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Urology

Relief from urinary conditions

Our Urology services at Princess Margaret cater to anyone who may have symptoms of the urinary tract (for both men and women, involving the kidneys, ureters, bladder and urethra) as well as issues related to the male reproductive system.

Common symptoms in both men and women include:

  • Difficulty passing urine (too often, too slowly, throughout the night) 
  • Blood in the urine 
  • Urinary incontinence 
  • Pain when urinating 

We also see men for PSA (Prostate Specific Antigen) tests, which screen for prostate cancer. Prostate cancer is one of the most common cancers affecting men today, making accurate diagnosis a priority for men that have any concerns. 

If you have been experiencing any difficulties urinating, why not come along to see one of our Urology specialists? Bringing the necessary expertise to patients based in Windsor, Ascot, Maidenhead and further afield, Princess Margaret offers you accurate assessment, diagnosis, and treatment in a timely fashion. 

A large majority of the urological conditions treated at Princess Margaret are not serious, and may be related to a lifestyle issue. Therefore, simple changes can make a huge difference for you, such as avoiding caffeine and/or alcohol, which are known bladder irritants and can affect frequency of urination.  

Pelvic floor exercises can also be very effective in managing and improving incontinence, and our physiotherapists can offer advice and guidance on these if required. 

If these lifestyle changes have been ineffective in reducing your symptoms, medication is normally the next step. Certain medications can relax the muscles in the bladder and in the prostate, meaning the bladder doesn’t squeeze so hard so you won’t have to pass urine as frequently and urgently. 

Other drugs known as ‘alpha blockers’ help to open up the ‘junction’ between the prostate and the bladder, making it easier for men to pass urine. 

Recurrent cystitis and urinary tract infections may be managed with antibiotics, with other treatments available for the right candidates, such as intravesical agents (delivered through a catheter directly into the bladder). 

Surgery may be considered for men with enlarged prostates in order to restore normal urinary function. This could include: 

  • Laser procedure to shrink the prostate 
  • Injecting the prostate with steam 
  • Balloon dilatation 
  • En bloc HoLEP with early apical sphincter release (specialist surgery to make the prostate smaller – more effective and safer, with fewer side effects) 

Operations might be needed for urgent cases such as prostate cancer, and our team work collaboratively with the Oncology department in such surgeries. 

For prostate cancer, Focal therapy/Partial oblation may be an option, which focuses treatment solely on the part of the gland where the cancer is found, rather than the whole prostate, resulting in fewer side effects. This treatment is not readily available elsewhere, making Princess Margaret the best choice for specialist surgery. 

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

 

Choosing to have your Urology surgery at Princess Margaret comes with a host of benefits, such as:

Assessments ASAP – Certain urological conditions are best treated at the earliest possible stage. If you’ve been experiencing any difficulties urinating, our consultants can see you for an assessment without delay, getting you an accurate diagnosis rapidly and the necessary treatment before your symptoms progress any further.

Patient Satisfaction – 97.9% of patients in 2020 said they would happily recommend Princess Margaret Hospital to friends and family in an independent report, and we’re confident that you’ll agree. 98% also said that the quality of care here at Princess Margaret Hospital was either ‘very good’ or ‘excellent’. We aim to make your stay with us as comfortable as possible, and these results highlight our continued efforts to ensure this is achieved.

Personalised care – We believe in a bespoke approach to treatment, tailoring each experience to our patients’ needs and whatever may be best for you. This is regularly reviewed, ensuring you get the necessary treatment at every stage of your patient journey.

State-of-the-art Prostate Surgery - Princess Margaret has invested in a brand new, high-quality holmium laser for prostate surgery, allowing men to return to normal lives much more quickly, with a shorter hospital stay and fewer recovery issues than other conventional methods. Focal Therapy also allows targeted treatment for prostate cancer, reducing side effects compared to other treatments. These highly-specialist treatments are not widely available elsewhere

Convenient appointments – With appointments available at dedicated clinics from Monday to Saturday, you are sure to find an appointment slot that suits your needs and availability. 

If you are having problems urinating, why not book a consultation with one of our Urology specialists today? Our consultants can outline all treatment options for you promptly, arranging any necessary diagnostic scans, treatment and surgery if required. 

For peace of mind and expert care, please contact Princess Margaret to book an appointment now.

 

Specialists offering Urology

Mr Jas Kalsi

Consultant Urological Surgeon & Andrologist

BSc(Hons), MBBS(Hons), MD, MRCS, FRCS(Urol)

BMI The Clementine Churchill Hospital 1 more BMI The Princess Margaret Hospital

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Mr Jeetesh Bhardwa

Consultant Urological Surgeon

MBChB, MRCS, MD, FRCS(UROL)

BMI Bishops Wood Hospital 1 more BMI The Princess Margaret Hospital

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Mr Harbinder Sharma

Consultant Urological Surgeon

BMEDSCI, BMBS, FRCSEd (UROL)

BMI The Manor Hospital 1 more BMI The Princess Margaret Hospital

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Mrs Nadine Coull

Consultant Urological Surgeon

MBBS, MS, FRCS (Urol)

BMI The Princess Margaret Hospital

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Mr Eric Nicholls

Consultant Paediatric Surgeon

FRACS FRCS

BMI The Princess Margaret Hospital

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Mr Marc E Laniado

Consultant Urologist

MD FRCS(Urol) FEBU

BMI The Princess Margaret Hospital

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