|Blood Tests||Stone Evaluation|
|Cystoscopy||Urine Flow Study|
|Digital Rectal Exam||Urodynamics|
|Post Void Residuals||X-Ray Tests|
A piece of tissue is obtained and sent to a pathologist to determine if cancer is present. In the urology office we commonly perform prostate biopsies. These are performed with ultrasound guidance. The rectum is locally anesthetized before the urologist takes several cores of prostate tissue with a biopsy needle. Other biopsies, such as those from the bladder, are usually performed in the hospital.
Several blood tests are useful to the urologist in order to determine the health of the urinary system. Some of the more commonly performed tests are the PSA, creatinine, BUN and testosterone.
The PSA is a test that helps to detect prostate cancer. The creatinine and BUN help assess kidney function. Testosterone is important when evaluating male erectile dysfunction. Several different blood tests are performed when evaluating infertility
CT stands for "computerized tomography" and is an x-ray technique that is much more sensitive than regular x-ray. It helps diagnose a variety of urologic disorders, such as stones, tumors and cysts.
A cystoscopy is a procedure that the urologist uses to look inside the patient's bladder. When it is done in the office, a local anesthetic is used to numb the urethra. The urologist inserts a small telescope-like instrument into the bladder and fills the bladder with some water while examining the urethra, the prostate in men and the inside of the bladder. Bladder tumors, other abnormalities of the bladder wall and stones are some of the conditions that can be observed with cystoscopy.
Cytology is a test used to look for cancer cells in the urine. A urine specimen is sent to a lab for the pathologist to examine for the abnormal cells.
Digital Rectal Exam
Digital rectal exam (DRE) is an exam of the prostate gland. The urologist inserts a gloved and lubricated finger into the rectum and feels the prostate. This exam is used to measure the size and feel the texture of the prostate. Any abnormal nodule or firmness can be felt and a decision can be made about whether an ultrasound and possible biopsy is needed.
Post Void Residuals
After a patient urinates, a brief ultrasound study of the bladder can show how much urine is left in the bladder. It is often important to know about this residual urine following surgery or when evaluating the patient's bladder for obstruction, especially from an enlarged prostate.
Prostate specific antigen is a substance released from the prostate tissue and can be measured by a simple blood test. Elevated levels of the antigen in the blood can indicate prostate cancer, but also can indicate inflammation of the prostate.
Semen analysis is done as a first step in determining male infertility. A laboratory technician examines the semen sample for the presence of sperm and the motility and quality of the sperm. A semen analysis is also done after a vasectomy to determine if the procedure has successfully eliminated sperm from the ejaculate.
Urinary tract stones are analyzed in a laboratory after they are either passed by the patient or removed surgically. The analysis of the stone composition allows the urologist to determine if future stones can be possibly prevented with medication or with dietary changes.
Ultrasound is an imaging tool that is often used in the urology office to examine the kidneys, the bladder, the prostate and the testicles. It helps the urologist diagnose many conditions such as tumors, cysts, stones, kidney enlargement and abnormal movement of the bladder and urethra.
Urine Flow Study
A urine flow study determines the rate and the force of urination as it measures the length of time it takes a patient to urinate. An abnormal flow study may indicate obstruction, as from an enlarged prostate, or poor bladder tone.
There are many tests performed on urine that help the urologist diagnose disease or monitor treatment. Some of the more commonly performed tests are a urinalysis, urine culture and sensitivity and 24-hour urine tests.
Urinalysis is performed in the office using a dipstick that detects and measures blood, sugar, protein and other substances in the urine. A microscopic exam of the urine finds blood cells, crystals, bacteria, yeast and other things that may be present.
Urine cultures are performed in the laboratory when a urinary tract infection is suspected. The culture is incubated for several hours and then any bacterial growth is examined by the lab tech to determine what bacteria is causing the infection. Sensitivity studies are performed on the culture growth to determine which antibiotics will kill the bacteria and clear up the infection.
24-hour urine tests are performed to detect many disease processes. The patient collects all urine expelled for 24 hours in a large bottle. The lab analyzes the urine for abnormal levels of the many substances that are filtered from the bloodstream by the kidneys.
Urodynamic testing is done to assess bladder function by measuring muscle tone and nerve activity during the process of filling the bladder with water and emptying the bladder during urination. The testing can be done in the office or in the x-ray department of a hospital. Pressure-measuring catheters are inserted into the bladder and rectum and small electrodes may be attached to the skin.
Many different x-ray studies may be prescribed to diagnose conditions of the urinary tract. Some of the more commonly performed x-ray studies are a KUB, an IVP and a VCUG. These x-rays may be performed in the office or in another radiology facility.
KUB is a simple x-ray of the kidneys, ureters and bladder.
IVP stands for intravenous pyelogram and is a series of x-rays taken after contrast (dye) is injected into the bloodstream. The contrast helps define the structures of the urinary tract as the urologist looks for stones, tumors or other conditions and abnormalities.
VCUG (Voiding Cystourethrogram) is done to examine the bladder and urethra while the bladder fills and empties. A radiopaque liquid (that can be seen on x-ray) is placed in the bladder through a catheter. The bladder is filled until the patient urinates. Radiographs (x-rays) are usually taken before, during, and after voiding. This test can reveal abnormalities of the inside of the urethra and bladder. The test can also determine whether the flow of urine is normal when the bladder empties.