Treatments
Cryotherapy
Cryotherapy is a minimally invasive treatment for prostate cancer that works by freezing the area with the cancer cells.
Cystoscopy
A cystoscopy usually involves a flexible instrument known as a cystoscope that is inserted into the urethra to examine the inside of the bladder.
Urolift
The UroLift System treatment is a revolutionary, minimally invasive approach to treating an enlarged prostate or BPH.
What Is Cryotherapy?
Cryotherapy is a minimally invasive treatment for prostate cancer that works by freezing the area with the cancer cells.
Who Is Cryotherapy Treatment Suitable For?
Cryotherapy treatment is sometimes suitable to treat men with localised prostate cancer that has not spread beyond their prostate gland. It is not suitable for:
- Extensive high grade cancers or
- Cancers that have spread outside the prostate gland
How Does Cryotherapy Treatment Work?
Cryotherapy is performed by a urologist, the procedure lasts approximately one hour as follows:
- Tiny probes called cryoneedles are inserted into the rectum/perineum and then inserted into area where the cancer cells are in the prostate gland via the wall of the rectum / perineum
- These probes freeze the cancerous area and then kill the cancer cells, but some normal cells also die.
- The aim is to kill cancer cells while causing minimal damage as possible to healthy cells.
- During the procedure a catheter is inserted to run warm water throughout the procedure to prevent the urethra from freezing.
- This catheter remains for a few days after the procedure to drain the bladder and allow the healing to take place.
How Long Does A Cryotherapy Session Take?
A cryotherapy procedure takes approximately 60-75mins. Generally the patient is able to go home the same day.
How Long Does Cryotherapy Take To Work?
As the cells die at the time of the procedure, cryotherapy treatment technically is instant. The follow up is done with blood tests and MRI scan in 10-12 weeks to assess the results.
What Are The Benefits Of Cryotherapy?
Cryotherapy benefits when comparing to other prostate cancer treatments, such as surgery or radiotherapy are:
- Less invasive
- Reduced blood loss compared to other treatments
- Shorter hospital stay
- Shorter recovery
- Less pain
- Less instance of erectile side effects
- Reduced chances of incontinence
What Are The Side Effects Of Cryotherapy?
The side effects of cryotherapy can include
It is rare for cryotherapy to cause
- rectal problems
- fistulas
Does Cryotherapy Treatment Hurt?
Cyrotherapy does not hurt as the patient is under general anaesthesia, however there can be general discomfort afterwards due to the catheter, but this normally subsides after 24-48 hours.
Can Cryotherapy Make You Sick?
No, cryotherapy cannot make you sick.
How To Prepare For Cryotherapy
There is no specific preparation required for cryotherapy but as with any other surgical procedure under anaesthesia, you must refrain from eating and drinking 6 hours before the procedure.
What Is A Cystoscopy?
A cystoscopy usually involves a flexible instrument known as a cystoscope (a thin tube with a camera and light at the end) that is inserted into the urethra (the hole where the urine is eliminated from the body) to examine the inside of the bladder.
What Is A Cystoscopy Used To Diagnose?
A cystoscopy is used to diagnose the following in the water pipe (urethra) and bladder:
- Inflammation
- Infection
- Stones
- Tumours (including bladder cancer)
Types Of Cystoscopy
There are 2 types of cystoscopy
Flexible Cystoscopy
- This is done under local anesthesia in an outpatient treatment room. The camera that is inserted is flexible meaning it is less invasive than a rigid cystoscopy allowing it to be performed in an outpatient setting. Flexible cystoscopy is entirely diagnostic and can only be used to confirm a suspected diagnosis.
Rigid Cystoscopy
- This is performed under general/regional anesthesia or sedation. It is done in a theatre setting as a daycase. The cystoscope is rigid and not flexible as in the case of a flexible cystoscopy. The benefits for rigid cystoscopy are that it can be used for treatment; eg. removal of small tumours, stones, taking a sample for biopsy or injecting substances such as botulinum toxin into the bladder wall.
How Long Does Cystoscopy Take?
A flexible cystoscopy examination itself takes about five minutes and you will be able to go home straight afterwards. The results will be discussed with you after your appointment
A rigid cystoscopy procedure itself takes only 5-10 minutes, but due the anesthesia or sedation the patient is required to spend at least half a day in the hospital.
What To Expect At Your Cystoscopy
The following steps explain what to expect at a cystoscopy appointment:
- A local anaesthetic jelly is used to numb and lubricate the urethra.
- The cystoscope is inserted into the bladder via the urethra (water pipe).
- The instrument is then moved up into the bladder
- Once the instrument is in place, the examination takes a few minutes to complete using the telescopic lens that is attached to the cystoscope.
- Sterile water fills the bladder to ensure that all the lining can be inspected.
- If a rigid cystoscopy is being performed, treatments such as removal of tissue or tumours can be performed at this stage if necessary.
Recovering From Your Cystoscopy
There is limited recovery from flexible cystoscopy, and patients can go back to work afterwards if desired.
Recovering from a rigid cystoscopy depends on whether a treatment has been performed or not. In general patents will go home the same day, passing urine will be uncomfortable the first few times. In general patients can return to work the following day.
What Are The Benefits Of Cystoscopy?
Flexible cystoscopy benefits are:
It can be performed within a 30-minute appointment
Results can be discussed during the appointment
It is minimally invasive allowing patients to return to their normal lives immediately.
What Are The Risks Of Cystoscopy?
The risks of cystoscopy are:
- Mild burning or bleeding on passing urine for a short period after the operation.
- Occasionally, infection of the bladder requiring antibiotics.
In rare cases the following risks can occur:
- Temporary insertion of a catheter.
- Delayed bleeding requiring removal of clots or further surgery.
- Injury to the urethra causing delayed scar formation.
In extremely rare instances, or those patients in high-risk groups the following may occur:
- Colonisation with MRSA
- Clostridium difficile bowel infection
- MRSA bloodstream infection
Is A Cystoscopy Painful?
A flexible cystoscopy is uncomfortable but the procedure itself only lasts 5 minutes
Introduction
The UroLift® System treatment is a revolutionary, minimally invasive approach to treating an enlarged prostate or BPH
What Is A UroLift® Procedure?
The UroLift® System treatment is a revolutionary, minimally invasive approach to treating an enlarged prostate, or BPH, that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra and without compromising sexual function.. There is no cutting, heating or removal of prostate tissue.
What Is UroLift® Procedure Suitable For?
Urolift is an alternative for patients with BPH or enlarged prostate looking for something other than drug therapy or more invasive surgery. Treatment might be right for you if any of the following apply:
- You do not want to take another pill everyday
- You have tried BPH medication but are unhappy with the side effects
- You do not want to undergo major surgery due to potential surgical risks of side effects and complications
- You want a BPH solution that preserves your sexual function
- You want to regain your quality of life with minimal downtime
How Does The UroLift System Work?
The UroLift system is a daycase procedure, performed under sedation or general anaesthesia, the procedure works as follows:
A camera with the ability to hold the Urolift implants is inserted into the urethra.
The tiny implants are then deployed onto the prostate lobes to hold the them apart so that a good channel can be achieved for flow of urine.
How Long Does It Take To Recover From A UroLift Procedure?
Typically, following Urolift procedure, patients return home the same day without a catheter.
Who is UroLift right for?
Urolift is generally suitable for people with small to medium sized prostates.
Urolift is not suitable for everyone, it depends on the size and shape of the prostate gland which sometimes needs to be assessed by cystoscopy prior to the procedure.
Urolift can also be used in patients with larger prostates if they are unsuitable for other surgical treatments
How Effective Is UroLift?
Good results are seen in patients with medium sized prostates.
Is UroLift Permanent?
There is limited data on the permanence of Urolift as it is a new innovation in treatment of enlarged prostate
Can UroLift Be Reversed?
No, the Urolift treatment cannot be reversed.
Why Choose UroLift?
The benefits of Urolift procedure make it a very attractive procedure for patients:
Less invasive compared to other procedures
Reduced blood loss compared to other treatments
Shorter hospital stay
Shorter recovery
Less pain
No erectile side effects
No incontinence
TURP vs Urolift: What’s Right For Me?
A clinician will recommend based on the following:
- Urolift is often indicated in patients who have small to medium sized prostates and younger men who do not want to experience erectile issues .
- TURP is the gold standard in treatment for BPH and enlarged prostate and is often indicated in men with larger prostates, and often in older men who are less concerned by erectile issues which are possible side effects of TURP. It requires general anesthesia and a 2 day hospital
Does UroLift Affect PSA
Urolift does not affect PSA.
How Much Does UroLift Cost?
The fees for a private Urolift comprise hospital and consultant fees. The consultant fees for the procedure are £1050
System treatment is a revolutionary, minimally invasive approach to treating an enlarged prostate, or BPH, that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.
Clinical data has shown that the UroLift® System treatment is safe and effective in relieving lower urinary tract symptoms due to BPH without compromising sexual function. The goal of the UroLift® System treatment is to relieve symptoms so you can get back to your life and resume your daily activities.
The urologist places tiny implants to hold the prostate lobes apart, like open curtains on a window, to relieve compression on the urethra. This allows urine to flow normally again. This can be done in the physician’s office under local anaesthesia. Typically, patients return home the same day without a catheter.
This is an alternative for patients looking for something other than drug therapy or more invasive surgery. Treatment might be right for you if any of the following apply to you:
- You do not want to take another pill everyday
- You have tried BPH medication but are unhappy with the side effects
- You do not want to undergo major surgery due to potential surgical risks of side effects and complications
- You want a BPH solution that preserves your sexual function
- You want to regain your quality of life with minimal downtime
Hormone Therapy
Hormone therapy is often used in combination with radiotherapy and is used in the treatment of prostate cancer.
HIFU
HIFU (high intensity focussed ultrasound) is a targeted therapy for prostate cancer which uses high frequency ultrasound waves to destroy cancer cells in the prostate. HIFU is used to treat men with localised prostate cancer that has not spread beyond their prostate.
PCNL
Supine Percutaneous Nephrolithotomy (PCNL) is a treatment usually reserved for larger stones in the kidney or upper ureter.
Introduction
Hormone therapy is often used in combination with radiotherapy and is used in the treatment of prostate cancer.
What Is Hormone Therapy?
Hormone therapy for prostate cancer is the use of hormones to stop the production of testosterone which promotes the growth of the cancer cells in the prostate.
Who Is Hormone Therapy Suitable For?
Hormone therapy is suitable as follows:
- Hormone therapy for prostate cancer is often used in combination with radiotherapy.
- Hormone therapy may also be recommended after radiotherapy or surgery to reduce the chances of cancerous cells returning.
- Hormone therapy is also used in patients where the prostate cancer has spread
What Does Hormone Therapy Do For Prostate Cancer?
Hormones control the growth of cells in the prostate. In particular, prostate cancer needs the hormone testosterone to grow. The purpose of hormone therapy for prostate cancer is to block the effects of testosterone, either by stopping its production or by stopping your body being able to use testosterone.
Types Of Hormone Therapy For Prostate Cancer
There are 3 types of hormone therapy:
Anti-androgen – these are tablets to block the effects or reduce the production of testosterone
LHRH agonists – these are injections to stop the production of testosterone, called luteinising hormone-releasing hormone (LHRH) agonists
LHRH antagonists – these are injections to stop the production of testosterone
How Is The Hormone Administered?
Hormone therapy is administered in two different way, depending on the type of therapy:
- Injections – LHRH agonist and antagonist are administered by injection
- Tablets – anti androgen treatment is given this way
How Successful Is Prostate Cancer Hormone Therapy?
Hormone therapy is a very successful treatment of prostate cancer and nearly every patient responds positively.
Possible Side Effects Of Hormone Therapy For Prostate Cancer
The main side effects of hormone therapy for prostate cancer are caused by their effects on testosterone. They usually go away when treatment stops. These side effect include:
loss of sex drive
erectile dysfunction (this is more common with LHRH agonists than anti-androgens)
Urocare London are a part of the Focal therapy users group and are able to offer this treatment to our patients.
HIFU (high intensity focussed ultrasound) is a targeted therapy for prostate cancer which uses high frequency ultrasound waves to destroy cancer cells in the prostate. HIFU is used to treat men with localised prostate cancer that has not spread beyond their prostate.
An ultrasound probe inserted into the rectum releases high-frequency sound waves through the wall of the rectum. These sound waves kill cancer cells in the prostate gland by heating them to a high temperature.
The risk of side effects from HIFU is usually lower than other treatments. However, possible effects can include impotence (in 5-10 in every 100 men) or urinary incontinence (in less than 1 in every 100 men). Back passage problems are rare. Fistulas (an abnormal channel between the urinary system and rectum) are also rare, affecting less than one in every 500 men. This is because the treatment targets the cancer area only and not the whole prostate.
Introduction
Supine Percutaneous Nephrolithotomy (PCNL) is a treatment usually reserved for larger stones in the kidney or upper ureter.
What Is PCNL? (H2)
Supine Percutaneous Nephrolithotomy PCNL is a minimally invasive technique to remove large stone burden from the kidneys. PCNL procedure usually takes up to 2-2.5 hours under general anaesthesia and requires a 1-2 night stay.
Who Is Supine Percutaneous Nephrolithotomy PCNL Kidney Surgery Suitable For? (H2)
PCNL procedure is suitable for people with large kidney stones, (usually more than 2cm)
What Is The PCNL Procedure?
- Following general anaesthetic a small incision is made in the skin and the kidney punctured using a fine needle.
- This tract is then dilated and a plastic tube inserted into the kidney.
- A telescope is passed through the tube.
- The stone is then visualised and identified and either removed whole or broken into small pieces.
- After the operation it is usual to be left with a small tube coming from the kidney for a couple of days.
How Long Does Recovery Take From PCNL?
Patients who have had PCNL are usually on their feet the next day and discharged from hospital within 48 hours and can resume normal activity within 2-3 weeks.
What Are The Advantages Of PCNL?
There are many advantages of PCNL:
- It is minimally invasive resulting in less pain and bleeding vs conventional open procedures
- Early recovery time and reduced hospital time
- Best modality for stone clearance
Potential Risks From PCNL
Complications of PCNL include:
- failure to access the kidney
- bleeding
- damage to adjacent surrounding organs
Ureteroscopy & Holmium Lasertripsy
Ureteroscopy is a diagnostic and therapeutic procedure used in the treatment of kidney stone and ureteric stones. This is performed under a general anaesthetic usually as a day case.
ESWL
Extracorporeal shock wave lithotripsy procedure (ESWL) or “kidney shock wave” procedure is one of the procedures used to treat kidney stones. It is the most non-invasive way of treating kidney and some ureteric stones.
TURBT
Transurethral resection of bladder tumour (TURBT) is one of the main surgical procedures used in the diagnosis and management of bladder cancer.
Introduction
Ureteroscopy is a diagnostic and therapeutic procedure used in the treatment of kidney stones and ureteric stones. This is performed under a general anaesthetic usually as a day case.
What Is A Ureteroscopy?
A ureteroscopy procedure is where a small telescope is placed via the urethra into the bladder and then up into the ureter and kidney if necessary. The stone is seen directly, often broken up with a laser and the fragments removed with a basket. A JJ stent is usually inserted at the end of the operation to stop the kidney becoming blocked by swelling of the ureter tube, blood or stone fragments.
What Is Lasertripsy?
Lasertripsy is the fragmentation of stones using holmium laser.
Who Is Ureteroscopy Suitable For?
A ureteroscopy is suitable for people with any kind of stone in the ureter and small stones (usually less than 1.5cm) in the kidney.
How Long Does A Ureteroscopy Procedure Take?
A ureteroscopy procedure usually takes 45 minutes to an hour and patients can go home the same evening
Are You Put To Sleep For Ureteroscopy?
Yes, a ureteroscopy is performed under general anaesthesia
What To Expect From Your Ureteroscopy Procedure?
The steps of a ureteroscopy are as follows:
- A small telescope is placed via the urethra into the bladder and then up into the ureter and kidney if necessary.
- The stone is visualised directly.
- The stone is broken up with a laser and the fragments removed with a basket.
- A JJ stent is usually inserted at the end of the operation to stop the kidney becoming blocked by swelling of the ureter tube, blood or stone fragments.
How Long Is Recovery From A Ureteroscopy?
A ureteroscopy has a fast recovery and patients can often return to routine activities the next day.
The Advantages Of Ureteroscopy
- The advantages of ureteroscopy are that it is:
- Minimally invasive, it involves no incisions and early return to work
- Less bleeding
- Less pain
What Are The Risks Of Ureteroscopy?
The risks of a ureteroscopy are:
- Infection
- Bleeding
- Pain
- Failure to clear stones
- Bladder and ureteric injury
Introduction
Extracorporeal shock wave lithotripsy procedure (ESWL) or “kidney shock wave” procedure is one of the procedures used to treat kidney stones. It is the most non-invasive way of treating kidney and some ureteric stones.
What Is ESWL?
Extracorporeal shock wave lithotripsy procedure (ESWL) uses ultrasound waves externally to target kidney stones and some stones in the ureter. It may involve multiple sessions of about 45 minutes each to fragment the stones. Once the stones have been fragmented, the patient then passes the stones spontaneously.
ESWL is performed by a trained radiology technician under the supervision of a consultant urologist. It is performed as day-case procedure in an ESWL suite.
Who Is ESWL Suitable For?
ESWL is suitable for patients with small to mid-sized kidney stones and some ureteric stones.
How To Prepare For ESWL
There is no specific preparation required for ESWL. When used for fragmentation of larger stones, a JJ stent may need to be inserted under anesthetic prior to the procedure.
What Happens During The Extracorporeal Shock Wave Lithotripsy Procedure?
The ESWL procedure is as follows:
ESWL performed on an outpatient basis in an ESWL suite
A pain killing injection or tablets are often given prior to the treatment starting.
The patient is awake, usually lying on their back.
Usually performed by a trained radiology technician and under the supervision of a consultant urologist, high energy shock waves are focussed at the stone using either x-ray or ultrasound to try and break the stone up into smaller pieces.
The procedure itself can be uncomfortable and it may take multiple treatments before it is clear if ESWL will break the stone or not.
Once fragmented the pieces will be passed by the patient spontaneously in the urine.
What To Expect After Extracorporeal Shock Wave Lithotripsy
It is common to experience the following after ESWL
- Blood in urine
- Discomfort passing urine
- Discomfort passing stone fragments
- Discomfort on the side of the abdomen where the kidney is.
Potential Side Effects Of ESWL
The risks of EWSL are as follows:
- Blood in the urine
- Bruising around the kidney
- Pain as the fragments pass or become stuck in the ureter.
Alternatives To Extracorporeal Shock Wave Lithotripsy
The alternatives to ESWL are ureteroscopy and lasertripsy
Introduction
Transurethral resection of bladder tumour (TURBT) is one of the main surgical procedures used in the diagnosis and management of bladder cancer.
What Does TURBT Mean?
Transurethral resection of bladder tumour (TURBT) is scraping of tumours from the bladder using an electric current.
Who Is TURBT Suitable For?
TURBT procedure is suitable for patients with tumours of the bladder
How Does A TURBT Spot Bladder Cancer?
The tumour is visualised by a camera that has been inserted via the urethra in the bladder.
How Long Does A TURBT Procedure Take?
A TURBT procedure takes approximately up to one hour.
How To Prepare For TURBT
There is no specific preparation for the TURBT procedure itself, however as it is performed under general anesthesia, a 6hour fast will be required beforehand.
What To Expect At Your TURBT Procedure
The following steps are carried out during the TURBT procedures:
- TURBT is carried out under general anaesthesia.
- The surgeon uses an instrument called a resectoscope to locate the visible tumours and shaves them away from the lining of the bladder using a mild electrical current.
- The removed tumours are then sent to a laboratory for histopathology.
- Following this procedure, a catheter is inserted into the bladder through the urethra and urine drains into a bag and the catheter is used to drain away any blood and debris from the bladder.
- Once the bleeding has settled, the catheter is removed before discharge from the hospital, usually within 24-48 hours.
What Happens After TURBT?
The following are experienced up to a week after the TURBT procedure
- Blood in urine
- Discomfort passing urine
- Difficulty passing urine
How To Relieve Pain After TURBT
Routine analgesics and anti inflammatories are best to relieve pain after TURBT procedure
What Are The Possible Risks Of TURBT?
The risks of TURBT are:
- Infection
- Bleeding
- Pain
- Bladder injury
Our Expertise
At Shivneri hospital, urological expertise meets compassionate care. Our specialized team of urologists and healthcare professionals is dedicated to providing unparalleled expertise in the diagnosis, treatment, and management of urological conditions. From cutting-edge diagnostics to personalized treatment plans, trust us for comprehensive and precise urological care tailored to your unique needs.”
Bladder
- Bladder Infection
- Bladder Cancer
- Overactive Bladder
- Urinary Incontinence
- Urinary Tract Infection
Prostate
- Prostate Cancer
- Prostatitis
- Prostate Enlargement
Kidney
- Kidney Cancer
- Kidney Stone
- Kidney Infection
Male Sex Organ
- Testicular Cancer
- Erectile Dysfunction
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