Treatment and Surgery Restoration of Incontinence

• Cystoscopy
  Cystostopy is an endoscopic technique which is considered one of the most important “diagnostic urological tests”, for the examination of the lower urinary system. The test takes a short time, is carried out with local anaesthesia and can be performed in the urologist’s private office, provided it is equipped with the proper endoscopic equipment. The test uses a flexible cystoscope with a diameter of a few millimeters, and can check the urethra for damage in the sphincter or narrowing, the urinary bladder walls, the ureter mouths, the prostate size in men, or whether there are stones, a tumor or growth in the urinary bladder. During the cystoscopy, tissue samples can be collected for biopsy, and some pathological damages can be cauterized. After cystoscopy, the patient may experience mild nuisance (burning sensation) during urination, as well as frequent urge to urinate. These problems do not last more than 2-4 hours and are treated with common pain killers. video

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• Urethroscopy
  Urethroscopy is an endoscopic technique which is considered one of the most important “diagnostic urological tests”. The test takes a short time, is carried out with local anaesthesia and can be performed in the urologist’s private office, provided it is equipped with the proper endoscopic equipment. The test uses a flexible cystoscope with a diameter of a few millimeters, and can check the urethra for damage in the sphincter or narrowing, inflammation or exophytic lesion. During the urethroscopy, tissue samples can be collected for biopsy, and some pathological damages can be cauterized. After urethroscopy, the patient may experience mild nuisance (burning sensation) during urination, as well as frequent urge to urinate. These problems do not last more than 2-4 hours and are treated with common painkillers. video

   

  Urethrotomy – Urethral Stent insertion
  Urethrotomy is an endoscopic technique which is considered as a minimally invasive procedure for the treatment of the anterior and posterior urethral strictures. The operation takes a short time and is carried out with local anaesthesia or light sedation and the proper endoscopic equipment. During this procedure, and with the aid of the optical urethrotome of only a few millimitres in diameter, we are capable of checking the urethra width, access the narrowing and, with proper handling achieve restoration of the narrowing to its normal diameter. In some cases, the surgeon may need to insert a URETHRAL STENT for a few weeks, in order for the normal diameter to be maintained. After urethrotomy, the patient may experience mild nuisance (burning sensation) during urination, as well as frequent urge to urinate. These problems do not last more than 2-4 hours and are treated with common painkillers.

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• Female Incontinence - T.V.T. insertion
  The treatment of a problem such as incontinence, which is intensely experienced by millions of women all over the world who worry about their socialization and hygiene, is a very sensitive and important field of research.
  A relatively new method for the treatment of female incontinence is the insertion of a special support tape in the urethra (tension-free trans-vaginal tape), which reinforces the capability of the urethral sphincter to prevent involuntary loss of urine. The tape consists of a thin polypropylene mesh. It is surgically inserted through a small (2cm) incision in the vagina underneath the urethra, thus lifting it and giving it a steady supportive sling by improving its involuntary convergence, which results to perfect impermeability. The procedure lasts approximately 20 minutes, is carried out with local or epidural anaesthesia. After insertion of the tape, the patient may experience mild nuisance (burning sensation) during urination, as well as frequent urge to urinate. These problems do not last more than 2-4 hours and are treated with common painkillers.  The patient must remain in hospital for one day, while morbidity is minimal. The patient may return to her normal sexual activity in a month’s period. video

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• Male Incontinence – Artificial Sphincter Implantation
  Male incontinence is a pathological condition that can occur to men as a post-operative complication. For people with urine incontinence who do not respond to any pharmaceutical treatment or want a rapid and permanent result, the artificial sphincter implantation is the permanent solution to the problem. There are several types of sphincters among which the interested patient can select after discussion with the Surgeon Urologist. The surgery lasts for approximately 3 hours and is carried out with spinal or epidural anaesthesia.
  Making a small surgical cut (incision) at the base of the penis, the posterior urethra is identified and prepared, which is where the artificial sphincter is implanted. This is a hydraulically inflating elastic cylinder which snares the posterior urethra, is connected with a small fluid tank and a pump mechanism placed in the scrotum. By applying slight pressure on the pump mechanism, the cylinder empties the fluid and urination is possible. When urination ends, by applying slight pressure again, the predetermined fluid quantity is gathered in the elastic cylinder from the tank, thus restoring the impermeability of the urethra. One-day hospitalization is required, while there is very small post-operative morbidity. Further complications either to the patient or the prosthetic device are statistically minimum. video video2

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  Congenital Urethral Valves - Restoration
  The congenital urethral valves cause obstruction of the prostatic urethra. This means that during urination these valves fall on the urethral tube causing valve obstruction of the urethra and allowing urine outlet only through the narrow opening they create. Their restoration is achieved in surgery with a special instrument, cystoscope, which identifies the cystoscope that cause the obstruction and with a special technique and the proper treatment they are cross-sectioned immediately with the use of electrodiathermy or laser, depending on the location, shape and size of the valves. The procedure is carried out with light sedation and the duration of the operation is analogous to the size of the valves. The patient must remain hospitalized for a day for observation, while the morbidity of the operation is minimal.

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• Urethral Diverticula – Restoration
  The congenital urethral diverticula is a rare condition which causes urethral obstruction. The restoration of the condition is carried out by surgical operation with a small, 2mm incision around the affected area. With a special technique and the proper handling the entire pathological tissue is prepared and then removed. The procedure is performed with light sedation depends on the size of the diverticulum. After the operation, the patient may experience mild nuisance (burning sensation) during urination, as well as frequent urge to urinate. These problems do not last more than 1-2 days and are treated with common painkillers.  The patient must remain in hospital for one day, while morbidity is minimal. The patient may return to their normal sexual activity in a month’s period. 

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• Cystocele – Vaginal Mesh Suspension Placement
  The methods for the restoration of damages in the vaginal wall due to prolapse of the internal pelvic organs, after a major surgery or due to old age are a great challenge, as regression and reappearance of symptoms is frequent.
  A new method for the treatment of cystocele is the placement of a special support – suspension mesh, which reinforces the support capability of the pelvic ground at the vaginal area, which, when weakened, allows the urinary bladder to prolapse through the vagina. The tape consists of a thin polypropylene mesh. It is surgically inserted through a small (4cm) incision in the vagina underneath the urethra, thus lifting the posterior bladder wall which prolapses and is supported in four spots at the side walls of the pelvic ground, providing steady support and improving the involuntary prolapse of the urinary bladder. The procedure lasts approximately 1 hour, is carried out with local or epidural anaesthesia. After insertion of the vaginal mesh suspension, the patient may experience mild nuisance (burning sensation) during urination, as well as frequent urge to urinate. These problems do not last more than 2-4 hours and are treated with common painkillers. The patient must remain in hospital for one day, while morbidity is minimal. The patient may return to her normal sexual activity in a month’s period.

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