Urological Services & Treatments

Blood in the urine (haematuria) can be visible (frank blood) or non-visible (detected via urine test). While often caused by non-cancerous conditions like UTIs or kidney stones, prompt evaluation is essential to rule out serious conditions.

Symptoms & Warning Signs

• Visible Haematuria: Urine appears pink, red, or dark brown.
• Non-Visible Haematuria: Found incidentally during routine health checks or urine dipstick tests.
• Associated Symptoms: Burning sensation when urinating, lower abdominal pain, back pain, or urinary frequency.

Diagnostic Investigations Offered

Following NICE NG12 guidelines for urgent urological assessment, we offer comprehensive, same-day diagnostic pathways:

• Urine Microscopy & Culture: To check for infection, kidney markers, or inflammatory cells.
• Flexible Cystoscopy: A quick, local-anaesthetic procedure using a thin, flexible telescope to directly inspect the lining of your bladder and urethra.
• Upper Tract Imaging: High-resolution Ultrasound or Multiphasic Contrast-Enhanced CT Urography (CTU) to evaluate the kidneys and ureters.
• Blood Tests: Kidney function (eGFR/Creatinine) and Full Blood Count.

Treatments

• Infections: Directed antibiotic therapy following culture sensitivities.
• Kidney/Bladder Stones: Minimally invasive removal or laser stone surgery (lithotripsy/ureteroscopy).
• Bladder Lesions: Endoscopic bladder tumor resection (TURBT) or surveillance plans.

Lower Urinary Tract Symptoms (LUTS) are common as men age and are frequently caused by Benign Prostatic Enlargement (BPE) or overactivity of the bladder muscle.

Symptoms

• Voiding Symptoms: Weak stream, hesitancy, straining, or incomplete bladder emptying.
• Storage Symptoms: Increased urgency, frequency, waking up multiple times at night (nocturia), or incontinence.
• Post-Micturition Symptoms: Dribbling after you have finished urinating.

Diagnostic Investigations Offered

• IPSS Score: Standardized questionnaire to measure symptom severity.
• Bladder Diary: Minimum 3-day tracking of fluid intake and urine output.
• Flow Rate & PVR Scan: Non-invasive ultrasound measure of urine flow strength and remaining urine.
• Digital Rectal Examination (DRE): Physical examination of prostate size and shape.
• Blood Tests: Prostate-Specific Antigen (PSA) testing and renal function tests.

Treatments Offered

• Conservative: Fluid modification, caffeine/alcohol reduction, bladder training.
• Medical: Alpha-blockers (Tamsulosin), 5-ARIs, Antimuscarinics/Beta-3 agonists.
• Surgical: TURP, Trans urethral Incision, Urolift, Laser Prostate Surgery (HoLEP).

A gentle, highly effective, permanent contraceptive solution for men. The technique eliminates the traditional fear of needles and surgical incisions, offering a fast recovery.

Key Benefits

• No Needles: Local anaesthetic is delivered using a specialized pneumatic jet-spray device that numbs the area instantly.
• No Scalpel: A tiny puncture access point is created instead of a surgical incision.
• Rapid Recovery: Performed under local anaesthetic in around 15–20 minutes.

The Procedure Pathway

• Initial Consultation: Medical history check, explanation of permanence, and consent.
• Procedure: Outpatient setting using jet-spray local anaesthesia and gentle division of the vas deferens tubes.
• Post-Procedure Care: Clear post-op recovery guidance.
• Clearance Testing: Semen analysis at 12–16 weeks post-procedure.

We provide compassionate, expert evaluation aligned with NICE NG123 guidelines to help restore your comfort and confidence.

Types of Incontinence

• Stress Urinary Incontinence (SUI): Leakage when coughing, laughing, sneezing, or exercising.
• Urgency Urinary Incontinence (UUI): Sudden, intense urge to urinate followed by involuntary leakage.
• Mixed Incontinence: A combination of stress and urgency symptoms.

Diagnostic Investigations Offered

• Bladder Diary: 3-day log of intake, output, and leakage.
• Urine Dipstick & Culture: To exclude active infection.
• Pelvic Examination: To check for associated pelvic organ prolapse.
• Urodynamics: Specialist pressure testing of the bladder to guide surgical planning.

Treatments

• First-Line: Pelvic Floor Muscle Training (PFMT), Bladder Retraining, lifestyle modifications.
• Medical: Antimuscarinics, Mirabegron, Topical vaginal oestrogen therapy.
• Advanced/Surgical: Botox injections, Percutaneous Tibial Nerve Stimulation (PTNS), Non-mesh surgical procedures (slings/colposuspension).

We offer expert, sensitive evaluation and management for a range of benign penile and scrotal conditions in adults.

Conditions Treated

• Erectile Dysfunction (ED) & Peyronie’s Disease: Evaluation of vascular/hormonal health, curvature, and painful erections.
• Phimosis & Balanitis: Recurrent inflammation or difficulty retracting the foreskin.
• Hydrocele & Epididymal Cysts: Fluid-filled swellings causing heaviness or discomfort.
• Varicocele: Enlarged veins within the scrotum.
• Testicular Pain: Investigation of persistent pain or unexplained lumps.

Diagnostic Investigations Offered

• High-Resolution Scrotal Ultrasound.
• Hormonal & Blood Profiles (Testosterone, LH, FSH, prolactin).
• Penile Vascular Ultrasound.

Treatments Offered

• Medical Treatments: Targeted oral therapies (PDE5 inhibitors), topical therapies.
• Surgical Procedures: Circumcision, Frenuloplasty, Hydrocelectomy, Epididymal Cystectomy, Varicocele Embolisation.
• Peyronie’s Disease: Conservative, injectable, or corrective surgical options.

Recurrent UTIs cause significant discomfort and disruption. Management follows a stepped, individualized approach starting with non-pharmacological measures, progressing to non-antibiotic strategies, and utilizing targeted antibiotics when necessary.

When Immediate Referral is Needed ("Red Flags")

• 2 or more episodes of symptomatic UTI within 6 months, or 3 or more within 12 months.
• Visible Haematuria (warrants urgent cancer pathway).
• High Fever, Chills, or Rigors (signs of acute pyelonephritis).
• Flank or Severe Kidney Pain.
• Inability to Pass Urine (Acute Retention).

Diagnostic Investigations

• Microbiological: Mid-Stream Urine (MSU) Culture before antibiotics to prevent unnecessary exposure and identify resistant organisms.
• Imaging: Ultrasound Scan of the Urinary Tract (KUB), Post-Void Residual (PVR) Volume Measurement, CT Urogram for complex cases.
• Cystoscopy & Urodynamics: Flexible Cystoscopy and Uroflowmetry/Multichannel Urodynamics if underlying bladder dyssynergia is suspected.

Gender-Specific Clinical Considerations

Evidence-Based Stepped Treatment

• Step 1: Lifestyle - Fluid intake, voiding hygiene, avoidance of irritants.
• Step 2: Non-Antibiotic - Vaginal Oestrogen Therapy, Methenamine Hippurate, D-Mannose/Cranberry.
• Step 3: Targeted Antibiotics - Single-Dose Post-Coital Prophylaxis, Stand-By Antibiotic Therapy, Low-Dose Continuous Prophylaxis (3-6 months).
• Step 4: Advanced - Intravesical Instillation Therapy (Hyaluronic Acid/Chondroitin Sulfate), Surgical Correction (TURP, HoLEP, prolapse repair).