Treatments & Procedures

Treatments for LUTS and BPH

The initial approach in managing bothersome ‘waterworks’ lower urinary tract symptoms (LUTS) is to employ conservative lifestyle measures such as: fluid intake management, avoiding caffeinated drinks and pelvic floor exercises.

The choices of medication include; Alpha Blockers, 5-alpha reductase inhibitors, Anti-cholingeric drugs, Beta3 agionist, Phosphodiesterase (PDE-5) inhibitors

When the symptoms from BPH are relatively severe or unresponsive to medication, then the standard next step is to consider procedures that aim to create as wide a passage as possible though the prostate gland; alternatives are either TURP (transurethal resection of the prostate) or procedures employing laser energy.

The Prostatic Urethral Lift (PUL) procedure using the Urolift device. The Urolift device is the very latest non-invasive approach to treating symptomatic BPH. The device lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.

Rezūm uses the natural energy stored in water vapour, or steam. It is a safe and effective treatment available to relieve symptoms associated with benign prostatic hyperplasia (BPH).

Professor Richard Hindley was the fist consultant to carry out this procedure both in the NHS and privately and is currently working with other surgeons ac...

We are excited to be pioneering a truly game changing treatment for treating Benign Prostatic Hyperplasia (BPH) and Neil Barber has been involved in the trials of this unique and novel procedure.

TURP has stood the test of time and remains the bench-mark operation to which all newer procedures are compared

For many decades the TURP (Transurethral Resection of the Prostate) has been considered the gold standard surgical treatment for men suffering with bothersome urinary symptoms resulting from growth of the prostate gland causing obstruction to the flow of urine out of the bladder. Whilst a relatively safe and reliable procedure, there are well descr...

Treatments and Diagnostics for Prostate Cancer

Active surveillance has been shown to be a safe strategy over many years. In our own series of over 200 men followed for up to 8 years, 95% remained on active surveillance (Bott British Journal of Urology 2005).

Magnetic resonance imaging (MRI) is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.

Template guided prostate biopsies or template prostate mapping (TPM) is performed as a day-case under a short general anaesthetic with the procedure taking 30-40 minutes. There can be some bruising afterwards but the risk of infection is greatly reduced using this approach.

Treatments for Advanced Prostate Cancer

High Intensity Focussed Ultrasound (HIFU) represents one of the newest and perhaps least invasive treatments available for men with prostate cancer that has not spread from the prostate gland itself, i.e localised disease.

This is removal of the whole prostate gland together with the seminal vesicles in the treatment of early prostate cancer. The procedure is performed through a number of small skin incisions using a ‘key-hole’ or laparoscopic approach or with a robot assisted laparoscopic approach.

Radical prostatectomy is one of the longest r...

Brachytherapy is a form of radiotherapy in which delivery of radiation is targeted directly to the prostate gland by implanting small radioactive pellets. Needles are inserted through the skin of the perineum. These needles are used to deliver the seeds which can either be left in place permanently (low dose) or temporarily (high dose).

Cryotherapy or cryoablation involves freezing areas of the prostate leading to destruction of the cancer cells. Ice crystals form inside and outside the cells causing them to subsequently burst. In addition to this, slowly thawing the cells by heating has been shown to lead to even better cellular destruction.

External beam radiotherapy uses high energy X-ray beams to treat prostate cancer. The X-ray beams are directed at the prostate gland from outside the body. The X-rays aim to destroy the cancer cells in the area they target. They are administered in small doses (fractions) over several days, usually Monday to Fridays.

Treatments for Bladder Stones

Bladder stones can be treated in a number of ways.  If they are small they can be crushed by passing a small telescope up the water pipe into the bladder.  The stones are grasped, broken and then washed out.  Larger stones may require removal either by making a small cut over the lower abdomen and taking them out directly through the...

Telescopic examination of the bladder. This is a common diagnostic procedure in Urology and involves passing a telescope down the water-pipe (urethra) into the bladder. It may be performed using a flexible instrument following the application of a local anaesthetic gel down the urethra or under a general anaesthetic where a slightly larger and m...

Involves the breaking up of a bladder stone usually under direct vision at cystoscopy. This can be performed using different technologies depending on the size of the stone.

Treatments for Bladder Cancer

Your consultant will talk to you about the treatment options for your particular type of cancer. You may be given a choice of treatments, but we will make sure you are fully informed as to the strengths and weaknesses of each one so you can make an informed decision.

This involves the removal of a small sample of bladder wall at the time of cystoscopy. The area removed (the biopsy) is usually cauterised to minimise the amount of blood in the urine after the procedure.

Cystoscopy using blue rather than white light to trigger a red glow or fluorescence from bladder tumours following administration of a chemical agent 1 hour or so prior to the examination. This may enhance the ability of the Surgeon to detect areas of bladder cancer.

During the telescopic examination of the bladder (cystoscopy), bladder tumours are ‘shaved’ or resected from the inside of the bladder wall with the aim of removing the entire tumour. Not normally carried out in favour of alternative minimally invasive procedures HIFU and Greenlight.

Treatments for Prostatitis

Treatment very much depends on the symptoms. Overall somewhere between 50-60% of all patients seen in outpatients will have troublesome urinary symptoms (LUTS). The most common sites of pain are perineal (63.3%) and testicular (57.6%). Other common problems are ejaculatory pain, pain in the pubic area and the tip of the penis. Treatment should very...

Treatments for Kidney Stones

Kidney stones are increasingly common and unfortunately can be very painful. It is important to confirm the diagnosis as well as a knowledge of the number, size and location of the stone or stones. This can lead to a tailored management approach for each patient.

If the stone is unlikely to pass by itself or is causing too many problems then intervention may be required.

Treatments for Kidney Cancer

Surgical removal of the kidney. If performed for kidney cancer, the kidney is removed within its surrounding tissues, which may or may not include the adjacent adrenal gland. Nephrectomy is now usually performed via a ‘key-hole’ or laparoscopic approach, allowing for a partial nephrectomy where the tumour is removed to allow the kidney ...

Other Urological Treatments and Procedures

Circumcision involves the removal of the foreskin and is performed for medical or religious reasons. The procedure may be performed under general or local anaesthetic. Healing takes 4-6 weeks and there may be some swelling particularly in the first few days.

The frenulum is the bridge of tissue connecting the foreskin to the head (glans) of the penis. If short, the frenulum may restrict normal erection or indeed may become torn during intercourse and bleed. Frenuloplasty is a procedure aimed at increasing the length of frenulum and may be performed under local or general anaesthesia.

An operation to repair a hydrocele involving excision and eversion of the hydrocoele sac. This procedure is typically performed as a daycase under general or local anaesthesia employing an incision through the scrotum.

An operation aimed at straightening the penis of those suffering with Peyronie’s Disease. Performed under a general anaesthetic usually on a daycase basis, this procedure is associated with some shortening of the penis.

Removal of a testis (or testicle). This may be performed either via a skin incision in the groin (for potential tumour) or through the scrotum (for non-cancerous causes).

This is fixation of the testis (or testicle). If performed in young children/ babies for undescended testis, the procedure is performed via a skin incision in the groin. If performed to stop the testis twisting (testicular torsion) it is via an incision in the scrotal skin.

This operation represents an alternative to circumcision where restriction of the normal retraction of the foreskin is limited by a band like tightness of that skin. The foreskin is therefore preserved. Preputioplasty may be performed under local or general anaesthesia.

Graduated gentle stretching of the urethra, either in the management of male urethral stricture or in women for a wide range of conditions including urethral syndrome and recurrent cystitis. For comfort, this is usually performed under a general anaesthetic.

Reconstructive surgery in the treatment of a scarred narrowing or stricture of the water-pipe or urethra to improve the flow of urine.

Usually performed under direct vision via a telescope, a urethrotomy is the cutting open of a scarred narrowing or stricture of the water-pipe or urethra to improve the flow of urine.

Vasectomy is probably one of the most effective contraceptive options available today. Either under general or more usually a local anaesthetic block, the drainage tubes from the testicles (vas deferens) are located and disconnected through small incisions of the scrotum.