Changes in Urology Treatment

Pacific Urology founders Drs. Stephen Taylor and Donald Hay strongly agree on one problem: the misperception that urology treatment requires surgery, long recovery times, outcomes that are not guaranteed or life-changing side effects.

“The truth is, it’s almost painless and quick and easy because of advancements in medical technology,” Taylor said.

Robotic surgery along with non-invasive and minimally invasive techniques are allowing urologists to enhance the quality of lives more simply than ever before.  “Urology has come a long way in the last 30 years,” Hay said. “Gentle modern day techniques and diagnostic tools used in the urologists’ office are excellent and non-invasive.”

“Twenty percent of what we did when we came out of medical school was open kidney stone surgery. We haven’t done that since 1985,” Taylor said.

Prostate biopsy, once a surgical procedure, has become an everyday test for urologists and is now painless for patients. Prostate cancer, once often considered a death sentence, is becoming more easily detectable early, allowing immediate treatment that is saving lives.

“Before the PSA (prostate-specific antigen) blood test, 90 percent of patients with prostate cancer presented to us at incurable stages. Now with the PSA, we can detect it 90 percent of the time when it is still potentially curable. Instantaneous painless ultrasound guided biopsies performed in a thousandth of a second to establish a diagnosis are a breakthrough,” Taylor said.

“As time went on our diagnostic tools have become better. When advanced imaging machines like CT scans and MRIs were developed, we didn’t have to perform exploratory surgeries anymore. These scans allowed us to determine if there was any  need for surgery,” Hay said.

Not only did CT scans and MRIs become routine tools for urologists, technology continued to advance so the scans became clearer and easier to read. This continued the trend towards faster and more accurate diagnosis.

“In 1987 technology advanced to the point where we could have ultrasound machines in our office. Before then, they were very expensive and the resolution wasn’t very good. With the improvements in the computer technology the images became dramatically better and easy to read,” Taylor said, adding that ultrasound “revolutionized” prostate cancer diagnosis.

But what many doctors consider to be the greatest revolution yet in urology is less than ten years old; minimally invasive robotic surgery.

“When the da Vinci robot came out, it specifically found a niche in urology. We felt like it was developed for urologists. Very few procedures remain that we have to do with open incisions,” Taylor said.  Looking to the future of medicine, Taylor foresees a day when cancer will be curable. Scientists are working on this right now, he said.

“I think within the next ten years kidney cancer will be treated with a pill or a shot as opposed to surgery,” Taylor said. “I think that will be true for all the cancers.”

Noteable changes in Urology

4000-BC	Circumcisions are first performed in Egypt.
400-BC	The Oath of Hippocrates is written: “I will not cut, even for the stone, but will leave such procedures to the practitioners of that craft.”
1556	French surgeon Pierre Franco successfully removes bladder stones from a child through a suprapublic incision.
1800’s	Practitioners of water casting attempted to diagnose a variety of diseases by observing patients’ urine in a flask.
1824	The procedure for crushing a bladder stone, known as lithotripsy, was performed by Jean Civiale in France.
1878	Maximilian Carl-Friedrich Nitze, a German urologist, presented the first working cystoscope.
1977	The human body is scanned with an MRI for the first time.
1994	The PSA Test is approved by the Food and Drug Administration.
2000's	The da Vinci robot revolutionizes minimally invasive surgical techniques.