General Urology

A/Prof Homi Zargar has expertise and extensive experience treating a broad spectrum of general urological conditions. Many minor urological procedures can be conveniently conducted in the office under local anaesthesia. For more complex procedures, A/Prof Zargar performs them at Western Private Hospital in Melbourne's western suburbs and Epworth Richmond.

Kidney stones

Kidney stones are crystallized deposits in kidneys, ranging from sand-sized to golf ball-sized.

• Primarily composed of calcium oxalate, they may also contain uric acid and struvite.

• Formation linked to factors: dehydration, oxalate-rich diet, and genetic predisposition.

• Causes intense pain as stones pass through the urinary tract.

• Diagnosis involves imaging tests; treatment varies based on stone size and type.

• Prevention through balanced diet, hydration, and addressing health conditions.

Lower urinary tract symptoms

Lower urinary tract symptoms (LUTS) include issues with bladder and urethra function.

• Common symptoms: increased frequency of urination, urgency, and nocturia.

• Difficulty initiating or maintaining urine flow is another LUTS.

• LUTS can result from various conditions, such as enlarged prostate, bladder overactivity, or urinary tract infections.

• Impact on quality of life: disturbed sleep, decreased productivity, and social limitations.

• Diagnosis involves medical history, physical examination, and sometimes imaging or urodynamic tests.

• Treatment options range from lifestyle changes to medications and surgical interventions.

• Regular check-ups with a healthcare professional are crucial for managing and addressing LUTS effectively.

Blood in the urine (haematuria)

Haematuria refers to the presence of blood in the urine, and it can be classified into two types.

• Microscopic haematuria is characterized by blood not being visible to the naked eye but detectable through urine testing.

• Macroscopic haematuria, on the other hand, involves visible blood, causing discoloration in shades of pink, red, brownish-red, or tea-colored urine.

• Gross haematuria is a synonymous term for visible blood in the urine.

• Common causes include urinary tract infections, kidney stones, or more serious conditions like bladder or kidney cancer.

• Diagnosing haematuria involves a thorough medical history, physical examination, and additional tests like imaging or cystoscopy.

• Treatment varies based on the underlying cause, ranging from antibiotics for infections to surgical interventions for more severe conditions.

• Seeking prompt medical attention for evaluation and management is crucial when experiencing haematuria.

Evaluation of elevated Prostatic Specific Antigen (PSA)

Prostate Specific Antigen (PSA) testing, when conducted appropriately, serves as a valuable tool for early prostate cancer diagnosis.

• Increased PSA levels may indicate the presence of cancerous prostate cells, prompting further diagnostic investigations.

• PSA testing has been proven to prevent death from prostate cancer by enabling early detection and intervention.

• However, it is not foolproof, as around a third of men with elevated PSA levels do not have prostate cancer.

• Causes of increased PSA beyond cancer encompass conditions like Benign Prostate Hyperplasia (BPH), urine infection, prostatitis, and urethral catheter use.

• While PSA testing can lead to early cancer diagnosis, it may also result in unnecessary anxiety and invasive follow-up procedures due to false positives.

• False negatives can occur, potentially delaying or missing a prostate cancer diagnosis.

• Decisions regarding PSA testing should involve informed discussions between individuals and their healthcare providers to balance potential benefits and pitfalls.

Benign prostatic hyperplasia (BPH)

Benign Prostate Hyperplasia (BPH) is the gradual enlargement of the central part of the prostate, leading to urethral compression and urine flow obstruction.

• Symptoms include weak urine flow, urgency, and nocturia (nighttime urination).

• BPH is non-cancerous and does not transform into cancer, considered a typical part of aging in men.

• The extent of enlargement and symptom severity vary widely among individuals.

• The impact of BPH on a man's quality of life is a crucial consideration for treatment decisions.

• Minor symptoms may not require treatment, as they pose no concern to some individuals.

• Effective treatment options exist for those experiencing significant quality-of-life issues.

• Medications can relax or shrink the prostate, while surgical procedures, like TURP, involve removing obstructing prostate tissue through a telescope passed through the urethra.

Penile and scrotal conditions

A variety of conditions can affect the penile and scrotal regions, ranging from benign to more serious issues. It is very important for you to seek prompt medical attention if any abnormalities or discomfort arise in these areas. Here are some common conditions:

• Hydrocele: Accumulation of fluid around the testicle, causing scrotal swelling.

• Phimosis: Tightening of the foreskin, limiting its ability to retract over the penis.

• Varicocele: Enlarged veins in the scrotum, potentially affecting fertility.

• Scrotal lesions: Abnormal growths or lumps on the scrotal skin, requiring medical evaluation.

• Epididymal cysts: Fluid-filled cysts near the testicle, often benign but may cause discomfort.

• Testicular torsion: Twisting of the testicle, a medical emergency requiring immediate attention.

• Orchitis: Inflammation of the testicles, often caused by infection and resulting in pain and swelling.

Urinary incontinence

Urinary incontinence, the involuntary leakage of urine, affects both men and women, significantly impacting their quality of life.

• Living in constant fear of urine leakage leads to embarrassment and restrictions in daily activities.

• Not life-threatening, but causes social limitations, hindrance in work and travel, and additional costs for protective devices.

• It is a prevalent condition, and individuals are encouraged not to suffer in silence.

• A comprehensive approach for assessment and management involves Urologists, Continence Nurse Specialists, and specialized Continence Physiotherapists.

• Treatment options are diverse, including physiotherapy, bladder retraining, medication, and surgery, tailored to individual preferences.

• Different types of urinary incontinence exist, such as urge incontinence with a sudden, intense need to urinate, and stress incontinence triggered by specific activities.

• Seeking professional help is crucial for effective management and improvement in the quality of life for individuals dealing with urinary incontinence.

erectile dysfunction

Erectile dysfunction (ED) is the inability to achieve or sustain an erection for satisfactory sexual performance.

• Multiple factors contribute to ED, including age, chronic health conditions (diabetes, hypertension), psychological factors (stress, anxiety), and lifestyle choices (smoking, excessive alcohol consumption).

• ED often serves as an early warning sign of cardiovascular issues, as it shares risk factors with heart disease.

• Hormonal imbalances, especially low testosterone levels, can contribute to erectile difficulties.

• Conditions affecting the nervous system, such as multiple sclerosis or Parkinson's disease, may lead to ED.

• Available treatments range from oral medications like Viagra to injectable drugs, vacuum erection devices, and surgical interventions.

• Psychological counseling and therapy can be beneficial in addressing underlying emotional causes contributing to ED.

• Adopting a healthy lifestyle with regular exercise, balanced diet, and managing stress can significantly improve erectile function in some cases.

office based procedures

Integral Office-Based Urological Procedures:

• Office procedures are crucial in urologic practices, facilitating convenient outpatient diagnostic and corrective interventions under local anaesthesia.

• Advantages Over Traditional Approaches:

  • Eliminates the need for hospital admission and general anaesthesia and minimizes delays and associated costs for patients and healthcare services.

• Commonality with Other Medical Specialties:

  • Similar to various medical disciplines, urologists can efficiently perform many procedures in the office, enhancing accessibility and patient convenience.

• Patient Comfort and Safety:

  • Patients walk out of the procedure room after completion, and a brief waiting period in the office ensures any immediate concerns are addressed before departure.

• Specialized Procedures by A/Prof Zargar and team

  • Cystoscopy, urethral dilation, vasectomy, adult circumcision, urodynamics, Botox injection into the bladder, percutaneous tibial nerve stimulation, and transperineal prostate biopsy are routinely and safely conducted in the office.