Skip to main content
SurgSpace

SurgSpace / Specialties / Urology

Urology

Kidneys, ureters, bladder, prostate and the male reproductive tract: stones and the obstructed infected kidney that cannot wait, bladder cancer surveyed and resected through the urethra, and a specialty that reached keyhole surgery before almost anyone else.

3 operations in depth5 interactive cases

Backdrop: Three-dimensional CT reconstruction of the urinary tract showing bilateral staghorn renal calculi against the skeleton · Goleisureintl · CC BY 4.0

See the disease

Conditions

The diseases, each with the image that defines it.

Each disease with the image that defines it: what it looks like, what the scan shows, and which operation answers it.

Urinary stone disease

Crystals, colic, and the one presentation that cannot wait.

The disease
Supersaturated urine crystallises, most often as calcium oxalate: dehydration, diet, anatomy and metabolic factors load the dice, and a first stone predicts more.
Colic
A stone entering the ureter announces itself in waves of loin-to-groin pain with a patient who cannot lie still: non-contrast CT is the diagnostic standard, and NSAIDs are the analgesic of choice where kidneys allow.
Who passes and who does not
Small distal stones mostly pass with time and analgesia; larger and more proximal stones increasingly do not, and persistent obstruction, uncontrolled pain or a solitary kidney move treatment forward.
Learn more
The toolbox
Shockwave lithotripsy from outside, ureteroscopy and laser from inside, percutaneous surgery for the big renal burdens: choice follows stone size, site and hardness.
The emergency
Fever plus obstructing stone equals urgent decompression, stent or nephrostomy, with stone treatment deferred: the one rule in this condition that is never negotiated.
Percutaneous nephrostomyCase: A stone, and a fever
Ultrasound
Renal ultrasound showing a dilated collecting system
Renal ultrasound · moderate hydronephrosis

  • Bladder cancer

    A field disease of the urothelium, staged by one muscle layer.

    Presentation
    Painless visible haematuria is the classic herald; persistent non-visible haematuria and refractory 'UTIs' in smokers are the quieter ones.
    The staging fork
    Everything divides at the detrusor: non-muscle-invasive disease is resected endoscopically and surveilled, sometimes for decades; muscle-invasive disease is a different cancer needing radical treatment.
    TURBT's double job
    The resection treats and stages at once, which is why sampling muscle in the specimen is a quality criterion: a TURBT without muscle may need doing again.
    Learn more
    The long relationship
    Non-muscle-invasive disease recurs habitually: surveillance cystoscopy, intravesical BCG or chemotherapy, and re-resection make bladder cancer one of oncology's longest doctor-patient relationships.
    Transurethral resection of bladder tumourCase: Blood in the urine, and no pain

  • Benign prostatic obstruction

    The ageing prostate, the frustrated bladder, and the flow between them.

    Mechanism
    Benign hyperplasia narrows the prostatic urethra; the detrusor first compensates with muscle, then fails with residuals: symptoms come from both the blockage and the bladder's response to it.
    Assessment
    Symptom scores, flow rate and residual volume quantify what the history sketches; examination and PSA keep the cancer question honestly in view.
    Management ladder
    Lifestyle and fluid timing, alpha-blockers for tone, 5-alpha-reductase inhibitors for bulk, and surgery, TURP as the reference operation, for retention, failed medication or complications.
    Learn more
    Complications of neglect
    Recurrent infection, bladder stones, high-pressure chronic retention and renal impairment: the end-stage bladder is the argument for not ignoring years of nocturia.
    TURP (transurethral resection of the prostate)Case: Twelve hours without passing urine

  • Prostate cancer

    A common cancer with an uncommon spread of tempos.

    The spectrum
    From indolent low-grade disease many men die with rather than of, to aggressive disease that metastasises to bone: grade (Gleason patterns) and stage set which story this is.
    Diagnosis
    PSA opens the question, multiparametric MRI shapes it, targeted biopsy answers it: the modern sequence reduces both missed cancers and unnecessary needles.
    Management by tempo
    Active surveillance monitors low-risk disease with intent to treat only on progression; surgery and radiotherapy treat localised significant disease; hormonal and systemic therapy manage the advanced.
    Learn more
    The honest trade
    Continence and potency are the currencies every radical treatment spends: shared decision-making is not a courtesy here, it is the clinical method.
    Case: A raised PSA at the health check

Hub shaped by the Surgical Specialties Lead with the Urology reviewer (open seat). Images and videos carry their source; educational use for supervised learning, not clinical guidance.