Common Urological Investigations
A mid-stream urine (MSU) is caught to look for infection in the urine.
Urinary cytology, often performed 3 times as early morning specimens, looks for abnormal cells suggestive of cancer.
Urinary flow rate
This specialized machine measures how fast your urine flow is, which gives an estimation as to degree of blockage is present.
Post-void residual urine volume
An ultrasound is used to assess how much urine remains in the bladder after urination.
A small camera is passed via the urethra to look inside the bladder. This is usually done with local anaesthetic gel.
CT or Ultrasound of the abdomen and pelvis
Depending on the indication, a CT or ultrasound in a radiology department, is used to visualize the kidneys, ureters, and abdominal and pelvic organs. This may involve injection of radiological contrast.
Multiparametric MRI prostate
If prostate cancer is suspected, MRI can help locate a lesion within the prostate, and sometimes show if there is extension outside of the prostate.
Guided biopsy of the prostate: Under anaesthetic, local or intravenous sedation, an ultrasound is placed into the rectum to visualize the prostate. Then a needle takes multiple cores of the prostate for the pathologist to examine under the microscope for presence of cancer.
Common Urological Procedures
A brief explanation of our common procedures is outlined below. Details specific to your case will be discussed in person with your urologist.
Rigid cystoscopy with biopsy
Transurethral resection of bladder mass (TURBT)
Under anaesthetic, a camera is placed via the urethra into the bladder. Any suspicious areas or masses are biopsied or removed using diathermy.
Bladder stone – holmium lasertripsy
Transurethral resection of prostate (TURP) or laser ablation of prostate
Under anaesthetic, a camera is placed via the urethra into the bladder. The prostate that encircles and occludes the urethra is removed or vaporized, opening up the channel for urine to be passed.
Radical prostatectomy: robotic-assist, laparoscopic or open
The aim of this procedure is to remove the entire prostate with the cancer. Traditionally, this was done via a midline incision (open). More recently, minimally invasive approaches using keyhole surgery, such as laparoscopic and robotic-assisted laparoscopic instruments have been utilized. After the prostate is removed, the bladder is joined to the urethra. The nerves responsible for erectile function lie very close to the prostate and can be injured during the operation.
Kidney and Ureter
This involves removal of the entire kidney for cancer. Depending on the size, location and type of the tumour, partial nephrectomy is not appropriate. If possible, laparoscopic (keyhole surgical approach) surgery may be used. Otherwise, the kidney will be removed via a larger incision.
For some renal masses, it may be possible to remove the mass and preserve the surrounding kidney. This depends on the size, location and type of the tumour. Similarly, a laparoscopic or open approach may be used.
Ureteroscopy or pyeloscopy
A small camera may be passed up through the urethra, bladder and into the ureter (and up to the kidney if required). This can be done as a diagnostic procedure (to look for a cause). The camera can also be used to take biopsies, and fragment stones (laser lithotripsy).
Extracorporeal shockwave lithotripsy (ESWL)
A non-invasive technique under anaesthetic, ESWL uses a focused acoustic pulse (sound wave) to break up or fragment stones.
Percutaneous Nephrolithotomy (PCNL)
A more invasive technique to remove complex, large (staghorn) kidney stones. Under anaesthetic, the kidney is punctured allowing a tract to be dilated between the skin to the kidney. The stones are then fragmented and extracted through the tract.
Testis and Scrotum
Repair of hydrocoele
Through an incision in the scrotum, the scrotal sac lining (tunica vaginalis) that contains the fluid is opened and partly removed to prevent recurrence.
The testis containing the mass is delivered to an incision made in the groin. A length of the spermatic cord (containing blood vessels and lymphatics in and out of the testis) is removed with the testis.