Branches of Urology

A discipline that involves the study of many organs and physiological systems

Urology can be broken down into subfields; listed below are sub-specialties within particular fields of urology:

ENDOUROLOGY is the branch of urology that deals with minimally invasive surgical procedures. Different from open surgery, endourology is carried out through instruments, and traditionally, transurethral surgery has been the cornerstone of endourology. Via the urethra, the complete urinary tract can be reached, enabling prostate surgery, surgery of tumors of the urothelium, stone surgery and simple urethral and ureteral procedures. In recent years, laparoscopy has evolved rapidly and will soon replace certain formerly open surgical procedures. Robotic tumor surgery of the prostate is the latest development in endourology and the fastest growing. Today, approximately 80% of prostatectomies in the U.S. are carried out by robotic surgery.

ONCOLOGIC UROLOGY concerns the surgical treatment of malignant genitourinary diseases such as cancer of the prostate, bladder, kidneys, testicles and penis. The medical treatment of advanced genitourinary cancer is in some countries done by urologic oncologists, in some countries by urologists.

NEUROUROLOGY concerns nervous system control of the genitourinary system, and of conditions causing abnormal urination. Neurological diseases and disorders such as multiple sclerosis, Parkinson's disease, and spinal cord injury can disrupt the lower urinary tract and result in conditions such as urinary incontinence, detrusor overactivity, urinary retention, and bladder sphincter dyssynergia. Urodynamic studies play an important diagnostic role in neurourology. Therapy for nervous system disorders includes clean intermittent self-catheterization of the bladder, anticholinergic drugs, injection of Botulinum toxin into the bladder wall and advanced and less commonly used therapies such as sacral neuromodulation. Less marked neurological abnormalities can cause urological disorders as well -- for example, abnormalities of the sensory nervous system are thought by many researchers to play a role in disorders of painful or frequent urination (e.g. painful bladder syndrome, formerly known as interstitial cystitis).[1]

ANDROLOGY focuses on the male reproductive system. It is mainly concerned with male infertility, erectile dysfunction and ejaculatory disorders. Since male sexuality is largely controlled by hormones, andrology overlaps with endocrinology. Surgery in this field includes re-fertilization procedures and the implantation of penile prostheses.

PLASTIC AND RECONSTRUCTIVE UROLOGY reestablishes functionality of the genito-urinary tract. Strictures of the urethra or the ureter often require reconstructive surgery. Another frequent procedure is the reconstruction of the urinary bladder from small bowel in conjunction with cancer surgery. In children, typical plastic procedures are the surgical correction of hypospadias and epispadias. Cosmetic surgery such as penis enlargement is rarely done in urology.

GYNECOLOGIC UROLOGY. Urinary incontinence in women is a common problem. The complex anatomy of the female pelvic floor with reproductive and urinary organs positioned close to each other makes women susceptible to developing problems in this region of the body. Thorough knowledge of the female pelvic floor together with urodynamic skills is necessary to diagnose and treat these disorders. Depending on the cause of the individual problem a medical or surgical treatment can be the solution.

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