Dr Sydney Nkateko
Mtsetweni

A cystoscopy allows Dr Mtsetweni to examine the inside of the bladder and urethra using a thin, flexible instrument with a built-in camera called a cystoscope. It is used to investigate blood in the urine, recurrent urinary tract infections, incontinence, bladder tumours, and enlarged prostate. Small stones or abnormal tissue can also be treated during the same procedure. Most patients are awake with a local anaesthetic gel applied for comfort, and the procedure typically takes 15–30 minutes.

Ureteroscopy is used to diagnose and treat kidney and ureteric stones. A thin scope is guided through the urethra and bladder into the ureter or kidney. Small stones can be removed whole; larger stones are first broken into tiny fragments using a Holmium laser (lithotripsy), which are then flushed or collected. This is a highly effective, incision-free approach with excellent results. A temporary ureteric stent is sometimes placed afterwards to aid healing and ensure urine flows freely while swelling settles.

Transurethral Resection of the Prostate (TURP) is the gold-standard surgical treatment for benign prostatic hyperplasia (BPH) — an enlarged prostate that causes difficulty urinating. No external cuts are made. A resectoscope is passed through the urethra and a wire loop removes excess prostate tissue, relieving the blockage. Patients typically experience a dramatic improvement in urine flow. A catheter remains in place for 1–2 days afterwards. TURP is performed under spinal or general anaesthesia, with a short hospital stay.

A prostate biopsy is recommended when a raised PSA (prostate-specific antigen) blood test or abnormal rectal examination raises the possibility of prostate cancer. Using ultrasound guidance (TRUS — transrectal ultrasound), Dr Mtsetweni takes small tissue samples from the prostate for laboratory analysis. An MRI fusion biopsy technique can also be used to target specific suspicious areas more precisely. Results are usually available within a week and inform decisions about further management or treatment.

A vasectomy is a safe and highly effective surgical method of permanent male contraception. Under local anaesthesia, Dr Mtsetweni makes one or two tiny openings in the scrotum, and a small section of each vas deferens — the tubes that carry sperm — is cut, tied or sealed. Sperm can no longer be released during ejaculation, but all other sexual function remains completely normal. The procedure takes approximately 20–30 minutes and patients return home the same day. A follow-up semen analysis confirms success after 8–12 weeks.

For large or complex kidney stones not suitable for ureteroscopy, PCNL is the procedure of choice. Under X-ray or ultrasound guidance, a small tract is created through the skin directly into the kidney. A nephroscope is then inserted and the stone is fragmented with a laser or ultrasonic probe and removed. PCNL achieves stone-free rates of over 85% in a single session, making it the most effective treatment for large stone burdens. Patients typically stay in hospital for 2–3 days and recovery is usually 2 weeks.

Transurethral Resection of Bladder Tumour (TURBT) is both a diagnostic and treatment procedure for bladder cancer. Using a resectoscope passed through the urethra, Dr Mtsetweni removes visible tumours from the bladder lining without any skin incisions. The removed tissue is sent for pathology to determine cancer type and staging. For early-stage cancer, TURBT may be curative. For more advanced disease, it provides essential staging information to plan further treatment such as BCG instillation, chemotherapy or cystectomy.

A laparoscopic nephrectomy is the minimally invasive surgical removal of a kidney — either in full (radical nephrectomy) or in part (partial nephrectomy). It is most commonly performed for kidney cancer or a non-functioning kidney. Using small port incisions and a camera, the surgeon removes the kidney without a large open cut. This approach results in significantly less pain, shorter hospital stays (2–3 days) and faster return to normal activity compared with open surgery. A person can live very well with one functioning kidney.

Medical circumcision involves the surgical removal of the foreskin and is performed for conditions such as phimosis (tight foreskin), recurrent infections, paraphimosis, or for personal and cultural reasons. Dr Mtsetweni performs adult circumcisions under local or general anaesthesia as a day procedure. The operation takes 30–45 minutes and patients go home the same day. Healing is complete within 4–6 weeks. Circumcision has well-documented benefits including reduced risk of urinary tract infections, sexually transmitted infections, and certain cancers.

Extracorporeal Shockwave Lithotripsy (ESWL) is a completely non-invasive treatment that uses focused sound waves to break kidney or ureteric stones into small fragments that then pass naturally through the urine over several days or weeks. Patients lie on a specialised machine and the shockwaves are precisely directed at the stone using X-ray or ultrasound targeting. No anaesthetic cuts or scopes are required. ESWL is ideal for smaller stones (up to approximately 2 cm) in accessible positions. The procedure takes 45–60 minutes and patients leave the same day.