This is your overview of the services we offer. Should you have any questions, you can of course get in touch with us and make an appointment.
Erectile Dysfunction (erection problems)
If you have problems with your erections, this can be due to multiple reasons. In some circumstances it can be due to blood vessel problems, diabetes causing nerve damage or low testosterone. Firstly you should seek your GPs opinion, as this can be dealt with easiliy in some cases; your GP may refer you to a specialist. At your conusltation you will need blood tests to check for any unknown causes for your erectile problems. In most patients erectile dysfunction can not be cured but it can be halted and the symptom dealt with using various medications including viagra or cialis. You can help yourself by ensuring you live healthily and keep your waist size down.
ED1000 is now being used for the treatment of Erectile Dysfunction in some men.
These can include a tight foreskin, problems having erections, a bent erection and odd lesions on the penis. Some men find these problems embarrassing but in the case of the latter, serious conditions can occur. A thorough consultation is provided and any tests needed will be undertaken. Surgery for some conditions may be appropriate and this will be discussed with you. Peyronie's disease treatments are available, including new treatments such as Xiapex or Xiapen injection therapy. See our dedicated Peyronies' section.
Pain, lumps and swellings may occur in the skin of the scrotum or inside the scrotal sac itself. If in the scrotal sac it can sometimes mean that you have a problem with the testicles. At your consultation it is ensured that a thorough examination is undertaken of the area and if needed a scan is organised. Depending on the cause the appropriate treatment is discussed with you, this may be painkillers, antibiotics, observation or in some cases surgery.
For men requiring contraception a vasectomy can be undertaken. You will require an assessment and examination first. We will discuss the benefits and risks of the procedure and how it can be done under local or general anaesthetic. Vasectomy is a reliable form of contraception but has a failure rate of 1 in every 1000-1500. Once undertaken it is not immediatley effective. Also it is not easily reversed, although this can be done with post reversal pregnancy rates no more than 50%.
A consultation is usually preferred with your partner. It is important to be certain that you are both in good physical shape and that you understand the important pitfalls of such surgery. Other options will discussed with you at your first consultation. The vasectomy reversal is undertaken using a loupes or microscope technique. This allows up to x24 magnification, which makes placement of fine sutures into the sperm carrying tubes more accurate. The chance of obtaining sperm after the procedure is high (up to 95%). The true success of vasectomy reversal lies in the chance of a pregnancy; this is much lower at up to 50%. Many factors affect the outcome of a vasecomy reversal and these will be discussed with you before any decision is made. (Please see vasectomy reversal page in navigation bar above).
Infertility - Male
In cases of infertility due to causes other than previous vasectomy we can provide specialist consultations and treatment including surgical sperm retrieval: open/closed TESE and PESA. We work closely with all reputable fertility clinics across the North West.
In cases where patients have problems such as premature ejaculation, inability to ejaculate or inability to sustain an erection we also provide specialist consultations. Treatment is available for such problems.
Our services also include rapid access to counselling services where patients require them. We have access to some of our regions most reputable counselling services for individuals and couples therapy.
Prostate Cancer Detection
A full consultation regarding the symptoms and signs of prostate cancer is undertaken. This includes examination, PSA testing, IPSS (Prostate symptom score), a flow test (if needed) and a discussion of the pros and cons of testing, what happens if your tests are positive and potential outcomes. A rectal ultrasound scan and prostate biopsies are carried out if needed. More davanced tests such as PSA ratio, PCA3 and genetic testing are also available. We offer Multiparametric MRI scanning, Transrectal prostate biopsy and state of the art Template guided Transperineal prostate biopsy.
Prostate Cancer Treatment
A discussion will take place on all available treatment options depending on the extent of the disease. This may include Active Surviellance (No treatment with monitoring), Radical Prostatectomy (Surgery), Radiotherapy (External beam and brachytherapy) with or with out anti-hormone treatment, Anti-hormone treatment (LHRH analogues) alone, or newer therapies such as HIFU and Cryotherpay. Access is provided to regional or national experts who may be able to treat your condition.
Recurrent Prostate Cancer
Treating prostate cancer recurrence depends on the facts surrounding your intial diagnosis (for example your intial PSA, Gleason score and stage), your PSA since treatment and, your current stage and which treatment you intially underwent. A discussion regarding this will be undertaken and the pro and cons of options discussed, for example Continued Monitoring, Anti-hormone Treatment, Radiotherapy (external beam), HIFU and Cryotherapy.
Haematuria (blood in the urine)
This is blood in the urine and it may be visble by eye or only by the microscope when your urine is tested. Up to 25 out of every 100 patients my have a significant cause for this, for example prostate disease, bladder cancer, infection, urinart tract stones and renal (kidney) cancer. A consultation with an examination is undertaken, after which the investigations needed to hopefully exclude any problem will be discussed and requested. These may include Blood tests, Urinary tract scans (Ultrasound), Urinary tract Xrays (plain and dye tests (IVU)), a local aneasthetic bladder examination (cystoscopy), Urine tests (for infection and abnormal cells) and sometimes a CT scan. NMP22 can also be used to aid diagnosis. If any cause is found then the appropriate treatment is discussed. Access is available to regional and national experts depending on your diagnosis.
The Management of Superficial (early) Bladder Cancer
Some types of superficial bladder cancer have a high risk of progression whilst most have a high risk of recurring. Your bladder will be examined, at the first diagnosis, under a general anaethestic. You will require further xray type imaging if it has not already been undertaken. It is likely that you will have medicine put into the bladder after this. The medicine can stop the disease from coming back. In some instances you may have the medicine on a weekly basis for 6 weeks and in other instances this may be for 8 weeks. You will require long term bladder checks to ensure the disease does not come back or get worse. This will be discussed with you. In some cases new tests can be undertaken, such as NMP22, that can sometimes help decide whether a local anaesthetic or general anaesthetic bladder check is indicated.
The Management of Invasive (late) Bladder Cancer
Invasive or late bladder cancer treatment starts with an accurate assessment of you and your disease. Then a discussion on treatment options can take place. Briefly the options include organ preservation using radiation therapy protocols or surgery, which involves removal of the bladder. The latter requires diversion of the urine into either a reconstructed bladder or a stoma. Long tern follow-up is required with both these forms of treatment to ensure either no disease returns or to ensure no comlications of the treatment arise.
The Management of Penile Lesions and Penile Cancer
Penile lesions can be simple, such as those due to thrush. Others can be due to inflammation, scarring, warts, sexually transmitted infection or cancer. In some cases the diagnosis is easily made on clinical examination and treatment can be initiated. In other cases a biopsy may be needed after which the correct treatment can be discussed and intiated. A diagnostic service as well as treatment is offerred. In particular treatment of early and late penile cancer can be administered. Sentinel node biopsy for penile cancer is a treatment/diagnosis that is being developed.
The Management of Renal (Kidney) Cancer
Kidney cancer is becoming commoner. Its management can include surviellance and removal of part or all of the kidney. In cases where there is spread out side from the kidney then other therapy can be given in addition e.g. inteferon, sutent etc., Your case can be discussed and the most appropriate treatment identified. Minmally invasive (key hole surgery) may be an option for you. We can discuss this.
The Management of Urinary Symtoms in the Male (Benign Prostate Disease)
Benign enlargement of the prostate is common as you get older. A full assessment of your symptoms will take place along with an examination that will include one of your prostate. You will have a urine test, a urine flow test, a symptom questionnaire and blood tests. With this information we can decide whether you require treatment and which type of treatment you need, that is medicines or surgery. Standard surgery is offerred as well as access to modern technology such as green light (KTP) laser.
The Management of Urinary Tract Infections
Infections in the urine can occur for many reasons. You will require a full assessment/examination along with urine and blood tests. For women urine infections are commoner than in men. In women, on most occassions these will resolve with antibiotics but if they return this can be troublesome and should require a specialist opinion. We can provide this to ensure that any treatable cause is identified. In men, urine infections require much earlier investigations as it is not common for them to happen. Men will need xrays, blood tests, and a bladder examination.
We also provide a service for individuals with scotal pain, scrotal lumps, erection problems, premature ejaculation, and pelvic pain.
The world of medicine is in a state of constant flux. This is where we will provide you with a selection of interesting news about the medical world and our practice.
Prostate SelectMDx is now available at our clinics. Please call in advance if you wish to be considered for this test.
New therapies (Fortacin) for Premature Ejaculation now available at Urology Clinics (April 2019)
Shock wave therapy can assist in Peyronies disease & Prostatitis (April 2019).
Peyronies disease can now be treated with collagenase injections (XIAPEX) (Jan 2018).
Multi-parametric MR scanning of the prostate can help in diagnosing prostate cancer. Available at Spire Manchester and The Chrsitie Clinic.