Urology

The Department of Urology at Metropolitan General covers the whole spectrum of modern Urology diagnostically, therapeutically and surgically.

The Department is supported by:

An endoscopy unit for the performance of all transurethral procedures: endoscopic removal of renal stones, transurethral removal of prostate, transurethral removal of bladder tumors, ureteroscopy for the management of ureteral stones and tumors, internal urethrotomy, percutaneous removal of large renal stones.
A laparoscopy unit for the treatment of various urinary conditions without the need of an open surgery, such as renal cysts, ureteral stones, nephrectomy, varicocele, cryptorchidism.

The Department treats all male and female lower urinary tract disorders (urinary incontinence), as well as male infertility and sexual dysfunction by highly specialized Urologists-Andrologists.

When necessary, microsurgeries or minimally invasive surgeries are performed for the optimum restoration of these conditions, and with only one day of hospital stay.

At the same time, experienced and specialized radiologists from the Department of Medical Imaging at Metropolitan General cooperate with the Urologists-Andrologists, conduct special imaging studies for male infertility and sexual dysfunction, such as testicular ultrasonography, epididymides ultrasonography, transrectal ultrasonography of the prostate and seminal vesicles, testicular vessels triplex, penile vessels triplex.

Fusion Biopsee: Transrectal ultrasound

Metropolitan General has the state-of-the-art prostate biopsy system, Fusion Biopsee, which provides accuracy in diagnosing prostate cancer by facilitating the creation of an appropriate treatment protocol.

Fusion transperineal biopsy of the prostate is the most advanced, accurate in diagnosis and the safest technique, especially in cases where there is a strong suspicion of cancer and the classic biopsy fails to reveal it.

Fusion Biopsee is an integrated system for guided transperineal prostate biopsy guided and monitored by integrated real-time ultrasound with MRI/PET/CT image fusion technology.
It consists of:

Built-in computer with advanced software for 3D image acquisition, processing, programming, navigation and reporting
High quality 3D ultrasound image
Single hole needle guidance
Portable and easy to move system

Fusion Biopsee's specialized software combines the patient's multiparametric MRI images with prostate ultrasound to identify and map suspicious lesions in real time with millimeter accuracy. In addition to the suspicious foci, random representative biopsies of the entire prostate are taken to ensure the correct diagnosis.

The technique is performed with a special ultrasound head and a mesh through the perineum (the skin between the testicles and the anus) and not through the rectum, thus minimizing the chances of severe urinary tract infection and sepsis that exist with the classic corrective biopsy (through the rectum), while not damaging the intestinal mucosa.

Urodynamic Testing

The urodynamic testing is the most accurate, available tool for evaluating the function of the lower urinary system (bladder, urethra and urethral sphincters) of men and women, whereas it provides accurate information about the storage and excretion of urine from the bladder. Its purpose is to reproduce the symptoms reported by the patient, so that by measuring the various physiological parameters to diagnose accurately the medical cause.

Metropolitan General has the complete High Precision Samba 8-channel Video - Urodynamic Study system by MMT / Dantec Corporation, suitable for all clinical urodynamic protocols. It has flexibility for additional functionality, which makes it extremely reliable. The system consists of the basic unit SambaPatientUnit, four (4) Pressurechannels, two (2) Uroflow channels and two (2) Electromyography (EMG) channels.

All known urodynamic tests are performed such as:

Uroflowmetry: It is the measurement and recording of the flow of outgoing urine over time
Measurement of residual urine in the bladder
Water Cystomanometry
Cystomanogram or filling cystometry (Cystometrogram-CMG or filling cystometry): is the measurement of intracystic pressure during bladder filling, usually with saline
Bladder-emptying cystomanometry
Pressure / Flow study (urinary cystomanometry) (Pressure - flow studies-PFS): is the method of recording the intracystic pressures that develop during urination, with simultaneous recording of urine flow. A graph is formed based on these two recordings that allows us to determine whether urination is obstructive, non-obstructive or doubtful.
Electromyography (EMG): is the recording of the electrical potentials of the sphincter mechanism of the perineum that takes place during the phase of filling or emptying the bladder or in both of these phases
Urethral pressure profile (UPP): is the graph that results from the recording of pressures inside the urethra and is performed by the constant traction of a special catheter from the urethra
Video-urodynamics (Video-urodynamic control): is the most complete urodynamic examination in which the filling of the bladder is done using a contrast substance and all the above-mentioned components of the examination are done with simultaneous radioscopic imaging of the lower urinary tract.
Biofeedback with animation

The recording during the urodynamic examination is in the form of diagrams of mathematical curves.

The process of urodynamic testing is painless. The patient notices some "discomfort", but no pain.

The examination is performed by specialized medical and nursing staff, in order to be performed and evaluated correctly.

Indications for Urodynamic Testing

Urodynamic testing is indicated in patients:

with urinary incontinence (involuntary loss of urine)
before prostate surgery
with persistent lower urinary tract problems and suffering from diabetes,
multiple sclerosis, Parkinson's disease, from a recent stroke, etc.
before surgery, in patients who have a complex clinical picture due to failed
previous treatment or surgery. Analytically, in patients who experience
mixed incontinence, obstructive symptoms, significantly increased urine
output, neurological diseases or other abnormal conditions (such as pelvic
prolapse or radiation history) that may contribute to lower urinary tract
dysfunction

Contact telephone number: 210 650 2662-2000

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