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Urology: Mr Tony Tien

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Summary

This on-demand teaching session is a must attend event for medical professionals interested in the specialty of Urology. It will be presented by a Urology Registrar, Mr. Tony Tnm and will cover Urology as a specialty, the various subspecialties, why Urology is a great specialty to work in, and a typical week in Urology training. We'll also look at the various techniques used to perform common Urology procedures and discuss various medical management treatments. Don't miss this great opportunity to learn more about Urology from an expert in the field!

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Learning objectives

Learning Objectives:

  1. Learn about the specialty of urology and why it is a friendly and beneficial career path.
  2. Become familiar with the different types of surgeries and medical treatments for specific urological conditions.
  3. Identify the endoscopic and open surgeries used to treat bladder and prostate cancers.
  4. Understand the management of urinary stones with flexible ureteroscopy and percutaneous nephrolithotomy.
  5. Acquire knowledge of the robotic arms used in laparoscopic and oncological surgeries.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

And so we'll move on to our plan. Ultimate talk of the day. So we have Mister Toney tnm who is a urology trail e on. He'll receive be, you know, speaking about urology as a specialty. You know, on why you should be interested on. Then we'll move onto plastics on then and we'll close the session. Thank you. Okay, great. Thank you for the introduction. Can everyone just confirm that you can hear me? Yeah. And see that? Okay. Perfect. So my name is the Tony too, and I'm a urology. Registrars from North London Diener E. I'm also the be thought medical student and foundation, not representative. So welcome to what I think is the friendliest on the best specialty. Eso the urology is the medical and surgical management off the urinary tract for both males and females. However, we also manage the male genitalia as the female genitalia is managed by the gynecologist. So about me, my path to urology. I graduated from Imperial Medical School in 2015 during the six years at medical school, and I did not get any urology rotation. I have my surgical rotations were a cataract surgery or general surgery, EMT, orthopedics and vascular surgery. I'm at the time of graduating. I knew I wanted to do surgery, but I wasn't quite sure what at that point I thought it might be colorectal surgery of vascular surgery. I then did my foundation training program for two years on again. I did not get a urology basement because I didn't really know I wanted to do urology then, but I thought I should try other such but specialties first. So I didn't taste a week in urology as an F one. Really enjoyed it. Fantastic trainers and very enthusiastic. Um, I thought I couldn't have my creative a shin based on one week. So again I did another, found another taste, weaken fto and again loved, loved it. And therefore my career aspirations is based on two weeks. So I applied for a course surgical training with a urology theme. So it was 12 months of neurology on other surgical specialties and then took a year to dom some research on clinical work before I became a urology training last year. So a lot of urologists are trained in core urology and also emergency urology, but they also attempt to train in in a subspecialty of urology such as the subspecialties on the side on the right hand side. On day I will go through then now, so call urology involves management off your teen urological problems, such as bladder cancers. On the left is a transurethral resection of the bladder tumor. So is on endoscopic procedure shaving way out? Bladder cancer on the same. On the top right is a T u R P PSA transurethral resection of the prostate. So again, we shave away at the prostate to get a bigger channels that to help the patient be through eso as well as endoscopic surgery. We do open surgery, said Watch, um, we could do circumcisions for various reasons and also on scrotal surgery. So hydrocele repair. We have a range off emergency urological problems. So at the on the top left his testicle it origin so twisted and testicle we have to save it or remove it. If it's too late on top, right is a fractured Penis. That area between represents a bazillion sign that you get with a fractured Penis, and it's our job to repair. It's an outpatient, doesn't get erectile dysfunction. Not unless our catheters that we manage with your would manage. Urinary retention is well, bottom right is an X ray with a patient. What looks like a four considers Penis for his urethra. So, Endo urology is the management of urinary tract stones. So on the radio graft on top left, consider stones in the stem cell. Inside it in the middle is a flexible ureteroscopy. So we use a thin urethroscope going into the kidney, and we use a laser to break down the stone and remove the stone fragments with a basket. On the bottom is a perfect a mist nephrolithotomy that involves making a hole in the patients back in the into the kidney and using instruments to break down the stains on relieve it from the patient. Oncology. In neurology, we have your kidney cancers, bladder cancers, prostate cancer so we can be removing each of these organs in London the mainstay off oncology operations or robotic Now so we dont want IQ cystectomies nephrectomies prostatectomy is here. The robotic arms are in the patient on. Then you stay on the console there on the operating from the console and the robotic arms do the movements that you're making on some units in the country also still do laparoscopic surgery as well. On the top, right is a partial nephrectomy. So it is a tumor there, and they're just removing the cancer only, and so even be kidney back up. Female neurological and your dynamic urology is mainly for female incontinence or incontinence in general. So the operation top left is the using a bit of small bell on making loopholes of it and stitching this onto the bladder so that you're increasing the bladder capacity so that they can hold more urine on the top. Right is on Eylea conduit. See a diverting the year and from the kidneys via a bit of the, um, bound again out into the abdomen. Virus Stamos. So that urine is coming out from stoma on in urology. I'm not, I'm describing are showing you what operations that we do. But the main stay off operative amazed A of treatment for our neurology patients are medical management, So the bottom is oh, talks. We can inject Botox into the patient's bladder to relax the bladder to help herget continents and overactive bladders. Andrology is the urology subspecialty dealing with male genitalia. So in Perot knees disease, which is a angulation of the Penis, we can. If it prevents the patient from having penetrative and sex, then we can do operations. The streets in the Penis. Also, the bottom right is a penile implant. So this is for erectile dysfunction is the last resort. So, as I explained, there's lots of medical treatments of four erectile dysfunction. But the last resort is a penile implant. For for the patient to have sexual intercourse in at the top is a microscope. So in mail, we also deal with male infertility. So if if I pay a there's a male patient who's infertile, then we can open up the testes and extract sperm cells for IVF. The other subspecialty, which is a newer subspecialty, now is advanced general urology. So there's a shift in trying to get a urologist to be able to provide all different types of a bladder out flu surgery because they're so many new and novel techniques now. So the top left is, ah, home, um, laser Nucleation of the prostate. It uses a laser to core out the prostate, pushed a prostate lobes into the bladder, and it uses a morcellator, which shreds up the prostate tissue or lobes on. Then it removes the prostate tissue in the top. Right is your left, which is like using a staple gun to stable. The prostate loads the side so that it creates a bigger channel on bottom. Left is resume, so it's a steam therapy. We inject a needle inside the prostate, and then you administer the steam treatment over time, the prostate in the Crozes on trips away, giving a larger channel on bottom. Right is green light phototherapy for the prostate, and again he achieves a wider channel. Other possible subspecialties in neurology include transplant surgery. So one of my consultants at my current hospital is a transplant surgeon and also a urologist. So she does transplant surgery. You can do pediatric urology as well. So pediatric patients who have understand the testicles, which leads operations to bring the testicle down. This is, ah, hypospadias repair. So this is when the opening of the urethra is further down the penile shaft or not, the distal tip on. Therefore, they are operations that we can do Teo to repair that only if it causes the patient's problems. So Why should you choose urology? Well, I feel like at the urology has an incredible breath. I think there's there's something for everyone because it's such a big variety of your energy, and there's a good variety of surgery. Diagnostics of minor procedures. So diagnostic PSA that prostate biopsies looking for cancer or flexible cystoscopy is there. Cameras look inside the bladder, looking for better cancers. There's a good mixture of medical management and surgeries. As I said, Main, stay off our neurology patient's medical treatment on generally is very good work. Life balance. Eso. If that's important to you, then do you consider urology on? I think it embraces new technology as well. So it is always new treatment for breaking down stones. I'm extracting stones of new, different type lasers on There's not some research going on. All the time in urology is is good offering off academia on I. I feel like what draw What drew me to urology is is a really friendly specialty, and great colleagues on the urologist tend to be very happy with their work on at work. So it's just a very good team dynamic in general. So this is what a typical week may look like in, you know, as a urology train. Easy, my decent. The case fitters on also some plastic biopsy clinics, flexible cystoscopy clinics. You get abdomen. Session can do an out patient clinic out patient clinic. A swell or uro dynamics is a test looking for a bladder sort of bladder out flu symptoms or just lower unit tract symptoms. In general, I'm also incontinence on. Then we can also have scenery. Teaching and MG T sessions is well, so there are a couple of paths to becoming a urologist. You go three foundation training on. Then you can go to court surgical training on then apply for specialty training on each of these arrows represent another interview process. There's also an academic clinical fellow, so a CF hosts well throughout the country. After foundation training, you can apply to that. It's a runs really program between ST One ST seven and then you can become a soldier at the end. It's not magic parts every year, mostly exam at the end of the training program, so foundation training is a two year program off different specialties. If you are interested in neurology, then prioritize urology when you rack your jobs to try to get a urology mutation, you may. If you do general surgery, you may also cover urology whilst on call, which is something that I will sit dead on. What I did was doing a taste the week of both F one F two. So once you've decided that you want to urology, then you can apply for course surgical training after foundation program, which is two years usually themto one specialty. So I wrote minimum or six months urology. But to have a good chance of the interview for ST three, you should do at least 12 months of urology, which is what I did on you would also do other rotations, such as general surgery in some regions of this opportunity to act up on be on the registrar rotor. So that was what I had to do for a year CT two, which is really beneficial for me as I was acting as a registration. So it was a good experience for when I would be asked, became register and you're expected to pass your membership to develop colleges surgeons by the end of court treating if you feel like research is something that you would like to do them. Consider applying for a CF post. Um, you can do research alongside of your clinical work, so you're given one day, a week of research or a research block on, and you'll be in a scientist supervised as well. So generally the tips for applications look ahead the next step for when your next applying for a job. So as an F one, I was looking at the CST portfolio guidance and trying to take off things as I go along my foundation training on. Also, look at ST three applications. Early on, you focus on the minimum entry requirements first and then plan to finish off your portfolio and try to get many points as possible. Always a link up with your registrars that you work with locally in the hospital on consultants on Baskin for advice would get them involved. Get them to involve your projects because you make it publications and presentations out there and also try to get as much hands on experience with urology as much as possible. So this is a photo off the last social of the more funding meeting, so we are very diverse bunch off surgeons. So, as you can see, is a good mix of males and females. Traditionally back in two days, I had a consulting urologist say that urology consult tend to be pale mail and stale on, but we're certainly moving on from those days, and it's a very sociable specialty on the first. A very diverse group was well, so I'm just going to tell you a bit about the Be Thought Conference is the salt sounds for past section of trainees were holding a conference in January next year. So we are accepting abstract. So if you do have any abstracts of projects that you're involved with and do something in the abstract, I'm also doing a medical student pre conference courses well, for the morning before the actual conference to do come along for that on. But if there are any questions, are happy to take them all. You could email the or essentially on Twitter. Great. Thank you, Tony. Um, has anyone got any questions? I'll just give them a second to type them in their chest if that if they have and telling you might said to worry. But what what I'm sort of part of urology you interested in specifically, You know, if you know so far or what it's too like, Yes, So that's the difficult bit because I do not know quite exactly what I want to do at the moment, So I do like, or urology and just finish up off my core urology. But I do need to pick us up. Specialty. I'm thinking about advanced general urology now and stone surgery on, so that might be something that I want to do. So, like Harry left operations for the prostates on stone surgery is a lot of a laser work because my breaking down students, I might do a mix off stones on her left. But I'm at the hospital. I'm currently out. They do robotic nephrectomies as well. So I was hoping the ST a few of those to see whether I like them. If I do, then I'm like to see something like that. Yeah, Nice. This year, that seems to be a lot of options with urology that I didn't quite appreciate. I don't think before that, and I can't. So we haven't got any questions in the chart at present. And so I I think every if we move on, then that would be great. But thank you very much for your talk on. All right. Thank you. Thank you for having me.