Prostate and Urethra

This is not an exhaustive list but includes some of the common procedures carried out by Ipswich Urology.

Flow test - (uroflowmetry) is a special investigation performed in the clinic to measure urinary flow. This is usually performed in conjunction with a post-micturition bladder scan (measures the amount of urine left in the bladder after passing water). Patients are requested to attend with a comfortably full bladder and pass urine, in private, into the flow machine. The results are helpful in assessing the cause of urinary symptoms and advising on treatments. This test is mainly used for males.

TRUS and prostate biopsy - Trans Rectal UltraSound is a method for scanning the prostate. This uses a narrow lubricated ultrasound probe which is passed gently into the rectum (back passage). The prostate can be visualised and measured and this technique also allows a needle to be guided directly into the prostate under local anaesthetic in order to take prostate biopsies (removal of pieces of tissue to send for microscopic examination). This procedure is performed when there is a suspicion of prostate cancer.

Urethrotomy - is a procedure to open up a stricture (scarred narrowing) of the urethra (waterpipe). It is performed under general anaesthetic using a cystoscope (telescope) and involves making an incision with a special knife mounted on the scope.

Urethral dilatation - is another technique for opening a narrowing of the urethra (waterpipe). This involves passing a series of metal dilators down the urethra under a general anaesthetic. A specialist will decide which treatment is appropriate.

TURP - Trans-Urethral Resection of the Prostate is an operation performed to remove the central portion of the prostate in order to remove obstruction and improve urinary symptoms or men who have suffered a complete urinary stoppage (retention of urine). This procedure is carried out under a general or spinal anaesthetic using a cystoscope (telescope) passed down the urethra (waterpipe) to the level of the obstructing prostate. A wire loop is used to resect (ream / cut away) small chips of prostate, in order to make a clear and open channel to the bladder. The chips are washed out at the end of the procedure and a catheter is inserted (drainage tube passed down the penis into the bladder). The catheter is removed after a day or two and patients are usually in hospital for 3-4 days. This can be a very successful procedure. A consultant needs to judge whether this is an appropriate procedure for each patient.

Radical prostatectomy - is an operation to remove the whole prostate and its capsule (outer coating) for the purpose of treating early prostate cancer. This can be performed as an open or laparoscopic (keyhole) operation. There are important issues for the patient making a choice of treatment for prostate cancer and a consultant would discuss these in great detail before making a final decision. Some patients will choose radiotherapy or initial active surveillance as the treatment for prostate cancer.

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