Office Procedures

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A substantial amount of what we do as urologists can be done in the office with light sedation and/or local anesthesia. In this section, you will find information about what to expect if you are scheduled for one of these procedures.

BLADDER BIOPSY

A biopsy is conducted by removing a sample of skin or tissue from a patient’s body for examination under a microscope to diagnose a medical condition.A biopsy can be obtained of the skin by removing a small amount of tissue with a special instrument. This can be done with local anesthesia to avoid pain. Biopsies of the prostate or kidney are typically obtained with specially designed needles that allow for the removal of small amounts of tissue. The needle is guided with ultrasound or special X-rays such as a CT scan. Biopsies can also be obtained from the bladder or ureter with specially designed endoscopes that are passed into these structures through normal urine passageways.After the biopsy specimen is obtained, it is sent for examination to a pathologist, who prepares a written report with information designed to help the doctor manage the patient’s condition properly.

CYSTOSCOPY

Cystoscopy, or cystourethroscopy, is a procedure that enables a urologist to view the inside of the bladder and urethra in great detail. It is commonly used to diagnose bladder tumors, identify obstruction of the bladder and look for any abnormalities of the bladder and its lining.

The procedure is usually performed as an outpatient procedure in a urology clinic or treatment room. Prior to the procedure, the patient will need to empty their bladder and will then be positioned on an examination table. After administration of local anesthesia, a cystoscope is inserted through the urethra into the bladder. The cystoscope is a thin, lighted tube that is either flexible or rigid. Water or saline is then instilled into the bladder through the cystoscope. As the fluid fills the bladder, the bladder wall is stretched thus allowing detailed viewing by the urologist. Under normal conditions, the bladder wall should appear smooth and the bladder should be normal size, shape and position and there should not be any blockages. If any tissue in the bladder wall appears abnormal, a small sample can be removed through the cystoscope to be analyzed.

The average cystoscopy takes about 10 to15 minutes.

After the cystoscope is removed, the patient’s urethra may be sore and they may feel a burning sensation for up to 48 hours. If discomfort persists, fever develops or urine appears bright red, a physician should be notified.

PROSTATE BIOPSY

A biopsy is conducted by removing a sample of skin or tissue from a patient’s body for examination under a microscope to diagnose a medical condition, especially cancer.

A biopsy can be obtained of the skin by removing a small amount of tissue with a special instrument. Biopsies of the prostate (or kidney) are typically obtained with specially designed needles that allow for the removal of small amounts of tissue. The needle is guided with ultrasound. Biopsies can also be obtained from the bladder or ureter with specially designed endoscopes that are passed into these structures through normal urine passageways.

After the biopsy specimen is obtained, it is sent for examination to a pathologist, who prepares a written report with information designed to help the doctor manage the patient’s condition properly.

ULTRASOUNDS

An ultrasound examination, also commonly referred to as a sonogram, is a painless, diagnostic technique that makes use of the behavior of sound waves in the human body. When these sound waves are transmitted into the body, they are reflected in specific ways by specific tissues and organs. These reflected waves can be used to produce images of internal organs without harm or exposure to radiation.
Depending on the reason for the study and the circumstances, ultrasound imaging may be performed in the urologist’s office, in the hospital or in an outpatient facility.

In most cases, very little preparation is needed for an ultrasound examination. Some examinations, such as a bladder scan for residual urine, require limited experience while others, such as ultrasound examinations of the kidneys, testicles or prostate, require more experience or expertise.’

The patient will be asked to lie down on the examination table. A clear, water-based gel is applied to the skin over the area to be examined. This gel helps with the transmission of the sound waves. A transducer, which is a hand-held probe, is then moved over that area. Prostate ultrasound examinations are performed by placing a specially designed probe into the rectum.

There is no risk of radiation with this study and the patient can resume their daily activities immediately following this test.

BOTOX FOR BLADDER

HOW CAN BOTOX® HELP ME?

BOTOX® works on the bladder muscle by blocking the nerve signals that trigger your overactive bladder. BOTOX® is a different treatment option when another type of medication (anticholinergic) does not work well enough or cannot be taken.1

By reducing bladder contractions, BOTOX® can help:

  • Reduce weekly urinary leakage episodes
  • Increase bladder capacity (how much urine your bladder can store)
  • Decrease the pressure in your bladder (high bladder pressure can cause urine leakage)

TUNA

Transurethral Needle Ablation, or TUNA is an effective, minimally invasive treatment for the symptoms of BPH – Benign Prostatic Hyperplasia. This is also the technical and generic term for Prostiva® RF Therapy. Because of the safety and effectiveness of TUNA, many patients and urologists opt for an RF treatment rather than chronic medication, which can cause significant side effects.1 TUNA is covered by Medicare as well as most private insurance plans.

UROLIFT

The UroLift® System treatment is a revolutionary, minimally invasive approach to treating an enlarged prostate, or BPH, that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.

Clinical data has shown that the UroLift System treatment is safe and effective in relieving lower urinary tract symptoms due to BPH without compromising sexual function1,2,3,4. The goal of the UroLift System treatment is to relieve symptoms so you can get back to your life and resume your daily activities.

How Does The UroLift System Work?

The UroLift System treatment is a straightforward procedure that is performed by a urologist. The urologist places tiny implants to hold the prostate lobes apart, like open curtains on a window, to relieve compression on the urethra. This allows urine to flow normally again. The UroLift System treatment can be done in the physician’s office under local anesthesia. Typically, patients return home the same day without a catheter.

Enlarged Prostate

An enlarged prostate can narrow or even block the urethra.

Step 1

The UroLift Delivery Device is placed through the obstructed urethra to access the enlarged prostate.

Step 2

Small UroLift Implants are permanently placed to lift or hold the enlarged prostate tissue out of the way and increase the opening of the urethra. The permanent Implants are delivered through a small needle that comes out of the UroLift Delivery Device and into the prostate.

Step 3

The UroLift Delivery Device is removed, leaving an open urethra designed to provide symptom relief.

Why Choose The UroLift System?

The UroLift System is an alternative for patients looking for something other than drug therapy or more invasive surgery. Treatment might be right for you if any of the following apply to you:

  • You do not want to take another pill every day
  • You have tried BPH medication but are unhappy with the side effects
  • You do not want to undergo major surgery due to potential surgical risks of side effects and complications
  • You want a BPH solution that preserves your sexual function
  • You want to regain your quality of life with minimal downtime

Benefits of the UroLift System include1,2,3:

  • Straightforward procedure
  • Minimally invasive
  • Minimal downtime
  • Typically no catheter or overnight stay required after treatment
  • Preservation of sexual function
  • Durable results
  • Rapid symptom relief, as early as 2 weeks post procedure

As with any medical procedure, individual results may vary. Speak with your urologist to see if the UroLift System procedure is right for you. Most common side effects are mild to moderate and include pain or burning with urination, blood in the urine, pelvic pain, urgent need to urinate and/or the inability to control the urge. Most symptoms resolve within two to four weeks after the procedure.

 

TUMT

The Prolieve® System is an in-office technology, a medical device that both heats the prostate and dilates the prostatic urethra. The purpose of the Prolieve® System is to treat the symptoms of enlarged prostate (BPH) in men who would benefit from drug or surgical therapy. The treatment was designed with patients’ needs and comfort in mind.

What to Expect During Your Prolieve® Treatment

  • The physician will insert a catheter into your urethra.
  • When microwave energy is turned on, it will be transmitted from a special antenna inside the catheter to provide heat to your prostate.
  • The heat will reduce the enlarged tissue of your prostate.
  • A small balloon that is also part of the catheter will inflate within the section of the urethra close to where the prostate is located.
  • During the entire 45-minute procedure, water will be circulating inside the catheter through your urethra.

For your safety, the Prolieve® System’s computer monitors the temperature surrounding the treatment area by means of a rectal temperature monitor. If the temperature at the monitor reaches 42ºC, the system will shut off automatically.

The Prolieve® System is FDA approved. The System’s design and operating protocol were investigated in clinical studies of other men suffering from BPH. The results showed the Prolieve® System is safe and effective.

  prolieve_system
Figure 1: This is a schematic illustration of a cross section of a prostate BEFORE treatment with the Prolieve® System.Figure 2: This is a schematic illustration of a cross-section of a prostate immediately AFTER treatment with the Prolieve® System.

Is the Prolieve® Treatment Right for You?

Although individual results may vary, in a clinical study many patients experienced significant relief from their enlarged prostate (BPH) symptoms*. Ask you doctor for more information.

*In a clinical trial, 74% (68/92) of Prolieve® System patients experienced a ≥ 30% improvement of their AUA total score, a measure of BPH symptoms, at one year.

What Results Can I Expect?

You should be able to go home right after the Prolieve® System Treatment. However, it is a good idea to have someone drive you home after the procedure. Most patients are able to resume their normal activities shortly after the treatment.

REZUM

What is Rezūm?

Rezūm is a transurethral RF thermal therapy to treat benign prostatic hyperplasia (BPH) that can be performed in a clinic or out-patient setting. Using a hand-held device, Rezūm delivers radiofrequency generated thermal therapy, in the form of water vapor, directly to the extra prostate tissue that is causing symptoms such as frequency, urgency, irregular flow, weak stream, straining and getting up at night to urinate.

*transurethral describes the minimally invasive procedure in which a device is inserted into the urethra.

Rezūm Patient Education

Benefits of Rezūm

Rezūm provides the following benefits:

  • Potential alternative to BPH medications
  • Relieves symptoms safely and effectively1
  • Provides noticeable symptom improvement within two weeks
  • Simple in-office/out-patient therapy
  • Does not require general anesthesia
  • Preserves sexual and urinary functions1
  • Allows patients to return to regular activities within a few days1

*Some of the information on our pages are provided by UrologyHealth.org, the official Web site of the American Urological Association Foundation, from the device manufacturer, or the pharmaceutical company.

The AUA Foundation is the world’s leading nonprofit urologic health foundation and the Official foundation of the American Urological Association.  Our goal is to promote health, provide hope and promise a future free of urologic disease, including cancer. The AUA Foundation partners with physicians, researchers, healthcare professionals, patients, caregivers, families and the public, established to support and promote research, patient/public education, and advocacy to improve the prevention, detection, and cure of urologic diseases.

The vision of the Foundation is to be the premier provider and resource for the most current, comprehensive and reliable urologic health information for patients and the public.

One of our representatives is eager to help you. For more details or to book an appointment. Contact us today at
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