Introduction

Welcome to my BLOG pages.

Hopefully this will add more value to my website and the information you require for your Urological issues. I may throw in some valuable life experiences at times. The opinions shared are mine and may not always align with urological literature.

It’s been a while since I have updated my website. Most of the information is still relevant. I have slightly changed some of my procedures. I will make the necessary changes to reflect this.

 

I am still a Brisbane Urologist, based at the Wesley Hospital. I do most of my major surgeries here.

I also work at St Andrews War Memorial Hospital in Springhill where I do my niche surgeries and investigations. I am still a big supporter for the use of Greenlight Laser vaporisation for the larger BPH prostates. It still has the benefit of a shorter hospital stay, using a smaller catheter and less risk of post operative bleeding. The caveat to this is the smaller prostates have a higher risk of bladder neck contractures (5%), which I try and anticipate to prevent any complications. Laser patient’s would have persistent dysuria following the surgery is a bit longer than the classic TURP.

A new procedure added to my armentarium of late is the Rezum therapy. This is a fantastic procedure for those blokes who want to maintain their ejaculation function. All medication prescribed for BPH causes transient retrograde ejaculation while using it. Most surgical procedures for BPH would provide permanent retrograde ejaculation with the exception of UroLift. Rezum is a quick procedure, with only a day admission. The drawback is a catheter for a minimum of 5 days, which in the scheme of things is a small price to pay.

All my urodynamic studies are done SAWMH with new up-to-date equipment. I used the air charged system, which is much easier with the set up and mobility while doing the procedure. I also utilise radiology to check on the radiological appearance of your bladder. A cystoscopy rounded off nicely with a full picture when discussing management options for your urinary issues. The urodynamic unit at St Andrews forms part of the Pelvic Medicine Centre, which then allows for cross communication with gynaecologists and colorectal surgeons to provide good outcomes for pelvic issues.

Both the Wesley Hospital and SAWMH War Memorial Hospital offers a robotic service through which all my prostate cancer surgeries are done. I have recently changed my technique to the HOODED technique which allows for much better sphincteric support, enabling quicker recurrence of continence. Length of stay in hospital on average 2 nights.

I travel up to Caboolture Private Hospital on a weekly basis where I review patient’s for their urological issues and offer a wide range of surgeries. This is an attempt to keep patient’s local and to reduce travelling down to Brisbane. Unfortunately some procedures require closer monitoring and more specialised equipment and may be transferred down to either the Wesley or SAWMH. I perform  both Greenlight laser vaporisation of prostate as well as Rezum therapy at Caboolture private hospital.

All 3 of these facilities have the capabilities for precision point transrectal ultrasound-guided prostate biopsies, which then is less traumatic to your perineum, with less chance of infection.

A new feature which has not been mentioned on the website is a monthly visit to Bribie Island where I meet the needs of my patients who find it difficult to travel to Caboolture for their appointments. This has proven to be fantastic for my patients. It also allows me a change of scenery. A win-win situation. Consulting is from the Ramsey consulting rooms at the Bribie Island central shopping centre in Bongaree.

As you may be aware I used to be a resident in Bundaberg more than 10 years ago, yet still have many patients in Bundaberg whom I visit on a 1 to 2 monthly basis. Small procedures are done at the Mater Hospital in Bundaberg usually requiring a local anaesthetic. Therefore negating travel down to Brisbane for a day procedure. The Mater was my first landing in Queensland and will always have a special place in my heart.

Unfortunately I no longer visit Redcliffe Public Hospital for my weekly Visiting Medical Officer appointment. It was absolutely fantastic providing service there for the patients of the Peninsula.

My focus in my urology practice has narrowed down over time to the lower urinary tract and I suppose you could then classify me as a functional urologist. In saying this I absolutely love doing robotic-assisted radical prostatectomies for prostate cancer. Kidney and ureteric stones are still the mainstay of any urology practice. Most of my surgeries are done with uretero-renoscopic surgery and using laser to fragment the stones. This is offered at all 3 Brisbane locations.

The milieu of incontinence surgery has changed over the years with mesh procedures no longer available worldwide. This came about due to mesh complications used for vagina prolapse procedures. Unfortunately mid urethral sling mesh procedures have been pulled in under this as well and therefore no mid urethral slings are available. This has resulted in urology and uro-gynecology reverting back to pre-mesh era procedures. Fortunately robotic surgery has allowed for a minimal invasive technique. We also tend to use more bulking agents than what we used in the past. Should you have any problems with your incontinence, we offer a Multidisciplinary Urology team who regularly meet to discuss problematic case scenarios.

I will post more blogs as time allows me.