Urinary problems

The Prostate Clinic provides treatment and expertise for a wide variety of urinary problems, from LUTS, to treatments such as bladder neck incisions, lasertripsy, litholapaxy, vasectomy, hydrocoele repairs, orchidopexy and more.


Bladder neck incision

Why we undergo this procedure:

This operation is ideal for men with a decreased urinary stream and problems passing urine because of a bladder neck stenosis or a urethral stricture. Scarring may have occurred within the urethra called a ‘urethral stricture’ or at the neck of the bladder ‘bladder neck stenosis’ which causes a narrowing of the urethra that affects urine flow and frequency.

A bladder neck incision is designed to improve the flow of urine, relieve urinary pressure in the bladder and prevent complications such as urine infections, bladder stones and kidney damage.


A bladder neck incision procedure involves an incision to the neck of the bladder where the prostate is restricting the flow of urine. A telescope is inserted through the urethra to your bladder neck. Blockages are seen and then surgically removed with a small knife instrument. A catheter tube is inserted into the bladder and fluid washed in and out to help settle any minor bleeding and to irrigate the bladder.

The operation is performed under either general or spinal anaesthetic and usually takes less than an hour.

After surgery:

The hospital stay is generally 2-3 nights and you may experience some discomfort immediately post-operatively but you will be given pain relief as needed. An intravenous drip will also be in your arm for 1-2 days so you will need to drink 2-3 litres of fluid per day.

Urine may contain blood or blood clots for 2-4 weeks but this is to be expected.

You can drive a car 1 week after surgery and return to work 2-3 weeks post surgery depending on your type of work.


Potential problems may include post-operative pain, infection, bleeding and long term complications may include impotence (2-4%), retrograde ejaculation when ejaculation enters the bladder (5-15%), urinary incontinence (less than 1%) and strictures of the urethra or bladder neck (1-2%).




Why we undergo this procedure:

Kidney stones can become trapped anywhere in the urinary tract including the kidney and ureter. If a stone gets stuck in the ureter it can cause a blockage and the back-up of urine into the kidney which can be quite painful and become infected.

Laser lithotripsy is an excellent option for when the kidney stones are too large to pass, irregular in shape, cause bleeding or damage to surrounding tissue.


A lasertripsy is a minimally invasive therapy used to break apart the kidney stone so it can pass through the ureter.

It is performed as a day procedure under general anaesthetic where a tiny scope is inserted through the urethra so a smaller scope can access the ureter and the kidneys to blast stones using laser technology.

After the procedure a ureteric stent will be used to ensure comfortable recovery and removed a week or so later under local anaesthetic.



After the procedure:

You will wake up with a catheter draining your bladder, you may have a temporary tube in your ureter (ureteric stent) to allow for urine to pass from your kidney to bladder without blockage which may be attached to the catheter and removed prior to discharge.

You may have some pain, blood in urine or urgency and frequency with urination which should resolve within a few days after surgery.

You can’t drive a car 24 hours after surgery.

You can return to work normally within 1-5 days depending on your type of work.


Complications following the procedure could include infection, stone pieces causing blockage of urine flow, blood clots in your urine and/or damage to other organs with heaving bleeding.



Why we undergo this procedure:

Bladder stones can form in the urine as a result of the minerals and salts being too concentrated in the bladder.

The procedure:

Litholapaxy is similar to lasertripsy and uses radio frequency to blast kidney stones.

The procedure takes approximately 15 to 60 minutes to perform and is done either under general anaesthetic or spinal anaesthetic.

A telescope is inserted into your bladder through the urethra to inspect the interior and the urethra and small stones are washed out through a telescope. Once the larger stones have been broken up, the small fragments produced can be removed using suction.

After the procedure:

You will need to stay in hospital for 2-3 days and you will have a bladder catheter in you which can be removed after one to three nights. You should drink twice as much fluid as usual within the first 24 to 48 hours to reduce the risk of infection and flush out your system.

Urine may be slightly painful and bloodstained but this should settle within a few days.

You can return to work when comfortable enough and your GP is satisfied.


Mild burning or bleeding on passing urine for short period after operation, infection of the bladder requiring antibiotic treatment, bleedings for a few days after the procedure, failure to remove all the stones, anaesthetic or cardiovascular problems, injury to the urethra resulting in scarring, perforation of the bladder requiring open surgical exploration and repair.



Why we undergo this procedure:

A vasectomy blocks the sperm from reaching the semen during ejaculation making it the birth control method with the highest level of effectiveness.

It is a safe and effective form of birth control for men who don’t want to be fathers in the future. It is an outpatient surgery with a very low risk of complications or side effects.

The procedure:

Tubes that carry sperm are cut and sealed. One or two cuts are made in the skin of the scrotum so the vas deferens can be reached. The vas deferens is cut and a small piece may be removed to leave a short gap between the two ends. The ends of the vas are then cut and the cut ends are tied or tissue is put between them. This is then repeated on the other vas. The scrotal cuts may then be closed with dissolvable stitches or left to close on their own.

Most people use a local anaesthetic but it can also be done undergeneral anaesthetic

The surgery usually takes around 10 to 30 minutes.

After the procedure:

You may be uncomfortable for a few days and need mild pain medication to take care of any pain.

A small lump (granuloma) may form from sperm leaking from the cut end of the vas into the scrotal tissues

Most people can return to work as early as the next day depending on the job.

It takes around three months after the time of the procedure for a vasectomy to fully begin working but you will need to have a sperm test to confirm that your semen contains no sperm.


There’s a small risk of bleeding in the scrotum. You can also experience blood in your semen, bruising of your scrotum, infection of the surgery site and swelling. Post-vasectomy pain syndrome also occurs in 1 or 2 men out of 100 vasectomies which is pain following a vasectomy and can be treated with anti-swelling meds



Hydrocele repairs

Why we undergo this procedure:

A hydrocele repair is surgery to correct the swelling of the scrotum that occurs when you have a hydrocele, which is a collection of fluid around a testicle.

Hydroceles form when the natural balance of fluid formation and absorption become imbalanced with a gradual accumulation of fluid. A hydrocele repair may be needed when the fluid collection is large enough to be causing pain or discomfort, it is large enough to be a nuisance or look unsightly, or there are recurrent infections.

The procedure:

A cut is made on the scrotum over the swelling and the surgeon drains the fluid after removing part of the hydrocele sac. Some stitches are put inside to stop the fluid returning and some skin stitches are used to close the skin edges together. A dressing is then put over the wound and you may also have a bandage around both testicles to prevent any swelling which can be removed after 24 hours.

General anaesthetic is used during this procedure so you will be asleep and pain-free during the procedure. It will also be a day procedure so you will be able to return home 3-4 hours after you have recovered from your general anaesthetic.

After the procedure:

There may be some discomfort, but you will be given strong pain killing and/or local anaesthetic drug in theatre which reduces the pain for the first few hours. Pain will be monitored and you will be offered more pain relief tablets as appropriate.

You are advised to take 10-14 days off work and to avoid any strenuous exercise or lifting.


It is common at about 2 weeks after surgery to have a degree of general tissue swelling with the appearance of the hydrocele returning, which will settle down after 6 weeks.

Occasionally, there may also be blood collection around the testes which resolves slowly or requires surgical removal. There may also be a possible infection of the incision or the testis requiring treatment with antibiotics or surgical drainage.

In the rare occasion, there may be a recurrence of fluid collection.

A general thickening of the scrotal tissues may be present which slowly reduces over a few months following surgery.



Why we undergo this procedure:

To move a testicle that has not descended down to its proper place in the scrotum. Undescended testes can cause further health issues such as infertility and an increased risk of testicular cancer.

The procedure:

The procedure is undertaken under general anaesthetic so you will be asleep. A small incision is made in the groin area over the testicle so the surgeon can bring it down into its proper place in the scrotum. A second incision is made in the scrotum. Tiny stitches that dissolve on their own are placed under the skin to make sure the testicle doesn’t pull back up and out of the scrotum. The incision will be covered by a simple dressing.

The surgery takes about 1 hour.

After the procedure:

The patient is guided into a recovery room and monitored for any complications. The stay in hospital is very short and most patients are released the same day. Pain relief is given on a regular basis to ensure comfort is maintained.


General complications can include pain, infection in the surgical site, bleeding, and scarring. Other specific complications can include the developing of a lump under the wound, shrinking of the testicle, prevention of sperm passing to the penis, the testicle returning to its original position and a reduction in fertility of a testicle that is brought down.




LUTs (lower urinary tract symptoms) are symptoms relate to problems with your lower urinary tract: your bladder, prostate and urethra.

A large Australian study has shown about 1 in 14 men in their 40s and nearly 1 in 3 men over 70 report moderate to severe LUTS.


The symptoms of LUTs may involve urinary frequency, urgency, a poor stream, hesitancy (a longer than usual wait for the stream of urine to begin), straining to urinate, nocturia (getting out of bed to pass urine) or a feeling of incomplete emptying.


LUTS may be caused by a urinary tract infection or an infection and inflammation of the prostate gland (prostatitis). LUTs can also be due to an underlying chronic medical condition such as diabetes, obesity, high blood pressure or obstructive sleep apnoea.

Testing and treatment:

We use an Ultrasound scan to assess the internal organs and help to diagnose a variety of conditions in the bladder and prostate It is a painless procedure with no anaesthetic required. A gel will be applied to your skin over the area to be scanned which allows the probe to slide easily over the skin and produce clearer pictures. The probe is moved back and forth over the area until completely examined and the gel is then wiped over your skin. There are no known risks from an ultrasound and its considered a very safe procedure.