Dr. Mohan Keshavamurthy

Consultant urologist, treating the kidneys, bladder, prostate and male reproductive system — stones, obstruction, urinary symptoms, incontinence and urological cancer. Most conditions here have several reasonable treatments, from medication to keyhole and laser techniques, and the consultation is about which one suits your anatomy and how you want to live afterwards.

What a urologist treats

The kidneys, bladder, prostate and male reproductive system — stones, obstruction, urinary symptoms, incontinence, and cancers of the kidney, bladder and prostate. Much of the work is now keyhole, endoscopic or laser rather than open surgery.

When you would be referred

A slowing urinary stream or needing to get up repeatedly at night, recurring stones, blood in the urine, or a raised PSA. Blood in the urine always needs investigating even when it is painless and settles on its own — particularly then.

At the first consultation

Most conditions here have several reasonable treatments, and the right one depends as much on how you want to live afterwards as on the anatomy. For an enlarged prostate that means weighing medication against a procedure, and being told plainly about the effects on ejaculation, which is the part most often left unsaid until afterwards.

What to bring, and what to ask

Recent ultrasound or CT imaging, PSA results over time rather than one value, a flow-rate study if you have had one, and a current medication list. Worth asking: what are the alternatives to the procedure being proposed, what are the effects on continence and on sexual function, and — for stones — will the stone be analysed and a metabolic cause looked for, since without that prevention is guesswork.