Dr. Lievano is a Urology doctor serving the DFW metroplex. His primary office location is at Baylor Scott & White in Fort Worth, Texas.
Urology surgeons focus on assessing, diagnosing and treating urinary tract diseases. They also specialize in conditions that affect the male reproductive system. Although some people think that urologists only treat men, women can see urology surgery doctors for issues such as incontinence, overactive bladder, urinary tract infections, pelvic floor dysfunction, and prolapse and vesicovaginal fistulas.
Recommended Dallas-Fort Worth Urology Surgery Doctors
Our doctors have specific interests and clinical skills in a variety of urological categories, such as:
- Robotic surgery
- Laparoscopic surgery
- Prostate surgery
- Reconstructive urinary surgery
What body parts do Urology Surgeons work on?
Some parts of the body that urology surgery doctors cover include the following:
- Bladder – The sac that collects urine for excretion
- Urethra – The duct through which urine is transported out of the body and semen is expressed in males
- Kidneys – A pair of organs that filter blood and remove waste and extra fluid to create urine
- Ureter – Duct through which urine moves from the kidneys to the bladder
- Adrenal Glands – Glands that sit on top of the kidneys and produce certain hormones
- Epididymis – Duct through which sperm passes in males
- Seminal Vesicles – Glands that are responsible for secreting some elements of semen
- Prostate – Gland in males that surrounds the neck of the bladder and releases prostatic fluid
- Penis – Male genital organ through which sperm and urine are released
- Testes – Organ that generates sperm
What medical conditions do Urology Surgeons diagnose and treat?
There are several medical conditions that can affect the function of these body parts in men and women. These may include:
- Urinary tract infections
- Male infertility
- Kidney disease
- Bladder prolapse
- Cancers of the urinary tract or male reproductive system
- Enlarged prostate
- Erectile dysfunction
- Kidney stones
- Undescended testes
- Urethral stricture
- Complex pediatric urological conditions
- Pelvic pain
Types of Urology Surgery
Sometimes, urology surgery is necessary to investigate or treat a particular disease. Urologic operations may be conducted laparoscopically or robotically. These procedures are considered to be minimally invasive. The surgeon will usually make one or a few small incisions. Robotic surgery may be used to treat prostate cancer, kidney disease, bladder cancer, hernias and urinary obstructions.
Open surgery is conducted through a large incision. It is more invasive and generally requires a longer recovery period.
Urology surgeons may complete a cystoscopy, a procedure that allows physicians to look at the bladder lining and the urethra. This is done by inserting a tube with a camera lens into the urethra and gradually moved into the bladder. It does not require making an incision in the skin.
You might need a cystoscopy if you have painful urination, blood in the urine or incontinence. This procedure may also be used to explore the cause of frequent urinary tract infections, diagnose bladder stones, assess inflammation and check for cancer.
During a cystoscopy, tools can be used to treat your condition if appropriate. For instance, doctors may remove tumors, small stones, polyps and abnormal tissue on the spot. They may also insert medication through the tube. Urologists may conduct a ureteroscopy in conjunction with a cystoscopy to extend a narrower scope into the ureters.
Laser treatment is especially useful for treating urinary stones. It has made open surgery for this type of disease almost obsolete. This type of operation may be used at the same time as a ureteroscopy. If a laser is not used, bladder and kidney stones may be removed manually using a tiny basket.
Shockwave lithotripsy may also be used to break up kidney stones, reducing their size so that they can pass. The Sometimes, a stent is placed in the ureter to keep it open and ease the passing of the stones. This procedure is effective approximately 50 percent of the time.
If shockwave lithotripsy doesn’t affect your kidney stones, the doctor may repeat the procedure. A urology surgeon may also conduct a percutaneous nephrolithotomy or nephrolithotripsy, abbreviated as PCNL. This procedure does require an incision, which doctors usually create in the back or side of the abdomen. Then, the stone is either removed through a tube or broken up with sound waves or a laser before it is extracted with a vacuum.
When is Surgery necessary?
Surgery is often recommended when lifestyle changes and medication don’t reduce your symptoms. Sometimes, for example, kidney and bladder stones pass on their own. If they’re so large that they’re causing significant pain, contributing to urinary tract infections or blocking the flow of urine, you may require surgery.
Exploratory surgery may also be performed to examine tumors and test them for cancer. Abnormal cells may be removed for testing. Tissue that can’t be removed during surgery may be burned.
Cancer surgery may also be conducted to remove known malignancies. For example, a radical prostatectomy is used to remove the prostate and surrounding tissue when cancer is found in the prostate and nearby lymph nodes. Surgeons can do this manually or laparoscopically.
Sometimes, an enlarged prostate doesn’t have cancerous cells but causes problems with urination. This condition, referred to as benign prostatic hyperplasia, removes the portion of the prostate that blocks the flow of urine.
Surgery may also be indicated for a hernia that doesn’t resolve or causes pain. Hernias often occur in women and men in the groin or abdominal area. They happen when internal tissue protrudes through weakness or a tear in the structure of the muscle or surrounding tissue. Surgery is the only way to treat most hernias, but an operation may not be necessary if the condition isn’t bothering you.
Sometimes, you don’t need to have a detrimental medical condition to qualify for urology surgery. Vasectomies are an effective form of birth control that involves cutting the vas deferens through a tiny incision in the scrotum. This prevents sperm from crossing into the semen. An operation can also be done to reverse a vasectomy.
The surgeons in the Dallas Fort-Worth area are dedicated to helping resolve your issues with minimally invasive techniques when possible. Contact one of these doctors to discuss your condition and symptoms and find out whether urology surgery is right for you.