) is sent through the probe into the prostate, freezing and destroying any cancerous tissue. The surgeon uses the aid of an ultrasound to visually guide the process and limit the damage to normal prostate tissue.What are the risks of cryotherapy?
There are several risks associated with this treatment, including:
- Impotence
- Incontinence
- Injury to the urethra and bladder, which could lead to further infection
- Obstruction or blockage of the urethra
- Recurrence of prostate cancer
What are the advantages of cryotherapy?
Since cryotherapy is noninvasive, it holds several advantages over other treatments for prostate cancer, including:
- Shorter hospital stay (one or two nights)
- Quicker recovery time
- Less blood loss
- Less swelling and pain
Urodynamic
What is urodynamic testing?
Urodynamic tests are performed to check for urinary incontinence and evaluate your bladder’s efficiency and function.Why is urodynamic testing done?
Urodynamic tests may be performed when:
- You have moderate to severe involuntary urination
- Your doctor suspects there are multiple causes for your incontinence
- Other tests to do not determine the cause of your incontinence
- You are considering having surgery
How are urodynamic tests performed?
For basic testing, you should arrive with a full bladder. You will urinate into a container while the volume of urine and the rate at which the bladder empties are measured. Next, a catheter is inserted into the bladder to measure the volume of any remaining urine. At this point, the bladder may be filled with water through the catheter until you have the first urge to urinate. More water may be added, while you resist urinating, until involuntary urination occurs.
Minimally Invasive Surgery
What is minimally invasive surgery?
Minimally invasive surgery refers to any procedure that is done through small incisions, using the aid of miniature microscopes, high-definition monitors, and/or small fiber-optic flashlights. The incisions made for a minimally invasive procedure require only a stich or two to close.What are some examples of minimally invasive procedures that your practice performs?
What are the benefits of minimally invasive surgery?
- Less trauma to the body
- Less blood loss
- Less need for pain medication
- Shorter hospital stay
- Shorter recovery time
- Smaller surgical scars
BPH Therapy
What is BPH?
BPH stands for benign prostatic hyperplasia, the medical term for an enlarged prostate. BPH is more than too many prostate cells. It involves hormones and occurs in different types of tissue.How is BPH treated?
There is no cure for BPH, but once treatment is started, growth is generally halted. Due to different ways BPH affects the individual, there are multiple types of treatment. Frequently, minimally invasive treatments will suffice.
What are the different kinds of treatment?
Medical Treatments
Alpha-adrenergic receptor blockers, such as Hytrin®, Cardura® and Flomax®, relax muscles around blood vessels within the prostate and bladder. This increases urinary flow and relieves urinary frequency and nocturia.Side effects include dizziness, fatigue and headaches. Flomax, since it focuses more on the prostate, has fewer side effects than Hytrin or Cardura, but some studies show that it may be less effective.
5-alpha reductas inhibitors, such as Proscar® (finasteride), obstructs the conversion of testosterone to dihydrotestosterone. This causes the prostate to shrink in size, thus reducing the BPH symptoms and increasing urinary flow rates.
Side effects include impotence, decreased libido and decreased volume of ejaculate. However, these side effects will go away once you stop taking your prescription.
Herbal medications have become popular recently. The most commonly used herbal treatment is Saw palmetto. Since this is an anti-inflammatory, it reduces the swelling of the prostate. Limited studies have been performed to test its effectiveness.
Minimally Invasive Procedures
The Prolieve® System is a medical device that can be used in-office to both heat the prostate and dilate the prostatic urethra to treat the symptoms of BPH.
During treatment, your physician will insert a catheter into your urethra, which will circulate water throughout the procedure. Microwave energy will be transmitted to a special antenna inside the catheter, heating the prostate and reducing the enlarged tissue. The procedure only takes 45 minutes.
Side effects with the Prolieve System include anal irritation, bleeding, bowel irritation, bladder spasms, urinary tract infection, urinary incontinence, retrograde ejaculation, pressure sensation, prostatitis, urethral irritation, erectile dysfunction, urinary clot retention, chronic pain at the procedure site, urinary urgency, and complete or incomplete urinary retention.
Prostiva RF Therapy, formerly known as transurethral needle ablation of the prostate (TUNA), heats the enlarged, inner part of the prostate to very high temperatures, shrinking the prostate and opening the urinary channel. The device used to perform this procedure is computer-controlled and uses radiofrequency energy to generate heat. Prostiva therapy can be performed in-office and usually takes only 30 to 60 minutes.
Side effects include decreased volume of ejaculate, urinary retention, urinary infection, burning with urination, frequent urination and a slower urinary stream.
Transurethral resection of the prostate (TURP)
TURP is the most common surgery to remove part of an enlarged prostate. During the procedure, an instrument is inserted up the urethra to remove the section of the prostate blocking urine flow. This is done using general or spinal anesthetic and commonly requires staying in the hospital for a day or two. Constipation, sexual activity and strenuous activity should be avoided for at least six weeks following the procedure.
Side effects include incontinence, problems with sexual performance and problems from surgery.
GreenLight™ Laser Therapy
GreenLight is a BPH treatment option that combines the effectiveness of TURP with fewer side effects. The procedure evaporates the prostatic tissue blocking the outlet of the bladder. GreenLight is generally performed under anesthesia as an outpatient procedure.
During the procedure, a telescope is inserted into the urethra up to the prostate. A laser fiber is then guided through the scope, gently vaporizing the prostate tissue.
