Urology

Urology is a surgical medical specialty concerned with the diagnosis, treatment, and follow-up of diseases of the urinary tract (kidneys, ureters, bladder, and urethra) and the male reproductive system. Providing services across a wide spectrum for patients of all ages, from kidney stones to bladder problems, and from prostate diseases to urological cancers, urology plays a critical role in resolving many health issues that directly affect quality of life. The Koru Hospital Urology Department provides comprehensive urological healthcare services to patients with its experienced specialist staff and advanced technological infrastructure.

Scope of the Urology Department

Urology is not only a surgical branch but also a versatile field of expertise that encompasses medical treatment, preventive medicine, and rehabilitation. It deals with diseases of organs such as the kidneys, ureters, bladder, urethra, prostate, testes, penis, and adrenal glands. Sub-specialties such as pediatric urology, urologic oncology, endourology, andrology, female urology, and neurourology demonstrate the extensive scope of urology.

Kidney Stone Disease (Urolithiasis)

Kidney stones are a very common urological problem in the community that can cause severe pain. This condition, which occurs as a result of minerals in the urine crystallizing to form stones, can lead to symptoms such as severe lower back and abdominal pain (renal colic), blood in the urine, nausea, and vomiting, depending on the size and location of the stone.

Minimal invasive methods are of great importance in the treatment of kidney stones. Thanks to advanced techniques such as extracorporeal shock wave lithotripsy (ESWL), endoscopic stone surgery (URS - ureterorenoscopy), flexible ureterorenoscopy (RIRS), and percutaneous nephrolithotomy (PNL), the need for open surgery has been largely eliminated.

The Koru Hospital Urology Department performs the treatment of kidney stones of all sizes using minimal invasive methods with laser lithotripsy technology and flexible endoscopes. Preventive strategies aimed at preventing the recurrence of stone formation are also implemented through stone analysis, metabolic evaluation, and dietary counseling.

Prostate Diseases

Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia is a condition that occurs with increasing frequency with age and significantly affects the quality of life of men. The enlargement of the prostate gland causes pressure on the urethra, leading to symptoms such as difficulty urinating, frequent urination, nocturia (waking up at night to urinate), weak urine flow, and a feeling of incomplete emptying.

For mild to moderate symptoms, medical treatment is applied using drugs such as alpha-blockers and 5-alpha reductase inhibitors. Surgical treatment options are utilized for patients who do not respond to drug therapy or who develop complications. Methods such as transurethral resection of the prostate (TUR-P), holmium laser enucleation (HoLEP), green light laser vaporization, and prostatic urethral lift are among the current surgical options.

Prostate Cancer

Prostate cancer is one of the most common types of cancer in men and usually does not show symptoms in the early stages. For this reason, regular PSA screening and digital rectal examination are recommended for men over the age of fifty and for men over the age of forty-five with a family history of prostate cancer.

Treatment options for prostate cancer detected at an early stage include active surveillance, radical prostatectomy (robotic or open surgery), and radiotherapy. Hormone therapy, chemotherapy, and new-generation targeted therapies are applied for advanced-stage disease. Multiparametric prostate MRI and fusion biopsy technologies are innovative approaches that significantly increase diagnostic accuracy.

Bladder Diseases

The bladder is an important organ responsible for the storage and controlled emptying of urine. Bladder diseases include bladder cancer, interstitial cystitis, overactive bladder, bladder stones, and urethral strictures.

Bladder cancer is a type of cancer that manifests itself with painless bleeding in the urine and where early diagnosis is vital. Visualization of the tumor via cystoscopy and histopathological diagnosis via transurethral resection (TUR-M) constitute the first step of the treatment process. Intravesical therapy (BCG or chemotherapy) is applied for superficial bladder cancers, while radical cystectomy and urinary diversion procedures are performed for muscle-invasive cancers.

Overactive bladder syndrome is characterized by frequent urination, sudden urgency, and urge incontinence, and is a condition that significantly affects quality of life. Behavioral therapies, bladder training, pelvic floor exercises, anticholinergic drugs, and beta-3 agonists are among the first-line treatment options. In resistant cases, advanced treatment methods such as botulinum toxin injection and sacral neuromodulation can be applied.

Urinary Incontinence

Urinary incontinence is a common problem that can occur through different mechanisms in both men and women and negatively affects social life. Urinary incontinence, which has different types such as stress incontinence, urge incontinence, and mixed incontinence, is a treatable condition.

Stress-type urinary incontinence, which is common in women especially after childbirth and during menopause, is treated with pelvic floor strengthening exercises and, if necessary, surgery (midurethral sling operation). In men, incontinence that may develop after prostate surgery is managed with pelvic floor rehabilitation and, if necessary, artificial sphincter implantation.

Andrology and Men's Health

Andrology is an important sub-branch of urology that deals with male reproductive health and sexual dysfunction. Male infertility, erectile dysfunction, Peyronie's disease, hypogonadism, and ejaculation disorders are the main topics of this field.

Semen analysis, hormone tests, scrotal ultrasonography, and genetic tests when necessary are used in the evaluation of male infertility. Varicocele surgery, microsurgical sperm retrieval techniques (micro-TESE), and hormonal treatments are the main treatment methods used in the management of male infertility.

Erectile dysfunction is not only a sexual problem but can also be an early indicator of cardiovascular diseases. For this reason, it is recommended that patients presenting with complaints of erectile dysfunction undergo a comprehensive cardiovascular risk assessment. Phosphodiesterase type 5 inhibitors, intracavernosal injection therapy, vacuum devices, and penile prosthesis implantation are among the treatment options.

Pediatric Urology

Childhood urological diseases constitute a special field that requires a different approach than adults. Undescended testis, hypospadias, vesicoureteral reflux, posterior urethral valve, ureteropelvic junction obstruction, and enuresis (bedwetting) are the most common pediatric urological problems.

Undescended testis is a condition seen in approximately three to five percent of male infants and requires surgical treatment if it has not descended spontaneously by the sixth month. Early surgical intervention is important for preserving testicular function and reducing the long-term risk of cancer. Hypospadias surgery is a microsurgical procedure aimed at correcting the condition where the urethral opening is on the underside of the penis.

Urological Cancers

In addition to prostate cancer, the urology department is also responsible for the surgical treatment of many types of cancer, such as kidney cancer, bladder cancer, testicular cancer, adrenal gland tumors, and upper urinary tract cancers. Thanks to laparoscopic and robotic surgical techniques, it is possible to remove these tumors using minimal invasive methods.

In kidney cancer, partial nephrectomy (removing the tumorous part of the kidney while preserving healthy kidney tissue) is the preferred approach where possible. Testicular cancer is one of the most common types of cancer in young men and is a highly treatable disease. Regular self-testicular examination is of great importance for early diagnosis.

Minimal Invasive and Robotic Surgery

In modern urological practice, open surgery is increasingly being replaced by minimal invasive methods. Thanks to laparoscopic surgery, robotic surgery, and endoscopic procedures, surgical treatment is possible with smaller incisions, less bleeding and pain, shorter hospital stays, and faster recovery.

Robotic surgery provides significant advantages, especially in prostate cancer, kidney cancer, and bladder cancer surgery, thanks to its superior imaging capacity and precise movement capability. Three-dimensional magnified images and articulated surgical instruments allow the surgeon to work more precisely.

When Should You Consult the Urology Department?

• Difficulty urinating: Weak urine flow, intermittent urination, difficulty starting urination
• Frequent urination and nocturia: Urinating more than eight times during the day and more than twice at night
• Blood in the urine: Visible or detected blood in tests
• Lower back and flank pain: Sudden onset, severe, fluctuating pain (suspicion of kidney stones)
• Urinary incontinence: Leaking urine during coughing, sneezing, or physical activity
• Urinary tract infections: Recurrent urinary tract infections
• Sexual dysfunction: Erectile dysfunction, premature ejaculation
• Infertility: Failure to achieve pregnancy despite one year of unprotected intercourse
• Testicular swelling or pain: A palpable hardness or mass in the testicle
• Childhood urological problems: Undescended testis, bedwetting, urinary tract infections
• High PSA: High PSA values detected in screening tests

Preventive Approaches in Urological Diseases

Lifestyle changes play an important role in the prevention of urological diseases. Adequate fluid intake, a balanced diet, regular physical activity, and avoiding smoking and excessive alcohol consumption are fundamental elements in maintaining urinary system health. Regular health check-ups and age-appropriate screening tests ensure that diseases are caught at an early stage.

In patients with a history of kidney stones, adequate water consumption, a low-sodium diet, and specific dietary recommendations according to the stone type reduce the risk of recurrence. Regular exercise, maintaining a healthy body weight, and regular urological check-ups after the age of fifty are recommended for maintaining prostate health.

In the Koru Hospital Urology department, our specialist physicians provide comprehensive urological healthcare services to our patients of all age groups using the most up-to-date diagnostic and treatment methods. You can consult our department for your complaints regarding the urinary system or male reproductive health.