Urology

Urology is a surgical medical science that deals with the urinary tract and male reproductive organs of men and women and deals with diseases of these systems. In summary, all kinds of discomfort related to the following limbs are of interest to urology.

  • Kidneys
  • Urinary channels
  • Bladder
  • Prostate gland
  • Semen channels
  • Urine tube
  • Testicles

Urology deals with both adult and pediatric patients. Sub-branches of urology can be listed as follows:

  • Pediatric Urology
  • Andrology (diagnosis and treatment of sexual dysfunctions)
  • Urological oncology (Uro-oncology)
  • Female urology – Urogynecology
  • Neuro-urology (Neurourology)
  • Kidney Diseases

Andrology (diagnosis and treatment of sexual dysfunctions)

Andrology is a branch of medicine that studies the fields of male and female sexual health and male infertility. Areas of interest may be listed as:

  • Erection defects in men
  • Female sexual dysfunctions
  • Male infertility

Erection Defects In Men

Erectile dysfunction is a common problem that affects one in ten men.

An erection problem is defined as an inability to reach a level of hardness that can provide successful sexual contact, or an inability to adequately maintain this level of hardness. It appears more often in men over the age of 40. Other sexual functions of men who experience erectile problems are often normal.

Causes of erectile dysfunction can be listed as:

  • Psychological causes: psychological causes include depression, stress and anxiety.
  • Vascular diseases
  • Diseases of the nervous system
  • High blood pressure and diabetes
  • Smoking
  • Medications: many medications used for high blood pressure, heart disease, and psychiatric diseases can be the cause of erectile problems.
  • Hormonal causes:

Erectile dysfunction can only be diagnosed after a doctor’s examination. Information obtained from the patient and physical examination are often diagnosed. Some simple tests may be requested to help diagnose.

The choice of treatment method depends on whether the cause is physical or psychological. If the problem is psychological, the help of psychologists specializing in sex therapy should be sought.

There are 4 main treatment methods used for erectile problems due to physical causes:

  • Oral medications
  • Vacuum device
  • Injection into the Penis: vein expander drugs are injected with the help of a thin needle. These drugs act by loosening the penile tissue and dilating the vessels
  • Penis prosthesis: the Penis prosthesis consists of two synthetic cylinders inserted into the penis by surgical intervention. The prosthesis does not affect the act of urinating and sexual functions such as ejaculation, orgasm

These treatment methods do not eliminate the cause. But it ensures that the level of erection that will allow sexual contact is reached.

Female sexual dysfunctions (reluctance, pain syndromes, arousal disorders, etc.)

Sexual dysfunction can occur for a variety of organic and psychological reasons. The incidence in women is 40%. Sexual dysfunctions in women are grouped as follows.

* Sexual desire disorders (disgust, etc.)

it can be seen as a lack/absence of sexual desire or even as an aversion to sexuality

it can occur for organic and psychological reasons.

sexual disgust, on the other hand, can be against sexual activity, genitals, or fluids. Causes include obsessions about developmental periods in childhood, false/inadequate sexual information, exposure to rape or trauma, inappropriate and abusive approaches to the partner, fear and anxiety about sexuality.

* Arousal disorders

in women who experience arousal disorder, there is not enough stimulation to enjoy foreplay and sexual intercourse. Causes include systemic diseases (such as diabetes), hormonal problems, menopause, drug use, nerve injuries that can occur as a result of surgical procedures.

* Painful Sexual Intercourse (Dyspareunia)

it is described as “dyspareunia ” in medical parlance and comes to understand the feeling of pain during sexual intercourse. 30% of women develop pain disorders after surgical attempts on the genitals, and 40% of women admitted to the clinic with this complaint have a medical problem with the reproductive organs.

• Vaginismus

O vaginismus; 1/3 of the outer part of the vagina during sexual intercourse stage is involuntary contraction and blocking the entrance of the penis. It can develop as a result of trauma, rape and undergoing surgical procedures. In addition, tissues formed in the area that are opened and stitched during childbirth can also occur due to inflammatory diseases of the genitals and Sexual Glands and vaginal changes in menopause.

vaginismus often occurs for psychological reasons or depending on the conditions of upbringing. It requires medical treatment, psychotherapy and sexual therapy.

In sexual dysfunctions, a treatment method is applied that will first eliminate the justification by determining the justification.

There is a range of treatments ranging from device therapies such as medication or vacuum to psychotherapy. Studies on new treatment methods are ongoing.

Male infertility (infertility)

Infertility is generally defined as the inability to perform reproductive function.

Male infertility depends on many reasons. Disorders of Sperm production, blockages in sperm channels, presence of antibodies to sperm, testicular trauma, hormonal disorders, anatomical problems, varicocele, past diseases, infections and some medications can lead to infertility. In addition, smoking and alcohol use, elevated testicular temperature ( high fever, wearing tight pants, etc. causes) can also occur due to external causes, such as excessive weight and excessive exercise.

For the diagnosis of infertility, the patient’s medical history and habits ( smoking, etc.) are evaluated first. Then a physical examination is performed. Diagnosis is supported by examinations such as semen analysis, urine analysis, hormone analysis.

In general, treatment is done to address the source of the problem. Infections and hormonal disorders are treated with medication.

Varicocele is found in 60% of infertile men. Varicocele is treated if it affects sperm production or makes the testicle shrink. Varicocele surgery should be performed under a microscope. In this way, The Binding of small vessels that are not visible to the eye increases the success of the operation and prevents varicocele recurrence.

If the causes of stricture in the place where the Sperm channels open to the prostate are detected, it is opened by cutting endoscopically. Congestion zones at other levels are found and removed under a microscope.

Assisted reproductive techniques are used for pregnancy. The most common method of assisted reproduction is IVF

Urological Oncology

It is a sub-department of urology that deals with cancers of urological organs.

It is also possible to treat urological cancers when they are diagnosed at an early stage. Its main related fields are:

  • Prostate cancer
  • Bladder cancer
  • Kidney cancer
  • Testicular cancer

Prostate Cancer

Although the cause of prostate cancer, which occurs only in men, is not exactly known, age, race and genetic factors have been found to play an important role. Among these factors, age stands out as the most important factor. The incidence of prostate cancer increases significantly at the age of 50 and older.

Prostate cancer does not give any symptoms in some patients. In some patients, symptoms such as frequent, strong, painful urination; blood and inflammation in the urine; and drip urination may occur. But since these symptoms are not just prostate symptoms, you should definitely consult a specialist to be sure.

Because the prostate progresses very slowly, it can be treated with medication, so it can also be treated with surgery.

Bladder Cancer

Bladder cancer in the bladder that allows the discharge cells forming organs and the bladder is usually complete recovery is subject to early diagnosis and treatment of bladder cancer. It usually occurs between 50 and 70 years of age and is 3 times more common in men than in women. This disease is more common in smokers than in workers in the paint, chemical and tire industries. It often manifests itself through the appearance of blood in the urine. But staying in the urine is not just a symptom specific to bladder cancer.

The exact treatment plan for bladder cancer is organized according to the depth of spread of bladder cancer and the degree of aggression of cancer cells

As a result of the pathological examination of the parts of the forehead after this operation, the final diagnosis of bladder cancer and how far it has progressed will be determined.

Treatment of Superficial Bladder Cancer with low aggression is based on cleaning the bladder from cancerous tissue with tour-bladder tumor operation and washing the inside of the bladder with immunological or chemotherapeutic drugs to reduce recurrence rates.

In bladder cancer that has spread to the muscle layer with high aggression, the method of completely removing the bladder and inserting a new bag made from the intestine instead of the old bladder is often used to accumulate urine Nov.

Kidney Cancer

Kidney cancer usually occurs between the ages of 50 and 70. It is 2 to 3 times more common in men than in women. The cause of kidney cancer is not yet fully known. However, smoking, genetic factors, high blood pressure, obesity, occupational risk factors ( steel industry, petroleum, cadmium, lead industry employees) and risk factors such as radiation exposure.

Kidney cancer does not initially give many symptoms. But as the tumor progresses, symptoms such as blood in the urine, pain, loss of appetite, weight loss, recurrent high fever, high blood pressure, and anemia appear.

Surgery is the main treatment for kidney tumor. Radiation therapy can be used to support surgery.

Testicular Cancers

Is the most common cancer in young men between the ages 19-44 years. It accounts for 1% of cancers seen in men. It is more common in Caucasian men than in other races.

The most common symptoms are pain, mass or growth in any testicle. In testicular cancer, chemotherapy can be used after surgery by urologists.

Female Urology ( Uroginocology)

His main interests are:

  • Involuntary urinary incontinence
  • Overactive bladder
  • Pelvic organ sagging

Involuntary Urinary Incontinence

The bladder (bladder) has two important functions. One is storing urine and the other is emptying it. Urinary incontinence occurs when the function of storing urine is disrupted. This condition may not always be caused by the bladder. Blockages in the last part of the urinary tract, urinary tract infections, and damage to the urinary retention mechanism also cause various types of urinary incontinence.

Urinary incontinence, which occurs especially in women during laughing, coughing and heavy lifting, is a fairly common disorder. This condition usually occurs in women who give birth in large numbers or difficulty, or as a result of the relaxation of the muscles in the lower abdomen for various reasons. Excess weight also contributes negatively to this condition.

Urinary incontinence is a symptom, not a disease. Although it is not usually a harbinger of a dangerous situation, it negatively affects the person’s life.

By determining the causes, exercises or medication are first tried. Currently, there are quite effective drugs against this problem. The duration and dose of drug therapy varies from patient to patient. But stress does not respond to urinary incontinence-type medication.

Overactive Bladder

It is a condition that severely disrupts the quality of life. Individuals often go to the toilet with a frequency that will affect their daily life, and urinary incontinence also occurs in advanced cases due to sudden jams. Studies have reported that 60% of women between the ages of 20 and 70 may have this complaint at some time in their lives or continuously..

Pelvic Organ Sagging

Sagging of the bladder, uterus, breech and intestines can cause serious problems in both anatomical and everyday life. By strengthening the pelvic floor muscles, discomfort can be treated without surgery in the early stages with exercise and biofeedback treatments, while in the later stages it is now possible to save women from this problem with extremely simple surgical interventions.

Kidney Diseases

The kidney is this organ that performs the task of filtering harmful substances in our blood. The main disorders seen in the kidney are:

  • Nephritis
  • Albumin
  • Kidney stones
  • Uremia
  • Kidney cancer
  • Kidney failure

Nephritis

Inflammatory diseases of the kidney are called nephritis. This disease is one of the most important causes of kidney failure. It is divided into 2 as microbial and non-microbial nephritis.

Microbial Nephritis (Pyelonephritis)

Another name is an upper urinary tract infection. It is a disease that has a sudden onset, mostly caused by bacteria. The factor is rarely a virus or fungus.

Symptoms of microbial nephritis include:

  • Fire
  • Sweat
  • Shake
  • Lowing pain
  • Painful urination
  • Frequent urination
  • Urgent urination request

A definitive diagnosis is made with a urine culture.

With antibiotic therapy, usually results are obtained. If there is an abscess, surgery may rarely be required. With proper treatment, it is possible to treat the disease permanently and without damage to the kidney. In untreated or late cases, germs can mix into the patient’s blood, leading to the loss of the patient

* Non-Microbial Nephritis

It is a condition of inflammation in the glomerule ( a filter in which blood entering the kidney is filtered) or in the tubule (long, curved pipes in which filtered blood turns into urine).

Symptoms of non-microbial nephritis include:

O frequent urination

don’t wake up from sleep that night and urinate

high blood pressure

O loss of salt, sugar, amino acid, protein in urine

reduction in vitamin D and blood production hormone (Erythropoietin)

he’s anemic.

O deterioration in the balance of water and salt

it’s kidney failure.

Chronic kidney failure occurs in cases where it progresses rapidly, and the patient may need dialysis. Each patient has a different treatment method. According to the kidney biopsy, the form of treatment is determined.

Albumin

It is a disease caused by the fact that the urine filtration capsules in our kidney do not work with full efficiency.

Kidney Stones

If there is a blockage as a result of inflammation in the urinary tract found in a person, the substances here precipitate, forming kidney stones in our body. As a result, kidney stones also cause severe pain and bleeding in our kidney. Sometimes in this disease, urine has also been seen to come out bloody.

The vast majority of stones up to 5 mm can be reduced with medication and abundant fluid intake. As the size of the stone grows, the probability of non-interventional reduction decreases.

ESWL (breaking stones with shock waves from outside the body) is the most commonly used method of treating kidney stones. During treatment, the Stone breaks into small pieces, focusing on the shock waves created outside the body. It is then expected that these parts will be disposed of with urine.

Percutaneous Nephrolithotripsy (PNL) is a current method of endoscopic surgery applied when the stone in the kidney is larger than 2 cm or cannot be broken by ESWL. Under general anesthesia, the stones are removed from the same path as a whole or broken by entering the kidney through a path created from a 1 cm incision in the lumbar region.

Another surgical treatment method is ureteroscopy. In this method, the stones are broken by laser by entering into the urethra with instruments called ureteroscopes. The advantage of ureteroscopy is that ureteroscopes are curlable and therefore can even enter pockets in the kidneys.

Uremia

Harmful substances that are transported to the kidneys through blood and excreted in the urine are called urea. A disease that occurs when urea is not excreted in the urine and remains in the body is also called uremia. This disease occurs as a result of the kidney’s inability to adequately filter urea. Constant headache, blurred vision, hiccups, need to sleep during the day and insomnia at night are seen in the patient. It is a disease that needs to be treated without wasting time.

Kidney Cancer

Kidney cancer usually occurs between the ages of 50 and 70. It is 2 to 3 times more common in men than in women. The cause of kidney cancer is not yet fully known. However, smoking, genetic factors, high blood pressure, obesity, occupational risk factors ( steel industry, petroleum, cadmium, lead industry employees) and risk factors such as radiation exposure.

Kidney cancer does not initially give many symptoms. But as the tumor progresses, symptoms such as blood in the urine, pain, loss of appetite, weight loss, recurrent high fever, high blood pressure, and anemia appear.

Surgery is the main treatment for kidney tumor. Radiation therapy can be used to support surgery.

Kidney Failure

The main functions of the kidney are ensuring the balance of water, salt, calcium in the body, removing harmful substances and drugs from the body through urine, and their contribution to the metabolism of hormones, sugar. In kidney failure, these functions of the kidney are impaired. Kidney failure can develop in two ways: sudden (acute) or insidious (chronic).

Causes of acute kidney failure include:

  • Decrease in blood pressure as a result of heavy bleeding, vomiting, diarrhea, burns
  • Pregnancy poisoning, miscarriages in unhealthy conditions
  • Heart failure
  • Kidney diseases
  • Obstruction of the urinary tract
  • Surgeries performed
  • Acute renal failure due to medications is a common problem, and therefore medications should be used strictly under the supervision of a doctor.

Causes of chronic kidney failure include:

  • Nephritis
  • Diabetes
  • Hypertension
  • Diseases of the urinary tract, such as stones, blockages, tumors
  • Kidney cysts

Symptoms of kidney failure can be listed as follows:

  • Night urination
  • Weakness, shortness of breath, palpitations
  • Decrease in the amount of urine,
  • Hypertension
  • Swelling around the hands, feet and eyes
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