What is a Urologist - Diagnosing and treating the prostate.

What is a urologist doing to diagnose and treat the prostate? The prostate can have three types of problems: prostatitis, benign prostatic hyperplasia, and prostate cancer. Each of these prostate problems are different in each individual. It is the job of the urologist to make a precise diagnosis so that you will be treated to the best that medicine has to offer.

What is a urologist doing to diagnose and treat benign prostatic hyperplasia (BPH)? BPH also known as an enlarged prostate affects the majority of men in their sixties and seventies. Symptoms of prostate enlargement include waking up at might to urinate, daytime urinary frequency, a weak stream, taking a while to start urinating, the urinary stream stopping and starting. The urologist diagnoses these symptoms as being caused by urinary retention due to a large obstructing prostate. A digital rectal exam, simple flow study, a post void bladder scan, and a urodynamic study may be used to confirm the extent of the BPH obstruction. A prostate ultrasound with biopsy may also be performed to rule out prostate cancer. Initially the urologist will give medication to help shrink the prostate and relax the bladder neck to help the bladder empty better. If the prostate enlargement is too big then these are a handful of procedures that will remove the extra prostate tissue that is squeezing the urethra closed and not allowing the bladder to empty properly. These procedures are the original transurethral resection of the prostate (TURP) which is performed under anesthesia with a loop of wire that is heated with electricity to cut out the prostate tissue from the prostatic urethra. The green light laser vaporizes the prostate tissue and the button TURP vaporizes the prostatic tissue and cauterizes the blood vessels. The urologist also has two office procedures for men with mild urinary retention from an enlarged prostate, one is transurethral microwave therapy (TUMT) and the other is the transurethral needle ablation (TUNA).

What is a urologist doing to diagnose and treat prostate cancer? The urologist looks at your prostate specific antigen scores (PSA scores), does a digital rectal exam, goes over your medical history and your family history (looking for members of your family that have had prostate cancer) and then decides if you need to have a prostate ultrasound with biopsies. The urologist takes about 12 biopsies from all around the prostate and the pathologist sends the report to the urologist. Once prostate cancer has been confirmed and the stage of the prostate cancer is determined the urologist will discuss the options available to you. The gold standard for prostate cancer treatment is the radical prostatectomy or prostate removal. Laparoscopic prostatectomy creates less scars, less blood loss and less recovery time. Two other prostate cancer surgery procedures are the prostate radiation seeding, and the prostate cryosurgery (freezing the prostate). The most recent improvement is the da Vinci surgery system or robotic surgery. The da Vinci prostatectomy has shown improved surgical outcomes. Dr. Bianco the founding Chief of Robotic Surgery at Mount Sinai Medical Center in Miami has researched robotic prostatectomy outcomes and has found that there is a steep learning curve and that the urologists that performed over 300 da Vinci prostatectomies have better surgical outcomes. So it would warrant a search to find an experienced robotic surgeon for your prostate cancer.

 

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