Department of Urology
In the field of urology, a marked increase has been recently noted in the number of malignant tumors such as prostate cancer and renal cancer, furthermore the role of a urologist is getting bigger such as urinary tract management for dysuria originating from enlargement of the prostate and neuropathy etc. in elderly people. Therefore, we think that urology is an important department to bear the 21st century’s medical care.
In our department, we provide safe and advanced medical care for community residents by our excellent facility and good staff. We perform daily clinical activities lead by highly specialized staff in each field such as malignant tumors in urology, urolithiasis, kidney transplantation, dysuria, and female urology. We also have 4 physicians who have urology laparoscopic technique certification (officially approved by the Japanese Urological Association, Japan Society for Endoscopic Surgery and Japanese Society of Endourology), which is difficult to obtain.
In the field of urology, especially in the field of malignant tumors, the progress and the spread of laparoscopic surgery is remarkable and many traditional abdominal operations are getting replaced with laparoscopic surgery and robotic-assisted surgery. Needless to say, laparoscopic surgery and robotic-assisted surgery are minimally invasive. We aim to establish laparoscopic surgery and robotic-assisted surgery procedures that are more powerful than abdominal operations, taking advantage of their clear and expanded operational vision at the maximum degree.
In addition, there are 12 affiliated hospitals all over Wakayama prefecture and the south side of Osaka prefecture. About 30 urologists are sent to the hospitals and they work to improve community medical care every day in alliance with Wakayama Medical University.
Malignant tumors in urology
Because most of patients in the Department of Urology are elderly people, patients with cancer account for 70 to 80% of all patients in facilities such as university hospitals. Especially, along with the spread of PSA (prostate‐specific antigen), patients with prostate cancer is recently dramatically increasing. In our department, we have performed laparoscopic radical prostatectomy as a one-step advanced technique from traditional laparotomy radical prostatectomy, but we introduced a robotic-assisted surgery system “The Da Vinci Surgical System” in 2012 and currently we mainly perform robotic-assisted radical prostatectomy. This technique enables accurate and exquisite surgical procedures by a combination of three-dimensional expanded vision and forceps with a high degree of mobility, and is expected to have a preservation of physiological urination, sexual function, and improvement of the degree of a radical cure. We have also performed high-dose-rate brachytherapy as a radiation therapy for a long time and the number of cases is at a top level in Japan.
For bladder tumors, we have worked on the establishment of neobladder reconstruction surgery as a urinary diversion after radical cystectomy. Regarding urinary diversion, ileal conduit was a standard procedure in the past, however neobladder reconstruction is widely adopted as the most advanced procedure at present because its urinary diversion allows urination closer to physiological.
We also provide leading edge medical care for other diseases including renal tumors, ureteral tumors, and testicular tumors.
Urolithiasis is in a trend of dramatic increase. Based on national statistics in 2005, 1 in 7 males and 1 in 15 females experience urolithiasis once in their life. We have been performing basic and clinical studies for urolithiasis for a long time and our specialized staff with abundant experience perform medical examinations and treatments. We try to perform standard therapy based on the guidelines for urolithiasis (compiled by the Japanese Urological Association, Japanese Society of Endourology and Japanese Society on Urolithiasis Research), and work on the establishment of a better treatment method.
The number of patients who have trouble with urination is definitely increasing. Different from cancer etc., it does not directly threaten your life, however problems related to urination lower your quality of life (QOL) more than you think. In fact, retirement homes that do not accept patients that require urethral catheterization are not rare. In medical practice for patients with dysuria, our foremost goal is to improve a patient’s QOL through an appropriate diagnosis and treatment, however we also need to pay careful attention to each individual patient’s living environment when we provide a treatment for them. We have a specialized clinic (outpatient clinic for urinary function) for 4 typical diseases causing dysuria (enlargement of the prostate, neurogenic bladder dysfunction, overactive bladder, and interstitial cystitis).