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Expert assessment and treatment of urological symptoms
It’s important to have the division, as we have to triage patients – via referrals we get from primary care – and some cases are less urgent than others, says our Consultant Urologist.
We tend to see the urgent cases here in clinic first.
The urgent patients are those with suspected cancer – prostate cancer may be suspected after a PSA (Prostate-specific antigen) blood test. Patients will have blood tests done via their GP – and if the PSA comes back slightly higher than the threshold, they may come to see us here at Albyn Hospital.
These patients may be experiencing some symptoms, for example, abdominal pain – usually in older, male patients. We would see these patients urgently and organise scans and prostate biopsies, if necessary.
Another symptom which may be indicative of cancer is visible blood in the urine; this may signify bladder cancer. An urgent referral will come to us, in this instance – and we will see the patient and organise urgent testing, such as a cystoscopy and an ultrasound scan.
Other types of urgent, urological cancers we see within our clinic include:
Within the benign cancer group, there are patients who will still need to be seen urgently – especially those with pain – including bladder pain (which could be due to an infection), kidney pain, or painful bladder syndrome.
With the latter, people tend to have lots of urinary symptoms, on top of pain and they may wake up at night to pass urine.
Kidney-type pain could be due to urinary tract infection, or kidney stones, which can cause a lot of grief and misery. Some of them can become an emergency, causing an obstruction in the kidneys, which can cause sepsis – an infection, which means these patients are also seen relatively urgently.
The more ‘routine’ and less urgent things we see in clinic include females with incontinence of urine – either stress incontinence of urine or urge incontinence of urine.
We see a lot of people with urinary tract infections, which is common, especially amongst women. We will see those patients and do what’s called a flow test – a physical test, where the patient will pass urine into a special machine containing a small bottle, which measures the flow of urine. This allows us to work out if the patient has a good flow or a poor flow.
A poor flow signifies obstruction, which can cause infection, in both males and females. We also perform cystoscopies on patients, to take a look at the obstruction and see if it’s mild or moderate. This is used for patients who get a lot of urinary tract infections.
For men, urinary symptoms – especially in older men – are usually due to obstruction of prostate enlargement, i.e. in benign prostate enlargement. Those patients are seen routinely, not necessarily urgently.
We also see a lot of patients with foreskin problems – i.e. the foreskin being tight, or unretractable. It’s a medical condition called phimosis and a lot of these patients may need surgery, in the form of a circumcision.
Vasectomy is offered at Albyn Hospital too. It is also available on the NHS, but the waiting list is long, so lots of people prefer to get it done privately.
Our Consultant Urological Surgeon will take a full medical history and ask you if you have any allergies. He will also ask you about your symptoms and how they are affecting your day-to-day life.
He may need to schedule some examinations, including a cystoscopy, which allows us to get a better look at the bladder.
Diagnostic cystoscopies, if needed, are done in theatre and usually under local anaesthetic.
Cystoscopies will be performed under general anaesthetic if we are expecting to do something – such as dealing with a blockage or stretching the urethra via something called a hydrodistension.
For those with a tight foreskin of the penis, circumcision is another common surgery performed within Albyn, as is urethral dilatation (also known as a stretch of the urethra).
A prostate operation, which will clear the prostate of an obstruction, including stones of the bladder (bladder stones) is another intervention offered, if needed. The procedure is called cystolitholapaxy and it is done endoscopically, so there are no cuts in the skin.
Medical surgeries or procedures aren’t always needed. Often, pain medication (such as Amitriptyline) is used for pain for urological conditions, including painful bladder syndrome.
The theory for painful bladder syndrome is that normally there is a lining of protein underneath the surface of the bladder. In this condition, though, this layer of protein is deficient or missing altogether, which is why the bladder is exposed to urine, which can cause symptoms of the bladder.
Below is a full list of the treatments we offer for urological conditions:
This is a diagnostic test, which involves us putting a small catheter into the bladder and another catheter up the back passage.
The catheter in the bladder fills up the bladder slowly with water, and the catheter measures the pressure of the bladder. It’s a useful test to do on patients who have problems with the bladder, including those with painful bladder syndrome.
If you’re looking for a urologist in Aberdeen, Albyn Hospital provides a wide range of Consultant-led appointments. At a glance, here are some reasons why you might choose Albyn Hospital for your appointment:
Consultant Urological Surgeon
MBChB MD FRCS (UROL & ED)
Albyn Hospital
Consultant Urological Surgeon and Honorary Senior Clinical Lecturer in Urology
MBChB, MRCSEd, PhD, FRCSEd (Urology)
Albyn Hospital
Chair in Gynaecology, Consultant Urogynaecologist
MBBCh, FRCOG, MD
Albyn Hospital
