Prostate Conditions Specialist in London

If you are getting up at night, noticing a weaker stream, living with pelvic discomfort, or you have been told your PSA is raised, it helps to have the picture explained properly before anyone talks about treatment. The Andrology Centre offers consultant-led prostate assessment in central London, using examination, blood and urine tests, flow studies and imaging to establish what is actually going on. Most prostate symptoms turn out to have a benign cause, and a good many men need no treatment at all — only a clear answer and sensible follow-up.

Prostate conditions we assess and treat

The prostate is a small gland that sits just below the bladder. It is about the size of a walnut and has a channel running through the middle of it, like a doughnut, through which you empty your bladder. Because of where it sits, almost anything that changes the prostate tends to show itself first as a change in how you pass urine.

We assess and treat the full range of prostate problems, with an emphasis on getting the diagnosis right before any treatment is recommended.

Benign prostatic hyperplasia (BPH)

A non-cancerous enlargement of the prostate. As the gland grows, the channel through the centre becomes tighter, which can cause a weak stream, hesitancy, getting up at night and a sense that the bladder has not emptied. BPH is very common and is not a form of cancer.

Prostatitis

Inflammation or infection of the prostate. It can cause pelvic or perineal pain, pain on passing urine or on ejaculation, and urinary difficulty. Some cases are bacterial and respond to antibiotics; others are inflammatory rather than infective and are managed differently.

Prostate cancer

Abnormal cells growing within the prostate gland. Many prostate cancers grow slowly and cause no symptoms for years, which is why assessment is based on examination, PSA and imaging rather than symptoms alone. Where cancer is diagnosed or suspected, care is arranged promptly along a specialist cancer pathway.

Raised PSA

A PSA result above the threshold for your age. A raised PSA is a reason to look further, not a diagnosis in itself. We look at the trend over time and at the reading in relation to the size of your gland before deciding what, if anything, needs to happen next.

Chronic pelvic pain syndrome

Persistent pelvic discomfort linked to prostate irritation, nerve sensitivity or long-standing inflammation, often with no infection found. It is a genuine and treatable condition, and it is not a sign of cancer.

Symptoms of prostate conditions

Prostate problems cause a wide range of symptoms. Some men notice only mild changes; others are troubled a great deal. How severe your symptoms are does not reliably tell you how serious the cause is, which is why assessment matters more than guesswork.

• Urinary: passing urine more often, particularly at night; a weak or slow stream; difficulty starting or stopping; a feeling that the bladder has not fully emptied.
• Sexual: erectile difficulty, reduced desire, pain on ejaculation, or blood in the semen.
• Physical: pelvic discomfort, lower back pain, burning on passing urine, or pain during ejaculation.
• Systemic: fever and chills where infection is present, along with fatigue and general weakness.
• Warning signs: visible blood in the urine, a sudden inability to pass urine at all, or unexplained weight loss.

Mild urinary symptoms in an older man are usually caused by benign enlargement, and in many cases no treatment is needed at all beyond reassurance and periodic review. If your symptoms do not bother you, treating them is not automatically the right answer.

When to seek urgent help

Most prostate symptoms can wait for a routine appointment. A few cannot. Seek same-day medical help, or attend an emergency department, if you are completely unable to pass urine despite a full and painful bladder, if you have a fever with shivering and pain in the pelvis or lower back, or if you are passing visible blood or clots. Blood in the urine needs prompt assessment even if it happens once and settles — see our page on blood in urine.

Why prostate problems develop

Prostate conditions arise for several reasons, and more than one can apply at once:

• Age-related hormonal changes.
• Normal growth of the prostate with age — the gland continues to grow throughout adult life.
• Bacterial infection reaching the prostate.
• A family history of prostate cancer.
• Genetic predisposition and ethnicity, with a higher risk in Black men.

Establishing which of these applies to you is the point of the assessment; it is what decides the treatment plan.

Who should have a prostate assessment?

It is worth arranging an assessment if any of these apply:

• You are over 45 and have not had your prostate checked.
• You have urinary symptoms, however mild — see problems passing urine.
• You have a family history of prostate cancer.
• You have other risk factors, such as being a Black man.
• A PSA test has come back above the threshold for your age.
• You have erectile or hormonal symptoms alongside urinary ones.

Assessment does not commit you to treatment. Many men come away knowing that what they have is benign and that nothing needs doing, which is a useful result in itself.

Understanding PSA

PSA, or prostate specific antigen, is a protein made only by the prostate. Its job is to stop sperm coagulating, which matters for fertility. Because it comes from the prostate alone, the amount in your blood reflects what the gland is doing — but it reflects any prostate activity, not cancer specifically.

The level that usually prompts further assessment rises with age, because the gland itself grows with age. The age-specific thresholds commonly used are:

• 40–49 years: under 2.5 ng/mL
• 50–59 years: under 3.5 ng/mL
• 60–69 years: under 4.5 ng/mL
• 70–79 years: under 6.5 ng/mL

A single number is only part of the picture. How the PSA changes over time (PSA velocity) and the reading in relation to the size of the gland (PSA density) often tell us more. Many ordinary things raise PSA: a large but entirely normal prostate, a urine infection, inflammation, vigorous exercise, recent ejaculation and examination of the prostate itself. A raised result is a prompt to investigate, not a verdict. Our guide to PSA levels by age explains these thresholds and what happens after a raised result.

How we assess you

We work through the same structured steps, stopping when we have a clear answer rather than testing for the sake of it.

• Consultation. A detailed discussion of your symptoms, medical history, medication and lifestyle, including how much the symptoms affect your day and your sleep.
• Physical examination. An examination to assess the size, shape and consistency of the prostate. It takes seconds and is explained fully before it is done.
• Blood tests. PSA, kidney function and, where relevant, hormone levels including testosterone.
• Urine tests. To identify infection or inflammation and to check for microscopic blood.
• Uroflow dynamics and scope assessment. Measuring the rate and pattern of your urine flow and how completely the bladder empties, with a telescope inspection of the urethra and bladder where indicated.
• Imaging and advanced tests. MRI scanning, or video urodynamic studies in more complex cases, when a more detailed picture of the gland and of bladder function is needed.

Treatment options

Treatment depends on the diagnosis and on how much the symptoms trouble you. Options may include:

• Lifestyle changes and monitoring, where symptoms are mild and the cause is benign.
• Medication to reduce the size of the prostate or to control symptoms.
• Antibiotics where infection is confirmed.
• Minimally invasive procedures aimed at widening the channel through the prostate.
• Referral into specialist cancer treatment where that is required.

Doing nothing for the time being, with review, is a legitimate plan and is often the right one. If you have already had surgery for prostate cancer, our page on life after prostate cancer surgery covers recovery, continence and sexual function.

Seeing a prostate specialist in London

The Andrology Centre is led by Mr Maj Shabbir, Consultant Urological Surgeon and Clinical Lead, past National Chair for Andrology at BAUS. He is joined by Ms Raveen Kaur Sandher, Consultant Urological Surgeon, and Ms Elsie Mensah, Urology Specialist, whose work covers bladder cancer, BPH and prostate diagnostics. All three practise at Guy’s & St Thomas’, named by Newsweek in 2025 as the number one urology service in Europe.

Appointments are available at HCA at The Shard (SE1 9BS), HCA at Canary Wharf (E14 5NR) and HCA at Guy’s Hospital (SE1 9RT). If you are paying for your own care, you do not need a GP referral. If you are using private medical insurance, your insurer will usually require one, so it is worth checking with them before you book.

To arrange an assessment, call +44 7889 318584 between 8am and 4pm, Monday to Friday, or email contact@theandrologycentre.co.uk.

Frequently asked questions

References and further reading