By Iptisam Abdallah, Kakamega
Daylight struck the skies flooding an orangish tinge into the horizon as I trotted along Maraba road.
As I was walking, a rusty metallic door of a roadside house creaked open and a boy of about 17 years came out with a damp mattress reeking of urine. A raspy feminine voice scolded at him “ Anika haraka na uoshe hayo makojoo. Kijana mkubwa unaniaibisha”
He shamefully leaned it on a wall facing the sun and hurriedly disappeared in the house slamming the door shut.
Curiosity gnawed my conscience as I tried to think of reasons of bed wetting at such a big age . It then dawned on me that it could be an issue of Urology.
Paving my way through mukombero and mandazi sellers along Kakamega road, I hurriedly walked towards the magnificent Golf hotel where Urology doctors had a conference.
I met two resident urologists from Kenyatta National Hospital, who after warm handshakes and a little chit- chat agreed to spill knowledge about Urology right into my absorbing brain.
Donning smiles, we sat inside a gazebo, Dr. Abdalla mwadzingo , Dr. Luwi Wekesa and I, eyes on each other ready for a fruitful question answer session.
‘‘Urology also known as genitourinary surgery is a branch of medicine that focuses on surgical and medical diseases of the urinary tract system and reproductive organs.
A Urologist is a medical doctor specializing in conditions that affect the urinary tract in men, women and children. This system constitutes the bladder, kidneys, ureters and urethra which are responsible for keeping the body clean. A Urologist also treats conditions involving reproductive organs and adrenal glands.’’ explained Dr. Abdalla .
‘Urologists treat an entire spectrum, including patients of all ages, gender and socio-economic status.’’ He added.
The Genitourinary system
Whilst wondering what such a difficult medical term meant, the two doctors warmly smiled and took turns explaining to me in the simplest way possible.
‘’The genitourinary system are the organs of the reproductive system and urinary system that urologists treat. They are grouped together due to their proximity to each other, their common embryological origin and the use of common pathways.
The urinary tract is the system that creates , stores and removes urine from the body.
It is composed of kidneys which are the organs that filter waste out of the blood to produce urine, ureters which are tubes through which urine flows from kidneys to the bladder, bladder which is the hollow sac that stores urine, urethra which is the tube through which urine travels from the bladder out of the body and adrenal glands which are the glands located on top of each kidney that release hormones.’’ said Dr. Abdalla.
Taking his turn to explain, Dr. Luwi continued;
‘The male reproductive organs are inclusive in the genitourinary system. This organs include the penis which is an organ that releases urine and carries sperm out of the body, prostate which is the gland underneath the bladder that adds fluid to sperm to produce semen and testicles which are two oval organs inside the scrotum that make hormone testosterone and produce sperm,’’
Conditions that Urologists treat
‘’Urologists treat a wide variety of conditions that affect the urinary system. In men, urologists commonly treat cancers of the bladder, kidneys, penis, adrenal and prostate glands, prostate gland enlargement known as benign prostatic hyperplasia, erectile dysfunction, male infertility, interstitial cystisis and other bladder disorders, kidney diseases and kidney stones, prostatitis which is inflammation of the prostate gland, urinary tract infection, varioceles or enlarged veins in the scrotum and urethral stricture.
In women, Urologists often treat urinary incontinence, bladder prolapse which is the dropping of the bladder in the vagina, cancers of the bladder, kidneys and adrenal glands, bladder conditions such as interstitial cystisis and overactive bladder, kidney and ureteral stones as well as ureteral infections.
In children, urologists commonly treat congenital diseases that cause urinary blockage, infections or difficulties urinating, bladder dysfunction that can be a cause of bed-wetting, circumcision revision, kidney conditions such as duplex kidney and kidney dysplasia ’’ Explained Dr. luwi.
When to consult a Urologist
‘’A Urologist should be consulted on occasions where one experiences changes in urination patterns to frequent, trouble in urinating ranging from a strong flow of urine, cloudy urine, blood stained urine to pain during urination, trouble getting or keeping an erection in men, infertility, vaginal heaviness or a feeling of something falling into it in females, pelvic pain and unwanted urination at night , when sneezing laughing or exercising.’’ Said Dr. Luwi.
Sub-specialties of Urology
‘’Urology is referred to as a surgical sub-specialty requiring four years of under-graduate education, four years of medical school and an additional five to six years of residency. After residency urologists can pursue advanced coursework and training in areas of urology of their interest that are referred to sub-specialties.
Sub-specialties of Urology include, urological oncology,laparascopy, pedriatic urology, andrology, endourology, female urology, reconstructive urology, and neurorology, ‘’
Confused of the constituents of the sub-specialties mentioned, Dr. Luwi smiled and further explained,
‘’The subspecialties involve; Urological oncology that is a medical specialty with surgeons who focus on the treatment of cancer in the urinary tract and male reproductive organs. Laparascopy, on the other hand consists of surgeons who perform minimally invasive surgeries using laparascopes which are cameras that see through the abdomen as an alternative to convectional open surgery. Pedriatic urology
has specialized surgeons who can diagnose, treat and manage childrens urinary and genital problems.’’
Taking a short pause, he continued, ‘’Andrology is aspecialist area of medicine involving male health issues such as fertility problems and sexual dysfunction. Endourology/ Calculi is a minimally invasive technique used to treat kidney stones and involves the stones being extracted or fragmented using tiny instruments through natural body channels such as the urethra , the bladder and ureter. Female urology is a sub-specialty that focuses on conditions of a woman’s reproductive and urinary tract. Reconstructive urology is a sub-specialty of urology that focuses on restoring both structure and function to the genitourinary tract. Lastly, Neurourology focuses on the nervous systems control of genitourinary organs.
Urological tests and treatments
‘’Before treatment, urologists have to run tests on patients to properly diagnose a disease for effective treatment procedures. The tests include; A variety of blood and urinary tests, studies of the bladder and lower urinary system called urodynamics to assess function of these structures, cystoscopy using a thin endoscope called a cytoscope to see inside the urethra and the bladder, imaging such as CT scan, MRI scan, PET scan, or ultrasound and contrast studies of the bladder or kidneys.’’ said Dr. Abdalla.
Taking his turn, Dr. Luwi guided me into the treatment procedures.
‘’Urological doctors use surgery as a treatment procedure. The surgeries involve endoscopic removal of the prostate, a kidney transplant, which involves replacing a diseased kidney with a healthy one, robotic surgery to remove bladder, kidney or prostate to treat cancer, extracorporeal shock-wave lithotripsy which is kidney stone removal or laser fragmentation of kidney and uteretic stones, cystoscopy, formation of a stoma to divert urine into a bag , scrotal surgery, a sling procedure which involves using strips of mesh to support the urethra and keep it closed to treat urinary incontinence and vasectomy which involve cutting and tying the vas deferens.’’
Contented with the loads of information I got about urology, I thanked the doctors and exchanging nice-to-meet –you handshakes, I left a happy soul.