FAQs

Most men have no problems after a vasectomy. Problems are uncommon but include the following:

  • As with any operation or cut to the skin, there is a small risk of a wound infection.
  • Bleeding inside the scrotum can make it swollen and painful. This is called a haematoma and may require further surgery.
  • It is possible for sperm to leak out of the cut tubes and collect in surrounding tissues. If this happens, hard lumps, called sperm granuloma (up to 10%), can form. Sperm granuloma is not harmful, and can be treated with anti-inflammatory medicines. However, occasionally they can be painful and need to be removed (2-3%).
  • A small proportion of men develop long-term testicular pain (chronic testicuar pain in 5%).This may be due to pinched nerves or scarring, congestive epididymitis as a result of elevated pressures in closed-ended vasectomy and may require further surgery.
  • Vasectomy failure is expected in 1 out 1000 men who undergo a vasectomy.
  • Very rarely, even when performed correctly, there is a very small risk (about 1 in 2000) the tubes can rejoin naturally and you will become fertile again.
  • If you have a general anaesthetic, as with any operation there is a small risk associated with the anaesthetic.

You will need to have two semen tests to ensure that your tubes are clear of sperm.

You need to have 20 ejaculates by 6 weeks so you can give a first semen sample. The second semen sample will be 6 weeks after the first one or three months after surgery.

If these semen samples are clear of sperm, you will be given the ‘all clear’.

You still need to use other forms of contraception, such as condoms, until you get the ‘all clear’.

  • A vasectomy involves cutting the two tubes (vas deferens) that carry sperm carry sperm from your testicles to your penis.
  • A vasectomy will not affect your sex drive or ability to enjoy sex.
  • You will still have erections and produce the same amount of fluid when you ejaculate. The only difference is that the fluid will not contain sperm.
  • Your body will still produce sperm, but they can’t travel out through your penis and are naturally reabsorbed by the body.
  • Vasectomy is a reliable method of permanent contraception – but not quite 100%. About 1 in 1000 operations are not successful, and semen tests show sperm still present after the operation.
  • Even after a successful operation about 1 in 2000 men who have had a vasectomy will become fertile again at some point in the future. This is because, rarely, the two ends of the cut vas deferens re-unite in time (Late recanalisation).
  • Before surgery you will be asked to sign a consent form.
  • This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

The alternatives to vasectomy include long-term contraceptive options for women.

  • A vasectomy should be considered a permanent operation.
  • However, some men come to regret the operation and want it reversed. A vasectomy reversal operation rejoins each of the tubes that carry sperm from the testicles to the penis, which were cut during a vasectomy. However, this doesn’t guarantee that your fertility will be restored and it is not funded by the NHS.
  • It will be done in the procedure room at outpatient clinic as a day case, which means that you can have the operation and go home the same day.
  • It is usually done with a local anaesthetic (but is sometimes done under a general anaesthetic).
  • Local anaesthetic is injected into a small area of skin on either side of the scrotum above the testes.
  • A small cut is then made to these numbed areas of skin.
  • The vas deferens can be seen quite easily under the cut Skin. It is cut, and the two ends are tied. The small cuts to the skin are then stitched back together with dissolvable stitches. The operation takes about 20-30 minutes.
  • There is usually some discomfort and bruising for a few days afterwards. This normally goes away quickly. The discomfort can be helped by wearing tight fitting underpants day and night for a week or so after the operation. It is also best not to do heavy work, exercise, or lifting for a week or so after the operation.

Hyaluronic Acid Injection is a clear, colourless liquid for use in the temporary replacement of the bladder lining. The primary component is sodium hyaluronate, a salt of hyaluronic acid, which occurs naturally in the fluids of the eye, the joints, and in the glycosaminoglycan (GAG) layer of the bladder lining. This layer – which is deficient in many patients with interstitial cystitis, and other painful bladder conditions – is believed to provide the bladder wall with a protective coating against irritants in the urine.

Hyaluronic Acid is instilled directly into the bladder. The procedure is quite painless and may be undertaken in a hospital/clinic, or self-administered following instruction from a Health Care Professional. For best results, Hyaluronic Acid should be retained in the bladder for as long as possible (a minimum of 30 minutes).

Hyaluronic Acid is administered initially once weekly, for four consecutive weeks, then monthly until symptoms resolve (approximately 2 to 4 months.

Potential side effects are minor and include mild bladder pain and small risk of urine infection

Urinary tract infections (UTIs) are common,  can be painful and uncomfortable, but they can be easily treated with a course of antibiotics.

UTIs are more common in women than in men. Up to half the population of women will suffer a urinary tract infection (UTI) within their lifetime, of which 25−35% will have a recurrent urinary tract infection within 3−6 months.

A recurrent UTI is defined as three or more uncomplicated infections documented by urine culture in the last 12 months.

Women are more likely than men to have a UTI. This is because in women, the urethra is closer to the anus than it is in men. Also, the urethra is much shorter in women, making it easier for bacteria to reach the bladder.
You are also more likely to develop a UTI if you have:

  • a condition that obstructs or blocks your urinary tract, such as kidney, ureter and bladder stones.
  • High post-vpoid residual volume: a condition that prevents you fully emptying your bladder (it’s easier for bacteria to multiply if urine stays in the bladder for too long)
  • A weakened immune system from chemotherapy or HIV for example.
  • a urinary catheter – a tube inserted into your bladder to drain away the urine.
  • Others: poorly controlled diabetes, cystocele or rectocele, poor fluid intake and constipation

Urodynamic Study is a test that assesses the function of your bladder and the bladder outflow tract (urethra). This test aims to replicate your bladder symptoms, then study them and determine their cause.

This test requires you to have a catheter (fine plastic tube) inserted into your urethra (urine passage) and another into the rectum (back passage).

During the test, your bladder will be filled with fluid through the catheter, while pressure readings are taken from the bladder and the abdomen. Then you will be asked to empty your bladder and the pressures during voiding (passing urine) are also recorded.

Urodynamic test is used to diagnose:

  • Stress urinary incontinence
  • Urge urinary incontinence
  • Mixed incontinence (stress and urge urinary incontinence).
  • Lower urinary tract symptoms such as: frequency of urine both day and night, slow urinary stream and post voiding dribbling.

Urodynamic test is particularly important if surgery or invasive treatment are considered, to make sure the correct procedure is performed.

When you arrive at the hospital, the test will be explained to you again. This is also your chance to ask any questions. You will be asked to change into a gown to protect your clothing during the tests.

Before the test, you will have a urine test to check if you have any water infection. You may be given a prophylactic antibiotics before (intramuscular injection) and/or after the procedure (tablets) depending on your past medical history.

The test takes between thirty minutes to an hour.

  • You need to increase your oral fluid intake after the study (2-3 L).
  • If you think you have developed an infection, take a sample of urine to your GP.
  • Make an appointment to see me to discuss the urodynamic result and the management plan.

What are the potential side effects of the test?

  • Discomfort passing urine: after the tests some people feel slight stinging or burning when they pass urine. If you drink plenty of fluids (3-4 pints) for 24 hours after the study, these symptoms should quickly settle. If discomfort lasts beyond this time, take a sample of your urine to your GP for testing because it may be a sign of infection.
  • Urine infection: there is a small risk that an infection will be introduced into the bladder during the tests, in spite of measures (i.e. sterile equipment) to prevent this. If you think you have developed an infection, take a sample of urine to your GP.
  • Blood in the urine: after the tests some people find a small amount of blood in their urine when they go to the toilet. If this lasts beyond 24 hours, you should see your GP because it may be a sign of infection.

The most prevalent symptoms include :

  • Bladder/suprapubic pain when the bladder is full, which improves after bladder emptying
  • The need to pass urine frequently day and night
  • Urgent need to pass urine due to bladder pain
  • Sleep disruption
  • Lower backache and pelvic pain

There are an estimated four hundred thousand people in the UK with IC/PB, of whom, 90% are women and 10% are men.

People of any age may be affected, including children, but two thirds are thought to be between 20 and 50 years of age. IC/PBS can affect anyone from any background.

It’s not clear what causes interstitial cystitis, however, one theory suggests that one of the protective layers of the bladder wall may “leak” in people with interstitial cystitis, allowing chemicals in the urine to irritate the bladder. It may be associated with other conditions, such as irritable bowel syndrome, endometriosis and fibromyalgia, as many women with interstitial cystitis also have these conditions.

People who have interstitial cystitis often have small areas of scarring, stiffness or bleeding on the wall of their bladder. Around 5-10% of people with interstitial cystitis have patches of inflammation and broken skin in the bladder, which leads to more severe symptoms. These are known as Hunner’s ulcers.

Interstitial cystitis (IC) is a condition resulting in recurring discomfort or pain in the bladder and the surrounding pelvic region. Its cause is unknown, but is believed to result from a chronic inflammation and degeneration of the bladder wall. It may be more appropriate to call IC “painful Bladder Syndrome” (PBS). IC/PBS has become a significant health problem due to its chronic debilitating character.

treatment for? Hyaluronic Acid is administered initially once weekly, for four consecutive weeks, then monthly until symptoms resolve (approximately 2 to 4 months)

Acid administered? Hyaluronic Acid is instilled directly into the bladder. The procedure is quite painless and may be undertaken in a hospital/clinic, or self-administered following instruction from a Health Care Professional. For best results, Hyaluronic Acid should be retained in the bladder for as long as possible (a minimum of 30 minutes).

Hyaluronic Acid Injection is a clear,colourless liquid for use in the temporary replacement of the bladder lining. The primary component is sodium hyaluronate, a salt of hyaluronic acid, which occurs
naturally in the fluids of the eye, the joints, and in the glycosaminoglycan (GAG) layer of the bladder lining. This layer – which is deficient in many patients with interstitial cystitis, and other painful bladder conditions – is believed to provide the bladder wall with a protective coating against irritant in the urine.

Possible common potential side-effects:

  • Urethral discomfort – you may feel a stinging sensation when you urinate, but this should only last a day or two. If the pain is severe and lasts for more than two days, please contact us or your GP.
  • Blood in the urine – you may have a small amount of bleeding from the cystoscope being passed up the urethra. Some patients do not have any bleeding at all, but some find their urine is slightly pink for a few days after this procedure. Drinking plenty of water (two to three litres spaced out over 24 hours) can help to clear the urine. If your urine remains pink after a few days, please contact us or your GP.
  • Infection – a urine infection can cause a fever and pain when you pass urine. The risk of this can be reduced by drinking plenty of water after the procedure.

Rare potential side effects:

  • Temporary insertion of a catheter – this may be required if you are unable to pass urine normally following the procedure.
  • Delayed bleeding requiring further surgery.
  • Injury to urethra causing delayed scar formation – this may require additional surgery in the future to
    widen the urethra.

A cystoscopy is the only way to have a close enough look at your urinary system to diagnose certain bladder conditions. If there are any alternatives, your doctor will discuss them with you.

Some urinary symptoms – such as those outlined below – are due to problems in the bladder or urethra. Sometimes the cause of your symptoms will be clear from X-rays or tests of your blood or urine, but often the only way your doctor can be sure what is going on is to look inside your bladder. A cystoscopy can help to diagnose the causes of symptoms such as:

  • Blood in your urine (haematuria)
  • Frequent urinary tract infections
  • Difficulty or pain when urinating (passing urine)
  • Frequency in passing urine (going more often day and night)
  • Slow urinary stream
  • Incontinence of urine (inability to control when you urinate).

A cystoscopy is a procedure that looks at the bladder and other parts of the urinary system. It involves inserting a special tube, called a cystoscope, into the urethra and then passing it through to the bladder. There are two types of cystoscope: rigid and flexible.

Your examination will use a flexible cystoscope, which is a fibre-optic tube that can move around bends in the urinary system. It is about the thickness of a pencil and has a tiny video camera on one end, so the doctor can view an image of your urinary system on a screen.

Flexible cystoscopes are generally used to help make a diagnosis or to see if a treatment has been successful.

Renal colic is a pain in the flank (loin) caused by a stone in the kidney or ureter, sometimes associated with blood in the urine (Gross or microscopic haematuria). Treatment should include analgesia (pain killers) and further stone management will depend on the location of the stone. Your doctor will discuss this with you in detail.

It is the presence of blood in the urine, either during a urine test (microscopic haematuria) or you can see it when you pass urine (red urine: gross haematuria). This is a serious symptom that needs to be investigated urgently and thoroughly by a urologist. It can be caused by serious conditions such as cancers of the bladder, kidney and prostate. It can also be caused by urinary infections or urinary stones (kidney stones). Please ask your doctor to refer you for a urology opinion.

This is a narrow area in the urethra (urination tube) that cases difficulty in passing urine. It can be caused by infection or trauma. The treatment is by widening of the narrow area using a telescope (optical urethrotomy), or by reconstructive surgery.

A swelling in the scrotum (sac) can be related to the presence of fluid (hydrocele, epididymal cyst), hernia, dilated blood vessels of the testis (varicocele), infection and trauma of the testis. However, a lump in the testis is a condition that needs urgent medical attention to rule out testicular cancer. Please ask your doctor to refer you to a urologist.

A circumcision could be performed if you wish to have it done for cultural or religious reasons. However it could be indicated to treat foreskin problems such as: tight foreskin (phimosis) and recurrent foreskin infections.

Prostate Specific Antigen (PSA) a protein produced by the prostate. A raised PSA on a blood test may indicate the presence of cancer of the prostate. However, PSA could also be raised as a result of a benign enlargement of the prostate, Urinary tract infection, a recent operation on the prostate or catheter insertion. Please ask your doctor if you have any concerns.

it is a painful condition of the prostate caused by infection or inflammation. You will feel pain in the perineum and genital area and sometimes during ejaculation. Your urologist will advise of some investigations to be done, and treatment options include antibiotics.

It is a similar condition to female menopause. It is related to a decrease in the male hormone Testosterone, with age. The symptoms are: Low energy level, Low well being Decreased muscle bulk/power, Loss of libido, and problems with erection.

It is a consistent or recurrent inability to achieve and/or maintain erection of the penis sufficient for sexual intercourse. It can be associated with high Alcohol intake, smoking, some medications, heart disease, diabetes, high Cholesterol, high blood pressure and a low Testosterone. It can also associate some emotional and psychiatric conditions.

It is a reliable form of male contraception. It involves cutting the two tubes (vas deferens) that carry sperm from your testicles to your penis. It will not affect your sex drive or ability to enjoy sex and you will still have erections and produce the same amount of fluid when you ejaculate. The only difference is that the fluid will not contain sperm.

A vasectomy reversal is an operation to rejoin each of the tubes that carry sperm from your testicles to your penis, which were cut during your vasectomy. Vasectomy reversal operations are more successful if they are done fairly soon after the original vasectomy. About 8 out of 10 men father children when their vasectomy is reversed within three years. If 15 years or more have passed since the vasectomy, this success rate falls to about 3 out of 10 men. It is important to understand that success is not guaranteed. Even if the operation is technically successful, the presence of sperm in your semen doesn’t guarantee that your partner will get pregnant.

The symptoms of prostate cancer could be similar to a benign enlargement of the prostate. Your Urologist will perform a clinical examination including a rectal examination, and may request a blood test (PSA: Prostate Specific Antigen) to help with the diagnosis. Treatment options will be discussed with you according to your specific condition.

The common symptoms are: increased urine frequency especially during the night, a sensation of needing to rush to empty bladder (urgency), and difficulty in starting the urine stream and a slow stream and sometimes an intermittent (stop-start) stream with dribbling after passing urine.

They start with medical treatment (tablets called alpha blockers, and 5-alpha reductase inhibitors). Now we aim to treat benign enlarged prostates in a non-invasive surgical way. This would include Greenlight laser prostate vaporisation. Sometimes we need to perform other types of surgical resection (TURP), depending on your condition. Please ask your doctor.

It is a form of prostate surgery to remove an benign enlarged prostate. The main advantage over conventional electrical surgery is that there is less bleeding. As a result of this you can have surgery as a day case without having to stay in hospital for 4 or 5 days and recovery is faster.

It is important to take the prescribed medications correctly and to drink plenty of fluids (at least 2 litres of water a day) and sometimes Cranberry Juice can help.

It is a problem with involuntary leak of urine. This could be in the form of: Urge Urinary incontinence: needing to rush to the toilet and inability to hold urine until reaching the toilet, leading to a leak. Stress Urinary incontinence: urine leaks during activities such as sports, walking, coughing and sneezing. Mixed urge and stress incontinence.

It is an uncommon painful condition of the bladder that most commonly affects females. The symptoms can resemble a urine infection (hyalouronic acid) but the urine test is negative. You may complain of urgency (rush to the toilet sensation), increased frequency of urination and bladder pain in the lower abdomen. Your Urologist will need to do more specialist tests to diagnose it. Please ask your doctor for further information.

Botox (botulinum toxin) is produced by bacteria called Clostridia botulinum. In some cases where all other treatments have failed to control frequency and urge incontinence, Botox may be needed to treat such symptoms. The main benefits of this therapy are relaxing the bladder muscle leading to a decrease in the number of times you go to the toilet, more warning to reach the toilet in time and therefore less chance of incontinence. It is given as a small injection into the bladder through a fine telescope.

This is a test which establishes the muscle activity of the bladder. It is carried out by a nurse and a doctor. Fine tubes are placed in your bladder and rectum (back passage). To prevent any discomfort, a local anaesthesia gel is used. The bladder will be gently filled with warmed sterile fluid and the muscle activity is monitored on a computer. You will be asked to empty your bladder at the end of the test. For further information and a leaflet regarding this test please press: Urodynamic study leaflet
Also before the urodynamic study you need to complete 2-day input output fluid chart: Input output fluid chart.

They are related to which part of the urinary tract is affected: Cystitis causes painful urination, increased urinary frequency and feeling of needing to empty the bladder urgently, with sometimes urine leak. If the Kidneys are affected (pyelonephritis/ kidney infection) there will be loin pain and high temperature (fever).

No. This could be a problem affecting both women and men, and also children

By life-style adjustments such as: Good fluid intake, decrease bladder irritant drinks (coffee, tea, fizzy drinks), management of constipation, bladder training and pelvic floor exercise. There are different types of drugs to strengthen the pelvic floor muscles and relax the bladder. Sometimes, you may need an operation If these simple measures don’t work. Please ask your doctor for further advice.