Urology & Neurourology

Urology is a branch of medicine which specializes in the treatment of conditions and diseases of the male and female urinary tract system and the male reproductive system. Urologists diagnose and treat various conditions and disorders associated with the kidneys, bladder, ureters, urethra and the male reproductive organs such as prostate, penis, and testes. They are dedicated to clinical excellence in urology care and patient education so patients can make informed decisions about their healthcare.

Working Areas

Urinary and fecal incontinence (Incontinence)

• Urinary retention
• Pelvi-perineal dysfunctions: (obstructed urination and defecation, male Erectile Disfunction)
• Chronic pelvic pain (CPP)
• Interstitial Cystitis – Pain Bladder Syndrome (IC/PBS)
• BPH
• Urinary stones
• Recurrent urinary tract infections (UTI)
• Chronic prostatitis in male

Frequently asked questions

What is Urodynamics?

Urodynamic studies (UDS) test how well the bladder, sphincters, and urethra hold and release urine. These tests can show how well the bladder works and why there could be leaks or blockages.

There are many types of urodynamic tests. A health care provider may recommend one or more based on your symptoms, but they are typically performed together as one test.

These tests, which are explained on the following pages, are all UDSs:

• Cystometry, or Getting a Cystometrogram
• Electromyography, or getting an Electromyogram (EMG)
• Urethral Pressure Profile
• Uroflowmetry
• Voiding Pressure Study (Pressure Flow Study)

Why Would I Need Urodynamics?

Urodynamics help find the cause of problems related to:

• Urine leaks/controlling your urine
• Bladder not emptying all the way
• The need to go too often
• The need to go suddenly
• Weak urine flow
• Urine flow stopping and starting (“intermittent”)
• Getting urinary tract infections often

Non-scapel Vasectomy

What is vasectomy?

Vasectomy is the procedure of choice for men who do not want to father any children (or any additional children). It is indicated for any fully informed man and can be carried out as an outpatient procedure. If the patient has previous scrotal surgery or has any other possible complicating factors (e.g. a needle phobia), the procedure can be carried out under a short general anaesthetic. The non-scalpel vasectomy (NSV) is an innovative approach to exposing the vas deferens tubes in the scrotum using two specialized surgical instruments. NSV, as compared to traditional incision technique, results in less bleeding and hematoma, less infection, and pain, and a shorter operative time.

Urinary Infection

Urinary tract infections (UTIs) are common infections that can affect the bladder, the kidneys and the tubes connected to them.

Anyone can get them, but they’re particularly common in women. Some women experience them regularly (called recurrent UTIs), UTIs can be painful and uncomfortable.

Symptoms of UTIs

Infections of the bladder (cystitis) or urethra (tube that carries urine out of the body) are known as lower UTIs. These can cause:

• A need to pee more often than usual
• Pain or discomfort when peeing
• Sudden urges to pee
• Feeling as though you’re unable to empty your bladder fully
• Pain low down in your tummy
• Urine that’s cloudy, foul-smelling or contains blood
• Feeling generally unwell, achy and tired

What is Pelvic Pain?

Chronic pelvic pain is one of the most common medical problems among women. Twenty-five percent of women with CPP may spend 2-3 days in bed each month. More than half of the women with CPP must cut down on their daily activities 1 or more days a month and 90% have pain with intercourse (sex). Almost half of the women with CPP feel sad or depressed some of the time.

Despite all the pain CPP causes, doctors are often not able to find a reason or cure to help these women.

CPP is any pelvic pain that lasts for more than six months. Usually the problem, which originally caused the pain, has lessened or even gone away completely, but the pain continues.

Diagnostic procedures

• Multichannel urodynamic tests (uroflowmetry, cystometry, pressure/flow study, urethral pressure profile, US post voiding residual evaluation, pelvic floor EMG)
• Diagnostic/operative flexible and rigid cystoscopy
• Somato Sensorial Evoked Potentials (SSEPs) , pelvic floor EMG, sacral area reflexes ( performed by neurophysiologist )
• Rectal manometry (performed by coloproctologist)
• ColorDoppler US for ED and infertility

Rehabilitation therapy

• Pelvic floor electrical stimulation (FES) and bio-feedback (BFB)
• Posterior tibial neuro stimulation (PTNS) invasive and transcutaneous
• Clean intermittent catheterization (CIC)
• Trans cutaneous sacral and pudendal neurostimulation

Therapeutic minimally invasive therapy

• One day Surgery (circumcision, vasectomy, hydrocelectomy, varicocele, TURB, TURP, endoscopic lithotripsy of renal and bladder stones, penile surgery for erectile dysfunction)
• Sacral roots neuromodulation for urinary and fecal incontinence, retention and CPP
• Pudendal nerve neuromodulation for urinary and fecal incontinence, retention and CPP
• Pudendal and obturator muscle nerve block for pharmacologic modulation of CPP
• Pulsed radiofrequency of pudendal nerve for CPP
• Intravesical instillation of drugs for Interstitial Cystitis

Patient Forms

History and Physical Form

ICIQ-UI Short Form

SHIM Score

International Prostate Symptom Score (I-PSS)

Studies

Urodynamics Studies

Pelvic Floor Dysfunction

Vasectomy

Pudendal Neuropathy

Male Pelvic Pain

Vulvodynia

Dr. Francesco Cappellano

Consultant Urology & Neurourology, Urodynamics FEBU (Fellow of European Board of Urology)

Book an appointment with Dr. Francesco our Urology specialist.

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