Consultant urology specialists Mr James Brewin and Mr Max Johnston, from New Hall Hospital discuss common urinary issues, enlarged prostate, and what to expect from treatment. If you’re experiencing urinary problems caused by an enlarged prostate or kidney stones, it’s completely understandable to have concerns.
To help reassure patients, consultant urologists James Brewin and Max Johnston, from New Hall Hospital, outline the most common symptoms, when to seek advice, and what treatment usually involves.
When should I see a consultant for urinary problems?
Mild urinary symptoms often appear as men get older and are commonly linked to benign prostate enlargement (BPE or BPH). Typical symptoms include weak flow, urgency, frequent urination and waking at night. When these start to affect daily life, a urologist can offer a range of effective treatments.
Some symptoms require urgent review by a GP, such as blood in the urine, repeated infections or severe leakage. While urinary symptoms rarely indicate prostate cancer, men with a family history or those of Black or mixed Black ethnicity may wish to discuss PSA testing. For men at average risk, screening decisions are best discussed with a GP or specialist.
What happens during a consultation?
A consultation begins with a discussion about your symptoms, how they impact you and your medical history. You may complete a symptom questionnaire such as the IPSS. A digital rectal exam may also be performed to assess the prostate. Diagnostic tests commonly include a urine flow rate test, an ultrasound scan to measure bladder emptying and prostate size, a urine dipstick test to check for infection or blood, and blood tests including PSA and kidney function. These results help your consultant identify the cause of symptoms and recommend a suitable treatment plan tailored to you.
What are the surgical options?
Surgery is usually considered when symptoms are moderate to severe, when medication is ineffective or when side effects are troublesome. Options range from minimally invasive procedures – such as Aquablation Therapy, Rezum, PAE, Urolift and iTIND – to established operations like TURP and HoLEP.
Minimally invasive options often have fewer side effects but may not last as long. At New Hall Hospital, HoLEP, Aquablation and TURP are most commonly performed, though all options are discussed based on individual needs.
What to expect on the day of your surgery
On arrival, nursing staff will check you in and confirm fasting and medication instructions. You will meet your anaesthetist and surgeon before going to theatre.
Hospital stay and recovery
Most patients go home the same day or the next. Driving should be avoided for 48 hours after general anaesthetic, and heavier activities for around four weeks.
Final message
Most urinary symptoms are due to benign prostate enlargement, and there is time to explore options.
Speaking with a specialist ensures you choose the most suitable approach. You can book your appointment here.