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Urology - Ealing Hospital services and surgeries

Services:

Outpatients clinics: clinics run daily and are both general and sub-speciality specific:

  • Stone clinic
  • Benign Prostatic Hyperplasia - enlarged non cancerous prostate condition which leads to difficulty on passing urine
  • Urinary incontinence - this includes assessing issues with passing urine unintentionally
  • Andrology service for erectile dysfunction, peyronies, testicular problems
  • General urology clinics
  • Trial without catheter: weekly clinic on Mondays
  • Bladder instillations: sodium hyaluronate - an instillation for re-current urinary tract  infections and bladder pain. Slots are available on Wednesday and Friday mornings
  • Urethral catheter insertion: slots are available for urethral catheter changes for patients who have special requirements or where the district nurses are unable to catheterise.

Surgery:

  • Renal stones treatments
  • Extracorporeal shockwave lithotripsy - an non-invasive treatment to use ultrasonic shockwave to break the stones, it requires no anaesthetic or insertion of cameras
  • Ureteroscopy - involves an anaesthetic and insertion of a camera to examine the ureter (the tube that connects the bladder and kidney)
  • Laser stone fragmentation - this involves an anaesthetic and insertion of a camera and an attachment to break renal tract stones up using a laser
  • JJ stent insertion and removal - a JJ stent is a plastic tube that may be required to help the kidney to drain, this can be for many reasons - most commonly to prevent kidney stones causing a blockage. They are inserted under anaesthetic but are usually removed under local anaesthetic in Endoscopy.
  • Percutaneous Nephrolithotomy  - removal of a kidney stone, using keyhole surgery
  • Laparoscopic urological surgery - simple nephrectomy removal of a kidney , PUJO - obstruction of the kidney,  varicocoele, undescended testicle (intra abdominal).
  • Prostate  surgery - transurethral resection of the prostate - removal of part of the prostate to help improve the urine flow
  • Trus biopsy - an ultrasound of the prostate where samples are removed to test for abnormal cells.

  • Urethral  surgery:
    Urethral dilatations – stretching of the water pipe to help urine flow.
    Urethrotomy – operation to relieve a narrowing (stricture in the water pipe)
    Meatoplasty – a small operation to open the opening of the water pipe (urethra)
    Urethroplasty – an operation to repair the waterpipe (urethra)       
  •  Bladder surgery:
    Bladder neck incisions – a small operation to loosen the opening to the bladder
    Transvaginal tape – this is an operation to help improve stress incontinence (urine leakage)
    Supra- pubic catheter insertion and changes – a catheter through the abdomen to drain urine
  • Endoscopy suite:
    Diagnostic flexible cystoscopy - a camera test under local anaesthetic to examine the water pipe and the bladder and the prostate in men.
    Botox - injected into the bladder for  some cases of incontinence when all other  treatments have failed
    Urethral dilatation - stretching of the water pipe
  • Investigations:           
    Urodynamic studies - a teat to assess the capacity and function of the bladder
    Flow rates - a test where the bladder is filled and then scanned to assess the volume. Urine is then passed into a special machine which provides a graph to allow assessment of the urine flow. A further scan is carried out afterwards to assess the amount of urine left in the bladder (post void residual)
  • Radiological imaging:
    Ultrasound, CT and MRI scans - these scans enable the urinary tract to be assessed and they provide images to enable accurate diagnosis and/or monitoring

  •  Practical teaching:
    Intermittent self catheterisation and dilatation - insertion of a plastic tube to enable urine to be drained or to stop the waterpipe shrinking (after a stricture)
    Vacuum device demonstration - a pump used to treat erection problems
    Caverject injections - injection into the penis to treat erection problems