greek version




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.


  • Testicular Biopsy
    The testicular biopsy is a test that enables us to check the existence of malignancy in a newly-found lump in the testis, the dysfunction in the production of sperm or the difficulty in releasing it during ejaculation phase in men with infertility elements. This test is performed with local anaesthesia or sedation using a biopsy needle or by making a small, 1cm incision in the testis. The test is safe and the nuisance that may be experienced by the patient is minimal and treated with common painkillers. Few-hour hospitalization is required and the morbidity of the operation is minimum.     video

  •  

  • Unilateral and Bilateral Orchiectomy
    Any painless bulge in the testis should be considered a tumor, until the opposite is proved. Lateral orchiectomy is the immediate treatment of testicular cancer. It is performed with high inguinal incision, opening of the inguinal pore, ligature of the spermatic chord and vessels and then removal of the testis. The operation takes approximately one hour and is conducted with spinal or epidural anaesthesia. One-day hospitalization is required, while morbidity is minimal. The surgery does not puts in danger the erectile ability and fertility of the patient. Immediately after surgery, the surgical preparation undergoes histological testing, which shows whether further and additional treatment is required.
    In cases of metastatic – hormonal-resistant prostate cancer, where decrease of testosterone levels is an immediate need, a bilateral subcupsular orchiectomy is performed. The operation is carried out with local anaesthesia or light sedation and takes less than one hour    . video

  •  

  • Cryptorhidism - Restoration
    It is the condition when the testicle is not located in its regular position within the cavity of the scrotum when the child is born. The proper age for the restoration of the condition is when the child is 18-24 months old. Of course there are cases in which the restoration is performed to adult patients also. The operation is carried on with general anaesthesia and its duration depends on the position of the testis (peritoneal cavity, inguinal canal), as there must be preparation of the spermatic vessels and the spermatic chord (where the testis is supported) in order for them to achieve the length required for the testis to reach its normal position. Then the testis is stabilized so it will not return to its prior position. The operation may be laparoscopic or with open surgery, and the option will be decided upon discussion with the Surgeon Urologist and after analyzing the specifics and particularities of each method in conjunction with the patient’s medical history. The operation takes approximately one hour and is carried out with spinal or epidural anaesthesia. One-day hospitalization is required, while morbidity is minimal.

     

    Testicular Torsion – Orcheopexy - Restoration
    The restoration of Testicular Torsion – Orcheopexy is an operation that must be performed within 6 hours from the onset of symptoms, due to the increased danger of permanent damage that may occur to the testis. It is usually observed with children and adolescents up to 18 years of age, it can, however, occur to older patients. The operation is carried out with general anaesthesia and its duration is approximately 45 minutes. A small (2cm) incision is made in the scrotum where the testis is firmly positioned so that torsion will not occur again. One-day hospitalization is required, while morbidity is minimal.     video

  •  

  • Varicocele - Restoration
    It is the dilatation of the veins of the spermatic cord which results in the formation of varicose venous networks. During the operation the urologist surgeon ligates and intersects the dilated testicular venous network in order to stop the retrogression and stagnation of blood around the testis. This is observed at the inner spermatic vain of the left testicular venous system due to anatomic particularities and is restored with a small (3cm) incision in the inguinal area. The operation takes approximately one hour, is carried out with general anaesthesia and the required hospitalization time is usually one day.
    There are 4 different surgical techniques:

    • -Palomo Method, high ligature
    • -Ivanissevich Method, inguinal ligature
    • -Marmar or Goldstein Method, subiguinal ligature
    • -Laparoscopic ligature

    Another, non-surgical, method for the treatment of varicocele is the Tauber technique, and consists of the injection of sclerotic substances in the inner spermatic vein with X-ray test.
    Which of these techniques will be finally preferred will be decided based on the individual problem and upon discussion with the medical care provider.     video

  •  

  • Hydrocele – Surgical Restoration
    Hydrocele is the collection of fluid between the petals of the tunica albuginea of the testicle (pre-formed fibrous capsule covering the testes), and is called idiopathically elytroid. The accumulation of fluid is progressive and painless. A small incision is made in the scrotum to open the cavity of the elytroid tunica of the testis. Then the fluid is removed and the elytroid tunica is reversed and firmly fixed in order to efface the already existent cavity so as not to recur. The operation is carried out with general or spinal anaesthesia. One-day hospitalization is required, while morbidity is minimal. Possible nuisance in the scrotum area do not last more than 2-4 hours and are treated with common painkillers.     video

  •  

  • Ligature and Excision of the Spermatic Chord – Unilateral or Bilateral
    This operation is performed to patients with extended or recurrent infections of the testes and to men who want a permanent contraceptive method. In the latter case, however, a written consent by both the patient and his wife is required. The operation is carried out with local anaesthesia or sedation and by opening a small, 1cm incision in the inguinal area. The operation lasts approximately 30 minutes, is safe and the nuisance that may be experienced by the patient is minimum and can be treated with common painkillers. After the operation the patient must remain in hospital for a few hours for observation.    video

  •  

  •  

  • Spermatocele – Surgical Restoration
    It is a small, soft cyst which contains accumulated fluid (mostly sperm) on the upper and rear part of the testis. This operation is performed by making a small incision in the scrotum in order to open the cavity of the elytroid tunica, and then identify and remove the cyst. Usually, specimen of the cyst is sent for biopsy. The operation is carried out with general or spinal anaesthesia. One-day hospitalization is required, while morbidity is minimum. Possible nuisance in the scrotal area do not last more than 2-4 hours and is treated with common painkillers.     video

  •  

  • Scrotocele/Scrotal Hernia (Bubonocele) – Laparoscopic Restoration
    It occurs to men and protrudes through the internal inguinal ring, the point where the testis descends and reaches its final position in the scrotum. This operation can be performed with 3 or 4 open, 3-cm, incisions in the area of the external inguinal ring. During the laparoscopic approach, and aided by special laparoscopic tools, the surgeon reaches the gape inguinal ring, identifies the hernial sack which has prolapsed and after careful preparation, the hernial sack and its content is pushed back inside the inguinal cavity. The gap which remains in the inguinal canal is covered with a special mash.
    The operation is carried out with general or spinal anaesthesia. One-day hospitalization is required, while morbidity is minimal. Possible nuisance in the scrotal area does not last more than 2-4 hours and is treated with common painkillers.

  •  

  • Testicular Prosthesis – Placement or Removal
    The absence of a testis in a man, regardless of his age or the reason of the absence, is a traumatic experience and causes great psychological problems. There are two types of prosthetic implants and they are manufactured in such a way that a support suture can be used in the scrotum in order to limit mobility. The operation is carried out with general anaesthesia, lasts approximately one hour and the incision is made in the inguinal area. The patient must remain in hospital for 24 hours. In cases where the implant causes health problems to the patient, its removal is performed with the same procedure.

  •  

  • Circumcision – Phimosis – Paraphimosis  - Restoration
    Circumcision is the excision of part of the foreskin which results to revealing the glans penis cannot be revealed due to cicatricial preputial stenosis (stenosis or narrowness of the foreskin) that prevents retraction. At times, several circumcision methods and techniques have been described. In the most common methods, the prepuce is cut circularly, 1cm beyond the end of the cicatricial pathology. After careful haemostasis, the internal petal of the foreskin is stitched to the external petal, using very fine absorbable sutures. The operation does not last more than 35 minutes and is carried out with light general sedation or local anaesthesia, depending on the patient’s age. Full restoration is achieved after 7-10 days, when the patient can return to his normal sexual activity.  video


  • Prepucial - Glanular Symphyses – Phimosis
    The Prepucial-Glanular sympheses is a condition where the glans penis of small children and adolescents cannot be revealed. Resolution of the sympheses can be performed in the urologist’s private office, provided it is properly equipped. This minor surgery does not last more than 15 minutes and is carried out with light local anaesthesia (gel xylocaine – cream emla) depending on the patient’s age. Possible nuisance in the area does not last more than 2-4 hours and is treated with common painkillers.

  •  

  • Cauterization of pathological findings of the external genitalia (e.g. condylomata, ulcerations, callosities)
    Cauterization is a safe method for the treatment of pathological findings of the external genitalia (condylomata, ulcerations, callosities etc.).
    There are 3 treatment techniques:

    • -Cold nitrogen
    • -Laser
    • -Electrocoagulation

    Treatment is safe and the nuisance that the patient may experience during or after the treatment is minimum and can be faced with common painkillers.

  •  

  • Penile Prostheses
    Among the main factors that create problems in the sexual life and the self-confidence of a man are the erectile dysfunction and the size of the penis, which sometimes affect the family and social environment of the person, creating serious psychological disorders. Further to the fact that this “problem” can be congenital, there is also a number of reasons that cause reduction of the erectile capability, such as hormonal disorders, bent penis, Peyronie’s disease, complete prostatectomy in cases of cancer and the administration of certain medications.
    Men with erectile dysfunction who do not respond to any pharmaceutical treatment, or want a rapid and permanent result, the penile prosthesis implant is the solution to the problem. There are several prosthesis types and the interested person will decide which one he will select after discussion with the Urologist Surgeon. The operation takes approximately one hour and is carried out with spinal or epidural anaesthesia.
    Making two small (approximately 2cm) incisions in the scrotum near the base of the penis (the incisions cannot be seen or noticed by the sexual partner), two hydraulically inflating elastic cylinders are implanted which are connected with a small fluid tank and a pump mechanism placed in the scrotum. By applying slight pressure on the pump mechanism the cylinders fill with fluid and penile inflation – erection is achieved. When sexual intercourse ends, by applying slight pressure again, the fluid quantity is removed from the elastic cylinders back to the tank, thus causing the penis to flaccid. 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.  Despite the fact that the prosthetic implant is synthetic, the aesthetic result is excellent and cannot be noticed when the penis is either erected or flaccid. After a month’s period from the operation, the patient can achieve a normal sexual life.     video

    Penis Lengthening – Penis Enlargement Interventions
    One of the main factors that create problems in the sexual life and the self-confidence of a man is the size of the penis, which sometimes affects the family and social environment of the person, creating serious psychological disorders.
    Microphallus can occur at birth due to hormonal disorders of after traumatic injuries. In some cases the male perception on “their insufficient, small-sized penis” does not comply with medical evaluation. There is no rule defining the normal size of the penis. Great attention must be paid, by both the surgeon and the patient, to pointing out the crucial difference between the psychogenic-psychosomatic cause and the medically considered as really existing.
    With this operation, the inner part (the base) of the organ becomes visible. The incisions are not performed on the penis but in the pubic area, without any intervention to the vessels and nerves of the penis. The operation takes approximately one hour and is carried out with spinal or epidural anaesthesia. There can be no prediction regarding the penile lengthening preoperatively. It usually ranges between 2 to 4cm, and the result is permanent. One-day hospitalization is required, while morbidity is minimal.
    This operation does not only achieve repair and a good result on the aesthetic level, but the main goal is to give a solution to the functional part of the problem. For these reasons the patient must consult the special Urologist-Andrologist in order to have a correct diagnosis and the proper results.

  •  

  • Penis Widening – Penis Enlargement Interventions
    One of the main factors that create problems in the sexual life and the self-confidence of a man is the size of the penis, which sometimes affects the family and social environment of the person, creating serious psychological disorders.
    Microphallus can occur at birth due to hormonal disorders of after traumatic injuries. In some cases the male perception on “their insufficient, small-sized penis” does not comply with medical evaluation. There is no rule defining the normal size of the penis. Great attention must be paid, by both the surgeon and the patient, to pointing out the crucial difference between the psychogenic-psychosomatic cause and the medically considered as really existing.
    This operation increases the penile diameter by injecting material between the Bucks fascia and the superficial (Dartos) fascia achieving 30%-40% widening. The operation takes approximately one hour and is carried out with spinal or epidural anaesthesia. The permanence of the result depends of the injected material. One-day hospitalization while morbidity is minimal.
    This operation does not only achieve repair and a good result on the aesthetic level, but the main goal is to give a solution to the functional part of the problem. For these reasons the patient must consult the special Urologist-Andrologist in order to have a correct diagnosis and the proper results. 

  •  

  • Peyronie’s Disease – Corpora Cavernosa Plastic Surgery
    A basic anatomic element in the penile structure are the two chambers running the length of the penis called corpora cavernosa. Diseases such as Peyronie’s disease, with causes mostly unknown, cause disfiguration and bending of the penis and many times hardening of the corpora cavernosa. Thepenilecurvatures are congenital or acquired and can be caused also by injury. Sometimes the damages in the corpora cavernosa can be such than the only solution is surgery. Thetreatmentofsuchconditiondepends on the size and type of the problem.
    With this operation, the surgeon reveals the corpora cavernosa where he identifies and prepares the damage (cicatricial plaque). Depending on the location and size of the damage as well as the penile curvature, the surgeon will decide upon his further surgical approach:

    • -NESBIT I – II.
    • -Damage removal and replacement by a flexible autologous or heterologous implant.
    • -Penile Prostheses placement

     The operation takes approximately one hour and is carried out with spinal or epidural anaesthesia. One-day hospitalization is required while morbidity is minimal.
    This operation does not only achieve repair and a good result on the aesthetic level, but the main goal is to give a solution to the functional part of the problem. For these reasons the patient must consult the special Urologist-Andrologist in order to have a correct diagnosis and the proper results. 


  • Priapism - Restoration
    It is the involuntary, painful and prolonged erection which persists after ejaculation despite the absence of sexual stimulation. The cause is inability of the corpora cavernosa to empty the blood that was accumulated in them in order to achieve erection. Surgical treatment must be sought immediately (within 6 hours), if the administered medication is ineffective. The surgical repair is performed immediately in the urologist’s office, with the blood discharge through 2 Trocars (medium calibre needles) which are inserted in the penis base for quick discharge and patient’s relief. The operation does not last longer than 20 minutes and is carried out with local anaesthesia. Full recovery occurs after 2-4 days, when the patient can return to his normal sexual activities.

  •  

  • Penile Fracture
    Penile fracture is the rupture of the tunica albuginea (the fibrous envelope) of the penis. Treatment must be immediate (within 6 hours) and surgical. Repair is achieved by stitching the injured fibrous envelope which results in the rapid haematoma discharge and the patient’s relief. The operation does not take more than 20 minutes and is carried out with local or general anaesthesia. Full repair occurs after 7-9 days. The patient may return to his normal sexual activity after 30 days. Treatment is safe and the nuisance that may be experienced during and after the operation is minimal and treated with common painkillers.


  •