We offer general urology services for conditions such as urinary stones, hematuria (blood in urine), hematospermia (blood in semen), prostate symptoms, urinary incontinence, erectile dysfunction, vasectomy, and circumcision where medically indicated.
We offer the procedures listed below:
Day case procedures
Other general procedures
Stone disease is very prevalent. It is estimated that 10% of the population will develop stone disease in their lifetime. A person who develops a kidney stone has a 50% risk of developing another stone in the next 10 years.
Yes. There are various types of stones – calcium oxalate, uric acid, triple phosphate, calcium phosphate and cystine stones.
Uric acid stones that are small can be dissolved with medication if they do not cause obstruction (pain, fever).
Recurrent stone formers should get their stone analysed to evaluate the type of stone. They must also get a 24 hour urine analysis to evaluate why they are forming recurrent stones.
General advice is to drink plenty of water, reduce salt in the diet and reduce animal protein. It is important to have a normal intake of calcium.
A high intake of animal protein can increase stone formation. Avoid large quantities of meat, eggs and dairy products.
Do not add salt to your food at the table.
Tips to help you increase your fluid intake:
Specific advice for certain stone types –
Individuals who are overweight also have high production of uric acid, therefore losing weight is beneficial.
There are three treatment options –
Stones can be treated provided patients do not have a concurrent infection. If there are signs of infection (fever, chills, etc) then drainage of the kidney as a temporary measure is necessary followed, at a later date, by definitive treatment of the stone.
ESWL cannot be done in pregnancy, patients on blood thinning medication (eg warfarin, xarelto, dabigatran, clopidogrel, brillanta), very overweight individuals.
Poor urine flow can be due to obstruction to flow such as a stricture urethra (narrowing in the urine tube) or prostatic enlargement. Occasionally this can be due to weak bladder musculature.
This is a normal process of ageing whereby the prostate enlarges in size. It can obstruct the flow of urine by impinging on the urethra.
BPH treatment is aimed at improving the lifestyle of the person involved and treatment is only necessary if the symptoms are moderate to severe. Mild symptoms require lifestyle modifications. A consultation with a Urologist is required to discuss this further.
For moderate and severe symptoms –
Several options include – urolift procedure, transurethral surgery and Greenlight laser ablation to remove the enlarged portion of the prostate.
Surgery for the treatment of BPH, by either TURP or open prostatectomy, only removes a part of the prostate gland; the section around the urethra that is blocking urine flow is removed. Prostate cancer is often treated by a radical prostatectomy where the whole prostate gland is removed.
Alpha blockers (Prazosin, Tamsulosin, Alfuzosin, Terazosin) – giddiness, dizziness, nasal congestion, retrograde ejaculation (semen goes back in the bladder rather than out the urethra on ejaculation), fatigue, precipitation of narrow angle glaucoma.
Caution – avoid if undergoing cataract surgery in the near future. Please refer to specific drug pamphlet for drug interactions and further useful information.
5 Alpha Reductase Inhibitors (Finasteride, Dutasteride) – fatigue, tiredness, decrease in libido decrease in ejaculate, erectile dysfunction, breast tenderness.
Caution – needs regular PSA assessment. This drug reduces the PSA levels and prostate cancer can occur at lower levels of PSA. Please refer to specific drug pamphlet for drug interactions and other useful information.
Combination therapy – alpha blocker along with 5 ARI.
The inability to sustain an erection to have a satisfactory sexual intercourse is called Erectile dysfunction.
1 in 5 men over the age of 40 years suffer from ED.
The cause is usually multifactorial in most cases.
Lifestyle modifications such as regular exercise, healthy diet, maintaining appropriate weight, avoiding excessive alcohol, smoking cessation and other factors causing atherosclerosis that can delay the occurrence of age related impotence.
On demand dosing –
Sildenafil – 25, 50, 100mg – recommended starting dose 5omg
Verdenafil – 5, 10, 20 mg – recommended starting dose 10 mg
Tadalafil – 10, 20mg – recommended starting dose 20mg
Daily dosing –
Tadalafil 5 mg daily
Common side-effects: headaches, flushing, dyspepsia, nasal congestion, backache and myalgia
Contraindicated in patients who take long and short-acting nitrates, nitrate-containing medications, or recreational nitrates (amyl nitrate)
Caution in patients with: ischaemic heart disease, heart failure, hypertensive with multidrug regimen and those taking other drugs which can prolong the action of PDE5I. Please refer to specific drug pamphlet for drug interactions and other useful information.
Recommended maximum usage is 3 times a week, with at least 24hrs between uses.
Contraindicated in men with hypersensitivity to the drug or risk of priapism. Please refer to specific drug pamphlet for drug interactions and other useful information.
Premature ejaculation happens when a man is unable to control the timing of ejaculation, and ejaculates before he and/or his partner feels ready for this to happen, and this causes distress.
This occurs due to imbalance in the chemicals resulting in lower threshold of ejaculation.
This occurs due to performance anxiety, new relationship, religious beliefs, etc.
Side effects – nausea, headache, diarrhoea, somnolence and dizziness. Refer to specific drug pamphlet for drug interactions and other useful information.