DORCHESTER 
UROLOGY
                  

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DORCHESTER PROSTATE CANCER CENTER


Dorchester Urology offers one of the best prostate cancer care in the country. This centre provides top treatment available only in the best treatment centres in the world. There are designated pathways which cater to the needs of any grade and stage of prostate cancer. Each individual case is reviewed by a team of experts who recommend the most appropriate investigations and treatment pathways according to the BAUS (British Association of Urological Surgeons) & EAU giidelines. . Patients with high age specific PSA and risk of early stage prostate cancer would have an MRI scan on the same day as their clinic appointment. Depending on the MRI findings Immediate plans are made for either TRUS (Trans rectal Ultrasound & Biopsy) or TPTB (Trans perineal template Bx). Patients with suspected advanced prostate cancer will have their treatment started on the same day followed by a Nuclear medicine bone scan to determine if they have metastatic disease. Once cancer is confirmed on the biopsy, immediate plans are made at the MDT (Multi disciplinary team ) meeting, according to the stage and grade of cancer to either have Radiotherapy, Brachytherapy (Radioactive seed implantation) or Robotic surgery.

Please see the following link:​

http://www.baus.org.uk/patients/symptoms/prostate_cancer

https://www.mskcc.org/nomograms/prostate

PROSTATE CANCER RISK CALCULATOR

The original Prostate Cancer Prevention Trial (PCPT) Prostate Cancer Risk Calculator (PCPTRC) posted in 2006 was developed based upon 5519 men in the placebo group of the Prostate Cancer Prevention Trial. it takes into account age, PSA, DRE findings. family Hx and previous Bx status along with the race to calculate the % risk of prostate cancer.
Please see the following link:
http://deb.uthscsa.edu/URORiskCalc/Pages/calcs.jsp

PROSTATE CANCER RISK REDUCTION DUE TO REGULAR EXERCISE/ DIET & STRESS RELIEF

Dorchester Urology is committed to educate men how to reduce the risk of developing prostate cancer, which is the most common male cancer in England. Every year nearly 35,00 men are diagnosed with prostate cancer. We give the most up to date advice to men re reducing the risk of prostate cancer or patients with advanced or recurrent cancer re incorporating healthy diet, decreasing stress and regular exercise into their daily routines to help slow the progression of prostate cancer.
Please see the following link:
https://prostatecanceruk.org/prostate-information/living-with-prostate-cancer/your-diet-and-physical-activity

DORCHESTER STONE CENTRE


Dorchester Urology offers a state of the art treatment for all types of Renal, Ureteric and bladder stones. It also offers modern Lasers and Keyhole surgery for kidney and Urinary stone disease. Mr Afzal specialises in treating complex renal and ureteric stones. His work is carried out to the highest professional standards supported by a team of specialist nurses, Uro-radiologists and experienced anesthetists.
Dorchester Urology also offers percutaneous nephrolithotomy (Key hole) surgery or all complex stag horn renal calculi. Large Staghorn calculi are removed with key hole surgery without subjecting patients to large flank incisions. Holmium laser is to treat renal calyceal and ureteric stones. ESWL ‘’Extracorporeal shock wave Lithotrypsy’’ treatment is offered for small renal and ureteric stones.

Please see the following link:

https://www.kidney.org/atoz/content/diet


HAEMATURIA, FAST TRACK/ ONE STOP CLINIC


There is an urgent one stop, fast track haematuria clinic for patients with blood in the urine. Patients can expect to have a clinical assessment including history and physical examination. An ultrasound scan to assess any renal abnormalities such as renal cancer, kidney stones, hydronephrosis which may be due to a ureteric or lower urinary tract pathology as well as bladder scan for any masses. A plain xray (KUB) is performed to visualise any renal and ureteric calculi. A flexible cystoscopy is performed to assess the lower urinary tract, bladder and urethra. This is an invasive procedure which carries a small risk (around 1-2%) of causing further haematuria or infection. It also causes some dysuria for 24 hours or so. It is important to remind patients that the majority will have either a benign cause or no obvious cause (possibly nephrological) for their haematuria. If patients are found to have an aggressive looking bladder or renal cancer, a urgent CT scan is arranged. In cases of visible / frank haematuria a CT Urogram is advised if no other cause has been identified to look more closely for any ureteric or upper tract pathology.

Please see the following link:

http://www.baus.org.uk/patients/symptoms/haematuria



LUTS/ PROSTATE SYMPTOMS ASSESSMENT CLINIC


Lower urinary tract symptoms (LUTS) include: a need to pass urine very frequently (frequency) without much warning (urgency); associated leakage of urine (urge incontinence); not being able to pass urine immediately (hesitancy); a decrease in the force of the urinary stream; it may be associated with having to pass urine more frequently at night (nocturia). Patients with one of these symptoms are offered history, clinical examination, IPPS score, PSA , and Ultrasound for residual urine.

Please see the following link:

http://www.niddk.nih.gov/health-information/health-topics/diagnostic-tests/urodynamic-testing/Pages/Urodynamic%20Testing.aspx

ENDOUROLOGY


Dorchester Urology offers most of the core endourological procedures; these include procedures like TURP, TURBT, optical urethrotomies, ureteroscopies, EKL and EHL of ureteric stones, Holmium laser fragmentation, cystolitholapaxies, retrograde pyelograms & insertion of JJ stents.

LAPAROSCOPIC SURGERY


Dorchester Urology offers minimally invasive (key hole) surgery for all types of Kidney/ Ureteric cancers along with treatment for non functioning obstructed/ infected kidneys and renal pelviureteric junction obstruction due to congenital abnormalities. Mr Afzal and his other colleagues offer laparoscopic nephrectomy, lapraroscopic pyeloplasty, laparoscopic radical nephro Ureterectomy, lap adrenalectomies & lap pyeloplasty.

Please see the following link:

http://www.nhs.uk/conditions/laparoscopy/Pages/Introduction.aspx

URODYNAMICS


Mr Afzal has a keen interest in treating overactive, neurogenic and hypersensitive bladders. He has extensive experience in Urodynamics study and does regular lists for patients who have complex lower urinary tract symptoms. Bladder filing is performed through a double lumen urethral catheter and vesicle pressure is recorded by a computer in response to filling and voiding. Management decisions are then based on these recording regarding surgery or anticholinergic medication.

Please see the following link:

http://www.nhs.uk/Conditions/Incontinence-urinary/Pages/Diagnosis.aspx

INCONTINENCE

Incontinence is caused by bladder abnormalities and/or sphincter (valve) weakness. Stress incontinence is due to sphincter weakness for which the commonest causes are multiple childbirth or prolonged labour. Urge incontinence is caused by bladder abnormalities for which the commonest cause is an overactive bladder (OAB). Conservative treatment can be successful in improving most forms of incontinence. Surgery is effective in incontinence, if conservative measures do not work.
Please see the following link:
http://www.baus.org.uk/patients/symptoms/incontinence


ANDROLOGY


Dorchester urology offers medical and surgical interventions for erectile dysfunction, Peyronie's disease and male infertility. There is a specialist Erectile dysfunction clinic where patients with male impotence are treated with oral medications, vacuum suction devices or Intra cavernous (penile) injections.

Please see the following link:

http://www.nhs.uk/conditions/Erectile-dysfunction/Pages/Introduction.aspx