Your initial consultation will involve your consultant taking a detailed medical history from you, which will help them understand the issues you’ve been facing. They will ask you questions such as:
- What symptoms have you been experiencing?
- How long have you had these symptoms?
- Are you in any pain? If so, can you describe the pain? Is it a stabbing or burning pain?
- Have you tried any treatments yet? How effective have they been?
- Are you currently taking any medication?
This will likely be followed by a physical examination to assess certain symptoms, and you will likely be asked for a urine sample.
Ultrasound scans may be required to show the kidneys and bladder, and these can be arranged promptly in our on-site Imaging department. Similarly, CT scans may be used to help diagnose cancer of the kidneys or bladder, as well as kidney stones somewhere in the urinary system, which cause severe pain. The ultrasound and CT scans show anatomical or structural information, making them a key component for diagnosis of certain conditions.
For men with significant urinary symptoms, a Flow Rate test can be done during your initial consultation, in which a dial in a modified toilet registers the speed of your urinary flow. This is often helpful in evaluating the cause of a man’s symptoms.
A visual inspection of the urinary tract may be necessary, in a procedure known as a flexible cystoscopy. Under a local anaesthetic, a very fine telescope is passed through the urethra (the tube that carries urine from the bladder to the outside world), showing the lining of the urethra and allowing your consultant to check for abnormalities. This can also be used to check the size and health of the prostate, as well as the lining of the bladder, checking for tumours or diverticular (a pouch protruding from the bladder wall).
If a PSA blood test has shown elevated levels, you will normally be sent for a specialised MRI to look at the inside of your prostate in order to confirm or disprove the presence of cancer. If needed, this can be followed up with a biopsy, where a small tissue sample is taken from the prostate and sent to the laboratory for analysis. At Princess Margaret, we offer highly-specialised MRI fusion biopsies, which are much more accurate, safe, and reliable than standard biopsies.
A Urodynamics test involves measuring the pressure in the bladder at the same time as passing urine, giving functional information about the lower urinary tract.
Once all test results have been returned, your consultant can make a definitive diagnosis, using a follow-up appointment to discuss treatment options with you. These will be explained clearly and concisely, and you will have the opportunity to ask any questions in order to make an informed decision on how you would like to proceed