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Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Related Experiment Video

Updated: May 1, 2026

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
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Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction.

Nikesh Thiruchelvam1

  • 1Department of Urology, Addenbrookes Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK.

Indian Journal of Urology : IJU : Journal of the Urological Society of India
|April 19, 2014
PubMed
Summary

Monopolar transurethral resection of the prostate (TURP) is the benchmark for benign prostatic hypertrophy (BPH) surgery. While many alternatives exist, none offer superior long-term outcomes compared to TURP, though some reduce morbidity.

Keywords:
Green light laserholmium laser enucleation of the prostatelaser prostatectomyprostatectomythulium lasertransurethral resection of the prostate

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Area of Science:

  • Urology
  • Surgical Technology

Background:

  • Benign prostatic hypertrophy (BPH) is a common condition affecting men.
  • Monopolar transurethral resection of the prostate (TURP) is the established gold standard for BPH surgical treatment.
  • Numerous alternative surgical techniques have been developed to improve upon TURP.

Purpose of the Study:

  • To review current literature, guidelines, and consensus on surgical options for BPH.
  • To provide an overview of established, emerging, and experimental BPH surgical techniques.
  • To highlight the need for patient counseling due to the multitude of procedures and unanswered questions.

Main Methods:

  • Literature review of current surgical options for BPH.
  • Analysis of international urological guidelines and consensus opinions.
  • Categorization of techniques into established, emerging, and experimental.

Main Results:

  • Monopolar TURP remains the gold standard for BPH surgery.
  • Alternative techniques, including bipolar TURP, laser prostatectomy, and minimally invasive options, have not surpassed TURP in long-term outcomes.
  • Improvements in surgical morbidity and hospital stay have been noted with newer procedures.
  • Significant questions remain regarding the pathophysiology of bladder outflow obstruction (BOO) and optimal BPH treatment.

Conclusions:

  • Despite numerous surgical alternatives, none have demonstrated superior long-term efficacy compared to monopolar TURP for BPH.
  • While some procedures offer reduced morbidity and shorter hospital stays, patient counseling is crucial due to the complexity and remaining questions in BPH management.