For the scientific daybook, see Urology ( diary )
Urology ( from Greek οὖρον ouron “ urine ” and -λογία -logia “ survey of ” ), besides known as genitourinary operation, is the branch of medicine that focuses on surgical and aesculapian diseases of the male and female urinary-tract organization and the male generative organs. Organs under the domain of urology include the kidneys, adrenal gland glands, ureters, urinary bladder, urethra, and the male generative organs ( testes, epididymis, virginia deferens, germinal vesicles, prostate gland, and penis ). The urinary and generative tracts are close linked, and disorders of one frequently affect the other. Thus a major spectrum of the conditions managed in urology exists under the domain of genitourinary disorders. Urology combines the management of medical ( i, non-surgical ) conditions, such as urinary-tract infections and benign prostate hyperplasia, with the management of surgical conditions such as bladder or prostate cancer, kidney stones, congenital abnormalities, traumatic injury, and stress incontinence. [ 1 ]
Urological techniques include minimally incursive robotic and laparoscopic operating room, laser-assisted surgeries, and other scope-guided procedures. Urologists receive educate in assailable and minimally encroaching surgical techniques, employing real-time sonography guidance, fiber-optic endoscopic equipment, and versatile lasers in the treatment of multiple benign and malignant conditions. [ 2 ] [ 3 ] Urology is closely related to ( and urologists frequently collaborate with the practitioners of ) oncology, nephrology, gynecology, andrology, pediatric operating room, colorectal operation, gastroenterology, and endocrinology. urology is one of the most competitive and highly try surgical specialties for physicians, with new urologists comprising less than 1.5 % of United States medical-school graduates each year. [ 4 ] [ 5 ] Urologists are physicians which have specialized in the field after completing their general degree in medicate. Upon successful completion of a residency program, many urologists choose to undergo further boost prepare in a subspecialty sphere of expertness through a family lasting an extra 12 to 36 months. Subspecialties may include : urologic surgery, urologic oncology and urologic oncological surgery, endourology and endourologic operating room, urogynecology and urogynecologic operating room, reconstructive urologic surgery ( a shape of reconstructive surgery ), minimally-invasive urologic surgery, pediatric urology and pediatric urologic surgery ( including adolescent urology, the treatment of previous or delayed puberty, and the treatment of congenital urological syndromes, malformations, and deformations ), transplant urology ( the field of transplant medicine and surgery concerned with transplant of organs such as the kidneys, bladder tissue, ureters, and, recently, penises ), voiding dysfunction, paruresis, neurourology, and androurology and sexual medicine. Additionally, some urologists supplement their fellowships with a master ‘s degree ( 2–3 years ) or with a Ph.D. ( 4–6 years ) in related topics to prepare them for academician a well as focus clinical use .
education [edit ]
United States [edit ]
In 2014, there were 126 residency programs that offered 296 categorical positions. [ 6 ] Urology is one of the early match programs, with results given to applicants by recently January ( 6 weeks before NRMP match ). Applications are accepted starting Sep 1, with some programs accepting applications until early Jan. [ 7 ] It is a relatively competitive forte to match into, with only 68 % to 77 % of US seniors matching between 2012 and 2015. [ 6 ] The number of positions has grown from 278 in 2012 to 296 in 2015. Matching is significantly more unmanageable for IMGs and students who have a class or more off before residency – match rates were 27 % and 55 % respectively in 2012. [ 8 ] The medical school environment may besides be a factor. A cogitation in 2012 besides showed after an analysis of peer rates from schools between 2005 and 2009 that 20 schools sent more than 15 students into urology ( 1 standard deviation above the median ), with Northwestern University sending 44 students over those 5 years. [ 9 ] After urology residency, there are seven subspecialties recognized by the AUA ( American Urological Association ) :
- Female Urology
- Transplant (renal)
Australia [edit ]
trail is completed through the Royal Australasian College of Surgeons [ 11 ] ( RACS ). The program requires six years of full-time aim ( for those who commenced prior to 2016 ), or five years for those who commenced after 2016. [ 12 ] The program is accredited by the Australian Medical Council. [ 11 ] Pre-requisites include : [ 13 ]
- Australian Citizenship, New Zealand Citizenship or Australian Permanent Residency
- General medical registration
- Completion of PGY2 (see: Medical education in Australia)
- Completion of the RACS Hand Hygiene Learning Module
nepal [edit ]
In Nepal, the courtly urologist degree awarded is MCh ( Magister Chirurgiae ). [ 14 ] This is a three years course mail masters and includes thesis and a mandatary publication. This academic degree is awarded after completing MBBS ( four and half year plus a annual rotatery [ check spelling ] internship ) and MS ( Mastery of operating room ) in general surgery ( three years course ). Till now two Universities Tribhuvan University and Kathmandu University ampere well as two Autonomous institutes BP Koirala Institute of health sciences and National Academy of Medical Sciences ( Bir Hospital ) run the MCh Urology program. 19, 20 This degree is equivalent to Clinical PhD and called as “ Chikitsa Bidhyabaridhi ” by Tribhuvan University ( Government University ) and is considered to be the highest degree among the surgical discipline degrees. Besides Urology, Cardiothoracic and Vascular Surgery, Surgical Gastroenterology, Plastic Surgery, and Neurosurgery MCh programmes besides run in the area .
ethiopia [edit ]
Urology is a relatively new sphere in Ethiopia. By 2001, there were only five qualify Urologists in the country. All trained afield, in countries like India, Tanzania and Hungary. Before this chapter, all Urology cases were managed by General surgeons. The alone Urological Unit in the area was at Tikur Anbessa Tertioary Hospital. The services provided admit ESWL and Endo- urology. The Urology train course of study was started in 2009 with a course of study for General Surgeons which had a three-year prepare plan. Up to 2019 six Urologists have graduated by this program for General surgeons. The first residency program started accepting General practitioners in 2010 for a five-year plan. [ 15 ] The first two years were trainings in General operation, the following three years were dedicated urology coach program, which included the same three year discipline as of the General surgeons three class course of study. It started with two residents who graduated in 2015 with a certificate in peculiarity of Urology. Up to 2019 seventeen Urologists have graduated from this five year residency program. From the start these programs in 2009 up to 2019, a total of 23 urologists have been trained in Tikur Anbessa Tertioary Hospital. presently there are 26 trainees in the program. One General surgeon who is in the 2nd year of the three year program and 25 residents who completed two years of cosmopolitan surgery train, as of 2020, 6 are in PGY3, 10 PGY4 and 9 PGY5. All of the Urologists who graduated from Tikur Anbessa Tertioary Hospital are presently working in different parts of the country [ 15 ]
Subdisciplines [edit ]
As a medical discipline that involves the care of many organs and physiologic systems, urology can be broken down into several subdisciplines. At many larger academic centers and university hospitals that excel in affected role concern and clinical research, urologists much specialize in a particular substitute discipline .
Endourology [edit ]
Endourology is the branch of urology that deals with the close manipulation of the urinary tract. [ 16 ] It has recently grown to include all minimally encroaching urologic surgical procedures. As opposed to open operation, endourology is performed using belittled cameras and instruments inserted into the urinary tract. Transurethral surgery has been the basis of endourology. Most of the urinary tract can be reached via the urethra, enabling prostate gland operating room, surgery of tumors of the urothelium, stone operating room, and simple urethral and urethral procedures. recently, the summation of laparoscopy and robotics has further subdivided this branch of urology .
laparoscopy [edit ]
Laparoscopy is a quickly evolving branch of urology and has replaced some open surgical procedures. Robot-assisted operating room of the prostate, kidney, and ureter has been expanding this field. Today, many prostatectomies in the United States are carried out by alleged robotic aid. This has created controversy, however, as robotics greatly increase the cost of surgery and the profit for the patient may or may not be proportional to the extra price. furthermore, current ( 2011 ) marketplace situation for automatic equipment is a de facto monopoly of one publicly held pot [ 17 ] which far fuels the cost-effectiveness controversy.
Urologic oncology [edit ]
Urologic oncology concerns the surgical treatment of malignant genitourinary diseases such as cancer of the prostate gland, adrenal gland glands, bladder, kidneys, ureters, testicles, and penis, equally well as the skin and hypodermic weave and muscle and fascia of those areas ( that particular subspecialty overlaps with dermatologic oncology and related areas of oncology ). The treatment of genitourinary cancer is managed by either a urologist or an oncologist, depending on the treatment type ( surgical or medical ). Most urologic oncologists in western countries use minimally invasive techniques ( laparoscopy or endourology, robotic-assisted operation ) to manage urologic cancers amenable to surgical management .
Neurourology [edit ]
Neurourology concerns nervous system restraint of the genitourinary system, and of conditions causing abnormal micturition. neurological diseases and disorders such as a stroke, multiple sclerosis, Parkinson ‘s disease, and spinal anesthesia cord injury can disrupt the lower urinary nerve pathway and result in conditions such as urinary incontinence, detrusor overactivity, urinary retention, and detrusor sphincter ataxia. Urodynamic studies play an important diagnostic function in neurourology. Therapy for skittish arrangement disorders includes clean intermittent self-catheterization of the bladder, anticholinergic drugs, injection of Botulinum toxin into the bladder wall and advanced and less normally use therapies such as sacral neuromodulation. Less marked neurological abnormalities can cause urological disorders as well—for exercise, abnormalities of the sensory nervous system are thought by many researchers to play a role in disorders of atrocious or frequent micturition ( e.g. irritating bladder syndrome besides known as interstitial cystitis ) .
Pediatric urology [edit ]
Pediatric urology concerns urologic disorders in children. such disorders include cryptorchidy ( undescended testes ), congenital abnormalities of the genitourinary nerve pathway, enuresis, underdevelop genitalia ( ascribable to delayed growth or delayed puberty, much an endocrinological problem ), and vesicoureteral reflux .
Andrology [edit ]
Andrology is the aesculapian specialization that deals with male health, particularly relating to the problems of the male generative system and urological problems that are unique to men such as prostate cancer, male birthrate problems, and surgery of the male generative system. It is the counterpart to gynecology, which deals with aesculapian issues that are specific to female health, specially generative and urologic health .
reconstructive urology [edit ]
reconstructive urology is a highly specialize airfield of male urology that restores both structure and function to the genitourinary tract. Prostate procedures, full or fond hysterectomies, trauma ( car accidents, gunfire wounds, industrial accidents, range injuries, etc. ), disease, obstructions, blockages ( for example, urethral strictures ), and occasionally, childbirth, can necessitate reconstructive surgery. The urinary bladder, ureters ( the tube that lead from the kidneys to the urinary bladder ) and genitalia are other examples of reconstructive urology .
Female urology [edit ]
Female urology is a arm of urology dealing with hyperactive bladder, pelvic electric organ prolapse, and urinary dissoluteness. many of these physicians besides practice neurourology and reconstructive urology as mentioned above. female urologists ( many of whom are men ) complete a 1–3-year fellowship after completion of a 5–6-year urology residency. [ 18 ] Thorough cognition of the female pelvic floor together with cozy understanding of the physiology and pathology of voiding are necessary to diagnose and treat these disorders. Depending on the cause of the person problem, a aesculapian or surgical discussion can be the solution. Their field of exercise heavily overlaps with that of urogynecologists, physicians in a sub-discipline of gynecology, who have done a three-year fellowship after a four-year OBGYN residency. [ 18 ]
Journals and organizations [edit ]
There are a total of peer-reviewed journals and publications about urology, including The Journal of Urology, European Urology, the African Journal of Urology, British Journal of Urology International, BMC Urology, amerind Journal of Urology , Nature Reviews Urology , and Urology . There are home organizations such as the American Urological Association, the American Association of Clinical Urologists, [ 19 ] European Association of Urology, the Large Urology Group Practice Association, [ 19 ] and The Society for Basic Urologic Research. Urology is besides included under the auspices of the International Continence Society. Teaching organizations include the European Board of Urology, adenine well as the Vattikuti Urology Institute in Detroit, which besides hosts an annual International Robotic Urology Symposium devoted to new technologies. The american english non-profit IVUMed teaches urology in developing countries .
urology in the COVID19 pandemic [edit ]
During the COVID-19 pandemic, urology services around the globe suspended their activities in feign countries and regions. International Associations ( such as european Association of Urology, New Zealand and Australia Association of Urology ) and urology departments from universities ( Cleveland Clinic and others ) have provided guidelines and recommendations on which urological procedures should or should not be prioritized during the pandemic. Optimizing resources and preventing patients with priority diseases from being negatively impacted. A taxonomic review was published in the European Journal Urology Focus, summarizing such recommendations. [ 20 ]
list of urological topics [edit ]
See besides [edit ]
References [edit ]
19. hypertext transfer protocol : //nams.org.np/about.php 20. hypertext transfer protocol : //www.iom.edu.np/ ? page_id=21
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