Suprapubic Prostatectomy
The indications for a suprapubic prostatectomy for benign disease are the same as for the retropubic approach, namely symptomatic bladder outlet obstruction from benign prostatic hyperplasia (BPH) or urinary retention…
Transrectal Ultrasound-Directed Prostate Biopsy
The first transrectal core needle prostate biopsy was first reported by Astraldi and colleagues in 1937. Since that time, advances in our understanding of prostatic zonal anatomy, ultrasound imaging, and…
Transperineal Prostate Biopsy
A safe and accurate biopsy technique is essential for the management of prostate cancer. Patients are selected for biopsy based on a complex algorithm of their PSA and kinetics, DRE…
Laser Treatment of Benign Prostatic Disease
Introduction Basics of Laser Therapy for Benign Prostatic Hyperplasia Laser technology was first implemented to treat benign prostatic hyperplasia (BPH) in 1986. The acronym “laser” stands for “Light Amplification by…
Anatomy and Principles of Excision of the Prostate
Surgical Approaches Radical prostatectomy remains a standard treatment option for men with localized prostate cancer. Even though this operation has developed over more than a century, it remains a challenging…
Transurethral Resection and Transurethral Incision of the Prostate
Indications Transurethral resection of the prostate (TURP) has played a storied role in American urology. Many of the same individuals who were crucial players in establishing the specialty of urology…
Female Vesical Neck Closure
Indications Female vesical neck closure is an uncommon procedure often reserved for those with severe urethral incompetence. There are a number of conditions in which vesical neck closure is indicated;…
Transperitoneal Vesicovaginal Fistula Repair
Vesicovaginal fistulas (VVFs) represent a challenging scenario for both the patient and surgeon. Many considerations must take place in advance of repair, including diagnosis of the fistula (visualization, dye test,…
Transvaginal Repair of Vesicovaginal Fistula
Preoperative Preparation and Planning Traditionally, it has been recommended to wait a minimum of 3 months after vesicovaginal fistula (VVF) diagnosis or last attempted repair before proceeding with repair because…
Transvesical Repair of Vesicovaginal Fistula
An abdominal approach to vesicovaginal fistula (VVF) repair should be considered in large, complex, supratrigonal fistulas in the setting of ureteral involvement, small-capacity bladder requiring augmentation, previously irradiated tissue, immobile…
