Dr Jo Schoeman
Urological Surgeon

        

Terminology

Urologist

A Surgeon specializing only in the Uro-genital tract. Therefore all the organs associated with the production, conveying and storage of urine, including continence thereof. Urology also includes the male sexual organs and function thereof.


Renal

Kidneys are the paired bean-shaped organs responsible for filtration and cleansing of your blood. They produce urine.


Adrenal gland

A small gland above each kidney responsible for hormones which help with metabolism, growth, fear-and-fight.


Ureters

Kidney pipes/tubes leading urine from the kidney to the bladder.


Bladder

Also known by its latin word the Cyst or Vesico which means a fluid containing sac or organ. Its function is to store and expel urine.


Urethra

The tube that conveys urine from the bladder to the opening of the bladder pipe (meatus).


Vero Montanum

The opening of the ejaculatory ducts in the prostatic urethra.


Seminal Vesicles

Small paired ducts behind the prostate and bladder, where the ejaculate is stored. Fructose is produced to feed the sperm cells.


Meatus

Opening of the urethra, Tip of penis in males and between clitoris and vaginal opening in females.


Penis

Male sexual organ, with 2 functions: a pointer for urination and sexual organ to facilitate procreation.


Testes

2 oval organs found in the scrotum responsible for male fertility. Produces sperm.


Scrotum

The sac below the penis containing the male testes. Also regulated temperature for optimal sperm production.


Perineum

Area between scrotum and anus.


Prostate

Accessory male sexual organ found below the bladder and above your external sphincter (pincher) It sits around the urethra with glandular tubes opening un the urethra. Produces the seminal fluid which helps to create a medium in which the sperm is nutured for fertilization.


PSA

Prostate Specific Antigen is an enzyme produced by the prostate which takes the ejaculate from a clotted to flow-able form helping with fertilization.


Lymphnodes

Small glands found in strategic places in the body which drain all lymph ( clean-up fluid) Most cancers drain to the regional lymphnodes.


Vagina

Female sexual organ as well as the birth canal facilitating the passage of the mature fetus during childbirth.


Urothelium

Umbrella cells that line the inside of Bladder, Ureters and renal pelvis as well as the urethra up to the distal urethra.


Cystoscoele

The prolapse of the bladder through the front vaginal wall to such a degree that it influences urination and bladder emoications.


Enterocoele

The prolapse of small bowel through the top of the vagina or back wall, being symptomatic.


Vault Prolapse

The top of a previously hysterectomized vagina inverting and pushing to the outside of the vagina.


Procidentia

A fully inverted vagina prolapsing outside the vagina. This could potentially be a dangerous situation and requires urgent review.


Rectocoele

The prolapse or herniation of the back wall of the vagina containing the rectum influencing defecaetion.


Cystoscopy

Looking inside the bladder with a camera.


Ureteroscopy

Looking up the ureters via the bladder.


CT IVP

Computed Tomography (Scan) using intravenous dye. An Intravenous Pyelogram is done. Radiographic contrast medium is injected through your veins and is taken in your circulation. It is the excreted by your kidneys which is then the pyelogram. It also delineates the kidneys, collecting systems and ureters.


Indwelling Urethral Catheter

A latex or silicone tube secured in the bladder with a balloon filled with water. Used to drain urine. Usually short-term use, yet can be used long-term 8 weeks at a stretch.


Suprapubic catheter

A catheter placed 2 cm above the pubic bone. Usually for longterm use as with patients with spinal injuries.


ISC

Intermittent self catheterisation. Where a catheter is used to empty the bladder on a regular basis where there is a neurological problem causing the inability to empty the bladder.


ISD

Intermittent self dilatation: usually where there is a narrowing in the urethra where a conservative approach is used in treating is with daily dilation using a catheter.


LUTS

Lower urinary tract symptoms consisting oiding and storage symptoms such as: slow stream, hesitancy, interrupted stream, nocturia, frequency urgency etc.


BPH

Benign prostate enlargement with or without LUTS symptoms.


Nocturia

Getting up more than once per night to urinate specifically.


Frequency

Having to use the toilet more than 8 times per day.


Urgency

Sudden uncontrollable desire to urinate, with fear of incontinence.


D’Amico risk stratification for prostate cancer

  • Low risk:
    • T1-T2a
    • Gleason 3,3;
    • PSA < 10
  • Intermediary risk:
    • T2b
    • Gleason 3,4; 4,3
    • PSA 10-20
  • High risk:
    • T2c
    • Gleason 4,4
    • PSA > 20

Cystogram

A radiological study where an indwelling catheter is present on the bladder or may be placed in the bladder to administer radiological contrast to asses the anatomy of the bladder, exclude vesico-ureteric reflux, posterior urethral valves in kids and to asses the vesico-urethral anastomosis after a radical prostatectomy.


Supine

Lying on your back.


Prone

Lying face down.


Lithotomy

Lying with your legs up, knees and hips flexed in 90 degree angle.


Hyper-lithotomy

Lithotomy position with the hips flexed more resulting in the pelvis tilting further forward.


Lateral position

Lying on your side with a 45degree angle with the bed.


Bipolar

An electrocautery in which both active and return electrodes are incorporated into a single handheld instrument, so that the current passes between the tips of the two electrodes and affects only a small amount of tissue.


Monopolar

An electrocautery in which current is applied through a handheld active electrode and travels back to the generator through an inactive electrode attached to the patient (the grounding pad), so that the patient is part of the electrical circuit.


Laser Vaporisation

The process of removing material from a solid (or occasionally liquid) surface by irradiating it with a laser beam.


TRUS

Trans Rectal Ultrasound guided Prostate visualisation and guided prostate biopsies.


Fudicial Marker

Usually a gold seed that is placed via TRUS in the prostate to mark the peripheral areas of the prostate enabling safe radiation.


Prophylactic Antibiotics

Antibiotics given before surgery to prevent infection.


Anti-coagulation therapy

Therapy with Warfarin or Clexane working on the Clotting cascade.


Anti-platelet therapy

Medications such as Asprin and Plavix that disables the function of platelets.


Laparoscopic Procedure

A procedure done with intra abdominal cameras and ports, a minimally invasive technique.


Open Surgery

A cut of variable lengths are made to access any urological organ to facilitate treatment.


Endoscopic Procedure

A camera procedure of the internal aspects of the bladder, prostate ureters and kidney. Usually done through the natural orifice of the urethra, occasionally through a puncture site through the back into the kidney.


General anaesthesia

The anaethiatist will put you to sleep and also paralyse your muscles and support your breathing using a ventilator.


Regional anaesthesia

A part of your body, usually the lower half of your body is paralysed and desensitised using a spinal injection of a local anaesthetic (Spinal / Epidural).