What is a Urologist - Diagnosing and treating the kidney.

What is a urologist doing to diagnose and treat the kidney? The urologist initially looks at your medical history, listens to your description of your kidney symptoms and gives a physical exam feeling the back for possible tumor growth in the kidneys, blood and urine specimens are collected, Images of the kidneys and urinary tract are taken with MRI, ultrasound, CT scan, or x-ray. Once the images and tests are reviewed the urologist will be able to see kidney stones, any kidney mass, or hydronephrosis deformity in the renal pelvis and the ureter. Infection in the urinary tract will be revealed from the urine specimens.

What is a urologist doing to treat kidney stones? The urologist will be able to view the kidney stones on the CT scans and find out how many there are, how big they are, where they are and even what shape they are. The urologist has several options on how to approach your case which will be discussed with you. Drinking a lot of fluids and waiting for the stone(s) to pass on their own is one option that may be considered with small kidney stones. The urology specialist may be able to look up into the ureter and pull the kidney stone out with a thin kidney stone basket. If the kidney stone is stuck in the ureter the urologic surgeon may use a ureteroscope it target a holmium laser at the kidney stone and knock it into small pieces. Another method is called a percutaneous nephrolithotomy which is when the urologist makes an incision in the back and enters the kidney directly. This type of kidney stone surgery is performed when the kidney stone is lodged in the kidney and a laser is used to break it apart and pull it out. Another approach is to use sound waves from outside of the body aimed at the kidney stone(s) in order to break them up so they can pass out of the urinary tract. This procedure is called extracorporeal shock wave lithotripsy or ESWL. Kidney stones can be one of the most painful events in your life but the urologist will give you medication so that you do not suffer.

What is a urologist doing to treat renal cell carcinoma? Kidney surgery (see “what is a kidney”) for a cancerous kidney mass has traditionally been a nephrectomy (kidney removal). In recent years statistics have shown that people that saved their kidney by just the removing the kidney tumor instead of the whole kidney. People that had the nephrectomy were found to have had a 25% increased risk of cardiac death and a 17% increased risk of death from any cause, compared to patients that receive partial nephrectomies. In order to improve medicine the NIH and NCI have been training urologists in oncology and how to remove multiple kidney tumors without resorting to a nephrectomy. They have also been teaching urologists how to remove difficult and complex kidney tumors such as the ones that are close to the renal arteries and the tumors that are growing right in the collecting tubes of the kidney. Unfortunately only 3% of the urologists in the US are trained in these kidney sparing complex partial nephrectomy surgeries. Dr. Maximiliano Sorbellini of the Urology Specialists has been trained in these kidney saving surgeries. Dr. Sorbellini is one of only a handful of theses specially trained urologic oncologists to perform the multiple tumor removal and complex tumor removal with a da Vinci partial nehrectomy using the da Vinci surgical system. To schedule an appointment call (305) 822-7227 or request an appointment online.

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