This first week of the summer immersion program I was able to meet with my summer mentor, begin discussion of my summer project, and view surgery as well as clinical procedures. This summer I am working with Dr. Te, he is a urologists and practices both clinical and surgical medicine. Immediately upon meeting my mentor I was able to observe my first surgery. Dr. Te, used a high powered laser to remove a section of his patients prostate that was blocking the patient's urethra. The blockage in the patient's urethra was due to an enlarged prostate, but not related to cancer. His enlarged prostate was impinging upon his urethra and preventing him from relieving his bladder. The operation took approximately three hours from start to finish.
In Dr. Te's clinical office I was able to observe tests and procedures that are done in the office for diagnosis. This first week I watched as urodynamic tests were preformed on patients that were having trouble urinating. Many of the patients are forced to push and strain to relieve their bladder. One patient in particular had MS and as a result experiences sphincter dyssynergia, this means that her urethra muscles contract while she is attempting to urinate and thus she has to physically push on her bladder to urinate.
Many of the patients that come into the urology clinic due to issues urinating. This symptom can result from an over extended bladder, problems with the sphincter muscles, and prostate enlargement, in men. During the urodynamics testing x-rays of the bladder and the urethra as well as pressure measurements of the flow exiting the bladder allows the doctor to diagnosis the possible cause of the urination problems. This test was usually used as the basis for further diagnostic procedure as well as determination of immediate treatment options.
Before working with Dr. Te I was unaware of the many different ways that an individuals' urination can be disrupted and the many different possible causes. In addition there are a lack of treatment options available for these patients and a risk of infection with some of the current therapies available. In addition, biomedical engineering could potentially make a large impact in this area.