Glossary

Commonly used terms in urology

5-alpha-reductase inhibitors

Class of drugs used primarily in the treatment of benign prostatic hyperplasia to inhibit growth.

A

Ablation

Removal of an organ (e.g. testicles).

Abscess

Collection of pus that has built up within the tissue of the body, usually caused by infection.

Adenoma

Benign tumour of epithelial tissue with glandular origin, e.g. of the prostate.

Aetiology

Study of the cause, set of causes, or manner of causation of a disease or condition.

Androgen blockade

Blockage of androgen production (testosterone) in the treatment of prostate cancer.

Androgens

Male hormones. The most important androgen is testosterone that is primarily formed in the testicles.

Andrologist

Men's doctor; usually a urologist specialising in endocrine and fertility disorders in males.

Antiandrogens

Class of drugs used in men to prevent androgens from expressing their biological effects on responsive tissues. (Some prostate cancer cells require androgens for growth. Antiandrogens are used to counteract cancer cell proliferation.)

Anticholinergics

Class of drugs that inhibit the activity of the bladder muscles. Anticholinergics are used in particular as the standard treatment for urge incontinence and overactive bladder (OAB).

Antifungals

Pharmaceutical fungicides used to treat and prevent fungal infections in humans (mycoses).

Antihormones

Substances used to suppress selected hormones or their effects within the human body and used for the treatment of hormone-dependent tumours (e.g. prostate cancer).

Antiinflammatories

Class of drugs used to reduce inflammation.

Antiseptic

Disinfecting substance for the skin, mucosa, and wounds.

Antispasmodics

Drugs that suppress muscle spasms, e.g. bladder spasms or colic.

Anuria

Nonpassage or extremely limited passage of urine (less than 100 mL in 24 hours). Main causes include severe failure of the kidneys and/or impairment of the urinary tract.

Artificial kidney

see Dialysis

Autoimmune disease

Abnormal immune response of the body involving formation of antibodies against substances and tissues normally present in the body.

Azoospermia

Lack of any measurable level of sperm in the semen based on a semen analysis to evaluate fertility.

B

Bacillus Calmette-Guérin (BCG)

Vaccine prepared from a strain of attenuated tuberculosis bacillus and used against tuberculosis and for the treatment of some bladder cancers in urology.

Bacteriuria

Passage of bacteria in the urine.

Balanitis

Inflammation of the glans penis.

Balanoposthitis

Inflammation of the glans penis and foreskin.

BCG

see Bacillus Calmette-Guérin

Bed wetting

see Enuresis

Benign prostatic hyperplasia (BPH, benign enlargement of the prostate, adenofibromyomatous hyperplasia)

Benign increase in size of the prostate that does not necessarily lead to symptoms. Prostatic hyperplasia is one of the most common diseases among men. About 60 % of all men aged 50 and up experience enlargement of the prostate. Signs of this benign enlargement of the prostate that impinges on the urethra include urination disorders, such as post-micturition dribbling, weak urinary stream or urinary hesitancy or retention. Advanced cases involve residual urine or urinary stasis, urinary tract infections, and urinary retention.

Biofeedback

Psychotherapeutic method of gaining greater awareness of many physiological functions primarily using instruments that provide information on the activity of those same systems based on visual and acoustic signals to enable patients to manipulate them at will.

Biopsy

Sampling of tissues, e.g. from the prostate, urinary bladder or kidney, for examination. Sampling is nearly painless. Samples are typically examined under a microscope often to determine whether they contain benign or malignant tissue.

Bladder infection (Urinary tract infection)

When bacteria in the urinary bladder cause an infection, it is called a bladder infection (simple cystitis). A bladder infection causes unpleasant symptoms, including frequent urination, burning urination, and often blood in the urine. Small children and women are most commonly affected by bladder infections due to their anatomy. An untreated bladder infection may spread to the upper urinary tract and become an inflammation of the kidneys (pyelonephritis).

Bladder sphincter dyssynergia

Consequence of a neurological pathology that disrupts central nervous system regulation of the micturition (urination) reflex resulting in dyscoordination of the detrusor muscles of the bladder and the male or female external urethral sphincter muscles.

Bladder training

The practice of controlled urination. Often used to treat incontinence or enuresis.

Blister pack

Peel-open transparent packaging for lubricants, such as Instillagel® and Endosgel®, and catheters.

BPH

see Benign prostatic hyperplasia

Brachytherapy

Brachytherapy (from the Greek word brachys meaning "short distance") is a form of radiotherapy where a sealed radiation source is placed inside or next to the area requiring treatment within the patient's body. The procedure is used to treat prostate cancer, whereby so-called "seeds" - small radioactive rods - are implanted directly into the tumour in the prostate from the perineum using cannulas.

C

Carcinoma

Cancer growth that develops from epithelial cells. Prostate carcinoma is among the especially slow-growing types of cancer, such that life expectancy is not necessarily reduced by this form cancer.

Castration

Any action, surgical (orchiectomy), chemical, or otherwise, by which a biological male loses use of the testicles.

Catheter

Tubular device made of latex or plastic that is inserted into hollow organs of the body. Depending on the intended use, it is called a urinary catheter, ureteral catheter, heart catheter, vascular catheter, etc. Urologists use catheters mainly to empty or irrigate the urinary bladder. (See also Indwelling catheter).

Catheterization

Insertion of a catheter into a hollow organ (e.g. the urinary bladder) for diagnostic and/or treatment purposes.

Chemolitholysis

Dissolution of urinary stones using medications. The option to use chemolitholysis depends on stone composition. Chemical dissolution is most successful in the case of urate stones.

Chemotherapy

Treatment with a chemotherapeutic agent to inhibit and/or reduce the growth of cancer cells. The combination of multiple medications is often required.

Chlamydia infection

One of the most common sexually transmitted diseases in Germany that is usually caused by the bacterial species Chlamydia trachomatis. However, other strains of Chlamydia, including Chlamydia pneunomiae and Chlamydia psittaci, are also considered to cause the disease. Chlamydia is transmitted primarily through unprotected sexual intercourse with multiple sexual partners. The disease often causes only minor symptoms or no symptoms at all. Symptoms occur during the 1st through the 6th week following infection, if at all, and usually involve itching, burning, and painful sensations during urination and/or genital discharge (in men and women). Due to the fact that abnormal symptoms frequently do not occur, the infection often goes unnoticed and untreated, but continues to be transmitted by the carrier. Only a small percentage of infections is identified and treated based on the occurrence of symptoms. Untreated chlamydial infections may result in infertility in both women and men.

Circumcision

Partial or complete removal of the male foreskin. In addition to medical indications, circumcision is commonly performed for religious, ritual, hygienic or aesthetic reasons.

Climacteric (Menopause)

Changes in hormone levels in men and women. Climacteric in women involves the years of hormonal changes that occur before and after menopause. It usually occurs in women between the ages of 45 and 55. Men also experience a similar decline in testicular hormone production (testosterone) that is called male menopause.

Cohabitation

An arrangement where two people who are not married live together in a sexually intimate relationship on a long-term or permanent basis.

Computed Tomography (CT)

Special radiological technique that produces cross-sectional (tomographic) images of a specific area of the body. The patient lies on a motorised table that slowly passes through a tunnel-shaped, rotating gantry equipped with x-ray tubes and detectors that form a fan-shaped beam of x-rays around the patient as the gantry rotates. The collected data are merged into tomographic images using computers. CT scans are used to diagnose a variety of diseases that require the assessment of organ size, organ boundaries, and/or organ structure.

Condom

A sheath-shaped barrier device made of rubber (latex) or polyurethane that is rolled onto the erect penis before intercourse and physically blocks ejaculated semen from entering the body of a sexual partner. If applied correctly, condoms are a reliable contraceptive method. Condoms are the only contraceptive that protects against the transmission of HIV/AIDS and other sexually transmitted diseases.

Condylomata acuminata (human papillomavirus infection)

Genital warts (condylomata acuminata) are caused by so-called papillomaviruses. They are easily recognisable as warts (and may develop a cauliflower appearance at advanced stages) on the penis, on or in the vagina, in the urethra, on the anus or in the rectum. They are spread through direct contact with the skin or mucosa of an infected partner, usually during unprotected oral, genital, or anal sex. Additional routes of transmission include close physical contact with an infected person or contact infections from contaminated objects (e.g. sex toys). The incubation period ranges from 4 weeks to several months. In addition to local chemical treatment, surgical removal may also be considered. Relapses commonly occur; as a result, periodic examinations over a longer period are indispensable.

Continence training

Special training to control the sphincter muscle of the bladder.

Cryptorchidism

Condition in which one or more of the testes is temporarily or permanently absent from the normal scrotal position.

CT

see Computed Tomography

Cystectomy

Surgical removal of all or part of the urinary bladder.

Cystitis

Inflammation of the urinary bladder.

Cystoscopy (Urethrocystoscopy)

Urological examination of the urinary bladder using a special endoscope (cystoscope). In men, this examination always includes the urethra and thus the examination is called urethrocystoscopy. In order to provide for pain-free cystoscopy, a sufficient amount of local anaesthetic Instillagel® is recommended.

Cytostatic agents

Medications that prevent cell growth and multiplication and thus inhibit cancer growth.

Cysts

Pathological, distinctly abnormal, closed sac usually containing fluid.

D

Detrusor urinae muscle

Multi-layered smooth muscle found in the wall of the bladder that contracts to release urine.

Diagnosis of exclusion

Diagnosis of a medical condition that is difficult to identify based on the elimination of similar but more easily diagnosed conditions.

Dialysis

Process for removing waste and excess water from the blood in the case of kidney failure. In addition to kidney transplant surgery, dialysis (from the Greek dialusis, meaning dissolution) is the most important method of artificial replacement for lost kidney function in cases of chronic kidney failure and provides treatment options in cases of acute kidney failure.

Digital rectal examination (DRE)

Examination in which the rectum and the prostate are carefully palpated with a finger. From the age of 45 onwards, all men should undergo this standard method of prostate cancer screening.

Dilation

Expansion and widening of a narrowed passage, e.g. the urethra, using a bouge.

DRE

see Digital rectal examination

Dyspareunia

Dyspareunia

Dysuria

Urinary urge with difficult and/or painful urination (miction) in the case of diseases involving the bladder, prostate, and urethra.

E

Echography

see Medical ultrasound

Ejaculate

Seminal fluid that is ejected (ejaculated) during orgasm in men.

Ejaculatio praecox (Premature ejaculation)

Premature ejaculation is a sexual disorder in men involving the inability to control the time of ejaculation during sexual intercourse. It is the most common sexual dysfunction among men.

Ejaculation

Emission of semen during orgasm in men.

Electromotive drug administration (EMDA)

Method of sending medications straight to an infected area using an electrical current.

Electromyography

see Pelvic floor EMG

EMDA

see Electromotive drug administration

EMG

see Pelvic floor EMG

Endometriosis

Disease in which tissue that normally grows inside the uterus grows outside it and which may cause infertility for reasons that are not entirely understood.

Endoscopy

Technique for looking inside the interior of a hollow organ or cavity of the body using a tubular instrument with a light source. Surgical procedures or tissue sample collection (biopsy) may also be performed during endoscopy.

Enuresis

Repeated inability to control urination in children aged 3 years and over and in adults.

Enuresis diurna: Daytime enuresis

Enuresis nocturna: Nighttime enuresis (bed wetting)

Erectile dysfunction (impotence)

Impotence involves a variety of very different issues. Libido, ejaculation, and the ability to achieve orgasm may be affected. Impotence in men mainly involves the inability to achieve an erection. These symptoms are mainly of a physical nature. However, psychic factors also often play a role in the ability to have sexual intercourse. The incidence of impotence increases with age. Very effective treatments for impotence are currently available.

Erection

Physiological phenomenon in which the penis becomes firmer, engorged and enlarged.

ESWL

see Extracorporeal shock wave lithotripsy

Excretory urography (intravenous pyelogram or IVP)

Radiological procedure used to visualise abnormalities of the urinary system following intravenous administration of radiographic contrast material.

Extracorporeal shock wave lithotripsy (ESWL)

Fragmenting of urinary stones, especially kidney stones, using an acoustic pulse. This treatment involves aiming externally focused shockwaves at the stone and breaking it up in such a way that it is able to be eliminated naturally through urination.

F

Fistula

Abnormal connection between two hollow spaces that forms between an organ of the body and the surface of the body (external fistula) or passes solely within the body (internal fistula).

Foreskin

see Praeputium

French scale (Fr)

System commonly used to measure the size of catheters and probes. 1 Fr = a diameter of 1/3 mm.

Frequent urination

Urination disorder with urge to urinate more often than usual (> 8 x per day) without any increase in urine volume, e.g. in the case of prostate diseases.

G

Gleason grading system (Gleason score)

System commonly in use worldwide for evaluating the prognosis of men with prostate cancer using samples from a prostate biopsy. Gleason scores range from 2 to 10, with 2 representing the most well-differentiated tumours and 10 the least-differentiated tumours.

Glycosaminoglycan (GAG) layer

Protective inner lining of the urinary bladder.

Gonadotropin-releasing hormone (GnRH) analogues

see Luteinizing hormone-releasing hormone (LHRH) analogues

Gonads

General term for the female and male endocrine glands, i.e. the ovaries and the testicles.

Grading

System for classifying the malignancy of tumours based on certain evaluation criteria.

Gynecomastia

Increase in the size of breast tissue in males due to elevated levels of oestrogen.

H

Haematospermia

Presence of blood in the sperm.

Haematuria

Presence of blood in the urine. Very few red blood cells are required to turn the urine red.

Hemicastration

Surgical removal of one of the testicles or ovaries, e.g. in the case of testicular tumour.

Hernia

Exit of an organ, especially the bowel, through the wall of the cavity in which it normally resides. The groin region is especially prone to herniation due to the inguinal and femoral canals, which permit passage of vessels and the spermatic cord (in men) downward to the legs. Men are more commonly affected by inguinal hernias than women. In addition to inguinal hernias, other forms of herniation include umbilical hernia and incisional hernia. Other areas of the abdominal wall may also be affected by herniation.

Herpes

Commonly occurring viral disease associated with blister formation on the genitals, among other places, that is also sexually transmissible.

HIFU

see High intensity focused ultrasound

High intensity focused ultrasound (HIFU)

Therapeutic method for the treatment of prostate cancer using ultrasound.

Histology

Study of the microscopic anatomy of cells and tissues of the body.

Hormone analogues

Synthetically manufactured hormone-like substances that are used in hormone therapy.

Hormone therapy

Use of hormones in medical treatment, e.g. the administration of antiandrogens to treat prostate cancer.

Hormones

Hormones are signaling molecules produced by glands in multicellular organisms that are transported by the circulatory system to target distant organs to regulate physiology and behaviour. They may be released from hormone-producing cells into the surrounding tissue (paracrine secretion) or the blood vessels (endocrine secretion).

Hydrocele

Pathological accumulation of serous fluid in a body cavity, e.g. hydrocele testis. Hydrocele may be congenital or occur with no identifiable cause. Surgery may be required if the hydrocele increases in size.

I

IC

see Interstitial cystitis

Ileal neobladder

Formation of a new urinary bladder using intestinal segments.

Ileostomy

Surgical formation of an opening through the abdominal wall for passage of intestinal waste (into an artificial external pouching system).

Immunomodulators

Substances, e.g. pharmaceutically active ingredients, or physical stimuli, e.g. heat or cold, that influence the body's immune system to fight diseases. See Immunotherapy.

Immunotherapy

Treatment of existing diseases by inducing, enhancing, or suppressing an immune response, e.g. through the use of medications.

Imperative urinary urge

Urinary urge that is unable to be suppressed or controlled and may be accompanied by pain, pressure, or cramps. The urinary urge may be so strong that involuntary urine loss may occur (urge incontinence).

Impotence

Inability of a man to achieve erection.

Incontinence

see Urinary incontinence

Indication

The reason for the selection of a certain diagnostic or therapeutic procedure for a disease.

Induratio penis plastica (IPP, Peyronie's disease)

A connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis that may result in deformity of the penis while erect. This deformity most commonly takes the form of abnormal curvature. IPP may result in severe pain during erection and the inability to have sexual intercourse.

Indwelling catheter (Foley catheter)

Tube, usually made of latex or silicone, that is inserted into the urinary bladder via the urethra (transurethral) or the abdominal wall (suprapubic). It is used to drain the urine. A balloon near the tip of the catheter is filled with an aqueous solution that prevents the catheter from leaving the bladder. The catheter is able to be left in the urinary bladder for prolonged periods. An indwelling catheter that has been inserted properly will not cause any symptoms.

Infertility

General term for sterility in women and men.

Inflammation of the kidneys (pyelonephritis)

Bacterial infection of the renal pelvis where urine is collected to be conveyed to the urinary bladder. It is commonly caused by an ascending infection, i.e. the pathogens spread up the urinary tract via the urethra, bladder, and ureter to the renal pelvis. These infections are commonly associated with malaise, groin and abdominal pain, and fever. Women are more commonly affected by pyelonephritis than men due to their relatively short urethra. Treatment mainly involves antibiotics.

Inflammation of the urinary tract

see Urinary tract infection

Inguinal hernia

Exit of an organ, especially the bowel, through the wall of the groin. The groin region is especially prone to herniation due to the inguinal and femoral canals, which permit passage of vessels and the spermatic cord (in men) downward to the legs. Men are more commonly affected by inguinal hernias than women. Surgical treatment is required in the case of inguinal hernia.

Instillation therapy

Introduction of medicinal solutions into the urinary bladder using a catheter.

Intermittent self-catheterisation (ISC)

Insertion of a catheter by the patient to empty his or her own bladder (multiple times daily). It is important to use a suitable lubricant here, such as Instillagel® or Endosgel®. ISC is mainly applied in the case of neurological disorders of micturition, e.g. paraplegia. ISC provides patients with greater mobility and quality of life.

International prostate symptom score (IPSS)

sA written screening tool for the diagnosis of symptoms and degree of severity of benign prostatic hyperplasia (BPH).

Interstitial cystitis (IC)

Chronic urinary tract infection. Interstitial cystitis is a chronic, abacterial (= not involving bacteria) inflammation of the bladder wall associated with pain and urinary urge. Those affected suffer from constant, severe urinary urge and experience stinging, cutting, and burning sensations in the lower abdomen, bladder, and/or urethra. Unlike so-called bacterial inflammations of the bladder, no pathogens are able to be detected in the urine in association with IC.

IPP

see Induratio penis plastica

IPSS

see International Prostate Symptom Score

Irritable bladder

see Overactive bladder

ISC

see Intermittent self-catheterisation

IIschuria

see Urinary retention

K

Kidney gravel

Tiny stones in the kidneys that are visible with the naked eye.

Kidney stones (nephroliths)

Solid pieces of material in the kidneys which are formed in the region of the renal calix and renal pelvis from minerals in urine and that may then become symptomatic. Kidney stones usually do not cause any pain. They will only cause renal colic if they reach the ureter and become ureteroliths.

L

Laparoscopy

Endoscopy of the abdominal cavity and its organs.

Leiomyoma

Tumour that occurs most frequently in the smooth muscle of the uterus (myometrium). Leiomyomas are the most common benign tumours of the female genital tract and may occur in any woman. While the benign tumours are not dangerous, they can have a significant negative impact on quality of life. They usually develop in women between the ages of 35 and 50. They may occur as isolated nodules or numerous fibroids on the uterine wall (Uterus myomatosus). The size of a leiomyoma may vary; some reach up to 20 centimetres and may simulate a pregnancy in the 5th month of gestation.

About one quarter of affected women are able to live with a leiomyoma and experience no symptoms, thus requiring no treatment. The remaining leiomyoma patients most commonly experience abnormal bleeding, such as heavy, prolonged monthly periods or intermenstrual bleeding. Other symptoms may include lower abdominal pain, pressure on the bladder, frequent urge to urinate, constipation, back pain or discomfort during sexual intercourse. These symptoms occur when the leiomyoma grows and presses on adjacent organs or nerve endings with a negative impact on their function. Sequelae, such as urinary tract infections or anaemia, may result.

Leukocyturia

Presence of white blood cells in the urine as a sign of an inflammatory process (e.g. urinary bladder infection).

LHRH analogues

see Luteinizing hormone-releasing hormone (LHRH)

Libido

Sex drive, desire for sexual activity.

Litholysis

Chemical dissolution of urinary and biliary calculi.

Local anaesthetic

SA drug that causes local anaesthesia.

Loop extraction

Removal of urinary stones with correspondingly shaped loops. The loops are advanced into the ureter using the ureterorenoscope. The loops are closed around the stone like a lasso and removed with the stone. Loop extraction is performed less frequently nowadays due to the high risk of injury and is increasingly being replaced by endoscopic procedures.

Lower urinary tract symptoms (LUTS)

General term for a group of medical symptoms involving the bladder, including urinary retention, urinary urge, and urinary stasis in patients with various diseases, e.g. BPH, overactive bladder.

Lubrication

Emission of mucilaginous liquid from the vagina during sexual intercourse. Lubrication facilitates the insertion of the penis during sexual intercourse.

Luteinizing hormone-releasing hormone (LHRH) analogues

The pituitary gland produces a so-called LHR hormone that influences the production of testosterone in men. LHRH analogues inhibit the effect of these LHR hormones. As a result, no more testosterone is produced and the growth of testosterone-dependent prostatic carcinoma is inhibited. LHRH analogues are the medicinal alternative to orchiectomy (surgical removal of the hormone-producing testicular tissue, also known as castration).

LUTS

see Lower urinary tract symptoms

M

Macrohaematuria

Presence of blood in the urine that is visible with the naked eye.

Magnetic resonance imaging

see Nuclear magnetic resonance (NMR) spectroscopy

Male sterilisation (Vasectomy)

Severing and tying/sealing of the vas deferens within the scrotum by means of an outpatient procedure. The testicles remain unchanged such that no changes in hormone levels are to be expected. Vasectomy is considered to be the easiest and most reliable contraceptive method in men.

Malignoma

Malignant neoplasm, cancer.

Medical ultrasound (ultrasonography, echography)

Application of ultrasound as an imaging technique for the examination of organic tissue in medicine. An ultrasonic image or sonogram is an image that is created using ultrasound. Ultrasound is the most commonly used imaging technique in medicine. A major advantage of ultrasound over radiography, another imaging technique frequently used in medicine, is the innocuousness of the soundwaves in use. Medical ultrasound is especially well suited for the examination of the urological organs, including the kidneys, urinary bladder, and prostate.

Menopause

Time of final menstruation. Onset of climacteric.

Metastasis

Spread of cancer from the cells of a malignant tumour (malignoma) from one organ or part to another not directly connected with it. Metastases are also called secondary tumours.

Microhaematuria

Amount of blood in the urine that is so small that it is only able to be identified under a microscope (or with a test strip).

Micturating cystourethrogram (MCUG) or voiding cystourethrogram (VCUG)

Urological technique that involves a radiological scan with a contrast material to visualise a patient's urethra and urinary bladder before and while the patient urinates (voids).

Micturition

Natural release of urine from the bladder.

Micturition diary or voiding diary

Table used to document fluid intake, number of visits to the toilet, urine volume, and involuntary losses of urine, where applicable. Voiding diaries provide overactive bladder, enuresis or urinary incontinence patients and their physicians with an overview of the patient's bladder function.

Micturition disorders

Disorders involving the inability to naturally release urine from the bladder, e.g. due to an enlarged prostate.

Midstream urine

Urine sample that is not collected at the start of urination, but rather once urination has begun. The urethral opening and its surrounding environment must be thoroughly cleaned prior to urination.

Muscarinic receptor antagonist

Agent that blocks the activity of the muscarinic acetylcholine receptors. These receptors control the mechanisms for emptying the bladder. Selective muscarinic receptor antagonists act only on very specific receptors, e.g. the M3 receptor plays a significant role in cases of overactive bladder.

Myometrium

Middle layer of the uterine wall consisting mainly of uterine smooth muscle cells.

N

Neoadjuvant hormone therapy

Hormone treatment administered prior to surgery or radiotherapy, e.g. to reduce the size of the tumour.

Neobladder

An artificial "new" urinary bladder that is surgically created from an isolated segment of the intestine, also known as an ileal neobladder or, more generally, a urinary diversion.

Nephroliths

see Kidney stones

Nephropathy

General term for disorders involving the kidneys and renal function.

Neurogenic bladder dysfunction

Dysfunction of the urinary bladder due to disease or disorder of the central nervous system, e.g. multiple sclerosis or paraplegia. Micturition (urination) is no longer able to be controlled.

NMR (Nuclear Magnetic Resonance)

see Nuclear magnetic resonance (NMR) spectroscopy

Nocturia

Frequent urination at night.

Normospermia

Normal count and function of male semen in the ejaculate.

Nuclear Magnetic Resonance (NMR)

see Nuclear magnetic resonance (NMR) spectroscopy

Nuclear magnetic resonance (NMR) spectroscopy

A computerised imaging technique based on a physical phenomenon in which nuclei in a magnetic field absorb and re-emit electromagnetic radiation. Unlike computed tomography, this technique uses no x-rays, but instead employs very strong, constant magnetic fields and radio waves.

O

OAB (Overactive bladder)

see Overactive bladder

Obstruction

Blockage of hollow organs in the abdominal cavity.

Oestrogens

General term for the female sex hormones formed in the ovaries, adrenal glands, and liver. The most important oestrogens include oestradiol, oestrone, and oestriol.

Oligozoospermia

Low concentration of sperm in the ejaculate (less than 50 million/mL).

Oliguria

Reduced urine production (less than ½ litre per day).

Oncology

Branch of internal medicine and science that deals with the formation, development, and treatment of tumours.

Opioids

Substances that are extracted from opiates or (semi-)synthetically produced medications with analgesic, soothing, tranquilizing, and psychotropic properties. The most well known analgesic of this group is morphine.

Orchiectomy

Surgical removal of the hormone-producing testicular tissue, also known as castration.

Overactive bladder (OAB)

Condition involving the frequent urge to urinate, often at night, that is unable to be suppressed. Those affected also experience incontinence (involuntary leakage of urine).

Overflow incontinence

Overflow incontinence occurs when urine is no longer able to drain properly, e.g. due to an obstruction downstream from the bladder, and the bladder ultimately "overflows". Damage to the nervous system, e.g. due to diabetes or alcoholism, may also result in overflow. Benign prostatic hyperplasia is a common condition that triggers this form of incontinence.

P

Palpation

Process of using one's hands to examine the body of a patient by touching the body's structures, e.g. the prostate, with one or more fingers and/or hands. Due to the fact that the prostate lies close to the rectum, physicians are commonly able to use the index finger to feel an enlargement or growth coming from the intestine.

Papillomavirus infections

see Genital warts

Paraphimosis

Constriction of the penis with swelling of the glans penis due to lack of blood flow. Primarily occurs when the foreskin of an uncircumcised penis becomes trapped behind the glans penis and is no longer able to be pulled back to its normal flaccid position. The condition requires medical attention because swelling and pain may increase and the patient will be unable to correct the situation himself. Paraphimosis is a urological emergency and requires immediate treatment. See also Phimosis, a condition of the penis where the foreskin cannot be fully retracted over the glans penis.

PCNL

see Percutaneous nephrolithotomy

Pearl Index

Common technique for reporting the effectiveness (failure rate) of a birth control method, named after American biologist Raymond Pearl. Example: 100 women use a certain contraceptive method for one year. During the period, an average of 3 women become pregnant. This results in a Pearl Index of 3 for the selected method. Several Pearl Index values are provided below as a guideline only:

Male sterilisation 0.1

Minipill 0.14 - 4

Female sterilisation 0.2 - 0.3

Intrauterine device (IUD) 1 - 2

Basal temperature method 1 - 3

Condom 3 - 4

Coitus interruptus 10 - 20

Pelvic floor EMG (Electromyography)

Recording of the electrical activity produced by pelvic floor muscles. Used to diagnose urination disorders.

Pelvic floor exercise

Series of exercises to strengthen the muscles of the pelvic floor. Usually done to treat urinary incontinence (involuntary leakage of urine).

Penile deviation

A deformation of the penis commonly associated with Peyronie's disease. A distinction is drawn between congenital and acquired penile deviation.

Congenital penile deviation involves a disorder in which the connective tissue proliferates with development of scarring or rupture of the corpus cavernosum, resulting in penile deviation or curvature.

Acquired penile deviation is usually the result of injury to the penis during sexual intercourse with traumatic rupture of the corpus cavernosum (penile fracture) and subsequent haemorrhage. Other causes include injury to the corpus cavernosum or sports injuries. As long as the penile deviation remains minor and has no negative impact on the mechanics of sexual intercourse, surgical treatment should be conservatively applied.

Penile self-injection therapy

Treatment method for erectile dysfunction involving injection of a vasoactive substance (e.g. Papaverine) directly into the corpora cavernosa of the penis.

Percutaneous nephrolithotomy (PCNL)

Invasive procedure for the removal of kidney stones (nephrolithiasis). With a small incision in the loin, a channel is created through which a nephroscope is passed into the kidney. This channel is also used to remove the kidney stones with tongue-grasping forceps or to fragment them using a laser or ultrasound for subsequent removal under direct visualisation.

Perineum

Region of the body between the anus and the external genitalia. In men, this region is between the anus and the scrotum; in women, the region is between the anus and the posterior pubic symphysis.

Peyronie's disease

see Induratio penis plastica

Phimosis

Condition of the penis where the foreskin cannot be fully retracted over the glans penis.

Phytotherapeutics

Herbal medicines made from plant-based active substances.

Pituitary gland

The pituitary is an endocrine gland. It is about the size of a pea and is located at the level of the nose in the middle of the head. It produces and secretes hormones that help control metabolism and other hormones, e.g. testosterone. The inhibition of certain pituitary hormones results in blockage of testosterone and an associated inhibition of hormone-dependent prostate cancer.

Polyuria

Excessive or abnormally large production or passage of urine.

Potency disorder

see Impotence

Pouch

A surgically constructed reservoir for urine or stool made of small and/or large intestine material if the bladder or bowels are required to be removed.

Praeputium

Foreskin of the penis.

Premature ejaculation

When semen is expelled from the penis soon after sexual activity and with minimal penile stimulation.

Priapism

Potentially painful medical condition in which the erect penis does not return to its flaccid state despite the absence of both physical and psychological stimulation. It may last for hours or weeks. The causes are complex. It is considered a medical emergency and requires immediate treatment by a urologist to prevent imminent impotence.

Prostate

Chestnut-sized organ located directly below the urinary bladder that forms a ring around the urethra. It consists in many individual glands whose excretory ducts emerge in the urethra. The main function of the prostate is to secrete a slightly alkaline fluid that forms a part of the semen and ensures the mobility of the sperm. The prostate, as well as the testicles, epididymis, and vas deferens, forms a part of the male genitalia.

Prostate cancer (prostate carcinoma)

Malignant prostate tumours are one of the most common types of cancer among men over the age of 50. The incidence increases with age. The cause is unknown, but appears to be associated with hormone levels; environmental factors and diet, however, may also be potential factors. Family history of prostate cancer also suggests a genetic cause. Prostate cancer generally grows very slowly and does not necessarily cause symptoms initially. As the tumour increases in size, symptoms become apparent during urination, such as difficulty urinating or increased frequency of urination, weak or interrupted urinary stream, and incomplete emptying of the bladder. If the cancer has spread to the bones, then bone pain may occur. Timely detection of prostate cancer is currently possible by means of a rectal examination and blood work (prostate-specific antigen).

Prostate carcinoma

see Prostate cancer

Prostate laser surgery

See Visual laser ablation of the prostate (VLAP)

Prostate-specific antigen (PSA)

The PSA value is able to be determined by means of a simple blood test and is an indicator of changes to the prostate. It is also commonly referred to as a biomarker. Elevated PSA values do not always mean prostate cancer. This must be verified on a case-by-case basis by means of a biopsy. However, the statistical likelihood of a pathological change increases with elevated values. The total PSA value (tPSA) should be below 2.5 ng/mL serum. It normally increases with advancing age, but should not exceed a limit of 4.0 ng/mL. The total PSA value is composed of complexed PSA (cPSA) and free PSA (fPSA). cPSA formation increases with prostate cancer, while fPSA is elevated in the case of benign prostate diseases. The fPSA quotient divided by tPSA is a very specific indicator for prostate cancer if the value is below 0.15.

Prostatic adenoma

see Benign prostatic hyperplasia

Prostatic adenomectomy

Surgical removal of a benign prostatic adenoma.

Prostatic hyperplasia

see Benign prostatic hyperplasia

Prostatitis

Inflammation of the prostate. A distinction is drawn between acute and chronic prostatitis. Symptoms include pain in the region of the groin and perineum, frequent urination.

PSA

see Prostate-specific antigen

PSA doubling time

Period during which the PSA value doubles.

Pyelonephritis

see Inflammation of the kidneys

R

Radiation

Radiation therapy

Radiation therapy (Radiotherapy)

Medical application of radiation in order to heal diseases or at least delay their progression. In a stricter sense, it is understood to mean the application of ionising high-energy rays (gamma rays, braking radiation, electrons, neutrons, protons, carbon ions) for the purposes of healing, usually in the case of malignant tumour diseases (cancer).

Radical prostatectomy

Surgical procedure for prostate cancer involving complete remove of the prostate together with the seminal vesicles.

Radiocystitis

Inflammation of the bladder following radiation therapy.

Radiogenic fibrosis

Proliferation of the body's own connective tissue (scar tissue) as an adverse effect of radiation therapy.

Radioisotope renography

A form of kidney imaging involving radioisotopes for the assessment of kidney function from static and dynamic view points. After injection into the venous system, the radioisotopic compound is excreted by the kidneys and its progress through the renal system can be tracked with a gamma camera. This provides information concerning kidney function and obstruction of urine flow.

Radiotherapy

see Radiation therapy

Rectal examination

Palpation of the prostate via the rectum. See also Rectal palpation.

Rectal palpation

Process of examining the prostate and rectum using a finger. Also known as digital rectal examination (DRE). Palpation of the prostate provides information concerning the prostate's size, its surface structure, any suspicious nodules, and any sensitivity to pain. Tumours in the rectum are also able to be detected by rectal palpation. Rectal palpation is part of the prostate screening process.

Rectum

Final segment of the digestive system that includes the last 12 - 16 cm of the large intestine and emerges at the level of the sphincter muscle in the anal canal, forming the lower opening of the digestive tract. It acts as a temporary storage site for faeces and provides for controlled elimination by defecation reflex.

Relapse prevention

Measures to prevent the recurrence of a disease (relapse). In urology, these mainly involve urinary tract infections or tumours of the bladder.

Renal colic

Radiating pain in the region of the kidneys and ureters caused by acute onset of obstructed urine flow from the kidney. The most common cause is a stone that is blocking the ureter (that connects the kidney to the bladder). Renal colic is usually accompanied by nausea and vomiting.

Residual urine

Urine that remains in the urinary bladder following urination. Causes of incomplete emptying of the urinary bladder include narrowing of the urethra and benign enlargement of the prostate (prostatic hyperplasia) in men. Residual urine provides favourable conditions for infections and lithiasis.

Retractile testicle

Testicle that may move back and forth between the scrotum and the groin.

Retrograde ejaculation

Following a surgical procedure, e.g. transurethral resection of the prostate, the semen, which would normally be ejaculated via the urethra, is redirected to the urinary bladder (also known as a "dry orgasm").

S

Scintigraphy/Scintigram

Diagnostic imaging technique used in nuclear medicine. The resulting image is called a scintigram. Scintigraphy involves radiolabelled pharmaceutical agents taken internally that become concentrated in an organ with the emitted radiation captured by external detectors (gamma cameras) to form images. This method provides information concerning organ function, e.g. renal scintigraphy. Bone scintigraphy enables the identification of certain abnormalities in bone (e.g. metastases). Radiation exposure is lower with scintigraphy than with comparable radiographic techniques.

Scrotum

Male reproductive structure that consists in a suspended sack of skin that contains the testicles, epididymis, segments of the vas deferens, and the end of the spermatic cord.

Seeds

Seeds or metal rods with a radioactive substance that are inserted directly into the prostate. They remain in the tissue and gradually emit radiation until they are no longer radioactive.

Self-catheterisation

see Intermittent self-catheterisation

Semen analysis

Analysis of the ejaculate to evaluate male fertility.

Seminoma

Malignant tumour of the testicle or malignant germ cell tumour originating from the germinal epithelium of the seminiferous tubules.

Sex hormones

General term for the hormones that influence male and female sexuality and reproduction. The female sex hormones include oestrogens and progestogens and the male hormones include testosterone in particular.

Sexually transmitted diseases (venereal diseases)

Contagious diseases primarily transmitted through sexual intercourse. These include syphilis, gonorrhoea (the clap), chancroid (soft chancre), and Lymphogranuloma venereum (LGV).

Sjögren's syndrome

Chronic, inflammatory, autoimmune disease in which the body's white blood cells destroy the exocrine glands, specifically the salivary and lacrimal glands, accompanied by rheumatic symptoms (joint and muscle pain).

Sperm

Mature spermatozoa.

Sphincter

Cylindrical muscle that normally maintains constriction of a natural body passage or orifice.

Staging

Process of determining the extent to which a tumour has developed or spread and/or the stage of the disease based on certain criteria.

Sterility

Inability to sire, conceive or carry a child to full term.

In men:

Insufficient sperm production and inadequate sperm motility are among the main potential causes of sterility in men. Deformities of the genital organs or diseases of the seminal ducts are other potential factors. Semen analysis and blood work provide significant support in clarifying the cause. Testicular tissue sampling is another examination option.

In women:

Hormonal imbalances, especially menstrual disorders, commonly result in sterility in women. Irregular menstruation may interrupt egg maturation or even result in absence of ovulation.

Endometriosis and leiomyomas are also widespread.

Stoma creation

Creation of an artificial opening for drainage of the urine or stool (into an artificial external pouching system).

Stress incontinence

see Urinary incontinence

Stricture

Abnormal narrowing of a tubular organ as the result of inflammation, scarring, or tumour, e.g. urethral stricture.

Sympathomimetic drugs

Stimulant compounds that mimic the effects of agonists of the sympathetic nervous system. For example, they are able to cause the sphincter muscle of the bladder to contract and the bladder muscles to relax.

T

Test strips

Specially prepared test strips used for urine and blood tests that provide immediate results.

Testicular torsion

Testicular torsion occurs when the spermatic cord (from which the testicle is suspended) twists, cutting off the testicle's blood supply, a condition called ischemia. Initial symptoms include pain in the lower abdomen, groin, and testicular region; the scrotum swells and becomes tender to the touch. Circulation to the testicle is reduced, posing a risk of testicle loss. Complete disruption of circulation to the testicle for more than 8 hours typically results in irreversible damage to the testicle. As a result, rapid surgical intervention to restore the flow of blood, i.e. surgical detorsion of the testicle, is required in cases of suspected testicular torsion. Testicular torsion is a urological emergency. Causes often include sudden movements during physical activity or trauma. However, spontaneous torsion may also occur with no identifiable cause, e.g. during sleep.

Testosterone

Male sex hormone that is formed in the testicles.

TNM staging system

see Tumour, lymph node, metastasis system

Trabeculated bladder

Thickening of the muscles of the urinary bladder wall. Indicates a chronic obstruction of urine flow.

Transrectal ultrasound (TRUS)

Ultrasound examination of the prostate via the rectum. A special, finger-sized ultrasonic probe is inserted into the rectum via the anus. The obtained images provide precise information concerning the size of the prostate and the presence of pathological structures. The main advantage of transrectal ultrasound is the ability to perform targeted biopsies for further testing in suspected cases of prostate cancer.

Transurethral

Via the urethra.

Transurethral microwave thermotherapy (TUMT)

Thermal, minimally invasive procedure for treatment of benign prostatic hyperplasia (BPH) by inserting a microwave urinary catheter into the urethra.

Transurethral needle ablation of the prostate (TUNA)

Technique that uses low-energy radio frequency energy delivered through two needles to ablate (destroy) excess prostate tissue by heating it up to 100 degrees Celsius. The energy from the probe heats and destroys the abnormal prostate tissue.

Transurethral resection of the prostate (TURP)

Surgical technique involving visualisation of the prostate via the urethra and removing tissue by electrocautery or sharp dissection. TURP is the standard operation for treatment of benign enlargement of the prostate.

TRUS

see Transrectal ultrasound

Tumour

Any abnormal swelling or growth of body tissue. A distinction is drawn between benign and malignant tumours.

Tumour, lymph node, metastasis system (TNM staging system)

Classification of malignant tumours based on their extent.

Tumour markers

Biological substances, such as proteins, antigens or hormones, whose elevated concentrations may indicate cancer or relapse. They are produced by the cancer cells themselves or are a reaction of other body tissues to tumour growth. They are measured in the blood, urine or tissue. Examples of tumour markers include: PSA, alpha-fetoprotein, beta-hCG.

TUMT

see Transurethral microwave thermotherapy

TUNA

see Transurethral needle ablation of the prostate

TURP

see Transurethral resection of the prostate

U

Undescended testicles

When a testicle fails to drop from inside the abdomen down into the scrotum and remains in the inguinal canal (Retentio testis inguinalis). Results in fertility disorders and increased risk of testicular cancer if left untreated.

Ureter

The ureter is a tube approx. 25 - 30 cm in length that propels urine from the kidneys to the urinary bladder.

Ureteroscopy

Endoscopic examination of the ureter using a ureteroscope. If the renal pelvis is also examined, then the examination is called a ureterorenoscopy. A flexible fibre optic device (ureteroscope) is inserted into the ureter via the urethra and bladder. Here, urinary stones are able to be directly visualised and fragmented with a laser or retrieved with special micro-baskets and forceps.

Ureterostomy, cutaneous

Creation of an artificial hole for one or more of the ureters in the abdomen for draining the urine.

Urethra

The urethra is a tube that connects the urinary bladder to the urinary meatus for the removal of fluids from the body. The urethra in women is very short (approx. 3 - 4 cm in length) and emerges at the female external urethral orifice above the vaginal opening. In men, the urethra is 20 - 25 cm in length and emerges at the glans penis.

Urethritis

Inflammation of the urethra

Urethrocystoscopy

see Cystoscopy

Urge incontinence

Heavy urinary urge that results in loss of bladder control.

Urinary bladder

Hollow organ on the pelvic floor that collects urine. The volume of the urinary bladder is 350 - 750 mL in men and 250 - 550 mL in women. The ureter conveys the urine from the renal pelvis to the urinary bladder. If the urinary bladder is full, then it is emptied via the urethra.

Urinary incontinence (weak bladder)

Inability to keep the urine in the bladder (involuntary leakage of urine). Urination involves a complicated balance between urethral closure and detrusor muscle activity and is partially controlled voluntarily by the brain. The spinal cord is largely involved in involuntary urination. This balance may be disrupted at various points. As a result, this is often described as a neurological disorder of micturition in the case of pathological changes to the nerves that supply and control urination (micturition), e.g. in cases of paraplegia.

Stress urinary incontinence involves insufficient strength of the sphincter muscle of the bladder.

Urge incontinence involves involuntary urination or a heavy urinary urge that results in loss of bladder control.

Finally, overflow incontinence occurs when urine is no longer able to drain properly, e.g. due to an obstruction downstream from the bladder, e.g. prostatic hyperplasia, and the bladder ultimately "overflows". Damage to the nervous system, e.g. due to diabetes or alcoholism, may also result in overflow.

Urinary incontinence biofeedback training

Training method to reinforce proper contraction of the pelvic floor muscles. Acoustic or visual alarms enhance the effectiveness of pelvic floor exercises and support patients in restoring proper and effective contraction of the pelvic floor muscles. Pelvic floor exercises in conjunction with biofeedback demonstrate greater efficacy in the treatment and/or healing of stress urinary incontinence.

Urinary retention (ischuria)

Inability to completely empty the bladder. Causes may include enlarged prostate, a urinary stone, or urethral stricture. The bladder distends and becomes unbearably painful. Rapid treatment involves emptying the bladder by means of catheterisation.

Urinary stones

Calculi formed by crystals and occurring throughout the urinary tract, i.e. in the kidneys (kidney stones), ureter, bladder, and urethra. The calculi often consist in calcium oxalate crystals. They comprise approx. 70-75% of all urinary stones. Other common components include uric acid, calcium phosphate, struvite or cystine.

Urinary stones have various causes, including inadequate fluid intake that may result in excessive urine concentration with formation of calculi in the form of stones. Improper diet, obesity, inflammations of the urinary tract, metabolic disorders, e.g. hyperparathyroidism, urinary tract obstructions, e.g. narrowing of the renal pelvis, and congenital disorders, e.g. cystinuria, are causes of urinary stone formation.

Urinary tract infection (Inflammation of the urinary tract)

The urinary tract includes the kidneys, ureters, bladder, and the urethra. It is commonly believed that urine is sterile until it reaches the urethra. When bacteria in the urinary tract cause an infection, it is called a urinary tract infection. Such infections may involve outcomes of varying severity, from a simple bladder infection to life-threatening inflammations of the kidney (nephritis) involving fever. The detection of bacteria in the urine with no symptoms of illness is called bacteriuria (see Bacteriuria). Small children and women are most commonly affected by urinary tract infections due to their anatomy. In men, the risk of a urinary tract infection increases with age.

Urine

Urine (from Latin Urina) is a liquid by-product of the body that is eliminated through a process called urination (or micturition). It is secreted by the kidneys and excreted through the urethra. Urination regulates fluid and electrolyte levels in the body and eliminates metabolic degradation products, especially the nitrogen compounds formed during degradation of proteins and nucleotides. Human urine is a liquid that is mainly yellow in colour. Numerous diseases have an impact on the composition of the urine. As a result, urine tests can provide information about disease. The natural release of urine from the bladder is called urination (micturition).

Urine culture

Freshly obtained urine is applied to a culture medium and then incubated for 24 hours in an incubator. This enables the detection of bacterial growth. If growth occurs, then the pathogen is identified and tested. Once the results become available, the patient is able to receive targeted treatment with the best possible medications.

Urine cytology

Test to detect malignant cells in the urine or bladder irrigation fluid based on a special stain.

Urine flow rate

see Uroflowmetry

Uroflowmetry

Test used to measure the flow of urine during a certain period (mL/sec). The test provides information concerning diseases of the bladder or prostate. The patient urinates in a funnel connected to an electronic uroflowmeter and the test is completely painless.

Urography

see Excretory urography

Urosepsis

Life-threatening complication of an infection, e.g. of the urinary tract. Impaired urinary flow with simultaneous urinary tract infection results in fever, chills, malaise, and pain. Urosepsis is dangerous because it involves the passage of bacteria from the urine to the bloodstream and is often fatal if left untreated.

Urostomy

Surgical procedure that creates a stoma for drainage of the urine into an artificial external pouching system.

Urothelium

Type of epithelium that lines much of the urinary tract.

Uterus

Female reproductive sex organ in which the fertilised egg matures to an embryo and then a foetus prior to birth.

V

Vaginismus

Physical or psychological condition that affects a woman's ability to engage in any form of vaginal penetration.

Varicocele

Abnormal enlargement of the pampiniform venous plexus in the scrotum that is visible and palpable. In addition to pain in the region of the testicles and/or groin, the alteration of testosterone levels may limit male fertility.

Vas deferens

Segment of the male genital tract that conveys the sperm from the epididymis to the urethra.

Vasectomy

see Male sterilisation

Vesicoureteral reflux

Condition in which urine flows retrograde, or backward, from the bladder into the ureters/kidneys. May provide favourable conditions for infections.

Visual laser ablation of the prostate (VLAP)

Transurethral (=via the urethra) removal of the prostate using laser beams and an endoscope. Various types of lasers are used.

VLAP

See Visual laser ablation of the prostate (VLAP)

Vulva

External female genital organs, i.e. the mons pubis, the labia majora and labia minora, the Bartholin's glands, the clitoris, and the urethral orifice above the vaginal opening.

W

Weak bladder

see Urinary incontinence

Y

Yeast infection (Fungal infection)

The most common fungal infection in the genital region is called candidiasis. It is triggered by Candida (a type of yeast), which occur throughout the body and form a part of our normal skin and mucosal flora. If there is a disruption in the normal balance, Candida may become predominant. Fungal diseases in the genital region are not uncommon especially among women who use a hormonal contraceptive method. Taking medications, such as antibiotics or cortisone, may also provide favourable conditions for a yeast infection. While candidiasis often causes only minor symptoms in men, it may result in severe itching, burning, discharge, and discomfort during sexual intercourse in women. Diagnosis of a yeast infection is done by culturing to determine the exact fungal type. Special medications (antimycotics) are used for treatment.