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Urological Investigations and Investigative Procedures

Investigations and investigative procedures are done within Urology to identify certain conditions and rule out others. The following list describes some of the main urological investigations undertaken.

Urine Tests ►

  • Urine Dipstick - a chemical strip is dipped into a mid stream sample of urine to look for abnormalities
  • Urine Culture - a mid stream urinary sample is sent to the microbiology laboratory to look for evidence of a urinary infection. If an infection in the urine is shown, the lab technicians will also report on which antibiotics the bacteria are sensitive to.
  • Urine Cytology - a urine test to exclude the presence of abnormal looking cells.

Blood tests ►

  • Prostate Specific Antigen (PSA) - a blood test used to assess the need for taking biopsies of the prostate.
  • Urea and Electrolytes - a blood test for assessing kidney function

Urodynamic investigations to assess urinary flow and bladder function ►

  • Flow Rate - men are invited to pass water in a private setting into a machine that records the urinary flow. This is rather like passing water into a urinal. You will need a comfortably full bladder in order for this test to produce a meaningful result.
  • Post Void Residual - a quick and painless ultrasound scan is used to check how much urine is left behind in your bladder after you have just passed water.
  • Cystometerogram (CMG) - this investigative procedure is used to diagnose abnormalities of bladder function.  A tiny transducer (pressure sensor) is introduced into the bladder alongside a urethral catheter. Another transducer is introduced into the back passage.  It is very slim and not painful. The transducers are used to measure the pressure within the bladder as it is slowly filled and when water is passed. This is helpful in identifying the presence of any obstruction (blockage of the urethra) and in assessing the advisability of bladder outlet surgery, such as TURP.
  • Frequency / Volume Chart - patients are asked to complete a voiding diary, otherwise known as a frequency volume chart. Record is made of the amount of urine passed (in millimetres) and the time it is passed over a three-day period. This gives the urologist useful information about your bladder habit.

Cystoscopy ►

This is a telescopic examination of the bladder, usually performed using a local anaesthetic jelly placed down the urethra (the patient is awake throughout the procedure). Occasionally cystoscopy is performed under a general anaesthetic (whilst the patient is asleep).

Radiological investigations ►

These investigations are performed in the radiology department.

  • Ultrasound Scan - a painless scan that does not involve any radiation. It allows the operator to look at the organs inside the body using high frequency reflected sound waves. It is precisely the same technology used to image the unborn baby in pregnancy. The operator will generate a report for the radiologist.
  • Intravenous Urography (IVU) - involves the injection of an Xray dye (contrast) that is filtered from the blood by the kidneys and concentrated in the urine. A series of Xray pictures are then taken to capture the outline of the kidney collecting system, ureters and bladder.
  • Computerised Tomography (CT scan) - an Xray test that involves lying in a narrow tunnel. The CT scan machine takes virtual slices of the body and then the computer ‘reconstructs’ the images of the organs.  The radiologist (the doctor who specialises in the diagnosis and treatment of disease using these technologies) will then produce a report for the urologist.  Occasionally an injection of Xray dye is necessary, similar to an IVU, to help improve the accuracy of the test.
  • Trans Rectal Ultrasound (TRUS) guided biopsies of the prostate - performed to obtain samples from the prostate gland (called biopsies) in testing for for prostate cancer. A slim ultrasound probe (about the thickness of a finger) is placed into the back passage using a lubricating gel.  Local anaesthetic is injected around the prostate.  Around 20 biopsies are taken.  This procedure is uncomfortable for some patients. Patients on warfarin, clopidogrel or aspirin will need to have ceased taking these medications before the procedure.

If patients require further information about any urological investigation please contact Mr Maan to make an appointment.