Urology

At the Group Florence Nightingale Hospitals, Urology Center, diseases of male and female urinary systems, and reproductive system of men are treated. In the Urology Center, diagnosis and treatment of all kinds of ailments related to kidneys, urinary ducts, bladder, prostate gland, semen ducts, urinary tract, testicles are performed.

Experts in Group Florence Nightingale Hospitals, Urology Center listen to and train their patients during diagnosis, and management of their diseases. They successfully manage diagnostic and therapeutic processes in a patient-oriented manner.

The Urology Center has many sub-branches such as andrology, functional urology, endourology, urooncology and pediatric urology. Diagnosis and treatment methods of all urological sub-branches are applied within the framework of the latest current approaches in the world standards of medicine. Almost all surgical interventions in the field of urology are now performed by closed surgery (laparoscopy, endoscopy) and robotic surgery. The most common branch of robotic surgery is again urology. Our Center tirelessly work for well-being of our patients with its experienced staff providing comprehensive services in specialized areas of urology.

General Urology
Pediatric Urology
Reconstructive Urology
Urological Oncology
Urogynecology
Neuro-Urology
Endourology
Robotic Urology
Andrology/Sexual Disorders

Benign prostatic enlargement

Benign prostatic enlargement (BPH) is one of the most common health problems faced by men at an advanced age and can significantly impair the quality of life if left untreated. Although many treatment methods have been described for BPH, one of the most advanced technological methods among them is HoLEP, Prostate Enucleation with Holmium Laser it means that.

For patients with active complaints due to prostate enlargement, surgical treatment becomes inevitable if they do not benefit from medical treatment. For many years, the endoscopic method has been preferred for small volume prostates (<90 g) and the open surgical method has been preferred for larger prostates (>90 g). However, rapid advances in laser technologies have allowed large prostates to be treated with endoscopic surgery with HoLEP. The main and big advantages here are that patients face fewer complications after surgery compared to open surgery, the rehabilitation period is shorter, and their quality of life is less impaired in the early postoperative period. It is important how deeply the energy used in endoscopic surgeries acts on the tissue. The laser energy used in the HoLEP technique spreads to a much smaller depth in the tissue than in other techniques. For this reason, the probability of damage to the nerves passing around the prostate and providing hardening with this energy is significantly reduced. For this reason, patients have no erection problems. In addition, the structure called the sphincter that provides urinary retention can be damaged in other surgical techniques, but thanks to the fact that this structure is outside the surgical field in HoLEP surgery, this structure can be clearly protected and after surgery, there are no complaints of urinary incontinence. Other important advantages of HoLEP surgery are that the hospital stay after the operation is quite short, the catheter can be removed on the first day after the operation, and there is less chance of bleeding compared to other surgeries. The patient can return to his daily life in a fairly short period of time and regain his sexual health. HoLEP is a technique that can be safely applied to a prostate of any size.

HoLEP surgery can be performed with both general and spinal (by numbing below the waist) anesthesia. With specially developed camera instruments, the entire urethra is evaluated for stenosis, starting with the initial hole of the urinary tract (urethra) at the tip of the penis (urethral mea). Growing prostate tissue is seen, and then the bladder (urinary bag) is reached. The inside of the bladder is evaluated from the point of view of a completely suspicious formation. Then, the growing prostate tissue is drawn with a Holmium Laser from certain boundaries until the prostate capsule is visible. All prostate tissue is separated from the capsule and sent to the bladder. Again, with the help of a specially developed device called a Morselator, prostate tissues are divided into small pieces in the bladder and removed from the body by vacuuming. After making sure that there is no bleeding with the Holmium laser, the procedure is terminated by placing one probe. HoLEP surgery removes all the prostate tissue left in the prostate capsule and pathological examination of these tissues reduces the likelihood of recurrence of the disease in the following years to a point that there is no possibility and allows you to diagnose other diseases. HoLEP is an effective and safe technique that can be safely used for the prostate of any size.

Why is MRI-TRUS Fusion Biopsy necessary?

According to 2020 data, prostate cancer is the second most common cancer after lung cancer. However, it ranks 5th in the list of the deadliest cancers. Early diagnosis is very important in prostate cancer, which is one of the cancer types that can be completely cured today. For this reason, it is recommended that patients over the age of 45 should be screened for prostate cancer in the urology outpatient clinic once a year.

If prostate cancer is suspected during screening, the diagnosis is made by prostate biopsy under the guidance of transrectal ultrasound (TRUS). In this method, 6-12 pieces are systematically taken from the prostate gland. Prostate cancer is found in approximately one in three patients in TRUS-guided prostate biopsy. If clinical suspicion persists in patients without cancer, repeat biopsy may be required. In this type of biopsies, besides the risk of missing an aggressive cancer, there is also the possibility of detecting clinically insignificant cancers that will not cause a lifelong problem to the patient.

Multiparametric MRI (MpMRI) imaging has been widely used in the diagnosis and staging of prostate cancer in recent years. With MpMRI, areas suspicious for cancer in the prostate are displayed with high accuracy. Cancerous areas within the prostate can cause clots, infections, e.t.c. more clearly distinguishable from pathologies. With MRI, the indication for biopsy is determined more precisely and unnecessary biopsies are avoided.

MRI-TRUS Fusion Biopsy is a biopsy method using a smart biopsy robot and advanced computer software. In this method, a 3-dimensional image of the prostate is created by superimposing MRI and ultrasound images in the computer environment. Sampling is performed with minimal deviation from cancer foci displayed in three dimensions.

How is MRI-TRUS Fusion Biopsy Performed?

The biopsy procedure is performed under general or local anesthesia.
Antibiotics are given before the procedure to reduce the risk of infection.
MpMRI is performed before fusion biopsy is performed in patients.
In MpMRI, areas with high tumor risk are marked on the computer.
With the fusion biopsy robot, the borders and size of the prostate gland are determined.
A 3-dimensional model of the prostate is created by superimposing MpMRI images and TRUS-guided images.
By directing the biopsy needle to the marked suspicious areas with the help of a robotic arm, tissue sampling is performed at sufficient depth from the targeted area with full accuracy.
The exact coordinates of the sampling areas within the prostate after biopsy are recorded for follow-up purposes.

Advantages of MRI-TRUS Fusion Biopsy

Sampling is performed with minimal deviation and error from areas with tumor risk.
The need for repeat biopsy is reduced.
Unlike standard biopsy, which is blinded, MpMRI can be directly biopsied from lesions suspected of cancer.
It enables faster diagnosis of clinically aggressive tumors.
It allows taking biopsies from areas that are technically difficult to take samples that cannot be visualized with ultrasound.

Prostate Surgery with the HoLEP Method

Benign prostatic enlargement (BPH) it is one of the most common health problems faced by men at an advanced age and can significantly impair the quality of life if left untreated. Although many treatment methods have been described for BPH, one of the most advanced technological methods among them is HoLEP, Prostate Enucleation with Holmium Laser it means that.

For patients with active complaints due to prostate enlargement, surgical treatment becomes inevitable if they do not benefit from medical treatment. For many years, endoscopic method has been preferred for small volume prostates (<90 g) and open surgical method has been preferred for larger prostates (>90 g). However, rapid advances in laser technologies have allowed large prostates to be treated with endoscopic surgery with HoLEP. The main and big advantages here are that patients face fewer complications after surgery compared to open surgery, the rehabilitation period is shorter, and their quality of life is less impaired in the early postoperative period. It is important how deeply the energy used in endoscopic surgeries acts on the tissue. The laser energy used in the HoLEP technique spreads to a much smaller depth in the tissue than in other techniques. For this reason, the probability of damage to the nerves passing around the prostate and providing hardening with this energy is significantly reduced. For this reason, patients have no erection problems. In addition, the structure called the sphincter that provides urinary retention can be damaged in other surgical techniques, but thanks to the fact that this structure is outside the surgical field in HoLEP surgery, this structure can be clearly protected and after surgery there are no complaints of urinary incontinence. Other important advantages of HoLEP surgery are that the hospital stay after the operation is quite short, the catheter can be removed on the first day after the operation, and there is less chance of bleeding compared to other surgeries. The patient can return to his daily life in a fairly short period of time and regain his sexual health. HoLEP is a technique that can be safely applied for prostate of any size.

HoLEP surgery can be performed with both general and spinal (by numbing below the waist) anesthesia. With specially developed camera instruments, the entire urethra is evaluated for stenosis, starting with the initial hole of the urinary tract (urethra) at the tip of the penis (urethral mea). A growing prostate tissue is seen, and then the bladder (urinary bag) is reached. The inside of the bladder is evaluated from the point of view of a completely suspicious formation. Then, the growing prostate tissue is drawn with a Holmium Laser from certain boundaries until the prostate capsule is visible. All prostate tissue is separated from the capsule and sent to the bladder. Again, with the help of a specially developed device called a Morselator, prostate tissues are divided into small pieces in the bladder and removed from the body by vacuuming. After making sure that there is no bleeding with the Holmium laser, the procedure is terminated by placing one probe. HoLEP surgery removes all the prostate tissue left in the prostate capsule and pathological examination of these tissues reduces the likelihood of recurrence of the disease in the following years to a point that there is no possibility and allows you to diagnose other diseases. HoLEP is an effective and safe technique that can be safely used for prostate of any size.