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Diseases and procedures of the prostate:   Enlargement (BPH)   Prostate cancer   Radical prostatectomy   TURP   Brachytherapy

Diseases and procedures of the bladder:   Bladder cancer   Cystoscopy   Cystectomy with Ileal conduit or Neobladder

Diseases and procedures of the kidney:   Kidney cancer   Kidney stones   Nephrectomy   ESWL

Other urological diseases and procedures:   Infections   Vasectomy

This page will provide you with information regarding various urological diseases and procedures (use links above), how to arrange to see Prof Sengupta, a urology symptom guide and pre-operative and post-operative instructions.

How to arrange to see Prof Sengupta

You will need to obtain a referral from your general practitioner before seeing Prof Sengupta. Please call Prof Sengupta's office on (03)95600844 to arrange a convenient appointment time. Various locations are available for consultation. It is important that you collect previous test results, especially X-rays, and bring them to your appointment to facilitate a thorough assessment.

We have put in place various measures to reduce the risk of COVID19 within the practice, based on guidance from the Victorian DHHS. A summary of our current measures are here. If you have any questions or concerns please contact the office to discuss.

Urological symptom guide

Blood in the urine

Although it looks concerning, blood in the urine is rarely an emergency. The amount of bleeding is usually much less than it looks, since the blood colours all of the urine. Most such episodes of bleeding stop within a day or two, and the urine clears up shortly thereafter. Drinking extra fluids helps clear up the urine.

Emergency treatment may however be required in a few cases. If there are clots which prevent the passage of urine, the bladder may fill up and need to be drained and washed out by a catheter. If the bleeding is occurring after a surgical procedure, it is advisable to notify your surgeon and seek their advice. If you are taking medications that reduce blood clotting (e.g aspirin, warfarin, clopidrogel), the bleeding may be heavier and may not stop by itself. If the bleeding has continued for a while, or you feel light-headed or unwell, it is advisable to seek medical help.

Blood in the urine can result from a number of causes of varying seriousness. This includes urine infections, prostate enlargement, prostate cancer, stones, kidney tumours and bladder cancer. Serious problems requiring treatment are found only in a small proportion of people experiencing urinary bleeding. Nonetheless, it is recommended that anyone found to have blood in the urine should have tests to identify the underlying cause. Typically, this would include blood and urine samples, scans to check the kidneys and a procedure to examine the inside of the bladder (cystoscopy). It is usually OK to have these tests organised at a time that suits (preferably within a month or so) rather than immediately.

Frequently, a cause for the bleeding may not be apparent on the tests. Under these circumstances, a further limited check-up in 6 to 12 months, including a follow-up urine test, is advisable. If urinary bleeding keeps persisting or recurring, the scans and cystoscopy may be repeated after 2 or 3 years.(top)

Difficulty passing urine

Symptoms such as poor urinary flow, difficulty starting urination and a sense of incomplete emptying may be caused by blockage of urine flow or decreased strength of bladder muscle, or both. The appropriate treatment depends on an accurate diagnosis. Blockages may be caused by prostate enlargement, prostate cancer or a narrowing (stricture) of the urethra (the tube that brings urine out from the bladder). Reduced contraction of the bladder may result from prolonged blockage or nerve damage e.g. from diabetes or pelvic fracture.

Working out the cause of difficult urination requires you to be assessed by a urologist. Various tests may need to be carried out, including blood and urine samples, urine flow tests, ultrasound scans and possibly a cystoscopy. If a blockage is found, appropriate treatment may include medications or surgery. A catheter may be necessary to drain the bladder in case of complete blockage or reduced bladder contraction. Additionally, treatment may also include alteration of fluid intake or modification of medications (especially diuretics).(top)

Frequent urination

Frequent, urgent or painful urination may result from irritation of the bladder. This may be due to infections, stones, cancers or diseases involving the nerve supply to the bladder, such as strokes. Paradoxically, these symptoms may also sometimes result from blockage of the bladder.

Your urologist will arrange for appropriate assessment to find the cause of your symptoms. In addition to the tests outlined above, this may include a urodynamic study (a test to check the pressures within the bladder).

Initial treatment is directed at removing the underlying cause where possible. Symptoms maybe relieved by using medications which reduce contraction of the bladder and physiotherapy for retraining the bladder. Rarely, if symptoms are severe and do not respond to these measures, surgery to enlarge the bladder may be considered.(top)

Prostate check

A "prostate check" refers to tests done on well men to check for prostate cancer. In simple terms, this involves an examination of the prostate by your doctor and a blood test to measure the PSA (prostate specific antigen) level in your blood. Current recommendations are for these tests to be done once a year starting at the age of fifty. (For men who are at high risk, especially those with one or more affected family members, it is recommended that testing start earlier.)

Abnormalities of the prostate gland or the PSA blood test raise the suspicion and require further testing. Please note, however, that this does not necessarily mean that you have prostate cancer, and many other factors may influence the results of these tests. An MRI-scan of the prostate is usually undertaken as a first step to look for abnormal areas within the prostate. Again, the presence of abnormalities on a MRI scan only indicates a suspicion, not confirmation of cancer. A biopsy of the prostate is usually required to confirm the presence of prostate cancer if suspected based on MRI scan findings or PSA changes.

If the biopsy does find prostate cancer, then your urologist will discuss treatment options with you. If the biopsy is negative, then further prostate checks should be continued, if necessary at a more frequent interval.(top)

Pre-operative instructions

These instructions are of a general nature, and you will be provided with more detailed and specific instructions prior to your surgical procedure. It is important to adhere to these instructions in order to prevent problems or cancellation of your procedure.

  • Please complete pre-operative tests as ordered by Prof Sengupta
  • If you normally take blood-thinning medications such as aspirin, warfarin, clopidrogel etc, you will need to stop them prior to surgery. Check with Prof Sengupta when to stop these tablets.
  • Most other medications should be continued until the time of surgery, with the exception of diabetic medications. If you are a diabetic, special arrangements may need to be made pre-operatively, so please highlight this to Prof Sengupta.
  • You will need to fast for a period of at least 6 hours pre-operatively. Usually this means from midnight before morning surgery, and from 7AM for afternoon surgery. Again, diabetic patients may need special precautions during this period.
  • Please bring to hospital all previous test results and X-rays, any relevant medical documents, especially insurance details, and personal items and clothing that you need.
  • If you are having a general anaesthetic, you will need a responsible friend or family member to escort you home and remain with you for 24 hours post-operatively.(top)

Post-operative instructions

Again, these instructions are of a general nature, and will be supplemented with specific instructions relevant to your surgery.

  • Carefully follow post-anaesthetic precautions, including avoidance of driving or the operation of heavy machinery for 24 hours. It is also recommended that for 24 hours after an anesthetic, you have a responsible adult with you.
  • You may be prescribed additional medications, most often pain killers or antibiotics. Please check the dosage instructions, and take as directed.
  • Some of your usual medications may need to be withheld for some time after surgery. In particular, blood-thinners such as aspirin, clopidrogel or warfarin should typically be stopped for the recommended duration (usually 1-2 weeks or until the bleeding clears up).
  • Prof Sengupta will indicate when he needs to see you again and whether further tests are needed before then.(top)

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