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Common Urological Conditions

Haematuria (blood in the urine) ►

This is a distressing symptom.  It nearly always requires further investigation to determine its cause. A wide range of conditions including kidney stones, bladder tumours and urinary infection can cause Haematuria. Sometimes the blood in the urine is not detectable to the eye, and is only discovered on ‘dipstick’ testing.  This uses a chemical strip, dipped into a urine sample to detect microscopic amounts of blood. If the urological tests do not reveal any abnormality, then further referral to a kidney physician, (called a nephrologist) may be necessary. If you have had blood in the urine you should seek urological advice as a matter of urgency. If you are passing sizeable dark red blood clots you are at a risk of urinary retention and should attend your Accident & Emergency department immediately.

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Urinary Tract Infection ►

Whilst UTIs are relatively common in women, they are a rare occurrence in men, requiring investigation by a urologist. These include infections of the bladder, prostate, testicle or epididymis.  Recurrent infections in women also require investigation, as do changes in patterns of infection or symptoms of kidney infection (known as pyelonephritis).

Infections can produce urinary symptoms including stinging when passing urine (dysuria), changes in urinary frequency, and urgency (rushing to the toilet for fear of incontinence).  Persistence of these symptoms also warrants urinary investigation. There is an advice sheet available to help prevent infections in those patients who have been fully investigated (Click here).  Most infections are treatable by a short course of antibiotics. 

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Disorders of the penile foreskin (prepuce) ►

These are common and include phimosis, which is scarring at the tip of the prepuce with difficulty passing water or prepuce retraction. Other conditions include balanitis, which covers infections of the prepuce and tip of the penis and discomfort caused by tightness of the prepuce during sexual activity. These conditions are treatable by a range of surgical procedures including circumcision, frenuloplasty and prepucioplasty.

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Urinary symptoms ►

Urinary symptoms are known as Lower Urinary Tract Symptoms or LUTS for short. They are caused by a wide range of urological diseases and require investigation by a urologist to establish their cause. A common cause is benign prostatic enlargement (see below).

LUTS include:

  • Poor urinary flow
  • Nocturia (passing water at night frequently)
  • Day time urinary frequency (passing water too often during the day)
  • Urgency (having to rush to the toilet to pass urine for fear of passing water involuntarily)
  • A feeling of having incompletely emptied one’s bladder
  • Dribbling urine after passing water (post micturition dribbling)

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Prostate cancer ►

Prostate cancer is a common cancer and is often found in men in the absence of any symptoms. There is an increased incidence in men with a family history of prostate cancer. Most prostate cancers are not aggressive.

The diagnosis is based on biopsies of the prostate, otherwise known as trans rectal ultrasound guided biopsies of the prostate or TRUS biopsies for short.

The decision to undergo biopsies is based upon a blood test (prostate Specific Antigen or PSA for short) and a per rectum examination of the prostate with a gloved finger.

The mildest cases can be observed or put on a surveillance programme. More advanced cases may require surgery or radiotherapy, whilst the more severe cases require treatment with hormone injections, which puts the cancer into remission in most cases.

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Benign (non cancerous) prostatic enlargement ►

Benign prostatic enlargement (or BPE) describes a common condition of the aging male whereby the prostate increases in size and may compress the urethra as it leaves the bladder. This ‘squeezing of the water pipe’ produces symptoms of poor urinary flow, hesitancy, urinary frequency, nocturia and post micturition dribbling. BPE is usually treatable with drugs, though in some cases surgery of the prostate may be necessary.

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Overactive Bladder syndrome ►

A urologist diagnoses overactive Bladder syndrome and interstitial cystitis after thorough investigation. An overactive bladder causes very disruptive symptoms of urinary frequency and urgency. It is usually treatable with conservative measures and / or tablets, which reduce the bladder’s activity and allow the patient to take control of their bladder.

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Kidney stones ►

These are very common. They form in the hollow part of the kidney where the urine collects, known as the pelvi-calyceal system. Once formed, kidney stones have the propensity to fall into the slender tubes on either side of the body that drain the kidneys down to the bladder (called ureters). If a stone gets trapped in the ureter it produces an extremely severe pain.  This condition is called renal colic and it requires urgent intervention by a urologist.

It is preferable to treat kidney stones before they produce pain, using a range of medical and surgical treatments.  Prevention of kidney stones is possible through appropriate lifestyle management. This is very important for patients with a history of stones; there is a 50% risk of forming another stone within ten years of the first.

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Urinary incontinence ►

Urinary incontinence in men and women is a common, disabling but treatable condition. It is necessary to diagnose the cause of the incontinence, which may include pelvic floor weakness, bladder overactivity and ‘overflow’, which occurs when the bladder is retaining fluid, which then leaks out.  Treatments include physiotherapy, lifestyle changes, medication and surgery.

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Erectile dysfunction ►

Erectile dysfunction (ED) used to be called impotence. It is a very common condition of the aging male.  Nearly all men and their partners will have suffered as a result of this distressing condition at one time or another. Patients who have ED must be assessed by a suitably trained doctor, usually a urologist, to exclude serious underlying diseases such as diabetes, peripheral vascular disease (narrowing of the arteries) and neurological diseases, all of which require specialist treatment. There is a close relationship between ED and cardiovascular disease of the heart so close attention will be paid to the patient’s risk factors, such as cigarette smoking.

A urologist using a combination of carefully selected medical treatments and lifestyle changes can manage the vast majority of ED very successfully. Surgery is rarely necessary as these treatments are highly effective.

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Scrotal swellings ►

The majority of scrotal swellings are entirely benign, however your GP or Urologist should exclude testicular cancer in all cases.  Most scrotal swellings are attributable to a collection of fluid around the testicle (so-called hydrocoele) or benign cystic enlargement (epidydymal cyst). These swellings are amenable to surgical treatment if they are troublesome.

Infertility and vaso-vasostomy (vasectomy reversal) ►

Male infertility is a difficult and emotive problem that requires prompt and thorough investigation by a urologist.  There a wide range of causes to be excluded, such as testosterone deficiency. If no specific cause can be identified, patients require frank advice and specialist referral for assisted or in vitro fertilisation. For patients who have had a vasectomy we offer microtubular vasectomy reversal (vaso-vasostomy using a microscope) at the Oaks Hospital.

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Men’s Health ►

Many men have concerns about their general health including urinary and prostate health or sexual function. These concerns may be difficult to discuss for some people. A men’s 'health review' can provide direct access to expert advice, along with the opportunity for information, reassurance or the early diagnosis of urological and other conditions. The review would be tailored to the patient and include a combination of the following:

  • Urine testing
  • Kidney function testing
  • PSA testing in appropriately counselled patients
  • Investigations for poor libido and testosterone deficiency
  • Sexual health advice
  • Liver function testing and alcohol consumption advice
  • Lifestyle advice
  • Blood pressure and cholesterol check
  • Instruction in testicular self-examination

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This list of conditions is by no means exhaustive and we would be happy to discuss your problem with you in clinic.