Common Urological Investigations

Common Urological Investigations

Urine tests

A mid-stream urine (MSU) is caught to look for infection in the urine.
Urinary cytology, often performed 3 times as early morning specimens, looks for abnormal cells suggestive of cancer.

Urinary flow rate

This specialized machine measures how fast your urine flow is, which gives an estimation as to degree of blockage is present.

Post-void residual urine volume

An ultrasound is used to assess how much urine remains in the bladder after urination.

Flexible cystoscopy

A small camera is passed via the urethra to look inside the bladder. This is usually done with local anaesthetic gel.

CT or Ultrasound of the abdomen and pelvis

Depending on the indication, a CT or ultrasound in a radiology department, is used to visualize the kidneys, ureters, and abdominal and pelvic organs. This may involve injection of radiological contrast.

Multiparametric MRI prostate

If prostate cancer is suspected, MRI can help locate a lesion within the prostate, and sometimes show if there is extension outside of the prostate.

Trans-rectal ultrasound

Guided biopsy of the prostate: Under anaesthetic, local or intravenous sedation, an ultrasound is placed into the rectum to visualize the prostate. Then a needle takes multiple cores of the prostate for the pathologist to examine under the microscope for presence of cancer.

Common Urological Conditions

Common Urological Procedures our Urologists perform

A brief explanation of our common procedures is outlined below. Details specific to your case will be discussed in person with your urologist.

  • Bladder

    Rigid cystoscopy with biopsy

    Transurethral resection of bladder mass (TURBT)
    Under anaesthetic, a camera is placed via the urethra into the bladder. Any suspicious areas or masses are biopsied or removed using diathermy.

    Bladder stone – holmium lasertripsy

    Urethra Slings

  • Prostate

    Transurethral resection of prostate (TURP) or laser ablation of prostate

    Under anaesthetic, a camera is placed via the urethra into the bladder. The prostate that encircles and occludes the urethra is removed or vaporized, opening up the channel for urine to be passed.

    Radical prostatectomy: robotic-assist, laparoscopic or open

    The aim of this procedure is to remove the entire prostate with the cancer. Traditionally, this was done via a midline incision (open). More recently, minimally invasive approaches using keyhole surgery, such as laparoscopic and robotic-assisted laparoscopic instruments have been utilized. After the prostate is removed, the bladder is joined to the urethra. The nerves responsible for erectile function lie very close to the prostate and can be injured during the operation.

  • Kidney and Ureter

    Radical Nephrectomy

    This involves removal of the entire kidney for cancer. Depending on the size, location and type of the tumour, partial nephrectomy is not appropriate. If possible, laparoscopic (keyhole surgical approach) surgery may be used. Otherwise, the kidney will be removed via a larger incision.

    Partial Nephrectomy

    For some renal masses, it may be possible to remove the mass and preserve the surrounding kidney. This depends on the size, location and type of the tumour. Similarly, a laparoscopic or open approach may be used.

    Ureteroscopy or pyeloscopy

    A small camera may be passed up through the urethra, bladder and into the ureter (and up to the kidney if required). This can be done as a diagnostic procedure (to look for a cause). The camera can also be used to take biopsies, and fragment stones (laser lithotripsy).

    Extracorporeal shockwave lithotripsy (ESWL)

    A non-invasive technique under anaesthetic, ESWL uses a focused acoustic pulse (sound wave) to break up or fragment stones.

    Percutaneous Nephrolithotomy (PCNL)

    A more invasive technique to remove complex, large (staghorn) kidney stones. Under anaesthetic, the kidney is punctured allowing a tract to be dilated between the skin to the kidney. The stones are then fragmented and extracted through the tract.

  • Testis and Scrotum

    Repair of hydrocoele

    Through an incision in the scrotum, the scrotal sac lining (tunica vaginalis) that contains the fluid is opened and partly removed to prevent recurrence.

    Radical orchiectomy

    The testis containing the mass is delivered to an incision made in the groin. A length of the spermatic cord (containing blood vessels and lymphatics in and out of the testis) is removed with the testis.