Frequently Asked Questions

Paediatric Urology

Do I need a referral from my GP?

Yes, this is advised for all new appointments. GPs are the cornerstone of the medical system in Ireland, and are in the best position to coordinate all your care requirements, and communication between GPs and specialists is vital.

Saying that, I will and do accept referrals from other specialists, and occasionally will see patients directly if they had previously seen a specialist for the same issue, but that specialist is either retired, or can’t see them anymore. If you are unsure, please call my office for further advice.

Will I have my surgery on the same day as my clinic appointment?

No, this does not really happen outside of an emergency setting. You may very well have bladder scans, or even diagnostic imaging in radiology the same day, but not surgery.

This needs to be coordinated to ensure that everyone and everything is ready to go on the day, and that includes you. It wouldn’t be fair or even ethical to see you in the clinic and expect you to be ready for surgery the same day.

In addition, from a logistics perspective, I can’t have a clinic list and a surgical list at the same time.

Will I stay in overnight after my surgery?

This is a good question, and it depends on the type of surgery. The majority of surgical cases that I perform are day cases (>90%) where you go home on the same day as your operation.

If I feel that it may be likely that you need to stay overnight, then we will definitely have that discussion long before your surgical date.

If, on the day you felt that you couldn’t go home, then that is a different scenario, and we would certainly see how we could best deal with that situation.

However, especially with children and adolescents, prior preparation and planning is critical.

Can I eat and drink before my clinic appointment?

Absolutely. There’s no need to fast at all before coming to the clinic. It can sometimes be a little scary or confusing coming to a hospital appointment, there’s no sense in being hungry and thirsty as well!

How long after surgery will I be off school?

This is a frequent question, and of course depends on the type of surgery performed. The range is anywhere between 1-14 days off school, but the majority of patients require a maximum of 1-2 days. I often mention to families that patients can go back to school the next day, as I’m confident about how
fast they will recover, but there is no issue with a couple of days at home is required. If notes are required for school, please ask. We would be very happy to issue you with one.

Does everybody who sees you need surgery?

No, not at all. In general, about 20-30% of the patients I see for various conditions opt for surgery.

Many of the treatments and advice that I provide don’t require an operation. In fact, contrary to popular belief, I try where possible not to operate unless there’s a good reason to.

Modern day surgery is about risk stratification, and applying risk:benefit ratios. Again, communication is key. Anybody can tell you that you need an operation, but that is – in my opinion – not informed consent.

You need to understand all the risks, benefits, and alternatives to a particular treatment before making a decision.

You have a large say in what treatment you get. Unless it’s life-threatening, you will hear me give you a recommendation, not an order.

How long does an appointment take?

Appointments generally last between 10-30 minutes. I don’t want to keep you waiting, or take up any more of your precious time than is required.

Sometimes, the findings are quite straightforward, and the outcome is surgery or education such as with hypospadias, or undescended testes. This is quite common with anatomical abnormalities. With functional issues such as wetting, or urinary tract infections, then it may take longer to advise and go through various treatment plans, as well as commencing Bladder Retraining/Urotherapy.

The aim is also to have you waiting as little time as possible in the waiting room. 98% of patients are seen within 10 minutes of their appointment slot.

How long will I have to wait for a clinic appointment?

I can generally see routine issues within 4 weeks of referral. If something appears to be a little more urgent, or if GPs or other specialists are concerned, then I can certainly adjust for that eventuality. My aim is to be able to see all patients within 4 weeks, even as the service grows, and I’m working with
my colleagues in hospital management to ensure this.

I have been able to see certain patients within 1- 7 days of referral where required. Having this kind of flexibility is important, and has advantages over
the public system waiting lists where you may have to wait months or even years to be seen.

Do you only see kids?

As a paediatric urologist, I spend 95% of my time seeing paediatric and adolescent patients. The other 5% is spent seeing adult patients with congenital urological issues. I think it is important that specialists spend as much time as possible working in their specific field.

As a fully trained and licensed adult urologist I could see adult patients, but I keep in close communication with my adult colleagues to ensure that everyone can have access to specialised care.

What can I expect at my appointment?

This is a great question! You can expect to be seen within 10 minutes of your appointment slot.

At present with COVID-19 restrictions, hospitals are limiting numbers to patients and one parent/carer/guardian. The first thing will be a quick and focussed history.

I try to speak to both patient and adult at the same time. Sometimes, you will see me clicking away on the computer keyboard, as patient files are generally digital now instead of the old paper chart.

There are some toys in the room for kids if they get bored. The physical exam is quick, and not at all painful. Your parent/carer/guardian and/or our nurse specialist will be present for this. Sometimes, I use a bladder scanner to measure how much urine is in the bladder.

This involves a little bit of cold gel on top of the
tummy. Most kids tell me it’s a little ticklish. Once we come up with a diagnosis, we then speak about how to manage it.

If a decision is made to go for surgery, then I will take care of all the paperwork
and you do not need to do anything. If the plan is to address wetting/constipation/infections, then I will be giving out patient education leaflets, and advice sheets, as well as some homework in the form
of diaries! It’s really important to fill these out at home as they are part of the treatment plan.

I want you to be completely clear with your management plan before you leave the clinic.

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