Mr Matt Hotston can provide private consultations, investigations, and treatment of a wide range of urological conditions.
Urinary symptoms related to bladder and prostate problems
Investigation and management of blood in the urine & raised PSA
Kidney stone treatment (including laser surgery)
Scrotal and foreskin complaints
Bladder cancer surgery (TURBT)
You do not need to suffer!
In men, daytime urgency, frequency, slow stream, and getting up frequently at night are commonly due to an enlarged prostate, an overactive bladder, or a combination of both. They can significantly impact on your quality of life, and if left untreated can sometimes lead to complications such as infections, bladder stones, and urinary retention (unable to void) requiring a catheter tube being fitted. If not too problematic, treatments can involve lifestyle changes with or without medication. For prostate-related symptoms, alternatives such as the Urolift and the TURP may be discussed. As previously described, Urolift is a minimally invasive day case procedure that can significantly improve urinary symptoms, get you off your medication, and prevent urinary retention.
TURP or ‘Transurethral Resection of the Prostate’ is a procedure that involves endoscopically removing the inner part of the prostate.
The prostate is only found in men and is located between the penis and the bladder and surrounds the urethra.
In the event that the prostate becomes enlarged, it can put pressure on both the bladder and urethra, which in turn, can affect urination.
Symptoms of an enlarged prostate, which may be improved after a TURP include:
For those that have required an emergency catheter fitted, the cause is commonly an enlarged prostate. The priority is to get you catheter free as soon as possible! Some medications may help you with this, but commonly the requirement is for an urgent endoscopic prostate operation called a TURP. This is whereby the inner ‘obstructing’ part of the prostate is cored under a general or spinal anaesthetic, a catheter is placed overnight, and removed the following day.
The commonest cause of frequency and urgency, with or without incontinence, is an overactive bladder. Management strategies include lifestyle advice +- medications to control bladder contractions. For more stubborn or severe symptoms, botox can sometimes be placed into the bladder lining. For recurrent UTIs, there can be a range of factors involved. Investigations may include urinary tract imaging +- bladder and urethra examination (cystoscopy). Management options are varied and would be focused on treating the causes and preventative measures.
Experiencing blood in the urine may represent a significant problem anywhere in your urinary tract, and invariably requires urgent investigation. If referred you will have a thorough consultation, examination, and if appropriate be offered tests in the form of imaging and a bladder examination which involves a cystoscopy, which is a procedure that involves looking inside the bladder using a thin camera called a cystoscope.
PSA, or prostate specific antigen, is a naturally occurring protein released by the prostate. If it is abnormally high for your age, or your GP is concerned after examining your prostate, you should have an urgent urological referral. Following an in depth consultation you may be offered urgent imaging followed by prostate biopsies.
If you have developed a scrotal swelling that is not improving you may have a ‘hydrocele’. This is whereby the layer around the testis (called the tunica vaginalis) produces fluid leading to significant swelling. The treatment is a ‘hydrocele repair’ which is a day case procedure under a short general anaesthetic (GA) to remove the fluid and prevent it recurring. The other common cause of swelling is the formation of ‘epididymal cysts’ which are benign fluid filled cysts coming from the epididymis (sperm tube behind the testicle). If causing symptoms, they can also be removed under a short general anaesthetic.
If you are getting problems with a tightening of your foreskin, which may also include discolouration, bleeding or splitting, you may have a condition called BXO (balanitis xerotica obliterans). This skin condition can cause significant problems, including painful erections, and even effects on urinating. In the early stages, topical steroid medication may help. Otherwise, a circumcision may be required. This is a day case procedure, either under local or general anaesthetic depending on preference.
Kidney stones are unfortunately common in the western world. They can cause significant symptoms including pain and urinary infections. The management includes investigating the causes, prevention measures, and active treatment. Your condition will be fully assessed and treatment options will be discussed in detail. If appropriate, laser endoscopic surgery may be offered, which is commonly as a day case procedure under general anaesthetic.
If you have been diagnosed with a possible bladder tumour growth, either by flexible cystoscopy or from a scan, you will require an initial operation to resect the bladder tumour, called a TURBT. This is performed either under a short general or spinal anaesthetic, commonly with a single overnight stay.