Glossary of Urologic Terms
Glossary of Terms
Below is a list of general terms related to the medical specialty of urology.
Absorbent Products: Pads and garments, disposable or reusable, worn to absorb leaked urine. Absorbent products include shields, undergarment pads, combination pad-pant systems, diaper-like garments, and bed pads.
Artificial Sphincter: Complicated cases of incontinence requiring implantation of a device known as an artificial urinary sphincter. People who might benefit from this treatment include those who are incontinent after surgery for prostate cancer or stress incontinence, trauma victims, and people with congenital defects in the urinary system. The artificial sphincter has three components, including a pump, a balloon reservoir, and a cuff that encircles the urethra and prevents urine from leaking.
The cuff is connected to the pump, which is surgically implanted in the scrotum (in men) or labia (in women). The pump can be activated (usually by squeezing or pressing a button) to deflate the cuff and permit the bladder to empty. After a brief interval, the cuff refills itself and the urethra is again closed. Because the artificial sphincter is an implant, it is subject to the risks common to implants, such as infection, erosion (breaking down of tissue), and mechanical malfunction. Yet with appropriate presurgical evaluation, operative techniques and postoperative follow-up, many problems can be avoided; and incontinent patients can experience an improved quality of life with this device.
Anemia: A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume.
Anxiety: A debilitating condition of fear, which interferes with normal life functions.
Assisted Reproductive Technologies (ART): New forms of fertility treatment incorporating many methods of sperm retrieval and preparation. Once the sperm have been processed to ensure optimal fertilizing potential, they are used in a variety of procedures that aid the process of conception. These procedures include artificial insemination (AI), in vitro fertilization (IVF), and sperm microinjection techniques.
Autologous: Derived from the same individual.
Behavioral Techniques: Different methods to help “retrain” the bladder and get rid of the urgency to urinate. (See biofeedback, bladder training, electrohydraulic lithotripsy, habit training, pelvic muscle exercises.)
Benign Prostatic Hyperplasia (BPH): A condition in which the prostate becomes enlarged as part of aging. It is caused by changing hormonal levels that increase the size of the prostate. The prostate may grow by cells multiplying around the urethra and squeezing it or by cells growing into the urethra and lower bladder. BPH is the most common disorder of the prostate.
Benign Tumor: A tumor that is not cancerous.
Bilateral: A term describing a condition that affects both sides of the body or two paired organs, such as kidneys.
Biofeedback: A procedure that uses electrodes to help people gain awareness and control of their pelvic muscles.
Bladder: A hollow muscular balloon-shaped organ that stores urine until it is excreted from the body.
Bladder Cancer: The fifth most commonly diagnosed cancer in the US, but bladder cancer is rarely discussed among the general public.
According to the American Cancer Society, more than 70,000 Americans are diagnosed with bladder cancer each year. Bladder cancer is more common among men than women. Incidence of the disease increases with age. People over the age of 70 are 2-to-3 times more likely to develop the disease than individuals between the ages of 30 to 54.
Cigarette smoking is a contributing factor of more than 50% of bladder cancer cases. Other causes and risk factors of the disease include: age, chronic bladder inflammation, consumption of Aristolochia fangchi herb, a diet high in saturated fat, exposure to secondhand smoke, family history, exposure to carcinogens in the workplace, certain medications, and infection of Schistosoma haematobium parasite.
Bladder Training: A behavioral technique that teaches the patient to resist or inhibit the urge to urinate and to urinate according to a schedule rather than urinating at the urge.
BPH: See Benign Prostatic Hyperplasia.
Brachytherapy: The placement of tiny radioactive pellets into the prostate gland. By utilizing ultrasound to place the seed pellets, damage to surrounding tissues is minimized. Approximately 13,500-16,000 rads of radiation energy are delivered directly to the prostate. This procedure is performed on an outpatient basis. It is a one-time procedure with very effective results. The 10-year follow-up outcome data parallels that of radical prostatectomy.
Catheter: A tube passed through the body for draining fluids or injecting them into body cavities. It may be made of elastic, elastic web, rubber, glass, metal, or plastic.
Catheterization: Insertion of a slender tube through the urethra or through the anterior abdominal wall into the bladder, urinary reservoir, or urinary conduit to allow urine drainage.
Chancre: A hard, syphilitic primary ulcer, the first sign of syphilis, appearing approx. 2-to-3 weeks after infection. The ulcer begins as a painless lesion or papule that ulcerates. It occurs generally singly, but sometimes may be multiple.
Chemolysis: Certain types of kidney stones can be dissolved with the application chemicals. Uric acid stones, for example, can be dissolved with a solution of sodium bicarbonate in saline. Cystine stones may be treated successfully with a combination of acetylcysteine and sodium bicarbonate in saline. Struvite and carbon apatite stones can be treated with an acidic solution of hemiacidrin. The procedure involves infusing the chemical solution into the affected area by means of a urethral catheter in a series of treatments over time until the stone is dissolved. The patient’s urine must be cultured regularly throughout the course of treatment to guard against urinary infection and prevent the buildup of excessive chemical levels, particularly magnesium, which can cause other health problems.
Colon: It’s another name for the large intestine.
Creatinine: A waste product that is filtered from the blood by the kidneys and expelled in urine.
Cryotherapy: An operation where probes are placed in the prostate. The probes are then frozen, which kills the prostatic cells.
Cystocele: A herniation of the bladder into the vagina.
Cyst: A lump filled with either fluid or soft material, occurring in any organ or tissue; may occur for a number of reasons but is usually harmless unless its presence disrupts organ or tissue function.
Cystectomy: Surgical removal of the bladder.
Cystoscopy: A flexible scope is inserted into the urethra and then into the bladder to determine abnormalities in the bladder and lower urinary tract.
Diabetes mellitus: A common form of diabetes in which the body cannot properly store or use glucose (sugar), the body’s main source of energy.
Diuretic: A drug that increases the amount of water in the urine, removing excess water from the body; used in treating high blood pressure and fluid retention.
Electrohydraulic Lithotripsy (EHL): A technique using a special probe to break up small stones with shock waves generated by electricity. Through a flexible ureteroscope, the physician positions the tip of the probe 1 mm from the stone. Then, by means of a foot switch, the physician projects electrically generated hydraulic shock waves through an irrigating fluid at the stone until it is broken into small fragments. These can be passed by the patient or removed through the previously described extraction methods. EHL has some limitations: It requires general anesthesia and is generally not used in close proximity to the kidney itself, as the shock waves can cause tissue damage. Fragments produced by the hydraulic shock also tend to scatter widely, making retrieval or extraction more difficult. This technique largely has been replaced by Laser Lithotripsy.
Enterocele: Herniation of the small bowel into the vagina.
Erectile Dysfunction: Commonly referred to as ED, erectile dysfunction is the inability to achieve and sustain an erection suitable for sexual intercourse. This condition is not necessarily considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.
Estrogen: Hormones responsible for the development of female sex characteristics; produced by the ovary. There are estrogen receptors in and near the urethra that keep it healthy. Low estrogen levels can be the cause of urethral irritation and contribute to recurrent UTIs.
External Beam Radiation Therapy: Radiation that is delivered to the affected area from outside the body. There are several different techniques, including IMRT, 3-D conformal, and Proton beam, among others. Often used for prostate cancer, it also can be beneficial in bladder cancer and certain types of testicular cancer. There can be some radiation effects on surrounding tissues.
Radiation therapy for precision treatment of prostate cancer is especially challenging without the correct technology.
Calypso and IGRT (daily image guidance) are two advanced technologies used in conjunction with IMRT to ensure that the highly tailored treatment is delivered exactly where it is intended with millimeter precision.
As a result, IGRT effectively minimizes unnecessary radiation exposure and damage to healthy tissue. IMRT alone cannot do this.
Before treatments begin, the physician implants small fiducial markers into the prostate utilizing a simple procedure to direct the radiation oncologist to the exact location of the prostate. During the course of radiation, either Calypso or IGRT will be used to locate these markers accurately and precisely every day. IGRT uses daily image guidance to do this, whereas Calypso uses a GPS-type system for real-time tracking of the prostate.
These daily location technologies ensure that the delivery of radiation is focused on the prostate during treatment. Both Calypso and IGRT have been shown in studies to reduce side effects associated with radiation therapy.
Extracorporeal Shock Wave Lithotripsy (ESWL): A procedure that uses highly focused sound waves projected from outside the body to pulverize kidney stones. This allows for a stone to be broken up into tiny pieces without having an invasive procedure.
Habit Training: A behavioral technique that calls for scheduled toileting at regular intervals on a planned basis. Unlike bladder training, there is no systematic effort to motivate the patient to delay voiding and resist urge.
Hematuria: A condition in which blood appears in the urine. With hematuria, the blood may be gross (visible to the naked eye) or microscopic (only visible under a microscope). Hematuria can originate from any location along the urinary tract.
Hormonal Therapy: Involves the use of antiandrogens. An androgen is a male hormone needed for the production of testosterone. By depriving the cancer cells of the testosterone they need for growth, tumors regress in size and cellular activity. Side effects include gynecomastia, the enlargement of breast tissue, hot flashes, and loss of libido (desire to have sex). Some long-term hormonal therapy is associated with the loss of muscle mass, osteoporosis, and malaise (loss of energy).
Hydrocele: A painless swelling of the scrotum caused by a collection of fluid around the testicle; commonly occurs in middle-aged men.
Hypermobility: A condition characterized in which the pelvic floor muscles can no longer provide the necessary support to the urethra and bladder neck. As a result, the bladder neck drops when any downward pressure is applied and causes involuntary leakage. This condition is a common cause of stress urinary incontinence.
Hyperplasia: Excessive growth of normal cells of an organ. This is seen frequently in benign prostatic hyperplasia.
Insemination: The placement of semen into a woman’s uterus, cervix, or vagina.
InterStim Continence Control Therapy: A therapy used in treating urge incontinence. A device, about the size of a pacemaker, is implanted into the sacral nerves of the lower spine, where it delivers electrical impulses that help regulate bladder function.
Interstitial Cystitis: A chronic bladder condition caused by damage to the protective lining of the bladder. Patients experience symptoms of urinary frequency, urinary urgency, or pain in the areas between the navel and the inside of the thighs that can be mild or severe and occasional or constant.
Intrinsic Sphincter Deficiency (ISD): A weakening of the urethra sphincter muscles. As a result of this weakening, the sphincter does not function normally regardless of the position of the bladder neck, or urethra. This condition is a common cause of stress urinary incontinence.
Irritable Bladder: Involuntary contractions of muscles in the bladder, which can cause lack of control of urination.
Kegel Exercises: Exercises to strengthen the muscles of the pelvic floor, which leads to more control and prevents leakage.
Kidney: One of a pair of organs located at the back of the abdominal cavity. Kidneys make urine through blood filtration.
Kidney Cancer: Approximately 30,000 Americans are diagnosed with kidney cancer each year. The disease is slightly more common in men than women and is usually diagnosed in individuals between the ages of 50 and 70. If kidney cancer is detected early, the survival rate ranges from 79% to 100%. Common risk factors for kidney cancer include: smoking/tobacco use, chronic kidney failure and/ or dialysis, polycystic kidney disease, von Hippel Lindau disease, a high-calorie diet. and low Vitamin E intake.
Common symptoms of kidney cancer may include: blood in the urine (hematuria); an abdominal mass or lump; fever; hypertension; pain in the side or lower back; persistent fatigue; rapid, unexplained weight loss; and swelling in the legs or ankles. Most often the diagnosis is made when a radiological study is done and the mass is seen on ultrasound, MRI, or CAT scan.
Kidney Stone: Rock-like masses within the urinary tract formed by the crystallization of various elements excreted in the urine. Common types of kidney stones are composed of calcium oxalate, calcium phosphate, uric acid, or magnesium ammonium phosphate.
Laparoscopy: Surgery using a laparoscope to visualize internal organs through a small incision. Generally is less invasive than traditional surgeries and requires a shorter recovery period.
Laser Prostatectomy: Surgery using a laser probe placed within prostatic tissue. Laser energy is then used to destroy prostatic tissue, which makes urination easier.
Lithotripsy: A procedure done to break up stones in the urinary tract using ultrasonic shock waves, laser, or electrical impulses so that the fragments can be passed easily from the body.
Low Testosterone: A symptom highly associated with multiple disease states including obesity, diabetes, hypertension, high cholesterol, and asthma. In the US today, more than four million adult men have low testosterone (sometimes called Low-T). Symptoms of this condition include low libido, decreased enjoyment of life, decreased ability to concentrate, and decreased sports performance.
Low testosterone is diagnosed through a blood test where physicians look for the level of testosterone and sex hormone binding globulin (SHBG), a protein that tightly binds testosterone and makes it unavailable for use by the target organ.
Menopause: The period that marks the permanent cessation of menstrual activity in women, usually occurring between the ages of 40 and 58 years old.
Metastasis: The spreading of a cancerous tumor to another part of the body.
Microwave (Transurethral Microwave Thermoablation [TUMT]): A specialized catheter placed in the bladder and positioned so that a small microwave antenna releases energy within the prostate. This energy slowly shrinks the prostate and relieves an obstruction, allowing for easier urination. This is usually done in the doctor’s office with light sedation.
Mixed Incontinence: Having both stress and urge incontinence.
Nephrectomy: Removal of an entire kidney.
Open Nephrolithotomy: An open removal of kidney stones and is the most invasive procedure for removing kidney stones. Because of advances in endoscopic techniques. this surgery is rarely required.
Orchiectomy: The surgical removal of one or both of the testicles.
Orchitis: Inflammation of a testicle.
Overactive Bladder: A condition characterized by involuntary bladder muscle contractions during the bladder-filling phase which the patient cannot suppress, causing frequent urination and sometimes urge incontinence.
Overflow Incontinence: When a bladder is unable to empty (from obstruction or lack of bladder function), a patient may have continuous overflow incontinence.
Percutaneous Nephrolithotomy (PCN): Meaning “through the skin,” the surgeon or urologist makes a 1 cm incision in the patient’s back, through which an instrument called a nephroscope is passed directly into the kidney and, if necessary, the ureter. Smaller stones may be manually extracted. Larger ones may need to be broken up with ultrasonic, electrohydraulic, or laser-tipped probes before they can be extracted. A tube may be inserted into the kidney for drainage. Stones that involve the entire kidney can be removed in this fashion.
Pelvic Muscle Exercises: Also called Kegel exercises, they are intended to improve your pelvic muscle tone and prevent leakage for sufferers of stress urinary incontinence. (See biofeedback.)
Periurethral Bulking Injections: A surgical procedure in which injected implants are used to “bulk up” the area around the neck of the bladder. They are used to treat incontinence in select patients.
Post-void Residual (PVR) Volume: A diagnostic test which measures how much urine remains in the bladder after urination. Specific measurement of PVR volume can be accomplished by catheterization, pelvic ultrasound, radiography, or radioisotope studies. The least invasive is through ultrasound evaluation.
Prostaglandin: Any of various oxygenated unsaturated cyclic fatty acids of animals that have a variety of hormone-like actions (as in controlling blood pressure or smoothing muscle contractions).
Prostate: A muscular, walnut-sized gland that surrounds part of the urethra. It secretes seminal fluid, a milky substance that combines with sperm (produced in the testicles) to form semen and produces the bulk of the fluid that is ejaculated.
Prostate Cancer: A disease that 1-in-6 men will be diagnosed with during his lifetime. Because of early detection and advanced treatment options, cure rates for prostate cancer exceed 90% when the cancer is diagnosed at an early stage.
Common risk factors for prostate cancer include: age (men over the age of 50 and African-American men over the age of 40 have a higher risk of developing prostate cancer); race/ethnicity (mortality rates of African-American men diagnosed with prostate cancer are twice that of men in other ethnic groups); genetics (men who have family members diagnosed with prostate cancer have a greater risk of developing the disease); and diet (diets rich in red meat and high-fat dairy products but low in fruits and vegetables may increase a patient’s risk of developing prostate cancer).
There are often no symptoms of early stage prostate cancer, so early detection and screening are paramount. The best ways to detect prostate cancer are: annual PSA (Prostate Specific Antigen) tests and digital rectal exams (DRE), beginning at age 50. High-risk men, such as African-Americans or men with a positive family history, should begin these annual screenings at age 40.
Prostate cancer is one of the more difficult diseases to treat, even though it is extremely more common that a man will likely die with prostate cancer than because of it. Because of this, some groups have recommended we not screen for prostate cancer; but, also consider that prostate cancer is the number-two cancer-killer of men in the US, and mortality rates have significantly decreased recently — an effect we believe is from early detection.
Prostatectomy: A surgical removal of the prostate.
These surgeries include:
Suprapubic / Retropubic Prostatectomy involves removing an obstructing prostatic tissue through a suprapubic incision below the belly button and not removing the prostate wholly; Suprapubic Prostatectomy requires incising the bladder to remove the obstructing tissue, while a Retropubic approach requires incising the prostatic capsule to remove the obstructing tissue; both approaches utilize an abdominal incision
Radical Retropubic Prostatectomy involves completely removing the prostate through an infraumbilical incision; lymph nodes can be sampled at the time of the operation, and the nerve-sparing procedure is easier to do via this operation
Perineal Prostatectomy where a perineal incision is utilized (near the anus); and
Robotic Prostatectomy which involves removing the prostate through multiple small incisions with the help of a robot; the movement of the robot is controlled by the surgeon who sits at a console next to the table.
Prostatic Stent: A wire device that is inserted through a cystoscope, then expands after placement, thus pushing prostate tissue away from passageway allowing for easier urination.
Prostatitis: Inflammation of the prostate.
Pubovaginal Sling: A surgical procedure in which a man-made or cadaveric piece of material is placed under the bladder neck to support and immobilize it. This technique improves sphincter function and decreases bladder neck movement, improving continence.
Pyelonephritis: Inflammation of the kidney, usually due to a bacterial infection.
Pyuria: The presence of pus in the urine; usually an indication of kidney or urinary tract infection.
Rectocele: A herniation of the rectum into the vagina.
Sexually Transmitted Disease (STD): Infections that are most commonly spread through sexual intercourse or genital contact.
Sling Procedures: Surgical methods for treating urinary incontinence, involving the placement of a sling made either of tissue obtained from the person undergoing the sling procedure or a synthetic material. The sling is anchored to endopelvic fascia, pubic bone and/or abdominal structures. It can also be placed through the obturator foramen (Transobturator Tape/Sling).
Sphincter: A ring of muscle fibers located around an opening in the body that regulates the passage of substances.
Stress Test: A diagnostic test that requires patients to lift something or perform an exercise to determine if there is urine loss when stress is placed on bladder muscles.
Stress Urinary Incontinence: The involuntary loss of urine during periods of increased abdominal pressure. Such events include laughing, sneezing, coughing, and lifting heavy objects.
Testicular Cancer: A disease most common in men between the ages of 18 and 32. According to the American Cancer Society, 7,600 cases of testicular cancer are diagnosed each year. Approximately 400 men die of the disease each year. Because of advanced treatment options and early detection, testicular cancer is successfully treated in more than 95% of cases.
Almost 95% of tumors in the testes originate in undeveloped germ cells. These tumors are known as germ cell tumors and occur in three forms: seminomas, nonseminomas, and stromal tumors. Stromal tumors originate in the supporting tissue of the testicles. Germ cell tumors are most common in men between the ages of 20 and 40, although patients of any age can develop testicular cancer.
Typical seminomas often cause unilateral testicle enlargement or a painless lump in the testicle. Nonseminomas typically develop in men between the ages of 15 and 35. These tumors account for 60% of germ cell tumors.
Testicular cancer may also develop in the stroma, the hormon- producing tissue of the testicles. Stromal tumors account for 4% of testicular cancer in men and 20% in boys.
There is no known cause of testicular cancer; but there are several risk factors for the disease: Cryptorchudisim (undescended testicle), Kilnefelter’s Syndrome, and family history.
Symptoms of testicular cancer may include: a mass or lump in the testicle, hardness in the testicles, feeling of heaviness or aching in the scrotum or lower abdomen, and increased hormonal levels (estrogen, testosterone, human chorionic gonadotropin).
Testosterone: The sex hormone that stimulates development of male sex characteristics and bone and muscle growth; produced by the testicles and in small amounts by the ovaries.
Transient Urinary Incontinence: Temporary episodes of urinary incontinence that are gone when the cause of the episode is identified and treated.
Urgent PC: A nondrug, nonsurgical treatment for an overactive bladder. The Urgent PC Neuromodulation System uses percutaneous tibial nerve stimulation (PTNS) to treat overactive bladder and associated symptoms of urinary urgency, urinary frequency and urge incontinence.
Urgent PC Neuromodulation System: A combination of a stimulator and a lead set. The stimulator generates electrical impulses that are delivered to the patient through the lead set. Using a thin needle electrode placed near the ankle as an entry point, the stimulator’s impulses travel along the tibial nerve to the nerves in the spine that control pelvic floor function. See Urgent PC orwww.uroplasty.com/patients/urgentpc for more information.
Urinary Incontinence: Urinary incontinence can occur in four forms, stress incontinence, urge incontinence, mixed urinary incontinence, or overflow incontinence. Patients suffering from stress incontinence experience urine leakage caused by an increase in abdominal pressure.
Urinary Tract Infections (UTI): Occur when bacteria enter the urinary tract and urethra and multiply. These infections typically develop in the lower urinary tract before progressing to the upper urinary tract if they remain untreated.
Vasectomy: A relatively short doctor’s office procedure, lasting approximately 30 minutes, and performed to cut and close off the tubes (vas deferens) that deliver sperm from the testes; it serves as a permanent form of birth control.
Vasectomy Reversals: Utilize an operating microscope and ultrafine sutures to reattach the inside and outside of the vas deferens.
Voiding Dysfunction: A condition in which the bladder does not function properly. It is estimated that as many as 25 million Americans suffer from bladder control problems. Several different types of voiding dysfunction are: urinary Incontinence, overactive bladder, nonobstructive urinary retention, and mechanical obstructions.