Urology

Specialty Name

Urology Surgery focuses on operative care of the urinary tract and male reproductive system, including kidney, bladder, prostate, ureteral, and testicular procedures. CSTs in urology support a wide range of cases from endoscopic stone removal to robotic prostatectomy and open kidney surgery. This specialty requires strong knowledge of endoscopic equipment, laparoscopic and robotic workflows, and the ability to manage fluid‑intensive procedures with precision and sterile technique

Role of CSTs

  • Assist with patient positioning, prepping, and draping for cystoscopy, lithotripsy, robotic, and open surgeries.
  • Maintain sterile technique during fluid‑heavy endoscopic procedures.
  • Anticipate surgeon needs during stone retrieval, prostate dissection, bladder repair, and kidney surgery.
  • Manage endoscopic towers, irrigation systems, laser fibers, and stone baskets.
  • Support robotic workflows for prostatectomy, nephrectomy, and pelvic reconstruction.
  • Handle specimens including stones, biopsies, and tissue samples with proper labeling.
  • Assist with accurate counts and efficient room turnover during high‑volume urologic cases.

Essential Skills

  • Proficiency with cystoscopy instruments, ureteroscopes, and stone retrieval tools.
  • Ability to anticipate surgeon needs during endoscopic, laparoscopic, and robotic procedures.
  • Skilled in managing irrigation systems, fluid flow, and visualization during endoscopy.
  • Competence with laser safety, fiber handling, and energy devices.
  • Ability to maintain sterile technique during fluid‑intensive procedures.
  • Effective communication with surgeons, anesthesia, and nursing teams.
  • Familiarity with robotic prostatectomy and nephrectomy workflows

Common Procedures

  • TURP (transurethral resection of the prostate)
  • TURBT (transurethral resection of bladder tumor)
  • Ureteroscopy with laser lithotripsy
  • Robotic prostatectomy
  • Robotic or laparoscopic nephrectomy
  • Partial nephrectomy
  • Pyeloplasty
  • Vasectomy and varicocelectomy
  • Hydrocelectomy
  • Orchiectomy
  • Bladder repair and reconstruction
  • Stone extraction and stent placement

Instruments & Equipment

Instruments

  • Ureteroscopes and stone retrieval baskets
  • Laser fibers for lithotripsy
  • TURP/TURBT resectoscopes
  • Laparoscopic and robotic urology instruments
  • Kidney and adrenal surgery sets
  • Prostatectomy and pelvic dissection tools
  • Biopsy forceps and graspers
  • Catheterization and stent placement tools

Equipment

  • Continuous irrigation systems
  • Laser systems (Holmium, Thulium)
  • Electrosurgical generators
  • Robotic surgical platforms
  • Laparoscopic insufflation units
  • Suction and irrigation devices
  • Positioning devices for lithotomy and lateral access
  • Stone fragmentation and retrieval systems

Workflow & Case Progress

  1. Patient positioning in lithotomy, supine, or lateral depending on the procedure.
  2. Prepping and draping with attention to urinary tract access.
  3. Initial endoscopic, laparoscopic, robotic, or open entry.
  4. Visualization and treatment of pathology (stone removal, tumor resection, dissection).
  5. Irrigation management and fluid control throughout the procedure.
  6. Placement of stents, catheters, or drains as needed.
  7. Hemostasis and specimen retrieval.
  8. Closure of incisions or trocar sites.
  9. Final counts and transfer to PACU with appropriate handoff

Sterile Technique Considerations

  • Protect the sterile field during scope insertion and tower adjustments.
  • Handle laser fibers with strict sterile and safety technique.
  • Maintain sterile technique during robotic docking and instrument exchanges.
  • Manage multiple instrument trays efficiently during high‑volume stone cases.
  • Ensure sterile technique during conversions from endoscopic to open surgery.

Career Pathways

  • Endourology Specialist
  • Robotic Urology Technologist
  • Stone Management Specialist
  • Urology First Assist (with additional training)
  • Clinical educator for urologic instrumentation
  • Device representative for urology platforms and lasers
  • Hybrid OR urology technologist

How to Prepare

  • Learn cystoscopy and ureteroscopy instrument names and functions.
  • Practice handling laser fibers, baskets, and irrigation systems.
  • Review workflows for TURP, TURBT, prostatectomy, and nephrectomy.
  • Observe urology cases to understand pacing and fluid management.
  • Strengthen sterile technique for endoscopic and robotic procedures.
  • Build familiarity with stent placement, catheterization, and stone retrieval tools.