Urology

Diagnostic methods in urology

According to statistics from leading Israeli clinics, about 33% of patients arrive at the Department of Urology for treatment with an incorrect or unspecified diagnosis. Therefore, the success of the entire treatment is highly questionable. That’s why, at Maimonides Medical Center, we apply a very responsible approach to the diagnostic program. For this, we use the most modern equipment only and complex diagnostics approaches.

There are some mostly used examinations::

• Review and anamnesis congregation.
• General clinical blood and urine examinationsSometimes other specific blood and urine examinations, for example, determination of PSA (prostate-specific antigen – tumor marker of prostate cancer).
• X-ray (including with contrast of urinary system organs), CT, MRI, PET-CT, MSCT with and without contrast – methods of medical detailed visualization in urology.
• Scintigraphy for distant metastases diagnosis in case of excretory and reproductive system malignant diseases.
• Ultrasound of kidneys, prostate, bladder, ultrasound of blood vessels.
• Neoplasm biopsy and biopsy specimens histological examination to verify diagnosis.
• Cystoscopy, ureteroscopy – organs examination from inside using endoscopic techniques. If necessary, a biopsy or medical procedure is immediately performed, for example, polyp removal in urinary bladder or a stone from ureter, etc.
• Urodynamic studies – allow to diagnose some problems of the urinary bladder. For example, micturition cystography allows to find vesicoureteral reflux, etc.

If we provide a biopsy on our patients during the diagnostic program, we must send tissue samples to our Israel, American, German pathology laboratories. Due to such detailed "molecular checks" the patient can be sure that the diagnosis is established accurately, and the treatment scheme is selected most optimally.

If a specific specialist or necessary technique is non-available, the patient will refer to subsidiary medical centers or Israeli partner clinics of the Maimonides Center.

Modern treatment and innovative procedures in The Department of Urology

Our department's urologists possess not only outstanding skills, but also unique technologies for providing a complex of urological surgical interventions. In our practice, we based on principles of Israeli medicine, which is known for its innovative approaches to treatment throughout the world.

If the clinical situation allows, urological surgeons always prefer minimally traumatic and organ-preserving operations, and in 45% of cases they succeed. Such gentle surgery is especially importantwhen it comes to children. Every year, pediatric urologists provide complex, but at the same time highly effective and low-traumatic surgical interventions. For example, treatment of such congenital defects as epispadias or hypospadias, pyeloplasty and other reconstructive surgies for congenital defects of kidneys and urinary tract.

The following modern treatment methods and procedures are widely used in the clinic:

• Holmium laser ablation of the prostate (HoLEP).
• Transurethral resection (TUR) of prostate adenoma.
• Laparoscopic radical prostatectomy.
• Laser endoscopic removal of prostate adenoma.
• Removal of prostate tumors using the new TOOKAD method.
• Ultrasonic ablation of tumors with focused high-intensity ultrasound.
• Cryoablation of the prostate gland.
• Ureterocystoneostomy – reimplantation of the ureter into the bladder in case of ureterocele.

Robotic surgeries using "Da Vinci" device are used in urology for radical robot-assisted prostatectomy. In this procedure, the instruments are not in the hands of the surgeon, but fixed in the manipulators of the robotic equipment , while the doctor is at the control panel.Thanks to this innovative approach, all operational risks are minimized.

Open prostate removal is used in the most difficult cases, when it is impossible to remove damaged by a malignant tumor prostate gland laparoscopically.

In The Department of Urology we actively used different modern methods of erectile dysfunction treatment for men. These are procedures such as injection therapy with Trimix and Biomixdrugs, shock wave therapy, PDE5i treatment (phosphodiesterase type 5 inhibitor drugs).

If necessary, men can undergo a phalloplasty procedure – installation of penis implantsThis is a surgical method of restoring an erection by implanting a special prosthesis inside the phallus.

Our clinic applies the most modern drug schemes for the prostate cancer treatment when surgery is contraindicated or when complex therapy schemes are used. One of them is gonadoliberin agonists or antiandrogens applicationg.This is one of the hormone therapy types, which is used in hormone-dependent tumors presence in the patient. The main aim of hormone therapy is to inhibit the action of androgens in a man's body, slow down the division of cancer cells, change their function such a way that they die on their own and no longer reproduce.

In prostate malignant neoplasms complex treatment we use such a type of radiation therapy as prostate brachytherapy. This is when a radioactive isotope in a capsule is placed directly into the tissue of a malignant prostate tumor, where the effect of radiotherapy is observed.At the same time the surrounding healthy tissues do not suffer from the effects of ionizing radiation.

A great advantage for our patients is the opportunity to participate in clinical research.On the basis of the medical center, different programs are constantly held to study the effectiveness of various experimental procedures and drugs. For some patients, this is a real chance for recovery, especially for those for whom all known standard therapy schemes have proven ineffective.

The medical center also provides a large number of modern urological interventions and procedures, for instance, radical nephrectomy, lithotripsy (remote and contact), laparoscopic operations on the kidneys, bladder, arterial and venous embolization of renal vessels, intravesical chemotherapy and immunotherapy for bladder tumors, ureteral stenting, bladder reconstruction, adrenalectomy (removal of the adrenal gland), vasectomy, and others. In accordance to this abilities, every patient who needs modern urological treatment will find the necessary help from us. At the same time, the treatment will be comfortable, affordable and highly effective.