Holistic Approach to UROLOGICAL Care
There are 59 beds in the urology ward on the 13th floor of Lifu Building.
The urology division has 4 outpatient clinics, shock wave lithotripsy room, stone analysis room, ultrasound room, urodynamic examination room, imaging urodynamic examination room, cystoscopy room, and three ORs exclusive to urology.
We work hard for the treatment and tracking of all urological related malignancies. Our urological oncology team meeting brings together specialists in urology, radiology, hematology, radiation oncology and pathology to discuss treatment guidelines, making sure of the patient's safety and treatment quality.
We are also quite achieved in the diagnosis and treatment of female urinary system diseases (urinary incontinence, bladder ptosis and overactive bladder, etc.) and children urinary diseases (hypospadias, cryptorchidism, vesicoureteral reflux, etc.).
There are four stages for clinical prostate cancer: in stage A, there is no lump found during palpation, but cancer cells are found in tissues after benign prostatic hypertrophy resection surgery; in stage B, lumps are found during palpation, but are still confined to the prostate; in stage C, cancer lesions are violating neighboring tissues and organs; and in stage D, cancer cells have spread to lymph nodes, bones, lungs or other organs.
The rate of total cure for stage A prostate cancer treatment in 10 years can be as high as 80% - 90%. Treatment options include prostatectomy, radiotherapy, hormonal therapy, chemotherapy, or even conservative non-treatment. The choice depends on the patient's age, physical condition, degree of differentiate of tumors, stage, and the patient's wishes.
Da Vinci prostate surgery
We offer da Vinci robotic surgery to assist laparoscopic, thoracoscopic, or endoscopic procedures, to provide surgeons with more options and expand the range of minimally invasive surgical procedures and operate more accurately.
The da Vinci robotic surgical system offers features that help physicians get better outcomes than traditional and basic minimally invasive surgery. In prostate surgery, it provides better tumor control and reduces side effects of prostate surgery.
Da Vinci can also be used in other surgery: minimally invasive cardiac surgery, minimally invasive cancer surgery, prostate cancer, endometrial cancer, morbid obesity, and heart valve insufficiency.
Bladder cancer is most common urological malignancy in Taiwan, with most cases being metastatic (90%). Squamous (5%) and adenocarcinoma (2%) are relatively rare. Clinical symptoms include hematuria and urination (frequent urination, dysuria).
Causes of bladder cancer include smoking (50% males, 33% females). Hair dyes, other dyes, leather manufacturing, paints and organic compounds are all risk factors.
The treatment of bladder cancer depends on the size of the tumor or the stage. Approaches include endoscopic tumor resection, local chemical perfusion, total cystectomy, bladder and ileal urinary bladder shunt urine, systemic chemotherapy, or radiation.
Urinary tract stones
Patient's safety and comfort is especially emphasized for the clinical treatment of urinary tract stones. Each patient receiving extracorporeal shock wave lithotripsy gets venous anesthesia (covered by health insurance). The entire process is monitored by anesthesia specialists.
Male sexual dysfunction
Male sexual dysfunction includes: erectile dysfunction (commonly known as impotence), persistent erection, premature ejaculation, delayed ejaculation, retrograde ejaculation, and so on.
There are many causes of erectile dysfunction. They are roughly categorized into: psychogenic erectile dysfunction (psychophysiological effects), organic erectile dysfunction (problems with organ parenchyma), or both. Psychogenic erectile dysfunction can be due to marital problems, depression, stress, guilt, anxiety, fatigue, excessive drinking, and so on.
The guidelines we recommend for the treatment of erectile dysfunction: first-line treatment is oral medication (except contraindications); when oral medication is invalid, try other treatments including vacuum suction, the penis sponge in vivo drug injection, and artificial penis surgery. It is important to use clinically proven treatments for erectile dysfunction.
Prostate cancer is common in elderly males. There is no symptom in early stages, and 40% of patients have metastasis when found with cancer.
Currently, diagnosis can be done through anus prostate palpation, serum prostate specific antigen detection. When abnormality is found in the test, transrectal prostate ultrasound and biopsy are conducted. Of the two diagnostic methods, serum prostate specific antigen PSA is more sensitive and objective, and is less affected by the physician’s subjective judgment.
PSA is secreted by prostate epithelial cells and is normally excreted through the urethra. If the lumen is obstructed, it flows back into blood vessels, resulting in an increase of value in serum. The rise of PSA value also appears in other conditions than cancer, such as prostate inflammation, post-prostate surgery or sectioning, indwelling catheter, or even anus prostate palpation, causing problems for accurate cancer diagnosis.
According to data obtained from many cases, we found 15% cancer for PSA values 4-10, 20% for 10-20; 45% for 20-50 and 95% for above 50. The diagnosis of cancer is less certain for PSA values 4-20. There are ways to improve diagnosis such as PSA value per unit volume, age-corrected PSA values, but they’re still not ideal.
There are two types of PSA in the serum: free and mixed. The latter is more often detected in prostate patients; therefore, detecting the ratio of free type PSA against total PSA can help to identify prostate cancer. We were the first hospital to introduce this approach. The ratio was 0.25 for 20 normal test subjects. Of the 30 patients who were tested for increased PSA, five diagnosed with cancer had an average ratio of 0.09, much lower than 0.28 for the other 25 who didn’t have cancer. This is a new, effective diagnostic method that can be used as a differential diagnosis and reference for prognosis tracking.