Patologías prostáticas y renovesicales

Prostatic and renovesical pathologies

Dr. Hernández tells us about the leading techniques performed at the Polyclinic for the treatment of different prostatic and renovesical pathologies.

Dr. Hernandez, could you tell me what kind of treatments are done at the center?

Since I joined the Polyclinic in 2011, there has been no other objective than to turn the Urology service into a current service, leader and notarized with the validity of the European guidelines, and all with the only challenge of getting out the patient of the consultation with the satisfaction of perceiving the effort of a whole human group in favor of a job well done.

Thus, we perform bladder oncological surgical treatment, urinary incontinence with diagnosis by urodynamics and intravesical injection with Botox, the diagnosis of prostate cancer by transrectal biopsy with sedation, and the recent incorporation of the laser both for the treatment of bladder, ureteral / intrarenal urinary calculus as well as benign prostatic hyperplasia by means of Thulium laser vaporization, among other services.

One of the episodes of his specialty that most sounds to us all are nephritic colic, what is it exactly?

A urinary stone is a solid formation produced by the accumulation of mineral salts present in the urine. It affects up to 25% of the population throughout its life. In the case of the detachment of a kidney stone in the ureter, obstruction and the consequent nephritic colic are produced, which will manifest as intense acute lumbar pain irradiated in the genital inguinal area and that does not yield to any postural change. A high percentage of cases requires treatment to expel it. The URS-RIRs (Ureteroscopy-intrarenal surgery) – Holmium laser is performed using a ureteroscope, connected to an HD camera that provides a high definition image of the urinary tract, which can be rigid or flexible. One or the other is used depending on the location and size of the calculation.

The fragmentation of the calculation is done with laser energy. If there are small fragments, they are removed with a basket and a double J catheter is left for one week, which is removed on an outpatient basis. It is performed under general anesthesia, usually lasts between 30-60 minutes and the admission is usually less than 24 hours. Since the recent acquisition by PCV of the Holmium laser for lithiasis in May 2018, more than 40 cases of ureteral lithiasis by laser have been resolved in 8 months with a total success rate and an average stay of 18h.

What is the prostate laser?

Laser surgery for prostatic photovaporization is a minimally invasive treatment for the enlarged prostate. The procedure uses a laser to perform photoselective vaporization (transformation of tissues in water vapor) of the prostate (VFP). It involves inserting a cystoscope through the penis and delivering a laser fiber that removes tissue that obstructs the urinary flow through the urethra, without bleeding, and, therefore, with fewer hours of a urethral catheter and hospital admission. The patient can be discharged at 24 h without a bladder catheter and is reincorporated into the activities of daily life (except efforts) on the third or fourth day.

Dr. Héctor Hernández Pozo, specialist in Urology and head of the Urology Service / Policlínica Comarcal de El Vendrell

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