Treatments

• General urology
• Treatment of prostatic symptoms with minimally invasive procedures including UroLift, TURP and Endoscopic Enucleation of Prostate (EEP)
• Kidney stones surgery including flexible ureteroscopy and laser stone fragmentation and percutaneous nephrolithotomy
• Investigations of haematuria and high PSA
• Treatment of erectile dysfunction and Peyronie's disease
• Vasectomy
• Circumcision (males of all age groups)
• Hydrocele
• Epididymal cysts excision
• Testicular varicocele surgery
• Investigations and treatment of recurrent urinary tract infections using iAluRil bladder instillations and Uromune^® vaccine
• Urological cancers diagnosis and treatment including renal, bladder, prostate and testicular cancers
• Female urinary incontinence
• Laparoscopic urological surgery

Urolift

The Urolift is a relatively new surgical procedure designed to treat men who have benign prostatic enlargement (BPE).  It is suitable for those patients where medication has been tried but has not been tolerated, or where it has not been effective.

Typically those patients who respond well to this surgery are those whose prostate is not very enlarged.  It may well suit the younger man who wishes to minimise the sexual side effects experienced from taking medication, and those men who find the side effects of conventional surgery unacceptable.

The Procedure

A small telescope-like instrument is passed along the waterpipe (urethra).  This instrument allows a small band, similar in design to a treasury tag, to be passed between the inner and outer surface of the lobe of the prostate gland.  This small implant retracts part of the lobe of the prostate, relieving the pressure/obstruction on the urethra, and obviating the need for any cutting or burning of tissue.  The number of bands put in place depends on the size and shape of the prostate.  After the surgery, most men are able to pass urine without the need for a catheter in situ post-operatively.

The surgery can be carried out either under sedation, or under a general anaesthetic, so that the patient is asleep throughout the procedure.  The choice of sedation or general anaesthetic will be determined following discussion with the surgeon and anaesthetist.

In general, patients will go home the same day the surgery is performed.

Benefits of Urolift

In most cases there is immediate improvement in the ability to pass urine, with the risks of sexual dysfunction being extremely small. It can be a suitable option for men who have not benefitted from medical therapy and those who would like to avoid major prostate surgery and catherisation

For more information please visit www.urolift.com

Intralesional collagenase therapy for Peyronie's disease (Xiapex)

What is Peyronie’s Disease?

Peyronie’s disease (PD) is one of the most commonly underreported diseases affecting the male population. It results in penile pain and curvature during erections which would hinder satisfactory penetrative sexual intercourse.

What is the underlying cause of PD?

PD is caused by inflammation of the tunica albuginea which is the outer coating of the penile cylinders (corpora cavernosa) responsible of expansion during erection. The exact cause of this inflammation is unknown but some men have more profound inflammatory reaction resulting in PD. PD can be associated with some chronic conditions such as diabetes, hypertension and lipid abnormalities. It I also more common in men with Dupuytren’s contractures, an inflammatory condition involving the tendons of the hand

What are the clinical manifestations of PD?

Patients usually present to their GPs with penile pain especially in the early stages. As the disease progress there will be a feeling of a palpable lump in the penis, penile curvature during erection or a recent onset of erectile dysfunction. Patients are usually advised to bring a photographic evidence of the curvature at the time of consultation to provide an accurate assessment to the degree and angle of curvature

PD has a profound effect on patients both physically and emotionally with almost 48% of them suffering from some degree of clinical depression

What are the goals of treating PD?

The principle of treating PD is to restore the function of the penis by correcting the curvature to enable penetration. It is important to remember that you don’t have to have a completely straight penis to restore the function.

Xiapex

This involves the injection of an enzyme known as collagenase within the PD plaque in order to dissolve the collagen fibres which are the main constituents of the plaque. This will result in softening of the plaque and subsequent reduction in the degree of the curvature. The injection has been tested scientifically and it confirmed improvement in the degree of curvature as well as the psychological well-being. The success seen in the initial clinical trials have granted Xiapex both the American FDA and European EMA approval.

Xiapex treatment has several advantages over surgery including

1. Office-based procedure
2. Performed under local anaesthesia
3. Well tolerated and minimal side effects
4. Very short recovery period

For optimal results it is advised only patients with a degree of curvature less that 90^o are selected. Patients are also advised that penile remodelling (stretching exercised performed at least 3-4 times a day) are vital for a successful outcome of the treatment. Xiapex treatment can be repeated depending on the initial response with a maximum of 3 injections involved.

Due to the minimally invasive nature of Xiapex treatment it should be the first line of treatment in patients with good erections and a degree of curvature less than 90^o. Patients with severe and more complex curvatures should be informed that Xiapex will not be very successful and surgery would be advisable

 For more information please visit https://thisispeyronies.com/peyronies-disease/treatment-peyronies-disease