Urology: patient information
Urological symptoms can have several causes. This guide helps you prepare for a consultation and does not provide a diagnosis. Dr Paweł Niwiński, specialist in urology, BIG registration 69920389301, assesses your circumstances individually.
When should you seek urgent help?
Contact your huisarts or huisartsenpost urgently if you cannot pass urine, develop sudden severe scrotal pain, have heavy bleeding or clots in urine with difficulty urinating, or have fever and chills with flank pain and feel very unwell. Call 112 in a life-threatening emergency. Do not wait for a routine appointment.
What can a consultation cover?
Prevention, investigation and conservative or medical treatment of urinary symptoms in women and men, and male reproductive-organ symptoms. Selected small outpatient procedures may be appropriate depending on the indication and available facilities. Ultrasound of the kidneys, urinary tract, testicles or scrotum may be considered. Bring previous results and a medication list.
Difficulty urinating and urine leakage
A weak stream, difficulty starting, frequent or night-time urination, urgency, incomplete emptying and leakage are lower urinary tract symptoms (LUTS). They are not always caused by an enlarged prostate. Benign prostate enlargement does not always need treatment. Leakage may involve urgency, dribbling after urination or previous surgery. Management depends on the cause and the effect on your life.
The prostate and PSA
Prostate symptoms do not automatically mean cancer. A raised PSA level can also relate to benign enlargement, inflammation or other factors. Age, symptoms and previous results help determine whether repeat testing or further investigation is needed.
Painful urination, infection and prostatitis
Burning, frequency, urgency and pain may relate to a urinary infection, urethritis or a sexually transmitted infection; these are not interchangeable diagnoses. Men with a possible bladder infection should contact their huisarts or huisartsenpost the same day. Fever, chills or flank pain require prompt assessment.
Possible prostatitis with fever, chills, feeling unwell and pain in the perineum or lower abdomen needs same-day assessment. Chronic symptoms are not always caused by bacteria. Recurrent symptoms can be assessed by a urologist.
Blood in the urine
Visible blood needs medical assessment even without pain. Possible causes include infection and stones, but further investigation may be necessary. A normal ultrasound does not rule out every cause. Heavy bleeding, clots, fever, flank pain or difficulty passing urine require urgent assessment.
Kidney and urinary stones
Colicky flank or back pain may relate to stones, but there are other possible causes. Seek urgent help for severe persistent pain, fever, chills, vomiting or inability to urinate. Recurrent stones may require investigation and an individual prevention plan.
The scrotum, penis and foreskin
Pain, swelling, epididymal symptoms, a tight foreskin or a short frenulum can be assessed during a consultation. Sudden severe scrotal pain needs immediate medical assessment.
Erection difficulties and early ejaculation
Erectile difficulties may relate to health, medication, lifestyle and psychological factors. Discuss how long the problem has lasted and its impact; do not stop prescribed medication yourself. Ejaculation earlier than desired, limited control and its effects can also be discussed.
Kidney abnormalities
An abnormal scan does not automatically mean that urological treatment is needed. Kidney function or kidney-tissue problems may require a nephrologist or internist. A mass does not automatically mean cancer; appropriate investigation and referral are important.
Preparing and paying for a consultation
Bring relevant results, previous clinical letters and your medication list. Stichting Med Partners describes private care without contracts with every insurer. Reimbursement is not guaranteed; check your policy beforehand.
Dr Niwiński's profile (PL) · Appointments · Fees · Preparation
The original information refers to NVU, Thuisarts and EAU. This guide does not replace personal medical assessment.