Urology treats urinary tract diseases in all genders and male reproductive issues, covering the kidneys, bladder, prostate, urethra, from infections to complex cancers.
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The goal of BPH treatment is to improve quality of life (QoL) and prevent complications such as urinary retention, kidney damage, and bladder stones. Treatment is individualized based on prostate size and patient preference.
PDE5 Inhibitors (e.g., Tadalafil): Relaxes pelvic smooth muscle and improves vascular perfusion. Excellent for men with both BPH and Erectile Dysfunction.
Liv Hospital prioritizes Minimally Invasive Surgical Therapies (MIST) and Endourology.
Aquablation: Robotic waterjet resection. Uses a high-velocity water jet to ablate tissue under ultrasound guidance—Heat-free, preserving ejaculation in many cases.
Treatment is strictly stage-dependent and involves a multidisciplinary team.
Localized Disease (Low to Intermediate Risk)
For patients with a single, visible tumor on MRI who wish to preserve function. Technologies like HIFU (High-Intensity Focused Ultrasound) or NanoKnife (Irreversible Electroporation) are used to ablate only the cancer, sparing the rest of the gland and preserving continence and potency.
Advanced/Metastatic Disease
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This is a common side effect of Alpha-blockers and prostate surgeries (TURP, HoLEP). Usually, the bladder neck closes tightly during orgasm to force semen out of the penis. Treatment relaxes or removes the bladder neck tissue, so semen takes the path of least resistance backward into the bladder. It is medically harmless (the semen is urinated out later) but causes a “dry orgasm” and infertility.
Both offer similar long-term cure rates for localized cancer. The choice depends on the side-effect profile and patient age. Surgery carries risks of immediate incontinence and ED (which usually improve over time) but removes the organ for pathology. Radiation avoids surgery but can cause long-term bowel irritation (proctitis) or progressive ED years later. Younger men often choose surgery; older men often choose radiation.
for glands larger than 60-80 grams? HoLEP is superior. It removes the entire adenoma (like peeling an orange), whereas TURP creates a channel in the middle (like coring an apple). HoLEP has a lower recurrence rate, removes more tissue, causes less bleeding, and allows for shorter catheter times. For small prostates, both are excellent options.
The “Trifecta” represents the ideal surgical outcome that surgeons aim for: 1. Cancer Control (Negative Surgical Margins/Undetectable PSA), 2. Urinary Continence (No pads needed), and 3. Potency (Ability to have erections). Robotic surgery has improved our ability to achieve the Trifecta by allowing precise dissection.
Historically, giving testosterone to men with a history of prostate cancer was forbidden (“adding fuel to the fire”). However, recent data suggest that in selected men who have been cured (undetectable PSA for a period of time) and are suffering from severe low-T symptoms, replacement therapy may be safe under strict urological supervision (“Saturation Model”).
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