Urology Department

The Urology Department of Hospital Jihlava provides the comprehensive urological care for adults, focusing mainly on urooncology, urolithiasis (urinary stones) and functional urology including urogynecology. It also provides routine acute and outpatient care for pediatric patients. In collaboration with paediatricians, it focuses mainly on the diagnosis and treatment of functional disorders of the lower urinary tract and enuresis. In addition to basic surgery, for children over 3 years of age, it also performs surgical treatment for some developmental defects of the urethra and external genitalia, so-called hypospadias.

Diagnostic capabilities

The Urology Department is well equipped for ultrasound, urodynamic and endoscopic examinations of its patients.
Ultrasound examination of the urinary tract and male genital organs, including Doppler sonography, is available to all patients in outpatient care, regardless of age. Similarly, ultrasound examinations are also carried out in hospitalised patients with a focus on preventive care. A simple but very beneficial non-invasive examination is uroflowmetry, recording urine flow, total voided volume and residual urine assessed by an ultrasound machine.
In connection with electromyography of the pelvic floor, uroflowmetry is used in the diagnosis of voiding disorders in children. Non-invasive methods are emphasized in the examination of children.
The endoscopic operating room is used for X-ray examinations of the upper and lower urinary tract using a contrast agent in the diagnosis of urinary transport disorders.
These diagnostic procedures are performed under local anaesthesia, sometimes under general anaesthesia, during hospitalisation.
Prostate biopsy is an important diagnostic procedure in the diagnosis of prostate cancer in men. The prostate is sampled using a thin biopsy needle through the wall of the rectum, into which an ultrasound probe is inserted to control the sampling sites. This is usually an outpatient procedure, after preparation of the patient at home, but it is also possible to perform a prostate biopsy under general anaesthesia, during hospitalisation, if a larger number of samples need to be obtained. In addition to objective examination, modern laboratory methods are used to indicate prostate biopsy, including PSA, fPSA, ratio, proPSA and PHI (prostate health index). The Department of Urology also has a method of fusion prostate biopsy, which significantly improves the diagnosis of prostate cancer and can save unnecessary repetition of conventional biopsy. It combines the advantages of two imaging modalities: magnetic resonance imaging and ultrasound for targeted punction of the prostate. The yield is around 95%. In the detection of prostate cancer, the Department of Urology, as an accredited centre, provides highly specialised services in the diagnosis and treatment.
Urodynamic examination plays an indispensable role in the investigation of urinary retention and voiding disorders in adults and children. It is used in both men and women before surgical treatment of urinary leakage, so-called incontinence. Comprehensive urodynamic studies with the use of an X-ray machine, the so-called video urodynamic examination, are carried out in patients with urinary disorders in connection with certain neurological diseases or after spinal injuries with partial or complete severance of the spinal cord. The aim of these time-consuming examinations is to protect kidney function and significantly improve the quality of life of these patients.
Thanks to our urooncology, lithiasis (urinary stones) and neurology clinics, our department provides special, long-term, so-called dispensary care for patients with oncological diseases, urinary stones or functional disorders of the lower urinary tract.
In the field of endoscopic examinations, the equipment meets current modern standards, which are also met by the new diagnostic and recording technology.
The Urology Department closely cooperates with the Urology Outpatient Clinic of the Jihlava Polyclinic.
The Urology Department also provides consultation services and participates in interdisciplinary cooperation in the hospital, especially for patients with oncological, neurological or gynaecological diseases.

Treatment

Modern urology treatment has long been moving towards minimally invasive surgical procedures, while also using new conservative therapies in the field of functional urology, behavioral and electrostimulation therapy. This approach is conditioned by quality diagnostics, which is aimed at early detection of not only uro-oncological diseases, but also causes leading to urinary difficulties or leakage of urine, so-called incontinence, in other patients.

Surgical procedures

The basic surgical treatment includes procedures for oncological diseases of the urinary tract and genital organs in men, as well as endoscopic and minimally invasive procedures for the treatment of urinary stones (urolithiasis) and, last but not least, procedures associated with benign growths of the prostate gland in men and surgery on the external genitalia in both men and women.
In uro-oncological surgeries, in addition to radical procedures associated with the removal of the organ affected by the tumour, rescue resection surgeries are performed in indicated cases, specifically on the kidneys and penis. In the case of radical removal of the bladder, so-called cystectomy, the derivation of urine by creating a reservoir from the intestine tissue, so-called neovesication, or by draining the urine into a collecting bag on the abdomen, again by means of an intestinal segment, called ureteroileostomy, is dealt with individually, after discussion with the patient. In the vast majority of cases, these are robotic-assisted surgical procedures.
In the surgical treatment of urinary stones, endoscopic or minimally invasive percutaneous procedures combined with modern shredding techniques in the form of laser or shock pulse technology are exclusively used.
Our department also specializes in reconstructive surgeries to resolve obstructions of the ureters or urethra, so-called strictures, as well as treatment of fistulas, i.e. non-physiological communication of the urinary tract with other organs.
Another specialty is the surgical treatment of urinary incontinence in both men and women. In women, in cooperation with gynaecologists, reconstruction of pelvic prolapse associated with urine leakage or, on the contrary, difficulties with urine evacuation.
The Urology Department provides care for patients with neurogenic bladder as a result of spinal cord injury following trauma or in connection with certain neurological diseases. In these patients, we try to stabilize the bladder function using Ona botulinumtoxin A, and in indicated cases, we also increase the bladder capacity by means of an intestinal patch, so-called augmentation, combined with the possibility of autocatheterization of the bladder by natural means through the urethra or through a catheterizable valve created from the appendix, so-called appendicectomy. In indicated cases, we offer the possibility of specific electrostimulation treatment (SDAF + SARS) in cooperation with neurosurgeons from Krajská zdravotní, a.s., in the hospital in Ústí nad Labem.
The Urology Department provides complex surgical treatment of injuries of the urinary tract and genital organs in men, including interdisciplinary cooperation in so-called polytraumatic conditions.