General Urology in London

General urology covers the everyday problems patients bring to a specialist: a slower stream, getting up at night, urgency, recurrent infection, kidney stones, blood in the urine, prostate symptoms, and pain or swelling in the testicles. Our clinic provides diagnosis and treatment across that range, led by consultants who practise at Guy’s & St Thomas’. Most patients who contact us want the same thing first — a clear answer on whether what they have noticed is serious, based on the right tests rather than on every available test.

What general urology covers

General urology deals with the urinary tract — the kidneys, ureters, bladder and urethra — and with the male reproductive organs. It covers most of the problems that bring patients to a specialist: passing urine too often, too slowly or too urgently, urinary infection, kidney stones, blood in the urine, prostate symptoms, and pain or swelling in the testicles.

Our London clinic provides diagnosis and treatment across that range, alongside the specialist andrology work the centre is known for. Most patients who contact us are not certain whether what they have noticed is serious. A large part of the consultation is answering that question properly — choosing the tests that will actually change the decision, and saying clearly when a finding needs treatment and when it does not.

Conditions we treat

We assess and treat a broad spectrum of urological conditions, including:

• Urinary tract infections (UTIs), including recurrent infection
• Blood in the urine (haematuria), visible or found on a dipstick test
• Kidney stones
• Enlarged prostate (benign prostatic hyperplasia, or BPH)
• Prostate cancer and other urological cancers
• Bladder disorders
• Overactive bladder
• Urinary incontinence
• Male fertility concerns
• Erectile dysfunction
• Testicular pain and swelling
• Prostatitis

Several of these have a page of their own, with more detail on assessment and treatment: blood in urine, problems passing urine, prostate conditions and male fertility. If your symptom does not appear on this list, it is still worth asking — general urology is deliberately broad.

When to see a urologist, and when a symptom can wait

It is reasonable to see a urologist when a urinary symptom is new, persistent, getting worse, or simply bothering you enough that you think about it. That includes a weaker or slower stream, getting up repeatedly at night, urgency, discomfort passing urine, recurrent infections, or a lump, ache or swelling in the scrotum.

Equally, plenty of findings need no treatment at all. Mild urinary symptoms that do not trouble you can often be monitored rather than treated. A small epididymal cyst that causes no pain, or a hydrocele that is not enlarging or uncomfortable, frequently needs nothing beyond a clear explanation and a plan for what to do if it changes. Being told plainly that something is harmless is a legitimate outcome of a consultation, and often the most useful one.

Some symptoms should not wait for a private appointment. Seek urgent medical help the same day — through A&E or NHS 111 — if you cannot pass urine at all despite a full and painful bladder, if you develop sudden severe pain or swelling in one testicle (this can be testicular torsion, where hours matter), if you have visible blood in the urine with clots or with an inability to pass urine, or if you have a high temperature with pain in the back or side and feel very unwell. Visible blood in the urine always needs investigation, even if it happens only once, is painless, and settles on its own.

Tests and investigations

Accurate diagnosis comes before treatment. We request tests selectively, based on your symptoms and examination, and we work with experienced radiologists for imaging. The investigations we most commonly use are set out below.

Blood tests

These may include PSA, kidney function, hormone profiles, genetic tests and cardiovascular risk assessment, depending on what is being investigated.

Urine tests and culture

Used to detect infection, blood or other abnormalities in the urine, and to identify which antibiotic an infection will respond to.

Ultrasound scanning

A scrotal ultrasound assesses the testicles and surrounding structures; scanning of the kidneys and bladder looks for stones, cysts, tumours, retained urine and other abnormalities. Ultrasound is painless and involves no radiation.

Uroflowmetry and urodynamic testing

Uroflowmetry measures the rate of your urinary stream. Urodynamic testing looks in more detail at how the bladder fills and empties, and helps distinguish obstruction from bladder dysfunction — a distinction that changes the treatment.

CT and MRI imaging

Detailed imaging of the kidneys, bladder and prostate, used where ultrasound alone cannot answer the question.

Penile diagnostics

Depending on the condition, this may include doppler ultrasound, MRI or nocturnal testing — relevant in erectile dysfunction and in Peyronie’s disease.

Flexible cystoscopy

A thin telescope passed along the urethra to inspect the urethra, prostate and bladder directly. It is done with local anaesthetic gel. Most patients find it uncomfortable rather than painful, and it is over within a few minutes.

Semen analysis and semen culture

Semen analysis assesses fertility; semen culture looks for deep-seated infection in the prostate gland, which is easily missed on urine testing alone.

What happens when you see us

Your first consultation

The appointment begins with a detailed discussion of your symptoms, medical history, medication and concerns, followed by examination where it is appropriate. Our guide to your first urology appointment explains each step in more detail. Consultations are private and confidential. Bring a list of your current medicines and any previous test results, including anything done through your GP, as this often saves repeating investigations.

Investigations

Tests are recommended on the basis of what you describe and what is found on examination, not as a fixed package. We explain why each one is being requested and what the possible results would mean. Turnaround varies: routine blood and urine tests come back sooner than specialist imaging, and results are reviewed and discussed with you as soon as they are available.

Your treatment plan

Once the diagnosis is clear, we agree a plan tailored to you. That may involve medication, lifestyle changes, a minimally invasive procedure, or surgery — and in many cases, monitoring with a review date rather than immediate treatment. Where more than one reasonable option exists, we set out the alternatives, including doing nothing for now, so that the decision is genuinely yours.

Follow-up and ongoing care

Follow-up appointments and continued monitoring are arranged where they add something: after a procedure, while a medication is being adjusted, or to keep an eye on a condition such as an enlarged prostate over time. You will know who to contact between appointments if something changes.

Who you will see

The centre is staffed by three specialists, all of whom practise at Guy’s & St Thomas’, whose urology service was named the number one urology service in Europe in the Newsweek World’s Best Specialised Hospitals ranking for 2025.

• Mr Maj Shabbir — Consultant Urological Surgeon and Clinical Lead of The Andrology Centre; past National Chair for Andrology at the British Association of Urological Surgeons (BAUS).
• Ms Raveen Kaur Sandher — Consultant Urological Surgeon.
• Ms Elsie Mensah — Urology Specialist, with a particular focus on bladder cancer, BPH and prostate diagnostics.

These are the specialists to whom other urologists refer their more complex cases. The advice you receive is impartial and evidence-based, and that includes advising against tests and treatments that are unlikely to help you.

Appointments, locations and referrals

We see patients at three HCA locations in London: The Shard (SE1 9BS), Canary Wharf (E14 5NR) and Guy’s Hospital (SE1 9RT). You can usually choose the site that is easiest for you, although some investigations are only available at particular locations.

If you are paying for your own care, you do not need a referral from your GP — you can contact us directly. If you are using private medical insurance, your insurer will usually require a GP referral before they will authorise the consultation, so it is worth checking your policy and obtaining an authorisation number before you book.

To arrange an appointment, call +44 7889 318584 between 8am and 4pm, Monday to Friday, or email contact@theandrologycentre.co.uk. If your question is urgent and outside those hours, contact NHS 111 or your nearest A&E department rather than waiting for a reply.

Frequently asked questions

References and further reading