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Urological Procedures - London

TURP: (Trans Urethral Resection of Prostate)

This is considered a gold standard procedure performed to rebore an enlarged prostate, causing blockage to the way out of the bladder in men and at times leading to acute stoppage of urine (urinary retention). It is performed as a day case or as an inpatient procedure under a general / an epidural anaesthesia. It involves a period of urethral catheterisation for up to 48 hrs. In addition to the conventional electric current resection of the prostate, it can also be done using Laser energy.


Prostate Biopsies:

Biopsies from the prostate are usually done under local anaesthesia as an outpatient when up to 12 samples are taken however, if more samples are required for making a diagnosis of prostate cancer then up to 24 samples are taken from the prostate and such procedure requires sedation / a short general anaesthesia and even an overnight stay in the hospital in selected cases.


Cystoscopy:

This procedure is commonly performed under local anaesthesia as an outpatient but at times may need to be performed under general anaesthesia as a day / overnight stay case particularly if it involves ancillary procedures such as stone removal etc.


TURBT: (Trans Urethral Resection of Bladder Tumour)

This is a standard procedure similar to TURP, performed to formally resect a bladder polyp (cancer) usually under a general / an epidural anaesthesia as an overnight stay procedure. Following confirmation of diagnosis of cancer of the bladder (superficial / non invasive) a regular check on the bladder lining with the aid of cystoscopy (camera examination) is necessary every 3 6 monthly to begin with and subsequently annually up to 10 years.


Bladder stone removal:

On an X-ray / scan diagnosis of a stone in the bladder, formal removal of this stone measuring anything up to 2.5 cm is performed via passage of a large cystoscope down the waterpipe under a short general anaesthesia as a day case / over night stay and stone crushed to bits and removed via the cystoscope without opening the bladder.


Vasectomy:

This is a method of permanent male sterilisation performed either under local anaesthesia or sedation as a day case. Patients are advised to resort to another means of contraception until the semen samples at the end of 12 and 16 weeks after this procedure are confirmed free of sperms before allowing them to rely on this procedure for contraception.


Vasectomy Reversal:

Reversal of vasectomy is a lengthier procedure performed under a general / epidural anaesthesia and using an operating microscope to bring the two cut ends of the vas deferens together to restore physical continuity on both sides. The overall success rate after this procedure is dependant on several factors and as such, these patients need to be counselled carefully and extensively before offering them this procedure.


TESE/m-TESE: (Testicular Sperm Extraction or Microscopic - TESE)

This is a process of retrieval of sperms from within the testicular tissue by taking small chunks out of one or both testis or using an operating microscope to retrieve individual sperms from the testis to be stored/frozen for future use. These procedures require a short general anaesthesia and the help of an embryologist for sperm banking.


Circumcision:

This is a routinely done minor procedure offered to boys/men alike for a tight /diseased foreskin and performed under a short general anaesthesia / sedation / local anaesthesia as a day case. It involves removal of the foreskin like a napkin ring and putting dissolvable stitches to connect the outer layer of the penile skin with the inner.


Hydrocelectomy:

Hydrocele is a collection of excessive amount of clear fluid (50 500 ml) around the testis and presents as a swelling of one or both sides of the scrotal sac which requires surgical drainage for sheer size of the swelling / pain or discomfort or for aesthetic purposes. Repair of hydrocele involves exploration of the scrotal sac under a short general anaesthesia, drainage of the fluid around the testis and excision of the sac holding the fluid collection and depositing the testis back into the scrotal sac. This is a routinely performed day case procedure but the recovery at times can take a little longer than expected.


Orchidectomy:

Removal of the whole testis is generally performed for a proven / strongly suspected diagnosis of testis cancer. This involves a cut in the groin to remove the testis along with the cord that it is hanging from and requires a short general anaesthesia for this procedure performed as a day case surgery.


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by Sudhanshu Chitale