A cystoscopy is used to investigate and treat bladder and urinary system problems including: urinary incontinence, frequent or intermittent urination, inability to urinate, urinary retention, pain or burning feeling when urinating, blood in your urine and pelvic pain.
Cystoscopy uses a thin tube with a light and camera at one end called a cystoscope. It’s inserted into your urethra and then into your bladder.
A flexible cystoscope is used to look inside your bladder. A rigid cystoscope is used if your urologist needs to pass small surgical instruments into your bladder, for example to obtain a biopsy or perform treatment.
Conditions that may be detected and monitored using a colonoscopy are: urinary tract infections, narrowed or blocked urethra, ureter problems, polyps, enlarged prostate gland, bladder stones and urinary tract cancers.
Transurethral resection of a bladder tumour (TURBT) is used to investigate and treat bladder tumours. Often it’s recommended if a cystoscopy has indicated a bladder tumour. These can be benign (non-cancerous) or malignant (cancerous).
A TURBT involves cutting away the tumour or tumours from the bladder wall and sending them for cancer examination. Once your urologist knows if the tumour is cancerous, and if so how far it’s advanced, then they can advise on the most suitable treatment.
Untreated benign bladder tumours continue to grow slowly. They can become very large and occupy too much space in your bladder and press on other organs in your body.
Malignant tumours will also grow unless they’re removed. Surrounding tissue can also be attacked by a malignant tumour or the cancer can spread into other areas of the body.
Adult circumcision involves the surgical removal of the foreskin from the penis under general anaesthetic.
It can be carried out for religious and cultural reasons or for medical reasons such as: tight foreskin (phimosis), recurrent inflamed/infected foreskin and penis head (balanitis), foreskin won’t return to its original position (paraphimosis), a dermatological condition of the penis head (balanitis xerotica obliterans) and penile cancer.
Circumcision surgery is available on the NHS but with restrictions and waiting lists. Adult circumcision is available at New Hall Hospital without restrictions or waiting.
If a penis is too bent during erection to allow penetration during sexual intercourse, then surgery to correct the curvature can be performed. This is known as penile straightening.
Penile straightening surgery is performed under general or spinal anaesthetic using a plication procedure to shorten the longer side of the penis and straighten it.
A prostate biopsy is the removal of prostate tissue samples so that they can be investigated further for signs of prostate cancer.
The prostate is a small gland found beneath the bladder that makes semen. A prostate biopsy aims to find out more about symptoms such as a lump in the prostate gland or high levels of prostate-specific antigen (PSA) in the blood.
You can have a prostate biopsy by one of three ways:
- trans-rectal (through the rectum, most frequently performed)
- transurethral (through the urethra)
- perineal (through the perineum - skin between the anus and the scrotum).
Treatment of bladder cancers
Bladder cancer means that malignant cancerous cells have been found in your bladder. Its treatment depends on the stage of cancer and other factors. Treatment options for bladder cancers include:
- Surgery - to remove the cancer cells. Your surgeon takes away early-stage bladder tumours or the whole bladder (radical cystectomy). It forms part of the treatment for most bladder cancers.
- Intravesical therapy - a liquid drug is introduced through a catheter directly into the bladder.
- Chemotherapy – drugs to treat cancer.
- Radiation therapy – high-energy radiation to kill the cancer cells.
- Immunotherapy - medicines given to encourage the immune system to recognise and destroy cancer cells.
Treatments are sometimes combined. Follow-up is needed to check for new cancers in the bladder.
Treatment for stress incontinence
Stress urinary incontinence (SUI) is when your bladder unintentionally leaks urine, normally when you take part in physical activity, cough, sneeze, laugh or lift something heavy. It happens when the pressure inside your bladder, as it fills with urine, becomes greater than the strength of the urethra to stay closed.
Pelvic floor muscle exercises, bladder training and medications are initially suggested. Surgery is advised if these aren’t successful. Surgeries for SUI include:
- tape procedures (tape holds up the urethra in the correct position)
- colposuspension (neck of the bladder is lifted and stitched)
- sling procedures (sling supports the bladder neck)
- artificial urinary sphincter (new sphincter stops urine from leaking).
A transurethral resection of the prostate (TURP) removes part of the prostate. It’s carried out if the prostate is enlarged and is putting pressure on your bladder and urethra affecting urination.
Performed under general or spinal anaesthesia, a TUPR passes a resectoscope (thin metal tube with a light source, camera and loop of wire) along your urethra to your prostate. The loop of wire is then heated to cut a section of your prostate.
A vasectomy is a method of male sterilisation or permanent contraception. It’s a minor procedure carried out under local anaesthetic. Your urologist will cut, block and seal the vas deferens tubes so that your sperm are stopped from entering your semen.
Often to have a vasectomy on the NHS you’ll have to wait. Here at New Hall Hospital we can offer a vasectomy without waiting.
Vasectomy reversal aims to reverse male sterilisation. It’s most successful if it’s performed soon after a vasectomy. Also known as a vasovasostomy, the procedure involves reconnecting the vas deferens tubes that were cut during a vasectomy.
You cannot have a vasectomy reversal through the NHS as it’s considered a permanent method of birth control. New Hall Hospital can perform a vasectomy reversal if required.