We have a talented and experienced team within our endoscopy department who carry out a wide variety of procedures for our day case patients. Day case means that patients spend less than three hours in the endoscopy unit at Spire Washington Hospital and whatever they need is performed under local anaesthetic or sedation, rather than requiring an overnight stay. Some procedures are purely exploratory to provide a full diagnosis while ailments treated as a day case tend to be minor and have fast recuperation times.
In this column endoscopy team leader Susan Nelson looks at urology – one of the many key services provided by our specialists – and the two types of exploratory investigations patients could potentially experience if they received a referral into Spire Washington Hospital with a urinary tract issue.
“When patients come to see a consultant in urology, they will most likely have had blood in their urine, repeated bladder infections, pain while passing urine (known as dysuria), urinary incontinence or a similar type of problem.
“As you’d expect, our consultants always start by gathering a full case history which helps them decide what type of investigation might be needed. In most cases this is either a cystoscopy or a trans-rectal ultrasound (TRUS).
“Cystoscopies are used to examine the lining of the bladder to identify areas of infection, bladder stones or tumours and during this short procedure a biopsy can be taken to aid the diagnosis. A cystoscopy can also identify weakness in the sphincter muscle, which can cause urinary incontinence, or enlargement of the prostate gland, which may have caused obstruction to the normal flow of urine. Catheterisation, re-catheterisation or post-operative stent removal can also be carried out.
“A cystoscopy only takes about 4-6 minutes and the patient is awake and there is no discomfort. The consultant usually gives immediate feedback, organises dates for any further investigations and follow up appointments. This allows our patients instant reassurance, but more importantly when they leave the department, they have peace of mind.
“The above is also true of the TRUS. This procedure takes about 15-20 minutes and is appropriate for people who have seen their GP about problems passing urine. They may struggle to pass water at all, not have a steady flow or they may have had a blood test showing a raised PSA.
“The TRUS is like any other ultrasound examination and uses sound waves to create an image that allows the consultant to measure the size and density of the prostate gland and determine whether any changes are due to a cancerous or non-cancerous condition. Biopsies are taken to provide a definitive diagnosis and the follow up appointment covers any further care and course of treatment required. There’s no pain at all from the procedure – patients regularly say that it sounds more daunting that it actually is.”
At the endoscopy day unit, patients usually have their procedure within a week of first seeing the consultant and follow up appointments are usually also within a week so you can see we pride ourselves on high quality, accessible healthcare. If you’d like treatment at Spire Washington Hospital, all you need to do is ask your GP for a referral and we’ll get you booked right in.