Day Care Procedure

urology consultant

Surgery performed on day care basis included ureteric stone basketing, ureteroenoscopic stone retrieval, JJ stenting, cystolithotripsy, TUR-BT, TUR-P and internal urethrotomy. Failure of complication rate was 0.97%. Most of the complications (26/29) could be detected early and managed by conversion of short admission into a regular one. Only 3 patients (0.1%) were admitted later on through the emergency. There was no mortality. In conclusion, we recommend urologic operative procedures on carefully selected patients on day-care basis to achieve two of the government's primary goals a) the provision of high quality services and b) the reduction of health care costs. Simultaneously a word of caution that it is unique challenge to be handled with care.

What Is Day Care Procedure

A day care procedure is a surgery or medical procedure that formerly required a prolonged stay in hospital but can now be completed in less than 24 hours.

Uroflowmetry

Uroflowmetry is a test that measures the volume of urine released from the body, the speed with which it is released, and how long the release takes.

What Does Uroflowmetry Involve?

For this test, a patient urinates into a special receptacle that measures the amount and flow rate of urine and time required to completely void their bladder. These assessments can help doctors evaluate how well the lower urinary tract is functioning or identify any obstruction of urine flow.

What Other Tests Are Typically Done With Uroflowmetry?

Uroflowmetry is often used with other tests to diagnose obstructed urinary outflow or urinary tract dysfunction, including:

  • Cystometry
  • Cystography
  • Retrograde cystography
  • Cystoscopy

Circumcision

Circumcision is the surgical removal of the skin covering the tip of the penis. The procedure is fairly common for newborn boys in certain parts of the world, including the United States. Circumcision after the newborn period is possible, but it's a more complex procedure. For some families, circumcision is a religious ritual. The procedure can also be a matter of family tradition, personal hygiene or preventive health care.

Why it's done

Circumcision is a religious or cultural ritual for many Jewish and Islamic families, as well as certain aboriginal tribes in Africa and Australia. Circumcision can also be a matter of family tradition, personal hygiene or preventive health care. Sometimes there's a medical need for circumcision, such as when the foreskin is too tight to be pulled back (retracted) over the glans. In other cases, particularly in parts of Africa, circumcision is recommended for older boys or men to reduce the risk of certain sexually transmitted infections.

Circumcision might have various health benefits, including:

  • Easier hygiene - Circumcision makes it simpler to wash the penis. However, boys with uncircumcised penises can be taught to wash regularly beneath the foreskin.
  • Decreased risk of urinary tract infections - The risk of urinary tract infections in males is low, but these infections are more common in uncircumcised males. Severe infections early in life can lead to kidney problems later.
  • Decreased risk of sexually transmitted infections - Circumcised men might have a lower risk of certain sexually transmitted infections, including HIV. Still, safe sexual practices remain essential.
  • Prevention of penile problems - Occasionally, the foreskin on an uncircumcised penis can be difficult or impossible to retract (phimosis). This can lead to inflammation of the foreskin or head of the penis.
  • Decreased risk of penile cancer - Although cancer of the penis is rare, it's less common in circumcised men. In addition, cervical cancer is less common in the female sexual partners of circumcised men.

The risks of not being circumcised, however, are not only rare, but avoidable with proper care of the penis. Circumcision might not be an option if certain blood-clotting disorders are present. Also, circumcision might not be appropriate for premature babies who still require medical care in the hospital nursery or for babies born with abnormalities of the penis. Circumcision doesn't affect fertility, nor is circumcision generally thought to enhance or detract from sexual pleasure for men or their partners.

Cystoscopy

Cystoscopy (sis-TOS-kuh-pee) is a procedure that allows your doctor to examine the lining of your bladder and the tube that carries urine out of your body (urethra). A hollow tube (cystoscope) equipped with a lens is inserted into your urethra and slowly advanced into your bladder. Cystoscopy may be done in a testing room, using a local anesthetic jelly to numb your urethra. Or it may be done as an outpatient procedure, with sedation. Another option is to have cystoscopy in the hospital during general anesthesia.

Why it's done

Cystoscopy is used to diagnose, monitor and treat conditions affecting the bladder and urethra.

  • Investigate causes of signs and symptoms Those signs and symptoms can include blood in the urine, incontinence, overactive bladder and painful urination. Cystoscopy can also help determine the cause of frequent urinary tract infections. However, cystoscopy generally isn't done while you have an active urinary tract infection.
  • Diagnose bladder diseases and conditions Examples include bladder cancer, bladder stones and bladder inflammation (cystitis).
  • Treat bladder diseases and conditionsSpecial tools can be passed through the cystoscope to treat certain conditions. For example, very small bladder tumors might be removed during cystoscopy.
  • Diagnose an enlarged prostate Cystoscopy can reveal a narrowing of the urethra where it passes through the prostate gland, indicating an enlarged prostate (benign prostatic hyperplasia).

Treatments using cystoscopy

  • Get urine samples from ureters (the ducts that carry urine from the kidneys to the bladder).
  • Inject dye for an X-ray procedure that tracks urine flow.
  • Inject medication to stop urine leakage.
  • Remove a ureteral stent (a tiny tube that holds open a ureter) placed during an earlier procedure.
  • Remove bladder stones, abnormal tissue, polyps or tumors.
  • Take small pieces of bladder or urethral tissue to biopsy (examine in a lab).
  • Treat urethral strictures (narrowing) or fistulas (holes that form between two areas).

What are the types of cystoscopies?

There are two types of cystoscopes. Your healthcare provider will use the one that works best for your specific procedure.

  • Rigid:These cystoscopes don’t bend. Your doctor may pass instruments through the tube to perform biopsies or remove tumors.
  • Flexible: Your doctor may use a bendable scope to examine the inside of the bladder and urethra and make a diagnosis.

Urodynamics Testing

Urodynamics testing measures how well the bladder, sphincters, and urethra store and release urine. Most urodynamics testing focus on the bladder’s ability to hold urine and empty steadily and completely. These tests help diagnose patients who have lower urinary tract symptoms such as

  • Urine leakage (incontinence)
  • Frequent urination
  • Painful urination
  • Sudden, strong urges to urinate (overactive bladder)
  • Problems starting a urine stream
  • Problems emptying the bladder completely
  • Recurrent urinary tract infections

Urodynamic Tests

Depending on your preliminary diagnosis, your doctor may recommend one or more of these urodynamic tests:

  • Uroflowmetry
  • Postvoid residual measurement
  • Cystometric test
  • Leak point pressure measurement
  • Pressure flow study
  • Electromyography
  • Video urodynamic tests

Frenuloplasty

A frenuloplasty of prepuce of penis (also known as a release of frenulum) is a frenuloplasty of the frenulum of prepuce of penis. An abnormally short or sensitive frenulum of the penis can make some types of sexual activity uncomfortable or even painful. This may be a complication of circumcision or a naturally occurring event. When it is a naturally occurring event, a short frenulum can restrict normal retraction of the foreskin during erection (a condition known as frenulum breve). The goal of treatment is to allow normal retraction of the foreskin. Circumcision may relieve this condition but is not indicated solely for treating frenulum breve. However, circumcision can also lead to an abnormally sensitive frenulum.