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Urology service in Dubai
Laparoscopy
This involves performing operations through “Key-Holes”. Previously these operations needed large painful and ugly incisions with associated prolonged hospital stay and periods away from work. Good cosmesis, less pain, and quick recovery are attractive to the patient and at the same time, excellent lighting and magnified vision are advantageous to the urologist.
Lower Tract Endourology
Access to the lower urinary system through the natural urinary passage is called endourology. This technique utilizes modern endoscopes and cameras through which urethral strictures, bladder stones, prostate enlargement(BPH treated by TURP) and bladder tumours can be treated with a short hospital stay and minimal discomfort.
Upper Tract Endourology
Access to the ureter and kidney is also possible now either through the standard passage such as Ureteroscopy or RIRSor through a small “Keyhole” through the skin called PCNL(This way once again small and large stones, tumours and other conditions in the upper urinary system can be treated with minimal pain and scar.
Renal Transplantation
Renal transplantation services are currently in the preparatory phase. Dialysis, vascular access surgery (arteriovenous fistula creation), CAPD catheter insertion facilities are available. The necessary accreditation to commence renal transplantation is being sought as the hospital was commissioned only recently.
Surgical Management Of Urinary Tract Stones
1. Percutaneous Nephrolithotomy (PCNL)
2. Laparoscopic Pyelolithotomy
3. Flexible Ureteroscopy and LASER (RIRS)
4. Ureterorenscopy (URS).
5. Cystolitholapaxy
6. Percutaneous Cystolitholapaxy (PCCL)
Surgical management of urological cancers
Screening, In-Depth assessment and management of kidney, ureter, bladder, prostate, testis, and penis cancers including the latest treatment options, Transrectal ultrasound-guided prostate biopsies, intravesical chemotherapy and immunotherapy for bladder cancers
Paediatric Urology
The urinary tract is the commonest organ system affected by birth defects. These defects can affect organs from the external genitalia till the kidney. These children usually present with obvious external defects of the penis usually where the prepuceal skin is redundant (Phimosis) or the opening of the urinary passage is not at the tip of the penis (hypospadias). These can be corrected by surgery with excellent results if performed by experienced surgeons.
Female Urology
Women of all ages are more prone to urinary tract. Usually they present with burning urination, frequent urination and sometimes blood in the urine. They are treated immediately with antibiotics after collecting a urine sample and usually respond quickly. More common reasons that bring women to the urologist are severe urgency and frequency of urination sometimes associated with inability to control (urge incontinence).
Functional Urology
Patients of all ages from childhood to elderly can have obstructive or irritative urinary symptoms. Slow stream, incomplete emptying, urgency, frequency and loss of control of urine are symptoms they may suffer from. These may be due to bladder muscle dysfunction, bladder neck and prostate dysfunction or even due to diseases like Diabetes, Parkinson’s disease, stroke , dementia or even severe constipation.
Management of Urinary stones
Stones within the urinary tract are one of the commonest problems faced by Urologist and especially by patients in the Middle East. This is because of their young demographic, climatic conditions and dietary habits.
Stones can occur in the kidney, the ureter (tube that drains urine from the kidney to the bladder) and urinary bladder.
They usually present with excruciating pain on one side of the abdomen, nausea and vomiting, blood in the urine and sometimes with infection.
Management is usually in the emergency department where pain relief is the first priority followed by urine and blood tests and imaging by Ultrasound and CT scans.
Majority of stones usually are small and 6mm or less and can be treated by medical means.
If pain persists or stone does not pass or gets complicated by repeated symptoms, infection or worsening kidney function intervention is needed.
In the past this involved major operations. Over the last 30 years advances in technology and instrumentation have made treatments as outpatient or day care procedures. This has greatly benefitted patients in terms of comfort, loss of work days and prolonged recovery.
Current treatments include ESWL (Extracorpreal shock wave lithotripsy) for kidney and ureteral stones. Herein the patient lies on a couch and the stone is broken by sound waves delivered from outside. The stones fragment and pass out in the urine.
Stones in the ureter and bladder and kidney can also be extracted by endoscopy (passing fine instruments into any part of the urinary tract)under anesthesia, visualizing the stone and then grasping it out or fragmenting it under vision with lasers. Some times large stones in the kidney may need to be removed by “key-hole” surgery called laparoscopy and PCNL.(Percutaneous nephrolithotomy).
Strict hydration and dietary controls and follow up is needed to prevent further stone occurrence in all patients.