UROLOGY

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Our unique offerings in urology include the following among many others that are not listed. These and many more are available at our centre right here in Lagos, Nigeria :

Transrectal Ultrasound Guided Prostate Biopsy.

A prostate biopsy uses transrectal ultrasound (through the rectum’s lining) imaging to guide several small needles through the rectum wall into areas of the prostate where abnormalities are detected.

The needles remove a tiny amount of tissue.

Usually six or more biopsies are taken to test various areas of the prostate. The tissue samples are then analyzed in a laboratory.

The results will help doctors diagnose disorders and diseases in the prostate.

If cancer is identified, the doctor will be able to grade the cancer and determine its aggressiveness or likelihood of spreading.

Direct Visualization and Internal Urethrotomy and Open Urethral Stricture Repairs

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Internal urethrotomy involves incising the stricture transurethrally using endoscopic equipment.

The incision allows for release of scar tissue.

Success depends on the epithelialization process finishing before wound contraction significantly reduces the urethral lumen caliber.

Cystoscopy

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Cystoscopy is endoscopy of the urinary bladder via the urethra. It may employ either a rigid or a flexible cystoscope and may be performed for either diagnostic or therapeutic purposes.

Monopolar and Bipolar transurethral resection of Bladder Tumor with Narrow Band Imaging

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Endoscopic treatment with transurethral resection of bladder tumor (TURBT) is the first-line treatment to diagnose, stage, and treat visible bladder tumors. In select patients, office-based fulguration of small tumors allows control of low-risk lesions without incurring the cost and inefficiencies of the operating room

According to Olympus, Narrow Band Imaging (NBI) is a powerful optical image enhancement technology that improves the visibility of blood vessels and other structures on the bladder mucosa. This makes it an excellent tool for diagnosing bladder cancer during cystoscopy.

White light is composed of an equal mixture of wavelengths. The shorter wavelengths only penetrate the top layer of the mucosa, while the longer wavelengths penetrate deep into the mucosa. NBI light is composed of just two specific wavelengths that are strongly absorbed by haemoglobin.

The shorter wavelength in NBI is 415 nm light, which only penetrates the superficial layers of the mucosa. This is absorbed by capillary vessels in the surface of the mucosa and shows up brownish on the video image. This wavelength is particularly useful for detecting tumours, which are often highly vascularised. The second NBI wavelength is 540 nm light, which penetrates deeper than 415 nm light. It is absorbed by blood vessels located deeper within the mucosal layer, and appears cyan on the NBI image. This wavelength allows a better understanding of the vasculature of suspect lesions.

Monopolar and Bipolar transurethral resection of the Prostate

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The premier treatment for symptomatic benign prostatic hypertrophy (BPH) was transurethral resection of the prostate (TURP). TURP was the first successful, minimally invasive surgical procedure of the modern era.

To this day, it remains the criterion standard therapy for obstructive prostatic hypertrophy and is both the surgical treatment of choice and the standard of care when other methods fail.

During this procedure the prostate is essentially shaved down using specialized equipment with an incision.

The major advantage of Bipolar technique is that it permits the use of saline (an isotonic fluid) as an irrigant.

This significantly lowers the risk of hyponatremia and the complications associated with glycine use in monopolar TURP.

Ureteroscopy and holmium laser lithotripsy for kidney stones

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Ureteroscopy is defined as upper urinary tract endoscopy performed most commonly with an endoscope passed through the urethra, bladder, and then directly into the upper urinary tract.

Indications for ureteroscopy have broadened from diagnostic endoscopy to various minimally invasive therapies.

Technological advancements have led to broader indications while minimizing peri-operative complications resulting in efficacious access to the upper tract.

Flexible ureteroscopy allows access to all parts of the upper urinary tract and can be employed for the treatment of ureteral and kidney stones.

Endoscopic lithotripsy, treatment of upper urinary tract urothelial malignancies, stricture incisions, and ureteropelvic junction obstruction repair are all current treatments facilitated by contemporary ureteroscopic techniques.

Because the application of ureteroscopic procedures has evolved from a diagnostic tool to a facilitator in complex therapeutic interventions, a proportional increase in the rate and severity of complications would be expected.

However, with improved instrumentation and evolution of surgical technique, the complication rate associated with ureteropyeloscopy has actually decreased significantly.