Urology Clinic - Urinary & Male Reproductive System

A urine culture involves growing bacteria in a lab. A culture is often used in conjunction with a urinalysis. This test reveals exactly what type of bacteria is causing the infection, allowing your doctor to determine the best medication to prescribe you.

Imaging tests such as ultrasounds, CT scans, and MRIs are typically used in patients who experience frequent infections. These tests allow your doctor to examine the urinary tract for any signs of abnormality. A contrast dye is sometimes used before imaging tests, as this dye helps to highlight the urinary tract structures.

A cystoscopy is often performed in those with severe, recurrent infections. This involves the use of a lens on a thin, long tube to allow for clear examination of the urethra and bladder.

Treatment for urinary incontinence depends on the nature of the incontinence, its severity, and the underlying cause.

Some less invasive options include behavioural training such as bladder training to delay urination when the desire to urinate occurs.

Your doctor will also advice on lifestyle changes that includes cutting back on alcohol, caffeine, or fluids to manage the bladder, schedule toilet breaks instead of waiting for the urge and pelvic floor muscles exercise to strengthen the muscles that help control urination.

Your doctor can also prescribe medication to:

• Calm an overactive bladder
• Treat urge incontinence
• Relax bladder and prostate muscles to make it easier to empty the bladder

For women, applying topical estrogen in the form of a vaginal cream may help tone and rejuvenate urethra and vaginal tissues to help with incontinence.

Other more invasive options include insertion of medical devices or surgery to support respective pelvic organs and prevent leakage.

Treatment options depend on your lifestyle, preferences, and health conditions.

They include:

• Oral medication that enhances the effects of nitric oxide which relaxes the muscles in the penis, increasing blood flow for an erection
• Drugs or suppositories that can be injected or placed directly into the penis
• Devices such as a penile pump or implants
• Moderate to vigorous aerobic activity to help improve erectile dysfunction in men
• Counselling if the cause relates to stress, anxiety, or depression.

Treatment options depend on:

• The effect of the symptoms on your daily activities
• Age
• Prostate size
• Overall health

Oral medications include drugs called:

• Alpha blockers to relax the prostate and bladder neck muscles, making it easier to urinate
• 5-alpha reductase inhibitors block hormones that stimulate prostate gland growth

Minimally invasive surgery options include:

• Transurethral microwave thermotherapy (TUMT) which uses heat to destroy prostate tissue
• Transurethral needle ablation which uses high-frequency radio waves, delivered through needles, to destroy areas of the prostate
• Transurethral resection of the prostate (TURP) where a surgeon inserts a lighted scope through the urethra and removes all but the other part of the prostate
• Water Vapour Therapy (Rezūm) which is newly introduced in Malaysia (available worldwide since 2015, FDA approved), is a quick, safe, and minimally invasive endoscopic procedure to enlarge the prostatic opening by injecting water vapour into the prostate, causing it to shrink and enlarge the opening. Pantai Hospital Sungai Petani is proud to claim that it is the first private medical facility to carry out this procedure in Malaysia

Other options include laser therapy or prostatectomy (removal of the prostate).

Treatment options will depend on how aggressive the cancer is, its spread, and your health. Immediate treatment may not be necessary for men diagnosed with low-risk prostate cancer.

Your doctor may suggest active surveillance where you are regularly followed up with blood tests, rectal examination, and biopsies (if needed) to monitor the disease progression.

Other options include:

• Surgery to remove the entire prostate gland (radical prostatectomy), along with some surrounding tissue and a few lymph nodes
• Radiation therapy
• External beam where you lie on the table while the machine moves around directing beams to your prostate.
• Internally placed radioactive seeds in your prostate tissue, delivering a low dose over an extended period.

Bladder cancer is often treated with:

• Chemotherapy to kill the cancer cells
• Immunotherapy, which boosts the immune system and increases your body’s ability to fight the cancer
• Radiation therapy, which assists in destroying cancer cells Surgery to remove the tumour. Depending on the severity of the cancer, lymph nodes may be removed as well
• Cystectomy, which involves removing of the bladder. If this is necessary, a section of the intestines will be used to create a new way to pass urine. The urine is diverted to an opening on the outside of the body and the patient will be required to wear a bag attached to this opening to collect and drain urine. This is referred to as an ostomy bag

Your doctor will perform a urinalysis, which involves testing the urine for signs of infection. Urinary tract infections are treated with antibiotics. The length of treatment is dependent upon the severity of your symptoms.

Other methods may be used in conjunction with antibiotic treatment to minimise pain. These frequently include:

• Applying heat
• Increasing fluid intake
• Probiotics
• Pain medications
• Medications to relieve pain during urination, such as phenazopyridine.
• Avoiding substances that irritate the bladder, such as coffee and spicy foods.

For urinary tract infections in patients who are otherwise healthy, a three-day course of antibiotics is typically sufficient in eliminating the infection. If the infection has spread to the kidneys, a longer course of antibiotics may be necessary.

Prostate procedures that urologists often perform include:

• Transurethral resection of the prostate to trim as well as seal enlarged prostate tissue
• Transurethral incision of the prostate to treat benign prostatic hyperplasia
• Rezum Water Vapour Therapy - uses water vapour to reduce the size of the prostate and provide lasting symptom relief from Benign Prostatic Hyperplasia (BPH) symptoms without invasive surgery or the potential side effects of prescription drugs

Vasectomy is a common surgical procedure many men get for male birth control. The vas deferens which transports the sperm from the testicles is cut and sealed during the procedure. A vasectomy is an out-patient procedure.

Men who want to have children again can have a vasectomy reversal, although this does not guarantee fertility