Hernia surgery with 3 key holes

Inguinal hernia is a weakness in the abdominal wall muscle through which some of the abdominal contents can protrude, causing a lump or pain in the groin region. It can occur in young boys or men in the middle age or elderly.

The only method of correcting this problem is by a surgical procedure to close the hole and strengthen the defect. Traditionally, this has been done by an open surgery, involving a cut measuring 5cm over the groin and repairing the defect with surgical sutures.

The latest technique of inguinal repair is by the laparoscopy total extra peritoneal mesh method. It involves making only 3 small holes, measuring between 0.5 to 1.0 cm on the abdomen and repairing the hernia defect with a thin but yet strong synthetic material. This will encourage the growth of natural tissue and muscle over the defect, resulting in a strong repair and lower risk of hernia recurrence in future.

The laparoscopy technique is less painful, results in a smaller scar and quicker recovery from surgery.

No more surgery for Kidney Stones

Kidney stones is a very common urology condition that can occur at all ages. It is four times more common in men than women. Kidney stones can produce a variety of symptoms. A very small stone measuring only a few millimeters can cause such severe pain that warrants a patient to call for an ambulance. On the other hand, a very large kidney stone can be silent and continue to cause damage to the  kidney, leading to infection and eventually destruction of the kidney.

Kidney stone treatment has changed dramatically over the last 20 years. Almost all stones can be treated by a non surgical method called Extra corporal shock wave lithotripsy or ESWL in short. A patient lies on a special bed with a hole to allow shock wave to be passed from the ESWL machine in to the body. These shock waves are focused and directed to the kidney stone, avoiding any damage to the kidney and other vital organs of the body. The shock wave direction is continuously monitored by x-ray or ultrasound to ensure accuracy of treatment. The entire treatment takes between 1- 1.5 hours and the patient can return home on the same day.

Reversal of Vasectomy - 2nd chance after vasectomy

Vasectomy is meant to be a highly effective and permanent method of family planning for men. However, few men may require a reversal of this procedure due to developments in later part of their life. The old relationship may have broken down and they have moved on to a new relationship. They may desire children from the new relationship.

Vasectomy reversal surgery offers a second chance for men who had vasectomy. This procedure is usually performed by an urologist who is trained in micro-surgical surgery technique.

Under general anesthesia, the ends of the previously divided vas deferens are located and brought together. The ends are trimmed to ensure that they are patent and sperm is seen in the fluid draining from the ends of the vas deferens. The ends of the vas deferens is then stitched together with 8-10 very fine stitches in a process called vaso-vasostomy This is done with the assistance of a surgical microscope for magnification and precision. The entire procedure may take between 3-4 hours. This can be done as a day surgery or a single night's stay in hospital.

The colour of the ejaculation fluid should change within 1-2 months after surgery, indicating the return of sperm. Return of sperm is seen in up to 90% of patients undergoing reversal of vasectomy surgery. However, pregnancy rate is much lower, dependant on the age of the patient and his partner.

What are the common urology conditions?

Urology is a surgical sub specialty that deals with problems related to the following organs:

1. kidney

2. adrenal gland

3. ureter (urine tube connecting kidney to bladder)

4. bladder

5. urethra (urine tube connecting bladder to the external)

6. penis and testes in males

Common urology conditions are stones in the kidney or ureter, infections of the bladder or kidney, prostate enlargement and cancer growing in the prostate, bladder or kidney.

These conditions may present with symptoms of pain over the back or lower part of the abdomen, blood in urine, pain during passage of urine, frequent urination and general symptoms such as lack of energy and loss of weight. In some conditions, they remain silent till the disease has progressed to an advanced state.

Evaluation of urology problems involve a physical examination, blood and urine tests and scans of the abdomen (ultrasound, CT scan or MRI). Sometimes, a cystoscope or a fine tube with a camera attached to its end in inserted in to the urine tube to inspect the health of urethra, prostate and bladder.