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Urology, also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary system and the reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs.
Laparoscopy is an operation performed in the abdomen or pelvis using small incisions with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis.
Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. Urinary incontinence is common in older women and has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis. UI is an example of a stigmatized medical condition, which creates barriers to successful management and makes the problem worse. People may be too embarrassed to seek medical help, and attempt to self-manage the symptom in secrecy from others.
Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum. Signs and symptoms may include blood in the stool, a change in bowel movements, weight loss, abdominal pain and fatigue. Most colorectal cancers are due to lifestyle factors and genetic disorders. Risk factors include diet, obesity, smoking, and lack of physical activity. Dietary factors that increase the risk include red meat, processed meat, and alcohol. Another risk factor is inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis. Some of the inherited genetic disorders that can cause colorectal cancer include familial adenomatous polyposis and hereditary non-polyposis colon cancer; however, these represent less than 5% of cases. It typically starts as a benign tumor, often in the form of a polyp, which over time becomes cancerous.
Physical fitness is a state of health and well-being and, more specifically, the ability to perform aspects of sports, occupations, and daily activities. Physical fitness is generally achieved through proper nutrition, moderate-vigorous physical exercise, and sufficient rest along with a formal recovery plan.
Cholecystectomy is the surgical removal of the gallbladder. Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. In 2011, cholecystectomy was the eighth most common operating room procedure performed in hospitals in the United States. Cholecystectomy can be performed either laparoscopically, or via an open surgical technique.
Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—that can develop in the wall of the large intestine. Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days. There may also be nausea, diarrhea or constipation. Fever or blood in the stool suggests a complication. People may experience a single attack, repeated attacks, or ongoing "smoldering" diverticulitis.
Perioperative mortality has been defined as any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital. Globally, 4.2 million people are estimated to die within 30 days of surgery each year. An important consideration in the decision to perform any surgical procedure is to weigh the benefits against the risks. Anesthesiologists and surgeons employ various methods in assessing whether a patient is in optimal condition from a medical standpoint prior to undertaking surgery, and various statistical tools are available. ASA score is the most well known of these.
High-intensity interval training (HIIT) is a training protocol alternating short periods of intense or explosive anaerobic exercise with brief recovery periods until the point of exhaustion. HIIT involves exercises performed in repeated quick bursts at maximum or near maximal effort with periods of rest or low activity between bouts. The very high level of intensity, the interval duration, and number of bouts distinguish it from aerobic (cardiovascular) activity, because the body significantly recruits anaerobic energy systems. The method thereby relies on "the anaerobic energy releasing system almost maximally".
Cystectomy is a medical term for surgical removal of all or part of the urinary bladder. It may also be rarely used to refer to the removal of a cyst. The most common condition warranting removal of the urinary bladder is bladder cancer.
Prostatectomy is the surgical removal of all or part of the prostate gland. This operation is done for benign conditions that cause urinary retention, as well as for prostate cancer and for other cancers of the pelvis.
Robot-assisted surgery or robotic surgery are any types of surgical procedures that are performed using robotic systems. Robotically assisted surgery was developed to try to overcome the limitations of pre-existing minimally-invasive surgical procedures and to enhance the capabilities of surgeons performing open surgery.
Radical retropubic prostatectomy is a surgical procedure in which the prostate gland is removed through an incision in the abdomen. It is most often used to treat individuals who have early prostate cancer. Radical retropubic prostatectomy can be performed under general, spinal, or epidural anesthesia and requires blood transfusion less than one-fifth of the time. Radical retropubic prostatectomy is associated with complications such as urinary incontinence and impotence, but these outcomes are related to a combination of individual patient anatomy, surgical technique, and the experience and skill of the surgeon.
Ashutosh K. Tewari is the surgeon in chief of urology at the Tisch Cancer Hospital. He is the chairman of urology at the Icahn School of Medicine at Mount Sinai Hospital in New York City. He is a board certified American urologist, oncologist, and principal investigator. Before moving to the Icahn School of Medicine in 2013, he was the founding director of both the Center for Prostate Cancer at Weill Cornell Medical College and the LeFrak Center for Robotic Surgery at NewYork–Presbyterian Hospital. Tewari was the Ronald P. Lynch endowed Chair of Urologic Oncology and the hospital's director of robotic prostatectomy, treating patients with prostate, urinary bladder and other urological cancers. He is the current president of the Society for Urologic Robotic Surgeons (SURS) and the Committee Chair of the Prostate Program. Tewari is a world-leading urological surgeon, and has performed over 10,000 robotically assisted procedures using the da Vinci Surgical System. Academically, he is recognized as a world-renowned expert on urologic oncology with over 250 peer reviewed published papers to his credit; he is on such lists as America's Top Doctors, New York Magazine's Best Doctors, and Who's Who in the World. In 2012, he was given the American Urological Association Gold Cystoscope Award for "outstanding contributions to the field of urologic oncology, most notably the treatment of prostate cancer and the development of novel techniques to improve the outcomes of robotic prostatectomy."
Treatment for prostate cancer may involve active surveillance, surgery, radiation therapy – including brachytherapy and external-beam radiation therapy, proton therapy, high-intensity focused ultrasound (HIFU), cryosurgery, hormonal therapy, chemotherapy, or some combination. Treatments also extend to survivorship based interventions. These interventions are focused on five domains including: physical symptoms, psychological symptoms, surveillance, health promotion and care coordination. However, a published review has found only high levels of evidence for interventions that target physical and psychological symptom management and health promotion, with no reviews of interventions for either care coordination or surveillance. The favored treatment option depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors include the man's age, his general health, and his feelings about potential treatments and their possible side-effects. Because all treatments can have significant side-effects, such as erectile dysfunction and urinary incontinence, treatment discussions often focus on balancing the goals of therapy with the risks of lifestyle alterations.
If medical treatment is not effective, surgery may need to be performed for benign prostatic hyperplasia.
Cancer rehabilitation has been defined in the scientific literature as a distinct field of medicine that focuses on reducing or eliminating side-effects of cancer treatment and improving survivors' strength, ability to function and quality of life
Conor P. Delaney MD, MCh, PhD, FRCSI, FACS, FASCRS, FRCSI (Hon.) is an Irish-American colorectal surgeon, CEO and President of the Cleveland Clinic Florida, the Robert and Suzanne Tomsich Distinguished Chair in Healthcare Innovation, and Professor of Surgery at the Cleveland Clinic Lerner College of Medicine. He is also the current President of the American Society of Colon and Rectal Surgeons (ASCRS). He was previously Chairman of the Digestive Disease & Surgery Institute at the Cleveland Clinic. He is both a Fellow and Honorary Fellow of the Royal College of Surgeons in Ireland and a Fellow of both the American College of Surgeons and American Society of Colon and Rectal Surgeons.
Ralph John Nicholls, FRCS (Eng), EBSQ is a retired British colorectal surgeon, Emeritus Consultant Surgeon at St Mark's Hospital London and Professor of Colorectal Surgery, Imperial College London.
References
- 1 2 3 "Principles and guidance for prehabilitation within the management and support of people with cancer". Macmillan Cancer Support. 30 Nov 2020.
- ↑ Wynter-Blyth, Venetia; Moorthy, Krishna (2017-08-08). "Prehabilitation: preparing patients for surgery". BMJ. 358: j3702. doi:10.1136/bmj.j3702. ISSN 0959-8138. PMID 28790033. S2CID 29658090.
- ↑ Alkarmi A, Thijssen DH, Albouaini K, et al. (June 2010). "Arterial prehabilitation: can exercise induce changes in artery size and function that decrease complications of catheterization?". Sports Medicine. 40 (6): 481–92. doi:10.2165/11531950-000000000-00000. PMID 20524713. S2CID 24870534.
- ↑ Jack S, West M, Grocott MP (September 2011). "Perioperative exercise training in elderly subjects". Best Practice & Research. Clinical Anaesthesiology. 25 (3): 461–72. doi:10.1016/j.bpa.2011.07.003. PMID 21925410.
- ↑ Skořepa, Pavel; Ford, Katherine L.; Alsuwaylihi, Abdulaziz; O'Connor, Dominic; Prado, Carla M.; Gomez, Dhanny; Lobo, Dileep N. (2024-01-22). "The impact of prehabilitation on outcomes in frail and high-risk patients undergoing major abdominal surgery: A systematic review and meta-analysis". Clinical Nutrition. 43 (3): 629–648. doi:10.1016/j.clnu.2024.01.020.
- ↑ Li C, Carli F, Lee L, et al. (April 2013). "Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study". Surgical Endoscopy. 27 (4): 1072–82. doi:10.1007/s00464-012-2560-5. PMID 23052535. S2CID 9888085.
- ↑ "High-intensity interval training rapidly improves fitness in patients awaiting surgery for urological cancer". NIHR Evidence (Plain English summary). National Institute for Health and Care Research. 2020-06-05. doi:10.3310/alert_40363. S2CID 242684291.
- ↑ Blackwell, J. E. M.; Doleman, B.; Boereboom, C. L; Morton, A.; Williams, S.; Atherton, P.; Smith, K.; Williams, J. P.; Phillips, B. E.; Lund, J. N. (10 March 2020). "High-intensity interval training produces a significant improvement in fitness in less than 31 days before surgery for urological cancer: a randomised control trial". Prostate Cancer and Prostatic Diseases. 23 (4): 696–704. doi:10.1038/s41391-020-0219-1. ISSN 1365-7852. PMC 7655502 . PMID 32157250.
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