Out Patient Clinic

RMU Tuesday and Friday
Follow up clinic Monday to Saturday

The Department of Urology looks after problems of the bladder and kidneys. This includes using medicines and surgery.

The urologists look after surgical problems of the urinary tract in both men and women. Urology also looks after problems of the genital tract in the male. This includes the bladder, kidneys, ureters, urethra for men and women. Also the male sex organs. The patients may have pain in the side from the kidney area or in the lower abdomen (tummy) from the bladder; problems passing urine/water (urinating/micturating/peeing); burning when passing urine; infections of the urine (waterworks); stones in the bladder or kidney; congenital problems of the urinary tract; men's problems; cancers of the urinary tract etc.

Renal physicians (Nephrologists) take care of medical conditions of the kidney, including renal failure (when the kidney stops working) and dialysis (artificial kidney). The two teams (ie Urology & Nephrology) often work together.

Urology specialises in

  • Urology Andrology – problems only men have – male sexual problems or infertility (unable to have a baby)
  • EndoUrology and Lithotripsy – EndoUrology is procedures (to diagnose and treat) done through instruments; eg cystoscope, laparoscope;
  • Lithotripsy - breaking up stones with the shock wave
  • Urodynamics – tests how the bladder works, see below for more information
  • Female Urology - problems of the urinary tract in ladies
  • Paediatric & Reconstructive Urology – children having problems with the bladder & kidneys and the urinary or genital tract . These may be from birth or from injury or disease.
  • Uro-Oncology – cancer of the kidneys, bladder, prostate, testis, penis & adrenals

Special X-rays
Urology patients often need special Xrays – these include:

Intravenous urogram (IVU) – an intravenous contrast (like a dye or colouring that shows up on xrays) is injected in to the patients arm. This then goes into the blood and out through the kidneys. So when an xray is taken the “contrast” shows up the shape of the kidneys, ureter and bladder (the ureter connects the kidneys to the bladder).

  • Micturating cystograms (MCU) – a catheter is put in through the urethra into the bladder. The contrast/colouring (like in the IVU) is put in through the catheter (the urethra is the tube from the outside to the bladder – we pass water (pee) through the urethra). Then the patient has to pass urine (pee) and xray pictures of the bladder and urethra are taken during this.
  • Ultrasound (USG) – special pictures of the kidney and bladder can be taken without using xray. Different information can be seen. USG, ultrasonography, uses sound waves to do this.
  • Computerised tomography (CT Scan) – xrays show the kidneys and bladder in detail.
  • Magnetic resonance images (MRI) – special pictures show details of the kidney and bladder

Own X-rays & Scans
Patients should give their own X-rays, from other hospitals, to the Xray department staff for scanning. (if you did not give them to the MRO for scanning before). Then collect them back after they have been scanned.

Nuclear Isotope scans
This is another way to test the kidney (renal) and see how well it is working.

Urology treatments & tests
Urine Flow Rate: Another useful test looks at how fast the urine is passed – the urine flow rate or uroflowmetry. Patients go to counter 240 with the receipt of payment and will get an appointment date and time and instructions. This test is done both in 240 and in the lithotripsy suite next to U ward. Patients need to pass at least 200 ml of urine for the test to give good results. So sometimes this test may have to be done again.

Post Void Residual (PVR): This looks at how well the bladder empties. No injections or catheters are needed. The patient passes urine – the technical word is “voids”. Then an ultrasound of the bladder is done and this can measure how much urine/water is left in the bladder after passing urine (voiding).

Extracorporeal Shock wave lithotripsy (ESWL): Stones can form in the kidney. Small ones often pass on their own, in the urine. Larger ones need treatment. Shock wave lithotripsy uses “shock waves” like vibrations to break up the stone, then the smaller pieces pass in the urine. This can be done with the machine outside the body (non-invasive) and can help to avoid an operation. The details such as cost of treatment, how long the treatment will be and the possible complications will be explained to the patient by the doctor in the lithotripsy room. This doctor can look at your xrays and tests on the hospitals computers – the Online Medical Record network. When you are having lithotripsy treatment you should go to the lithotripsy room and do not need to go to outpatients till the doctor in lithotripsy discharges you.

Urodynamics: looks at how the bladder fills and the pressures inside the bladder.

Cystoscopy: This looks inside the bladder with an endoscope. This is a small tube with a small camera that is put into the bladder through the urethra (like putting in a catheter). The bladder and urethra can then be checked for problems.

Video-urodynamics: This is urodynamics done with xray pictures that show the bladder emptying. They have to be done in a room with an xray videoing machine.

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