A
acute renal failure (ARF)
Definition: a sudden decrease in renal (kidney) function sufficient to cause a build up of waste products in the body. There are 3 major categories of ARF:
1) Pre-renal causes: A decrease in blood flow going into the kidney.
2) Renal causes which are a result of problems within a kidney.
3) Post-renal or obstructive causes, i.e. as a result of obstruction to the renal outflow of urine.
atonic bladder
In this situation the bladder muscle is unable to contract at all and acts like a floppy bag. It can be caused by bladder outflow obstruction, for instance, as a consequence of prostatic enlargement. If the obstruction is relieved the bladder may not be able to empty due to the lack of bladder muscle function.
AUS – artificial urinary sphincter
This is a device that can be implanted into the body that can assist with continence if the body’s normal sphincter has been damaged. This can occur after operation for stress incontinence in women or prostate cancer in men, or in certain neurological conditions.
B
benign prostatic hypertrophy (BPH)
This is enlargement of the prostate gland as part of the normal ageing process in men. This is under the hormonal control of testosterone. About 10% of men in their forties and up to 90% of men in their eighties have this enlargement of the prostate.
bladder
The bladder is an organ sited within the bony pelvis that stores urine (produced in the kidneys). The bladder empties at intervals expelling urine from the body.
bladder outflow obstruction (BOO)
This is a reduction in flow of urine out of the bladder due to high-pressure resistance. BPH can lead to BOO in some instances.
bone scan
A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner.
brachytherapy
this a newer procedure made popular in the USA, whereby small radioactive needles are implanted into the prostate. This allows a local, high dose of radiation to penetrate and kill off the cancer cells.
C
carcinoma in situ (CIS)
Cancer cells found only on the surface of the inner lining of the bladder, which is always considered a high grade tumour with the potential to spread out of the bladder if not treated effectively.
clean intermittent self-catheterization (CISC)
In this situation the patient passes a small catheter down the urethra in order to empty the bladder. This is usually advised if the patient is retaining urine within the bladder in certain situations.
computed tomography scan (CT scan)
A series of detailed pictures of areas inside the body taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computed tomography scan, computerized tomography, computerized axial tomography scan, and CAT scan.
cushing’s disease
This is caused by the excessive production of adrenocorticotrophic hormone (ACTH) by the pituitary gland. ACTH then stimulates the adrenal glands to produce excessive cortisol.
Symptoms include increased appetite and drinking lethargy hair loss abdominal weight gain susceptibility to infections and thinning and weakening of the skin.
cushing’s syndrome
This is a condition resulting in the increased production of cortisol a hormone produced by the adrenal glands within the body. It can be caused by the excessive intake of steroid hormones.
Symptoms include increased appetite and drinking lethargy hair loss abdominal weight gain susceptibility to infections and thinning and weakening of the skin.
cystitis
Literally means “inflammation of the bladder”. It is usually caused by urinary tract infection, however there are situations where cystitis like symptoms can occur in the absence of infection. Symptoms include frequency and urgency of urination, burning or pain on passing urine and occasionally blood in the urine. A simple urine test will usually determine whether there is any infection.
cystolitholapaxy
This is the breaking up and removal of a bladder stone using a cystoscope
cystolithotomy
This is the removal of a bladder stone via an incision through the abdominal wall.
cystoscope
This is a small telescope that can be passed down the urethra into the bladder for diagnostic purposes or treatments, such as, insertion of J-J stent or treatment of bladder tumours. Rigid cystoscopy is carried out under general anaesthetic.
D
detrusor failure
This is a failure of the bladder muscle to contract. It can occur in situations such as bladder outflow obstruction in BPH. Patients who undergo relief of obstruction (e.g. by TURP) may still not be able to empty their bladder fully due to this weakness of the bladder muscle.
duplex system
This is an anatomical variation that you may be born with. It usually implies a doubling of the urinary system, commonly giving rise to 2 ureters instead of 1 on each side. The duplex system may be on the left or right side or, on rare occasions, both sides.
E
ESWL (extracorporeal shock wave lithotripsy)
This is a procedure that uses a magnified sound wave to shatter stones within the kidney and ureter. It is usually carried out as an outpatient procedure with the patient awake.
There may be some discomfort during this procedure however light pain relief is usually all that is necessary.
F
flexible cystoscopy
This is a small flexible telescope that can be passed down the urethra for the purposes of diagnosis. It gives a good view of both urethra and bladder.
The flexible cystoscope is passed after giving a lignocaine local anaesthetic jelly to numb the urethra.
G
no content yet
H
haematuria
This is the passage of blood in the urine. This can range from a slight pinkish discolouration of the urine to obvious blood with clots passing.
HIFU
High Intensity Focused Ultrasound. A recently developed procedure for the treatment of localized prostate cancer.
I
ileal conduit
An ileal conduit is a small urine reservoir that is surgically created from a small segment of bowel. This technique is a form of reconstructive surgery to replace the bladder or bypass obstructions or disease in the bladder so that urine can pass out of the body.
immunotherapy
Treatment to stimulate or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments.
incontinence
This is the involuntary loss of urine. This can be due to bladder abnormality or sphincter (outlet) abnormalities.
intravenous urogram (IVU)
This is a special X-ray test where some dye is injected into a blood vessel of the arm and a series of x-rays are taken to outline the urinary tract. As the dye passes out in the urine, images of the kidneys, ureter and bladder can be seen and any abnormalities can be detected.
intravesical chemotherapy
The aim of this treatment is to treat the cancer and stop it from coming back. This is the main way of treating CIS . First you need to have a catheter (tube) put into your bladder and then the nurse puts the chemotherapy drug into your bladder through the catheter. Then the catheter may be taken out. You have to try not to pass any urine for the next two hours.
This gives the treatment time to work. You usually have this treatment weekly for 6 weeks. Your specialist may suggest you have more intravesical therapy 6 weeks after your last weekly treatment, and then 6 monthly for the next 2 to 3 years. This is called maintenance therapy.
J
j-j stent
This is a small plastic tube that is placed into the urinary system using a cystoscope.
The procedure is carried out under general anaesthetic and the tube is sited from the bladder into the kidney. It will allow drainage of urine from the kidney into the bladder.
It is used to relieve obstruction if, for instance, a stone is blocking the ureter. It is called a J-J stent because of its curled shape at each end.
K
kidney
The 2 kidneys are bean shaped organs approximately 12cm in length sitting either side of the spine at the level of the middle back.
They have many functions including removal of waste products from the body, production of urine and are important in controlling the body’s water and salt balance.
The kidneys are also play an important role in controlling blood pressure.
KUB x-ray
KUB stands for kidney, ureter and bladder and it is a plain X-ray film to look at the urinary system and the abdomen as a whole. This plain X-ray usually reveals any obvious calcifications or stones within the urinary system.
L
laparoscopic nephrectomy
This is a type of keyhole surgery to dissect the kidney from its surrounding tissues and remove the diseased kidney. See Laparoscopic Nephrectomy section for full explanation.
lignocaine
This is a local anaesthetic that is used in procedures such as flexible cystoscopy.
lower urinary tract symptoms (LUTS)
These are the symptoms that the patient notices when the urine flow is affected. Typical symptoms include hesitancy of urine flow, reduced urine flow, dribbling at the end of urination, urgency and frequency and also having to get up at night to pass water (nocturia). The combination of BPH and BOO can cause these symptoms to occur.
M
metastases
Metastases – this is a secondary cancerous growth formed by transmission of cancerous cells from a primary growth located elsewhere in the body.
micturition
The act of passing urine.
MRI – magnetic resonance imaging
A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as CT or X-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones.
N
nephrectomy
surgical removal of the kidney .
nephrocalcinosis
This describes deposits of calcium salts (e.g. oxalate or phosphate) within the small ducts and tissue of the kidneys. If nephrocalcinosis is sever it may lead to an overall decrease in kidney function. The calcium salts may be the starting point of kidney stones.
nephrolithiasis
This describes the presence of one or more stones within the kidney urinary collecting system or ureter.
nephroscope
This is a telescope that is used during PCNL (percutaneous nephrolithotomy) to examine the inside of the kidney system and to enable treatment of kidney stones.
nephrostomy
A nephrostomy involves putting a small needle directly into the kidney to drain urine, if the kidney is obstructed.
nocturia
This means having to passing urine at night. This is a common symptom of bladder outflow obstruction (BOO) due to prostatic enlargement.
O
oncologist
An oncologist is a medical specialist who manages patients with cancer. Your urologist will often involve an oncologist to advise and help with the management of patients with difficult urological cancers.
Oncologists may suggest the use of chemotherapy or radiotherapy as part of the management plan for your urological cancer.
open nephrectomy
This is an operation whereby a kidney is surgically removed. A large incision is made, usually over the line of one of the lower ribs or across one side of the abdomen.
A simple nephrectomy usually carried out for benign disease e.g. stone disease, infections (e.g. pyelonephritis), whereby just the kidney is removed.
A radical nephrectomy is an operation to remove a cancerous kidney and usually involves removing the kidney complete with its outer fatty covering, the adrenal gland and upper ureter.
orchidectomy
This is a surgical procedure whereby the testicles are removed. It is usually carried out as an option in the treatment for advanced prostate cancer.
Removal of the testicles reduces the amount of testosterone in the body which in turn removes the “drive” for prostate cancer.
P
paraneoplastic syndrome
This refers to a large unrelated group of medical problems, which can arise in patients suffering with cancer.
It appears to be the result of a release of chemical substances from the cancer cells, which can then travel and affect other organs.
partial nephrectomy
This involves removing the part of the kidney that is diseased. It can be carried out for localised scarring of a kidney due to infection or stones.
It is also carried out if the patient has a small localised cancer with accompanying reduced kidney function.
PCA3
A genetic probe urine test used in the diagnosis of prostate cancer. PCA3 is a urine-based assay used to provide clinicians with information for patients who have an elevated serum PSA, in conjunction with a previous negative prostate biopsy.
prostatitis
This literally means inflammation of the prostate. This is the most common urological diagnosis in men under the age of 50. It can affect between 10-30% of men.
The symptoms of chronic prostatitis include pain on passing urine, pain in the pelvis area as well as pain in the testicles, upper legs and sometimes in the lower abdomen.
A stressful lifestyle can sometimes aggravate the symptoms of prostatitis. Investigations will look for a bacterial cause; however, on most occasions no specific bacteria will be found.
Treatment will depend on the clinical history and examination and the results of investigations. This will be discussed at your consultation.
PSA blood test
A blood test that measures levels of a protein called Prostate Specific Antigen that is manufactured exclusively by the prostate gland; elevated levels of PSA can indicate prostate problems.
pyelonephritis
An infection of the kidney as a result of a urinary tract infection.
Q
no content yet
R
radical cystectomy
Surgery to remove the bladder as well as nearby tissues and organs as a curative measure for localized bladder cancer.
rectal examination
This is an examination performed by the doctor using lubricating jelly to examine the prostate. The patient is usually lying on his left side with the knees bent.
Examination of the prostate in this way will allow an estimation of prostatic size and examination for any irregularities of the prostate.
renal cell carcinoma
renal cell cancer is the most common type of kidney cancer in adults. Over 80 out of every 100 kidney cancers diagnosed in the UK are this type.
In renal cell cancer, the cancerous cells are found in the lining of the tubules (the smallest tubes inside the kidney that help filter the blood and make urine).
Generally, how aggressive the cancer is likely to be is graded in a particular way, by looking at the cells under a microscope. The kidney cancer grading system is called the Fuhrman system.
renal colic
This is a sudden abdominal pain caused by the passage of a stone down the urinary tract. The pain may be very severe causing the patient to double over and possibly vomit.
The pain is typically intermittent, coming in waves and the patient may not be able to sit still. The site of the pain will be in the loin, over the abdomen, in the groin area or tip of the penis or a combination of all of the above.
The patient may require opiate (morphine) pain relief to relieve the symptoms.
renogram
This is a type of kidney scan which reveals how much of the kidney is actually functioning and if there is any obstruction to the urine flow out of the kidney.
A tiny amount of radioactive liquid is injected into the blood stream and the pictures are taken as the contrast is removed in the urine.
rigor
A shaking chill usually associated with kidney infection (e.g. pyelonephritis). The uncontrollable shaking may accompany a high fever and may also be intermittent in nature.
S
schistosomiasis
any of various generally tropical diseases caused by infestation with schistosomes, widespread in rural areas of Africa, Asia, and Latin America through use of contaminated water, and characterized by infection and gradual destruction of the tissues of the kidneys, liver, and other organs. Also called bilharziasis, snail fever.
squamous cell carcinoma (SCC)
This is a type of bladder cancer that begins in the thin, flat cells of the bladder lining. Squamous cell carcinoma develops as a result of chronic irritation and inflammation of the bladder.
staghorn calculus
Large kidney stone filling the whole of the urinary collecting system of that kidney.
stenosis
abnormal narrowing of a tubular structure of the body, usually due to scarring.
stoma bag
a urine collection device that is odour-free, not visible under clothing, which can be disposable or reusable.
T
transitional cell carcinoma (TCC)
TCC is a cancer arising from the lining of the urinary tract. TCC commonly arises in the bladder, however it may occur in any part of the urinary tract, including kidneys, ureter and urethra.
TCC is the most common form of cancer found within the bladder.
transurethral resection of bladder tumour (TURBT)
TURBT is carried out under a general or spinal anaesthetic. A rigid cystoscope is passed through the urethra into the bladder and the bladder cancer growth (tumour) is removed.
A small wire loop is used which acts a small heating element. This enables the tumour to be removed and stops any bleeding that may occur.
This tumour specimen can then be looked at under the microscope to grade it and so help with the further management of the bladder cancer.
transurethral resection of prostate (TURP)
This is a procedure to “core out” the prostate. The aim of this procedure is to relieve the symptoms of bladder outflow obstruction and BPH. This is performed under general anaesthetic.
TRUS biopsy
Trans Rectal UltraSound of the prostate and biopsy is used to obtain very small samples of prostate tissue so that they can be looked at under the microscope to see if cancer cells are present.
U
ureter
This is a thin muscular tube enabling urine to travel from the kidney down to the bladder
ureteroscopy
This is a procedure using a very small calibre telescope to look into the ureter which is the tube connecting the kidney to the bladder.
It is usually performed as part of the treatment for ureteric stones and also sometimes for investigation into the causes of haematuria. This is performed under general anaesthetic.
urethra
This is the tube (or waterpipe) leading from the bladder out of the body.
urinary tract infection (UTI)
This is an infection of the urine, giving rise to symptoms of cystitis (pain on passing urine, urgency and frequency with occasional blood in the urine) or pyelonephritis (kidney infection).
V
varicocele
This is an enlargement of the veins around the spermatic cord and testicle. This is normally the result of abnormal or incompetent valves within the veins that cause a build up of blood, causing dilatation of the veins around the testicle.
Classically the scrotum feels like a “bag of worms” when the patient is standing. The swelling is usually painless and more common on the left side.
Varicocoeles are possibly the cause of infertility in up to 40% of men who have attended infertility clinics.
video cystometrogram (VCMG)
This is a test to look at how the bladder is functioning when it fills and during emptying.
Von Hippel Lindau disease
A rare inherited disorder characterized by the abnormal growth of tumors and/or cysts in the kidneys, eyes, brain, spinal cord, adrenal glands, and other parts of the body. While many of the tumors are benign (non-cancerous), some-especially those of the kidney-may be malignant (cancerous). Renal cell carcinomas are the major form of cancer in VHL disease and are seen in up to 45 percent of patients. The current standard treatment is surgical removal.