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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Urologist
Category: Urology
Satisfied Customers: 34679
Experience:  MBBS MS (Surgery) Vast experience and routinely perform all urology procedures including endoscopy.
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Why would a urologists want to do exploratory surgery on a

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Why would a urologists want to do exploratory surgery on a male that's 64 years old who had blood in there urine and thought that it was because of kidney stones?



What are the previous investigations and medical imaging done?


Dr. Arun

Customer: replied 8 years ago.
A CAT scan was done and they did find some small kidney stones. But the doctor said that they were too small to cause the blood in his urine. So now there check for cancer.



Nowadays medical imaging has evolved leaps and bounds and exploratory surgery in just suspicion of cancer is usually not done. Following are the steps to detect cancer in cases of suspicion;


1) Urine cytology; the cancer cells in urine would show in majority of incidences.

2) Intravenous pyelogram

3) Renal scan; it is a nuclear scan study, shows malignancy.

4) Renal angiogram; likely to show any growth in kidney as there would be new blood vessel formation.


Urologist can contemplate these investigations which are sure to reveal, if there is cancer.


Please feel free for your follow up questions.


Dr. Arun

Customer: replied 8 years ago.
So exploratory surgery is an option that a urologist would not use these. what about hematuria? would that be a reason for exploratory surgery?



Hematuria or blood in urine cannot be the reason for doing exploratory surgery. If the urologist do all the investigations, I had mentioned, he is very likely to ascertain the cause of hematuria and surgery may not be required. The various causes for this bleeding in urine (hematuria) can be;


1) Kidney and bladder stones

2) Urinary Tract Obstruction

3) Urinary Tract Trauma

4) Excessive exercise

5) Urinary tract Infection

6) Sickle Cell Disease

7) Kidney and bladder tumor


Read the resource;


Urine culture and an ultrasound are the first investigative protocol. Intravenous pyelography, CT scan, cystoscopy, etc may be followed depending on the initial investigative results. The investigation of hematuria begins with a search for bacteruria (bacteria in urine) or pyuria (pus in urine). If either is present, a urine culture should be ordered to confirm urinary tract infection (UTI). In the absence of infection, the next step is to distinguish glomerular and nonglomerular sources of hematuria. Following would be required in step wise fashion;


1) Intravenous pyelography

2) Multidetector CT urography

3) Cystoscopy (camera examination)


If these investigations are not conclusive for the diagnosis MR urography would be advised.


It is pleasure and privilege assisting you.


Dr. Arun

Customer: replied 8 years ago.

Dr. Phophalia,


I just found out that the doctor will be doing a cystoscopy. Does this mean it could something very serious? or When a urologist perform that procedure what does that mean?



Cystoscopy is to see the bladder with a camera. By this, urologist want to see if there is a source in the bladder which is responsible for the hematuria. This can be a bladder stone or bladder tumor. Prostate also is visualized in the procedure. This does not points to the seriousness of the disease. This is a standard protocol of the care.


Dr. Arun

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