Urology or Urological Surgery is a super-speciality field within the broad field of General Surgery. Urology has developed into a major speciality over the last 30 years, thanks to some extraordinary contribution from advances in technology namely, application of LASER energy, keyhole surgery and ROBOTICS to mention a few. These advances have helped generate an extraordinary level of interest in the field of Urological Surgery not only amongst surgical trainees, more and more of who wish to pursue a career in Urology but also amongst patients who potentially need an Urological procedure for their problem and are increasingly able to choose a particular type of procedure and a place / unit to have it and a surgeon to perform it for them.
The urinary system or tract is a small but important part of the human body and encompasses kidneys (one on either side at the back of the abdomen, just underneath the lower rib cage), ureters (tubes draining individual kidney into the bladder), urinary bladder deep down into the pelvis, in men the prostate gland at the apex/neck of the bladder wrapping around the urethra or water pipe and a pair of seminal vesicles at the back of the prostate (both organs contributing to semen production), and again only in men, a 15-20 cm length of water pipe/urethra contained/concealed within the penis and finally in men only, the penis and testes in the scrotal bag (with their attachments namely epididymis and the spermatic cord) forming the male genital system.
The short length of urethra / water pipe emerging from the neck of the bladder in women is covered under the female Urological system but the female genital system namely the ovaries, fallopian tubes and the uterus/cervix along with vaginal /vulval outlet comes under the realms of Gynaecology as a separate speciality covering women's health.
Despite Urology covering such a small part of the human body, the field of Urological Surgery has traditionally been subdivided in to many sub-specialities over the years, with Urological Surgeons finding their niche in a subspecialty and developing their interest and expertise in that particular field.
Uro-oncology: dealing with Urological cancers: further subdivided into cancers of the upper urinary system involving kidneys and the ureters as well as the hormone secreting gland called adrenal sitting on top of each kidney and cancers of the lower urinary tract including bladder and prostate cancers. Both these sub-specialities use Robotic technique where it is available otherwise use the keyhole technique without Robot.
Endo-urology: dealing with benign diseases inc. urinary stone disease, again divided into upper tract endo-urology for benign (non-cancerous) diseases of the kidneys and upper half of the ureters and lower tract endo-urology dealing with benign diseases of the lower urinary tract namely lower half of the ureter, bladder, urethra and prostate in men. This sub-speciality also encompasses procedures involving biopsy and or removal of cancers involving the ureters, bladder and urethra, all procedures done down the waterpipe using telescopes.
Andrological Surgery +/- Reconstructive surgery: dealing with conditions such as male sexual dysfunction (erectile / ejaculatory dysfunction), bent penis, penile and testicular lumps / swellings, male factor in infertile couples, hypogonadism inc. testosterone therapy, cancers of the penis and testis, stricture disease of the urethra/water pipe, circumcision and vasectomy for permanent sterilisation.
Female Urology +/- Neuro-urology: dealing with problems of the female lower urinary tract including stress incontinence and vaginal tape surgery as, well as problems arising from neurological diseases affecting waterworks/lower urinary tract function.
Paediatric Urology: dealing with urological problems seen in children up to 16 years of age.
Majority of Urological Surgeons specialise in one of these broad sub-specialities in addition to doing all core urological procedures mainly focussed on diagnosis of urological conditions.
Please call Mr Chitale today for further information.