How to discover urinary diseases and the appliance of robotic arms
The human urinary system consists of a series of organs including kidneys, ureters, urethra, bladder, and prostate (for male). Unfortunately, urinary diseases are some of the most common among today’s population, regardless of gender or age. These diseases can be caused by other systemic diseases of the body, and also affect other systems and even our whole body. To make matters worse, some early-stage symptoms of urinary system diseases are hard to identify. With robotic arms used more and more widely in modern-day medical operations, including urinary system surgeries, the Global Times recently interviewed Dr Zhu Gang, Chief Urologist and Chair of Urology at Beijing United Family Hospital, who at the time had just completed a robotic-assisted surgery.
Global Times: Is there any specific group of people who are more at risk of urological diseases? Are middle-aged and senior males among the highest-risk groups?
Zhu: Urological diseases are common in all ages, including fetuses and babies, but the diseases of different ages are not the same. For small children, most patients are of congenital diseases, and for younger adults stone diseases are more common. There is about a 25-percent risk in a person’s lifetime that they will get the stone. Also, young adults are more likely to suffer from prostatitis while more senior and elderly people are patients with prostatic hyperplasia.
Global Times: What is the incidence of prostate cancer?
Zhu: Prostate cancer is a very common disease. It is ranked ninth among the top-10 most common tumors in China and the fifth-highest incidence of tumors among males. Compared with the Asian population, whose incidence rate is about 30/100,000, the European and American incidence rates are four times higher. Therefore, in Europe and the US, it is the second-highest mortality rate disease among males. But this disease has been thoroughly studied in every aspect from diagnoses, treatment and medicine.
Global Times: Is there any symptom that may easily be neglected but is an indication of urological diseases?
Zhu: Yes, there are a few. For example hematuria is the most commonly seen symptom of urological diseases, and painless hematuria is more of a precursor to tumors. Lumbago, or lower back pain, especially unilateral lower back pain, may indicate a kidney problem on that side. And high blood pressure can be an indication of adrenal problems. Family medical history is also a reason for prostate cancer.
A man, aged over 50, will have a two-times-higher incidence of prostate cancer if one family member has had it, and the incidence rate can be eight times higher if two family members have had prostate cancer. Therefore, I recommend regular medical examinations. I had a patient who had a 1.9-centimeter tumor. It was difficult to discover it without the examination. Because urological organs are deep inside our body, small tumors are hardly felt. But it is during a tumor’s early stage that the possibility of a cure is the highest.
Global Times: Recently, the Urology Department of Beijing United Family Hospital successful completed a very complicated robotic surgery for testicular cancer. Compared with open surgery and laparoscopic surgery, what are the advantages of robotic surgery?
Zhu: Speaking of surgery fineness, laparoscopic surgery is already a revolution, because a laparoscope is able to enlarge the picture of the operation area, making the vision clearer. Robotic surgeries can further enlarge the picture and help increase the fineness of surgery. In the aspects of safety, pain control and tumor control, robotic surgery is by far the best option. Robotic surgery has been widely applied in prostate cancer surgery. In the US, about 95 percent of prostate cancer radical operations are done by robotic arms.
Dr Zhu Gang (second from right) and this team receives a thank you card from a patient's daughter.
Dr Zhu Gang in a robotic surgery