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Common Urologic Procedures
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At UrologyAustin, we provide the most advanced technology and treatment of urologic conditions. Our office is equipped with the latest equipment and our practice is dedicated to providing the latest techniques in minimally invasive therapies.
Common Urologic X-rays
 CT Scan
IVP (intravenous pyelogram)
KUB (kidneys, ureters, and bladder)
Renal Ultrasound
Scrotal Ultrasound
Cystoscopy
Retrograde Pyelography
Ureteroscopy
Lithotripsy
Transrectal Ultrasound
Biopsy of the Prostate
Common Urologic X-rays
CT Scan
A CT (computerized tomography) scan, also known as a CAT scan, is an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if necessary, three-dimensional images of the internal organs and structures of the body. The test is extremely valuable in examining the type and extent of kidney disorders, such as masses, stones and cysts.
What to expect: A large, donut-shaped x-ray machine will take images at several different angles around your body. These images are processed by a computer to produce cross-sectional pictures. Often, an intravenous contrast (or x-ray dye, an iodine-based liquid given in the vein) is used to make organs and structures, such as the kidneys and blood vessels, much more visible. If you are allergic to intravenous contrast, tell the CT technologist prior to the CT scan. If a CT scan of the abdomen or pelvis is ordered, oral contrast is usually given to help opacify the bowel.
IVP
An IVP (intravenous pyelogram) is performed to examine the kidneys, ureters and bladder. An intravenous contrast material is injected, and its progress through the urinary tract is recorded on a series of captured images. An IVP enables the radiologist to study the anatomy and function of the kidneys and urinary tract. If you are allergic to intravenous contrast, tell the CT technologist prior to the CT scan.
What to expect: You will lie on an examination table, and the contrast material will be injected, usually in a vein in your arm. After the injection, you may experience a flush of heat and a metallic taste in your mouth. These common side effects usually disappear within a few minutes and are no cause for concern. During the imaging process, you may be asked to turn from side to side and to hold several different positions. Near the end of the exam, you will be asked to empty your bladder so an additional film can be taken of your bladder after it empties.
KUB
A KUB (kidneys, ureters and bladder) is an abdominal x-ray performed to look for problems with the kidneys or bladder. The test can be useful in evaluating pain in the lower back on either side of the spine that may be caused by certain urinary tract problems.
What to expect: You will lie on your back on an x-ray table. After the x-ray machine is positioned over your abdomen, you will be asked to hold your breath and lie still while the x-ray pictures are taken. Sometimes only one picture will be taken while you are lying on your back. (This is the supine abdominal or KUB x-ray.) However, sometimes two pictures may be taken: one while you are lying down (supine view) and one while you are standing (erect view).
Renal Ultrasound
An ultrasound, also called sonography, is performed to examine the internal structures of the body using high-frequency sound waves. A renal ultrasound can be used to determine the size and position of the kidneys and to detect obstruction of the kidney, kidney stones or masses in the kidney.
What to expect: You will lie on your back on an examination table, and a clear, water-based gel will be placed on your abdomen to facilitate the transmission of the sound waves. The right kidney will be imaged by moving a transducer (a hand-held probe) over the right, upper abdomen. To evaluate the left kidney, you may have to roll toward the right to expose the left flank (the area on the side of the body between the rib and hip).
Scrotal Ultrasound
A scrotal ultrasound is performed to examine masses in the scrotum. It is also helpful in evaluating solid and cystic masses within the testes. This test will help differentiate potential cancers from less serious lesions.
What to expect: You will lie on your back on an examination table, and the scrotum will be elevated on a towel. Gel will be applied, and a transducer will be moved over the scrotum.
Cystoscopy (with or without retrograde pyelography)
Cystoscopy is a procedure that allows your doctor to view the inside of the bladder and urethra. The procedure can be used to diagnose bladder tumors and to identify obstruction of the bladder.
What to expect: Cystoscopy is usually performed as an outpatient procedure in your doctor's office or at a surgical center. Prior to the procedure, you will need to empty your bladder. You will then be positioned on an examination table. After administration of local anesthesia, a cystoscope (a thin, lighted tube) will be inserted through the urethra into the bladder. Water or saline will then be instilled into the bladder through the cystoscope. As the fluid fills the bladder, the bladder wall stretches, allowing detailed viewing by your doctor. If any tissue in the bladder wall appears abnormal, a small sample can be removed through the cystoscope for analysis. After the cystoscope is removed, the urethra may be sore, and you may feel a burning sensation for approximately 72 hours. If discomfort persists, fever develops or your urine appears bright red, contact your physician.
Retrograde Pyelography
Your doctor may perform retrograde pyelography in conjunction with cystoscopy if he or she is evaluating hematuria or recurrent or suspected cancer. Like an IVP, retrograde pyelography uses a contrast material to produce x-ray images of the ureters and kidneys. However, in retrograde pyelography, the dye is injected directly into the ureters rather than into a vein.
What to expect: Retrograde pyelography is performed on an outpatient basis and is usually done in the doctor's office or a surgical center. You may or may not require anesthesia. Cystoscopy is performed, and a small catheter is inserted into the opening of the ureter in the bladder. Dye is injected, and fluoroscopy (an imaging technique that takes a real time picture of the body) is performed to visualize the ureters and kidneys.
Ureteroscopy
Ureteroscopy is a procedure used to treat ureteral stones. It is considered the preferred method of treating lower ureteral stones and stones that cannot be treated with lithotripsy. (To learn about lithotripsy, please see below.)
What to expect: Ureteroscopy involves the use of ureteroscopes (small, flexible or semi-rigid telescopes) that can be inserted up the urethra, through the bladder and into the ureter without an incision. These instruments allow your doctor to view a ureteral stone. They also have small, working channels through which various devices can be passed to remove or fragment the stone. Anesthesia is generally used during the procedure, and occasionally a stent is left in the ureter for a few days while healing takes place. The majority of ureteroscopic procedures can be performed on an outpatient basis. Risks associated with ureteroscopy include perforation and the formation of stricture (scar tissue), especially if the stone has been impacted or embedded within the wall of the ureter for longer than two months.
Lithotripsy
Extracorporeal shock wave lithotripsy (ESWL®) is the most frequently used procedure for eliminating kidney stones. It works by directing ultrasonic or shock waves, created outside your body through skin and tissue, until they hit the kidney stones. The stones break down into sand-like particles that can be easily passed through the urine.
What to expect: Most devices for performing lithotripsy use either x-rays or ultrasound to help your doctor locate the stone(s). In most cases, shock wave lithotripsy is done on an outpatient basis without anesthesia. Although the procedure is considered safe and effective, it may still cause some complications. You will probably have blood in your urine for a few days after treatment. You may also experience bruising and minor discomfort in the back or abdomen as a result of the shock waves. Shattered stone particles may cause discomfort as they pass through the urinary tract. In some cases, your doctor may insert a stent through the bladder into the ureter to help the fragments pass.
Transrectal Ultrasound
Biopsy of the Prostate
A transrectal ultrasound is performed to evaluate men considered to be at risk for prostate cancer. Since early prostate cancer cannot be diagnosed with the ultrasound results alone, a transrectal ultrasound is usually performed with a simultaneous prostate biopsy. Transrectal ultrasound may also be used to obtain the volume or size of the prostate for treatment planning purposes and when transurethral resection of the prostate or thermal therapies of the prostate are planned.
What to expect: You may be asked to use an enema prior to the procedure to ensure an adequate examination. You will lie on your side on an examination table. A transducer will be inserted into the rectum to obtain an image of the prostate. After measuring the prostate volume and identifying any suspicious areas, biopsies will be obtained by inserting a special needle through a channel on the transducer. Six to14 biopsies are usually performed. Local anesthesia may or may not be used when performing the biopsy. The main risks of the procedure include infection and bleeding from the rectum or bladder. You may also notice blood in your ejaculate for several weeks. This is common and is not a cause for concern. You will be asked to refrain from heavy physical activity for 48 hours after the procedure. Oral antibiotics will be administered prior to and after the biopsy to reduce the risk of infection.
GreenLight PVPTM (Photoselective Vaporization of the Prostate) is a breakthrough laser procedure for the treatment of enlarged prostate, a condition known as Benign Prostatic Hyperplasia (BPH). PVP is a safe, effective and minimally invasive, outpatient treatment. A patented green light laser (the GreenLight PV Laser System) provides the energy for the procedure. During GreenLight PVPTM, a thin fiber is inserted into the urethra through a cystoscope (an instrument that allows your doctor to examine the inside of the bladder and prostate). The fiber delivers green laser energy that vaporizes and removes enlarged prostate tissue, creating an open channel and better urine flow.
What to expect: Before the GreenLight PVPTM Laser Procedure, patients had to choose between an effective - yet invasive - surgical procedure called Transurethral Resection of the Prostate (TURP), heat therapies (which were safer but less effective) and medication. During TURP, enlarged prostate tissue is surgically removed, resulting in symptom relief and restored urine flow. The procedure requires a hospital stay of one to four days (usually one), and a catheter must be worn for one to three days. Recovery time averages four to six weeks. Complications may include excessive blood loss, blood transfusion, incontinence, impotence, infection, painful urination and retrograde ejaculation. Heat therapies use different energy sources to heat and destroy prostate tissue. The destroyed tissue remains in the prostate and becomes scar tissue, resulting in an incomplete reduction of tissue and prostate swelling that can cause increased urinary symptoms for several weeks or months. You may need to wear a catheter for a few days or several weeks. GreenLight PVPTM successfully combines the effectiveness of TURP with the safety and ease of a minimally invasive procedure.
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