{"id":17684,"date":"2021-01-25T12:08:15","date_gmt":"2021-01-25T12:08:15","guid":{"rendered":"https:\/\/urosassociats.com\/tratamientos\/prostate-laser-and-reconstructive-urology\/"},"modified":"2026-04-10T06:36:27","modified_gmt":"2026-04-10T06:36:27","slug":"prostate-laser-and-reconstructive-urology","status":"publish","type":"project","link":"https:\/\/urosassociats.com\/en\/treatments\/prostate-laser-and-reconstructive-urology\/","title":{"rendered":"Prostate Laser and Reconstructive Urology"},"content":{"rendered":"<div id=\"cmsmasters_row_3285ufyhdf\" class=\"cmsmasters_row cmsmasters_color_scheme_default cmsmasters_row_top_default cmsmasters_row_bot_default cmsmasters_row_boxed\">\n<div class=\"cmsmasters_row_outer_parent\">\n<div class=\"cmsmasters_row_outer\">\n<div class=\"cmsmasters_row_inner\">\n<div class=\"cmsmasters_row_margin\">\n<div id=\"cmsmasters_column_mvgdm2pjt\" class=\"cmsmasters_column one_first\">\n<div class=\"cmsmasters_column_inner\"><div class=\"cmsmasters_tabs tabs_mode_tour tabs_pos_left\">\n<ul class=\"cmsmasters_tabs_list\">\n<li id=\"cmsmasters_tabs_list_item_1444dx78cj\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-27\">\n<span>PATHOLOGY \/ SYMPTOMS:<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_xcp5ie0et\" class=\"cmsmasters_tabs_list_item current_tab\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Benign prostatic hyperplasia<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_beeqqgs098\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Pyeloureteral junction syndrome<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_hl256i1wrq\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Ureteral stricture<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_ynayp4uo27\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Urethral stricture<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_gw3hgnw51h\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Laser in Urology<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_vktn8ga5c7\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-8\">\n<span>TREATMENTS:<\/span>\n<\/a>\n<\/li><\/ul>\n<div class=\"cmsmasters_tabs_wrap\">\n<div id=\"cmsmasters_tab_1444dx78cj\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<ul style=\"user-select: auto;\">\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">BENIGN PROSTATIC HYPERPLASIA.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">PYELOURETERAL JUNCTION SYNDROME.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">URETERAL STENOSIS.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">URETRAL STENOSIS.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">LASER IN UROLOGY.<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_xcp5ie0et\" class=\"cmsmasters_tab active_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Benign prostatic hyperplasia<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The prostate is an organ located in the male pelvis, just below the bladder, hugging the urethra. Its function is basically sexual, participating in the formation of seminal fluid and contraction at the time of ejaculation.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Benign prostatic hyperplasia is the result of noncancerous growth of the tissue that makes up the prostate. Its causes are not known, but it seems to be related to hormonal changes that occur with aging. By the age of 60, half of the male population already has microscopic signs of benign prostatic hypertrophy (BPH) and by the age of 70, more than 40% have an increase in prostate size that can be detected with scanning. The normal size of the prostate is similar to that of a chestnut. <\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptoms<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">In people with an enlarged prostate, the severity of symptoms varies, but they tend to gradually worsen over time. Common signs and symptoms of benign prostatic hyperplasia include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Need to urinate frequently or urgently<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Increased frequency of urine at night (nocturia)<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Difficulty starting to urinate<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Weak or stopping and restarting urine flow<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Drip after urinating<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Inability to empty the bladder completely<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Less common signs and symptoms include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary tract infection<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Inability to urinate<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Blood in the urine<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The size of the prostate does not necessarily determine the severity of symptoms. Some men with a mildly enlarged prostate may have significant symptoms while other men with a larger prostate may have only mild symptoms.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Differential diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Diseases that produce symptoms similar to those of an enlarged prostate include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary tract infection<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Inflammation of the prostate (prostatitis)<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Narrowing of the urethra (urethral stenosis)<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Scarring of the bladder neck as a result of previous surgeries<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Kidney or bladder stones<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Problems with the nerves that control the bladder<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Prostate or bladder cancer<\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aetiology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The prostate gland is located below the bladder. The tube that carries urine from the bladder to the outside of the penis (urethra) passes through the center of the prostate. When the prostate enlarges, it begins to obstruct the flow of urine.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Most men have continuous prostate growth throughout life. In many men, this continuous growth enlarges the prostate enough to cause urinary symptoms or to significantly obstruct the flow of urine.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">It&#8217;s not entirely clear what causes an enlarged prostate. However, it could be due to changes in the balance of sex hormones as men age.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Risk factors<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Risk factors for enlarged prostate glands include the following:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aging.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Enlarged prostate glands rarely cause signs and symptoms in men younger than 40. About one-third of men experience moderate to severe symptoms by age 60, and about half by age 80.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Family history.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Having an affected blood relative, such as a parent or sibling, means you&#8217;re more likely to have problems.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Lifestyle.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Obesity increases the risk of benign prostatic hyperplasia, while exercise can reduce it.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Complications<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Complications of an enlarged prostate may include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Sudden inability to urinate (urinary retention)<\/b><span style=\"font-weight: 400; user-select: auto;\">). You may need to have a tube (tube) inserted into your bladder to drain urine. Some men with an enlarged prostate require surgery to relieve urinary retention.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urinary tract infections.<\/b><span style=\"font-weight: 400; user-select: auto;\"> The inability to completely empty the bladder can increase the risk of urinary tract infection. If urinary tract infections occur frequently, you may need surgery to remove part of your prostate.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Bladder stones.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Bladder stones occur due to the inability to completely empty the bladder. Bladder stones can cause infection, bladder irritation, blood in the urine, and obstruction of urine flow.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Bladder damage.<\/b><span style=\"font-weight: 400; user-select: auto;\"> If the bladder has not completely emptied, this can cause it to stretch and weaken over time. As a consequence, the muscular wall of the bladder no longer contracts properly and this makes it more difficult to completely empty the bladder.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Kidney damage.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Pressure on the bladder due to urinary retention can directly damage the kidneys or allow bladder infections to reach the kidneys.<\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Most men with an enlarged prostate do not develop these complications. However, acute urinary retention and damage to the kidneys can pose serious health hazards.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Medical <\/span><b style=\"user-select: auto;\">history<\/b><span style=\"font-weight: 400; user-select: auto;\"> it is essential for diagnosing BPH and the severity of lower urinary tract symptoms. In our practice, the urologist may use resources such as <\/span><b style=\"user-select: auto;\">Quality of life questionnaires<\/b><span style=\"font-weight: 400; user-select: auto;\"> to numerically assess the degree to which the pathology affects the patient. <\/span> <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Physical exam, including <\/span><b style=\"user-select: auto;\">digital rectal examination<\/b><span style=\"font-weight: 400; user-select: auto;\">, is fundamental. By means of digital rectal examination, the morphology and consistency of the prostate is assessed and at the same time the tone of the anal sphincter is evaluated. <\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Some complementary examinations are also very useful<\/span>, and include a <b style=\"user-select: auto;\">urinalysis<\/b><span style=\"font-weight: 400; user-select: auto;\"> (by dipstick or culture) to rule out a possible urinary tract infection, the determination of PSA<\/span><b style=\"user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">, the assessment of renal function and an <\/span><b style=\"user-select: auto;\">ultrasound study <\/b><\/b> <span style=\"font-weight: 400; user-select: auto;\">(transrectal and\/or abdominal). Performing a renewal-resonography will rule out possible complications (urinary lithiasis, bladder diverticula, dilatation of the urinary tract, renal or bladder tumors) and quantify the post-voiding residue. It is a simple method that has no contraindications or risks and that allows estimating the volume and prostatic morphology quite accurately. <\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">In addition, in most cases <\/span> a <b style=\"user-select: auto;\">flowmetry<\/b> is carried out, <span style=\"font-weight: 400; user-select: auto;\">which is a simple study that objectively measures the flow of the urinary stream, and allows us to classify the flow into obstructive or non-obstructive.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Other more complex tests, such as <\/span><b style=\"user-select: auto;\">the urodynamic study<\/b>, <span style=\"font-weight: 400; user-select: auto;\">will be performed in specific cases, in which the prostate symptomatology is associated with other pathologies (neurological, intrinsic bladder) or when the diagnosis is not so clear with conventional tests.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Currently, European clinical guidelines in Urology recommend the annual performance of PSA and the practice of digital rectal examination in men over 50 years of age as methods of screening for prostate cancer and monitoring of BPH. Some authors consider that in people under 50 years of age it is only advisable to screen individuals at high risk of presenting it due to the existence of a family history of cancer. In this case, they start the study from the age of 40.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">In our facilities of Uros Associats we can perform all the complementary examinations commented: Ultrasound, flowmetry and urodynamic study,<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Treatment of benign prostatic hyperplasia can vary, depending on the severity of symptoms and how they affect the patient&#8217;s quality of life. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"> <b style=\"user-select: auto;\">Adrenergic blocking drugs<\/b><span style=\"font-weight: 400; user-select: auto;\"> They can help patients with mild and moderate symptoms. They are medicines that are taken once a day, every day. Its function is based on decreasing resistance to urinary flow without modifying the contractility of the bladder muscle. They relax the muscle tone of the bladder neck and prostate, improving symptoms and maximum urinary flow. They are not exempt from side effects: retrograde ejaculation, headaches, asthenia, drowsiness, nausea, nasal congestion, dizzying sensation and dizziness due to orthostatic hypotension (sudden decrease in blood pressure), which constitutes the worst tolerated secondaryism, although it may disappear over weeks, as the body makes compensatory internal adjustments in blood pressure.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"> <b style=\"user-select: auto;\">Hormone-blocking drugs<\/b><span style=\"font-weight: 400; user-select: auto;\"> They induce a regression of the increase in prostate size and increase the speed of maximum urinary flow, thus improving the patient&#8217;s symptoms. They have the disadvantage that they take time to be effective (minimum 6 months) and that they can occasionally cause disorders of sexual function (decreased libido, ejaculatory dysfunction and impotence) and others such as gynecomastia, increased breast sensitivity and skin rashes. These drugs also lower serum PSA to 50%.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Phytotherapy <\/span><b style=\"user-select: auto;\"><\/b><span style=\"font-weight: 400; user-select: auto;\"> It consists of the application of plant extracts (Pygeum africanum, Serenoa repens), whose mechanism of action is not clearly known. They produce variable urodynamic improvements. They have few side effects and their economic cost is low.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Surgery <\/span><b style=\"user-select: auto;\"> <\/b> <span style=\"font-weight: 400; user-select: auto;\">is the most effective treatment for BPH. It has several modalities: <\/span><b style=\"user-select: auto;\">endourological<\/b> surgery, <span style=\"font-weight: 400; user-select: auto;\">which is performed through the urethral duct, without skin incisions (<\/span><b style=\"user-select: auto;\">transurethral resection or P-TUR, prostatic photovaporization, laser prostatic enucleation -HoLEP, ThuLEP-<\/b><span style=\"font-weight: 400; user-select: auto;\">) and <\/span><b style=\"user-select: auto;\">open surgery<\/b><span style=\"font-weight: 400; user-select: auto;\">. It is performed under general or spinal anesthesia. They are absolutely indicated in patients who have had recurrent urinary retention, repeated urinary tract infections, upper urinary tract obstructive uropathy, and severe hematuria. These procedures try to remove all adenomatous prostate tissue, that is, the one that obstructs the urethra. Therefore, the prostate is not completely removed. All these surgical techniques are very safe and effective in expert hands such as those of our Urologists specialists of Uros but in a minority of patients complications may appear, <\/span><span style=\"font-weight: 400; user-select: auto;\">such as infection and bleeding. Also, 1 to 3% of men develop <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/trastornos-renales-y-del-tracto-urinario\/trastornos-de-la-micci%C3%B3n\/incontinencia-urinaria-en-adultos\"><span style=\"font-weight: 400; user-select: auto;\">urinary incontinence<\/span><\/a><span style=\"font-weight: 400; user-select: auto;\"> transitory or permanent. 5% of patients may also develop erectile dysfunction. After BPH surgery, most men ejaculate semen into the bladder instead of through the urethra (retrograde ejaculation).<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Currently, open surgery and prostate TUR have given way to the most modern techniques with Laser (photovaporization and HOLEP or prostatic enucleation) that provide the same results but avoiding the problems derived from an incision in the skin (they are made through the duct) and also with better bleeding control.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">At Uros Associats we have a super qualified team for the diagnosis, treatment and control of BPH. Several of our specialists have been pioneers in Spain in the development of various laser techniques for the treatment of prostate hypertrophy Our urologists will advise you the best treatment depending on your clinical characteristics as well as your preferences and the severity of the symptoms.<\/span><\/p>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_beeqqgs098\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Pyeloureteral junction syndrome<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Obstruction of the pyeloureteral junction (UPU) is the most common cause of hydronephrosis (dilation of the urinary system) in childhood. It affects 1 in 1,500 pregnancies. It occurs as a result of the narrowing of the junction between the renal pelvis and the ureter. Obstruction of the UPU causes a restriction of urinary flow from the pelvis to the proximal portion of the ureter and, as a consequence, there is a retrograde increase in pressure in the renal pelvis. This increase in pressure causes damage to the functional mass of the kidney, and can lead to functional annulment of the kidney. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The diagnosis of this pathology has varied greatly in recent years, being detected in early stages, even before birth. This is due to the performance of follow-up ultrasounds in all pregnant women. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">It is more common in men than in women with a 3-4\/1 ratio, affects more frequently the left kidney (up to 60%) and in 20-40% of cases occurs in both kidneys.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptoms<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Before the use of prenatal ultrasound, the most common forms of presentation were <\/span><b style=\"user-select: auto;\">abdominal pain<\/b><span style=\"font-weight: 400; user-select: auto;\"> sometimes accompanied by vomiting, <\/span><b style=\"user-select: auto;\">urinary tract infection<\/b><span style=\"font-weight: 400; user-select: auto;\"> and <\/span><b style=\"user-select: auto;\">haematuria <\/b> <span style=\"font-weight: 400; user-select: auto;\">macroscopic spontaneous or after a banal trauma. Other symptoms were <\/span><b style=\"user-select: auto;\">abdominal mass<\/b><span style=\"font-weight: 400; user-select: auto;\"> and <\/span><b style=\"user-select: auto;\">diffuse gastrointestinal discomfort<\/b><span style=\"font-weight: 400; user-select: auto;\">. Although more rare, in some cases obstructive hydronephrosis was a casual ultrasound finding. Despite prenatal diagnosis, children are still diagnosed with symptomatic hydronephrosis at later ages. In these cases, the delay in diagnosis can lead to severe damage to the renal parenchyma, which is sometimes irreversible. However, patients diagnosed in late childhood, even in adulthood, are described in whom kidney function is preserved.<\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aetiology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Congenital stenosis of UPU is generally secondary to congenital <\/span><b style=\"user-select: auto;\">malformations<\/b><span style=\"font-weight: 400; user-select: auto;\"> that determine alterations in the amount and orientation of the ureteral muscle layers and prevent the conduction of the peristaltic wave of the excretory system.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Obstruction of late UPU is usually secondary to <\/span><b style=\"user-select: auto;\">extrinsic compression of the ureter<\/b><span style=\"font-weight: 400; user-select: auto;\">. The most frequent cause is the existence of <\/span><b style=\"user-select: auto;\">Aberrant polar vessels<\/b><span style=\"font-weight: 400; user-select: auto;\">. These aberrant vessels are usually branches of the renal artery or even the aorta, variants of renal vascular anatomy and normally supplying the lower pole of the kidney. Less commonly, compression is caused by angulations of the ureter, retroperitoneal fibrosis, or flanges caused in previous surgeries. In these cases, hydronephrosis is not present at birth and the accumulation of a certain amount of urine in the renal pelvis is necessary to stop the flow of urine, so that the increase in pressure only manifests intermittently.<\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">The primary diagnosis is usually made by <\/span><b style=\"user-select: auto;\">ultrasound.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Casual, because many congenital cases are totally asymptomatic. It will then be completed with functional tests, such as the <\/span><b style=\"user-select: auto;\">CT-urography or intravenous urography<\/b>, <span style=\"font-weight: 400; user-select: auto;\">and, above all, the <\/span><b style=\"user-select: auto;\">diuretic renogram<\/b><span style=\"font-weight: 400; user-select: auto;\">. The renogram allows to assess the degree of obstruction before a dilation of the urinary tract, also providing information on the function of each kidney separately.<\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Many cases of UPU syndrome require no more than <\/span><b style=\"user-select: auto;\">close follow-up<\/b><span style=\"font-weight: 400; user-select: auto;\">, with <\/span><b style=\"user-select: auto;\">periodic functional imaging<\/b> tests <span style=\"font-weight: 400; user-select: auto;\"> and <\/span><b style=\"user-select: auto;\">kidney function tests<\/b>.<span style=\"font-weight: 400; user-select: auto;\">. These are asymptomatic cases and those in which the renogram does not demonstrate a significant alteration of the excretory function of the affected kidney.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">In the presence of significant obstruction or the association of clinical infection or abdominal pain, it will be solved by <\/span><b style=\"user-select: auto;\">surgery.<\/b><span style=\"font-weight: 400; user-select: auto;\">. The most used technique is the &#8220;pyeloplasty&#8221;, consisting of the removal of the affected pyeloureteral junction and the anastomosis (union) of the pelvis to the ureter, usually leaving a catheter that will be removed in the postoperative period. It can be performed by open, laparoscopic or robotic surgery, depending on the age of the patient and availability of the center, with very similar results (good results in more than 90% of cases).<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Other options that can be used are <\/span><b style=\"user-select: auto;\">balloon dilations or cutting inside the pyeloureteral junction endoscopically (electric \/ laser)<\/b><span style=\"font-weight: 400; user-select: auto;\">. Its results are good, although somewhat lower than in pyeloplasty, being more recommended in cases of restenosis. <\/span><\/span><\/p>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_hl256i1wrq\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Ureteral stricture<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The ureters are the tubes that carry urine from the kidneys to the bladder. In the ureter, scar tissue can form after an accident or surgery. It can also form due to a health problem, such as endometriosis or cancer. That scar tissue causes the ureter to narrow. This condition is known as stenosis. Urine cannot pass through the ureter properly and collects in the kidney, which can be painful. It can also cause urinary tract and kidney infection or kidney damage. <\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aetiology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">The different processes that can cause the formation of ureteral stenosis are generally associated with <\/span><b style=\"user-select: auto;\">decreased blood flow of the affected ureter, trauma in previous interventions, periurethral fibrosis or neoplasms.<\/b><span style=\"font-weight: 400; user-select: auto;\"> The <\/span><b style=\"user-select: auto;\">radiotherapy<\/b><span style=\"font-weight: 400; user-select: auto;\"> Applied to the pelvis or abdomen, used to treat tumors of other organs, it can be one of its causes.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Ureteral stricture can be caused by benign processes such as: <\/span><b style=\"user-select: auto;\">Lithiasis, fibrosis (aortic aneurysm, endometriosis), infections (tuberculosis, schistosomiasis), iatrogenic lesions (open surgery, endoscopic instrumentation) or benign neoformations of the ureter.<\/b><span style=\"font-weight: 400; user-select: auto;\"> There are malignant processes capable of causing ureteral stenosis: <\/span><b style=\"user-select: auto;\">Malignant neoformations of the ureteral wall, metastatic tumors of the cervix, ovary, colon-rectum, prostate<\/b><span style=\"font-weight: 400; user-select: auto;\">etc.<\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptoms<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">The most common symptom of ureteral stricture is <\/span><b style=\"user-select: auto;\">renal colic<\/b><span style=\"font-weight: 400; user-select: auto;\">, almost identical to that experienced when you have a stone inside the ureter. <\/span> <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">In addition, it is common for patients with this type of pathology to have more <\/span><b style=\"user-select: auto;\">urinary tract infections of the upper tract (pyelonephritis).<\/b> <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Kidney <\/span><b style=\"user-select: auto;\">failure<\/b><span style=\"font-weight: 400; user-select: auto;\"> It is a consequence of severe and evolved stenosis, since chronic obstruction to the physiological excretion of urine from the affected kidney causes it to be canceled. If the other kidney cannot meet the body&#8217;s fluid and electrolyte filtration needs, kidney failure will set in. <\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Medical <\/span><b style=\"user-select: auto;\">history<\/b><span style=\"font-weight: 400; user-select: auto;\"> (history of previous urinary instrumentation, nephritic colic, pelvic or abdominal surgery, radiotherapy, tumors, etc.) It is essential to suspect ureteral stenosis. In addition, various complementary resources are used: <\/span><\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Imaging tests.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Such as ultrasound, tomography, intravenous urography, retrograde or anterograde pyelography, and renal scan.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Blood and urine tests.<\/b><span style=\"font-weight: 400; user-select: auto;\"> They allow to detect renal failure and associated infections.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Treatment is multimodal, and almost always requires some minimally invasive or invasive intervention. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urinary diversion.<\/b><span style=\"font-weight: 400; user-select: auto;\"> It is usually the first therapeutic act. A JJ catheter or nephrostomy catheter is placed, whose function will be to recover and \/ or maintain the function of that renal unit. In addition, in case of upper tract infections, such as obstructive pyelonephritis or urinary sepsis, it is a very effective emergency therapy.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Endoscopic treatment. <\/b><\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Ureteral dilatation balloons<\/b><span style=\"font-weight: 400; user-select: auto;\">, the therapeutic success of which approaches 60% in stenosis of 1 cm or less. There are several types: cutting, diathermic and barometer-controlled. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Placement of ureteral stents<\/b><span style=\"font-weight: 400; user-select: auto;\">, more effective in stenoses of malignant origin (cancers), with successes approaching 80% one year after placement. They can migrate in 3% of cases, and produce perforations of the ureter in 1%.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Placement of metal ureteral catheters.<\/b><span style=\"font-weight: 400; user-select: auto;\"> They are effective in 60% of non-malignant stenosis, with a lower success rate in malignant and radiotherapy-induced stenosis. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Endoscopic ureterotomy with Holmium laser.<\/b><span style=\"font-weight: 400; user-select: auto;\"> It has a success of 60% at 2 years of follow-up. The complication rate is low, at around 5%.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Surgery<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"> <b style=\"user-select: auto;\">Ureteroplasty<\/b><span style=\"font-weight: 400; user-select: auto;\"> is a surgery performed to solve the stricture.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Surgery can be performed laparoscopically, robotic surgery, or it can be done through open surgery. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Ureteroplasty can be performed by <\/span><b style=\"user-select: auto;\">ureteral reimplantation, bladder mucosal flaps, buccal mucosal grafts or through interposition of vascularized segments of small intestine.<\/b> <span style=\"font-weight: 400; user-select: auto;\"> These techniques will be chosen depending on the extent and location of the stenosis.<\/span><\/span><\/p>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_ynayp4uo27\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urethral stricture<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urethral stenosis is a scar that narrows some point of the urethral canal, restricting the flow of urine from the bladder to the outside. It can cause a variety of urological problems, including infection or urinary retention.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptomatology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Signs and symptoms of urethral stricture include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Decreased urine flow<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Incomplete emptying of the bladder<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urine drop by drop<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Difficulty, straining, or pain when urinating<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Increased need to urinate or more frequent urination<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary tract infection<\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aetiology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Scarring that can shrink the urethra may be due to:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Iatrogenic after medical instrumentation, from probing to transurethral surgery.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Intermittent or long-term use of a tube inserted through the urethra to drain the bladder (catheter).<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Trauma or injury to the urethra or pelvis.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">An enlarged prostate or previous surgery to remove or shrink an enlarged prostate gland.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Cancer of the urethra or prostate.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Sexually transmitted infections.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Radiotherapy.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urethral tightness is more common in men than in women. The cause is often unknown.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Clinical questioning is mandatory. It asks about urinary symptoms and how they affect the patient&#8217;s quality of life. In addition, their surgical history or urinary instrumentation, sexually transmitted infections, etc. are investigated.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The complementary tests requested are:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urinalysis:<\/b><span style=\"font-weight: 400; user-select: auto;\"> looks for signs of infection, blood, or cancer in the urine<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Flowmetry:<\/b><span style=\"font-weight: 400; user-select: auto;\"> measures the strength and amount of urine flow<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Pelvic ultrasound:<\/b><span style=\"font-weight: 400; user-select: auto;\"> looks for urine in the bladder after you urinate<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Retrograde urethrography:<\/b><span style=\"font-weight: 400; user-select: auto;\"> uses x-rays to look for a structural problem or injury to the urethra, as well as analyze the extent and location of urethral stricture<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Cystoscopy:<\/b><span style=\"font-weight: 400; user-select: auto;\"> examines the urethra and bladder with a thin, tube-like device that has a lens (cystoscope) to look at these organs<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The treatment will depend on each case. Available treatment options include:<\/span><\/p>\n<ul style=\"user-select: auto;\">\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Catheterization.<\/b><span style=\"font-weight: 400; user-select: auto;\"> The most common first step in treating urine obstruction is to insert a small tube (catheter) into the bladder to drain it. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Dilatation.<\/b><span style=\"font-weight: 400; user-select: auto;\"> The doctor inserts a small cannula through the urethra that goes into the bladder. Larger and larger dilators are passed over the cannula to gradually increase the size of the urethral opening. This outpatient procedure may be an option for recurrent urethral strictures.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urethroplasty.<\/b><span style=\"font-weight: 400; user-select: auto;\"> It is a procedure that involves the surgical removal of the narrowed parts of the urethra or widening of the urethra. In addition, the procedure could involve reconstruction of surrounding tissues. In short strictures it is possible to dry out the damaged part of the urethra and join the ends with stitches (<\/span><b style=\"user-select: auto;\">end-of-end urethroplasty<\/b><span style=\"font-weight: 400; user-select: auto;\">). In longer stenosis, tissues from other areas of the body, such as the skin or buccal mucosa, can be used to make grafts during reconstruction (<\/span><b style=\"user-select: auto;\">urethroplasty with graft<\/b><span style=\"font-weight: 400; user-select: auto;\">). <\/span> <\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Endoscopic urethrotomy.<\/b><span style=\"font-weight: 400; user-select: auto;\"> For this procedure, your doctor inserts a thin optical device (cystoscope) into your urethra, then inserts instruments through the cystoscope to section the stenosis or vaporize it with a laser. This surgical procedure has a faster recovery, leaves minimal scarring, and presents less risk of infection, although there is a chance of recurrence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Implanted stent or indwelling catheter.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In certain cases, an artificial permanent tube (stent) may be chosen to keep the urethra open or an indwelling catheter to drain the bladder. However, these procedures have several disadvantages, such as the risk of bladder irritation, discomfort, and urinary tract infections. In addition, they need to be closely monitored. Generally, urethral stents are a measure of last resort and are not usually used.<\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_gw3hgnw51h\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Laser in Urology<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Laser means &#8220;<\/span><b style=\"user-select: auto;\">L<\/b><span style=\"font-weight: 400; user-select: auto;\">ight <\/span><b style=\"user-select: auto;\">A<\/b><span style=\"font-weight: 400; user-select: auto;\">mplification by <\/span><b style=\"user-select: auto;\">S<\/b><span style=\"font-weight: 400; user-select: auto;\">timulated <\/span><b style=\"user-select: auto;\">E<\/b><span style=\"font-weight: 400; user-select: auto;\">mission of <\/span><b style=\"user-select: auto;\">R<\/b><span style=\"font-weight: 400; user-select: auto;\">adiation&#8221;. <\/span> <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">It is a technology increasingly used in minimally invasive endourological procedures, improving the therapeutic arsenal of the urologist in a large number of pathologies. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The LASER system has certain advantages over other tissue cutting systems, such as: the transmission of large amounts of energy through flexible fibers, high safety and efficiency, due to the low risk of injury to adjacent structures, selectivity by specific tissues according to wavelength and a wide margin of action, due to the ability to regulate both the amount of energy emission transmitted, as well as its frequency. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">There are different types of lasers depending on their wavelength, frequency and tissue penetration. The most used in urology are the Holmium laser, the Tulio laser and the Green laser.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Holmium Laser<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">It is a laser with a wavelength of 2,140 nm and a minimum penetrability in the tissue of 0.4 mm and is absorbed by water. It allows the realization of different minimally invasive techniques. This makes it currently the most versatile and important type of laser in Urology.<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Benign prostatic hyperplasia.<\/b> <span style=\"font-weight: 400; user-select: auto;\"> Thanks to a photothermal contact mechanism allows the <\/span> enucleation <b style=\"user-select: auto;\">of the prostate (prostatic enucleation with Holmium laser)<\/b><span style=\"font-weight: 400; user-select: auto;\">, avoiding the classic adenomectomy (open surgery). It allows a significant reduction in hospital stay, blood loss and urinary catheter time.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Ureteral\/urethral stenosis.<\/b><span style=\"font-weight: 400; user-select: auto;\"> It is useful in the surgery of the narrowing of the ureter, pyeloureteral junction and urethra. This laser allows to section the fibrous callus and expand the lumen of the treated duct. A catheter is left to tutor the duct for a few days or weeks.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urinary lithiasis<\/b><span style=\"font-weight: 400; user-select: auto;\">. It allows to eliminate kidney stones and ureter, vaporizing or fragmenting them. The Holmium laser is used as an adjuvant in ureteroscopy, percutaneous renal surgery and endoscopic cystolithopathy. Holmium is applied at different frequencies, depending on the type of effect we want to apply on urinary calculus. If you want to vaporize or fragment into millimeter pieces we will use high frequency at low energy. If we intend to fragment into larger pieces we will use low frequency and high energy.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment of tumors of the urinary tract.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Bladder and upper urinary tract tumors can be treated by vaporization. It is mainly indicated in superficial and small tumors. <\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Green Laser (Greenlight XPS 180 W)<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">It is a laser with a wavelength of 532 nm and a penetrability of 0.8 mm. It is minimally absorbed by water and much more by hemoglobin. Its fundamental application is the minimally invasive treatment of <\/span><b style=\"user-select: auto;\">Benign prostatic hyperplasia. <\/b><span style=\"font-weight: 400; user-select: auto;\">The technique of treatment of this condition can be fundamentally of two types.<\/span><\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Prostatic vaporization.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Indicated mainly in prostate of small and medium size, below 40cc. It consists of vaporizing the tissue until leaving a good channel for urination. Advantages: minimal bleeding, very short hospital stay and need for 24-hour bladder catheterization. The results are similar to those of prostate resection, but with better recovery. Mixed techniques of anatomical vaporization and vapo-enucleation can be done.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Prostatic enucleation.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Indicated in moderate and large prostates. It consists of the endoscopic reproduction of the classic open adenomectomy. It allows the complete enucleation of the adenoma and its subsequent morcellation within the bladder. Similar to adenomectomy, with comparable results, but with countless advantages. Reduces hospital stay and bladder catheterization, postoperative pain and bleeding. Also, recovery and return to normal activity is much earlier than with open surgery. This technique can also be performed with the Holmium laser, which has gradually displaced the green laser due to its great versatility, and is currently the technique of choice for prostate enucleation.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Tulio Laser<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">It has a variable wavelength between 1.75 and 2.22 \u03bcm, and is mainly applied in prostate hyperplasia. The techniques are similar to green laser and Holmium and in recent times it is also applied for the treatment of lithiasis. Its use is much less widespread than that of the previous lasers commented.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">In Uros Associats we use laser technology in all endourological procedures in which it can be used, since we understand that it represents the ideal system for the minimally invasive and effective treatment of a wide variety of pathologies. We select each type of laser according to the characteristics of each patient and each pathology, since we can have all of them. We have expert specialists in the application of laser technology in urology, both in the treatment of lithiasis, enucleation and prostatic vaporization, and in the conservative management of urinary tract tumors. <\/span><\/p>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_vktn8ga5c7\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<ul style=\"user-select: auto;\">\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">PROSTATIC ENUCLEATION WITH HOLMIUM LASER.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">TRANSURETHRAL RESECTION OF THE PROSTATE.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">PROSTATIC PHOTOVAPORIZATION.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">HOLEP.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">INTERNAL OR ENDOSCOPIC URETHROTOMY.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">TERM-TERMINAL URETHROPLASTY.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">URETHROPLASTY WITH ORAL MUCOSA.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">LAPAROSCOPIC PEELOPLASTY.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">ROBOTIC PEELOPLASTY.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">LAPAROSCOPIC URETERAL REIMPLANTATION.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">ROBOTIC URETERAL REIMPLANTATION.<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"cmsmasters_row_\" class=\"cmsmasters_row cmsmasters_color_scheme_default cmsmasters_row_top_default cmsmasters_row_bot_default cmsmasters_row_boxed\">\n<div class=\"cmsmasters_row_outer_parent\">\n<div class=\"cmsmasters_row_outer\">\n<div class=\"cmsmasters_row_inner\">\n<div class=\"cmsmasters_row_margin\">\n<div id=\"cmsmasters_column_\" class=\"cmsmasters_column one_first\">\n<div class=\"cmsmasters_column_inner\"><div class=\"cmsmasters_text\">\n<div id=\"toggle\" style=\"user-select: auto;\">\n<div class=\"toggle_container \" style=\"user-select: auto;\">\n<div class=\"block\" style=\"user-select: auto;\">\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><img fetchpriority=\"high\" decoding=\"async\" class=\"size-full wp-image-15863 aligncenter\" style=\"user-select: auto;\" src=\"https:\/\/urosassociats.com\/wp-content\/uploads\/2021\/01\/cirugia-minimamente-invasiva.jpg\" alt=\"\" width=\"600\" height=\"400\" srcset=\"https:\/\/urosassociats.com\/wp-content\/uploads\/2021\/01\/cirugia-minimamente-invasiva.jpg 600w, https:\/\/urosassociats.com\/wp-content\/uploads\/2021\/01\/cirugia-minimamente-invasiva-300x200.jpg 300w, https:\/\/urosassociats.com\/wp-content\/uploads\/2021\/01\/cirugia-minimamente-invasiva-580x387.jpg 580w\" sizes=\"(max-width: 600px) 100vw, 600px\" \/><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">The prostate is a gland of the male reproductive system that, together with the seminal vesicles, is responsible for producing semen. It is the size of a walnut and is located under the bladder, in front of the rectum. But over the years, its central part can grow to the point of compressing the urethra, causing what is known as the benign prostatic adenoma.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">This obstruction can cause difficulty emptying the bladder, a phenomenon that affects more than half of men over 50, half of whom require treatment.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"cmsmasters_row_5s2f89hxp\" class=\"cmsmasters_row cmsmasters_color_scheme_default cmsmasters_row_top_default cmsmasters_row_bot_default cmsmasters_row_boxed\">\n<div class=\"cmsmasters_row_outer_parent\">\n<div class=\"cmsmasters_row_outer\">\n<div class=\"cmsmasters_row_inner\">\n<div class=\"cmsmasters_row_margin\">\n<div id=\"cmsmasters_column_l44gkpjgf5\" class=\"cmsmasters_column one_first\">\n<div class=\"cmsmasters_column_inner\"><div 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