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Urology

Urology at BMI Albyn is divided into two aspects, one is benign, and the other is for cancer (or suspicion of cancer)

The urology service at BMI Albyn Hospital can be divided into two aspects – one is benign, and the other is for cancer (or suspicion of cancer).

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.

Prostate Cancer

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 BMI 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:

  • Testicular cancer (with a symptom being a testicular lump or painful testicle). This is more common in younger, male patients. These patients are taken very seriously, especially due to their age, and they will be referred to us urgently.
  • Kidney cancer (with symptoms including pain and blood in the urine)
  • Penile cancer (patients may present with a lump in the penis).

Benign Cancers

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.

Urinary Tract Infection or Kidney Stones

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.

Prostate Enlargement

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.

Foreskin Problems

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

Vasectomy is offered at BMI 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

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 BMI 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.

Medication

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:

  • Bladder instillation
  • Rigid cystoscopy and bladder biopsies
  • Cystoscopy and hydrodistension
  • Rigid cystoscopy prostatic massage for chronic prostatitis
  • Cystoscopy and urethral dilatation (female)
  • Cystoscopy and optical urethrotomy/urethral dilatation
  • Cystoscopy and meatal dilatation/meatotomy
  • Frenuloplasty of the penis
  • Preputioplasty of the penis
  • Circumcision
  • Vasectomy
  • Reversal of vasectomy
  • Transurethral resection of bladder tumour
  • Transurethral resection of prostate
  • Bladder neck incision
  • Cystolitholapaxy
  • Cystoscopy, retrograde study and ureteric stent insertion
  • Diagnostic ureteroscopy
  • Ureteroscopy, lithotripsy and stone fragmentation and extraction
  • Hydrocoele repair (due to scrotal swelling or epididymal cyst)
  • Excision of epididymal cyst
  • Bladder instillation of Ialuril/Cystistat/Gepan (for painful bladder syndrome, recurrent UTIs, etc.)
  • Urodynamic study.

BMI Albyn Hospital is the only private hospital north of Fife, so our urology clinic serves the north of Scotland, including the Shetland islands. Patients come from Elgin, Wick, inverness and Dundee too.

It’s quicker, with shorter waiting times.

New services are being introduced soon, too (summer 2021) – one of which is called the urodynamic study.

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 Albyn, BMI Albyn Hospital provides a wide range of Consultant-led appointments. At a glance, here are some reasons why you might choose BMI Albyn Hospital for your appointment:

  • Flexible appointments and shorter waiting times – At BMI Albyn Hospital, waiting times are short and appointment times are flexible.
  • Consultant-led appointments – Your appointment will be Consultant-led, and you will see the same person each time you visit.
  • Patient satisfaction and personalised care – Albyn BMI Hospital has been awarded a 98.1% patient satisfaction score, with the results compiled by Quality Health.
  • Remote consultations – You may have the opportunity to use a platform like Microsoft Teams to chat to a consultant from the comfort of your home.

Want to make an appointment with our Consultant Urological Surgeon here at BMI Albyn Hospital? Simply use our handy online urological consultations booking system.

Specialists Offering Urology

Mr Thomas Lam

Consultant Urological Surgeon and Honorary Senior Clinical Lecturer in Urology

MBChB, MRCSEd, PhD, FRCSEd (Urology)

BMI Albyn Hospital

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Dr Said Fadel Mishriki

Consultant Urological Surgeon

MB, BCh, LRCP, MRCS, FRCSEd, FRCS, MD, FRCS(Urol)

BMI Albyn Hospital

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Mr Nick Cohen

Consultant Urologist

MBChB, FRCS, FRCS (Urol)

BMI Albyn Hospital

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