?

South Auckland > Public Hospital Services >

Urology | Counties Manukau | Te Whatu Ora

Public Service, Urology

Description

Formerly Counties Manukau Health Urology

What is Urology?
Urology is the branch of medicine that looks at diseases of the urinary system in females and the genitourinary system (urinary system plus genital organs) in males.

The urinary system is made up of the: 

  • kidneys (where urine is formed from material filtered out of the blood)
  • ureters (tubes that carry urine from the kidneys to the bladder)
  • bladder (a balloon-like organ that stores urine)
  • sphincter muscles (muscles around the opening of the bladder into the urethra)
  • urethra (the tube that carries urine to the outside of your body).

The male genital organs include the penis, scrotum and prostate gland. The prostate is a walnut-sized gland located between the bladder and the penis and in front of the rectum. The urethra passes through the centre of the prostate.

A doctor who specialises in disorders of the urinary system and also the male reproductive system is known as an urologist. A doctor who specialises in kidneys and their function is called a nephrologist.

Services provided at the SuperClinic include: Urologists, Nurse Practitioner and Nurse Specialist consultations; investigations e.g. urodynamics, cystoscopies, prostate biopsies; and day stay surgery for minor urological procedures.

Provision of urology services for Counties Manukau patients is part of the regional urology service.  Patients requiring inpatient surgery or acute presentations requiring surgery are treated at Auckland City Hospital - click here to go to the Auckland Hospital urology service page where you will find a number of patient information sheets. Alternatively our other regional service site includes Waitemata District Health Board - click here to view their site.

Consultants

Referral Expectations

Your GP will send us a letter explaining your condition. We will make an appointment time for you, based on your health need, and send it directly to you. For urgent needs e.g. malignant tumours you will be seen right away. For other conditions e.g. chronic prostatitis, you will be seen within 5 months. 

Urology outpatient clinics consist of first assessment (FSA), follow-up appointments and procedural appointments.  You will be seen in the outpatient clinic by a Urologist, Nurse Practitioner, Registrar or a Medical Officer Sub-Specialty (MOSS) who will provide specialist assessment and discuss treatment options and recommendations with you.  If surgery is required you will be added to the waiting list.  Minor urological surgery and a range of selected surgeries are done at Manukau Surgery Centre, whilst other urological surgery is done at Auckland City Hospital. 

Counties Manukau Health cannot admit acute urology patients.  Patients presenting to Middlemore's Emergency Department with urological issues will be transferred to Auckland City Hospital if they require admission or acute surgery.

 To clinic visits you need to bring with you:

  1. Any letters or reports from your doctor or other hospital
  2. Any X-Rays, CT or MRI films and reports
  3. All medicines you are taking including herbal and natural remedies
  4. Your pharmaceutical entitlement card
  5. Your ACC number, if you have one

 Please read your appointment letter carefully, as you may need to come to clinic with a full bladder, or have an x-ray before you see the doctor.

Nurse Practitioner explained here

Fees and Charges Description

There are no charges for services to public patients if you are lawfully in New Zealand and meet one of the Eligibility Directions specified criteria set by the Ministry of Health.  If you do not meet the criteria, you will be required to pay for the full costs of any medical treatment you receive during your stay.

To check whether you meet the specified eligibility criteria, visit the Ministry of Health website.

For any applicable charges, please phone the Accounts Receivable Office on (09) 276 0060.

Procedures / Treatments

Benign Prostatic Hyperplasia (BPH)

This is an enlargement of the prostate gland. In BPH there may be difficulties in passing urine as the enlarged prostate can cause a blockage. Patients with BPH often notice an increased urge to empty the bladder, especially at night. Many men over 60 years of age have some BPH. There are many different treatment options available for people with BPH. Most commonly your doctor can prescribe tablets to improve urinary function. BPH patient information (PDF, 27.4 KB)

This is an enlargement of the prostate gland. In BPH there may be difficulties in passing urine as the enlarged prostate can cause a blockage. Patients with BPH often notice an increased urge to empty the bladder, especially at night. Many men over 60 years of age have some BPH. There are many different treatment options available for people with BPH. Most commonly your doctor can prescribe tablets to improve urinary function.
Bladder Cancer

What causes bladder cancer is not always clear, but the risk of developing bladder cancer can be increased by smoking, getting older, long term bladder problems and unsafe exposure to aniline dyes which are used in some industries. Bladder tumours usually form in cells lining the bladder. Once a tumour begins to enlarge, it may stay in the lining or grow into the wall of the bladder. If untreated, the tumour may then grow into other structures such as lymph nodes. If the cancer enters the bloodstream it may spread to other areas of the body (metastasis). Often the first symptom noticed is blood in the urine. Other symptoms such as needing to pass urine more often or feeling as if you need to go but can’t, affect about 1/3 of people with early bladder cancer. As the tumour grows these symptoms affect more people. The first test to diagnose bladder cancer is usually a urine sample. Sometimes a tube will be inserted through the urethra and the bladder will be washed with liquid to try to wash out some cancer cells for diagnosis. If cancer is suspected, the next step is usually a cystoscopy (a tube is inserted into the urethra to allow the doctor to look inside the bladder). If there is a tumour the doctor can take a small sample (biopsy) for testing. CT or MRI scans are also used to scan the body to see if the cancer has spread to other areas. Treatment depends on the size of the tumour and how much it has grown into the bladder wall. Surgery may be considered especially if the tumour is still small. The surgeon can insert a cystoscope through the urethra and cut out the tumour or burn it away. If the tumour has grown more deeply the surgeon may cut open the abdomen and remove some or the entire bladder (a partial or full cystectomy). If the whole bladder is removed an artificial bladder will be created on the inside or a urostomy bag on the outside. Radiotherapy (an x-ray beam) can be used as the main treatment in some people and in others may be used after surgery to remove any remaining cancer cells. In early cancer, drugs (chemotherapy) or another treatment called BCG may be placed directly into the bladder to kill cancer cells (intravesical treatment). Usually though, chemotherapy is used in the later stages where it can attack cancer cells throughout the body (not just the bladder) and help stop the cancer spreading.

What causes bladder cancer is not always clear, but the risk of developing bladder cancer can be increased by smoking, getting older, long term bladder problems and unsafe exposure to aniline dyes which are used in some industries.

Bladder tumours usually form in cells lining the bladder. Once a tumour begins to enlarge, it may stay in the lining or grow into the wall of the bladder. If untreated, the tumour may then grow into other structures such as lymph nodes.
If the cancer enters the bloodstream it may spread to other areas of the body (metastasis).

Often the first symptom noticed is blood in the urine.  Other symptoms such as needing to pass urine more often or feeling as if you need to go but can’t, affect about 1/3 of people with early bladder cancer. As the tumour grows these symptoms affect more people.

The first test to diagnose bladder cancer is usually a urine sample. Sometimes a tube will be inserted through the urethra and the bladder will be washed with liquid to try to wash out some cancer cells for diagnosis.
If cancer is suspected, the next step is usually a cystoscopy (a tube is inserted into the urethra to allow the doctor to look inside the bladder). If there is a tumour the doctor can take a small sample (biopsy) for testing.
CT or MRI scans are also used to scan the body to see if the cancer has spread to other areas.

Treatment depends on the size of the tumour and how much it has grown into the bladder wall.
Surgery may be considered especially if the tumour is still small. The surgeon can insert a cystoscope through the urethra and cut out the tumour or burn it away.
If the tumour has grown more deeply the surgeon may cut open the abdomen and remove some or the entire bladder (a partial or full cystectomy). If the whole bladder is removed an artificial bladder will be created on the inside or a urostomy bag on the outside.
Radiotherapy (an x-ray beam) can be used as the main treatment in some people and in others may be used after surgery to remove any remaining cancer cells.
In early cancer, drugs (chemotherapy) or another treatment called BCG may be placed directly into the bladder to kill cancer cells (intravesical treatment). Usually though, chemotherapy is used in the later stages where it can attack cancer cells throughout the body (not just the bladder) and help stop the cancer spreading.
Bladder Flow Test

This involves passing urine into a special machine to see what the flow of urine is like. The test needs to be done when you have a full bladder so you can either come to your appointment with a full bladder or come early to drink when you get here.

This involves passing urine into a special machine to see what the flow of urine is like. The test needs to be done when you have a full bladder so you can either come to your appointment with a full bladder or come early to drink when you get here.
Fiducial Marker Placement

In this procedure, the urologist passes an ultrasound probe into the rectum. He then passes a needle with the fiducial marker (also known as a gold seed) down the probe and places the marker into the prostate. Three markers are placed, before you have radiotherapy for the treatment of prostate cancer. It is important that you read your appointment letter carefully as there are instructions with it. There is a prescription for antibiotics that you need to get. You may also need to have a blood test. Fiducial Marker Insertion Patient Information (PDF, 17.7 KB)

In this procedure, the urologist passes an ultrasound probe into the rectum.  He then passes a needle with the fiducial marker (also known as a gold seed) down the probe and places the marker into the prostate.  Three markers are placed, before you have radiotherapy for the treatment of prostate cancer.

It is important that you read your appointment letter carefully as there are instructions with it. There is a prescription for antibiotics that you need to get.  You may also need to have a blood test.
Flexible Cystoscopy

The clinician is able to look inside your bladder by inserting a cystoscope, or small flexible tube, into the urethra. Local anaesthetic gel is used to numb the area. The procedure only takes a few minutes and no special preparation is needed. Flexible Cystoscopy Procedure - Patient Information Sheet (PDF, 645.1 KB)

The clinician is able to look inside your bladder by inserting a cystoscope, or small flexible tube, into the urethra. Local anaesthetic gel is used to numb the area. The procedure only takes a few minutes and no special preparation is needed.
Haematuria

This term means blood in the urine and may be the result of inflammation or other problems with your kidneys, blockages in your ureter, infection or other problems with your bladder or problems with your prostate.

This term means blood in the urine and may be the result of inflammation or other problems with your kidneys, blockages in your ureter, infection or other problems with your bladder or problems with your prostate.
Kidney Stones

This term refers to stones in the urinary system. They form in the kidneys but can be found anywhere in the urinary system. They vary in size and the amount of pain they cause. Many of these stones can pass through without help but some require medical intervention. Extracorporeal shockwave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into very small particles and are easily passed through the urinary tract in the urine. Kidney Stones- A Patient Guide (PDF, 1.8 MB)

This term refers to stones in the urinary system. They form in the kidneys but can be found anywhere in the urinary system. They vary in size and the amount of pain they cause. Many of these stones can pass through without help but some require medical intervention. Extracorporeal shockwave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside the body travel through the skin and body tissues until they hit the denser stones. The stones break down into very small particles and are easily passed through the urinary tract in the urine.

Kidney (Renal) Failure

Kidney failure occurs when the kidneys cannot remove waste products from the blood or control the amount of water in your body. Acute kidney failure occurs suddenly and may be the result of injury, loss of large amounts of blood, drugs or poisons. Kidneys may return to normal function if they are not too badly damaged. Chronic renal failure means a slow decline in kidney function, which may not be noticed immediately. If renal function continues to deteriorate dialysis may be needed.

Kidney failure occurs when the kidneys cannot remove waste products from the blood or control the amount of water in your body. Acute kidney failure occurs suddenly and may be the result of injury, loss of large amounts of blood, drugs or poisons. Kidneys may return to normal function if they are not too badly damaged. Chronic renal failure means a slow decline in kidney function, which may not be noticed immediately. If renal function continues to deteriorate dialysis may be needed.
Nocturnal Polyuria

Nocturnal polyuria means passing large amounts of urine at night, but normal amounts during the day. Nocturnal Polyuria Patient Information (PDF, 114.4 KB)

Nocturnal polyuria means passing large amounts of urine at night, but normal amounts during the day.

Prostate Cancer

Prostate cancer typically consists of many very small, tumours within the prostate. At this stage, the disease is often curable (rates of 90% or better) with standard treatments such as surgery or radiation. Unfortunately, at this stage the cancer produces few or no symptoms and can be difficult to detect. If untreated and allowed to grow, the cells from these tumours can spread to other parts of the body in a process called metastasis. Once the cancer has spread beyond the prostate, cure rates drop dramatically. In most cases, prostate cancer is a relatively slow-growing cancer, which means that it typically takes a number of years for the disease to become detectable, and even longer to spread beyond the prostate. However, a small percentage of patients experience more aggressive forms of prostate cancer. Treatments options for prostate cancer include surgery, radiation, hormone treatment and chemotherapy. Which treatment is chosen depends on factors such as the stage of the cancer and the patient’s age, other health issues and willingness to undergo certain procedures or therapies – some of which may have side effects.

Prostate cancer typically consists of many very small, tumours within the prostate. At this stage, the disease is often curable (rates of 90% or better) with standard treatments such as surgery or radiation. Unfortunately, at this stage the cancer produces few or no symptoms and can be difficult to detect. If untreated and allowed to grow, the cells from these tumours can spread to other parts of the body in a process called metastasis. Once the cancer has spread beyond the prostate, cure rates drop dramatically. In most cases, prostate cancer is a relatively slow-growing cancer, which means that it typically takes a number of years for the disease to become detectable, and even longer to spread beyond the prostate. However, a small percentage of patients experience more aggressive forms of prostate cancer. Treatments options for prostate cancer include surgery, radiation, hormone treatment and chemotherapy. Which treatment is chosen depends on factors such as the stage of the cancer and the patient’s age, other health issues and willingness to undergo certain procedures or therapies – some of which may have side effects.
Prostatitis

This is the term used to describe inflammation of the prostate gland. Symptoms can include increased need to pass urine and pain on passing urine as well as perhaps lower back pain. Sometimes this inflammation is due to an infection and an antibiotic will be prescribed, otherwise pain relief medication may be prescribed. Prostatitis: Patient Information (PDF, 124.9 KB)

This is the term used to describe inflammation of the prostate gland. Symptoms can include increased need to pass urine and pain on passing urine as well as perhaps lower back pain. Sometimes this inflammation is due to an infection and an antibiotic will be prescribed, otherwise pain relief medication may be prescribed.

Proteinuria

This term means protein in the urine and may indicate that there is a problem with your kidneys.

This term means protein in the urine and may indicate that there is a problem with your kidneys.
Transrectal Ultrasound Guided Biopsy of the Prostate (TRUS)

In this procedure, the radiologist/urologist passes an ultrasound probe into the rectum and then takes approximately 12 biopsies or tissue samples under ultrasound guidance. It is important that you read your appointment letter carefully as there are instructions with it. There is an antibiotic prophylaxis that you need to get, and a laboratory form for a rectal swab and urine test. TRUS Biopsy Patient Information Sheet (PDF, 425.5 KB)

In this procedure, the radiologist/urologist passes an ultrasound probe into the rectum and then takes approximately 12 biopsies or tissue samples under ultrasound guidance.
 
It is important that you read your appointment letter carefully as there are instructions with it. There is an antibiotic prophylaxis that you need to get, and a laboratory form for a rectal swab and urine test.
Urinalysis

Urinalysis is a test that examines the content of urine for abnormal substances such as protein or signs of infection. This test involves urinating into a special container and leaving the sample to be studied.

Urinalysis is a test that examines the content of urine for abnormal substances such as protein or signs of infection. This test involves urinating into a special container and leaving the sample to be studied.
Urinary Incontinence

Urinary incontinence or loss of bladder control is the involuntary passage of urine (passing urine without meaning to). There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men.

Urinary incontinence or loss of bladder control is the involuntary passage of urine (passing urine without meaning to). There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men.
Urinary Retention

Urinary retention, or abnormal holding of urine in the bladder, is a common urological problem. Possible causes of acute urinary retention (sudden inability to urinate) include a blockage in the urinary system, stress or nerve problems. Chronic urinary retention (some urine is always left in the bladder after emptying) may be caused by bladder muscle failure, nerve damage, or obstructions in the urinary tract. Treatment for urinary retention depends on the cause.

Urinary retention, or abnormal holding of urine in the bladder, is a common urological problem. Possible causes of acute urinary retention (sudden inability to urinate) include a blockage in the urinary system, stress or nerve problems. Chronic urinary retention (some urine is always left in the bladder after emptying) may be caused by bladder muscle failure, nerve damage, or obstructions in the urinary tract. Treatment for urinary retention depends on the cause.
Urinary Tract Infections (UTIs)

A UTI is caused by an infection in the urinary tract. Women get UTIs more often than men. UTIs are treated with antibiotics. Drinking lots of water also helps by flushing out the bacteria. If the infection is in the bladder it is called cystitis. If the infection is in the kidneys it is called pyelonephritis.

A UTI is caused by an infection in the urinary tract. Women get UTIs more often than men. UTIs are treated with antibiotics. Drinking lots of water also helps by flushing out the bacteria. If the infection is in the bladder it is called cystitis. If the infection is in the kidneys it is called pyelonephritis.
Urodynamic Tests

Urodynamic tests measure the storage of urine in the bladder and the flow of urine from the bladder through the urethra. Your doctor may want to do an urodynamic test if you are having symptoms that suggest problems with the muscles or nerves of your lower urinary system and pelvis. The procedure involves inserting a catheter (thin tube) into the urethra and another one into the rectum. A machine then measures the activity of your bladder. A 3-day bladder diary will be sent to you. You need to fill this up and bring it on your urodynamics appointment. Urodynamics Information Sheet + Bladder Diary (PDF, 680.3 KB)

Urodynamic tests measure the storage of urine in the bladder and the flow of urine from the bladder through the urethra. Your doctor may want to do an urodynamic test if you are having symptoms that suggest problems with the muscles or nerves of your lower urinary system and pelvis.

The procedure involves inserting a catheter (thin tube) into the urethra and another one into the rectum. A machine then measures the activity of your bladder.

A 3-day bladder diary will be sent to you. You need to fill this up and bring it on your urodynamics appointment.

Document Downloads

Contact Details

Manukau SuperClinic™

South Auckland

Manukau SuperClinic™ has a Call Centre to receive incoming calls related to outpatient services. The Call Centre is open to receive calls between 7:30 AM and 6:00 PM Monday to Friday.

Module 10
Manukau SuperClinic™
901 Great South Road
Manurewa

Information about this location

View on Google Maps

Get directions

Street Address

Module 10
Manukau SuperClinic™
901 Great South Road
Manurewa

Postal Address

Manukau SuperClinic™
PO Box 98743
Manukau City
Manukau 2241

This page was last updated at 1:27PM on September 21, 2023. This information is reviewed and edited by Urology | Counties Manukau | Te Whatu Ora.