Why should you see a urologist? A urotherapist’s point of view

In your opinion, why should patients visit their urologists?
In general, men tend to delay going to a doctor. So when they tell me about their symptoms such as haematuria, Lower Urinary Tract Symptoms (LUTS), bladder pain etc., I urge them to see a urologist. And often they would have conference calls with the referred urologist during consultations with me.

For some patients, it is crucial to go to see the doctor as soon as possible. The symptoms might be indicative of cancer. Or it can be completely harmless and only small adjustments are needed to get a better quality of life. They won’t know for sure until they see their doctors.

Why do think some patients are hesitant to see a urologist?
I think it’s because some patients are very private and/or consider the symptoms or illness a sensitive topic. Some patients think the symptoms or illness will just pass over time. Others are possibly afraid of what the doctor will find.

What is the scope of your responsibilities as a urotherapist?
As a urotherapist, my main responsibilities include patient observation through different urological tests and by knowing a patient’s medical history; guiding patients to better cope with their illnesses; helping keep their dignity intact; and motivating them especially during rehabilitation. My referrals are mainly from urologists, gynaecologists and paediatricians.

I follow up with patients who have different bladder dysfunctions such as incontinence (urine and fecal), stress incontinence, bladder pain, erectile dysfunction, bladder cancer and prostate cancer. I explain the relationship between cause and symptom of the bladder and intestines disorder. I offer advice in pelvic floor training, self-catheterisation, self-blocking, prevention of urinary tract infections (UTIs), biofeedback, advice on diet and fluid intake, and toilet habits etc.

Do you extend assistance to the families of the patients, too?
I follow up on a large group of patients who have undergone radical prostatectomy. They’re on a 10-day check, where catheters and stitches are removed after surgery. The second check is after six weeks. During these checks, my colleagues and I encourage patients to have their family with them; they usually bring their partners. We give the patients and their partners the opportunity to ask questions. We address leakage issues, precautionary measures, erection-enhancing methods, rehabilitation, physical activities and family stress.

In addition, we offer a two-day course every six months for patients who have or had prostate cancer. We encourage them to invite a family member to go with them; usually they bring their partners.

What would improve the knowledge of patients with regard to urology?
Perhaps we need more campaigns to educate the public. I think we have to increase the amount of general information on urological diseases and make it more readily accessible.

Please describe a memorable patient case(s) wherein seeking urological care has changed his/her life.
I recall two patients; an adult male and an eight-year-old girl. The  male patient had several infections and suffered frequent urination at night. He was constantly tired and in turn, his quality of life was affected. He went to the clinic for flowmetric and residual measurements. He filled out three drinking  lists and three pee lists. We found 1400 ml of Resturin, and discovered he had overflow incontinence. The cystometry showed a relaxed bladder.  We’ve taught him self-catheterization. He catheterises five times a day. He has been sleeping better ever since.

The eight-year-old patient began to pee in bed every night since she was three. Last year, she had UTI and suffered from stomach pains. During a talk with her, she disclosed that said she was afraid of being locked in the toilet stall at school. She drank 50 ml of milk at breakfast, then she did not drink anymore nor pee while at school. When she got home that was when she drank a lot.

After safeguarding measures at school’s restroom to show her there’s nothing to fear, she finally dared to go. She also agreed to drink 300 ml at breakfast, 500 ml at school and 300 ml after school (these amounts are based on her body weight). She also started to drink less in the evening. Now she doesn’t pee in bed anymore, there’s no incidence of UTI and stomach pains as well.

Posted: 14/08/2017