Urology Treatments
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Urology Treatments

New Urolift procedure available at Duchy Hospital

The Urolift is a new procedure to treat enlarged prostate problems or benign prostatic hyperplasia (BPH).  It’s a revolutionary treatment which provides rapid and durable relief from the symptoms associated with BPH and has been clinically proven to be safe and effective.  It provides an alternative for patients looking for an alternative to drugs or major surgery.

The Urolift procedure is minimally invasive treatment which lifts or holds the enlarged prostate tissue out of the way so that it no longer blocks the urethra.  There is no cutting, heating or removal of prostate tissue.  Patients normally experience symptom relief as early as 2 weeks post-op.  Typically, there is no overnight stay and no catheter is required.

Cystoscopy

When a urologist performs a cystoscopy, they are investigating, and treating if necessary, problems of your bladder and urinary system such as: urinary incontinence, needing to urinate often, irregularly, or not at all, pain or a burning sensation when urinating, blood in your urine and pelvic pain.

A cystoscopy involves the insertion of a cystoscope (a thin, lighted tube with lenses) into your urethra and then into your bladder. It’s also known as a cystourethroscopy. Water or saline is passed through the cystoscope into your bladder and as it fills the bladder wall is stretched allowing your urologist to see clearly.

Most frequently a flexible cystoscope is used to look inside your bladder. A rigid cystoscope may be used to obtain a biopsy or perform treatment.

A cystoscopy will detect and treat any blockages and abnormal tissue including: a narrowed or blocked urethra, polyps, an enlarged prostate gland, bladder stones, urinary tract infections and urinary tract cancers.

TURBT

If you’ve had a cystoscopy that’s indicated a bladder tumour, a transurethral resection of a bladder tumour (TURBT) is often the next step to investigate and treat the bladder tumour. A tumour is an abnormal growth of the body’s tissue cells and can be classified as benign (not cancer) or malignant (cancer).

During a TURBT the tumour will be cut away from your bladder wall and sent off for cancer examination. Your urologist will be able to advise on treatment once they have the results and they know if it’s benign or cancerous, and if so how far it’s advanced.

Benign bladder tumours continue to grow slowly and can become very large so that they take up too much space in your bladder and start to press on other organs in your body. For these reasons, it’s likely that your urologist will recommend the tumour is removed.

Malignant tumours also continue to grow and surrounding tissue can also be attacked by the malignant tumour or the cancer can spread into other areas of the body. Your consultant will discuss the best course of treatment for you.

Treatment of bladder cancers

Treatment of bladder cancer depends on the stage of cancer and other factors. They may be combined to get the best results and include:

  • Surgery - removes the cancer cells. It’s normally part of the treatment for bladder cancers. Early-stage bladder tumours may be taken away or the whole bladder (radical cystectomy) may be removed.
  • Intravesical therapy - a liquid drug is passed through a catheter into the bladder.
  • Chemotherapy – drugs to treat cancer. Can be localised or for the whole body.
  • Radiation therapy – high-energy radiation used to kill the cancer cells.
  • Immunotherapy - medicines that encourage the immune system to recognise and destroy cancer cells.

Prostate biopsies

The prostate is a small gland located under the bladder. Its function is to make semen.

A prostate biopsy removes some prostate tissue samples to allow them to be investigated for signs of prostate cancer. It’s recommended if you’ve symptoms such as high levels of prostate-specific antigen (PSA) in the blood or a lump in the prostate gland.

A prostate biopsy can be performed by one of three ways:

  1. trans-rectal (most often used - through the rectum)
  2. transurethral (through the urethra)
  3. perineal (through the skin between the anus and the scrotum called the perineum).

TURP

If your prostate is enlarged, putting pressure on your bladder and urethra and causing difficulties with passing urine, you may have a common condition called benign prostatic hyperplasia (BPH). A transurethral resection of the prostate (TURP) may be advised to treat BPH by removing part of your prostate.

It’s normally carried out under general or spinal anaesthesia. It involves passing a thin metal tube with a light source, camera and loop of wire, called a resectoscope, along your urethra to your prostate. The loop of wire is then heated and a section of your prostate gland is cut away.

Adult circumcision

Adult circumcision is the surgical removal of the foreskin from the penis under general anaesthetic. 

It’s performed for religious, cultural or medical reasons including: tight foreskin (phimosis), the recurrent inflammation and infection of the foreskin and penis head (balanitis), the foreskin doesn’t go back to its original position (paraphimosis), a dermatological condition of the penis head (balanitis xerotica obliterans) and penile cancer.

The NHS offers circumcision surgery with restrictions and waiting lists. Duchy Hospital can perform adult circumcision without restrictions or waiting.

Penile straightening

Penile straightening is surgery to correct the curvature of a penis. It’s performed if the penis bends too much whilst erect to permit penetration during sexual intercourse. It’s thought to occur due to diseases such as Peyronie’s disease and congenital curvature of the penis.

Penile straightening surgery uses a plication procedure that shortens the longer side of the penis to straighten it. It’s performed under general or spinal anaesthetic.

Treatment for stress incontinence

Stress incontinence is when you lose urine without meaning to during physical activity, such as coughing, sneezing, laughing, lifting or exercise.

It’s caused by the sphincter pelvic muscles, which support the bladder and urethra, being weakened and unable to prevent urine from flowing when pressure is placed on the abdomen. It may also occur from weakened pelvic muscles that support the bladder and urethra.

Treatment depends on how severe your symptoms are and how much they are affecting your daily life. Pelvic floor muscle exercises, bladder retraining and medications may be recommended at first. If these aren’t successful, then surgery may be advised. There are many surgical options:

  • Anterior vaginal repair - for women with a bulging bladder into the vagina (called a cystocele).
  • Artificial urinary sphincter – replacement of sphincter, most often in men.
  • Collagen injections – to make the area around the urethra thicker and help control urine leakage.
  • Sling - to support the bladder neck.
  • Colposuspension – bladder and urethra is lifted and stitched.
  • Tension-free vaginal tape - to hold up the urethra in the correct position.

Vasectomy

A vasectomy is an effective and permanent form of male contraception. It’s a minor, safe surgical sterilisation carried out under local anaesthetic. The two tubes that carry sperm from the two testicles to the urinary tract, called vas deferens, are surgically cut, blocked and sealed so that sperm can’t pass through into the semen and be released to fertilise a woman's egg during sexual intercourse.

A vasectomy can be performed on the NHS but there’s normally a wait. Here at Duchy Hospital we can carry out a vasectomy without having to wait.

Vasectomy reversal

Vasectomy reversal is performed to reverse male sterilisation and allow men to become fertile again.

Here at Duchy Hospital our surgeons can re-join the previously separated vas deferens tubes with microsurgical techniques and fine sutures, known as micro-surgical vasectomy reversal.

A vasectomy reversal is not available on the NHS as a vasectomy is considered a permanent method of birth control.