Conditions I treat

Andrology is the branch of urology dealing with male reproductive and sexual health, and with reconstruction of the genitourinary tract. It is a small sub-specialty, and most general urologists see only a handful of these conditions in a year. That matters, because several of the problems below are managed badly by default — a urethral stricture stretched repeatedly rather than reconstructed, a low sperm count sent straight to IVF without anyone establishing the cause, an erection problem treated with tablets alone when the underlying issue is hormonal or vascular.

My practice is built around six areas: male infertility and microsurgery, genito-urethral reconstruction, prosthetic surgery, prostate cancer survivorship, sickle cell urology, and complex redo surgery where a previous operation has not worked. Each of the pages below explains what the condition is, what causes it, how it is properly assessed and what the realistic options are — including the option of doing nothing, which is sometimes the right answer.

When to consider a specialist opinion

You do not need to have exhausted every other avenue before asking for a specialist view. It is worth seeking one if any of the following apply:

• You have been told an operation is your only option, and nobody has explained why
• A previous procedure has not worked, or the problem has come back
• You have had the same treatment repeatedly — repeat dilatations, repeat courses of antibiotics — without a plan for stopping the cycle
• You have been given a diagnosis without being examined
• You are being asked to accept a symptom as permanent when you have not been told what causes it
• The condition is affecting your relationship, your work or your mood, and nobody has acknowledged that

Consultations take place at HCA Healthcare UK outpatient centres at The Shard and Canary Wharf, and video consultations are available for initial discussions, second opinions and reviewing results. Many of the men I see travel from outside London or from abroad; where that is the case, an initial remote consultation usually means travel is only needed for the procedure itself.