About a century ago, words like operation and surgery could not have been said without utmost apprehension and deep unease at the heart. But thanks to the advancement in the field of medicine and the integration of this advancement with other scientific disciplines, the fear factor has been reduced significantly. Surgical procedures have been revisited and revised, tools and techniques have been invented which have streamlined and smoothened the entire OT experience. In this discussion, we take a look at some of the more common urological surgeries and try to understand their purpose. Not only that, but we are also going to discuss the pros and cons associated with these surgeries. All we want in return from you is undivided attention till the very end of this discussion!
Defining urologic surgery
But before we jump into the details of different surgical procedures, it is important to define the term in the first place. What do the doctors mean when they use the term urological surgery? In simpler words, it refers to the integration of surgical activities to treat urinary obstruction, dysfunction, inflammation, and malignancy[i]. The surgical activities cited in this definition include colon and urogenital organs Urological surgeries are mostly focused on the kidney, bladder, uterus, pelvis, scrotum, and urethral areas.
Urological problems: A recap
We have defined the term in the previous section. However, the problems that might necessitate a urological surgery are still obscure to you. Hence, now we mention the specific problems that can lead to the need for urological surgery. Well, an injury to the pelvic region is one of the biggest reasons for urological surgery. Similarly, a spinal cord injury can also lead to urological surgery [ii]. Then, conditions like prostate infections and malignancies like carcinomas are also a major reason for surgical treatment of this nature. One obvious reason for a urological surgery, which some of you might already be familiar with, is kidney stones. Other reasons for a urological surgery include conditions like pancreatic diseases and hernias.
The first step in the series of events that lead to urological surgery is testing. Please note that when the word testing is used, it has a three-fold meaning here. Blood, urinary, and organ function testing [iii]. Reliance on imaging techniques has increased big time with time. Hence, the appropriateness of laparoscopic surgery is also evaluated. Endoscopies are super helpful since they can let the surgeon and the physician assess the internal state of organs. A rectal examination is ordered in case of rectal surgery.
Common urological procedures
Now that you are familiar with the basics and background involved, we can finally discuss the point around which this whole discussion has been orchestrated. Urological surgeries. Since we are cramped for time and space, we are going to discuss only the most common surgical procedures concisely.
1- Genitourinary reconstruction
This is a surgical procedure that is aimed at improving the quality of life [iv]. The goal of this type of urological surgery is to rectify a congenital defect mostly. However, the surgery is also useful in minimizing the extent of damage inflicted by an existing disease.
A nephrectomy serves more than one purpose. But first, what does it mean? It is the surgical removal of the kidney. The primary purpose of nephrectomy is to treat renal injuries or diseases[v]. The secondary purpose of nephrectomy is to remove a healthy kidney for a kidney transplant. An interesting point to note here is that the kidney can be harvested from living or dead both.
3-Neurogenic bladder surgery
The term neurogenic bladder refers to a condition in which bladder control is lost or significantly diminished. The reasons for this condition are numerous, the most significant ones of which are nerve injury and multiple sclerosis [vi]. Surgical treatment of this condition can have two possible goals. One, artificial sphincter implantation, an electrical device that can stimulate the bladder muscles. Second, the creation of a urinary diversion. Either way, the surgery takes care of this major stress which the people with a neurogenic balder have to suffer from.
As you might have guessed, this is a surgical treatment for the partial/complete removal of the prostate [vii]. What are the reasons because of which a prostatectomy might be ordered? Well, surgical treatment is recommended especially in situations like prostate cancer or prostatic hyperplasia. The prostate gland is removed via a small surgical incision.
Replacement or reconstruction of the urethra is the primary goal of urethroplasty [viii]. The narrowing of the urethra because of scar tissue is one of the reasons why a urethroplasty might be prescribed to a person.
Benefits of urological surgery
Puts mind and heart back at peace! But we know you are looking for something more concrete than that. Of course, there are several benefits on offer, as far as urological surgeries are under discussion. These surgical procedures are predominantly less invasive as compared to traditional surgical interventions [ix]. The surgeon/physician has more control as well since there is state of the art equipment to facilitate you. And since the processes are less invasive, the healing times are shorter as well. This means that you can leave the hospital sooner than you might be expecting!
Even though it is the 21st century, and the operative procedures are more efficient than ever, one cannot rule out the side effects. What are the risks during the surgery? Well, minor bladder injuries and distention of urinary drainage bag with gas are some of the complications that the surgeons need to be careful about in the OT. If things have been done the right way, there is no reason why you should feel any pain post-surgery. But if you do, the best thing would be to consult the doc immediately. Studies have shown that the overall complication rate for urological surgery is 4.4%, while the mortality rate is as low as 0.08%[x].
How long do you need to stay in the hospital? A more accurate answer depends on the type of surgery you have undergone, but the average span of stay can be anywhere between one day to one week. However, for the surgeries that require a stent, the duration can be longer as well.