Thank you for visiting our website. This site is designed primarily as a resource for current and future patients who need urological services.
Meet A/Professor Prem Rashid by clicking on the video clips below that are connected to conditions A/Professor Prem has a special interest in.
The urinary tract system comprises the kidneys, little tubes that run down to the
bladder called ureters. Urine is then stored in the bladder and passed out through
the urethra. Urinary tract infections can occur in men & women for a variety of
reasons and become apparent usually because of discomfort or pain with passing urine,
increased frequency of passing urine and sometimes an unpleasant odour. At other
times a urinary tract infection may exist without any symptoms at all. The most
common way of diagnosing a urinary tract infection would be from assessment of symptoms
that may be present as well as assessment of the urine through a pathology lab.
When a diagnosis is confirmed, antibiotics usually help resolve the infection. If
there are associated problems that lead to urinary tract infections, they would
often be assessed by a urologist.
Blood in the urine should always be taken seriously while sometimes bleeding in
the urinary tract may be due to a non-serious condition, at other times it may suggest
physical problems with the urinary tract, including stones as well as cancers of
the kidney, bladder or prostate gland. The kidneys can form growths on them, they
can include fluid filled structures called cysts, which are usually not serious,
although sometimes kidney cysts are serious and will require either repeated observation
with imaging or surgery. In addition, solid tumours of the kidney are quite often
cancerous and require surgery. Surgery can involve removing only part of the kidney
(partial nephrectomy) or the whole kidney. Most kidney surgery is now performed
with telescopic techniques.
The prostate gland is a structure that sits below the bladder, in the middle, and
is responsible for some of the reduction of seminal fluid. When the prostate enlarges
it can affect the function of the bladder, commonly referred to as bladder outlet
obstruction, and at other times the prostate gland can become cancerous. This is
called prostate cancer. A PSA blood test and digital rectal examination are used
to assess the risk for prostate cancer and these can be undertaken by your general
practitioner. If there is concern about your risk, you may be referred to a urologist
for a prostate biopsy where small amounts of tissue from the prostate are taken
to be looked at under a microscope for clarification. Prostate cancer can be managed
in a variety of ways and these are detailed in “Prostate Cancer – Your Guide to
the Disease, Treatment Options and Outcomes”.
For further information, please select one of the following videos below:
Bladder cancer is a less commonly known cancer. It most often becomes apparent when
blood is passed in the urine. Sometimes it shows up on imaging studies, including
ultrasound or CT scan, and often needs diagnostic testing, which is known as a cystoscopy,
where a telescope is passed into the bladder to visually examine the bladder. Most
bladder cancer can be treated by endoscopic techniques. When advanced, however,
the bladder would need to be removed. This is referred to as cystectomy.
There are a variety of scrotal conditions that can cause swelling and/or pain. The
most common are benign fluid collections within the scrotal cavity near the testicle.
These include epididymal cysts and hydroceles. More importantly in younger men,
sometimes relatively painless swellings can occur that can be hard and these may
be testes cancer. If there is any doubt, clinical examination by your GP should
be performed and most often an ultrasound of the scrotum can be very helpful. If
there remains doubt, a referral to a urologist is often required.
Stone disease most commonly presents as an unexpected and sudden onset of pain that
can range from back pain and radiate all the way to the front. In men it can radiate
to the tip of the penis or the testicle, and with women, to the labia. Stone disease,
when severe, usually results in a visit to the Emergency Department for pain relief
and subsequent management following imaging studies, most commonly CT scan. Most
stones can be treated with telescopic techniques and there are also a variety of
non-invasive techniques that can be used.
Urinary incontinence is common in some groups of men and women. There are a variety
of conservative measures that can help, including bladder training and pelvic floor
exercises. When these are no longer effective, a variety of slings can be placed,
most commonly as day surgery, to limit the amount of leakage, and when severe, artificial
urinary sphincters can be placed into the lower urinary tract to control leakage.
Sometimes leakage is managed by a urinary diversion, most commonly in the form of
a urethral catheter placed in the bladder.
As men age, erectile failure becomes more common. Initially the erections become
softer and less reliable and ultimately erectile failure becomes evident. It is
important that your GP assesses you for any risk that may predispose you to erectile
failure. Most commonly men are trialed on medicines that are currently in three
forms, including Viagra, Levitra and Cialis. When these are no longer effective,
penile injection therapy can be undertaken and if that fails, penile implant surgery
can be considered.
An overactive bladder is one that wants to go all the time. This is most evident
in frequency of passing urine as well as a strong urge. Overactive bladders need
to be assessed by a urological service. Most commonly the treatment involves conservative
measures involving bladder training, pelvic floor exercises and the use of drugs,
use of medications that can settle down bladder contractions and sensations. Sometimes
further investigations including urodynamic studies or cystoscopy may be required.