Your first urology appointment: what to expect

Published 22 October 2026

Many people arrive at a first urology appointment with two worries: what is wrong, and what is going to happen to them in the room. This guide deals with the second, so you can concentrate on the first. It covers what to bring, what you will be asked, what the examination involves and why, which tests may follow, what happens afterwards and what our consultations cost.

What happens at a first urology appointment?

A first urology appointment is mostly a conversation, followed by an examination if it will help and a plan for any tests. The consultant asks about your symptoms and your health, examines you where that adds information — always with your agreement — and then explains what they think is going on, which tests would settle the remaining questions, and what the options are. Our general urology page lists the conditions we see.

The conversation matters most. In urology, the pattern of symptoms — when they happen, what makes them better or worse, how they have changed — often points towards the cause before any test is done. That is why you may be asked questions that seem unrelated to the reason you came.

What should I bring to a urology appointment?

Bring anything that saves repeating a test or a question:

• A list of your medicines, with doses, including anything bought over the counter or taken as a supplement. Some medicines affect the bladder, the prostate or erections, so the list is clinically useful. Some, such as finasteride and dutasteride, also lower the PSA level (by at least half, according to BAUS), which changes how a PSA result is interpreted.
• Previous results and letters, such as PSA results with their dates, urine results, scan reports and letters from your GP or another specialist. A PSA reading means more when it can be compared with earlier ones.
• A bladder diary, if your problem is with passing urine (see below).
• Your insurance details, if you are claiming: your insurer’s pre-authorisation code and your membership number. Insurers usually want a GP referral first; if you are paying for yourself, you do not need one.
• A short written list of questions.

If you would like someone with you for support, tell us when you book. At some sites, including The Shard, HCA asks patients to attend alone unless a companion has been arranged in advance. Wear clothes that are easy to take off from the waist down. Otherwise, eat, drink and take your usual medicines as normal unless you have been told otherwise.

Do I need a full bladder for my appointment?

Only if you have been told that a urine flow test or an ultrasound scan of your bladder is planned; follow the instructions you are given for each. Otherwise there is no need to arrive with a full bladder.

A flow test, or uroflowmetry, measures how fast you pass urine. You pass urine into a device that records the speed of the stream, and an ultrasound bladder scanner is then normally used to check whether your bladder has emptied fully. The British Association of Urological Surgeons (BAUS) advises arriving with your bladder comfortably full, because with less than 150 ml in the bladder the result may not be satisfactory. The speed of the stream depends partly on how much urine there is, so a small volume cannot give a representative reading.

If you find it hard to hold on, you do not need to over-fill your bladder and risk leaking on the way. BAUS advises telling the staff as soon as you arrive, because you can usually be given enough to drink in the clinic; if a flow test is booked, ask about this when you book so it can be planned around you. The test sometimes has to be repeated once your bladder refills, so allow extra time.

Should I keep a bladder diary before the appointment?

Yes, if your problem is with passing urine: record three consecutive ordinary days and bring the diary with you. On the BAUS chart you note the time and amount of every drink and every time you pass urine, measured in a jug if you can, along with any leakage, which turns impressions such as “I go all the time” into numbers the consultant can work with. Our guide to waking at night to urinate explains how to keep one and what it can show.

What will the urologist ask me?

Expect detailed, practical questions, some of them personal, because the answers change what happens next. Depending on why you have come, they cover your urinary symptoms (how often you go by day and night, the strength of the stream, straining, urgency, leakage, pain or blood); erections, ejaculation and, if relevant, fertility — asked even if you came about your bladder, because some conditions and medicines affect both; your general health, operations and medicines; family history, particularly of prostate or other urological cancers; and what you drink, including caffeine and alcohol.

You may also be asked to complete a short questionnaire about your urinary symptoms, such as the International Prostate Symptom Score (IPSS), which gives a baseline score to compare after treatment.

What does a urologist examination involve?

The examination depends on your symptoms, is explained before it starts, and is only done with your agreement. It may include:

• Your abdomen, to check for tenderness or a bladder that is not emptying.
• Your penis and testicles, to look and feel for lumps, swelling, tenderness, a tight foreskin, curvature or scarring.
• A rectal examination of the prostate, explained below.
• Your blood pressure, which BAUS includes in a full examination for prostate symptoms.

You will usually be asked to undress from the waist down. A video or telephone appointment cannot include an examination; if one is needed, an in-person appointment is arranged.

Will I have a prostate examination at my first visit?

Not necessarily. A prostate examination is offered when it will help — most often for urinary symptoms or a raised PSA — and you can decline it. Prostate Cancer UK is clear that you do not have to have one, and that a PSA blood test can be done on its own.

The examination is called a digital rectal examination, or DRE. The prostate sits just in front of the rectum, so it can be felt through the wall of the back passage. You lie on your side with your knees drawn up towards your chest. The clinician wears a glove, puts lubricating gel on one finger, and gently slides it into the back passage to feel the size, shape and texture of the gland. You may find it slightly uncomfortable or embarrassing, but it is not usually painful and does not take long.

It is useful but not a completely accurate test on its own, which is why it is interpreted alongside the PSA, your symptoms and, where needed, imaging. Our page on prostate conditions explains how these fit together, and our guide to PSA levels by age covers the numbers.

Can I have a chaperone, and can I say no?

Yes to both. You can ask for a chaperone at any point, and you can also bring your partner, a friend or a relative for support; at some sites a companion needs arranging when you book, as explained above.

No examination or test goes ahead without your consent. As NHS guidance sets out, consent must be voluntary and informed: you are told what is involved, why it is suggested and what the alternatives are, including not having it. You can change your mind and withdraw your consent at any point. If declining limits what the consultant can conclude, they will tell you plainly.

Which tests might be done or arranged?

Tests are chosen from your symptoms and examination, not as a fixed package. Your consultant will tell you which are needed, where they will be done and how you will get the results.

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If a PSA test is likely, NHS guidance is to avoid ejaculating, anal sex and activity that leaves you out of breath, including cycling, for 48 hours beforehand, because these can raise the PSA level and make the result less accurate. After a urine infection, the NHS advises waiting four to six weeks once it has cleared before having a PSA test. If any of these apply, tell the consultant; it may be better to take the blood another day than to interpret a misleading number.

What happens after the appointment?

You should leave knowing what the consultant thinks is most likely, what is still uncertain, and what happens next — tests, treatment, a change to a current medicine, or monitoring with a review date. With your permission, we write to your GP so that your records are complete and any future care is safe; we will not write without it. A follow-up to go through results often needs no examination, so it can usually be held by video or telephone.

What does a first appointment cost?

An initial consultation costs £300 or £350, depending on the consultant and whether it is in person or by video or telephone; tests, scans and procedures are quoted separately, in writing, before you commit to them. Our fees and insurance page lists every fee and explains how insurance pre-authorisation works, and our comparison of private and NHS urologists may help if you are weighing the two.

What if I feel embarrassed?

Many people do, and what you describe or show is the everyday work of a urology clinic, where examining the genitals and asking about erections and bladder control is routine. Use whatever words you are comfortable with, or write things down beforehand and hand them over. You can also choose who you see — our team includes male and female clinicians (see our consultants). Consultations are private and confidential, and often the most useful outcome of a first appointment is being told clearly that something is not serious. If erection problems are the reason you are coming, our page on erectile dysfunction treatment describes how they are assessed.

What if symptoms get worse before my appointment?

Do not wait for your appointment if any of these happen; they need emergency care the same day:

• Testicle pain: go to A&E immediately or call 999 if you have sudden, severe pain in a testicle (at any age), testicle pain with feeling or being sick or tummy pain, or testicle pain that has lasted more than an hour or continues when you are resting. Do not drive yourself.
• A prolonged erection: call 999 or go to A&E if you have an erection that lasts more than 3 to 4 hours, or a painful erection lasting more than 1 hour if you have sickle cell disease.
• Being unable to pass urine at all despite a full and painful bladder, or visible blood in the urine with clots or with difficulty passing urine: go to A&E.
• A high temperature with pain in your back or side and feeling very unwell: get help the same day through A&E or NHS 111.

Some changes need checking urgently, though not as an emergency. For a new lump or swelling in a testicle, ask for an urgent GP appointment or contact NHS 111. Even a single episode of visible blood in the urine that settles on its own should be checked: ask for an urgent GP appointment or contact NHS 111.

For a routine appointment, call +44 7889 318584 (Monday to Friday, 8am to 4pm) or email contact@theandrologycentre.co.uk.

Frequently asked questions

References and further reading