Endourology involves the use of minimally invasive procedures for the diagnosis and treatment of various urological conditions. These techniques mostly involve inserting surgical instruments through the urethra. However, certain procedures also involve accessing the urinary tract percutaneously.

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Diseases and conditions

  • Kidney, Ureter, and Bladder stones: Urinary stones occur in the urinary tract. They may be present in the kidneys (kidney stones), ureters (ureteral stones), and urinary bladder (bladder stones). The majority of the stones are made of calcium, especially calcium oxalate. The other types of stones are uric acid stones, struvite stones, and cystine stones.
  • Prostate Enlargement: Prostate enlargement, also known as benign prostatic hyperplasia, is a condition characterized by increased growth of the prostate tissue with age in men. Patients with this condition experience frequent urination, increased nighttime urination, dribbling urine, weak urine stream, and problem initiating urination.

Procedures and treatment

  • Cystoscopy: Cystoscopy is a diagnostic and treatment procedure performed with the help of a cystoscope, used to examine the lining of the urinary bladder. A cystoscope is a thin, long tube with a camera at the end. Urologists recommend cystoscopy in patients suspected of having bladder stones, bladder inflammation, enlarged prostate, urinary fistulas, urethral strictures, bladder cancer, and urinary tract infections.
  • Stenting: Ureters are the tubes that connect the kidneys with the bladder. Several conditions in the ureters, such as ureteral stones, kidney stones, inflammatory bowel disease, blood clots, scar tissue buildup, ureteropelvic junction obstruction, and tumors, partially or completely block the flow of urine. Urology surgeons place a thin tube, called a ureteral stent, in the ureters to hold them open for easy passage of urine.
  • URSL: Ureteroscopic lithotripsy is a procedure to remove stones from the bladder, ureters, and kidneys. This procedure is performed under anesthesia. During this procedure, the surgeon inserts a ureteroscope through the urethra and guides it into the urinary tract. Ureteroscope is a long, thin tube with a small fiber optic camera at one end. Once the stone is located, it is either taken directly with a stone basket or broken into small pieces with a laser.
  • PCNL: Percutaneous nephrolithotomy is a procedure used for removing urinary tract stones that are too large to be removed by other forms of treatment, such as ureteroscopy or shock wave lithotripsy. As compared to open stone surgery, PCNL has fewer complications.
  • Mini PCNL: Mini-PCNL is a minimally invasive surgery for removing renal stones. Compared to standard PCNIL, mini-PCNL is performed with smaller instruments and requires a smaller opening. For instance, while standard PCNL is generally done through a sheath size of 24 to 30 F, mini-PCNL uses a sheath size of 14 to 20 F.
  • RIRS: Retrograde intrarenal surgery is recommended for removing kidney stones. It involves using a fiberopti endoscopic camera to visualize the stone in the kidney and a Holium laser to break the stone into small pieces.
  • TURP: Transurethral resection of the prostate is recommended in patients with an enlarged prostate in whom the medications are unable to relieve the symptoms. It involves removing a section of the prostate gland by inserting a resectoscope into the urethra and guiding it to the prostate gland.
  • Laser prostatectomy:It is advised by urological surgeons to relieve moderate to severe urinary symptoms caused due to enlarged prostate. During this procedure, the pieces of the prostate are cut with the help of a laser. The techniques used in laser prostatectomy are Holmium Laser Ablation of the Prostate (HoLAP), Photoselective Vaporization of the Prostate (PVP), and Holmium Laser Enucleation of the Prostate (HoLEP).