Private Male Urinary Symptoms Assessment

Many men put off seeing a doctor about urinary problems, but there's no need to put up with them. Getting checked early can rule out anything serious and often means simpler treatment works well.

You may benefit from a urinary assessment if you:

• need to pass urine more often, especially at night

• get sudden, strong urges to go

• have a weak or stop-start flow

• feel you need to go again straight after finishing

• find it hard to start, or need to strain

• leak urine

If an enlarged prostate isn't treated, it can sometimes lead to UTIs, bladder stones, kidney damage, or acute urinary retention. Acute urinary retention is when you suddenly can't pass urine at all, which requires urgent medical attention.

Urinary symptoms in men are most often caused by an enlarged prostate. The prostate sits just below the bladder and wraps around the urethra, so as it grows, it can press on the urethra and slow the flow of urine. Symptoms can also come from the bladder itself, an infection, a narrowed urethra or, less often, prostate cancer.

Things that can increase your risk of urinary symptoms include:

• getting older

• hormonal changes

• a family history of prostate problems

• certain medicines, such as some cold and allergy remedies and tricyclic antidepressants

• having had bladder stones or kidney stones before

• long-term (chronic) inflammation

• being overweight

• not being physically active

• a diet high in fat and red meat

We know that talking about urinary problems can feel awkward. Your consultant will take time to put you at ease and explain each step before it happens. The consultation usually lasts 30 to 45 minutes.

Assessment usually follows these steps:

1. Your consultant will ask about your symptoms, your medical history, any medicines you take, and your lifestyle. You may also fill in a short prostate symptom questionnaire, which scores how much your symptoms affect your daily life.

2. They'll look at your bladder diary, if you've kept one, to see how often you pass urine, how much you drink, and when your symptoms happen.

3. They may carry out a digital rectal examination. This is where your consultant gently places a gloved, lubricated finger into your back passage (rectum) to feel the size and shape of your prostate. It only takes a few seconds.

4. You'll be asked for a urine sample. A quick dipstick test can help rule out an infection or blood in your urine.

5. You'll have a urine flow test. You'll pass urine into a special toilet or funnel (a flow meter) that measures how fast and how much urine you pass.

6. A quick ultrasound scan of your bladder will measure any urine left behind after you've been to the toilet (post-void residual).

7. Your consultant will explain what the likely cause of your symptoms is and agree a plan with you. This may be watchful waiting, lifestyle changes, medicine, or a minimally invasive procedure.

Further tests for urinary symptoms 

Sometimes your consultant will need more information before they can confirm the cause of your symptoms. Where possible, these tests will be done on the same day as your consultation. They may include:

• blood tests – including a prostate-specific antigen (PSA) test, which measures a protein made by the prostate, and other blood tests to check your general health

• ultrasound – a painless scan that uses sound waves to look at your bladder, prostate, and kidneys

• urodynamics – tests that measure the pressure in your bladder as it fills and empties

• flexible cystoscopy – a thin, bendy tube with a camera is passed into your bladder through the urethra so your consultant can look at the lining

• MRI scan – a detailed scan of the prostate, which may be recommended if your PSA level is raised

• CT scan – a detailed scan that can show stones or other changes in your kidneys and bladder

• prostate biopsy – small samples of tissue are taken from the prostate and checked in a laboratory

Your total time at Welbeck will be longer if you have any of these tests on the same day as your initial consultation.

A male urinary symptoms assessment is very safe, and the risks are minimal. The rectal examination may feel briefly uncomfortable, but it shouldn't be painful. You can ask your consultant to stop at any time.

If your PSA level is raised, you may need further tests, such as an MRI scan, to find out why. A raised PSA doesn't always mean cancer, and your consultant will explain what your result means for you.

If you need a flexible cystoscopy, there's a small risk of:

• a urine infection

• temporary blood in your urine

Your consultant will explain the risks before you have any test and answer your questions.

No special preparation is needed, but a few simple steps can help you get the most from your appointment. They also help make sure your test results are accurate.

Before your assessment, we recommend that you:

• arrive with a comfortably full bladder, so you can have a urine flow test

• keep a bladder diary for at least 3 days, recording what you drink, when you pass urine, and when you have any symptoms

• make a list of all the medicines and supplements you take

• bring the results of any previous PSA tests, blood tests, or scans

• avoid ejaculating and vigorous exercise for 48 hours beforehand if you're having a PSA test, as both can raise your PSA level

Drinking much more than usual, being constipated, or moving around a lot can affect the accuracy of the flow test. If this happens, your consultant may ask you to repeat it.

There's no recovery time after the assessment, so you can go back to your normal activities straight away.

Your consultant will discuss your urine flow test results with you at your appointment, and you'll receive a full report within 24 hours. We'll contact you once the results of any blood tests, including PSA, are ready. You'll receive your results and a written treatment plan, and with your consent, we'll also share these with your GP.

If you've had a flexible cystoscopy, drinking plenty of water for the rest of the day can help ease any discomfort. Contact us or your GP if you have a high temperature, pain that gets worse, or blood in your urine that lasts more than a couple of days, as these can be signs of an infection.

Many men find their symptoms improve with simple changes or medicine, and not everyone needs a procedure. Depending on the cause of your symptoms, your consultant may recommend:

• watchful waiting – regular check-ups to keep an eye on mild symptoms that aren't bothering you too much

• lifestyle changes – such as cutting down on caffeine and alcohol

• medicine – to relax the prostate, shrink it over time, or calm an overactive bladder

• prostatic urethral lift (UroLift) – small implants hold the enlarged prostate away from the urethra

• Rezum water vapour therapy – steam is used to shrink extra prostate tissue

• iTIND – a temporary device gently reshapes the prostate to widen the channel for urine, and is then removed

• transurethral resection of the prostate (TURP) – part of the prostate is removed through the urethra

• laser therapy – a laser is used to remove extra prostate tissue

• aquablation – a robot-guided water jet removes extra prostate tissue

• bladder instillation – medicine is passed directly into the bladder

• Botox injections to the bladder - Botox is injected via a cystoscope to temporarily relax the bladder muscle

All of these treatments are available under one roof at Welbeck, from medicine to the latest minimally invasive procedures.

Please contact our Urology centre for pricing information.

At Welbeck, our urology specialists are experts in their field and are dedicated to providing world-class, individualised care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if needed to ensure you receive the best possible treatment as quickly as possible, all under one roof.

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

We accept both self-referrals and referrals from your GP or a specialist for this assessment. If you already have your referral, please share it with us when you book your appointment, and a member of our clinical team will be in touch.

If you'd like to schedule a consultation with one of our consultant urologists, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients.