Urology involves the medical and surgical treatment of male and female patients with disorders affecting their genito-urinary tract (kidneys, ureters, bladder, prostate, urethra, testicles, and penis).

Common urological problems include:

1. Lower Urinary Tract Symptoms (LUTS)

In men these symptoms are often having a slow stream, urinary frequency, getting up at night to pee (nocturia), or even not being able to pee at all (urinary retention). In women these symptoms may be a feeling of not being able to hold on (urinary urgency), urinary frequency, or stress urinary incontinence (leaking).

These symptoms are usually related to benign (non-cancerous) diseases of the bladder or prostate (in men) but may be related to more serious disease. The investigation and management of LUTS is usually non-invasive and often involves lifestyle changes, specific exercises or medication. Occasionally an operation is required but this involves only a short stay in hospital.

Mr Hughes is an expert at injecting Botox into the bladder for men and women with overactive bladder symptoms that don’t respond to medication. For men with obstructive symptoms secondary to benign enlargement of the prostate Mr Hughes can offer Bipolar TURP (transurethral resection of the prostate) or the new Urolift (link please to https://www.urolift.com) procedure. This is a minimally invasive daycase procedure with very few side effects and which doesn’t involve a post-operation catheter. Urolift has revolutionised the way we manage men with troublesome LUTS

2. Blood in the urine (Haematuria)

Common causes are infection, urinary tract stones, trauma or, more seriously, urological cancers arising most commonly from the bladder or kidneys. Blood in the urine can arise from anywhere in the urinary tract and the investigations are straight-forward. You would have a telescopic examination (flexible cystoscopy) of the bladder under local anaesthetic and an ultrasound scan of the kidneys. The flexible cystoscopy is usually performed by Mr Hughes on the private patient wing of the hospital on a Wednesday afternoon but other times are available on request. The procedure itself takes only a few minutes and is generally well tolerated. There is no preparation required and you would be in the hospital for less than 30 minutes. The ultrasound scan is usually performed by a consultant radiologist at the Jersey X-ray Services based at the Lido Medical Centre, Hotel de France on St Saviours Road. If you have blood in your urine you should be investigated promptly.

3. Prostate Cancer

This is the commonest urological cancer and the commonest solid organ cancer in men. There are approximately 47,000 new diagnoses per year in the UK and 11,000 deaths related to prostate cancer. The diagnosis of prostate cancer is usually made with an MRI of the prostate followed by a biopsy which is performed under local anaesthetic.. The decision of whether to have an MRI and biopsyis guided by a blood test called the PSA (prostate specific antigen) and a finger examination of your prostate. The PSA blood test is not diagnostic and routine screening for prostate cancer with the PSA test is not currently recommended for a number of reasons. However, men over the age of 45 with a family history of prostate cancer would be advised to have their PSA checked. There are a number of different treatment options available for managing prostate cancer depending on the result of your biopsy and MRI scan. For further information on PSA testing and prostate cancer in general please see the link below

4. Urinary Tract Stones

Renal colic (flank to groin pain associated with a kidney or ureteric stone) accounts for approximately 50% of urological emergency presentations to the A&E department. Anyone who has passed a stone will tell you it is excruciatingly painful and braver people than me have said it is even more painful than childbirth! The diagnosis is usually confirmed with an ultrasound or CT scan and there are a number of different treatment options depending on the size and location of your stone (s) and your medical and physical health.

Mr Hughes is a specialist at treating urinary tract stones. Jersey General Hospital where he operateshas a LASER machine which is specifically used for fragmenting stones during a short operation under general anaesthetic.

5. Testicular Cancer

Testicular cancer affects approximately 2000 men per year in the UK and accounts for just over 1% of all urological cancers. It is almost 100% curable if diagnosed early. Therefore we recommend that men perform regular testicular self-examination (TSE). If you notice a firm lump or any new swelling then you should be investigated promptly. Diagnosis is made by clinical examination and an ultrasound scan. The mainstay of treatment for testicular cancer involves a day case operation to remove the testicle through a small incision in the groin. Thereafter you would undergo a CT scan to check if there were any signs of spread of the disease. Some patients are offered chemotherapy to reduce the risk of the disease recurring. For further information on TSE please follow this link.

6. Recurrent Urinary tract infection (UTI)

This is one of the commonest reasons for young or peri-menopausal women to seek a urological referral. There are some important potential causes that should be ruled out through simple, non-invasive investigations but the majority of persistent or recurrent UTIs can be managed with lifestyle advice, non-antibiotic and when appropriate anti-biotic therapy.

Disease / procedure specific information leaflets

For more information about your condition and the treatment options then please follow the link below to the website of the British Association of Urological Surgeons.

Jersey Urology, Gloucester Street Clinic, 8A Spectrum, Gloucester Street, St Helier, JE2 3DE. 01534 639500

Website created by James O'Brien