Wangaratta Urology

Relevant Anatomy

Urological Conditions - Relevant Anatomy

Benign Prostatic Hyperplasia (BPH)

This is an enlarged prostate. The prostate is a male reproductive gland that produces fluid to nourish the semen and sits at the base of the bladder. The urethra or water pipe runs through the middle of the prostate. The normal sized prostate is roughly the size of a walnut. In the majority of men the prostate grows as they get older. This can cause blockage to the passage of urine from the bladder.

    Some of the more common symptoms of this include:
  • reduction in the stream
  • incomplete emptying
  • urgency to urinate
  • more frequent desire to urinate
  • getting up to urinate more during the night

Occasionally, when it progresses you may not be able to urinate at all requiring a catheter. Depending on the severity it can be treated by watchful waiting, medication or surgery (Trans Urethral Resection of Prostate (TURP) or ‘re-bore’)

Prostate Cancer

  • second most common cause of cancer death in Australian men
  • 3300 Australian men per year die from prostate cancer
  • diagnosis based on digital examination through rectum (back passage) and blood test (PSA).
    PSA refers to prostate specific antigen, a protein that is produced in the prostate and enters the bloodstream. PSA is produced by both normal and cancerous cells within the prostate. However, cancerous cells tend to leak more PSA into the bloodstream. PSA can rise in other conditions such as prostatitis (prostate infection or inflammation). Because of its limitations, the PSA is not a stand-alone test in identifying men at high risk of harbouring prostate cancer, therefore a prostate examination forms an important part of the decision making. In addition a small proportion of men with prostate cancer have a normal PSA.
  • if suspected, a small procedure to biopsy the prostate will be recommended todetermine if prostate cancer is present
  • there are many options for treatment if the prostate cancer is confined to the prostate (most), depending on a number of factors including age, medical co-morbidities, voiding symptoms and patient wish. These include watchful waiting, active surveillance (watching but plan to actively treat if progresses), surgery or radiotherapy

Bladder Cancer

  • often diagnosed due to blood in the urine either visible or invisible (microscopic)
  • can also present with recurrent urine infections or irritable urinating symptoms
  • diagnosed via a cystoscopy (telescope into the bladder) which can be performed with local anaesthetic jelly or anaesthetic.
  • if diagnosed treatment involves surgical removal with telescope called TransUrethral Resection of Bladder Tumour (TURBT) using a hot electrode (wire) to scrape the tumour off the bladder
  • most bladder cancers are confined to the inner lining and require only regular cystoscopies after to detect recurrences
  • if the cancer has gone deeper into the bladder more aggressive treatment such as cystectomy (bladder removal) or chemo-radiotherapy may be required

Kidney Cancer

  • diagnosed with symptoms such as haematuria (blood in the urine) or now more frequently incidentally whilst having CT scan or ultrasound
  • can be cancer of the kidney meat or the inner lining of the kidney where the urine runs through
  • treatment is usually surgical removal either just the tumour if feasible or the whole kidney
  • this can often be performed laparoscopically (keyhole) available in Wangaratta, the advantage being shorter hospital stay, less pain and quicker recovery